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1.
《Child abuse & neglect》2014,38(12):1945-1954
Little is known about the extent to which parental conflict and violence differentially impact on offspring mental health and substance use. Using data from a longitudinal birth cohort study this paper examines: whether offspring exposure to parental intimate partner violence (involving physical violence which may include conflicts and/or disagreements) or parental intimate partner conflict (conflicting interactions and disagreements only) are associated with offspring depression, anxiety and substance use in early adulthood (at age 21); and whether these associations are independent of maternal background, depression and anxiety and substance use. Data (n = 2,126 women and children) were taken from a large-scale Australian birth-cohort study, the Mater University of Queensland Study of Pregnancy (MUSP). IPC and IPV were measured at the 14-year follow-up. Offspring mental health outcomes – depression, anxiety and substance use were assessed at the 21-year follow-up using the Composite International Diagnostic Interview (CIDI). Offspring of women experiencing IPV at the 14-year follow-up were more likely to manifest anxiety, nicotine, alcohol and cannabis disorders by the 21-year follow-up. These associations remained after adjustment for maternal anxiety, depression, and other potential confounders. Unlike males who experience anxiety disorders after exposure to IPV, females experience depressive and alcohol use disorders. IPV predicts offspring increased levels of substance abuse and dependence in young adulthood. Gender differences suggest differential impact. 相似文献
2.
ObjectivesTo determine the prevalence of intimate partner violence (defined as any physical violence during the last 12 months or previously) among mothers who maltreat their children, and to examine whether mothers’ experiences of intimate partner violence (IPV) are associated with repeated reports (rereports) of children to Child Protective Services (CPS) during the following 18 months.MethodsData for the analyses were from the National Survey of Child and Adolescent Well-Being (NSCAW), a national probability study of children investigated for child maltreatment. The sample of 5,501 children (ages 0–14) was randomly selected from the families who entered the US child welfare system between October 1999 and December 2000. The analysis sample was restricted to 1,236 families in which caregivers were: (1) the alleged perpetrators of the child maltreatment at baseline (independently of substantiation status) and (2) the biological mothers (n = 1,212 or 98.6%), adoptive mothers (n = 17 or 1%), or stepmothers (n = 7 or 0.3%) of children not placed in out-of-home care.ResultsChildren of mothers physically abused by an intimate partner during the last 12 months or previously at the intake interview (44%) were twice as likely as children of mothers who had not experienced such violence to be rereported to CPS (29% vs. 14%, Odds Ratio = 2.0, 95% Confidence Interval = 1.1–3.4). Rereports occurred almost twice as quickly for children of mothers who experienced IPV compared to children of mothers who had not experienced IPV (Hazard Ratio = 1.9, 95% Confidence Interval = 1.1–3.0).ConclusionsThe higher risk and speedier rereports of child maltreatment associated with intimate partner violence highlights the need for universal assessment and provision of services for IPV among families that are investigated by CPS. 相似文献
3.
Early studies examining parenting in the setting of intimate partner violence (IPV) often focus on abuse by the IPV perpetrator or effects of long term exposure. This review addresses how intimate partner violence impacts victim parenting. Seven databases were searched for the time period 1970–2015. Included were comparative studies involving children 11 years or younger. Quality ranking was based on: confirmation of victim status, consideration of co-perpetration, heterogeneity of the population, and standardization of measurements. Of 13,038 studies reviewed, 33 included studies showed that victimization is associated with negative parenting practices. Based on data presented within individual studies, 21 studies were eligible for meta-analysis which demonstrated modest effect sizes with high levels of heterogeneity. There was a negative correlation between IPV and positive parenting (r = -0.08; 95% CI: −.12, − .04); positive correlation between IPV and physical aggression (r = .17; 95% CI: .11, .23) and neglect (r = .12; 95% CI: .01, .23); and a trend toward positive correlation between IPV and psychological aggression (r = .23; 95% CI: −.94, .47). A synthesis of studies unsuitable for meta-analysis reinforced these findings. The review demonstrated ongoing methodological issues with extant literature. 相似文献
4.
