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Objective: Research has documented the associations of child maltreatment with a range of physical health problems, but little is known about the physical growth patterns of children who experience maltreatment in early childhood. This study aimed to examine the association between various discipline approaches and physical growth in preschool-aged children., Methods: In the first year of preschool, parents of 661 Chinese preschool-aged children completed a questionnaire with items pertaining to the frequency of using physical maltreatment, psychological aggression, neglect, and nonviolent discipline toward the child. Children's weight and height were assessed annually using direct assessment in the first and two subsequent years. Longitudinal analyses were performed using multiple regression models., Results: More frequent neglect and psychological aggression during the first year of preschool were associated with a higher likelihood of a decreased BMI z score in subsequent years. Conversely, increased experience of physical maltreatment in the first year was associated with an increased likelihood of having overweight or obesity in the third year., Conclusions: Results indicate that early maltreatment experience can impact physical growth. This highlights the importance of preventing abusive parenting and encouraging healthy habits in young children who have experienced maltreatment to decrease their future risk for weight problems., (© 2024 The Authors. Obesity published by Wiley Periodicals LLC on behalf of The Obesity Society.)

Emerging evidence has documented the positive association between child maltreatment and both phenotypes of pathological narcissism (i.e., vulnerable and grandiose narcissism). However, results across these studies are inconsistent. Therefore, the present meta-analysis aimed to examine the extent to which child maltreatment is associated with vulnerable and grandiose narcissism, and whether these associations differed by study or sample characteristics. A systematic literature review was conducted in Web of Science, ScienceDirect, PubMed, Google Scholar, and China National Knowledge Infrastructure. Three-level meta-analyses were performed in R to synthesize the effect sizes. A total of 15 studies ( N  = 9,141 participants) producing 129 effect sizes were included. Results showed that child maltreatment was positively related to both vulnerable narcissism (mean r  = .198; p  < .001) and grandiose narcissism (mean r  = .087; p  < .001), but only to a small extent. Further, the association between child maltreatment and vulnerable narcissism was stronger for neglect ( r  = .278) than for physical abuse ( r  = .130). The strength of the association between child maltreatment and grandiose narcissism was larger for samples that were on average younger than 18 years ( r  = .187) than for samples that were on average older than 18 years ( r  = .068). Also, the strength of the association was stronger for females than for males. Child maltreatment is a risk factor for developing both vulnerable and grandiose narcissism. Interventions targeting pathological narcissism should be aware of potential trauma resulting from victimization of child maltreatment., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Theoretical and empirical evidence has suggested that child maltreatment victimization is associated with rejection sensitivity. However, empirical evidence on this association is inconsistent. Therefore, this meta-analysis aimed to examine the overall association between child maltreatment and rejection sensitivity, and to investigate variables that may affect the strength of this association. Studies eligible for inclusion were searched in the databases: Web of Science, Science Direct, PubMed, MEDLINE, and China National Knowledge Infrastructure after which relevant studies were coded. Studies were synthesized in advanced three-level meta-analytic models in R. A total of 16 studies ( N  = 5,335 participants) yielding 41 effect sizes were included. Results showed that child maltreatment is significantly and positively related to rejection sensitivity (mean r  = 0.230; p  < .001), and to a small extent. Furthermore, this association is stronger for emotional abuse ( r  = 0.275) than for physical abuse ( r  = 0.157). It is not affected by the mean age and gender distribution of primary study samples nor by sample type (community sample versus clinical sample). It is concluded that child maltreatment is a risk factor for developing rejection sensitivity later in life. Therefore, interventions for rejection sensitivity should consider potential trauma resulting from prior child maltreatment experiences., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: The intersections between intimate partner violence (IPV) and child abuse and neglect (CAN) have received growing attention from the research community. However, there is limited research examining the risk factors for CAN among children of battered women who have experienced severe IPV and seek refuge in shelters., Objective: In the current study, we examined the co-occurrence of IPV and CAN and the risk factors for CAN in a sample of battered women., Participants and Setting: We recruited 260 battered women who were staying in women's shelters in Hong Kong., Methods: We analyzed the data collected from the risk assessment reports of battered women and focused on IPV against women, CAN, and risk assessment., Results: Nearly half of the battered women had reported both IPV against themselves and CAN against their children. These women were, in general, younger, unemployed, and had been living in Hong Kong for less than seven years as new immigrants. Other risk factors for CAN in violent families included women's conflicts with their partner and abusers with higher levels of stress and approval of violence., Conclusions: This exploratory study of risk factors for the co-occurrence of IPV and CAN advances our understanding of the causes of violence against women and children in families with violence. Our findings suggest that additional integrated services should be offered to both battered women and their children during their stay in shelters and after shelter departure. Addressing IPV and CAN and reducing adverse consequences needs greater collaboration among the various stakeholders across the social services, health, educational, and legal sectors.

