Association of perpetrator relationship to abusive head trauma clinical outcomes
Abstract The diagnosis of abusive head trauma (AHT) remains a significant public health problem with limited prevention success. Providing protection from further harm is often challenged by the difficulty in identifying the alleged perpetrator (AP) responsible for this pediatric trauma. The objecti...
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| Veröffentlicht in: | Child abuse & neglect 2013-10, Vol.37 (10), p.771-777 |
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| creator | Scribano, Philip V Makoroff, Kathi L Feldman, Kenneth W Berger, Rachel P |
| description | Abstract The diagnosis of abusive head trauma (AHT) remains a significant public health problem with limited prevention success. Providing protection from further harm is often challenged by the difficulty in identifying the alleged perpetrator (AP) responsible for this pediatric trauma. The objective of this study was to evaluate demographic and clinical characteristics of children with AHT and the relationship between APs and their victims in a large, multi-site sample. Understanding the AHT risks from various caregivers may help to inform current prevention strategies. A retrospective review of all cases of AHT diagnosed by child protection teams (CPT) from 1/1/04 to 6/30/09 at four children's hospitals was conducted. Clinical characteristics of children with AHT injured by non-parental perpetrators (NPP) were compared to parental perpetrators (PP). There were 459 children with AHT; 313 (68%) had an identified AP. The majority of the 313 children were |
| doi_str_mv | 10.1016/j.chiabu.2013.04.011 |
| format | Article |
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Providing protection from further harm is often challenged by the difficulty in identifying the alleged perpetrator (AP) responsible for this pediatric trauma. The objective of this study was to evaluate demographic and clinical characteristics of children with AHT and the relationship between APs and their victims in a large, multi-site sample. Understanding the AHT risks from various caregivers may help to inform current prevention strategies. A retrospective review of all cases of AHT diagnosed by child protection teams (CPT) from 1/1/04 to 6/30/09 at four children's hospitals was conducted. Clinical characteristics of children with AHT injured by non-parental perpetrators (NPP) were compared to parental perpetrators (PP). There were 459 children with AHT; 313 (68%) had an identified AP. The majority of the 313 children were <1 year of age (76%), Caucasian (63%), male (58%), receiving public assistance (80%), and presented without a history of trauma (62%); mortality was 19%. Overall, APs were: father (53%), parent partner (22%), mother (8%), babysitter (8%), other adult caregiver (5%); NPP accounted for 39% of APs. NPPs were more likely to cause AHT in children ≥1 year (77% vs. 23%, p < 0.001) compared to PP. Independent associations to NPP included: older child, absence of a history of trauma, retinal hemorrhages, and male perpetrator gender. While fathers were the most common AP in AHT victims, there is a significant association for increased risk of AHT by NPPs in the older child, who presents with retinal hemorrhages, in the hands of a male AP. Further enhancement of current prevention strategies to address AHT risks of non-parental adults who provide care to children, especially in the post-infancy age seems warranted.</description><identifier>ISSN: 0145-2134</identifier><identifier>EISSN: 1873-7757</identifier><identifier>DOI: 10.1016/j.chiabu.2013.04.011</identifier><identifier>PMID: 23735871</identifier><identifier>CODEN: CABND3</identifier><language>eng</language><publisher>Oxford: Elsevier Ltd</publisher><subject>Abusive head trauma ; Adult and adolescent clinical studies ; Age Factors ; Biological and medical sciences ; Caregivers - psychology ; Child ; Child Abuse ; Child abuse & neglect ; Child Abuse - prevention & control ; Child Abuse - psychology ; Child Abuse - trends ; Child care ; Child, Preschool ; Clinical outcomes ; Craniocerebral Trauma - classification ; Craniocerebral Trauma - prevention & control ; Craniocerebral Trauma - psychology ; Demography ; Female ; Head injuries ; Humans ; Infant ; Infant, Newborn ; Injuries of the nervous system and the skull. Diseases due to physical agents ; Male ; Males ; Medical sciences ; Mental health ; Organic mental disorders. Neuropsychology ; Parent-Child Relations ; Parents - psychology ; Pediatrics ; Perpetrator ; Poverty ; Prevention ; Prevention. Health policy. Planification ; Psychiatry ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Retrospective Studies ; Risk Factors ; Siblings ; Social psychiatry. Ethnopsychiatry ; Trauma ; Traumas. Diseases due to physical agents ; United States - epidemiology ; Victimology</subject><ispartof>Child abuse & neglect, 2013-10, Vol.37 (10), p.771-777</ispartof><rights>Elsevier Ltd</rights><rights>2013 Elsevier Ltd</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2013 Elsevier Ltd. All rights reserved.</rights><rights>Copyright Pergamon Press Inc. Oct 2013</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c475t-28bf553daef620feaa7261d139d8fd261bad062f0ff904be844e2aeb3772636d3</citedby><cites>FETCH-LOGICAL-c475t-28bf553daef620feaa7261d139d8fd261bad062f0ff904be844e2aeb3772636d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.chiabu.2013.04.011$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,30999,33774,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27889683$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23735871$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Scribano, Philip V</creatorcontrib><creatorcontrib>Makoroff, Kathi L</creatorcontrib><creatorcontrib>Feldman, Kenneth W</creatorcontrib><creatorcontrib>Berger, Rachel P</creatorcontrib><title>Association of perpetrator relationship to abusive head trauma clinical outcomes</title><title>Child abuse & neglect</title><addtitle>Child Abuse Negl</addtitle><description>Abstract The diagnosis of abusive head trauma (AHT) remains a significant public health problem with limited prevention success. Providing protection from further harm is often challenged by the difficulty in identifying the alleged perpetrator (AP) responsible for this pediatric trauma. The objective of this study was to evaluate demographic and clinical characteristics of children with AHT and the relationship between APs and their victims in a large, multi-site sample. Understanding the AHT risks from various caregivers may help to inform current prevention strategies. A retrospective review of all cases of AHT diagnosed by child protection teams (CPT) from 1/1/04 to 6/30/09 at four children's hospitals was conducted. Clinical characteristics of children with AHT injured by non-parental perpetrators (NPP) were compared to parental perpetrators (PP). There were 459 children with AHT; 313 (68%) had an identified AP. The majority of the 313 children were <1 year of age (76%), Caucasian (63%), male (58%), receiving public assistance (80%), and presented without a history of trauma (62%); mortality was 19%. Overall, APs were: father (53%), parent partner (22%), mother (8%), babysitter (8%), other adult caregiver (5%); NPP accounted for 39% of APs. NPPs were more likely to cause AHT in children ≥1 year (77% vs. 23%, p < 0.001) compared to PP. Independent associations to NPP included: older child, absence of a history of trauma, retinal hemorrhages, and male perpetrator gender. While fathers were the most common AP in AHT victims, there is a significant association for increased risk of AHT by NPPs in the older child, who presents with retinal hemorrhages, in the hands of a male AP. Further enhancement of current prevention strategies to address AHT risks of non-parental adults who provide care to children, especially in the post-infancy age seems warranted.</description><subject>Abusive head trauma</subject><subject>Adult and adolescent clinical studies</subject><subject>Age Factors</subject><subject>Biological and medical sciences</subject><subject>Caregivers - psychology</subject><subject>Child</subject><subject>Child Abuse</subject><subject>Child abuse & neglect</subject><subject>Child Abuse - prevention & control</subject><subject>Child Abuse - psychology</subject><subject>Child Abuse - trends</subject><subject>Child care</subject><subject>Child, Preschool</subject><subject>Clinical outcomes</subject><subject>Craniocerebral Trauma - classification</subject><subject>Craniocerebral Trauma - prevention & control</subject><subject>Craniocerebral Trauma - psychology</subject><subject>Demography</subject><subject>Female</subject><subject>Head injuries</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Injuries of the nervous system and the skull. Diseases due to physical agents</subject><subject>Male</subject><subject>Males</subject><subject>Medical sciences</subject><subject>Mental health</subject><subject>Organic mental disorders. Neuropsychology</subject><subject>Parent-Child Relations</subject><subject>Parents - psychology</subject><subject>Pediatrics</subject><subject>Perpetrator</subject><subject>Poverty</subject><subject>Prevention</subject><subject>Prevention. Health policy. Planification</subject><subject>Psychiatry</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Siblings</subject><subject>Social psychiatry. Ethnopsychiatry</subject><subject>Trauma</subject><subject>Traumas. Diseases due to physical agents</subject><subject>United States - epidemiology</subject><subject>Victimology</subject><issn>0145-2134</issn><issn>1873-7757</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><sourceid>BHHNA</sourceid><recordid>eNqFkluL1DAUgIMo7jj6D0QCIvjSmlub9EVYFm-woKA-hzQ5YTK2TU3ahf33ps6sC_tiCCSE75ycfDkIvaSkpoS27461PQTTrzUjlNdE1ITSR2hHleSVlI18jHaEiqZilIsL9CznIymjkc1TdMG45I2SdIe-XeYcbTBLiBOOHs-QZliSWWLCCYa_5_kQZrxEXC7L4QbwAYzDhVlHg-0QpmDNgOO62DhCfo6eeDNkeHFe9-jnxw8_rj5X118_fbm6vK6skM1SMdX7puHOgG8Z8WCMZC11lHdOeVe2vXGkZZ543xHRgxICmIGey8Lx1vE9envKO6f4e4W86DFkC8NgJohr1lQILmjXMlXQ1w_QY1zTVKrbqDKJLPAeiRNlU8w5gddzCqNJt5oSvRnXR30yrjfjmghdjJewV-fkaz-C-xd0p7gAb86AyUWUT2ayId9zUqmuVbxw708cFGs3AZLONsBkwYUEdtEuhv9V8jDB3ef8glvI92_WmWmiv2_dsTUH5aSEd5T_AW0rtVs</recordid><startdate>20131001</startdate><enddate>20131001</enddate><creator>Scribano, Philip V</creator><creator>Makoroff, Kathi L</creator><creator>Feldman, Kenneth W</creator><creator>Berger, Rachel P</creator><general>Elsevier Ltd</general><general>Elsevier</general><general>Elsevier Science Ltd</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7U3</scope><scope>7U4</scope><scope>BHHNA</scope><scope>DWI</scope><scope>K7.</scope><scope>K9.</scope><scope>WZK</scope><scope>7X8</scope></search><sort><creationdate>20131001</creationdate><title>Association of perpetrator relationship to abusive head trauma clinical outcomes</title><author>Scribano, Philip V ; Makoroff, Kathi L ; Feldman, Kenneth W ; Berger, Rachel P</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c475t-28bf553daef620feaa7261d139d8fd261bad062f0ff904be844e2aeb3772636d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Abusive head trauma</topic><topic>Adult and adolescent clinical studies</topic><topic>Age Factors</topic><topic>Biological and medical sciences</topic><topic>Caregivers - psychology</topic><topic>Child</topic><topic>Child Abuse</topic><topic>Child abuse & neglect</topic><topic>Child Abuse - prevention & control</topic><topic>Child Abuse - psychology</topic><topic>Child Abuse - trends</topic><topic>Child care</topic><topic>Child, Preschool</topic><topic>Clinical outcomes</topic><topic>Craniocerebral Trauma - classification</topic><topic>Craniocerebral Trauma - prevention & control</topic><topic>Craniocerebral Trauma - psychology</topic><topic>Demography</topic><topic>Female</topic><topic>Head injuries</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Injuries of the nervous system and the skull. Diseases due to physical agents</topic><topic>Male</topic><topic>Males</topic><topic>Medical sciences</topic><topic>Mental health</topic><topic>Organic mental disorders. Neuropsychology</topic><topic>Parent-Child Relations</topic><topic>Parents - psychology</topic><topic>Pediatrics</topic><topic>Perpetrator</topic><topic>Poverty</topic><topic>Prevention</topic><topic>Prevention. Health policy. Planification</topic><topic>Psychiatry</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology. Psychiatry</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Siblings</topic><topic>Social psychiatry. Ethnopsychiatry</topic><topic>Trauma</topic><topic>Traumas. Diseases due to physical agents</topic><topic>United States - epidemiology</topic><topic>Victimology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Scribano, Philip V</creatorcontrib><creatorcontrib>Makoroff, Kathi L</creatorcontrib><creatorcontrib>Feldman, Kenneth