The Combined Effect of Maltreatment and Caregiver Contexts on the Trajectory of Children's Problematic Behaviors
Much research has been done on the effects of early maltreatment, caregiver risks, and contextual risk on children’s externalizing (EBs) and internalizing (IBs) behaviors. Little research, however, has combined these types of risk in the same analysis. One study combining early maltreatment with risk factors (Kotch et.al., 2008, Pediatrics) found that early neglect was the strongest predictor of increasing EBs through age 8 while accounting for caregiver depression and neighborhood safety.
The current study builds on Kotch et.al. by including more caregiver risk factors, analyzing IBs, and extending trajectories into adolescence. It is hypothesized that children parented in a multiple risk context, including early maltreatment (age 4 or younger), demonstrate more IBs and EBs at age 4 and show a larger increase over time than the rest of the sample.
Methods
720 children from the Longitudinal Studies of Child Abuse and Neglect living with their non-foster parent caregivers were studied. Child protective services reports tracked by caregiver were analyzed to gather maltreatment information. Seven profiles of caregiver risk were identified using a latent profile analysis of data gathered on caregiver depression, alcohol misuse, discipline, social supports, stress, and neighborhood quality. One profile had no risks. Three single-risk profiles were identified (poor supports, alcohol misuse, or authoritarian caregiving), as were three multiple-risk profiles: depression and alcohol misuse with poor supports and stress; highly aggressive parenting in poor neighborhoods; and depression with stress.
Hierarchical linear modeling was used to predict the main effects of caregiving and maltreatment on EBs and IBs. Time*caregiving, time*abuse, and time*neglect interactions were generated to predict rate of increase in behavior between ages 4 and 14. Time was treated categorically to assess rate of change at specific child ages.
Results
Compared to the no-risk group, children from all caregiving profiles exhibited more EBs and IBs at age 4. Significantly elevated EBs and IBs were seen in the authoritarian caregiving and the three multiple risk caregiving profiles, with children from the depression/alcohol profile exhibiting the most EBs and children from the highly aggressive parenting profile exhibiting the most IBs. Both abuse and neglect affected EBs at age 4 but not IBs.
None of the time*caregiving interactions were significant in the growth rate of EBs and IBs. However, both time*abuse and time* neglect interactions predicted an increase in IBs between ages 8-14. For EBs, only time* neglect predicted an increase of EBs - and only between the ages of 4 and 10.
Implications
The difference in children’s problematic behaviors at age 4 based on caregiver risk highlights two important intervention needs for caregivers to reduce EBs and IBs in preschool children: discipline strategies and coping-focused depression treatment. However, identification of maltreating caregivers as early as possible, regardless of caregiving context, is necessary to minimize EBs and IBs in the long term. Finally, special attention should be paid to older children who experienced early maltreatment, as IBs appear more likely to emerge later in life, while EBs are more immediate to the child's experience of maltreatment.