Episodes Of Abuse Research Articles

Mental Health Symptoms, Binge Drinking, and the Experience of Abuse During the COVID-19 Lockdown in Mexico.

Background: The health crisis associated with the COVID-19 pandemic is causally linked to negative mental health symptoms in the same way as other diseases such as Ebola.Objective: The purpose of this paper is to describe the relationship between mental health symptoms, binge drinking, and the experience of abuse during the COVID-19 lockdown.Method: We surveyed 9,361 participants, all Mexican, with an average age of 33 years old (SD = 10.86). In this group of people, we found out that 59% were single (5,523), 71% were women (6,693). Forty-six percentage were complying with lockdown procedures (4,286), 50% were partially complying (4,682), and 4% were not complying at all (393). The invitation to participate was open from April 24th to April 30th during the second stage of the pandemic in Mexico, in 2020, characterized by voluntary complete lockdown staying at home. Thus, we used a cross-sectional online survey design to assess mental health risk factors related to the COVID-19 pandemic. The survey was available on a WebApp designed by Linux®, PHP®, HTML®, CSS®, and JavaScript®. We calculated descriptive and inferential analysis to describe the mental health average distribution as a function of the lockdown, binge drinking, and experience of abuse. To calculate the reliability and validation of the subscales, we used Cronbach's Alpha and Factor Loading. We run the confirmatory factor loading analysis, and we described the relationship between each latent variable and its item factor load, obtained through structural modeling equations, derived from 179 iterations and 207 parameters (t[1,171] = 28,079.418, p < 0.001). We got a CFI of 0.947, a TLC of 0.940, an RMSEA of 0.049 (0.049–0.050), and an SRMR of 0.048.Findings: The results indicated that reported attitudes such as avoidance, sadness, withdrawal, anger, and anxiety were associated with acute stress, which was linked to an anxiety condition caused by uncertainty about achieving or maintaining overall good health.Discussion and Prospects: People in lockdown mentioned a sudden increase in alcohol consumption. They lived episodes of physical and emotional abuse, in contrast with those who stated that they did not go into lockdown or consume alcohol, or experienced abuse.Limitations: Further studies should diagnose mental health conditions as part of the impact of COVID-19, ensure their follow-up, and assess the effect of providing remote psychological care. There is a need to explore methods to curb the increase in the number of people affected by post-traumatic stress disorder.

The Challenge of Identifying Pediatric Abusive Head Trauma During the COVID-19 Pandemic.

The Challenge of Identifying Pediatric Abusive Head Trauma During the COVID-19 Pandemic.

Margins, Subjectivity, and Violence in Elena Ferrante’s Cronache del mal d’amore

ABSTRACT This article examines the manifold representations of violence against women in Elena Ferrante’s earlier novels: L’amore molesto (1992), I giorni dell’abbandono (2002) and La figlia oscura (2012). Episodes of domestic violence, stalking, and sexual abuse permeate the tissue of Naples – the chronotope of all of Ferrante’s texts and, simultaneously, a synecdoche of the male violence perpetrated therein. Reading the author’s ideas about the female body against feminist approaches and, especially, against her own theoretical apparatus, this article contends that the corporeal is deployed as a counter-strategy to gender violence that, albeit not always victorious, challenges patriarchal definitions of ‘woman’ framed through the normative male gaze. By establishing a link between the pivotal, yet still contentious, concepts of smarginatura and frantumaglia and gender violence, this reading offers new interpretative insights into the author’s aesthetics and into her treatment of female agency.

Association of Child Abuse and Systemic Lupus Erythematosus in Black Women During Adulthood.

Exposure to psychosocial stressors may contribute to the onset of systemic lupus erythematosus (SLE) through dysregulation of the adaptive stress response. The present study was undertaken to assess the relationship of childhood physical and sexual abuse to risk of SLE among Black women. Using data from the Black Women's Health Study, we followed 36,152 women from 1995 through 2015 with biennial questionnaires. Women reported on exposure to abuse during childhood (up to age 11) in 2005. Self-reported cases of incident SLE were confirmed as meeting the American College of Rheumatology SLE classification criteria by medical record review. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for SLE among women exposed to physical or sexual abuse during childhood, controlling for potential confounders. We confirmed 101 cases of incident SLE and identified patients who had completed questions on child abuse during 670,822 person-years of follow-up. Both physical and sexual abuse during childhood were associated with statistically significant increases in SLE incidence. The HR for SLE associated with ≥2 episodes of severe sexual abuse compared to no abuse was 2.51 (95% CI 1.29-4.85) after adjustment for alcohol consumption, smoking, body mass index, oral contraceptive use, age at menarche, and parental education. The multivariable-adjusted HR for SLE with ≥5 episodes of severe physical abuse was 2.37 (95% CI 1.13-4.99). Our results suggest that sexual and physical abuse during childhood increase SLE risk during adulthood among Black women. Research is necessary both to confirm this finding and to understand potential mediating mechanisms.

