Risk Factors For Child Maltreatment Research Articles

Estimating the alcohol-related burden of child maltreatment among Māori in Aotearoa, New Zealand.

To assesses the alcohol-related burden of child maltreatment among Māori in Aotearoa New Zealand. We compared the risk of child maltreatment among Māori (0-17 years) exposed to parents with alcohol-related hospitalisation or mental health/addiction service use. We also conducted a sensitivity analysis to estimate the number of cases of maltreatment that could be attributed to alcohol among Māori. A cohort study of 16,617 Māori aged 0-17 and their parents from 2000 to 2017 was conducted using the Statistics New Zealand Integrated Data Infrastructure. A Bayesian piecewise exponential model estimated the risk of time to first child maltreatment event. This analysis used data from child protection, hospital, mortality and police records, and specifically focused on the risk associated with exposure to parents with an alcohol-attributable hospitalisation or mental health/addiction service use event. Potential confounders for both parents and Māori (0-17 years) were included. We calculated a population-attributable fraction to estimate the proportion of maltreatment cases that could be attributed to alcohol in 2017. Results showed a 65% increased risk for young Māori exposed to parents with heavy alcohol use. We estimated 17% of substantiated child maltreatment among Māori could be attributed to parental hazardous alcohol consumption. Severe or hazardous alcohol consumption among parents is a risk factor for child maltreatment among Māori. Māori alcohol consumption and harm are symptomatic of wider inequities related, among other things, to the ongoing effects of colonisation, as well as gaps in the regulation of alcohol sales.

On the Overlap of Commercial Sexual Exploitation and Intimate Partner Violence: An Exploratory Examination of Trauma-Related Shame.

Every year, millions of people experience intimate partner violence (IPV) and commercial sexual exploitation (CSE), with researchers increasingly discussing the overlap between these two forms of interpersonal violence. However, researchers have not yet used quantitative methods to examine the link between IPV and CSE or to explore potential mechanisms underlying the overlap, including child maltreatment risk factors and psychological mechanisms. One potential mechanism is trauma-related shame, a symptom of post-traumatic stress disorder commonly experienced by both victims of CSE and IPV. The current study explores trauma-related shame, childhood maltreatment, and IPV and their associations with CSE using a sample of 174 primarily Black women. Binomial logistic regression is used to analyze the impact of IPV, child abuse and neglect, and trauma-related shame on CSE. Results indicate that IPV and trauma-related shame are both significant predictors of CSE. Implications for future research and the incorporation of shame in trauma-related treatment are discussed.

Beaten to Blindness: Battered Baby Syndrome

Introduction: A battered child is one who sustains repetitive physical injuries due to non-accidental violence inflicted by a parent or guardian. Child abuse encompasses behaviors exposing the child to various forms of physical or sexual abuse, neglect, or emotional misconduct. Typically, battered child syndrome is diagnosed through a disparity between the history provided by the child's caregivers and the findings of clinical examination. Case details: An 18-month-old girl child was admitted to a tertiary care hospital, presenting with a four-day history of fever, vomiting for two days and a seizure episode. The child had a history of head injury one week ago, resulting in transient unconsciousness. Upon examination, multiple healed and fresh injuries were observed on the face, hands, and right thigh. CT brain revealed hypodensity areas with a mildly displaced fracture of the left frontal bone. Fundus examination identified bilateral multiple intraretinal hemorrhages and papilledema. X-ray showed a fracture of the right proximal tibia. The child required ventilator support during the hospital stay, and subsequently, developed retinal blindness. The child was managed accordingly. Discussion: The classical feature of Battered Baby Syndrome is the discrepancy between the nature of injuries and the history provided, and the delay between the injury and medical attention. The parental risk factors for child abuse are poverty, social isolation, drug addiction, violent environment, family history of abuse, communication skills deficit and the child related risk factors are children with special needs, children with behavior problems, bonding deficit. etc. Conclusion: The current case sheds light on the unfortunate prevalence of this condition within the Indian context, urging point-of-care health providers to stay vigilant and informed about child abuse patterns in the community. It serves as a crucial reminder of the responsibility we all share in safeguarding the well-being of children.

