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Disclosure of Child Physical Abuse and Perceived Adult Support among Swedish Adolescents
Karlstad Univ, Karlstad, Sweden.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation Research.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation Research.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation Research.
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2017 (English)In: Child Abuse Review, ISSN 0952-9136, E-ISSN 1099-0852, Vol. 26, no 6, p. 451-464Article in journal (Refereed) Published
Abstract [en]

Compared to child sexual abuse (CSA), little is known about disclosure of child physical abuse (CPA). Enhancing the understanding of the characteristics of disclosure is necessary for improved child protection. The aim of the present study was to examine disclosure of CPA and perceived adult support using both quantitative and qualitative data from a survey of child maltreatment carried out among a nationally representative sample of Swedish adolescents (n = 3202). We found that adolescents who experienced any child maltreatment (CPA, emotional abuse, neglect and witnessing intimate partner violence) were less likely to be able to identify an adult confidant compared to those without a history of abuse. Among the adolescents who reported severe CPA, 52 per cent had disclosed the abuse and the most frequent recipient of disclosure was a peer or sibling. Eleven per cent had disclosed to professionals within school, child protective services or law enforcement. Lack of trust in adults appeared to be the most prominent reason for non- disclosure. Several adolescents who had disclosed abuse to professionals perceived an ineffective response, primarily because of professionals' lack of a child perspective. Some respondents experienced supportive interventions, specifically from school social workers. These patterns showed close similarity to disclosure of CSA.

Place, publisher, year, edition, pages
2017. Vol. 26, no 6, p. 451-464
Keywords [en]
child maltreatment, child physical abuse, disclosure, social support, adolescents
National Category
Pediatrics
Identifiers
URN: urn:nbn:se:uu:diva-343325DOI: 10.1002/car.2443ISI: 000416432500005OAI: oai:DiVA.org:uu-343325DiVA, id: diva2:1188875
Available from: 2018-03-08 Created: 2018-03-08 Last updated: 2018-04-17Bibliographically approved
In thesis
1. Health sector and community response to child maltreatment in Sweden and in a European context
Open this publication in new window or tab >>Health sector and community response to child maltreatment in Sweden and in a European context
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background Child maltreatment is a public health problem of global magnitude. This thesis examined different aspects of the multi-sector response to child maltreatment in Sweden and in Europe.

Aims To explore how child physical abuse (CPA) is disclosed and how adolescents perceive adult support when they report physical abuse. To examine how police-reported cases of suspected CPA were associated with criminal investigation procedures and prosecutions. To assess how physicians who care for maltreated children across Europe are organised to recognise and respond to child abuse and neglect. To investigate time trends in rates of childhood deaths in Sweden recorded as due to external, ill-defined and unknown causes, from 2000 to 2014.

Methods We analysed data from a school-based national survey of adolescents, police records of reported suspected CPA in a metropolitan area, a purposeful survey of European child abuse physicians and individual-level data from the Swedish cause of death register. We used quantitative methods to calculate prevalence, descriptive statistics, odds ratios, logistic regression and trends in mortality rates. Qualitative methods included content analysis and narrative synthesis.

Results Only a minority of reported CPA was brought to the attention of professionals and the most prominent barrier to disclosure was lack of trust in adults or authorities. The police-reported cases of suspected CPA were characterised by high severity, but only a small proportion of the 158 alleged child victims were physically examined and only half were forensically interviewed. All 88 responding physicians in 22 European countries described multidisciplinary involvement in the management of suspected child maltreatment, but wide variations in the organisational approaches were revealed. A sustained decline in childhood deaths from external causes during a 15-year period was observed. A sizeable number of infant deaths were recorded each year as ill-defined or with incomplete documentation from clinicians.

Conclusions The results presented in this thesis suggest that the multi-sector response in Sweden and in Europe is insufficiently organised, with no clear mandate for the health sector to robustly combat child maltreatment, and that this may undermine the ability of society to adequately protect children.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2018. p. 101
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1465
Keywords
Child physical abuse, Cause of death, Child death review, Disclosure, Police report, Child mortality, Register data, Multidisciplinary team
National Category
Medical and Health Sciences Clinical Medicine
Research subject
Pediatrics; Pediatrics
Identifiers
urn:nbn:se:uu:diva-347796 (URN)978-91-513-0342-0 (ISBN)
Public defence
2018-06-07, Gunnelsalen Auditorium, Psychiatry House, Sjukhusvägen 10, Uppsala, 13:15 (English)
Opponent
Supervisors
Funder
The Swedish Crime Victim Compensation and Support Authority
Available from: 2018-05-16 Created: 2018-04-17 Last updated: 2018-06-05

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Otterman, GabrielLucas, StevenTindberg, YlvaJanson, Staffan

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