The association between child maltreatment and health risk behaviours and conditions throughout life in the Australian Child Maltreatment Study.

OBJECTIVE: To estimate associations between all five types of child maltreatment (emotional abuse, neglect, physical abuse, sexual abuse, and exposure to domestic violence) and health risk behaviours and conditions. DESIGN, SETTING, PARTICIPANTS: Nationally representative survey of Australian residents aged 16 years and older conducted by computer-assisted telephone interviewing. MAIN OUTCOME MEASURES: Associations between child maltreatment and the following health risk behaviours and conditions: current smoker, binge drinking (at least weekly in past 12 months), cannabis dependence (according to the Cannabis Severity of Dependence Scale), obesity (based on body mass index), self-harm in past 12 months, and suicide attempt in past 12 months. RESULTS: A total of 8503 participants completed the survey. All five types of child maltreatment were associated with increased rates of all of the health risk behaviours and conditions that we considered. The strongest associations were in the youngest age group (16-24-year-olds). Sexual abuse and emotional abuse were associated with the highest odds of health risk behaviours and conditions. Cannabis dependence, self-harm and suicide attempts were most strongly associated with child maltreatment. Experiencing more than one type of child maltreatment was associated with higher rates of health risk behaviours and conditions than experiencing one type of child maltreatment. CONCLUSIONS: Child maltreatment is associated with substantially increased rates of health risk behaviours and conditions. Prevention and intervention efforts should be informed by trauma histories, and holistic psychosocial care should be incorporated into programs focusing on behaviour change.

What type of survey research questions are identified by adults as upsetting? A focus on child maltreatment.

BACKGROUND: Research on child maltreatment is imperative to inform evidence-based prevention and intervention efforts. Nonetheless, researchers continue to face barriers due to the perceived sensitivity and possibility of harm when asking about these experiences. While studies have started to explore reactions to participating in research on sensitive topics, there are notable limitations and fewer have focused on child maltreatment. OBJECTIVE: The objective of this study was to better understand adult respondents' identification of, and reactions to, potentially upsetting questions in the context of a well-being and experiences survey, with a focus on child maltreatment. METHODS: Data were from the first wave of the Well-Being and Experiences Study in Manitoba, Canada: a computerized self-reported community-based survey of adolescents and their parents/caregivers administered individually at a research facility. The current study focused on parents/caregivers' responses (N = 1000). The study utilized a mixed methods approach with descriptive statistics and qualitative thematic analyses of open-ended responses of their perceptions of upsetting questions. RESULTS: Overall, few respondents (15.1 %) identified any questions as upsetting. Ten themes emerged in respondents' recall of upsetting questions, including maltreatment and other themes often perceived as less sensitive. Only 4% identified maltreatment-related questions as upsetting. Among those who identified any questions or maltreatment-specific questions as upsetting, most felt they were important to ask and should not be removed (92.7 %-97.5 %). These findings suggest that retrospective survey questions about experiences of child maltreatment involving adult samples are not associated with major upset and should be included in future health and social surveys.