A 12-year prospective study of the long-term effects of early child physical maltreatment on psychological, behavioral, and academic problems in adolescence

Abstract

Objective: To determine whether child physical maltreatment early in life has long-term effects on psychological, behavioral, and academic problems independent of other characteristics associated with maltreatment.

Design: Prospective longitudinal study with data collected annually from 1987 through 1999.

Setting and participants: Randomly selected, community-based samples of 585 children from the ongoing Child Development Project were recruited the summer before children entered kindergarten in 3 geographic sites. Seventy-nine percent continued to participate in grade 11. The initial in-home interviews revealed that 69 children (11.8%) had experienced physical maltreatment prior to kindergarten matriculation.

Main outcome measures: Adolescent assessment of school grades, standardized test scores, absences, suspensions, aggression, anxiety/depression, other psychological problems, drug use, trouble with police, pregnancy, running away, gang membership, and educational aspirations.

Results: Adolescents maltreated early in life were absent from school more than 1.5 as many days, were less likely to anticipate attending college compared with nonmaltreated adolescents, and had levels of aggression, anxiety/depression, dissociation, posttraumatic stress disorder symptoms, social problems, thought problems, and social withdrawal that were on average more than three quarters of an SD higher than those of their nonmaltreated counterparts. The findings held after controlling for family and child characteristics correlated with maltreatment.

Conclusions: Early physical maltreatment predicts adolescent psychological and behavioral problems, beyond the effects of other factors associated with maltreatment. Undetected early physical maltreatment in community populations represents a major problem worthy of prevention.

Figure 1

Representative significant maltreatment × gender interactions from analyses of covariance. School absences were obtained from official school records. Aggression and Anxiety/Depression subscale scores are from the mothers' reports. Note: Although not shown here, interactions were significant for subscales of Dissociation, PTSD, Social Problems, Thought Problems, and Social Withdrawal. These effects replicated those shown for Aggression and Anxiety/Depression. The bar represents the group mean with SE.

Figure 2

Significant maltreatment × ethnicity interactions from analyses of covariance. School absences and suspensions were obtained from official school records. Behavior problems were determined from adolescent reports. The bar represents the group mean with SE.

Figure 3

Number of psychological and behavioral problems experienced by maltreated and nonmaltreated adolescents.