Prevalence and Risk Factors of Child Abuse: A Descriptive-Analytical Study in Ilam Province, Iran, in 2020

Background and aims: Child abuse is one of the major health and social problems in all countries, which is affected by a set of cultural, social, and family factors and some characteristics of children. The present study was performed to determine factors related to child abuse in Ilam province. Methods: This descriptive-analytical study was designed in 2020 in Ilam province, Iran. Ninety-nine children who had a document of child abuse in social emergency centers were included in the study by the census method. In addition, one hundred and thirty-three children of similar age were selected from the community level by the multi-stage sampling method. The required data were collected using a researcher-made questionnaire whose validity and reliability were confirmed, and a significant level of less than 5% was considered statistically significant. Results: Overall, 53.5% of participants were in the non-abused group, and 46.5% were in the abused children group. Neglect and emotional abuse were the most common types among the abused children. A significant difference was reported between all kinds of child abuse in the abused and non-abused groups (P<0.001). There was a significant relationship between the number of family members with both sexual and nutritional child abuse (P<0.001). Conclusion: Overall, family, economic, and social factors are related to child abuse. Social service counselors recommend the introduction of these factors during the consultation with parents.

Experiences of grief and maltreatment among orphans in foster homes in Namibia

Orphans in SSA are often cared for in foster homes. Although there is no consistent picture of whether orphans experience more often than non-orphans child maltreatment, they are at risk of facing violence in their home situation. This study aimed to understand how Namibian orphans experience their treatment in foster care and how exposure to maltreatment influences their experiences of grief. An ethnographic design was used in which 46 children, adolescents, their carers and various experts in northern Namibia participated. Focus groups, individual interviews and art-based methods were used. The results show that the majority of the orphans experience a form of maltreatment, including differential treatment between themselves and the biological children in the household. Risk factors for child maltreatment are identified on child, carer and household level. Children and adolescents long for their parents when they are treated badly and feel the parent could have protected and comforted them, which shows the important role of having a secure foster home situation in coping with parental loss. Parenting interventions to positively influence the risk of child maltreatment in foster care are recommended.

Household crowding and income loss increases intimate partner violence during the pandemic among isolating families with young children in the United States

The COVID-19 pandemic presents significant risk for family violence. Risk for intimate partner violence (IPV) may be especially pronounced among families with young children that are isolating in crowded households and experiencing severe income loss. Because child exposure to IPV is increasingly recognized as a form and risk factor for child maltreatment, understanding factors contributing to IPV among families with young children can inform prevention and intervention efforts regarding family and child well-being during and after the pandemic. The present study examines the hypothesis that IPV during the pandemic would be more likely among families with a history of IPV that are isolating in crowded households and/or experiencing severe income loss resulting from the pandemic. Parents (n = 363) of 4- to 10-year-olds living in the United States completed an online survey with demographic, pandemic experiences, and IPV questionnaires. Family history of IPV was strongly associated with recurring IPV during the pandemic (Cramer’s V = .55). Induction rates of IPV during the pandemic were low; four families experienced IPV for the first time during the pandemic. Household isolation (r = .12), household crowding (r = .13), and severity of income loss (r = .25) were significantly and positively associated with IPV during the pandemic. Income loss was positively associated with IPV during the pandemic at low and average levels of household crowding. At high levels of household crowding, families were at high risk for IPV during the pandemic regardless of the severity of income loss. Our findings indicate that isolating families with young children are at-risk for recurring IPV during the pandemic, especially if they are also experiencing household crowding and/or severe income loss.

