Child maltreatment and quality of life: a study of adolescents in residential care

Hanne Klæboe Greger,Thomas Jozefiak,Stian Lydersen,Arne Kristian Myhre

doi:10.1186/s12955-016-0479-6

Abstract

BackgroundChildhood maltreatment is an important risk factor for mental and physical health problems. Adolescents living in residential youth care (RYC) have experienced a high rate of childhood maltreatment and are a high-risk group for psychiatric disorders. Quality of life (QoL) is a subjective, multidimensional concept that goes beyond medical diagnoses. There is a lack of research regarding the associations between childhood maltreatment and QoL. In the present study, we compare self-reported QoL between adolescents in RYC in Norway with and without maltreatment histories, and adolescents from the general population. We also study the impact of number of types of adversities on QoL.MethodsAdolescents aged 12–23 years living in RYC in Norway were invited to participate in the study; 400 participated, yielding a response rate of 67 %. Maltreatment histories were assessed through interviews with trained research assistants, and completed by 335 adolescents. Previous exposure to maltreatment was reported by 237 adolescents. The Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents (KINDL-R) was used. Nonexposed peers in RYC (n = 98) and a sample of adolescents from the general population (n = 1017) were used for comparison. General linear model analyses (ANCOVA) were conducted with five KINDL-R life domains as dependent variables. Linear regression was used to study the effect of number of types of adversities.ResultsExposed adolescents in RYC reported poorer QoL than peers in control groups. Compared with nonexposed peers in RYC, the 95 % confidence intervals for mean score differences on the KINDL-R subdomains (0–100 scale) were 1.9–11.4 (Physical Well-being), 2.2–11.1 (Emotional Well-being), −0.7–10.0 (Self-esteem), and 1.8–10.9 (Friends). Compared with the general population sample, the 95 % confidence intervals for mean score differences were 9.7–17.6 (Physical Well-being), 7.9–15.3 (Emotional Well-being), 3.6–12.5 (Self-esteem), and 5.3–12.8 (Friends). Number of types of adversities was associated with a poorer QoL score on all subdomains (Physical- and Emotional Well-being, Self-esteem, Friends, and School).ConclusionsChildhood maltreatment was associated with a poorer QoL score. We suggest the use of QoL and maltreatment measures for all children and adolescents in RYC.

Highlights

Childhood maltreatment is an important risk factor for mental and physical health problems
In a recently published article, we found that the maltreated adolescents in residential youth care (RYC) had a very high prevalence of psychiatric diagnoses (80 %) compared with the nonmaltreated adolescents (64 %) in RYC, and that exposure to increasing numbers of types of childhood adversities significantly increased the risk of having several psychiatric diagnoses according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) [24]
The primary aim of this study was to assess the Quality of life (QoL) of adolescents in RYC units who have reported previous experience of maltreatment, and to compare them with adolescents in the same RYC units without this experience, and with adolescents from the general population

Summary

Introduction

Childhood maltreatment is an important risk factor for mental and physical health problems. We compare self-reported QoL between adolescents in RYC in Norway with and without maltreatment histories, and adolescents from the general population. Reported prevalence rates of childhood maltreatment vary in different studies and in different countries. In the Norwegian general population, studies have reported a prevalence of physical abuse of 5–6 % (both sexes) and sexual abuse of 10–14 % (girls) and 3–4 % (boys) [17, 18]. The Adverse Childhood Experiences (ACE) study in the United States found higher rates of maltreatment, with a prevalence of childhood physical abuse of 27 % (girls) and 30 % (boys), and a prevalence of child sexual abuse of 25 % (girls) and 16 % (boys) [20]. The childhood prevalence of witnessing intimate partner violence in high-income countries has been estimated as 8–25 % [21]

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