Understanding abusive head trauma related factors: A qualitative study of victim's parents and professionals in...

The incidence of abusive head trauma (AHT) is not declining in many countries with developed economies. The current understanding of factors associated with a high risk of AHT may need revision to better account for the complexity of the phenomenon.

To gain a better understanding of the multiple factors associated with AHT events based on the experience of professionals involved in AHT cases and non-offending parents of victims in order to inform prevention strategies.

Sixteen professionals and 13 parents of infant victims.

Qualitative study based on thematic data analysis of semi-structured interviews.

Coding and thematic analysis of the 28 interviews (total duration 27 h) brought up 21 sub-categories of AHT-related factors. Professionals identified infants' inconsolable crying and caregivers' overwhelming stress as the main factors related to AHT events, whereas parents emphasized shaking as a result of the caregiver's temporary unavailability to meet the infant's needs, along with a poor relationship with the victim, negative attributions for the infant's behavior, and lack of empathy.

An infant's persistent crying should not be considered the only factor triggering AHT. Rather, it is a vulnerability factor that, when combined with other perpetrator-related and situational factors, can explain AHT events. These findings may help improve the effectiveness of current prevention programs, which are primarily based on increasing parental knowledge and awareness of persistent crying, and contribute to theoretical models of AHT.