子どもの身体的虐待の世代間的な継続性:証拠はどれくらい良いのか?
I O Ertem1, J M Leventhal, S Dobbs
1Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA. ertem@dialup.ankara.edu.tr
Lancet (London, England)
|October 7, 2000
まとめ
子供の頃の身体的虐待は,次世代の虐待のリスクを増やす可能性があります. しかし,ほとんどの研究には厳格な方法論が欠け,子供に対する身体的虐待の世代間伝播に疑問を投げかけている.
科学分野:
- 公衆衛生は公衆衛生である.
- 子どもの発達 子供の発達 子供の発達
- 心理学 心理学とは
背景:
- 子どもの頃の身体的虐待は,自分の子どもを虐待する確率が高くなるという一般的な信念があります.
- 子どもの身体的虐待のこの世代間伝染を裏付ける経験的証拠は,体系的に検討されていない.
- 既存の研究は,しばしば方法論的厳格性が欠け,その設計を批判的に評価することが必要である.
研究 の 目的:
- 子どもの身体的虐待の世代間伝播を調査する研究の方法論的質を体系的に評価する.
- 仮説的なランダム化対照試験から派生した8つの方法論的基準に対して研究設計を評価する.
主な方法:
- 1965年から2000年の間に英語で出版された研究の体系的なレビューが行われました.
- 2世代に渡る身体的虐待を報告した研究を含み,比較グループが特徴でした.
- 2人の独立した研究者が,各研究の8つの既定の方法論的基準への遵守を評価した.
主要な成果:
- 10つの研究が特定されました (4つのコホート, 1つの横断, 5つのケース・コントロール).
- 4つの研究では,虐待歴のある親の間で,児童虐待の相対リスク (4.75~37.8) が著しく高まっていることが示されました.
- しかし,方法論的な欠陥が多かった: 5つの研究ではリコール/検出バイアスがあり,5つの研究では適切な対照群が欠如し,8つの研究では適切なフォローアップが行われず,6つの研究では虐待に対する親の責任が確認されなかった. ほとんどの研究では,社会人口学的要因を混同することを制御できませんでした.
結論:
- 8つの方法論的基準を満たした1つの研究のみが,子供の身体的虐待の世代間継続性 (相対リスク12.6) の強力な証拠を提供しました.
- 6つの基準を満たす別の研究では,その仮説 (相対リスク1.05) が支持されなかった.
- 提案されたモデルおよび方法論的基準は,有害な結果のための世代間リスク要因に関する将来の研究の科学的質を高めることができます.
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