Background: The role of sleep deprivation in the relationship between child poly-victimization and pediatric quality of life (PedsQL) has received little attention., Objective: This study aims to provide a profile of the association between child victimization and poly-victimization and PedsQL among children, examining the role of sleep quality patterns in these relationships., Participants and Setting: We conducted a cross-sectional school survey study of family structure and child victimization among families in Hong Kong in 2016-17 with two-stage stratified sampling. The final sample consisted of 5, 567 students recruited from a representative sample of 107 kindergartens, primary schools, and secondary schools in all districts of Hong Kong., Methods: Multi-phase regression analysis and simple slope analysis were conducted to examine the moderating effects of sleep quality between child victimization and PedsQL., Results: The findings showed that children who experienced four or more types of victimization were more likely to show parasomnia and daytime dysfunction symptoms than those experiencing one to three types of victimization and non-victims. It also revealed significant relationships between child poly-victimization and lower levels of PedsQL, which were moderated by parasomnia and daytime dysfunction., Conclusions: This study has implications for clinicians in targeting the pattern of sleep changes combined with holistic screening in outpatient services for early detection of child poly-victims., Competing Interests: Declaration of competing interest The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

There has been a lack of high-quality evidence concerning the association between childhood maltreatment and psychiatric diagnoses particularly for Axis II disorders. This study aimed to examine the association between childhood maltreatment exposure and Axis I and Axis II psychiatry disorders using electronic health records. In this study, the exposed group (n = 7473) comprised patients aged 0 to 19 years with a first-time record of maltreatment episode between January 1, 2001 and December 31, 2010, whereas the unexposed group (n = 26,834) comprised individuals of the same gender and age who were admitted into the same hospital in the same calendar year and month but had no records of maltreatment in the Hong Kong Clinical Data Analysis and Reporting System (CDARS). Data on their psychiatric diagnoses recorded from the date of admission to January 31, 2019 were extracted. A Cox proportional hazard regression model was fitted to estimate the hazard ratio (HR, plus 95% CIs) between childhood maltreatment exposure and psychiatric diagnoses, adjusting for age at index visit, sex, and government welfare recipient status. Results showed that childhood maltreatment exposure was significantly associated with subsequent diagnosis of conduct disorder/ oppositional defiant disorder (adjusted HR, 10.99 [95% CI 6.36, 19.01]), attention deficit hyperactivity disorder (ADHD) (7.28 [5.49, 9.65]), and personality disorders (5.36 [3.78, 7.59]). The risk of psychiatric disorders following childhood maltreatment did not vary by history of childhood sexual abuse, age at maltreatment exposure, and gender. Individuals with a history of childhood maltreatment are vulnerable to psychiatric disorders. Findings support the provision of integrated care within the primary health care setting to address the long-term medical and psychosocial needs of individuals with a history of childhood maltreatment., (© 2022. The Author(s).)

Study Questions Child victimization is a major public health concern across the globe. Many previous studies have focused on separate categories of child victimization and health correlates, paying less attention to children affected by multiple forms of violence. Studies encompassing families' residential mobility and social support in the context of child poly-victimization are limited. This study examines the prevalence of child poly-victimization in Hong Kong and the associations between family structure, residential mobility, social support, and child poly-victimization. Subjects and Methods The analysis employed data from a cross-sectional, school-based survey in Hong Kong. A two-stage stratified sampling procedure was employed to maximize the representativeness of the sample. All children born in Hong Kong and receiving education in the sampled schools were included as eligible participants. A total of 5,567 children and their caregivers from 107 schools (kindergartens, primary schools, and secondary schools among 18 districts in Hong Kong) were randomly recruited in the study. Findings A total of 32.2% of the children experienced one-to-three types of victimization and 23.1% reported experiencing four or more types of victimization in the preceding year. Child victimization and its various aspects were negatively associated with family support, positively correlated with the number of times the child had moved house, and the number of siblings at home. The strongest association appeared to be between child maltreatment and family, while a relatively weaker but still significant connection was found between peer and sibling victimization and family support. Major Implications Successful family functioning and social stability are key to protecting children from victimization. This study provides insights into the importance of supporting families as a whole in preventing child poly-victimization. It also highlights family structure and social support in reducing the negative impacts of child victimization.