Voluntary binge-patterned alcohol drinking and sex-specific influences on monoamine-related neurochemical signatures in the mouse gut and brain.

Altered monoamine (i.e., serotonin, dopamine, and norepinephrine) activity following episodes of alcohol abuse plays key roles not only in the motivation to ingest ethanol, but also physiological dysfunction related to its misuse. Although monoamine activity is essential for physiological processes that require coordinated communication across the gut-brain axis (GBA), relatively little is known about how alcohol misuse may affect monoamine levels across the GBA. Therefore, we evaluated monoamine activity across the mouse gut and brain following episodes of binge-patterned ethanol drinking. Monoamine and select metabolite neurochemical concentrations were analyzed by ultra-high-performance liquid chromatography in gut and brain regions of female and male C57BL/6J mice following "Drinking in the Dark" (DID), a binge-patterned ethanol ingestion paradigm. First, we found that alcohol access had an overall small effect on gut monoamine-related neurochemical concentrations, primarily influencing dopamine activity. Second, neurochemical patterns between the small intestine and the striatum were correlated, adding to recent evidence of modulatory activity between these areas. Third, although alcohol access robustly influenced activity in brain areas in the mesolimbic dopamine system, binge exposure also influenced monoaminergic activity in the hypothalamic region. Finally, sex differences were observed in the concentrations of neurochemicals within the gut, which was particularly pronounced in the small intestine. Together, these data provide insights into the influence of alcohol abuse and biological sex on monoamine-related neurochemical changes across the GBA, which could have important implications for GBA function and dysfunction.

Profiling Children Sexual Abuse in a Sample of University Students: A Study on Characteristic of Victims, Abusers, and Abuse Episodes.

Because of its prevalence and its potential negative consequences, child sexual abuse (CSA) is a public health problem in every country in the world. Knowledge of the characteristics of abuse episodes (victim, abuser, relationship between them, type of sexual contact, duration, threat and/or use of force) is essential to specify the contents of intervention programs for the detection and reduction of the negative consequences of CSA. Starting with an initial sample of 1605 university students of both sexes (70.9% women, 29.1% men), aged between 18 and 26 years (M = 21.1, SD = 2.2), 90 participants who had suffered an episode of CSA up to age 16 were selected (84.4% women, 15.6% men; Mage = 21.1, SD = 2.2). It was found that: (1) there was a higher prevalence of CSA among women and that the victims’ average age when they suffered abuse was around 11 years; (2) the abusers were mostly male, close to the victims, and with an average of slightly less than 30 years; and (3) there was a significant proportion (25.6%) of CSA cases with penetration and in which force was used or threatened. These results are relevant, as they show that there is still a noteworthy prevalence of CSA cases on university campuses that needs to be addressed. Knowing the characteristics of these episodes is critical to implementing more effective interventions.

Traumatisme sexuel ou physique dans l’enfance : quel impact sur l’évolution d’un premier épisode psychotique ?

BackgroundIf exposure to childhood trauma increases the risk to later develop a psychotic disorder, the impact of such events on clinical presentation and outcome after a first psychotic episode deserves attention both in order to identify specific patients’ needs and to develop adapted therapeutic interventions. MethodsThree hundred and sixty-two patients treated at TIPP-Lausanne, a specialized program for the treatment of the early phase of psychotic disorders, were assessed prospectively, from baseline and every six months until the end of the 36 months of treatment. We compared characteristics of patients exposed to childhood sexual and/or physical abuse to those of non-exposed patients. ResultsOne hundred and eight patients (29.8 %) were exposed to at least one episode of physical and/or sexual abuse during childhood. Exposed patients displayed higher levels of positive and depressive symptoms and had lower levels of functioning throughout the entire three year follow-up period. ConclusionsThe prevalence of exposure to major traumatic events during childhood in early psychosis patients is very high, and it has an important impact on symptomatic and functional outcome. However, when clinical care is adapted, such patients seem to have a great potential for recovery. This justifies the implementation of specialized early psychosis programs and additional research in order to develop specific and adapted therapeutic strategies for such patients.

