The association between child maltreatment and health risk behaviours and conditions throughout life in the Australian Child Maltreatment Study

Abstract Objective To estimate associations between all five types of child maltreatment (emotional abuse, neglect, physical abuse, sexual abuse, and exposure to domestic violence) and health risk behaviours and conditions. Design, setting, participants Nationally representative survey of Australian residents aged 16 years and older conducted by computer‐assisted telephone interviewing. Main outcome measures Associations between child maltreatment and the following health risk behaviours and conditions: current smoker, binge drinking (at least weekly in past 12 months), cannabis dependence (according to the Cannabis Severity of Dependence Scale), obesity (based on body mass index), self‐harm in past 12 months, and suicide attempt in past 12 months. Results A total of 8503 participants completed the survey. All five types of child maltreatment were associated with increased rates of all of the health risk behaviours and conditions that we considered. The strongest associations were in the youngest age group (16–24‐year‐olds). Sexual abuse and emotional abuse were associated with the highest odds of health risk behaviours and conditions. Cannabis dependence, self‐harm and suicide attempts were most strongly associated with child maltreatment. Experiencing more than one type of child maltreatment was associated with higher rates of health risk behaviours and conditions than experiencing one type of child maltreatment. Conclusions Child maltreatment is associated with substantially increased rates of health risk behaviours and conditions. Prevention and intervention efforts should be informed by trauma histories, and holistic psychosocial care should be incorporated into programs focusing on behaviour change.


Figure 1 .
Figure 1.Proportions of adults who were current smokers, by experience of child maltreatment and gender*

Figure 2 .
Figure 2. Proportions of adults who reported binge drinking weekly or more often, by experience of child maltreatment and gender*

Figure 3 .
Figure 3. Proportions of adults who were classified as having cannabis dependence, by experience of child maltreatment and gender*

Figure 4 .
Figure 4. Proportions of adults who were classified as having obesity according to body mass index, by experience of child maltreatment and gender*

Figure 5 .
Figure 5. Proportions of adults who had self-harmed in the previous 12 months, by experience of child maltreatment and gender*

Figure 6 .
Figure 6.Proportions of adults who had attempted suicide in the previous 12 months, by experience of child maltreatment and gender*

22) Physical abuse 7.40 (4.82-11.4) 4.79 (3.42-6.71) Sexual abuse 10.6 (6.86-16.4) 6.21 (4.42-8.73) Exposure to domestic violence 7.28 (4.78-11.1) 4.02 (2.89-5.58) Suicide attempt in past 12 months Emotional abuse 7.38 (3.20-17.0) 6.73 (3.45-12.6)
Separate models fit for each type of sexual abuse with three categories of exposure: experienced this type of maltreatment during childhood, experienced any other type of maltreatment during childhood, did not experience maltreatment during childhood; bold text denotes that odds ratio is significantly higher than 1 at P < 0.05.† Model adjusted for age group and gender only.‡ Model adjusted for age group, gender, socio-economic status (based on postcode of residence and quintiles of the Index of Relative Socio-Economic Disadvantage), experience of financial hardship during childhood, and current financial strain. *

Suicide attempt in past 12 months Emotional abuse 2.09 (1.12-3.88) 2.31 (1.40-3.81)
Single models fit with adjusted effects fitted for each type of child maltreatment; bold text denotes that odds ratio is significantly higher than 1 at P < 0.05.† Model adjusted for age group and gender only.‡ Model adjusted for age group, gender, socio-economic status (based on postcode of residence and quintiles of the Index of Relative Socio-Economic Disadvantage), experience of financial hardship during childhood, and current financial strain. *