Associations between abuse, neglect, and at-risk family interactions with adolescent psychiatric disorders.

BACKGROUND

While maltreatment is a well-established risk factor for psychopathology, recent literature highlights the need to consider the role of broader family dynamics in shaping diagnostic outcomes.

OBJECTIVE

This study adopts a framework that integrates both formal abuse/neglect and at-risk family interactions, aiming to identify diagnosis-specific adversity profiles.

PARTICIPANTS AND SETTINGS: This cross-sectional analysis, conducted at a single site as part of the Family and Care study, includes hospitalized adolescents diagnosed with one or more conditions from nine diagnostic categories. Participants were recruited over a 4-year period in an 8-bed psychiatric unit within a university-affiliated psychiatric department.

METHOD: Data on abuse and neglect were collected through the European Child Abuse and Neglect dataset and the At-Risk Family Interactions and Levers (ARFIL) scale, a 30-item clinical tool, measured family interactions. We hypothesized that patterns of maltreatment and at-risk relationships would vary by diagnosis.

RESULTS

Among the 425 participants, emotional abuse prevalence was 46.1 %, physical abuse 21.4 %, sexual abuse 25.1 %, and neglect 70.5 %. Significant differences by age, gender, global assessment of functioning scores, and hospitalization duration were observed between diagnostic groups (p < .05). Personality, Oppositional Defiant, and Trauma and Stress-related Disorders showed higher ARFIL diversity and intensity scores compared to other diagnoses, highlighting the distinct influence of at-risk family dynamics in addition to formal abuse or neglect. All diagnoses exhibited a specific set of associations but mood and psychotic disorders.

CONCLUSIONS

Distinct maltreatment and at-risk family interaction profiles were associated with specific diagnoses. Assessing both maltreatment and family dynamics enhances understanding of patient environments and provides targeted therapeutic insights.