This study examined the elevated risk of intimate partner violence (IPV) among persons with mental health-related disabilities (MH-RD) and the extent to which known risk factors accounted for this phenomenon. Data were drawn from a nationally representative sample of 33,127 Canadians collected in 2014 as part of Statistics Canada's General Social Survey. Results showed that respondents with MH-RD had more than three-fold increased odds of both overall and severe IPV victimization. Although females were more likely to possess a MH-RD, males and females with MH-RD reported similarly elevated odds of IPV victimization. Risk factors that contributed to a significant reduction in elevated odds of IPV for respondents with MH-RD were child maltreatment (CM), respondents' nonprescription drug abuse, and perpetrators' jealous, monitoring, and socially isolating behaviors. The inability to test additional risk factors and bidirectionality in the relationship between MH-RD and IPV may have contributed to the failure to fully account for these respondents' elevated odds of IPV. Future research is needed to understand the complex mechanisms contributing to the elevated risk of IPV and enhance prevention and intervention strategies for this underresearched and underserved vulnerable population.

Rapid repeat pregnancy (RRP) often occurs in teenage and young mothers. Mothers with a history of RRP are more likely to experience high stress increasing their risk of child maltreatment. Despite these challenges, some mothers can continue to cope adaptively. Social support may play a role in empowering these mothers to overcome the childbearing difficulties. Although the protective effects of social support are well recognized, there has been little evidence on the relative importance of sources of support. For example, whether support from family and friends is equally important in relieving parenting stress remains unanswered. RRP, a social phenomenon encompassing various adverse living and parenting issues, provides an ideal research context to investigate the role of family and friends in preventing child maltreatment. This study examined whether family cohesion and friends' support moderated the association between RRP and child maltreatment in young mothers. We recruited 392 Chinese teenage and young mothers from a population-based integrated young mothers supporting program in Hong Kong. Questionnaires on pregnancy history, family cohesion, social support, and risk of child maltreatment were administered. Moderation analysis was conducted to examine the effect of RRP on child maltreatment as a function of family cohesion or friend support. Results showed that RRP was associated with a higher risk of child neglect (adjusted odds ratio [aOR] = 1.72, p < .05) and physical maltreatment (aOR = 1.91, p < .01), and that family cohesion was more important than friend support in mitigating the risk of child maltreatment for mothers with a history of RRP. Our findings suggest that interventions for young mothers, particularly those with a history of RRP, should be family-based so the whole family can be empowered to tackle the childrearing burden.

There is inconsistent evidence on the association between prenatal substance exposure and child behavioral problems. Children affected by maternal substance misuse are vulnerable to physical abuse and neglect. Few studies have examined factors contributing to internalizing and externalizing problems in these children. This study, with a focus on children with prenatal substance exposure, investigated whether family characteristics (the duration of maternal substance misuse postpartum or the existence of a sibling) moderated the association between adverse exposure (physical abuse or neglect) and behavior (internalizing or externalizing problems). We recruited 54 Hong Kong Chinese mothers with registered records of substance misuse during pregnancy and their children (2-9 years). Mothers completed questionnaires on drug use patterns during pregnancy and postpartum, abusive and neglectful parenting behaviors in the preceding year, and children's current behavioral problems. Moderated regression analyses tested whether abusive and neglectful parenting behavior interacted with family characteristics to affect child behavioral problems. The existence of a sibling moderated the relationship between neglect experience and internalizing problems, with a positive relationship observed only among single children (adjusted B [95% confidence interval] = 3.70 [0.98, 6.41], p = .012). The duration of maternal substance misuse postpartum moderated the relationship between physical abuse experience and externalizing problems, with a positive relationship observed only among children of mothers abusing substances beyond the child's infancy period (adjusted B [95% confidence interval] = 6.86 [2.34, 11.38], p = .008). The results show that the impact of physical abuse and neglect experiences depend on the type of behavior assessed and family and child characteristics. Positive sibling relationship and early detoxification in the mother can foster healthy behavioral development for children exposed prenatally to maternal substance misuse.

This study aimed to examine the associations between different types of child maltreatment and health-related quality of life (HRQoL) and emotional and social problems in adolescents, and to examine the moderating effect of social support on those associations. A cross-sectional survey was conducted between January and June 2016 in Hong Kong. The sample comprised 351 parent and adolescent dyads from low-income families. The parents reported on child maltreatment (physical abuse, psychological aggression, and neglect), and the adolescents reported on their HRQoL, emotional problems, and social problems. The adolescents' perceived social support was included as a potential moderator. Results of the study show that child physical abuse was strongly associated with emotional and social problems ( B = 0.91-1.45, p < .05). Lower overall HRQoL was associated with psychological aggression ( B = -3.96, p < .05) and neglect ( B = -4.14, p < .05). Physical functioning was affected by psychological aggression ( B = -3.16, p < .05), and emotional functioning was affected by neglect ( B = -4.82, p < .05). Social functioning was impacted by all three types of maltreatment ( B = -9.16 to -5.26, p < .05). This study extends previous literature by showing the varying effects of different types of child maltreatment on children's health in the context of low-income families. The findings of this study also support that peer social support may buffer the effects of child physical abuse on adolescents' emotional and social problems.

