When harm does not simply reverse: Asymmetric within-child associations between child maltreatment allegations and...

The prevailing literature on child maltreatment often assumes directional symmetry, such that behavioral problems associated with increasing adversity would be expected to improve commensurately as adversity diminishes.

To test the symmetry assumption by examining whether within-child increases and decreases in maltreatment allegations show commensurate associations with changes in behavioral problems.

Data were drawn from the Longitudinal Studies of Child Abuse and Neglect, recruited across five regions of the United States (Eastern, Southern, Midwestern, Southwestern, and Northwestern), comprising 1298 children (7288 person-wave observations) assessed prospectively from ages 4 to 16.

We applied asymmetric fixed effects models, a method that decomposes within-individual fluctuations in maltreatment into independent cumulative increases and decreases, to predict behavioral problems.

Standard fixed effects models yielded misleading null estimates by forcing symmetry. In contrast, asymmetric models showed that maltreatment increases were significantly associated with higher internalizing (β⁺= 0.153, p < 0.01) and externalizing (β⁺ = 0.220, p < 0.01) problems. Crucially, equivalent decreases were not associated with commensurate recovery. This asymmetry was pervasive for internalizing behaviors (Wald p= 0.004), where five of six maltreatment subtypes exhibited pronounced resistance to spontaneous recovery. For externalizing behaviors, asymmetry was marginal (Wald p= 0.048), with physical abuse alone demonstrating robust persistence (p = 0.003).

Within-child associations between maltreatment allegations and behavioral problems were asymmetric, particularly for internalizing problems. Reductions in documented allegations were not accompanied by commensurate behavioral improvements, underscoring the inadequacy of standard symmetrical assumptions and highlighting the potential importance of targeted therapeutic interventions beyond initial crisis removal.