Risk factors in child maltreatment: A meta-analytic review of the literature

doi:10.1016/j.avb.2006.03.006

Aggression and Violent Behavior

Volume 14, Issue 1, January–February 2009, Pages 13-29

https://doi.org/10.1016/j.avb.2006.03.006 Get rights and content

Abstract

This review presents the results of a series of meta-analyses identifying the relative strength of various risk factors for child physical abuse and neglect. Data from 155 studies examining 39 different risk factors were included in the review. Large effect sizes were found between child physical abuse and three risk factors (parent anger/hyper-reactivity, family conflict and family cohesion). Large effect sizes were also found between child neglect and five risk factors (parent–child relationship, parent perceives child as problem, parent's level of stress, parent anger/hyper-reactivity, and parent self-esteem).

Introduction

Maltreatment of children is a prevalent social problem. The National Clearinghouse on Child Abuse and Neglect reported that in 2002 an estimated 896,000 children were the victims of child abuse or neglect. Child physical abuse is defined as non-accidental injury (including bruises, welts, cuts, burns, broken bones, or other tissue damage) to the child inflicted by a parent or a caregiver in a parenting role. Child neglect is defined as failure of a parent or a caregiver in a parenting role to provide adequate supervision, safety, medical care, education, or other necessities to the child. Although a large number of studies have examined risk factors for child maltreatment, the findings of these studies are inconclusive. In addition, although child neglect has been consistently shown to be the most frequently substantiated type of child maltreatment, research on child neglect is limited (Schumacher, Slep & Heyman, 2001). However, the research that has been conducted (e.g., McDonald & Marks, 1991) indicates that while there is some overlap in factors related to abuse and neglect, the best prediction of re-abuse is attained when abuse and neglect are analyzed separately. Therefore, the present study summarizes the literature on child physical abuse and neglect and uses a meta-analytic design to determine the strength of the relationship between each risk factor and abuse or neglect across the literature as a whole. While other types of child maltreatment have been examined in the literature, i.e., child sexual abuse, emotional abuse and undifferentiated child maltreatment, the focus of this review is limited to two types of child maltreatment, i.e., child physical abuse and child neglect.

Section snippets

Review of literature

Empirical literature on child abuse has shifted in focus over the past several decades. Earlier studies tended to focus more on psychological and personality characteristics of the offender, especially those of the mother. Later studies have examined a variety of factors pertaining to family members, the family system, and the environmental milieu. Previous reviews of demonstrate this trend. Baumrind (1995) reviewed literature on parent psychological factors and child abuse. She notes that

Theoretical perspective

Much of the research on child maltreatment to date is guided by the theory that maltreatment stems from individual pathology. This focus on individual pathology is evident from the large number of studies examining risk factors pertaining to the offending parent (Buchholtz and Korn-Bursztyn, 1993, ⁎Giles-Sims, 1997, ⁎Hazler and Denham, 2002, ⁎McCanne and Milner, 1991, Milner and Chilamkurti, 1991, Milner and Dopke, 1997) and to the child victim (Veltman and Browne, 2001, ⁎Westcott, 1991).

Methods

Definitions or criteria for physical abuse and neglect vary from study to study. We did not include child sexual abuse, infanticide, Munchausen's syndrome by proxy or failure to thrive in our definition. Because risk factors for these types of abuse were likely to be different from risk factors for other forms of child physical abuse or neglect, studies examining these types of abuse were also not included in these analyses.

Meta-analysis results

The coded studies produced 656 distinct effect sizes reflecting the relationship between one of the 39 risk factors and either child physical abuse or child neglect. These effect sizes were used to calculate composite effect sizes for each risk factor by each form of maltreatment. Composite effect sizes were calculated for 39 risk factors and child physical abuse (see Table 1) and for 22 risk factors and child neglect (see Table 2). No studies were found for 17 factors with child neglect. A

Discussion

This study was guided by Bronfenbrenner's (1979) ecological theory. We predicted that variables within the parent–child interaction and/or parent's report of child behavior level of the microsystem would be most proximal to the issue of child maltreatment and would have the strongest effect sizes. In fact, the two strongest risk factors for neglect (parent child relationships and parent perception of child as problem) were from this level. However, the strongest effect sizes for child physical

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^☆: This material is based upon work supported by the Cooperative State Research, Education, and Extension Service, U.S. Department of Agriculture, and the U.S. Air Force, under Agreement No. 98-EXCA-3-0654. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the views of the U.S. Department of Agriculture or the U.S. Air Force. We thank Dr. Joel Milner, Lt. Col. Dari Tritt, Col Rene' Robichaux, Ms. Marciann Day, for their assistance in this project. In addition, we want to thank Dr. David Sugarman for his comments on earlier versions of this manuscript.

¹: Citations used in meta-analysis are marked with an asterisk (⁎).

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Risk factors in child maltreatment: A meta-analytic review of the literature☆

Abstract

Introduction

Section snippets

Review of literature

Theoretical perspective

Methods

Meta-analysis results

Discussion

Child Abuse and Neglect

Child Abuse and Neglect

Aggression and Violent Behavior

Child Abuse and Neglect

Child Abuse and Neglect

Child Abuse and Neglect

Child Abuse and Neglect

Child Abuse and Neglect

Child Abuse and Neglect

Child Abuse and Neglect

Child Abuse and Neglect

Child Abuse and Neglect

Infant Behavior and Development

Child Abuse and Neglect

Journal of the American Academy of Child Psychiatry

Child Abuse and Neglect

Child Abuse and Neglect

Comprehensive Psychiatry

Journal of the American Academy of Child and Adolescent Psychiatry

Child Abuse and Neglect

Children and Youth Services Review

Journal of Child Psychology

Journal of Applied Developmental Psychology

Child Abuse and Neglect

Child Abuse and Neglect

Child Abuse and Neglect

Child Abuse and Neglect

Child Abuse and Neglect

Antecedents of child abuse

Journal of Pediatrics

Parental divorce and adult well-being: A meta-analysis

Journal of Marriage & the Family

Unrealistic expectations and problem-solving ability in maltreating and comparison mothers

Journal of Consulting and Clinical Psychology

Abusing, neglectful, and comparison mothers' responses to child-related and non-child-related stressors

Journal of Consulting and Clinical Psychology

Child maltreatment and optimal caregiving in social contexts

Etiology of child maltreatment: A developmental–ecological analysis

Psychological Bulletin

Parental agreement-disagreement on child-rearing orientations and gender-related personality correlates in children

Child Development

Pathways from child maltreatment to internalizing problems: Perceptions of control as mediators and moderators

Development and Psychopathology

Mother–child interactional style in abuse, neglect, and groups: Naturalistic observations in the home

Journal of Abnormal Psychology

Physically abusive and nonabusive mothers' perceptions of parenting and child behavior

American Journal of Orthopsychiatry

The ecology of human development

Mother–infant interaction and attachment in physically abusing families

Journal of Reproductive and Infant Psychology

Children of adolescent mothers: Are they at risk for abuse?

Adolescence

Family interaction in abusive, neglectful, and normal families

Child Development

An inventory for assessing different kinds of hostility

Journal of Consulting and Clinical Psychology

Childhood physical abuse, childhood social support, and adult child abuse potential

Journal of Interpersonal Violence

Maternal inconsistent socialization: An interactional pattern with maltreated children

Child Abuse Review

Maternal language input and child maltreatment

Infant Mental Health Journal

Child abuse and neglect and the development of mental disorders in the general population

Development and Psychopathology

Child abuse related to life change and perceptions of illness: Some preliminary findings

The Family Coordinator