Childhood maltreatment is a strong risk factor for subsequent violence, including violent behaviors in young adulthood and offspring maltreatment after becoming a parent. Little is known about the specific circumstances under which supportive relationships may help disrupt this cycle of violence throughout the life course. We conducted two complementary analyses to assess whether maternal social support in early childhood, and also paternal involvement in middle childhood, could prevent the intergenerational transmission of violence, using data from the Avon Longitudinal Study of Parents and Children (n = 11,384). We found that higher levels of maternal social support in the postpartum period reduced the odds of offspring maltreatment at ages 0–8 years (OR = 0.95, 95% CI 0.93–0.96). When classifying mothers according to their abuse history, this protective association of social support was observed among mothers with no history of childhood maltreatment and among those with only childhood maltreatment (and not postpartum intimate partner violence [IPV]), but not among mothers who reported IPV since the child’s birth. We then extended our analysis of these offspring forward in time and found that paternal involvement at ages 9–10 years was associated with a reduced risk of offspring self-reported violent perpetration at ages 18–20 years (OR = 0.85, 95% CI = 0.77–0.94). This protective association was generally apparent among all subgroups of children, including those with a history of childhood maltreatment. Together these results highlight the protective influence of supportive relationships against the intergenerational transmission of violence, depending on abuse history, context, and timing, with important implications for the prevention of childhood maltreatment and mitigation of its negative effects. 相似文献
5.
《Child abuse & neglect》2014,38(12):1966-1975
The relational model of trauma (Scheeringa & Zeanah, 2001) proposes that infants’ trauma symptoms may be influenced by their mothers' trauma symptoms and disruptions in caregiving behavior, although the mechanisms by which this occurs are less well understood. In this research, we examined the direct and indirect effects of a traumatic event (maternal intimate partner violence [IPV]), maternal trauma symptoms, and impaired (harsh and neglectful) parenting on infant trauma symptoms in a sample of mother–infant dyads (N = 182) using structural equation modeling. Mothers completed questionnaires on IPV experienced during pregnancy and the child's first year of life, their past-month trauma symptoms, their child's past-month trauma symptoms, and their parenting behaviors. Results indicated that the effects of prenatal IPV on infant trauma symptoms were partially mediated by maternal trauma symptoms, and the relationship between maternal and infant trauma symptoms was fully mediated by neglectful parenting. Postnatal IPV did not affect maternal or infant trauma symptoms. Findings support the application of the relational model to IPV-exposed mother–infant dyads, with regard to IPV experienced during pregnancy, and help identify potential foci of intervention for professionals working with mothers and children. 相似文献
6.
ObjectivesNeuroendocrine alterations may help explain health differences between intimate partner violence (IPV) exposed children and non-exposed children. We sought to determine the feasibility of having families, recruited at a child asthma visit, collect at home and return via mail child salivary samples, and whether socio-demographic variables were associated with sample return. For those returning samples, we examined whether past-year IPV exposure was associated with total cortisol output (AUC) and the magnitude of the cortisol awakening response (CAR), and whether these cortisol values were associated with asthma control.MethodsFifty-five families with an asthmatic child of any age were recruited from 2 pediatric asthma clinics. At the time of the visit, parents completed a survey packet which included a modified version of the Conflict Tactics Scale to assess IPV. Parents were given supplies to collect 3 child salivary cortisol samples (awakening, 30-min after awakening, bedtime) at home on a typical day, and return them via mail. Medical records also were abstracted.ResultsFifty-three percent (n = 29) returned child salivary samples. Families who returned samples typically returned them within 2 weeks, most commonly before we made a reminder call. Parental male sex was associated (p = .06) with increased rate of return at the trend level. In multivariable models, a 1-unit increase in IPV was significantly associated with a .93 SD increase in root-transformed total cortisol output (AUC) (un-standardized beta = 2.5; SE .59; p = .001). The odds of uncontrolled asthma were marginally higher for every nmol/l increase in CAR (OR 1.04; 95% CI 1.0, 1.1; p = .06).ConclusionsThis study provides support for the feasibility of obtaining a moderate return of salivary specimens from a convenience sample. Findings that IPV was associated with elevated total cortisol output and uncontrolled asthma was marginally associated with cortisol awakening response suggest that future studies should investigate whether cortisol mediates the IPV-child asthma relationship. 相似文献
7.
