Multi-Type Maltreatment and Adolescent and Adult Mental Health and Substance Use Outcomes: A Latent Class Analysis

Abstract

Child abuse and neglect pose a significant threat to the health and well-being of children. Research shows that child abuse and neglect rarely occur in isolation from one another. Limited research has investigated the ways in which child abuse and neglect co-occur and whether these patterns are similar for males and females. Further, little is known as to whether particular combinations of abuse and neglect share similar predictors or result in similar impairments in substance use and mental health outcomes. The current study used latent class analysis (LCA) to empirically examine the overlap of child abuse and neglect using data from the Lehigh Longitudinal Study. LCA models were run separately for males and females to understand whether the overlap of maltreatment was similar across gender. Childhood stressors were examined as a predictor of class membership using multinomial logistic regression. As a final step, class differences in adolescent and adulthood mental health and substance use outcomes were examined. LCA identified 3 subgroups of maltreatment for both males (Class 1: Physical abuse, sexual abuse, & neglect; Class 2: Low maltreatment; Class 3: Physical abuse & emotional abuse) and females (Class 1: Sexual abuse & neglect; Class 2: Low maltreatment; Class 3: Physical abuse & emotional abuse). While the interpretation of the classes was similar across gender for two of the three identified classes, males and females differed in the interpretation of one class. Examining childhood stressors as a predictor of class membership, males and females demonstrated a similar pattern. High levels of stressors differentiated between those in the low maltreatment class and the other identified maltreatment classes however childhood stressors did not differentiate between the identified maltreatment classes. Overall, few differences between the classes were identified for males and females across substance use outcomes in adolescence and adulthood. Mental health difficulties were higher for both males and females in classes defined by child sexual abuse. Results for both males and females did not suggest that one combination of child abuse and neglect resulted in worse outcomes compared to other combinations of abuse and neglect. These findings suggest that males and females experience the overlap of child abuse and neglect in similar ways. Further, little evidence was found for differences among the identified maltreatment classes suggesting that little information is gained by knowing the particular combination of maltreatment an individual experienced. Limitations of the current study are discussed.