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      The neglect of child neglect: a meta-analytic review of the prevalence of neglect

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          Abstract

          Purpose

          The aim of the current meta-analysis was to provide an estimate of the prevalence of physical and emotional neglect by integrating prevalence figures from the body of research reporting on neglect. An attempt was also made to unravel the substantial variation in prevalence figures reported in primary studies by analyzing the effects of procedural factors and sample characteristics on combined prevalence rates.

          Methods

          Studies providing prevalence rates of child neglect were searched using electronic databases, exploring specialized journals, and by searching references of publications for other relevant studies. Data were extracted using a coding system. Intercoder reliability was satisfactory. A comprehensive meta-analysis was conducted.

          Results

          Child physical neglect prevalence rates were found for 13 independent samples with a total of 59,406 participants, and child emotional neglect prevalence rates were found for 16 independent samples with a total of 59,655 participants. The overall estimated prevalence was 163/1,000 for physical neglect, and 184/1,000 for emotional neglect, with no apparent gender differences. The influence of research design factors on the prevalence of physical neglect was more pronounced than on the prevalence of emotional neglect. Studies on physical neglect in ‘low-resource’ countries were conspicuously absent.

          Conclusions

          Child neglect is a problem of considerable extent, but seems to be a neglected type of maltreatment in scientific research. This is illustrated by the deplorable dearth of studies on child neglect, especially in low-resource countries. Recommendations for the design of future prevalence studies are proposed.

          Electronic supplementary material

          The online version of this article (doi:10.1007/s00127-012-0549-y) contains supplementary material, which is available to authorized users.

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          Most cited references28

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          Adverse childhood experiences and the risk of depressive disorders in adulthood.

          Research examining the association between childhood abuse and depressive disorders has frequently assessed abuse categorically, thus not permitting discernment of the cumulative impact of multiple types of abuse. As previous research has documented that adverse childhood experiences (ACEs) are highly interrelated, we examined the association between the number of such experiences (ACE score) and the risk of depressive disorders. Retrospective cohort study of 9460 adult health maintenance organization members in a primary care clinic in San Diego, CA who completed a survey addressing a variety of health-related concerns, which included standardized assessments of lifetime and recent depressive disorders, childhood abuse and household dysfunction. Lifetime prevalence of depressive disorders was 23%. Childhood emotional abuse increased risk for lifetime depressive disorders, with adjusted odds ratios (ORs) of 2.7 [95% confidence interval (CI), 2.3-3.2] in women and 2.5 (95% CI, 1.9-3.2) in men. We found a strong, dose-response relationship between the ACE score and the probability of lifetime and recent depressive disorders (P<0.0001). This relationship was attenuated slightly when a history of growing up with a mentally ill household member was included in the model, but remained significant (P<0.001). The number of ACEs has a graded relationship to both lifetime and recent depressive disorders. These results suggest that exposure to ACEs is associated with increased risk of depressive disorders up to decades after their occurrence. Early recognition of childhood abuse and appropriate intervention may thus play an important role in the prevention of depressive disorders throughout the life span.
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            Overlapping confidence intervals or standard error intervals: What do they mean in terms of statistical significance?

            We investigate the procedure of checking for overlap between confidence intervals or standard error intervals to draw conclusions regarding hypotheses about differences between population parameters. Mathematical expressions and algebraic manipulations are given, and computer simulations are performed to assess the usefulness of confidence and standard error intervals in this manner. We make recommendations for their use in situations in which standard tests of hypotheses do not exist. An example is given that tests this methodology for comparing effective dose levels in independent probit regressions, an application that is also pertinent to derivations of LC50s for insect pathogens and of detectability half-lives for prey proteins or DNA sequences in predator gut analysis.
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              Long-term consequences of child abuse and neglect on adult economic well-being.

              Child abuse and neglect represent major threats to child health and well-being; however, little is known about consequences for adult economic outcomes. Using a prospective cohort design, court substantiated cases of childhood physical and sexual abuse and neglect during 1967-1971 were matched with nonabused and nonneglected children and followed into adulthood (mean age 41). Outcome measures of economic status and productivity were assessed in 2003-2004 (N 1/4 807). Results indicate that adults with documented histories of childhood abuse and/or neglect have lower levels of education, employment, earnings, and fewer assets as adults, compared to matched control children. There is a 14% gap between individuals with histories of abuse/neglect and controls in the probability of employment in middle age, controlling for background characteristics. Maltreatment appears to affect men and women differently, with larger effects for women than men. These new findings demonstrate that abused and neglected children experience large and enduring economic consequences.
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                Author and article information

                Contributors
                +31-71-5273434 , vanijzen@fsw.leidenuniv.nl
                Journal
                Soc Psychiatry Psychiatr Epidemiol
                Soc Psychiatry Psychiatr Epidemiol
                Social Psychiatry and Psychiatric Epidemiology
                Springer-Verlag (Berlin/Heidelberg )
                0933-7954
                1433-9285
                15 July 2012
                15 July 2012
                March 2013
                : 48
                : 3
                : 345-355
                Affiliations
                Centre for Child and Family Studies, Leiden University, PO Box 9555, 2300 RB Leiden, The Netherlands
                Article
                549
                10.1007/s00127-012-0549-y
                3568479
                22797133
                cb2e5af2-7de0-45d4-a232-d9f6f6fcf451
                © The Author(s) 2012
                History
                : 29 November 2011
                : 21 June 2012
                Categories
                Original Paper
                Custom metadata
                © Springer-Verlag Berlin Heidelberg 2013

                Clinical Psychology & Psychiatry
                emotional neglect,epidemiology,meta-analysis,physical neglect
                Clinical Psychology & Psychiatry
                emotional neglect, epidemiology, meta-analysis, physical neglect

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