Risk factors in child maltreatment: A meta-analytic review of the literature☆
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.
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Citations used in meta-analysis are marked with an asterisk (⁎).