Previous studies have not focused on how intimate partner violence (IPV) during pregnancy predicts early postnatal child abuse. This study identifies the continuity and spillover effects of IPV during pregnancy on IPV and child abuse and neglect (CAN) at 1-month and 3-month postnatal periods. A total of 822 pregnant women were recruited at the third trimester of pregnancy at two obstetric hospitals in Tokyo, Japan, from June 2016 to September 2017. IPV during pregnancy and IPV and CAN at 1 month and 3 months postnatal were obtained through self-reported questionnaires. Results show that the rate of IPV was highest during pregnancy (16.4%), and there was significant continuance (69.4%) of this occurrence of IPV after childbirth (1 month: 13.9%; 3 months: 13.7%). In addition, the rate of CAN was 20.0% at 1 month postnatal and slightly increased at 3 months postnatal (21.8%). Furthermore, this study indicates that IPV during pregnancy was significantly associated with CAN at 1 month and 3 months postnatal (β = .16 and β = .14) and with IPV at 1 month (β = .68), and subsequently, IPV at 1 month was significantly associated with IPV at 3 months postnatal (β = .56). This study suggests the importance of conducting screenings for IPV during the perinatal period and providing intensive health interventions for abused women to support their parenting from pregnancy to 3 months postnatal to prevent or reduce CAN at 1 month and 3 months postnatal.

Objective: The aims of this study are to (a) provide reliable estimates of prevalence rates of family polyvictimization by synthesizing the findings from the existing literature, (b) examine the effect sizes of the impact of one type of family victimization on other types of family victimization, and (c) investigate the correlates of family polyvictimization., Method: Databases of literature published on or before April 2018 were searched. A total of 59 publications met the inclusion criteria and were included in the analysis for the combined odds ratios ( OR s) to estimate the associations among different types of family victimization; 38 of them (99,956 participants) were used for the calculation of the combined prevalence rates of family polyvictimization., Findings: The overall co-occurrence rates of family victimization were 9.7% among the general population and 36.0% among the clinical population. The combined OR of other type(s) of victimization when one was present was 6.01 ( p < .001). Longitudinal studies show that, when a family reported intimate partner violence, the odds of child abuse and neglect within the same family at a later stage was 3.64 ( p < .001). Depression and post-traumatic stress disorder were two significant correlates associated with family polyvictimization., Conclusion: Family polyvictimization is prevalent across the world. The high co-occurrence rates and strong associations between different types of victimization on different family members warrant the need for the early detection of victims and effective preventions and interventions using a family approach, instead of treating victims from the same family individually.

Although previous research has demonstrated larger households to be at higher risk of physical abuse and neglect of children, we argue that unilateral conceptualization of larger households as a risk factor is inappropriate. Application of resource dilution theory must capture the possibility that larger families may have more members with both the agency and will to intervene against child maltreatment. We hypothesized a negative interaction between household size and protective informal social control by family members in predicting abuse injuries and neglect. A three-stage probability proportional to size cluster sample representative of Novosibirsk, Russia, was collected from 306 cohabiting couples. One parent in each household was interviewed. A focal child was selected using most recent birthday. When responses limited to families with minor children (below age 18) were selected, 172 families remained in the data. Physical abuse and neglect were measured using the Conflict Tactics Scales (CTS). Protective informal social control by family members was measured using the Informal Social Control of Child Maltreatment (ISC&#95;CM) Scale. Models were tested using random effects regression and logistic regression. Nearly 7% of focal children were injured in the last year, 10% were neglected. Consistent with previous research, protective informal social control was associated with lower odds of injury and fewer instances of neglect. The significant negative interaction between household size and protective control is consistent with the idea that larger households may be protective when adult family members intervene against maltreatment to protect children. Replication and further investigation of protective ISC&#95;CM in Western populations is much needed. Future research should not conceptualize or measure household size as a unilateral risk factor.