Violence against adolescent girls occurs at alarmingly high rates in conflict-affected settings, in part due to their increased vulnerability from their age and gender. However, humanitarian programming efforts have historically focused either on child abuse prevention or intimate partner violence prevention and have not fully addressed the specific needs of adolescent girls, including engagement of caregivers to reduce risk of violence against adolescent girls. Thus, the objectives of this analysis are to examine the whether gendered and parental attitudes of caregivers in South Kivu, Democratic Republic of Congo (DRC) were associated with their adolescent girls’ experiences of violence and girls’ attitudes towards IPV. Cross-sectional data from 869 girls (10–14 years) and their caregivers (n = 764) were drawn from a baseline assessment of a violence prevention evaluation conducted in 2015. Findings suggest that female caregiver’s gender equitable attitudes for adults may be associated with reduced odds of sexual abuse and less acceptance of IPV for adolescent girl children. Parenting attitudes and beliefs and gender equity for girl children were not associated with violence risk for girls, while increased accepting attitudes of negative discipline were only associated with lowered odds of sexual abuse. Understanding of caregivers’ attitudes may provide potential insight into how to more effectively engage and develop programming for caregivers to promote the safety and well-being of adolescent girls. 相似文献
8.
Cruelty toward companion animals is a well-documented, coercive tactic used by abusive partners to intimidate and control their intimate partners. Experiences of co-occurring violence are common for children living in families with intimate partner violence (IPV) and surveys show that more than half are also exposed to abuse of their pets. Given children's relationships with their pets, witnessing such abuse may be traumatic for them. Yet little is known about the prevalence and significance of this issue for children. The present study examines the experiences of children in families with co-occurring pet abuse and IPV. Using qualitative methods, 58 children ages 7–12 who were exposed to IPV were asked to describe their experiences of threats to and harm of their companion animals. Following the interviews, template analysis was employed to systematically develop codes and themes. Coding reliability was assessed using Randolph's free-marginal multirater kappa (kfree = .90). Five themes emerged from the qualitative data, the most common being children's exposure to pet abuse as a power and control tactic against their mother in the context of IPV. Other themes were animal maltreatment to discipline or punish the pet, animal cruelty by a sibling, children intervening to prevent pet abuse, and children intervening to protect the pet during a violent episode. Results indicate that children's experiences of pet abuse are multifaceted, potentially traumatic, and may involve multiple family members with diverse motives. 相似文献
9.
10.
Early childhood exposure to family violence predicts increased risk for psychopathology. However, violence between partners and towards children often co-occur. This complicates efforts to determine how experiences of family violence contribute to early mental health problems. Utilizing mother-report data on harsh parenting and intimate partner violence (IPV) from two large community-based, socioeconomically and ethnically diverse samples of 3–5-year-old children, we illustrate the value of a bifactor method for characterizing a family climate in which verbal and physical violence are more chronic and pervasive among family members. In our Calibration sample (N = 1,179), we demonstrate the fit of a bifactor model with a shared violence factor reflecting violence among partners and towards children and orthogonal factors for physically harsh parenting and IPV. Examination of item distributions along quartiles on the identified factors reveals that violent behaviors are most frequent/chronic in families with high scores on the shared violence factor. Next, we apply this model in Validation (N = 1,316) and lab-visit samples (N = 369). Children’s symptoms and impairment showed relatively strong and consistent associations with the shared factor. Some unique associations with IPV and harsh parenting were also observed. Overall, patterns suggest particularly negative impact when verbal and physical violence are more chronic and pervasive among family members. Finally, evidence supporting the bifactor model’s validity relative to multi-method data from coded interviews about child abuse and IPV and observed parenting is presented. Findings illustrate the value of a bifactor approach for the meaningful characterization of shared and specific features of family violence. 相似文献
11.
A growing body of research documents that various forms of violence exposures are interrelated. This paper presents a conceptual model, which accounts for the relationship between youth witnessing intimate partner violence (IPV) at home and their subsequent engagement in bullying behaviors and victimization by peers. A comprehensive search of major databases was conducted within a 12-year period (1999–2011). Based on this review, we provide empirical evidence, which documents that youth who witness IPV are at increased risk for bullying behaviors and peer victimization. Next, we posit a mediational model, which suggests that the relationship between witnessing IPV and bullying behavior and peer victimization is mediated by psychological problem behaviors, lower school success, and problematic peer interactions. We also explore potential moderating factors that may exacerbate or buffer the effects of witnessing IPV, such as age, gender, race/ethnicity, parenting practices, and peer relationships. This overall conceptual model should be empirically tested and has important implications for guiding future research on the relationship between IPV and bullying behaviors and victimization among youth. 相似文献
12.
