Citation

Isumi A, Doi S, Ochi M, Kato T, Fujiwara T. Am. J. Epidemiol. 2021; ePub(ePub): ePub.

Copyright

(Copyright © 2021, Oxford University Press)

DOI

10.1093/aje/kwab275

PMID

34788359

Abstract

Toxic stress caused by child maltreatment can lead to adverse mental health outcomes in later life; yet, unmeasured confounding remains a major issue in many previous studies. To examine the association between child maltreatment and resilience and behavior problems among early elementary school children, we used data from a population-based longitudinal survey targeting all first-grade children in 2015 in Adachi City, Japan. Children whose caregivers provided valid responses in the 2015 (1st grade, 6-7 years old), 2016 (2nd grade, 7-8 years old), and 2018 (4th grade, 9-10 years old) waves were included for the analysis (N=2,920). Fixed effects regression models revealed that child maltreatment was inversely associated with resilience (coefficient: -0.89, 95% confidence interval (CI): -1.05, -0.72) and prosocial behavior (coefficient: -0.03, 95% CI: -0.05, -0.003) and positively associated with behavior problems (coefficient: 0.32, 95% CI: 0.27, 0.37) over four years, after controlling for all time-invariant confounders and measured time-varying confounders, and survey year. These associations were consistent across sex. Child maltreatment may hamper the development of resilience and prosocial behavior and induce behavior problems in early elementary school children over time. Future research should identify modifiable protective factors for better mental health among maltreated children.

Language: en

Keywords

resilience; child maltreatment; behavior problems; early elementary school children; prosocial behavior