The Impact of Perceived Sleep, Mood and Alcohol Use on Verbal, Physical and Sexual Assault Experiences among Student Athletes and Student Non-Athletes.

Previous research has shown that student athletes are more likely to be involved in a physical altercation or be a victim of verbal, physical and/or sexual abuse than student non-athletes, which can have long-lasting negative effects on mood, behavior and quality of life. In addition, among college students, sleep difficulties are ubiquitous and may deteriorate the unique life experience that university represents. The influences of poor sleep quality, mood and alcohol consumption related to these events are examined here between student athletes and student non-athletes. A series of hierarchical logistic regressions explored the relationship between verbal, physical and sexual assault risk factors. Results suggest that poor sleep, alcohol consumption and mood are all associated with exposure to a physical altercation or episode of abuse, irrespective of athlete status. Results also show that variables targeting self-reported difficulty sleeping and experiences of verbal, physical and sexual assault were positively associated. However, given the cross-sectional nature of the study, it is impossible to establish the direction of these relationships.

Imprecision About Body Mechanics When Child Witnesses Are Questioned About Sexual Abuse.

In child sexual abuse cases, a central part of the child's testimony is their description of the abuse episode. However, it is often difficult for children to describe the body mechanics of abuse, and miscommunications are likely to occur. In the present study, we examined questions about the mechanics of abuse in trial transcripts (N = 63) to identify sources of miscommunication (N = 130) between attorneys and children (5-12 years old, M age at trial = 9.44, SD = 1.97). We found that both attorneys and children used imprecise language, which led to miscommunication. Specifically, the imprecise use of sexual terminology and the word "touch," polarity items, broad open-ended questions, anaphora and elliptical questions, and "how" questions led to imprecision in attorneys' questions. Imprecise attorney questions often elicited underinformative answers from children, including misinterpretations of the grain size (i.e., level of detail) requested. In response to these underinformative answers, attorneys at times asked highly focused and leading questions, which led to further miscommunications. Implications and recommendations for future research on how best to elicit details about the mechanics of abuse from children are discussed.

Mental Health Consequences of Lockdown During the COVID-19 Pandemic: A Cross-Sectional Study.

ObjectiveWe aimed to provide an overview of the psychological status and behavioral consequences of the lockdown during the COVID-19 pandemic in Libya.MethodsA cross-sectional study was conducted among the Libyan population through May and June 2020 in more than 20 cities. The survey comprised basic demographic data of the participants and anxiety symptoms measured using the seven-item Generalized Anxiety Disorder scale (GAD-7) with ≥15 as the cut-off score for clinically significant anxiety symptoms. Additionally, a survey regarding the lockdown effect was administered, which consisted of several parts, to measure the lockdown status.ResultsA total of 8084 responses were recorded, of which, 5090 (63%) were women and 2994 (37%) were men. The mean age (SD) for study participants was 27.2 (8.9) years. Among the participants, 1145 (14.2%) reached the cut-off score to detect anxiety symptoms; however, of the study variables, only five were predictors of clinically significant anxiety: age, gender, marital status, work status, being a financial supporter for the family, and being infected with COVID-19. Women had 1.19 times higher odds to exhibit anxiety symptoms than men. Increasing age was significantly associated with reduced likelihood of exhibiting anxiety symptoms, whereas being married was significantly associated with higher likelihood of anxiety symptoms, compared to not being married. Being suspended from work was associated with an increase in the likelihood of anxiety symptoms. However, we found that being infected with COVID-19 was associated with a 9.59 times higher risk of exhibiting severe anxiety symptoms. Among the study participants, 1451 (17.9%) reported a physical and/or verbal abuse episode from family members, 958 (11.9%) reported abuse outside the family, and 641 (7.9%) reported abuse from enforcers, during the lockdown.ConclusionOur study provided an overview of the psychological and behavioral status, among those who resided in Libya during the civil war and COVID-19 pandemic. The study demonstrates a concerningly high level of clinically significant anxiety during lockdown among the Libyan population during Libya’s lockdown period.