BackgroundEvidence suggests intimate partner violence (IPV), substance use, and depression adversely affect the disciplinary practices of caregivers involved with child welfare; however, it remains uncertain whether the combined effects of these conditions are syndemic.ObjectiveThe purpose of this study was to examine the (1) associations between IPV, problematic drug use, problematic alcohol use, and depressive symptoms and self-reported disciplinary practices among a sample of mothers with child welfare contact; and (2) effect of co-occurrence of these conditions on child disciplinary practices.Participants and settingWe used data from the second cohort of the National Survey of Child and Adolescent Well-Being (NSCAW II). The analysis focused on 965 biological mothers with children who were subjects of child abuse/neglect investigations between February 2008 and April 2009 in the United States.MethodWe conducted multiple linear regression analyses.ResultsOur findings showed that IPV (B = .28; 95% CI = [.04, .53]) and depressive symptoms (B = .27; 95% CI = [.03, .52]) were independently associated with psychologically aggressive disciplinary practices. Also, IPV was independently associated with physically aggressive disciplinary practices (B = .64; 95% CI = [.18, 1.11]); and IPV (B = .21; 95% CI = [.06, .35]) and depressive symptoms (B = .22; 95% CI = [.07, .37]) were independently associated with neglectful parenting strategies. A significant effect was found for the interaction between problematic drug use and depressive symptoms with physically aggressive practices as the outcome. As the number of conditions caregivers had increased, so did their propensity for self-reporting each of the disciplinary practices (p < .05).ConclusionsThe findings highlight the need for using a more holistic/multidisciplinary approach to child maltreatment prevention research, policy, and intervention. 相似文献
13.
Young children are at significant risk of exposure to intimate partner violence (IPV), and vulnerable to exposure-related psychopathology, yet few studies investigate the effects of exposure to IPV on children under the age of 5 years. The current study investigated the role of maternal PTSD symptoms and parenting strategies in the relationship between mothers’ IPV experiences and psychopathology in their young children, ages 3–6 years in a community-based cohort of 308 mother-child dyads at high risk for family violence. Data were collected from 2011 to 2014. IPV history and maternal PTSD symptoms were assessed by self-report questionnaires. Children’s symptoms were assessed with a developmentally-sensitive psychiatric interview administered to mothers. Punitive/restrictive parenting was independently-coded from in-depth interviews with mothers about their disciplinary practices. Hypothesized direct and indirect pathways between physical and psychological IPV, maternal PTSD, maternal parenting style, and children’s internalizing and externalizing symptoms were examined with mediation models. Results indicated that neither physical nor psychological IPV experienced by mothers was directly associated with children’s symptoms. However, both types of victimization were associated with maternal PTSD symptoms. Examination of indirect pathways suggested that maternal PTSD symptoms mediated the relationship between mothers’ psychological and physical IPV experiences and children’s internalizing and externalizing symptoms and mothers’ restrictive/punitive parenting mediated the relationship between mothers’ psychological IPV and children’s externalizing symptoms. In addition, there was a path from maternal physical IPV to child externalizing symptoms through both maternal PTSD symptoms and restrictive/punitive parenting. Findings highlight the importance of supporting parents in recovering from the sequelae of their own traumatic experiences, as their ensuing mental health symptoms and parenting behaviors may have a significant impact on their children’s emotional health. 相似文献
14.
BackgroundExperiences of intimate partner violence (IPV) victimization negatively impact maternal parenting. However, little is known about the association between fathers’ perpetration of IPV and paternal parenting.ObjectiveTo examine associations between fathers’ IPV perpetration against the child’s mother and fathers’ stimulation and spanking practices with their young child.Participants and SettingWe used two waves of data from the Fragile Families and Child Wellbeing Study in the United States. The analytic sample comprised of 2,257 biological fathers who had been in a romantic relationship with the child’s mother.MethodsFathers’ IPV perpetration at year 1 and 3 was measured based on maternal report. Fathers were categorized into: never perpetrators (no IPV at either year), persisters (IPV at both years), desisters (IPV at year 1 only), and emergers (IPV at year 3 only). Fathers’ parenting at year 3 was measured based on self-reported stimulation (e.g., reading books, playing games, telling stories) and spanking.ResultsApproximately one-third of fathers never perpetrated IPV, 35.8% were persisters, 14.4% were desisters, and 16.9% were emergers. For stimulation, persisters (β=-0.16, 95% CI: -0.25, -0.06) and emergers (β=-0.25, 95% CI: -0.36, -0.14), but not desisters (β=-0.02, 95% CI: -0.14, 0.11), were less engaged in stimulation than fathers who never perpetrated IPV. However, for spanking, there were no differences in the associations by father IPV profiles.ConclusionsFindings suggest that fathers’ perpetration of IPV is related to their stimulation practices. Partner-abusive men and their children may benefit from parenting programs that promote engagement in stimulation and improve the quality of parent-child relationships. 相似文献
15.