The bidirectional temporal relationship between parenting stress and child maltreatment: A cross-lagged study based on intervention and cohort data

BackgroundParenting stress has long been proposed as a major risk factor for child maltreatment. However, there is a lack of evidence from existing studies on the temporal sequence to establish a causal relationship. This study aims to examine bidirectional temporal relationships between parenting stress and child maltreatment. MethodsLongitudinal data from two different sources were analysed: a pre-post study of an online parenting programme conducted across six countries - the ePLH Evaluation Study, and a prospective cohort study in the United States - LONGSCAN. Cross-lagged panel model on parenting stress and child maltreatment was used in each dataset. ResultsBased on repeatedly measured data of 484 caregivers in the ePLH study across five time points (every two weeks), we found that parenting stress at an earlier time point predicted later child maltreatment (IRR = 1.14, 95 % CI: 1.10,1.18). In addition, the occurrence of child maltreatment was associated with higher subsequent short-term parenting stress (IRR = 1.04, 95 % CI: 1.01,1.08) and thus could form a vicious circle. In the LONGSCAN analysis with 772 caregivers who were followed up from child age of 6 to child age of 16, we also found parenting stress at an earlier time point predicted later child maltreatment (β = 0.11, 95 % CI: 0.01,0.20), but did not observe an association between child maltreatment and subsequent long-term parenting stress. LimitationsPotential information bias on the measurements. ConclusionsThis study provides evidence for a bidirectional temporal relationship between parenting stress and child maltreatment, which should be considered in parenting intervention programmes.

The Effects of Neighborhood Trust and Support on Parenting Stress of Mothers With Young Children in Japan.

While childrearing can enhance mothers' psychological well-being, parenting can also increase mental stress for mothers with young children, which is considered a risk factor for child maltreatment. A lack of social capital reportedly influences mothers' parenting, but few studies have investigated the effects of social capital on the perception of mental stress and well-being associated with childrearing among mothers with young children. Therefore, we investigated the effects of lower perceived neighborhood trust and support on higher mental stress and/or lower well-being associated with childrearing among Japanese mothers with children aged 2 to 3 years. A total of 570 mothers with children (aged 2-3 years) in nursery school were invited to join the survey. The childrearing perspective scale for mothers (CPS-M97) was used to evaluate mothers' perceptions of mental stress and well-being associated with childrearing. Odds ratios (ORs) reflecting lower satisfaction/fulfillment scores (ie, well-being) and/or higher burdened/anxious scores (ie, mental stress) associated with perceived social capital levels were analyzed, after adjusting for confounding factors. The OR for lower satisfaction/fulfillment scores was significantly higher (OR = 1.77) for mothers with lower neighborhood trust. Significantly increased ORs for higher burdened/anxious scores were found in mothers with lower neighborhood trust (OR = 1.50) and support (OR = 1.49). The ORs for poor mental status, with lower satisfaction/fulfillment scores and higher burdened/anxious scores, were significantly increased in mothers with lower neighborhood trust (OR = 1.96) and lower neighborhood support (OR = 2.10). Higher social capital was associated with higher psychological well-being and/or lower mental stress in Japanese childrearing mothers. These results suggest that enhancing social capital is necessary to facilitate successful parenting that contributes to the prevention of child maltreatment.

Breaking the Silence: Investigating the Prevalence and Key Risk Factors of Child Maltreatment among Male Working Children in a Rural Community in Bangladesh