PTSD presenting as possession states in children and adolescents in rural Sri Lanka: a case series

Dissociative disorders are usually a result of trauma and stress. They may stem from chronic trauma such as repeated episodes of physical, emotional, or sexual abuse or may follow acute trauma. Dissociative symptoms such as possession states following trauma have been described in the literature, especially inchildren and adolescents. This article highlights three case reports where patients with PTSD presented with dissociative symptoms following significant traumatic events.

Negotiating Alienation and marginality in the Selected Verses of Indo-Guyanese Poet Mahadai Das

Indo-Caribbean literature opens a new vista of study of successful female poets and writers who have contested a literary space for themselves in the arena of West Indian literary discourse. These female writers have boldly denounced any legacy of Eurocentric literature and established their independent school of writing. The emancipation from ‘colonial possessiveness’, (July,1993, p. 80) (a term used by Ramabai Espinet in her writing) and a frantic effort to find new roots in the land of exile are the unique features of Indo-Caribbean literature. A rich cultural heritage, ancestral art, exotic cuisine, customs and costumes are the marks of exclusive oriental culture that is distinctly imprinted in their literature. Indo-Guyanese poetess, Mahadai Das (1954-2003), a prolific poetess of South- Asian descent in her collection of poetry I want to be a Poetess of my People (1977) presents an unparalleled account of the Guyanese people’s journey from immigration to independence. The episodes of violence, mutilation and physical abuse gave Indo-Caribbean female writers a new ability to articulate their woes of immigration and annihilation. The images like sailing back to India, the torments of indentureship and exile as well as racial and political turmoil in the land are interwoven together to form the prime content of their work. These female writers battle the fear of female authorship, since their voice had been long suppressed owing to the monopoly of male literary artists in the mainstream West Indian literature. The present paper proposes to study the theme of alienation and marginality as reflected in the selected verses of Indo-Guyanese writer Mahadai Das.

Violence against pregnant women in the experience of the rape centre of Turin: Clinical and forensic evaluation

Pregnant women can be victims of violence: as a matter of fact, far from being a protective factor, pregnancy can trigger or worsen episodes of abuse. Studies conducted by the WHO highlight that its incidence fluctuates between 1% and 28%. Therefore violence during pregnancy is endemic all over the world and involves all social strata.We analysed 113 medical records concerning pregnant women (average age 27.9 ± 6.0 years, 80 foreigners), who turned to the Centro Soccorso Violenza Sessuale, one of the two Italian Rape Centre, in Turin between January 1st, 2005 and December 31st, 2017. Fifty-three women were visited in the first trimester, 41 in the second, and 16 in the third, while 3 during the puerperium. The current partner was accused to be the abuser by the 84.4% of the Italian women and by the 69.2% of the foreigners. Sixty-eight women suffered multiple forms of violence, while 98 suffered only physical violence, and 3 reported only sexual abuse. According to 20 women, violent episodes increased during pregnancy. The clinical history of these women was characterized by some recurrent physical symptoms, such as pelvic pain, abdominal pain, facial pain and headache and 54 women presented injuries (abrasions and ecchymosis).Our results confirm that violence in pregnancy is a social and public health problem. Therefore it is important that the health personnel should be prepared not only to care for women seeking help, but above all its better preparation could also identify victims of violence, which do not report abuse.

Helping Clients Victimized by Intimate Partners Through Stages of Change: An Emotion-Focused Approach

Intimate partner violence results in extensive negative mental health outcomes including depression, posttraumatic stress, and anxiety. Moreover, victimized partners who experience cumulative episodes of abuse over time can also present severe affect dysregulation and interpersonal difficulties. Preliminary evidence for existing psychological treatments shows that these are globally effective on a symptomatic level and in reducing revictimization. Nonetheless, systematic reviews show high attrition rates and suggest that future interventions need to address a wider range of emotional difficulties and contextual challenges according to readiness for change. In this article, our goal is to contribute to the development of more responsive interventions that are tailored to individual experiences of violence with a focus on personal values, self-determination, and autonomy, as well as promoting adaptive coping and safety. More specifically, we describe how the intervention principles and experiential tasks of a neohumanistic model, emotion-focused therapy, can be integrated into a mediating readiness for change framework to help victimized clients receiving psychological treatment. We address four main problematic content-affective states that may hinder the therapeutic progress (interrupting fear of change, decisional pain, overwhelming safety concerns, and long-term interpersonal injuries), their association with stages of change, and how they can be resolved in-session using emotion-focused principles and interventions. The implications for future research are also discussed.