《Child abuse & neglect》2014,38(12):1934-1944
Children exposed to intimate partner violence (IPV) are at increased risk of experiencing behavioral difficulties including externalizing and internalizing problems. While there is mounting evidence about mental health problems in children exposed to IPV, most of the research to date focuses on IPV exposure as a unitary, homogeneous construct. The purpose of this study was to examine the association between subtypes of IPV exposure on child functioning and presence of harm within a child welfare sample. Given the evidence of the “double whammy” effect, co-occurring IPV exposure was also examined. Using data from the Canadian Incidence Study of Reported Child Abuse and Neglect – 2008 (n = 2,184) we examined whether specific IPV exposure subtypes or their co-occurrence resulted in a greater risk of child maladjustment. Information was obtained from child welfare workers’ reports. Caregiver and household risk factors were also examined. Co-occurring IPV exposure resulted in the greatest risk for reported child maladjustment. Exposure to emotional IPV and direct physical IPV were significantly associated with increased risk of internalizing problems and presence of harm. Caregiver mental health and lack of social support emerged as significant risk factors for behavior problems. This study adds to the evidence that exposure to subtypes of IPV may be differentially related to child functioning. Given that risk factors and child functioning is part of the decision-making framework for case worker referrals, this study provides important preliminary evidence about how the child welfare system operates in practice with respect to sub-types of exposure to IPV. These findings suggest that intervening with children exposed to different types of IPV may require a tailored approach. 相似文献
16.
This study uses longitudinal data from the Project on Human Development in Chicago Neighborhoods (PHDCN) to examine the effects of exposure to school violence, community violence, child abuse, and parental intimate partner violence (IPV) on youths’ subsequent alcohol and marijuana use. We also examine the cumulative effects of being exposed to violence across these domains. Longitudinal data were obtained from 1,655 adolescents and their primary caregivers participating in the PHDCN. The effects of adolescents’ exposure to various forms of violence across different life domains were examined relative to adolescents’ frequency of alcohol and marijuana use three years later. Multivariate statistical models were employed to control for a range of child, parent, and family risk factors. Exposure to violence in a one-year period increased the frequency of substance use three years later, though the specific relationships between victimization and use varied for alcohol and marijuana use. Community violence and child abuse, but not school violence or exposure to IPV, were predictive of future marijuana use. None of the independent measures of exposure to violence significantly predicted future alcohol use. Finally, the accumulation of exposure to violence across life domains was detrimental to both future alcohol and marijuana use. The findings support prior research indicating that exposure to multiple forms of violence, across multiple domains of life, negatively impacts adolescent outcomes, including substance use. The findings also suggest that the context in which exposure to violence occurs should be considered in future research, since the more domains in which youth are exposed to violence, the fewer “safe havens” they have available. Finally, a better understanding of the types of violence youth encounter and the contexts in which these experiences occur can help inform intervention efforts aimed at reducing victimization and its negative consequences. 相似文献
17.
There is ongoing debate about the reliability of parental reports on child victimization. Some studies have shown that they are useful, whereas some others have provided contrary evidence suggesting that parents are not accurate in reporting child victimization, especially when they are the one who inflicted the violence. This study aimed to (a) examine the reliability of parental reports of adolescents’ experiences of victimization, including that inflicted by parents as well as others, by comparing them with self-reports using a parent–child matched sample from China; and (b) explore the possible reasons underlying any disagreement between the parental and adolescent reports. A total of 2,624 parent–adolescent pairs were recruited during 2009 and 2010 in 6 cities in China. Parents were asked to report the victimization experiences of their child using of the Juvenile Victimization Questionnaire, and these reports were matched with the adolescents’ self-reports of victimization. Low levels of parent–adolescent agreement in reporting were found (Cohen's kappa = .04–.29). Except for sexual violence, parents were significantly less likely to report all types of victimization. Overall, lower levels of agreement were found in the reporting of (a) less severe types of victimization, (b) victimization outside the family, and (c) victimization involving parents as perpetrators. Intimate partner violence between parents was significantly associated with discrepancies between reports. The findings suggest that parents might not be reliable as a single source of information on certain types of adolescent victimization. 相似文献
18.