Introduction. Child labor is widely regarded as one of the most severe forms of child maltreatment (CM), but little is known about how working children, especially in low-income countries like Bangladesh, experience different forms of CM. This paper explores the extent of physical, psychological, and sexual abuse and neglect experienced by working children and determines the important risk factors for these forms of CM among them. Methods. This cross-sectional study included 398 working children from four local Bazars (rural marketplace) of Raiganj Upazila, Sirajganj district, who were enrolled in this study in March and April of 2017, through a snowball approach, due to a lack of a list of working children. The International Child Abuse Screening Tools for Children (ICAST-C) was used to estimate the different forms of CM in this study. Results. Lifetime prevalence of psychological abuse (PsyA), physical abuse (PA), neglect, and sexual abuse (SA) were 100%, 100%, 82.7%, and 13.5%, while the past year prevalence rates were 100%, 84.2%, 67.1%, and 9.9%, respectively. Common forms of PsyA experienced by children include shouting, yelling, or screaming, as well as restrictions on outings and time-outs. PA typically involves slapping on the face or head, hitting with objects (excluding the buttocks), and ear twisting. Watching pornography is the primary form of SA, while the leading form of neglect is unmet medical needs. The prevalence of PsyA, PA, SA, and neglect was higher among children who lived with individuals other than their parents. Both PsyA and PA were found to be associated with family violence, such as the presence of weapons in the household and adults engaging in frightening screaming behavior. Additionally, children who were bullied by their siblings, had a parent with a primary level of education or less, and always felt safe at home were at an increased risk of experiencing PA. Children who did not feel safe at home all the time were more likely to experience SA. Furthermore, for every one-year increase in schooling, the likelihood of experiencing neglect decreased by 8.3% (B: -.157, P value < .003). Conclusion. Nearly all male working children in rural areas of Bangladesh experienced PsyA and PA, and adult negligence was also prevalent. Although male SA is not a widely discussed issue in Bangladesh, the results of this study are alarming.

Child-related risk factors and injuries in cases of physical child abuse

Abstract Background When evaluating child welfare risk, recognition of abuse-related injuries and knowledge of risk factors for child abuse are important aspects. The purpose of this study was to evaluate child-related risk factors and particularities of injuries in cases of physical child abuse, to use the results for preventive child protection. Methods This retrospective case control study evaluated case files of 368 physically abused children (age range 0–14 years) referred to forensic medicine in 2004–2015. Death cases and cases that could not be separated from sexual abuse and neglect were excluded and 363 controls without suspicion of abuse were recruited from a pediatric clinic. Demographic data, state of care and previous illnesses were compared in both groups by determining χ2-test and Fisher’s exact test. Concerning injuries, specified mechanism of origin, type of violence, localization on the body and frequency of life-threatening and repeated abuse were evaluated. Results Male gender and age group of infants/toddlers were identified as significant child-related risk factors. In over 90%, injuries resulted from blunt trauma, with the skin (86%) and skeletal system (22%) most commonly involved. Injuries were located in almost 60% on obvious parts of the body. Reported causes for trauma were mostly accident mechanisms. Repeated abuse was found in over half and life-threatening injuries in nearly 20% of the cases. Conclusion As part of the daily work pediatricians and other child protection workers are able to identify suspected cases early. Therefore, good understanding of typical risk factors and injuries including plausibility check of the reported origin are important aspects. Periodic reassessment of child well-being and mandatory visit to pediatricians could avoid repeated and severe child maltreatment with life-threatening consequences.

Fathers' mental Ill-health and child maltreatment: A systematic review of the literature

BackgroundParental mental ill-health is often described as a risk factor for child maltreatment. Yet the literature commonly foregrounds maternal mental ill-health. To obtain a more complete picture, it is crucial to also understand the associations between fathers’ mental health and child maltreatment. AimTo provide a narrative synthesis of evidence about the relationship between fathers’ mental health and child maltreatment. MethodFour electronic databases were searched, identifying 5479 citations. 151 studies were brought to full-text review. 37 were included in the study. ResultsStudies revealed mixed evidence for associations between forms of paternal mental ill health and child maltreatment, with stronger evidence for paternal depression and weak or no evidence for PTSD and anxiety. Many confounding factors were identified across the papers. DiscussionThe small number and limited range of good quality studies indicate the need to correct the relative invisibility of fathers within research about mental health and child maltreatment. At present, the available evidence is not sufficient to draw firm conclusions about the association between fathers’ mental health and child maltreatment or appropriate policy and practice responses.

Poverty and child maltreatment: a systematic review

ABSTRACT Poverty has long been indicated as a risk factor for child maltreatment. This review aims to synthesize the existing literature regarding the relationship between income-level poverty and child maltreatment in the United States. Of the 27 studies included, approximately 40% measured poverty using only income indicators, and 71% measured child maltreatment using administrative data. While the type of child maltreatment varied across studies, the associations generally revealed that higher income decreased the risk of child maltreatment, or families living in poverty had a higher risk of child maltreatment. The current study proposed several child welfare-related implications based on the findings.

