Prevalence of mental disorders among Australian females: Comparison according to motherhood status using Australian birth cohort data.

PURPOSE: Studies examining mental disorders among women have primarily focused on either depression, anxiety, or substance use disorders and not included the broader spectrum of mental disorders. Mixed evidence exists on the prevalence rates of mental disorders among mothers. This study compares the prevalence of different mental disorders and mental comorbidities between mothers and non-mothers and assesses correlates of mental disorders among mothers. METHODS: A population-based birth cohort design was adopted, consisting of 40,416 females born in Queensland, Australia, in 1983/84. Linked administrative data from hospital admissions were used to identify mental disorders. Cumulative incidence curves of different mental disorders were created separately for mothers and non-mothers. RESULTS: Mental disorder prevalence among females by age 29-31 years was 7.8% (11.0% for mothers and 5.2% for non-mothers). Mothers were overrepresented in almost all categories of mental disorders, with overrepresentation becoming more pronounced with age. Mothers with a mental disorder were more likely to be unmarried, Indigenous, young at birth of first child, have greater disadvantage, and have a single child, compared to mothers without a mental disorder. Nearly half of the mothers (46.9%) had received a mental disorder diagnosis before having their first child. CONCLUSIONS: Mothers, particularly unmarried, Indigenous, having greater disadvantage, and younger at birth of first child, represent a unique group with high vulnerability to mental disorders, that begins in childhood and is amplified with age. Presence of significant mental disorder comorbidities among females highlights the critical importance of a comprehensive, integrated approach to prevent and address multiple comorbidities.

Mental Disorders Among Mothers in Contact with the Criminal Justice System: A Scoping Review and Meta-analysis.

This scoping review critically assessed evidence regarding mental disorders among mothers involved with the criminal justice system (CJS) and provided pooled prevalence rates of mental disorders. In total, 27 studies were included in the review, with 23 studies from the United States of America and 26 focused on incarcerated mothers. The findings supported the evidence on substantial burden of mental disorders, among CJS-involved mothers. Several factors contributing to mental disorders were identified, including history of abuse/incarceration/mental illness, a greater number of pregnancies, child-rearing responsibilities, less contact with children, and poor social support, which were organised using a socioecological model. However, significant gaps in the current evidence base were apparent, including inconsistencies in methodologies and outcomes assessed and a lack of large, longitudinal studies. The study highlights the importance of high-quality longitudinal research to extend knowledge around causal pathways between different risk or protective factors and mental disorders among CJS-involved mothers.

Child Sexual Abuse Victimization Amongst Detained Adolescents and Incarcerated Young Adults: Findings from an Australian Population-Based Birth Cohort Study.

To guide prevention and intervention efforts, the prevalence and impact of child sexual abuse (CSA) victimization among detained and incarcerated populations requires further examination, particularly with consideration of multi-type maltreatment experiences and sex-based variations. This longitudinal population-based study explores these relationships in an Australian birth cohort comprising all individuals born in Queensland in 1983 and 1984 (n = 82,409; 48.68% female). Data include all notified and substantiated harm(s) from child protection services (0 to 17 years), and sentences to youth detention and/or adult incarceration between ages 10 and 30. Findings indicate greater prevalence of CSA amongst detained/incarcerated individuals compared to the general population but emphasize the impact of cooccurring maltreatment (particularly neglect) on the likelihood of custodial outcomes. Important sex-based differences were noted in the intersection of CSA victimization and detention/incarceration. Findings reinforce the need for trauma-informed practices when working with custodial populations, particularly females, and highlight opportunities for prevention of detention/incarceration in at-risk populations, in line with a broader public health approach to child protection.

Psychiatric illness and the risk of reoffending: recurrent event analysis for an Australian birth cohort.

