Friday, September 18, 2009

Recent Studies on Child Abuse and Neglect: Child Deaths From Inflicted Injuries: Household Risk Factors and Perpetrator Characteristics (2005)

Perpetrator information is highlighted in bold. Because of space limitations, I'm just including the abstract.

http://pediatrics.aappublications.org/cgi/content/full/116/5/e687?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&author1=Patricia+G.+Schnitzer&searchid=1131459092756_5247&stored_search=&FIRSTINDEX=0&sortspec=relevance&journalcode=pediatrics

Published online November 1, 2005
PEDIATRICS Vol. 116 No. 5 November 2005, pp. e687-e693 (doi:10.1542/peds.2005-0296)

Child Deaths Resulting From Inflicted Injuries: Household Risk Factors and Perpetrator Characteristics
Patricia G. Schnitzer, PhD* and Bernard G. Ewigman, MD, MSPH

* Department of Family and Community Medicine, School of Medicine, University of Missouri, Columbia, Missouri
Department of Family Medicine, Biological Sciences Division, Pritzker School of Medicine, University of Chicago, Chicago, Illinois

Objective. To determine the role of household composition as an independent risk factor for fatal inflicted injuries among young children and describe perpetrator characteristics.

Results. We identified 149 inflicted-injury deaths in our population during the 8-year study period. Children residing in households with unrelated adults were nearly 50 times as likely to die of inflicted injuries than children residing with 2 biological parents (adjusted odds ratio: 47.6; 95% confidence interval: 10.4–218). Children in households with a single parent and no other adults in residence had no increased risk of inflicted-injury death (adjusted odds ratio: 0.9; 95% confidence interval: 0.6–1.9). Perpetrators were identified in 132 (88.6%) of the cases. The majority of known perpetrators were male (71.2%), and most were the child's father (34.9%) or the boyfriend of the child's mother (24.2%). In households with unrelated adults, most perpetrators (83.9%) were the unrelated adult household member, and only 2 (6.5%) perpetrators were the biological parent of the child.

Conclusions. Young children who reside in households with unrelated adults are at exceptionally high risk for inflicted-injury death. Most perpetrators are male, and most are residents of the decedent child's household at the time of injury.

References.
Overpeck MD, Brenner RA, Trumble AC, Trifiletti LB, Berendes HW. Risk factors for infant homicide in the United States. N Engl J Med. 1998;339 :1211 –1216[Abstract/Free Full Text]

Stiffman MN, Schnitzer PG, Adam P, Kruse RL, Ewigman BG. Household composition and risk of fatal child maltreatment. Pediatrics. 2002;109 :615 –621[Abstract/Free Full Text]

Herman-Giddens ME, Brown G, Verbiest S, et al. Underascertainment of child abuse mortality in the United States. JAMA. 1999;282 :463 –467[Abstract/Free Full Text]

Herman-Giddens ME. Underrecoding of child abuse and neglect fatalities in North Carolina. N C Med J. 1991;52 :634 –639[Medline]

Ewigman B, Kivlahan C, Land G. The Missouri child fatality study: underreporting of maltreatment fatalities among children younger than five years of age, 1983 through 1986. Pediatrics. 1993;91 :330 –337[Abstract/Free Full Text]

McClain PW, Sacks JJ, Froehlke RG, Ewigman BG. Estimates of fatal child abuse and neglect, United States, 1979 through 1988. Pediatrics. 1993;91 :338 –343[Abstract/Free Full Text]

Crume TL, DiGuiseppi C, Byers T, Sirotnak AP, Garrett CJ. Underascertainment of child maltreatment fatalities by death certificates, 1990–1998. Pediatrics. 2002;110 (2). Available at: www.pediatrics.org/cgi/content/full/110/2/e18

Overpeck MD, Trumble AC, Berendes HW, Brenner RA. Risk factors for infant homicide. N Engl J Med. 1999;340 :895 –896[Free Full Text]

West S. Risk factors for infant homicide [letter]. N Engl J Med. 1999;340 :895

Wissow LS. Infanticide. N Engl J Med. 1998;339 :1239 –1241[Free Full Text]

Schloesser P, Pierpont J, Poertner J. Active surveillance of child abuse fatalities. Child Abuse Negl. 1992;16 :3 –10[CrossRef][Web of Science][Medline]

Martin MJ, Walters J. Familial correlates of selected types of child abuse and neglect. J Marriage Fam. 1982;44 :267 –276[CrossRef][Web of Science]