Enhancing child safety and well-being in the northern territory: Bridging gaps in support services and strengthening community engagement

This article reports on a study that provides insights into the challenges faced by practitioners in the Northern Territory (NT) who support families in enhancing child safety and well-being, particularly for children at risk of or exposed to domestic or family violence. Despite increased funding for programs aimed at improving children's safety and well-being, reports and substantiations of child maltreatment in the NT continue to escalate. Interviews with twelve participants from various organizations involved in child protection services, family support services, and residential care shed light on the existing gaps in support services, including limited resources for families escaping domestic violence and inadequate assistance for children transitioning from out-of-home care. The findings emphasize the need for early intervention services targeted at families displaying risk factors for child maltreatment. Additionally, community consultation is crucial for the design and implementation of support programs that align with the unique needs of communities, including the necessity of maintaining connections to community, culture, and family to address concerns related to meeting basic needs. The study calls for a comprehensive approach that integrates community input, cultural safety, and tailored support programs to bridge these gaps and facilitate lasting positive changes. By addressing these challenges, there is a potential to mitigate child maltreatment and improve the well-being of children and families in the NT, contributing to the overall welfare of the community.

Predicting mental and behavioral health service utilization among child welfare-involved caregivers: A machine learning approach

Caregiver substance misuse (SM) and mental illness (MI) are risk factors for child abuse and neglect and are associated with more intensive CPS involvement including increased risk of foster care placement and multiple re-reports. This study examines the prevalence of SM and MI among 929 CPS-involved caregivers during the early phases of CPS involvement and explores the extent to which family and CPS-case characteristics predict referral and service receipt. We used a machine learning approach to identify the strongest predictors of SM and MI service receipt by comparing the predictive strength of random forest and logistic regression models. Results indicate a high prevalence of self-reported need for SM (13%) and MI (34%) services among caregivers. Nearly one-quarter (23.5%) of caregivers with SM needs and 34% of caregivers with MI needs did not receive needed services. Frequent contact with CPS workers, adverse experiences in adulthood, and court involvement were strong predictors of both SM and MI service uptake. Findings suggest the need for consistent screening for SM and MI among primary caregivers at the early stages of CPS-involvement, as well as enhanced referral practices. Machine learning applications for applied social science researchers are also discussed.

Early detection of risk for maltreatment within Dutch preventive child health care: A proxy-based evaluation of the long-term predictive validity of the SPARK method

BackgroundFor effective prevention of child maltreatment, it is crucial that risk factors for child maltreatment are identified as early as possible. In the Dutch preventive child healthcare, the SPARK-method is used for this purpose. ObjectiveThe current study investigated the predictive validity of the SPARK-method for predicting child protection activities, as a proxy for child maltreatment, and whether the estimation can be improved with an actuarial module. Participants and settingParticipants included a community sample of 1582 children of approximately 18-months-old for whom the SPARK was administered during well-child visits at home (51 %) or at the well-baby clinic (49 %). MethodsSPARK measurements were linked to data on child protection orders and residential youth care over a 10-year follow-up period. The predictive validity was evaluated using Area Under the receiver operating characteristic Curve (AUC) values. ResultsResults showed good predictive validity for the SPARK clinical risk assessment (AUC = 0.723; large effect). The actuarial module led to a significant improvement in predictive validity (AUC = 0.802; large effect), z = 2.05, p = .04. ConclusionThese results show that the SPARK is suitable for estimating the risk of child protection activities and that the actuarial module is a valuable addition. The SPARK can be used to support professionals in preventive child healthcare with their decision on appropriate follow-up actions.

