Louise Arseneault
Institute of Psychiatry
Social, Genetic & Developmental
Psychiatry Centre
Violent abuse:
Can we identify factors to minimize its
harmful impact for young victims?
Royal College of Psychiatrists Faculty of Child and Adolescent
Psychiatry Annual Residential Meeting
Edinburgh, 18th September 2013
Parallels between
bullying and maltreatment
Bullying
Maltreatment
intent to harm
intent to harm
physical/verbal
physical/verbal
exclusion
reject/neglect
repeated
long lasting
prevalence = 13%
prevalence = 15%
imbalance of power
imbalance of power
Differences between
bullying and maltreatment
Bullying
Maltreatment
perpetrators – peers
perpetrators – adults
impact = emerging
impact = well studied
The E-Risk Longitudinal Twin Study
Follow up
Lifetime child maltreatment
Child maltreatment
• Interview from Child Development Study
– Disciplined severely enough to have been hurt?
– Worried that someone else may have harmed child?
– Social service involvement
• Research workers took detailed notes of the events
reported by mothers
• All cases reviewed by office team which rated likelihood
that child had been harmed
– not maltreated
– possibly or definitely maltreated
The E-Risk Longitudinal Twin Study
Follow up
Lifetime child maltreatment
Mothers’ history of abuse
Mothers’ history of abuse
Childhood Trauma Questionnaire (CTQ)
– Abuse (Emotional, Physical, and Sexual)
– Neglect (Emotional and Physical)
•
•
•
•
I felt loved …………………………………………………………
I thought my parents wished I had never been born …………
I felt that someone in my family hated me …………………….
People in my family hit me so hard that it left me with bruises or
marks …………………………………………………………
• I believe I was sexually abused ………………………………...
Mothers’ and children’s
experiences of maltreatment
Mothers’ maltreatment
Children’s maltreatment
Present
26%
None
74%
Jaffee et al., JAH, 2013
Mothers’ and children’s experiences of
maltreatment
Mothers’ maltreatment
Children’s maltreatment
56% families
with maltreatment
Present
26%
81 mothers exposed
to severe maltreatment
None
74%
Jaffee et al., JAH, 2013
Mothers’ and children’s experiences of
maltreatment
Mothers’ maltreatment
81 mothers exposed to severe
maltreatment
44% families
escaped
maltreatment
Jaffee et al., JAH, 2013
Promotive factors
• Sibling warmth
• Maternal warmth
• Intimate relationship with partner
• High SES
• High social support
% of children
Prevalence of children’s maltreatment
according to promotive factors
Children with maltreatment
Children without maltreatment
Factors breaking the cycle of violence from
one generation to the next
5
Odds Ratio
4
3
2
1
ns
ns
ns
0
Jaffee et al., JAH, 2013
Factors breaking the cycle of violence from one
generation to the next
5
Odds Ratio
4
3
2
1
ns
ns
0
Jaffee et al., JAH, 2013
The E-Risk Longitudinal Twin Study
Follow up
Childhood bullying
Being frequently bullied is associated
with experiencing psychotic symptoms
5
Controlling for
Risk ratio
4
3
Individual and socioeconomic factors
Genetic susceptibility
Children’s psychopathology
2
1
Baseline risk
Arseneault et al., Am J Psychiatry, 2011
Being bullied is associated with emotional
and behavioural problems
0.6
Effect Size (d)
0.4
0.2
0
Primary Secondary
School
School
Life Time
Emotional Problems
Primary Secondary
School
School
Life Time
Behavioural Problems
Shakoor et al., JACP, 2011
Bullying as a risk factor for
maladjustment
Not all bullied children go on to experience
difficulties
What factors protect bullied children form
developing emotional and behavioural
difficulties?
Text here?
Family factors
Measures
Source
Ages
Maternal warmth
2 raters coding expressed
emotion (EE) 5 minute
speech sample
5, 10
Sibling warmth
Mother
7, 10
Atmosphere at
home
Home visitors
7, 10
Behaviorual problems (z-scores)
Emotional problems (z-scores)
Maternal warmth protects children
from the impact of being bullied
0.6
0.4
0.2
0
-0.2
-0.4
-0.6
Bullied
Not bullied
High maternal warmth
0.6
0.4
0.2
0
-0.2
-0.4
-0.6
Bullied
Not bullied
Low maternal warmth
Bowes et al., JCPP, 2010
Behaviorual problems (z-scores)
Emotional problems (z-scores)
Sibling warmth protects children from
the impact of being bullied
0.6
0.4
0.2
0
-0.2
-0.4
-0.6
Bullied
Not
bullied
High sibling warmth
0.6
0.4
0.2
0
-0.2
-0.4
-0.6
Bullied
Not bullied
Low sibling warmthBowes et al., JCPP 2010
Bowes et al., JCPP, 2010
Behaviorual problems (z-scores)
Emotional problems (z-scores)
A positive atmosphere at home protects
children from the impact of being bullied
0.8
0.6
0.4
0.2
0
-0.2
-0.4
-0.6
-0.8
Bullied
Not
bullied
High positive atmosphere at
home
0.8
0.6
0.4
0.2
0
-0.2
-0.4
-0.6
-0.8
Bullied
Not
bullied
Low positive atmosphere at
home Bowes et al., JCPP, 2010
Conclusions
• Childhood maltreatment and bullying victimization
contribute to the cycle of violence and to children’s
mental health problems
• Healthy relationships in the family can break the
transmission of abuse from one generation to the next
and can also protect children from developing emotional
and behavioural difficulties after being bullied
Thank you!