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Cycles of violence in England and Wales: the contribution of childhood abuse to risk of violence revictimisation in adulthood.

ABSTRACT: BACKGROUND:Interpersonal violence is a leading cause of death and disability globally, has immediate and long-term impacts on individuals' health and wellbeing, and impacts global health care expenditures and national economies. A public health approach to violence prevention is crucial, and addressing risk factors is a key priority. Global research has demonstrated that childhood adversity increases risk of a range of poor outcomes across the lifecourse. This study examined the association between being a victim of child abuse and the risk of physical assault (PA), intimate partner violence (IPV), and sexual violence (SV) victimisation in adulthood. METHODS:Data from a nationally representative survey of household residents (adults aged 16 to 59?years; n?=?21,845) was analysed. Types of child abuse examined included physical, sexual, and psychological abuse and witnessing domestic violence. Logistic regressions examined the independent relationships between child abuse types, experiencing multiple types, and adulthood violence outcomes. RESULTS:Most individual types of child abuse were significantly associated with each adulthood violence outcome, after controlling for sociodemographics and other abuse types. Compared to individuals who experienced no abuse in childhood, those who experienced one form of abuse were over twice as likely to experience PA in the past year and three times as likely to have experienced IPV and/or SV since age 16?years, whilst individuals who experienced multiple types were three, six, and seven times more likely to experience PA, IPV, and SV, respectively. After controlling for sociodemographics and multi-type childhood victimisation, the type or combination of types which remained significant differed by violence outcome; child psychological and physical abuse were significantly associated with IPV; psychological and sexual abuse with SV; and psychological abuse with PA. CONCLUSIONS:Prevention of child abuse is an important goal, and evidence from the current study suggests such efforts will have a downstream effect on preventing interpersonal violence across the lifecourse. With adulthood victimisation likely to compound the already detrimental effects of childhood abuse, and given that many associated outcomes also represent adversities for the next generation, breaking the cycle of violence should be a public health priority.

SUBMITTER: Butler N

PROVIDER: S-EPMC7667802 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Cycles of violence in England and Wales: the contribution of childhood abuse to risk of violence revictimisation in adulthood.

Butler Nadia N Quigg Zara Z Bellis Mark A MA

BMC medicine 20201116 1

<h4>Background</h4>Interpersonal violence is a leading cause of death and disability globally, has immediate and long-term impacts on individuals' health and wellbeing, and impacts global health care expenditures and national economies. A public health approach to violence prevention is crucial, and addressing risk factors is a key priority. Global research has demonstrated that childhood adversity increases risk of a range of poor outcomes across the lifecourse. This study examined the associat ...[more]

PMID: 33190642

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Project description:BackgroundThe recent World Report on Disability highlighted violence as a leading cause of morbidity among disabled people. However, we know little about the extent to which people with disability experience different violence types, and associated health/economic costs. The recent introduction of disability measures into the England&Wales victimization survey provided an opportunity to address this gap.Methods and findingsAnalysis of the 2009/10 British Crime Survey (BCS), a nationally representative cross-sectional survey of 44,398 adults living in residential households in England&Wales. Using multivariate logistic regression, we estimated the relative odds of being a victim of past-year violence (physical/sexual domestic or non-domestic violence) in people with disability compared to those without, after adjusting for socio-demographics, behavioural and area confounders. 1256/44398(2.4%) participants had one or more disabilities including mental illness ('mental illness') and 7781(13.9%) had one or more disabilities excluding mental illness ('non-mental disability'). Compared with the non-disabled, those with mental illness had adjusted relative odds (aOR) of 3.0(95% confidence interval (CI) 2.3-3.8) and those with non-mental disability had aOR of 1.8(95% CI: 1.5-2.2) of being a victim of past-year violence (with similar relative odds for domestic and non-domestic violence). Disabled victims were more likely to suffer mental ill health as a result of violence than non-disabled victims. The proportion of violence that could be attributed to the independent effect of disability in the general population was 7.5%(CI 5.7-9.3%), at an estimated cost of £1.51 billion. The main study limitation is the exclusion of institutionalised people with disability.ConclusionsPeople with disability are at increased risk of being victims of domestic and non-domestic violence, and of suffering mental ill health when victimized. The related public health and economic burden calls for an urgent assessment of the causes of this violence, and national policies on violence prevention in this vulnerable group.

Project description:ObjectivesTo examine if, and to what extent, a history of adverse childhood experiences (ACEs) combines with adult alcohol consumption to predict recent violence perpetration and victimisation.DesignRepresentative face-to-face survey (n=12?669) delivered using computer-assisted personal interviewing and self-interviewing.SettingDomiciles of individuals living in England and Wales.ParticipantsIndividuals aged 18-69 years resident within randomly selected locations. 12?669 surveys were completed with participants within our defined age range.Main outcome measuresAlcohol consumption was measured using the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) and childhood adversity using the short ACEs tool. Violence was measured using questions on perpetration and victimisation in the last 12 months.ResultsCompliance was 55.7%. There were strong positive relationships between numbers of ACEs and recent violence perpetration and victimisation in both sexes. Recent violence was also strongly related to positive AUDIT-C (?5) scores. In males, heavier drinking and ?4ACEs had a strong multiplicative relationship with adjusted prevalence of recent violent perpetration rising from 1.3% (95% CIs 0.9% to 1.9%; 0 ACEs, negative AUDIT-C) to 3.6% (95% CIs 2.7% to 4.9%; 0 ACEs, positive AUDIT-C) and 8.5% (95% CI 5.6% to 12.7%; ?4ACEs, negative AUDIT-C) to 28.3% (95% CI 22.5% to 34.8%; ?4ACEs, positive AUDIT-C). In both sexes, violence perpetration and victimisation reduced with age independently of ACE count and AUDIT-C status. The combination of young age (18-29 years), ?4ACEs and positive AUDIT-C resulted in the highest adjusted prevalence for both perpetration and victimisation in males (61.9%, 64.9%) and females (24.1%, 27.2%).ConclusionsThose suffering multiple adverse experiences in childhood are also more likely to be heavier alcohol users. Especially for males, this combination results in substantially increased risks of violence. Addressing ACEs and heavy drinking together is rarely a feature of public health policy, but a combined approach may help reduce the vast costs associated with both.

Dataset Information

Cycles of violence in England and Wales: the contribution of childhood abuse to risk of violence revictimisation in adulthood.

Publications

Cycles of violence in England and Wales: the contribution of childhood abuse to risk of violence revictimisation in adulthood.

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