Socioeconomic and Demographic Risk Factors of Child Sexual Abuse in Pakistan: A Case Study of Khyber Pakhtunkhwa Province

Child sexual abuse is a harsh reality and a threat of harm to children. Pakistan’s high population growth and increasing poverty has resulted in child labor on streets. Children are exposed to all forms of abuse including sexual exploitation. The main objective of this study is to find out the risk factors of child sexual abuse. The present study has been conducted in the capital city of Khyber Pakhtunkhwa province, Pakistan. The respondents have been selected from places where children are found most often, selling products, or wondering in search of jobs. Primary data was collected through semi-structured questionnaire using snowball sampling. The total response was found at 50, including Pakistani and Afghan refugees’ children. According to the results 76% children are deprived of their parents’ proper attention, 96% are very poor and just earning below Rs. 8000, 66% are in the age group of 8 to 12 years, 72% of the respondents have only one room in their house, 78% respondents are not enrolled in school; about 22 % sample respondents left the school early, 64% of the respondent having large family size (family members more then 6), and 98% of the victims were out of homes for earnings. It is concluded that the main risk factors of child abuse consist of poverty, child labor, large family size, school dropout, and low parental warmth. With respect to most of the variables, no significant difference was found between the two nationals.

A randomized controlled trial of Safer Kids – A program for parents reported for child abuse: Short-term effects on further reports of child abuse and related risk factors

BackgroundMillions of children are victims of child abuse world-wide. Consequences include long-term health impacts and large societal costs. Parent training is promising to prevent abuse, but challenges with motivation and attrition must be overcome to reach parents in need. ObjectiveTo assess the effectiveness and acceptability of Safer Kids, a cognitive behavioral therapy-based parenting program delivered immediately after a report of child abuse. Safer Kids is used within the Child Welfare Services (CWS) in Sweden but has never been evaluated in an RCT. Participants and settingIn total, 112 families with children 2–12 years referred to the Swedish CWS for physical or emotional child abuse participated. MethodsFamilies were randomized to Safer Kids or intervention as usual (IAU). Data from parents, children and CWS were analyzed with multilevel and survival analyses. Primary outcomes were parent-rated child abuse potential and re-reports of abuse. Secondary outcomes were child abuse risk factors and treatment satisfaction. ResultsData 4 and 7 months from baseline were available for 96 % of the families. All except one family (98 %) who started Safer Kids completed the program. Both groups improved from baseline to follow-ups on most effectiveness outcomes. The changes were not statistically different between groups. Parents and social workers were more satisfied with Safer Kids than IAU. ConclusionsShort manualized parenting programs can be a way to reach parents reported for child abuse with support. Safer Kids is a viable option to the CWS's standard interventions, as it was equally effective and slightly better accepted than IAU.

Child protection services during COVID-19 in Oman, child protection workers views

Introduction: Child Protection Services (CPSs) are dedicated to providing protection and responding to any threats a child could face as children worldwide could be abused. Recently, the COVID-19 pandemic affected all aspects of life. Procedures implemented to restrict the spread of the disease (such as reduced access to services, school closure, and social distancing measures) had an impact on child life and maltreatment. Therefore, it is important to know the impact of this pandemic on child abuse and protection. Aim and rationales: This study aimed to assess the impact of COVID-19 on CPSs in Oman by studying the change in the number of reported cases of child abuse and the change in the reporting procedure at the Ministry of Social Development (MOSD). In addition, know the impact of the restriction measures on child rights and risk factors of child maltreatment based on CPSs workers’ opinions and experience. To understand the adaptation of the CPSs to the change in work and life environment imposed by COVID-19. Method: A cross-section study was conducted using a semi-structured questionnaire, that was distributed to the workers involved in the CPSs at the MOSD in Oman. Data also were collected from the statistical bulletins on the Ministry’s website. Results: COVID-19 pandemic was not found associated with a significant change in the number and type of child abuse cases reported to the MOSD. The reporting procedures also did not change. In addition, the pattern of child abuse types did not change before and during the pandemic, as neglect cases were the most. The participants judged the restriction measures affecting family life through separation, cyber abuse, and reduced educational support. With regard to intervention and follow-up procedures, the main difference was in the communication processes by using online communication methods and reducing the fieldwork for mild cases. Conclusion: CPSs in Oman were not much affected by the COVID-19 pandemic, which may reflect the success of this system in dealing with the restriction measures. However, more solutions should be developed to adapt to these circumstances in the future altogether.