Extant evidence has shown that insecure adult attachment is related to dysfunctional parenting styles that heighten parents' risk of child maltreatment. However, there is a lack of studies appraising the evidence for the association between insecure adult attachment and child maltreatment. This meta-analytic study examined the relationship between parents' adult attachment and child maltreatment perpetration/child abuse potential. Studies examining the relationship between parents' adult attachment and child maltreatment/child abuse potential published before February 2017 were identified through a systematic search of online databases. In total, 16 studies ( N = 1,830) were selected. Meta-analysis based on random-effects models shows a significant positive association between insecure attachment and child maltreatment (pooled effect size: odds ratio [ OR ] = 2.93, p = .000). Subgroup analyses show insecure attachment was more strongly associated with failure to thrive ( OR = 8.04, p = .000) and filicide ( OR = 5.00, p < .05). Medium effect sizes were found for subgroup analyses on insecure romantic attachment ( OR = 3.76, p = .000), general attachment ( OR = 3.38, p = .000), attachment to own child ( OR = 3.13, p = .001), and to own parents ( OR = 2.63, p = .000) in relation to child maltreatment.

Previous studies point to a link between parenting style and child maltreatment, but evidence from a Chinese context is lacking. We investigated the association between parenting style and child maltreatment in Hong Kong, and examined whether family socio-economic status and child gender moderate this relationship. Using stratified random sampling, 7585 children in Grade 1 to Grade 3 of 51 schools in Hong Kong were recruited and their parents were invited to complete the questionnaire. The past year weighted prevalence for minor physical abuse, severe/very severe physical abuse, psychological abuse, and neglect were 63.9%, 23.4%, 84.1%, and 23.2%, respectively. Authoritarian parenting was associated with all types of child maltreatment (prevalence ratio (PR) range: 1.10⁻1.53; p < 0.001), whereas authoritative parenting was associated with a lower risk of all types of child maltreatment (PR range: 0.89⁻0.97; p < 0.001). Child maltreatment is prevalent in Hong Kong and is strongly associated with parenting style. The association was significantly stronger among girls and those with higher family socioeconomic status. Education to empower parenting skills may alleviate the burden of child maltreatment.

Objective: To examine the incidence and trend of child maltreatment and its associated health problems in Hong Kong by linking healthcare and social service databases., Study Design: Data on 4816 children under the age of 18 years registered with the Child Protection Registry and matching health records in public hospitals in Hong Kong from 2003 to 2010 were extracted. Associations were examined between different types of child maltreatment and child's medical diagnosis according to the International Statistical Classification of Diseases and Related Health Problems, 10th Revision codes including suicidal attempt (X60-X84), nonchild maltreatment related injuries (S00-S99; T00-T98, excluding T74 and T76 that are maltreatment related injuries), mental health problems (F00-F99), and congenital malformations/chromosomal abnormalities (Q00-Q99)., Results: Significant rising trends were found for child physical abuse, neglect, and sexual abuse during the period from 2003 to 2010. Psychological abuse remained stable. Risk of suicide attempt was higher among children suffering from sexual abuse, psychological abuse, and children experiencing multiple abuses; mental health diagnoses were more common in victims of psychological and multiple abuses. Congenital malformations and chromosomal abnormalities were more commonly found among neglected children., Conclusions: In contrast to the decreasing trend observed in the West during the study period, there has been an escalating trend in child maltreatment in Hong Kong and child maltreatment is strongly associated with major health problems. This is one of the first studies to demonstrate the power of linking healthcare and social service databases, which allows for both a better understanding of the impact of child maltreatment and as a guide future policy and service planning., (Copyright © 2018 Elsevier Inc. All rights reserved.)