BACKGROUND: Psychiatric illness is a well-established risk factor for criminal justice system involvement, but less is known about the relationships between specific psychiatric illnesses and reoffending. Research typically examines reoffending as a single discrete event. We examined the relationship between different psychiatric disorders and types of reoffending while accounting for multiple reoffending events over time. METHODS: Data were drawn from a population cohort of 83,039 individuals born in Queensland, Australia, in 1983 and 1984 and followed to age 29-31 years. Psychiatric diagnoses were drawn from inpatient health records and offending information was drawn from court records. Descriptive and recurrent event survival analyses were conducted to examine the association between psychiatric disorders and reoffending. RESULTS: The cohort included 26,651 individuals with at least one proven offence, with 3,580 (13.4%) of these individuals also having a psychiatric disorder. Individuals with any psychiatric disorder were more likely to reoffend compared to those without a disorder (73.1% vs. 56.0%). Associations between psychiatric disorders and reoffending varied across age. Individuals with a psychiatric disorder only started to accumulate more reoffending events from ~ 27 years, which accelerated up to age 31 years. There were both specificity and common effects in the associations between different psychiatric disorders and types of reoffending. CONCLUSIONS: Findings demonstrate the complexity and temporal dependency of the relationship between psychiatric illness and reoffending. These results reveal the heterogeneity present among individuals who experience psychiatric illness and contact with the justice system, with implications for intervention delivery, particularly for those with substance use disorders.

Psychiatric disorders and offending in an Australian birth cohort: Overrepresentation in the health and criminal justice systems for Indigenous Australians.

OBJECTIVE: Most studies that examine psychiatric illness in people who offend have focused on incarcerated samples, with little known about the larger population of individuals with criminal justice system contact. We examine the overlap between proven offences and psychiatric diagnoses with an emphasis on experiences for Indigenous Australians. METHODS: In a population-based birth cohort of 45,141 individuals born in Queensland, Australia, in 1990 (6.3% Indigenous), psychiatric diagnoses were identified from hospital admissions between ages 4/5 and 23/24 years and proven offences were identified from court records (spanning ages 10-24 years). Prevalence rates for offending, psychiatric diagnoses and their overlap were examined for Indigenous and non-Indigenous individuals. Associations between specific psychiatric diagnoses and types of offending were examined using logistic regressions. RESULTS: There were 11,134 (24.7%) individuals with a finalised court appearance, 2937 (6.5%) with a diagnosed psychiatric disorder and 1556 (3.4%) with a proven offence and diagnosed psychiatric disorder, with Indigenous Australians significantly overrepresented across all outcomes. Compared with non-Indigenous Australians, Indigenous Australians were younger at their first court finalisation (Cohen's d = -0.62, 95% confidence interval = [-0.67, -0.57]), experienced a higher number of finalisations (d = 0.94, 95% confidence interval = [0.89, 1.00]) and offences (d = 0.64, 95% confidence interval = [0.59, 0.69]) and were more likely to receive custodial (d = 0.41, 95% confidence interval = [0.36, 0.46]) or supervised (d = 0.55, 95% confidence interval = [0.50, 0.60]) sentences. The overlap between offending and psychiatric illness was more pronounced for Indigenous Australians compared with non-Indigenous Australians (14.8% vs 2.7%). Substance use disorders were the most prevalent psychiatric diagnosis among individuals with a court finalisation (9.2%). CONCLUSIONS: Indigenous Australians were significantly overrepresented in court finalisations and psychiatric diagnoses. Indigenous Australians with a psychiatric diagnosis were at highest risk of experiencing a court appearance, emphasising the importance of culturally appropriate mental health responses being embedded into the criminal justice system.

Intergenerational (Dis)continuity of Child Maltreatment: Variation by Parents' Childhood Victimization Experiences and Sex.

This longitudinal population-based study examines the association between maltreatment victimization experiences and the likelihood of intergenerational (dis)continuity of maltreatment. Our data include all individuals born in 1983/1984 in Queensland (QLD), Australia who are registered as parents via birth records and who experienced system contacts for maltreatment victimization in childhood (n = 2906). Child safety data on system contacts as a child victim and person responsible for harm to a child were obtained from the Department of Children, Youth Justice and Multicultural Affairs. Out-of-home care experiences and maltreatment frequency, timing, and type were examined. Results indicated that childhood maltreatment experiences significantly differed between parents who were not subsequently responsible for harm to a child (cycle breakers) and parents who were subsequently responsible for harm to a child (cycle maintainers). Different patterns of association were observed across sex. These findings highlight the importance of recognizing the heterogeneity of victim maltreatment experiences and associated risk of maltreatment for their children, and can inform effective and targeted interventions by tailoring these by sex and developmental period.

Intimate partner violence: the effect of gender and contextual factors on community perceptions of harm, and suggested victim and criminal justice responses.

