Background

Although children with histories of maltreament are more likely to engage with mental healthcare than non-maltreated children, few studies have examined the impact of maltreatment on children's mental health outcome improvement over time.

Objective

The current study addresses this gap in the present literature by exploring the ways that histories of physical, sexual, and emotional abuse and exposure to domestic violence can influence children's improvement on mental health outcomes commonly associated with trauma.

Participants and setting

De-identified routine care data from 58 community mental health agencies across Ontario, Canada, representing 16,517 children was obtained. This data represented assessments that occurred between February 2015 and December 2021.

Methods

General linear models were used to illustrate the effect of each trauma type on change scores computed between baseline and follow-up assessments of externalizing behaviours, risk of harm to others, depressive symptoms, risk of suicide and self-harm, and anxiety, while adjusting for baseline scores, inpatient status, time between assessments, and select demographic variables.

Results

When the effects of each trauma type was considered separately, children without histories of trauma consistently showed greater improvement than those with that trauma across all mental health outcomes (0.07–0.44, p < 0.01). When all trauma types were considered together, sexual abuse was associated with some of the most significant negative impacts on children's mental health improvements.

Conclusions

Our findings highlight an urgent need for the implementation of standardized, evidence-based assessments that screen trauma histories of children accessing mental health supports and research examining the impact of trauma on children's treatment responsiveness.

中文翻译：

---

虐待儿童对获得社区心理健康护理的儿童和青少年心理健康结果改善的影响

背景

尽管有虐待史的儿童比未受虐待的儿童更有可能参与心理保健，但很少有研究调查虐待对儿童心理健康结果随时间改善的影响。

客观的

目前的研究通过探索身体、性和情感虐待的历史以及接触家庭暴力如何影响儿童改善通常与创伤相关的心理健康结果，从而解决了现有文献中的这一差距。

参与者和设置

获得了来自加拿大安大略省 58 个社区心理健康机构的去识别化常规护理数据，代表 16,517 名儿童。该数据代表了 2015 年 2 月至 2021 年 12 月之间发生的评估。

方法

一般线性模型用于说明每种创伤类型对基线和后续外化行为评估、伤害他人的风险、抑郁症状、自杀和自残风险以及焦虑之间计算的变化分数的影响，同时调整用于基线分数、住院状态、评估之间的时间以及选择人口统计变量。

结果

当分别考虑每种创伤类型的影响时，没有创伤史的儿童在所有心理健康结果方面始终比有创伤的儿童表现出更大的改善 (0.07–0.44，p  < 0.01)。当所有创伤类型一起考虑时，性虐待与对儿童心理健康改善的一些最显着的负面影响有关。

结论

我们的研究结果强调迫切需要实施标准化的、基于证据的评估，以筛选获得心理健康支持的儿童的创伤史，并研究创伤对儿童治疗反应的影响。