title: Effects of the child-perpetrator relationship on mental health outcomes of child abuse: it's (not) all relative.
abstract: The present study was conducted to better understand the influence of the child-perpetrator relationship on responses to child sexual and physical trauma for a relatively large, ethnically diverse sample of children and youth presenting for clinical evaluation and treatment at child mental health centers across the United States. This referred sample includes 2,133 youth with sexual or physical trauma as their primary treatment focus. Analyses were conducted to ascertain whether outcomes were dependent on the perpetrator's status as a caregiver vs. non-caregiver. Outcome measures included psychiatric symptom and behavior problem rating scales. For sexual trauma, victimization by a non-caregiver was associated with higher posttraumatic stress, internalizing and externalizing behavior problems, depression, and dissociation compared to youth victimized by a caregiver. For physical trauma, victimization by a non-caregiver was also associated with higher posttraumatic symptoms and internalizing behavior problems. The total number of trauma types experienced and age of physical or sexual trauma onset also predicted several outcomes for both groups, although in disparate ways. These findings are consistent with other recent studies demonstrating that perpetration of abuse by caregivers results in fewer symptoms and problems than abuse perpetrated by a non-caregiving relative. Thus, clinicians should not make a priori assumptions that children and adolescents who are traumatized by a parent/caregiver would have more severe symptoms than youth who are traumatized by a non-caregiver. Further exploration of the role of the perpetrator and other trauma characteristics associated with the perpetrator role is needed to advance our understanding of these findings and their implications for clinical practice.
authors.affiliation: University of Maryland School of Medicine, Division of Psychiatric Services Research, Department of Psychiatry, 737 West Lombard Street, Fifth Floor, Baltimore, MD 21201, USA.
authors.forename: Laurel J
authors.initials: LJ
authors.lastname: Kiser
authors.affiliation: University of South Florida, Mental Health Law and Policy Department, 13301 Bruce B. Downs Blvd., Tampa, FL 33612, USA; Yale University Child Study Center, 230 South Frontage Road, New Haven, CT 06520, USA.
authors.forename: Carla Smith
authors.initials: CS
authors.lastname: Stover
authors.affiliation: Boston University School of Medicine, Mental Health Counseling and Behavioral Medicine Program, 72 East Concord Street, Suite B-2903, Boston, MA 02118-2526, USA.
authors.forename: Carryl P
authors.initials: CP
authors.lastname: Navalta
authors.affiliation: University of California, San Francisco, Child and Adolescent Services, Department of Psychiatry, San Francisco General Hospital, Box 0852, SFGH CAS, San Francisco, CA 94110-0852, USA.
authors.forename: Joyce
authors.initials: J
authors.lastname: Dorado
authors.affiliation: North Shore Hospital/Zucker Hillside Hospital, Department of Psychiatry, 400 Community Drive, Manhasset, NY 11030, USA.
authors.forename: Juliet M
authors.initials: JM
authors.lastname: Vogel
authors.affiliation: University of Illinois at Chicago, Institute for Juvenile Research (MC 747), Department of Psychiatry, 1747 West Roosevelt Road, Room 155, Chicago, IL 60608-1264, USA.
authors.forename: Jaleel K
authors.initials: JK
authors.lastname: Abdul-Adil
authors.affiliation: University of California, Los Angeles, Department of Biostatistics, UCLA School of Public Health, Los Angeles, CA 90095-1772, USA.
authors.forename: Soeun
authors.initials: S
authors.lastname: Kim
authors.affiliation: Duke University Medical Center, National Center for Child Traumatic Stress, 411 West Chapel Hill Street, Suite 200, Durham, NC 27701, USA.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Lee
authors.affiliation: University of Maryland, Department of Psychiatry, 701 West Pratt Street, Baltimore, MD 21201, USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Vivrette
authors.affiliation: Duke University School of Medicine, UCLA-Duke National Center for Child Traumatic Stress, 411 West Chapel Hill Street, Suite 200, Durham, NC 27701, USA.
authors.forename: Ernestine C
authors.initials: EC
authors.lastname: Briggs
mesh_terms: D000293:Adolescent; D017028:Caregivers / Q000523:psychology*; D002648:Child; D002649:Child Abuse / Q000523:psychology*; D057237:Criminals / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D013315:Stress, Psychological; D014481:United States
keywords: Child abuse; Child traumatic stress; Child–perpetrator relationship; Mental health outcomes