Brief Communication: Physical Abuse of Boys and Possible Associations with Poor Adult Outcomes
Philadelphia Veterans Affairs Medical Center and University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104-6021, USA. Annals of internal medicine
(Impact Factor: 17.81).
10/2005; 143(8):581-6. DOI: 10.7326/0003-4819-143-8-200510180-00008
Men's childhood physical abuse experiences are understudied.
To obtain descriptions about men's personal childhood physical abuse histories and estimate their association with adult outcomes.
Population-based telephone survey.
Urban areas with high frequency of domestic violence against girls and women.
298 men recruited through random-digit dialing.
6 Conflict Tactics Scale items and psychiatric, sexual, and legal history questions.
One hundred of 197 (51%) participants had a history of childhood physical abuse. Most (73%) participants were abused by a parent. Childhood physical abuse history was associated with depression symptoms (P = 0.003), post-traumatic stress disorder symptoms (P < 0.001), number of lifetime sexual partners (P = 0.035), legal troubles (P = 0.002), and incarceration (P = 0.007) in unadjusted analyses and with depression symptoms (P = 0.015) and post-traumatic stress disorder symptoms (P = 0.003) in adjusted analyses.
There may have been inaccurate recall of past events. Lack of exposure time data disallowed direct comparison of abuse perpetration by mothers versus fathers. Other unmeasured variables related to childhood physical abuse might better explain poor adult outcomes.
The high frequency of childhood physical abuse histories in this population-based male sample, coupled with the high proportion of parent perpetrators and the association between childhood physical abuse and adult outcomes that are often associated with perpetration of violence, argues for more study of and clinical attentiveness to potential adult outcomes of men's own childhood physical abuse histories.
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- "Similarly, 33% of Japanese female juvenile offenders (Ariga et al., 2008), 27% of Swiss male juvenile offenders (Urbaniok, Endrass, Noll, Vetter, & Rossegger, 2007), and 10% to 19% of detained youth in the United States (Abram et al., 2004; Cauffman, Feldman, Waterman, & Steiner, 1998; Ford, Hartman, et al., 2008; Steiner, garcia, & Matthews, 1997) meet criteria for PTSD, with similar prevalence among boys remanded to secure facilities compared to those in mental health treatment programs (Urbaniok et al., 2007). Exposure to complex trauma in childhood puts adolescents and young adults at risk for PTSD (Copeland, Keeler, Angold, & Costello, 2007; Holmes & Sammel, 2005; Kilpatrick et al., 2000; Kilpatrick et al., 2003), depression (Hazen, Connelly, Roesch, Hough, & Landsverk, 2009; Holmes & Sammel, 2005; Kilpatrick et al., 2000; Kilpatrick et al., 2003; Manly, Kim, Rogosch, & Cicchetti, 2001; McCloskey & Lichter, 2003), suicidality (Ford, Hartman, et al., 2008; Swahn & Bossarte, 2007; Waldrop et al., 2007), substance use disorders (Ford, Hartman, et al., 2008; Kilpatrick et al., 2000; Kilpatrick et al., 2003), and legal problems and incarceration (Holmes & Sammel, 2005). Polyvictimized youth are at risk for severe sequelae including psychological distress (Finkelhor, Ormrod, & Turner, 2007a, 2007b; Hazen et al., 2009; Turner et al., 2006), psychiatric disorders (Cuevas, Finkelhor, Ormrod, & Turner, 2009; Ford, Elhai, et al., 2010), preteen initiation of substance use (Hamburger, Leeb, & Swahn, 2008), and delinquency (Cuevas, Finkelhor, Turner, & Ormrod, 2007; Ford, Elhai, et al., 2010). "
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ABSTRACT: Youth in secure juvenile justice settings (e.g., detention, incarceration) often have histories of complex trauma: exposure to traumatic stressors including polyvictimization, life-threatening accidents or disasters, and interpersonal losses. Complex trauma adversely affects early childhood biopsychosocial development and attachment bonding, placing the youth at risk for a range of serious problems (e.g., depression, anxiety, oppositional defiance, risk taking, substance abuse) that may lead to reactive aggression. Complex trauma is associated with an extremely problematic combination of persistently diminished adaptive arousal reactions, episodic maladaptive hyperarousal, impaired information processing and impulse control, self-critical and aggression-endorsing cognitive schemas, and peer relationships that model and reinforce disinhibited reactions, maladaptive ways of thinking, and aggressive, antisocial, and delinquent behaviors. This constellation of problems poses significant challenges for management, rehabilitation, and treatment of youth in secure justice settings. Epidemiological and clinical evidence of the prevalence, impact on development and functioning, comorbidity, and adverse outcomes in adolescence of exposure to complex trauma are reviewed. Implications for milieu management, screening, assessment, and treatment of youth who have complex trauma histories and problems with aggression in secure juvenile justice settings are discussed, with directions for future research and program development.
Available from: Curtis Florence
- "A nationally representative study of children aged 0–17 reported that 10.2% of US children experienced some form of maltreatment in 2008 (Finkelhor, Turner, Ormrod, & Hamby, 2009). CM has been shown to have lifelong adverse health, social, and economic consequences for survivors, including behavioral problems (Felitti et al., 1998; Repetti, Taylor, & Seeman, 2002); mental health conditions such as posttraumatic stress disorder (Browne & Finkelhor, 1986; Holmes & Sammel, 2005; Moeller, Bachmann, & Moeller, 1993); increased risk for delinquency, adult criminality, and violent behavior (Fang & Corso, 2007; Widom & Maxfield, 2001); increased risk of chronic diseases (Browne & Finkelhor, 1986; Felitti et al., 1998); lasting impacts or disability from physical injury (Dominguez, Chalom, & Costarino, 2001); reduced health-related quality of life (Corso, Edwards, Fang, & Mercy, 2008); and lower levels of adult economic well-being (Currie & Widom, 2010). Given the high prevalence of CM and the many negative short-and long-term consequences of CM, the economic costs of CM may be substantial. "
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ABSTRACT: To present new estimates of the average lifetime costs per child maltreatment victim and aggregate lifetime costs for all new child maltreatment cases incurred in 2008 using an incidence-based approach.
This study used the best available secondary data to develop cost per case estimates. For each cost category, the paper used attributable costs whenever possible. For those categories that attributable cost data were not available, costs were estimated as the product of incremental effect of child maltreatment on a specific outcome multiplied by the estimated cost associated with that outcome. The estimate of the aggregate lifetime cost of child maltreatment in 2008 was obtained by multiplying per-victim lifetime cost estimates by the estimated cases of new child maltreatment in 2008.
The estimated average lifetime cost per victim of nonfatal child maltreatment is $210,012 in 2010 dollars, including $32,648 in childhood health care costs; $10,530 in adult medical costs; $144,360 in productivity losses; $7,728 in child welfare costs; $6,747 in criminal justice costs; and $7,999 in special education costs. The estimated average lifetime cost per death is $1,272,900, including $14,100 in medical costs and $1,258,800 in productivity losses. The total lifetime economic burden resulting from new cases of fatal and nonfatal child maltreatment in the United States in 2008 is approximately $124 billion. In sensitivity analysis, the total burden is estimated to be as large as $585 billion.
Compared with other health problems, the burden of child maltreatment is substantial, indicating the importance of prevention efforts to address the high prevalence of child maltreatment.
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