Contributions of Neglect Subtypes and Family History in DSM-IV Disorders: Findings from the NCS-R

摘要: Despite the prevalence of neglect in the child welfare system, understanding of the etiology of neglect remains limited in scope. Limitations are driven by the frequent reliance on child protective services (CPS) data which consists of identified cases and consequently, the most serious of all cases, or through a few population based studies that operationalize neglect as a homogenous phenomenon rather than as distinct subtypes. Furthermore, most studies of neglect focus on maternal deficiencies while paternal factors are largely ignored. This study is meant to address these considerations by utilizing the National Comorbidity Survey Replication (NCS-R), a broad population based sample of US citizens, to explore the associations between mental health disorders and neglect subtypes. The aims were to investigate distinctions between maternal and paternal psychopathology and subtypes of neglect compared to other forms of maltreatment, key differences across lifetime DSM-IV disorders between neglect subtypes and other forms of maltreatment, and how the presence of maternal and paternal psychopathology and maltreatment subtype increase the likelihood of lifetime DSM-IV diagnoses. Out of all neglect subtypes, supervisory neglect was the most prevalent form of neglect and also had the strongest association to most lifetime DSM-IV disorders. Paternal emotional neglect was associated with lifetime mood and behavior disorders as well as phobias compared to those without this experience. Conversely, maternal emotional neglect did not have a significant relationship to any disorder. Similarly, lack of care (LOC) neglect did not increase the risk of any lifetime disorder and even reduced the likelihood of substance disorders compared to those without LOC history. Findings between paternal psychopathology and neglect subtypes indicate that assessments of neglect should expand to include paternal functioning and availability. Supervisory neglect, LOC neglect, and exposure to family violence all demonstrated a greater relationship with paternal substance disorders and/or antisocial behaviors than maternal depression and anxiety. However, therapeutic service delivery and research measures for both neglect and family violence are almost exclusively targeted toward the mother. Approaches that engage, assess, and intervene with both parental figures are critical to the welfare of children.