title: Child maltreatment and quality of life: a study of adolescents in residential care.
abstract: BACKGROUND
  Childhood maltreatment is an important risk factor for mental and physical health problems. Adolescents living in residential youth care (RYC) have experienced a high rate of childhood maltreatment and are a high-risk group for psychiatric disorders. Quality of life (QoL) is a subjective, multidimensional concept that goes beyond medical diagnoses. There is a lack of research regarding the associations between childhood maltreatment and QoL. In the present study, we compare self-reported QoL between adolescents in RYC in Norway with and without maltreatment histories, and adolescents from the general population. We also study the impact of number of types of adversities on QoL.
  
  
  METHODS
  Adolescents aged 12-23 years living in RYC in Norway were invited to participate in the study; 400 participated, yielding a response rate of 67 %. Maltreatment histories were assessed through interviews with trained research assistants, and completed by 335 adolescents. Previous exposure to maltreatment was reported by 237 adolescents. The Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents (KINDL-R) was used. Nonexposed peers in RYC (n = 98) and a sample of adolescents from the general population (n = 1017) were used for comparison. General linear model analyses (ANCOVA) were conducted with five KINDL-R life domains as dependent variables. Linear regression was used to study the effect of number of types of adversities.
  
  
  RESULTS
  Exposed adolescents in RYC reported poorer QoL than peers in control groups. Compared with nonexposed peers in RYC, the 95 % confidence intervals for mean score differences on the KINDL-R subdomains (0-100 scale) were 1.9-11.4 (Physical Well-being), 2.2-11.1 (Emotional Well-being), -0.7-10.0 (Self-esteem), and 1.8-10.9 (Friends). Compared with the general population sample, the 95 % confidence intervals for mean score differences were 9.7-17.6 (Physical Well-being), 7.9-15.3 (Emotional Well-being), 3.6-12.5 (Self-esteem), and 5.3-12.8 (Friends). Number of types of adversities was associated with a poorer QoL score on all subdomains (Physical- and Emotional Well-being, Self-esteem, Friends, and School).
  
  
  CONCLUSIONS
  Childhood maltreatment was associated with a poorer QoL score. We suggest the use of QoL and maltreatment measures for all children and adolescents in RYC.
authors.affiliation: Department of Child and Adolescent Psychiatry, St. Olavs Hospital, Pb 6810 Elgeseter, 7433, Trondheim, Norway. hanne.k.greger@ntnu.no.|Norwegian University of Science and Technology (NTNU), Faculty of Medicine, RKBU Central Norway, Pb 8905 MTFS, 7491, Trondheim, Norway. hanne.k.greger@ntnu.no.
authors.forename: Hanne Klæboe
authors.initials: HK
authors.lastname: Greger
authors.affiliation: Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), Faculty of Medicine, Pb 8905 MTFS, 7491, Trondheim, Norway.|Children's Clinic, St.Olavs Hospital, Pb 3250 Sluppen, 7006, Trondheim, Norway.
authors.forename: Arne Kristian
authors.initials: AK
authors.lastname: Myhre
authors.affiliation: Norwegian University of Science and Technology (NTNU), Faculty of Medicine, RKBU Central Norway, Pb 8905 MTFS, 7491, Trondheim, Norway.
authors.forename: Stian
authors.initials: S
authors.lastname: Lydersen
authors.affiliation: Department of Child and Adolescent Psychiatry, St. Olavs Hospital, Pb 6810 Elgeseter, 7433, Trondheim, Norway.|Norwegian University of Science and Technology (NTNU), Faculty of Medicine, RKBU Central Norway, Pb 8905 MTFS, 7491, Trondheim, Norway.
authors.forename: Thomas
authors.initials: T
authors.lastname: Jozefiak
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002649:Child Abuse / Q000523:psychology* / Q000706:statistics & numerical data*; D002652:Child Behavior / Q000523:psychology*; D002653:Child Behavior Disorders / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008603:Mental Health / Q000706:statistics & numerical data; D009664:Norway / Q000453:epidemiology; D011788:Quality of Life / Q000523:psychology*; D012112:Residential Facilities / Q000706:statistics & numerical data; D012307:Risk Factors; D012649:Self Concept; D057566:Self Report; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Adolescents; Child abuse; KINDL-R; Maltreatment; Quality of life; Residential care