This study aims at providing a profile of the association between different types of child victimization and polyvictimization and health-related quality of life (HRQoL) among school-aged children, and examining the impact of family structure and social support on the negative health consequences associated with violent victimization. We conducted a cross-sectional school survey in Hong Kong using a two-stage stratified sampling procedure. The final sample comprised 4139 children's self-reports and proxy-reports (boys=51.5%; mean age=6.3). The main outcome was HRQoL measured with the Pediatric Quality of Life Inventory (PedsQL). Family structure was represented by parents' marital status, major caregivers, number of siblings and the living arrangement of children. Child victimization, social support, and demographic characteristics were also measured. All types of child victimization were associated with compromised HRQoL, and the strength of association varied across different types of child victimization. Family structure (in particular the number of siblings and whether additional childcare was received from grandparents) and social support were associated with better HRQoL. The negative associations between child victimization and polyvictimization and HRQoL were reduced when there was an adjustment made for family structure and social support. Findings show that family structure and social support are related to a reduction in negative health consequences for child victimization. The varying strengths of negative associations between victimization and HRQoL highlight the possibility that the effects of child victimization on health might not be homogeneous., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Background: Although childhood trauma and violence against women are global public health issues, few population-based data from low-income and middle-income countries exist about the links between them. We present data from the UN Multi-country Study on Men and Violence in Asia and the Pacific, exploring the pathways between different forms of childhood trauma and violence against women., Methods: In this multicountry study, we interviewed multistage representative samples of men and women, aged 18-49 years, in Asia and the Pacific, using standardised population-based household surveys. Men were interviewed in six countries, and women in four. Respondents were asked questions about their perpetration or experience of intimate partner violence or non-partner sexual violence, childhood trauma, and harsh parenting (smacking their children as a form of discipline). We used maximum likelihood multivariate logit models to explore associations between childhood trauma and violence against women, and fitted path models to explore associations between experience and perpetration of child maltreatment., Findings: Between Jan 1, 2011, and Dec 1, 2012, 10 178 men and 3106 women completed interviews in this study, with between 815 and 1812 men per site and 477 and 1103 women per site. The proportion of men who experienced any childhood trauma varied between 59% (n=478, 95% CI 54·0-63·3; Indonesia rural site) and 92% (n=791, 89·4-93·8; Bougainville, Papua New Guinea). For women, the results ranged from 44% (n=272, 37·7-50·8; Sri Lanka) to 84% (n=725, 80·7-86·8; Bougainville, Papua New Guinea). For men, all forms of childhood trauma were associated with all forms of intimate partner violence perpetration. For women, all forms of childhood trauma were associated with physical intimate partner violence, and both physical and sexual intimate partner violence. There were significant, often gendered, pathways between men's and women's perpetration and experiences of childhood trauma, physical intimate partner violence, harsh parenting, and other factors., Interpretation: The data point to both a co-occurrence and a cycle of abuse, with childhood trauma leading to violence against women and further child maltreatment, which in turn increases the risk of experience or perpetration of violence during adulthood. Efforts to prevent both forms of violence would benefit from a meaningful integrated approach. Interventions should promote positive parenting, address inequality and the normalisation of violence across the life course, and transform men's power over women and children., Funding: Partners for Prevention. National studies were funded by the UN Population Fund in Bangladesh and China, UN Women in Cambodia and Indonesia, UN Develoment Programme in Papua New Guinea, and CARE in Sri Lanka., (Copyright © 2017 The Authors. Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND license. Published by Elsevier Ltd.. All rights reserved.)

Although studies have reported a linkage between young pregnancy and child maltreatment risk, it is still unclear about what factors place young mothers at greater risk of maltreating their child in Chinese context. Based on the socio-ecological model, risk factors in 4 domains: family background/structure, maternal stressors, mother-child interaction, and child behavioral issue in relation to physical assault, neglect, both physical assault and neglect, and either physical assault or neglect among Chinese young mothers in Hong Kong were assessed. 392 young mothers were recruited from an integrated supportive program for young mothers. The mean age of mothers at delivery was 21.8 (SD=3.0) and 52.3% were married. Individual risk factors and cumulative risk domains related to different child maltreatment groups were examined. Our results show both overlapping and unique risk factors across the domains associated with physical assault and neglect. Further, young families exposed to higher number of risk domains show higher rates for physical assault and neglect, co-occurrence of physical assault and neglect, and either form of maltreatment. In addition, various risk domains were found to be particularly important for different forms of maltreatment: family background/structure domain was found to be an important risk domain for neglect; mother-child interaction domain for both physical assault and neglect; family background/structure and maternal stressors domains for either physical assault or neglect. Closer examination of a subgroup of adolescent mothers aged 18 and below shows that family background/structure was an important risk domain for this group., (Copyright © 2017. Published by Elsevier Ltd.)

Objective: We investigated the incidence and seasonal patterns of child maltreatment hospitalisations in Hong Kong., Design: A retrospective study of subjects aged under 19 years with a primary diagnosis of child maltreatment admitted to hospitals in Hong Kong from 2001 to 2010. Data were retrieved from the centralised database of all 42 public hospitals in the Hospital Authority., Main Outcome Measures: Child maltreatment incidence rate., Results: A consistent seasonal pattern was found for non-sexual maltreatment in children aged 6-18 years (p<0.001). Hospitalisations peaked in May and October but dipped in August and January. No significant seasonal patterns were found for sexual maltreatment or among children under 6 years. The seasonal pattern of child maltreatment coincided with the two school examination periods. The annual child maltreatment hospitalisation rate in Hong Kong in 2010 was 73.4 per 100 000 children under 19 years, more than double that in 2001., Conclusions: A peculiar seasonal pattern and an alarming increasing trend in child maltreatment hospitalisation were observed in Hong Kong, which we speculated to be related to school examination stress and increasing socioeconomic disparity. Our findings highlighted differences in the trends of child maltreatment between Hong Kong and the West. Professionals and policymakers should be made aware of these trends and develop effective strategies to tackle child maltreatment., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.)

