Risk Factors for Abuse

The picture of child abuse is complex, with social, psychological, economic, and environmental factors all playing a part. Often there is evidence of family stress followed by a triggering event leading to abuse. Newberger (5) pinpointed the following three categories of predisposing family stress:

1. Child factors—disability, learning difficulties, behavior problems, adoption.

2. Parental factors—mental health problems, alcohol or drug abuse, domestic violence, previous abuse as a child.

3. Sociosituational factors—single parent, young parent, new partner, poverty, unemployment.

Gibbons et al. (6) studied children on the child protection registers in England and Wales (that is, children identified by agencies as at risk for significant harm and for whom a child protection plan had been developed) and found that domestic violence was recorded in more than one-fourth of cases. A substantial minority of parents had histories of mental illness, criminal behavior, or substance abuse. Substance abuse is more common worldwide and is associated with an elevated risk of neglect in the children of substance-abusing parents. Children with disabilities are at greater risk of becoming victims of abuse and neglect than children without disabilities, estimated at 1.7 times greater, with physical abuse 1.6 times more likely (7).

The harmful effect of socioeconomic deprivation on children is well established. Poverty is associated with postnatal and infant mortality, malnutrition and ill health, low educational attainment, delinquency, teenage pregnancy, and family tension and breakdown. Parental stress leads to greater vulnerability of the children, and common stress factors include unemployment and debt, which are linked to poverty. Abuse occurs throughout all social classes, but children from the most disadvantaged sectors of society are brought to the attention of child protection agencies more frequently (8) than those from nondisadvantaged sectors.

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