Sandra A. Graham-Bermann Gabrielle Gruber Kathryn H. Howell Laura Girz 《Child abuse & neglect》2009,33(9):648-660
ObjectiveTo evaluate the social and emotional adjustment of 219 children in families with varying levels of intimate partner violence (IPV) using a model of risk and protection. To explore factors that differentiate children with poor adjustment from those with resilience.MethodologyMothers who experienced IPV in the past year and their children ages 6–12 were interviewed. Standardized measures assessed family violence, parenting, family functioning, maternal mental health, and children's adjustment and beliefs.ResultsUsing cluster analysis, all cases with valid data on the Child Behavior Checklist, Child Depression Inventory, General Self-Worth and Social Self-Competence measures were described by four profiles of children's adjustment: Severe Adjustment Problems (24%); children who were Struggling (45%); those with Depression Only (11%); and Resilient (20%) with high competence and low adjustment problems. Multinomial logistic regression analyses showed children in the Severe Problems cluster witnessed more family violence and had mothers higher in depression and trauma symptoms than other children. Resilient and Struggling children had mothers with better parenting, more family strengths and no past violent partner. Parents of children with Severe Problems were lacking these attributes. The Depressed profile children witnessed less violence but had greater fears and worries about mother's safety.ConclusionFactors related to the child, to the mother and to the family distinguish different profiles of adjustment for children exposed to IPV who are living in the community. Resilient children have less violence exposure, fewer fears and worries, and mothers with better mental health and parenting skills, suggesting avenues for intervention with this population.Practice implicationsFindings suggest that child adjustment is largely influenced by parent functioning. Thus, services should be targeted at both the child and the parent. Clinical interventions shaped to the unique needs of the child might also be tested with this population. 相似文献
19.
The present study examined the associations between authoritarian parenting beliefs, attributions of hostile intent, negative affect, and harsh parenting practices. General population parents (N = 183; 31.1% fathers) completed self-report measures of authoritarian parenting beliefs and read vignettes describing children engaging in transgressions. Following each vignette, parents indicated the extent to which they would attribute hostile intent to the child, feel negative affect, and respond with harsh parenting practices (e.g., yelling, hitting). As hypothesized, parents who subscribed to higher levels of authoritarian beliefs attributed more hostile intent to the child and expected to feel more negative affect in response to the transgressions. In turn, higher levels of hostile attributions and negative affect were associated with increased likelihood of harsh parenting practices. Results from a path analysis revealed that the association between authoritarian parenting beliefs and harsh parenting practices was fully explained by attributions of hostile intent and negative affect. 相似文献
20.
Shaking and smothering in response to infant crying are life-threatening child abuse. Parental childhood abuse history is known to be one of the most robust risk factors for abusing their offspring. In addition to childhood abuse history, other adverse childhood exposures (ACEs) need to be considered due to co-occurrence. However, few studies have investigated the impact of ACEs on caregivers shaking and smothering their infant. This study aims to investigate the association of ACEs with shaking and smothering among caregivers of infants in Japan. A questionnaire was administered to caregivers participating in a four-month health checkup between September 2013 and August 2014 in Chiba City, Japan, to assess their ACEs (parental death, parental divorce, mentally ill parents, witness of intimate partner violence, physical abuse, neglect, psychological abuse and economic hardship), and shaking and smothering toward their infants (N = 4297). Logistic regression analysis was used to examine the cumulative and individual impacts of ACEs on shaking and smothering. Analyses were conducted in 2015. A total of 28.3% reported having experienced at least one ACE during their childhood. We found that only witness of IPV had a significant association with shaking of infant (OR = 1.93, 95% CI: 1.03–3.61). The total number of ACEs was not associated with either shaking or smothering. Our findings suggest that shaking and smothering in response to crying can occur regardless of ACEs. Population-based strategies that target all caregivers to prevent shaking and smothering of infants are needed. 相似文献