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Citation |
Clemens V, Huber-Lang M, Plener PL, Brahler E, Brown RC, Fegert JM. Eur. J. Psychotraumatol. 2018; 9(1): e1510278. |
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Affiliation |
Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany. |
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Copyright |
(Copyright © 2018, The Author(s), Publisher Co-action Publishing) |
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DOI |
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PMID |
30220980 |
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PMCID |
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Abstract |
Background: Child maltreatment is a major public problem, associated with enormous consequences on the individual and socioeconomic level. Studies show a clear impact of child maltreatment on long-term physical health. However, there is a lack of analyses comprising a wide variety of subtypes of maltreatment and addressing cumulative effects of different maltreatment subtypes experienced during childhood on physical health. Objective: The objective of this analysis was to assess the association of different subtypes and the intensity of child maltreatment with long-term physical health outcomes. Methods: In a cross-sectional observational approach, a representative sample of the German population (N=2510) was assessed regarding socioeconomic information, their current health status, and their experiences of child maltreatment using the Childhood Trauma Questionnaire (CTQ). Chi2-Tests were performed to compare differences of physical health conditions in adulthood in association with child maltreatment and binary regression analyses to assess the relationship of physical health and number of different subtypes of maltreatment experienced during childhood. Results: Odds increased significantly for obesity (1.8), diabetes (1.26), cancer (1.28), hypertension (1.16), chronic obstructive pulmonary disease (1.51), history of myocardial infarction (1.29) and stroke (1.31) with increasingenhancing number of experienced subtypes of child maltreatment. Growing intensity of each subtype of maltreatment was associated with higher rates of all assessed physical health conditions, which could point towards a dose-dependency of the relationship between maltreatment and long-term physical health. Conclusions: Child maltreatment is associated with increased odds for the leading morbidity and mortality causes in Germany. Interventions encompassing secondary and primary preventive strategies are critical to target this major public health problem and its devastating consequences. Language: en Antecedentes: El maltrato infantil es un problema público mayor, asociado a enormes consecuencias a nivel individual y socioeconómico. Los estudios muestran un impacto claro del maltrato infantil sobre la salud física a largo plazo. Sin embargo, existe una carencia de análisis que comprendan una amplia variedad de subtipos de maltrato y aborden los efectos acumulativos de diferentes subtipos de maltrato experimentados durante la infancia sobre la salud física. Objetivos: El objetivo de este análisis fue evaluar la asociación de diferentes subtipos y la intensidad del maltrato infantil con consecuencias en la salud física a largo plazo. Métodos: En un enfoque observacional transversal, se evaluó una muestra representativa de la población germana (N=2510) en cuanto a información socioeconómica, su estado de salud actual, y sus experiencias de maltrato infantil usando el Cuestionario de Trauma Infantil (CTQ por sus siglas en Inglés). Se realizaron tests de Chi2 para comparar diferencias de condiciones de salud física en la adultez en asociación con maltrato infantil y análisis de regresión binaria para evaluar la relación entre salud física y número de diferentes subtipos de maltrato experimentado durante la infancia. Resultados: Las probabilidades (expresadas en O.R.) aumentaron significativamente para obesidad (1.18), diabetes (1.26), cáncer (1.28), hipertensión arterial (1.16), enfermedad pulmonar obstructiva crónica (1.51), historia de infarto al miocardio (1.29) y apoplejía (1.31) con número mayor de subtipos de maltrato infantil experimentados. La intensidad creciente de cada subtipo de maltrato se asoció con tasas mayores de todas las condiciones de salud física evaluadas, lo que puede apuntar a una dependencia de dosis de la relación entre maltrato y salud física a largo plazo. Conclusiones: El maltrato infantil se asocia con aumento de probabilidades para las causas principales de morbilidad y mortalidad en Alemania. Intervenciones que abarquen estrategias preventivas secundarias y primarias son críticas para impactar este problema de salud publica mayor y sus consecuencias devastadoras. Language: es 背景：儿童虐待是一个重大公共问题，给个人和社会经济带来严重后果。研究表明童年虐待对长期身体健康有明显影响。然而，还缺乏相关研究对多种虐待亚型进行分析，并关注儿童期所经历的不同虐待亚型对身体健康的累积效应。 目标：该分析的目的是评估童年虐待的不同亚型及其强度与长期身体健康状况的关联性。 方法：在横断观察研究中，搜集了一个德国人口的代表性样本（N = 2510）的社会经济信息，目前的健康状况，并使用儿童创伤问卷（CTQ）评估其童年虐待的经历。使用卡方检验比较不同成年期身体健康状况与儿童虐待的关系的差异；使用二元回归分析考察身体健康与儿童期不同虐待亚型数量之间的关系。 结果：肥胖（1.18），糖尿病（1.26），癌症（1.28），高血压（1.16），慢性阻塞性肺病（1.51），心肌梗死病史（1.29）和中风（1.31）的概率随着童年所经历虐待亚型数量的增加而显著增加。不论哪种虐待亚型，其强度增加与所有被评估的身体健康问题的比率升高相关，这可能说明虐待与长期身体健康之间关系具有'程度相关性'（dose dependency）。 结论：儿童期虐待与德国几大首要致病和致死疾病的发生率增加有关。制定干预措施，设计次要和主要预防方案，对解决这一重大公共卫生问题和减轻其严重后果至关重要。. Language: zh |
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Keywords |
Child abuse and neglect; cancer; child maltreatment; chronic obstructive pulmonary disease; diabetes; hypertension; myocardial infarction; obesity; physical health outcomes; stroke; • Studies addressing cumulative effects of different child maltreatment subtypes on physical health are sparse, especially those comprising emotional and physical neglect.• Odds for obesity, diabetes, cancer, hypertension, chronic obstructive pulmonary disease, history of myocardial infarction and stroke increased when any kind of child maltreatment was reported.• Growing intensity of each maltreatment subtype was associated with higher rates of all assessed conditions.• Odds for all conditions increased with increasing number of maltreatment subtypes that were experienced. |