Population-Based Estimates of Associations Between Child Maltreatment Types: A Meta-Analysis

Abstract

Although it is accepted that experiences of child maltreatment are multidimensional and often include several correlated but distinct experiences, many clinical and research decisions regarding exposure and treatment do not consider their potential overlap or potential independence. The purpose of this meta-analysis-using a single retrospective self-report measure, the Childhood Trauma Questionnaire (CTQ), in population-representative samples-was to investigate the magnitude and specificity of associations between forms of child maltreatment. A systematic review of studies available on PubMed, PsycINFO, and Google Scholar was conducted, resulting in the inclusion of nine journal articles, 11 independent samples, and 25,415 participants. Data were converted from Pearson correlations to Z statistics and pooled using a random effects model. All maltreatment types were positively and significantly associated. Effect sizes varied from medium to large, with (1) physical abuse and emotional abuse (Z = 0.72, 95% CI [.48, .96]), (2) physical neglect and emotional neglect (Z = 0.62, 95% CI [.43, .81]), and (3) emotional abuse and emotional neglect (Z = 0.54, 95% CI [.35, .72]) demonstrating the strongest associations. These analyses provide evidence of the associations between types of child maltreatment, indicate the likelihood of shared risk, and point to characteristics that may link different types of maltreatment. These findings have important clinical implications as they may help guide comprehensive screening for associated maltreatment types as well as intervention and prevention efforts. Limitations include the relatively few studies included and those associated with the CTQ-a retrospective, self-report measure that does not account for the concurrence of experiences.

Keywords: Childhood Trauma Questionnaire; abuse; child maltreatment; meta-analysis; neglect.