W</creatorcontrib><creatorcontrib>Berger, Rachel P</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Social Services Abstracts</collection><collection>Sociological Abstracts (pre-2017)</collection><collection>Sociological Abstracts</collection><collection>Sociological Abstracts</collection><collection>ProQuest Criminal Justice (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Sociological Abstracts (Ovid)</collection><collection>MEDLINE - Academic</collection><jtitle>Child abuse & neglect</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Scribano, Philip V</au><au>Makoroff, Kathi L</au><au>Feldman, Kenneth W</au><au>Berger, Rachel P</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association of perpetrator relationship to abusive head trauma clinical outcomes</atitle><jtitle>Child abuse & neglect</jtitle><addtitle>Child Abuse Negl</addtitle><date>2013-10-01</date><risdate>2013</risdate><volume>37</volume><issue>10</issue><spage>771</spage><epage>777</epage><pages>771-777</pages><issn>0145-2134</issn><eissn>1873-7757</eissn><coden>CABND3</coden><abstract>Abstract The diagnosis of abusive head trauma (AHT) remains a significant public health problem with limited prevention success. Providing protection from further harm is often challenged by the difficulty in identifying the alleged perpetrator (AP) responsible for this pediatric trauma. The objective of this study was to evaluate demographic and clinical characteristics of children with AHT and the relationship between APs and their victims in a large, multi-site sample. Understanding the AHT risks from various caregivers may help to inform current prevention strategies. A retrospective review of all cases of AHT diagnosed by child protection teams (CPT) from 1/1/04 to 6/30/09 at four children's hospitals was conducted. Clinical characteristics of children with AHT injured by non-parental perpetrators (NPP) were compared to parental perpetrators (PP). There were 459 children with AHT; 313 (68%) had an identified AP. The majority of the 313 children were <1 year of age (76%), Caucasian (63%), male (58%), receiving public assistance (80%), and presented without a history of trauma (62%); mortality was 19%. Overall, APs were: father (53%), parent partner (22%), mother (8%), babysitter (8%), other adult caregiver (5%); NPP accounted for 39% of APs. NPPs were more likely to cause AHT in children ≥1 year (77% vs. 23%, p < 0.001) compared to PP. Independent associations to NPP included: older child, absence of a history of trauma, retinal hemorrhages, and male perpetrator gender. While fathers were the most common AP in AHT victims, there is a significant association for increased risk of AHT by NPPs in the older child, who presents with retinal hemorrhages, in the hands of a male AP. Further enhancement of current prevention strategies to address AHT risks of non-parental adults who provide care to children, especially in the post-infancy age seems warranted.</abstract><cop>Oxford</cop><pub>Elsevier Ltd</pub><pmid>23735871</pmid><doi>10.1016/j.chiabu.2013.04.011</doi><tpages>7</tpages></addata></record> |
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| subjects | Abusive head trauma Adult and adolescent clinical studies Age Factors Biological and medical sciences Caregivers - psychology Child Child Abuse Child abuse & neglect Child Abuse - prevention & control Child Abuse - psychology Child Abuse - trends Child care Child, Preschool Clinical outcomes Craniocerebral Trauma - classification Craniocerebral Trauma - prevention & control Craniocerebral Trauma - psychology Demography Female Head injuries Humans Infant Infant, Newborn Injuries of the nervous system and the skull. Diseases due to physical agents Male Males Medical sciences Mental health Organic mental disorders. Neuropsychology Parent-Child Relations Parents - psychology Pediatrics Perpetrator Poverty Prevention Prevention. Health policy. Planification Psychiatry Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Retrospective Studies Risk Factors Siblings Social psychiatry. Ethnopsychiatry Trauma Traumas. Diseases due to physical agents United States - epidemiology Victimology |
| title | Association of perpetrator relationship to abusive head trauma clinical outcomes |
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