Objective: Childhood physical abuse (CPA) can lead to adverse mental health outcomes in adulthood, but its potential impact on Chinese populations is still unclear. This meta-analysis is the first to examine the association between CPA and mental health outcomes in Chinese populations., Study Design: Studies published before December 31, 2014 were identified from Embase, CINAHL, Scopus, PsycINFO, PubMed, and Chinese National Knowledge Infrastructure databases. Studies with data on the association between CPA and mental health outcomes from Chinese subjects were included. Twenty-four studies were initially identified but two were excluded because of poor quality. Two reviewers independently extracted data to generate summary effect sizes using a random-effects meta-analytic model. A priori subgroup and sensitivity analyses were performed to evaluate heterogeneity and bias in these studies., Results: Our meta-analysis of 22 studies found a significant positive association between CPA and overall mental health outcomes among all Chinese subjects (pooled effect size: odds ratio [OR] = 2.16, 95% confidence interval [CI] = [1.87, 2.49]) and among community samples (pooled effect size: OR = 2.06, 95% CI [1.71, 2.48]). Based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, diagnostic criteria, CPA was more strongly associated with Axis II (OR = 2.62, 95% CI [2.13, 3.22]) than Axis I disorders (OR = 1.85, 95% CI [1.58, 2.17])., Conclusions: The detrimental effects of CPA on mental health outcomes in Chinese populations were comparable to, if not more than, the West. Contrary to the Chinese belief that physical punishment is a safe way to discipline children, our findings highlight the potential harm to mental health and the need to change this parenting practice., (© The Author(s) 2015.)

The objective of this study is to evaluate the effectiveness of parenting programs in reducing child maltreatment and modifying associated factors as well as to examine the moderator variables that are linked to program effects. For this meta-analysis, we searched nine electronic databases to identify randomized controlled trials published before September 2013. The effect sizes of various outcomes at different time points were computed. From the 3,578 studies identified, we selected 37 studies for further analysis. The total random effect size was 0.296. Our results showed that parenting programs successfully reduced substantiated and self-reported child maltreatment reports and reduced the potential for child maltreatment. The programs also reduced risk factors and enhanced protective factors associated with child maltreatment. However, the effects of the parenting programs on reducing parental depression and stress were limited. Parenting programs produced positive effects in low-, middle-, and high-income countries and were effective in reducing child maltreatment when applied as primary, secondary, or tertiary child maltreatment intervention. In conclusion, parenting programs are effective public health approaches to reduce child maltreatment. The evidence-based service of parenting programs could be widely adopted in future practice., (© The Author(s) 2015.)

The study examined the prevalence of the co-occurrence of intimate partner violence (IPV) and child maltreatment (CM) to determine whether IPV is a factor associated with the latter. A total of 5,841 students from a representative sample of schools in Hong Kong were surveyed. The results show that the lifetime and preceding-year co-occurrence rates of IPV and CM were 12.3% and 3.6%, respectively. IPV and parents' use of psychological aggression and corporal punishment led to increased odds of physical violence. This study suggests a need for the comprehensive assessment of IPV and CM., (© The Author(s) 2015.)