Dubowitz H, Hampton RL, Bithoney WG, Newberger EH. Inflicted and noninflicted injuries: differences in child and familial characteristics. Am J Orthopsychiatry. 1987;57 :525 –535[Web of Science][Medline]

Zuravin SJ. Unplanned childbearing and family size: their relationship to child neglect and abuse. Fam Plann Perspect. 1991;23 :155 –161[CrossRef][Web of Science][Medline]

Chaffin M, Kelleher K, Hollenberg J. Onset of physical abuse and neglect: psychiatric, substance abuse, and social risk factors from prospective community data. Child Abuse Negl. 1996;20 :191 –203[CrossRef][Web of Science][Medline]

Wilson M, Daly M, Weghorst SJ. Household composition and the risk of child abuse and neglect. J Biosoc Sci. 1980;12 :333 –340[Web of Science][Medline]

Creighton SJ. An epidemiological study of abused children and their families in the United Kingdom between 1977 and 1982. Child Abuse Negl. 1985;9 :441 –448[CrossRef][Web of Science][Medline]

Harrell FE Jr, Lee KL, Mark DB. Multivariable prognostic models: issues in developing models, evaluating assumptions and adequacy, and measuring and reducing errors. Stat Med. 1996;15 :361 –387[CrossRef][Web of Science][Medline]

SAS [computer program]. Version 8.0. Cary, NC: SAS Institute, Inc; 1999

Rothman KJ, Greenland S. Modern Epidemiology. Philadelphia, PA: Lippincott-Raven; 1998
Showers J, Apolo J, Thomas J, Beavers S. Fatal child abuse: a two-decade review. Pediatr Emerg Care. 1985;1 :66 –70[Medline]

Malkin CM, Lamb ME. Child maltreatment: a test of sociobiological theory. J Comp Fam Stud. 1994;25 :121 –133

Daly M, Wilson M. Child abuse and other risks of not living with both parents. Ethol Sociobiol. 1985;6 :197 –210

Wilson M, Daly M. Risk of maltreatment of children living with stepparents. In: Gelles RJ, Lancaster JB, eds. Child Abuse and Neglect: Biosocial Dimensions. New York, NY: Aldine De Gruyter; 1987:215–232

Baldwin JA, Oliver JE. Epidemiology and family characteristics of severely-abused children. Br J Prev Soc Med. 1975;29 :205 –221[Web of Science][Medline]

Smith SM, Hanson R, Noble S. Social aspects of the battered baby syndrome. Br J Psychiatry. 1974;125 :568 –582[Web of Science][Medline]

Ebbin AJ, Gollub MH, Stein AM, Wilson MG. Battered child syndrome at the Los Angeles County General Hospital. Am J Dis Child. 1969;118 :660 –667[Abstract/Free Full Text]

Keenan HT, Runyan DK, Marshall SW, Nocera MA, Merten DF, Sinal SH. A population-based study of inflicted traumatic brain injury in young children. JAMA. 2003;290 :621 –626[Abstract/Free Full Text]

Kaplun D, Reich R. The murdered child and his killers. Am J Psychiatry. 1976;133 :809 –813[Abstract]

Gil DG. Incidence of child abuse and demographic characteristics of persons involved. In: Helfer RE, Kempe CH, eds. The Battered Child. Chicago, IL: University of Chicago Press; 1968:19 –40
Bergman AB, Larsen RM, Mueller BA. Changing spectrum of serious child abuse. Pediatrics.
1986;77 :113 –116[Abstract/Free Full Text]

Ricci L, Giantris A, Merriam P, Hodge S, Doyle T. Abusive head trauma in Maine infants: medical, child protective, and law enforcement analysis. Child Abuse Negl. 2003;27 :271 –283[CrossRef][Web of Science][Medline]

Starling SP, Holden JR, Jenny C. Abusive head trauma: the relationship of perpetrators to their victims. Pediatrics. 1995;95 :259 –262[Abstract/Free Full Text]

Jason J, Gilliland JC, Tyler CW Jr. Homicide as a cause of pediatric mortality in the United States. Pediatrics. 1983;72 :191 –197[Abstract/Free Full Text]

Herman-Giddens ME, Smith JB, Mittal M, Carlson M, Butts JD. Newborns killed or left to die by a parent: a population-based study. JAMA. 2003;289 :1425 –1429[Abstract/Free Full Text]

Olds DL, Eckenrode J, Henderson CR Jr, et al. Long-term effects of home visitation on maternal life course and child abuse and neglect. Fifteen-year follow-up of a randomized trial. JAMA. 1997;278 :637 –643[Abstract/Free Full Text]