Known groups validity of the SPARK36: To guide nurse-led consultations for the early detection of child developmental and parenting problems.

Early detection of child developmental and parenting problems is important for timely prevention. The SPARK36 (Structured Problem Analysis of Raising Kids aged 36 months) is a novel broad-scope structured interview guide aimed at assessing parenting concerns and needs for support for child developmental and parenting problems, using the parental and professional's (Youth Health Care nurses) perspective. The applicability of the SPARK36 in practice was already demonstrated. Our aim was to evaluate its known groups validity. SPARK36 data were collected in a cross-sectional study in 2020-2021. The known groups validity was assessed by testing two hypotheses: the SPARK36 risk assessment shows a higher risk of parenting and child developmental problems in children (1) from parents with a lower socioeconomic status and (2) from families with ≥4 risk factors for child maltreatment. To test the hypotheses, Fisher's exact tests were applied. In total, 29 Youth Health Care nurses from four School Health Services performed SPARK36-led consultations with 599 parent-child pairs to assess the risk for child developmental and parenting problems. Both hypotheses were accepted at a significant p level. The results of the known groups validity support the hypothesis that the SPARK36 risk assessment for child developmental and parenting problems is carried out in a valid way. Future research is needed to assess other aspects of the validity and reliability of the SPARK36. This is a first step in validating the instrument for use during a nurse-led consultation with parents of 3-year-olds in Flemish School Health Services. Thereby, SPARK36 supports the nurses in accomplishing their assignment, making a risk assessment, and contributes to quality of care. This study aimed to evaluate the known groups validity of the SPARK36. Therefore, it was not conducted using input from the public or the patient population.

Risk factors of self-reported physical child abuse during the COVID-19 pandemic in Japan: work-related changes in men and fear of COVID-19 in women.

There is no global consensus on whether pandemic-related factors are related to child abuse. How the pandemic reinforces the risk factors of child abuse might depend largely on individuals' current and past lifestyles in each country. Some changes of lifestyles continue after the pandemic, and it is important to understand which factors are strongly associated with child abuse. We analyzed the pandemic-related characteristics of offenders and non-offenders of self-reported child physical abuse from Internet survey data in Japan and discussed how the pandemic affected physical child abuse and what caused the difference by gender. We conducted a cross-sectional study on physical child abuse by caregivers based on the Internet survey conducted from September to October 2021. We divided the participants who were living with their child aged less than 14 years into offenders and non-offenders based on the answer to the question about physical child abuse. The population distribution of the sample was compared to that of caregivers under the same conditions in a large Japanese dataset. The association between their characteristics and physical child abuse was analyzed by univariable and multivariable analysis. The caregivers analyzed in the cohort had similar population distributions to those in the large Japanese dataset. As risk factors of male offenders, "work from home 4-7 days/week," "decreased work," "normal relationships with household members (compared to good relationships)," "COVID-19 infected, both themselves and household members, within a year," "unwillingness to receive COVID-19 vaccination because the license process of the vaccine is doubtful," "high levels of benevolent sexism," and "history of child abuse" were observed. As risk factors of female offenders, "bad relationships with household members (compared to good relationships)," "fear of COVID-19," "COVID-19 infected, both themselves and household members, within a year," "feelings of discrimination related to COVID-19 in the past two months," and "history of child verbal abuse" were observed. Among male offenders, a significant relationship was observed regarding work-related changes, which may have been reinforced by the pandemic. Furthermore, the extent of the influence and fear of losing jobs caused by these changes may have varied according to the strength of gender roles and financial support in each country. Among female offenders, a significant relationship was observed regarding fear of infection itself, which is consistent with the findings of other studies. In terms of factors related to dissatisfaction with families, in some countries with prominent stereotyped gender roles, men are thought to experience difficulties adapting to work-related changes induced by crises, while women are thought to experience intense fear of the infection itself.