Drawing on previous research on intimate partner violence, child maltreatment, and informal social control, we hypothesized relationships between child abuse severity and (1) protective informal social control of intimate partner violence (ISC&#95;IPV) by neighbors, (2) intimate terrorism, (3) family order, and (4) the power of mothers in intimate relationships. In what we believe may be a first study of physical child abuse by parents in Nepal, we used a three stage cluster approach to draw a random sample of 300 families in Kathmandu. Random effects regression models were used to test the study hypotheses. The analyses found support for hypotheses one and two, but with an important caveat. Although observed (actual) protective ISC&#95;IPV had the hypothesized negative association with child abuse severity, in one of our models perceived protective ISC&#95;IPV was positively associated with child abuse severity. The models clarify that the overall direction of protective ISC&#95;IPV appears to be negative (protective), but the positive finding is important to consider for both research and practice. A significant relationship between family order and child abuse severity was found, but the direction was negative rather than positive as in hypothesis three. Implications for neighborhood research and typological research on IPV and child maltreatment are discussed., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Multiple forms of violence may co-occur on a child. These may include various forms of child victimization and different types of family violence. However, evidence that child victims are more likely to witness other types of family violence has been lacking in China. Using data of a large and diverse sample of children recruited from 6 regions in China during 2009 and 2010 (N=18,341; 47% girls; mean age=15.9 years), the associations between child victimization and family violence witnessed were examined. Descriptive statistics and the associations between child victimization, demographic characteristics, and family violence witnessed were analyzed. Lifetime and preceding-year rates were 71.7% and 60.0% for any form of child victimization and 14.0% and 9.2% for poly-victimization (having four or more types of victimization), respectively. Family disadvantages (i.e., lower socio-economic status, single parents, and having more than one child in the family) were associated with child victimization and poly-victimization. Witnessing of parental intimate partner violence, elder abuse, and in-law conflict also increased the likelihood of child victimization and poly-victimization, even after the adjustment of demographic factors. Possible mechanisms for the links between family violence and child victimization are discussed. The current findings indicated the need for focusing on the whole family rather than the victim only. For example, screening for different types of family violence when child victims are identified may help early detection of other victims within the family., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Objective: To assess the impact of intimate partner violence (IPV) against pregnant women on subsequent perpetration of child abuse and neglect (CAN) by parents; and to test the mediation effect of recent IPV on the link between IPV during pregnancy and subsequent CAN., Methods: This study was a longitudinal follow-up of a population-based study on pregnancy IPV conducted in antenatal clinics in 7 public hospitals in Hong Kong in 2005. Of all participants in the 2005 study, we recruited 487 women (with 184 having reported pregnancy IPV in the 2005 study) with newborn babies for a follow-up telephone interview in 2008. Participants responded to the Abuse Assessment Screen (AAS), the Parent-Child Conflict Tactics Scale, and some questions assessing demographic information., Results: The most common form of physical violence was corporal punishment, with a prevalence rate of 75.1% in the preceding year and 75.4% over their lifetime. Physical maltreatment was less likely to be reported, accounting for 4.7% in the preceding year and 4.9% over their lifetime. The preceding-year and lifetime prevalence rates of neglect were 11.3% and 11.5%, respectively. Findings from logistic regression analyses showed that IPV experienced by participants during pregnancy was associated with greater odds of both lifetime (aOR=1.74) and preceding-year child physical maltreatment (aOR=1.78). Results of the regression analyses also provided supportive evidence for the mediation effect of recent IPV victimization on the relationship between IPV during pregnancy and recent CAN against children., Conclusion: IPV against women during pregnancy predicted subsequent CAN on newborns in Chinese populations. This underscores the importance of screening pregnant women for IPV in order to prevent CAN at an early stage. Home visitations are suggested to break the cycle of violence within a nuclear family., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

The present study developed the Child Abuse Risk Assessment Scale (CARAS), an actuarial instrument for the assessment of the risk of physical child abuse. Data of 2,363 Chinese parents (47.7% male) living in Hong Kong were used in the analyses. Participants were individually interviewed with a questionnaire assessing their perpetration of child abuse and some theoretically or empirically tested factors associated with child abuse. Using the split-half validation procedure, the 5-factor, 64-item CARAS was created and validated. When applying to the second half of the split sample, the CARAS had a sensitivity of 81.9%, a specificity of 77.8%, and an overall accuracy of 78.1%. The area under the receiver operating characteristic curve (AUC) was .91. Overall, our findings showed that the CARAS is a simple, systematic and validated instrument identifying at-risk population of child maltreatment in Chinese societies.

Objective: This study assessed the co-occurrence of child maltreatment and intimate partner violence (IPV) and examined the association between them., Method: The cross-sectional study recruited a population-based sample of 1,094 children aged 12-17 years in Hong Kong. Structured questionnaires were used to collect data from the children. The prevalence of occurrence of child abuse and neglect by parents and exposure to IPV in both the past year and lifetime was examined, and their correlates were assessed using univariate and multivariate logistic regression., Results: The results show that 26% and 14.6% of child participants had been exposed to IPV physical assault, and 44.4% and 22.6% had been subjected to a parent's corporal punishment or to physical maltreatment from a parent in their lifetime and the year preceding the study, respectively. Among those families characterized by IPV, 54.4% and 46.5% were involved in child physical maltreatment over the child's lifetime and in the preceding year, respectively., Conclusions: Multivariate logistic regression analyses revealed that children exposed to IPV were at higher risk of being victims of neglect, corporal punishment, and physical maltreatment or severe physical maltreatment by their parents than children who were not exposed to IPV, even when child and parent demographic factors were controlled for., Practical Implications: The higher risk of child physical maltreatment associated with IPV highlights the need for an integrated assessment to screen for the presence of multiple forms of family violence within the family, and for intervention to assess effective responses to both IPV and child maltreatment by child protective service workers and domestic violence agencies., (Copyright © 2011 Elsevier Ltd. All rights reserved.)