Impairment in Young Adults Associated With Child Maltreatment

Abstract

Although research in the past two decades has provided information about the distribution and determinants of child maltreatment, as well as associated impairment in mental and physical health, little is known about the social functioning of maltreated youth during the transition to adulthood. As well, methodological challenges in conducting child maltreatment research, such as ethical and legal barriers to asking youth about such exposure has limited the advancement of new knowledge in this field. This thesis investigated three key areas in the child maltreatment field. The first paper explored the psychometric properties of a self-report measure of child maltreatment (Childhood Experiences of Violence Questionnaire Short Form: CEVQ-SF). The second paper examined the possible association between exposure to child physical and sexual abuse and labour force outcomes among young adults using a community-based sample (Ontario Child Health Study: OCHS). The third paper considered an important methodologic question that commonly is raised when considering the relevance of cross-sectional versus longitudinal designs in child maltreatment research - the robustness of associations between exposure to child maltreatment and adult health outcomes, depending on design. Results of this thesis showed that: 1) the CEVQ-SF is a reliable and valid approach to measuring child physical and sexual abuse; results were comparable iii PhD Thesis M. Tanaka, McMaster - Health Research Methodology to the validated original version, 2) in the OCHS sample, there was a significant association between child abuse with personal income; these associations were not fully explained by childhood variables, current mental and physical health, and educational attainment, 3) the estimates of the association between child maltreatment and adult health outcomes did not systematically differ by study design, and furthermore, the timing of measuring self-report of child maltreatment and adult outcomes did not systematically influence the magnitude of these associations within the cohort. The research conducted for this thesis provides further support for a possible link between child maltreatment and reduced economic productivity and identifies a potential new mechanism. Results also suggest that the impact of child maltreatment on adult emotional and behavioural outcomes is independent of study design, but there is still the need for a universal definition and standard approaches to measuring child maltreatment in exploring this finding