Psychosocial Development of Maltreated Children: A Prospective Study

Between 2007-2010 the Child Protection Team (CPT) at University Children's Hospital Zurich was the first in Europe to follow up the development of maltreated children in a hospital sample . The follow-up took place 2-3 years after the child had been reported to the CPT. As a major result, children's health-related quality of life (HRQoL) had been impaired in maltreated children compared to controls (Jud, Landolt, Tatalias, Lach, & Lips, 2012). However, this difference only emerged for the self-assessment of HRQoL by children aged 6 years or older .To address limitations, the CPT at University Children's Hospital Zurich and Children's Hospital Baden AG propose a prospective study with a baseline at the time of report to the CPT and a two year follow-up. This study aims at analyzing HRQoL, behavior and mental health of maltreated children prospectively and will be the first to provide data on changes in HRQoL in the aftermath of maltreatment. We assume the following hypotheses:

• The HRQoL and mental health of children will be impaired following maltreatment even while controlling for others possible predictors of impaired HRQoL and mental health.
• We assume a dose-response relationship between severity of maltreatment and impaired HRQoL. Multiple maltreatment is hypothesized to have a larger impact then a single type of maltreatment.
• At baseline, HRQoL scores are hypothesized to be at a markedly low level. We assume a slight increase in HRQoL from baseline to first follow-up, but not a continuing increase to second follow-up.

Study Overview

• Status: Terminated
• Conditions: Quality of Life
• Intervention / Treatment: Other: no intervention

Detailed Description

Between 2007-2010 the Child Protection Team (CPT) at University Children's Hospital Zurich was the first in Europe to follow up the development of maltreated children in a hospital sample (Jud, Lips, & Landolt, 2010). Out of a total 180 children in the 2005/2006 CPT caseload, 42 children between 2.5 and 16.5 years and their primary caregiver participated (Jud, Lips, et al., 2010). The follow-up took place 2-3 years after the child had been reported to the CPT. Non-CPT reported hospital patients were used as controls, matched for age, gender, nationality, and medical condition. As a major result, children's health-related quality of life (HRQoL) had been impaired in maltreated children compared to controls (Jud, Landolt, Tatalias, Lach, & Lips, 2012). However, this difference only emerged for the self-assessment of HRQoL by children aged 6 years or older (Jud et al., 2012). The assessment of children's HRQoL by primary caregivers showed no significant differences for maltreated children compared to controls for all age groups. An essential lack of understanding of the child's experiences and beliefs is not only likely to affect the child's HRQoL, but may also contribute to cur-rent and future risk of maltreatment (Jud et al., 2012). Furthermore, maltreated children had increased depression scores and more behavior problems compared to controls. Detailed results can be found in Jud et al. (Jud et al., 2012; Jud, Lips, et al., 2010). To address these limitations, the CPT at University Children's Hospital Zurich and Children's Hospital Baden AG propose a prospective study with a baseline at the time of report to the CPT and a two year follow-up. This study aims at analyzing HRQoL, behavior and mental health of maltreated children prospectively and will be the first to provide data on changes in HRQoL in the aftermath of maltreatment. Based on a literature review and findings of the previous follow-up study, we assume the following hypotheses:

• The HRQoL and mental health of children will be impaired following maltreatment even while controlling for others possible predictors of impaired HRQoL and mental health.
• We assume a dose-response relationship between severity of maltreatment and impaired HRQoL. Multiple maltreatment is hypothesized to have a larger impact then a single type of maltreatment.
• At baseline, HRQoL scores are hypothesized to be at a markedly low level. We assume a slight increase in HRQoL from baseline to first follow-up, but not a continuing increase to second follow-up.
• We assume differing trends for outcome variables in the aftermath of maltreatment and intend to analyze if types of trends are associated with clusters of risk and protective factors (cf. Chaffin, Bard, Hecht, & Silovsky, 2011).

• Study Type: Observational
• Enrollment (Actual): 17

Contacts and Locations

Study Locations

• Switzerland
  • Zürich, Switzerland, 8032
    • University Children's Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 1 day to 15 years (CHILD)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

The sample is drawn from in- and outpatients reported to CPTs at University Children's Hospital Zurich and Children's Hospital Baden AG between July 2013 and August 2015.

Description

Inclusion Criteria:

• Inpatients
• Outpatients
• Sexual abuse
• Physical maltreatment
• Psychological maltreatment
• Neglect
• Substantiated maltreatment
• Indicated maltreatment
• Aged 0-15 years at recruitment

Exclusion Criteria:

• telephone counseling
• Munchausen Syndrome by proxy
• Maltreatment not confirmed
• Aged 16 years and older at recruitment

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Psychosocial development	Normed and established instruments will be used for psychosocial assessment of children and caregivers. The assessment of child's development and well-being by primary caregivers will be complemented by child's self-assessment. Instruments: SON-R 2.5-7 (≥2.5 y.) DDST (0-5 years) KIDSCREEN-27 (≥8 y.) SDQ (11-17 y.) UCLA PTSD Index CDI (≥8 y.) CFT 1 (6-9.5 y.) or CFT 20-R (8.5-16 y.)	Four years

Collaborators and Investigators

• Sponsor: University Children's Hospital, Zurich
• Collaborators: Kantonsspital Baden
• Investigators: Principal Investigator: Andreas Jud, Dr., University Children's Hospital, Zurich

Study record dates

Study Major Dates

• Study Start: February 1, 2014
• Primary Completion (ACTUAL): January 1, 2017
• Study Completion (ACTUAL): January 1, 2017

Study Registration Dates

• First Submitted: May 13, 2014
• First Submitted That Met QC Criteria: May 22, 2014
• First Posted (ESTIMATE): May 28, 2014

Study Record Updates

• Last Update Posted (ESTIMATE): February 9, 2017
• Last Update Submitted That Met QC Criteria: February 7, 2017
• Last Verified: February 1, 2017

More Information

Terms related to this study

• Keywords: quality of life; childhood; neglect; maltreatment
• Other Study ID Numbers: KEK-ZH-Nr. 2013-0331