Multi-type maltreatment in childhood and psychological adjustment in adolescence: questionnaire study among adolescents in Western Herzegovina Canton.

Aim: To determine the prevalence and intercorrelation of different forms of childhood maltreatment and psychological problems in adolescents in Western Herzegovina Canton.

Method: A questionnaire study was conducted in March 2003 on a convenient sample of 458 third-grade high-school students (39% boys) aged between 15 and 20 (median age, 17). Data were collected using a sociodemographic questionnaire, Family Adaptability and Cohesion Evaluation Scales III, Child Maltreatment Questionnaire, Youth Self-Report, and Rosenberg Self-Esteem Scale. Sociodemographic and family characteristics and exposure to maltreatment were analyzed as possible predictors of exposure to a particular type of abuse and subsequent psychological adjustment problems.

Results: Out of 458 students, 77% were emotionally abused, 52% physically abused, 30% neglected, 20% witnessed family violence, and 13% of girls and 21% of boys were sexually abused before the age of 14. Significant association between the maltreatment by a mother, father, and other adults were found for emotional and physical abuse and for neglect and witnessing family violence (r=0.413-0.541, P<0.001 for all). Significant correlation was found between all forms of abuse (r=0.163-0.594, P<0.05), except between sexual abuse and witnessing family violence (r=0.048, P=0.351). Almost two-thirds of students were exposed to multi-type maltreatment in childhood. Family characteristics and maltreatment scores significantly predicted anxiety/depression (R=0.456, R(2)=0.076), withdrawal (R=0.389, R(2)=0.049), somatic complaints (R=0.437, R(2)=0.059), social problems (R=0.417, R(2)=0.063), attention deficit and hyperactivity disorder (R=0.368, R(2)=0.045), rule-breaking behavior (R=0.393, R(2)=0.045), aggression (R=0.437, R(2)=0.078) (P<0.001 for all), as well as self-esteem (R=0.371, R(2)=0.035, P=0.003).

Conclusion: Most third-grade high-school students in Western Herzegovina Canton were exposed to multi-type maltreatment in childhood, regardless of the war experience. Emotional and physical abuse were most frequently combined forms of maltreatment. Sociodemographic and family characteristics and exposure to some forms of abuse were significant predictors of exposure to other forms of abuse. Exposure to maltreatment in childhood predicted difficulties in psychological adjustment in adolescence.