The epidemiology of child maltreatment and its association with mental and somatic health in Norwegian teenagers – a national survey among 9240 12-16-year olds

Abstract Background Child maltreatment has emerged as a key public health issue because of its serious consequences and long-term costs. Still, there are few large epidemiological studies on the prevalence of child maltreatment in adolescents, despite being a crucial transitional period making it particularly important to study. Aims We aimed to estimate the prevalence of physical, emotional, and sexual abuse in Norwegian adolescents, as well as health and daily functioning in abused versus non-abused youth. Methods A representative sample of 9240 Norwegian 12-16-year olds (response rate of 86.6%) completed a web-based survey designed to measure lifetime and last-year prevalence of physical and emotional abuse, sexual abuse by adults or peers, and neglect. We also assessed mental and physical health, and daily functioning, including sleep, school absence. Results Four percent of the sample (no sex difference) reported at least one episode of severe physical abuse from a caregiver during their childhood, while an additional 15% percent reported less severe abuse episodes. While 6% reported sexual abuse by an adult, 22% had experienced sexual abuse by a peer, the latter escalating significantly during adolescence. There was a large overlap in exposure types; more than 50% of those experiencing physical abuse, had also experienced emotional abuse. Conclusions Severe maltreatment was strongly associated with parental risk factors such as low SES, substance abuse, and immigrant status, while less severe violence was more randomly distributed. Somatic and mental health and daily functioning were significantly more negatively affected in maltreated youth compared to non-abused peers.

‘Everyone Has Secrets’: Revealing the Whistleblower in Hollwood Film in the Examples of &lt;em&gt;Snowden&lt;/em&gt; and &lt;em&gt;The Fifth Estate&lt;/em&gt;

‘Everyone Has Secrets’: Revealing the Whistleblower in Hollwood Film in the Examples of &lt;em&gt;Snowden&lt;/em&gt; and &lt;em&gt;The Fifth Estate&lt;/em&gt;

Dental care - an emotional and physical challenge for the sexually abused.

The aim was to explicate persistent psychological and bodily memories of sexual abuse and how they are expressed during dental appointments. The participants comprised 13 sexually abused individuals (11 women), who recalled and expressed these experiences during a dental appointment. They were encouraged to describe, in detail, aspects of the appointment which triggered memories of the sexual abuse. The interviews were recorded, transcribed verbatim, and analyzed using Qualitative Content Analysis. The identified overall theme illustrating the latent content was 'An echo of sexual abuse transformed into (dys) functional reactions'. The first category covering the manifest content was 'The inner invisible struggle', with two subcategories: (i) mental inscriptions of the abuse experience; and (ii) consequences of the dental encounter. The second category was 'The discoverable manifestations', with two subcategories: (i) enigmatic communication; and (ii) expressions of bodily memories. The dental appointment arouses similar psychological stressful reactions as the episodes of abuse; both implicit and explicit expressions are recognizable. Dental staff can contribute to disclosure by improved understanding of the strain a dental appointment can cause in patients who have been subjected to sexual abuse and familiarity with the associated bodily expressions.

The impact of the Great Recession on California domestic violence events, and related hospitalizations and emergency service visits

ObjectiveExplore the impact of the Great Recession on domestic violence (DV) related hospitalizations and emergency department (ED) visits in California. MethodsHospital and ED data were drawn from California's Office of Statewide Health Planning and Development (OSHPD). DV-related hospitalizations and ED visits in California were analyzed between January 2000 and September 2015 (53,596), along with total medical costs. Time series were divided into pre-recession (Jan 2000-Nov 2007) and recession/post-recession (Dec 2007-Sept 2015) periods. ResultsThe medical cost of DV-related hospitalizations alone was estimated as $1,136,165,861. A dramatic increase in DV episodes was found potentially associated with the Great Recession. The number of ED visits per month tripled from pre- to post-recession (104.9 vs. 290.6), along with an increased number of hospitalizations (77.1 vs. 95.6); African Americans and Native Americans were disproportionally impacted. In addition, psychiatric comorbidities, severe DV episodes, in-hospital mortality and charge per hospitalization escalated. The rise in DV hospitalizations and ED visits beginning in December 2007 was mainly attributable to physical abuse episodes in adults; minors had no change in DV trends. DiscussionRecessions are frequent in modern economies and are repeated cyclically. Our study provides critical information on the effects of the 2007 financial crisis on DV-related healthcare service utilization in California. Given the current financial crisis associated with COVID-19, which expert predict could extend for years, the results from this study shine a spotlight on the importance of DV-related screening, prevention and response.

