Article summary with A systematic review of reviews of the outcome of noninstitutional child maltreatment by Carr a.o. - 2020

What is child maltreatment?

Child maltreatment refers to physical, sexual, and emotional abuse, and physical and emotional neglect, or a combination of these various types of trauma. It reflects an international consensus about what constitutes unacceptable childcare and the violation of children´s human rights. The etiology of child maltreatment is complex and multidimensional and involves factors associated with perpetrators, children, the nature of maltreatment, and the immediate and broader social, economic, and cultural context in which maltreatment occurs. It is associated with adverse outcomes across the lifespan in physical health, mental health, and psychosocial adjustment.

What causes a lack of scientific clarity linking child maltreatment to adverse outcomes?

The lack of scientific clarity is largely due to the scope and methodology of systematic reviews and meta-analyses. Some reviews focused on one type of maltreatment, others on a narrow range of outcomes. Few researches link together evidence on the effects of multiple forms of maltreatment on a wide range of outcomes.

What are the main findings of reviewing the scientific data on child maltreatment and adverse outcomes?

• Child maltreatment is associated with a wide range of physical health problems, such as a pro-inflammatory state associated with reduced immune system efficiency, underpinning many other physical health problems.
• Adult survivors of child maltreatment show abnormalities in brain structure and functioning, as well as the endocrine system, underlying mental health problems.
• Child maltreatment is associated with adverse psychosocial outcomes across the life span, such as difficulties in making and maintaining relationships, managing sexual and aggressive impulses, adjustment in school and work, and maintaining a satisfying quality of life.
• The occurrence of multiple forms of severe maltreatment are associated with more adverse outcomes.
• Specific forms of maltreatment seem to be associated with specific outcomes. For example, physical abuse is linked with aggressions, sexual abuse with sexuality problems, and emotional abuse with mental health problems.

What recommendations can be made for policy, practice, and research with regards to child maltreatment?

Several recommendations can be made:

• To prevent child maltreatment, child maltreatment prevention programs as well as community-wide parent training programs should be implemented.
• For survivors of child maltreatment, a universal trauma-informed approach to the provision of health care should be provided, as well as evidence-based group therapy.
• There is a need for more longitudinal studies on the psychosocial and physiological mechanisms that link maltreatment to adverse outcomes across the lifespan.