Using a vignette to depict physical violence by an intimate partner, a 2 (perpetrator gender) X 2 (participant gender) X 2 (frequency) X 2 (intent to cause harm) between subjects factorial design was used to examine under what circumstances individuals perceive: an incident should be illegal, the extent of harm, and appropriate victim and criminal justice responses. There were 868 participants from the Brisbane (Australia) community (48.5% males). The actions of male perpetrators were viewed more seriously and the victims were recommended to seek more forms of assistance when the perpetrator was male. There were few differences in perceptions of violence according to participant gender. The frequency of the violence affected the participant's responses but the intentions of the perpetrator did not. Results are discussed in terms of stereotypes of intimate partner violence (IPV) and the implications for help-seeking behavior by victims.

Prevalence of psychiatric disorders for Indigenous Australians: a population-based birth cohort study.

AIMS: Limited information exists about the prevalence of psychiatric illness for Indigenous Australians. This study examines the prevalence of diagnosed psychiatric disorders in Indigenous Australians and compares this to non-Indigenous Australians. The aims were to: (1) determine prevalence rates for psychiatric diagnoses for Indigenous Australians admitted to hospital; and (2) examine whether the profile of psychiatric diagnoses for Indigenous Australians was different compared with non-Indigenous Australians. METHODS: A birth cohort design was adopted, with the population consisting of 45 141 individuals born in the Australian State of Queensland in 1990 (6.3% Indigenous). Linked administrative data from Queensland Health hospital admissions were used to identify psychiatric diagnoses from age 4/5 to 23/24 years. Crude lifetime prevalence rates of psychiatric diagnoses for Indigenous and non-Indigenous individuals were derived from the hospital admissions data. The cumulative incidence of psychiatric diagnoses was modelled separately for Indigenous and non-Indigenous individuals. Logistic regression was used to model differences between Indigenous and non-Indigenous psychiatric presentations while controlling for sociodemographic characteristics. RESULTS: There were 2783 (6.2%) individuals in the cohort with a diagnosed psychiatric disorder from a hospital admission. The prevalence of any psychiatric diagnosis at age 23/24 years was 17.2% (491) for Indigenous Australians compared with 5.4% (2292) for non-Indigenous Australians. Indigenous individuals were diagnosed earlier, with overrepresentation in psychiatric illness becoming more pronounced with age. Indigenous individuals were overrepresented in almost all categories of psychiatric disorder and this was most pronounced for substance use disorders (SUDs) (12.2 v. 2.6% of Indigenous and non-Indigenous individuals, respectively). Differences between Indigenous and non-Indigenous Australians in the likelihood of psychiatric disorders were not statistically significant after controlling for sociodemographic characteristics, except for SUDs. CONCLUSIONS: There is significant inequality in psychiatric morbidity between Indigenous and non-Indigenous Australians across most forms of psychiatric illness that is evident from an early age and becomes more pronounced with age. SUDs are particularly prevalent, highlighting the importance of appropriate interventions to prevent and address these problems. Inequalities in mental health may be driven by socioeconomic disadvantage experienced by Indigenous individuals.

"Who maltreats? Distinct pathways of intergenerational (dis)continuity of child maltreatment".

BACKGROUND: Maltreatment victimization history is an established risk factor for child maltreatment across generations. However, many parents with a victimization history do not maltreat, and many parents with no victimization history do have victimized children. OBJECTIVES: To understand differences in demographic and maltreatment risk factors across the following intergenerational patterns of maltreatment: cycle maintainers, cycle breakers, cycle initiators, and a comparison group (no maltreatment). PARTICIPANTS AND SETTING: Data were drawn from a large population-based cohort in Queensland, Australia and included 32,574 biological parents and their children. Maltreatment experiences as a victim or person responsible for harm towards a child were obtained from the Queensland Child Protection System. METHODS: Multinomial regression was completed with the full sample to compare the three maltreatment groups with the comparison group. Logistic regressions were conducted on all pairwise combinations of maltreatment groups. Models accounted for several demographic and maltreatment factors. RESULTS: Compared with breakers, maintainers were more likely to be Indigenous (OR = 1.86), never married (OR = 0.34), younger at first birth (OR = 0.87), have ≥3 children (OR = 1.99), be younger at first-and older at last-maltreatment victimization (ORs = 0.97 and 1.07, respectively), and experience a higher frequency of victimization (OR = 1.05). Amongst maltreaters, males were significantly more likely to be initiators while females were more likely to be maintainers (OR = .62). There were few other differences between initiators and maintainers. CONCLUSIONS: Meaningful differences among the three maltreatment groups were revealed suggesting that research should focus on the intergenerational discontinuity of maltreatment.