title: Burden attributable to child maltreatment in Australia.
abstract: Child maltreatment is a complex phenomenon, with four main types (childhood sexual abuse, physical abuse, emotional abuse, and neglect) highly interrelated. All types of maltreatment have been linked to adverse health consequences and exposure to multiple forms of maltreatment increases risk. In Australia to date, only burden attributable to childhood sexual abuse has been estimated. This study synthesized the national evidence and quantified the burden attributable to the four main types of child maltreatment. Meta-analyses, based on quality-effects models, generated pooled prevalence estimates for each maltreatment type. Exposure to child maltreatment was examined as a risk factor for depressive disorders, anxiety disorders and intentional self-harm using counterfactual estimation and comparative risk assessment methods. Adjustments were made for co-occurrence of multiple forms of child maltreatment. Overall, an estimated 23.5% of self-harm, 20.9% of anxiety disorders and 15.7% of depressive disorders burden in males; and 33.0% of self-harm, 30.6% of anxiety disorders and 22.8% of depressive disorders burden in females was attributable to child maltreatment. Child maltreatment was estimated to cause 1.4% (95% uncertainty interval 0.4-2.3%) of all disability-adjusted life years (DALYs) in males, and 2.4% (0.7-4.1%) of all DALYs in females in Australia in 2010. Child maltreatment contributes to a substantial proportion of burden from depressive and anxiety disorders and intentional self-harm in Australia. This study demonstrates the importance of including all forms of child maltreatment as risk factors in future burden of disease studies.
authors.affiliation: School of Public Health, University of Queensland, Herston, QLD, Australia.
authors.forename: Sophie E
authors.initials: SE
authors.lastname: Moore
authors.affiliation: Metro North Mental Health, Royal Brisbane and Women's Hospital, Herston, QLD 4029 Australia; The University of Queensland Centre for Clinical Research, Herston, QLD 4029 Australia.
authors.forename: James G
authors.initials: JG
authors.lastname: Scott
authors.affiliation: School of Public Health, University of Queensland, Herston, QLD, Australia; Queensland Centre for Mental Health Research, Wacol, QLD, Australia; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
authors.forename: Alize J
authors.initials: AJ
authors.lastname: Ferrari
authors.affiliation: Department of Paediatrics, Logan Hospital, Metro South Hospital and Health Service, QLD, Australia; School of Medicine, University of Queensland, Herston, QLD, Australia.
authors.forename: Ryan
authors.initials: R
authors.lastname: Mills
authors.affiliation: Children and Youth Research Centre, School of Public Health and Social Work, Queensland University of Technology, QLD, Australia.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Dunne
authors.affiliation: School of Public Health, University of Queensland, Herston, QLD, Australia; Queensland Centre for Mental Health Research, Wacol, QLD, Australia; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
authors.forename: Holly E
authors.initials: HE
authors.lastname: Erskine
authors.affiliation: Gender Violence and Health Centre, London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Karen M
authors.initials: KM
authors.lastname: Devries
authors.affiliation: Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; University of New South Wales, National Drug and Alcohol Research Centre, Sydney, NSW, Australia; Melbourne School of Population and Global Health, University of Melbourne, Melbourne VIC 3010, Australia.
authors.forename: Louisa
authors.initials: L
authors.lastname: Degenhardt
authors.affiliation: Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
authors.forename: Theo
authors.initials: T
authors.lastname: Vos
authors.affiliation: School of Public Health, University of Queensland, Herston, QLD, Australia; Queensland Centre for Mental Health Research, Wacol, QLD, Australia; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
authors.forename: Harvey A
authors.initials: HA
authors.lastname: Whiteford
authors.affiliation: School of Criminology and Criminal Justice, Griffith University, Australia.
authors.forename: Molly
authors.initials: M
authors.lastname: McCarthy
authors.affiliation: Institute of Health and Biomedical Innovation, Queensland University of Technology, QLD, Australia; School of Public Health and Social Work, Queensland University of Technology, QLD, Australia.
authors.forename: Rosana E
authors.initials: RE
authors.lastname: Norman
mesh_terms: D000293:Adolescent; D000328:Adult; D001008:Anxiety Disorders / Q000453:epidemiology* / Q000523:psychology; D001315:Australia / Q000453:epidemiology; D002648:Child; D002649:Child Abuse / Q000523:psychology* / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000066550:Physical Abuse / Q000523:psychology*; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000453:epidemiology / Q000523:psychology; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Anxiety disorders; Australia; Child emotional abuse; Child maltreatment; Child neglect; Child physical abuse; Child sexual abuse; Depressive disorders; Intentional self-harm