Association of abuse-specific, familial, and post-incident factors with patterns of behavior problems in sexually abused preschoolers

BackgroundThe negative effects of child sexual abuse are well known; however, limited research has been conducted on the symptom patterns and their predictors in sexually abused preschoolers. ObjectiveThe aim was to identify the subtypes of parent-reported behavior problems and sexual behaviors among sexually abused preschool-aged children using latent profile analysis (LPA) and investigate factors that can affect the identified subtypes.Participants and Setting: Participants included 194 (28 males; 166 females) sexually abused children (age, 3–6 years) located in the Republic of Korea. MethodsLPA was performed using the seven syndrome scales of the Korean version of the Child Behavior Checklist for ages 1.5–5 and the Child Sexual Behavior Inventory as indicators. Demographic, sexual abuse characteristics, familial variables, and post-incident variables were compared between the derived classes. Multinomial regression analysis was performed to investigate the predictors for each class. ResultsFour classes were obtained from LPA: “Mild” (29.9 %), “Moderate” (18.0 %), “High Internalizing” (21.6 %), and “High Internalizing/Externalizing” (29.9 %). The Mild group included more cases of a single episode of abuse or victimization by strangers and immediate disclosure. Marital conflict was significant in differentiating the High Internalizing/Externalizing group from the other groups. ConclusionsSexually abused preschoolers could be classified into three groups according to severity, and the severe group could be classified into two heterogeneous groups. Furthermore, relationship with the perpetrator may predict more serious internalizing behavior problems, and marital conflict may be associated with complex symptoms involving externalizing and sexual behavior problems.

The link between hearing impairment and child maltreatment among Aboriginal children in the Northern Territory of Australia: is there an opportunity for a public health approach in child protection?

BackgroundInternational studies provide evidence of an association between child disabilities, including hearing impairment (HI), and child maltreatment. There are high prevalences of ear disease with associated HI, and child maltreatment among Australian Aboriginal children, but the link between HI and child maltreatment is unknown. This study investigates the association between HI and child maltreatment for Aboriginal children living in the Northern Territory (NT) of Australia.MethodsThis was a retrospective cohort study of 3895 Aboriginal school-aged children (born between 1999 and 2008) living in remote NT communities. The study used linked individual-level information from health, education and child protection services. The outcome variables were child maltreatment notifications and substantiations. The key explanatory variable, HI, was based on audiometric assessment. The Kaplan–Meier estimator method was used in univariate analysis; Cox proportional hazards regression was used in multivariable analysis.ResultsA majority of the study cohort lived in very remote (94.5%) and most disadvantaged (93.1%) regions. Among all children in the study cohort, 56.1% had a record of either HI or unilateral hearing loss (UHL), and for those with a history of contact with child protection services (n = 2757), 56.7% had a record of HI/UHL (n = 1564). In the 1999–2003 birth cohort, by age 12 years, 53.5% of children with a record of moderate or worse HI had at least one maltreatment notification, compared to 47.3% of children with normal hearing. In the 2004–2008 cohort, the corresponding results were 83.4 and 71.7% respectively. In multivariable analysis, using the full cohort, children with moderate or worse HI had higher risk of any child maltreatment notification (adjusted Hazard Ratios (adjHR): 1.16, 95% CI:1.04–1.30), notification for neglect (adjHR:1.17, 95% CI:1.04–1.31) and substantiation (adjHR:1.20, 95% CI:1.04–1.40), than children with normal hearing. In the 2004–2008 birth cohort, children with moderate or worse HI had higher risk of a substantiated episode of physical abuse (adjHR:1.47, 95% CI:1.07–2.03) than children with normal hearing.ConclusionOur findings demonstrate the urgent need for HI and child maltreatment prevention strategies through raised community awareness and inter-agency collaboration. Effective information-sharing between service providers is a critical first step to a public health approach in child protection.