title: Experience by children and adolescents of more than one type of maltreatment: Association of different classes of maltreatment profiles with clinical outcome variables.
abstract: Most victims of child abuse have experienced more than one type of maltreatment, yet there is a lack of understanding of the impact of specific combinations of types of maltreatment. This study aimed to identify meaningful classes of maltreatment profiles and to associate them with short-term clinical outcomes. A total of 358 German children and adolescents aged 4-17 with a known history of child maltreatment were included in the study. Through interviews and questionnaires, information was obtained from participants and their primary caregivers on history of maltreatment, sociodemographics, psychopathology, level of psychosocial functioning, and health-related quality of life. Types of abuse were categorized into six major groups: sexual abuse in general, sexual abuse with penetration, physical abuse, emotional abuse, neglect, and exposure to domestic violence. A latent class analysis (LCA) was performed to determine distinct multi-type maltreatment profiles, which were then assessed for their associations with the sociodemographic and clinical outcome variables. The LCA revealed that participants could be categorized into three meaningful classes according to history of maltreatment: (1) experience of multiple types of maltreatment excluding sexual abuse (63.1%), (2) experience of multiple types of maltreatment including sexual abuse (26.5%), and (3) experience of predominantly sexual abuse (10.3%). Members of Class 2 showed significantly worse short-term outcomes on psychopathology, level of functioning, and quality of life compared to the other classes. Three distinct profiles of multiple types of maltreatment were empirically identified in this sample. Exposure to multiple types of abuse was associated with poorer outcomes.
authors.affiliation: University of Ulm, Department of Child and Adolescent Psychiatry/Psychotherapy, Germany. Electronic address: Andreas.Witt@uniklinik-ulm.de.
authors.forename: Andreas
authors.initials: A
authors.lastname: Witt
authors.affiliation: University of Ulm, Department of Child and Adolescent Psychiatry/Psychotherapy, Germany.
authors.forename: Annika
authors.initials: A
authors.lastname: Münzer
authors.affiliation: University of Ulm, Department of Child and Adolescent Psychiatry/Psychotherapy, Germany.
authors.forename: Helene G
authors.initials: HG
authors.lastname: Ganser
authors.affiliation: University of Ulm, Department of Child and Adolescent Psychiatry/Psychotherapy, Germany.
authors.forename: Jörg M
authors.initials: JM
authors.lastname: Fegert
authors.affiliation: University of Ulm, Department of Child and Adolescent Psychiatry/Psychotherapy, Germany.
authors.forename: Lutz
authors.initials: L
authors.lastname: Goldbeck
authors.affiliation: University of Ulm, Department of Child and Adolescent Psychiatry/Psychotherapy, Germany.
authors.forename: Paul L
authors.initials: PL
authors.lastname: Plener
mesh_terms: D000293:Adolescent; D001499:Bayes Theorem; D002648:Child; D002649:Child Abuse / Q000145:classification* / Q000523:psychology*; D002675:Child, Preschool; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D011379:Prognosis; D011594:Psychometrics; D011788:Quality of Life
keywords: Child abuse and neglect; Child maltreatment; Latent class analysis; Multi-type maltreatment; Psychological outcomes