Effects of Maltreatment in the Home Setting on Emotional and Behavioural Problems in Adolescents: A Study from Zhejiang Province in China

Abstract

The aim of the study was to determine the effects of different types of maltreatment on adolescents' emotional/behavioural problems in Zhejiang Province, eastern China. Adolescents aged ten to 16 years in two urban and two rural schools were invited to complete a questionnaire survey, including experiences of maltreatment and emotional/behavioural problems. In total, 791 questionnaires were eligible for analysis. Preceding-year prevalence was 5.6 per cent for minor physical maltreatment, 27.6 per cent for moderate physical maltreatment and 4.6 per cent for severe physical maltreatment, 47.5 per cent for emotional maltreatment and 8.2 per cent for non-contact punishment. Witnessing domestic violence was reported by 49.4 per cent of the adolescents. Emotional maltreatment was consistently associated with a higher risk of emotional/behavioural problems (relative risk ratio (RRR) ranging from 1.85–2.36) after adjusting for other maltreatment exposures and socio-economic factors. Severe physical maltreatment showed the strongest association with behavioural problems (RRR = 4.75 (95% confidence interval 1.74, 12.98), P = 0.002). Witnessing domestic violence alone was not associated with emotional/behavioural problems in adolescents. The effect size of emotional maltreatment was greater for girls, while physical maltreatment had greater effects among boys. There was a cumulative negative effect with an increasing number of maltreatment types. The results indicate an important need: to educate parents, to identify high-risk children and to introduce a formal child protection system in China. ‘The aim of the study was to determine the effects of different types of maltreatment on adolescents' emotional/behavioural problems in Zhejiang Province, eastern China’. Key Practitioner Messages: Emotional maltreatment was consistently and robustly associated with an increased risk of both emotional and behavioural problems after adjusting for other maltreatment exposures and socio-economic factors. Severe physical maltreatment showed the strongest association with behavioural problems but not with emotional problems, while witnessing domestic violence alone was associated with neither of them. An increase in the number of maltreatment types had a cumulative negative effect on child emotional and behavioural problems.