Evidence map›Paper›PMID 40210705›Full record

SynthesisNature human behaviour2025

Health effects associated with exposure of children to physical violence, psychological violence and neglect: a Burden of Proof study.

Luisa S Flor, Caroline Stein, Gabriela F Gil, Mariam Khalil, Molly Herbert, Aleksandr Y Aravkin, Alejandra Arrieta, María Jose Baeza de Robba, Flavia Bustreo, Jack Cagney and 31 more

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Nature human behaviour, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

41 authors.

Luisa S FlorInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA. lsflor@uw.edu.
Caroline SteinInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.ORCID http://orcid.org/0000-0003-4777-1630
Gabriela F GilInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Mariam KhalilInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Molly HerbertInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Aleksandr Y AravkinInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Alejandra ArrietaInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
María Jose Baeza de RobbaSchool of Nursing, The Pontifical Catholic University of Chile, Santiago, Chile.
Flavia BustreoFondation Botnar, Basel, Switzerland.
Jack CagneyInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.ORCID http://orcid.org/0000-0002-4191-8702
Renzo J C Calderon-AnyosaMcGill University, Montreal, Quebec, Canada.
Sinclair CarrInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.ORCID http://orcid.org/0000-0003-0421-3145
Jaidev Kaur ChandanWarwick Medical School, University of Warwick, Coventry, UK.
Joht Singh ChandanInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.ORCID http://orcid.org/0000-0002-9561-5141
Carolina V N CollDepartment of Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
Fabiana Martins Dias de AndradeFederal University of Minas Gerais, Belo Horizonte, Brazil.
Gisele N de AndradeFederal University of Minas Gerais, Belo Horizonte, Brazil.ORCID http://orcid.org/0000-0003-0433-8351
Alexandra N DebureSchool of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA.ORCID http://orcid.org/0009-0005-3125-2248
Erin DeGrawInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Ben HammondInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.ORCID http://orcid.org/0000-0001-9928-6843
Simon I HayInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.ORCID http://orcid.org/0000-0002-0611-7272
Felicia M KnaulInstitute for the Advanced Study of the Americas, University of Miami, Coral Gables, FL, USA.
Rachel Q H LimInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.
Susan A McLaughlinInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Nicholas MethenyNell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA.ORCID http://orcid.org/0000-0003-2295-2945
Sonica MinhasInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.ORCID http://orcid.org/0000-0001-9271-8623
Jasleen K MohrInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.
Erin C MullanyInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Christopher J L MurrayInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.ORCID http://orcid.org/0000-0002-4930-9450
Erin M O'ConnellInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Vedavati PatwardhanInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Sofia ReinachVital Strategies, New York, NY, USA.ORCID http://orcid.org/0000-0003-1957-8243
Dalton ScottSchool of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA.ORCID http://orcid.org/0000-0003-2312-4463
Cory N SpencerInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Reed J D SorensenInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Heidi StöcklInstitute of Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-University Munich, Munich, Germany.ORCID http://orcid.org/0000-0002-0907-8483
Aisha TwalibuInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Aiganym ValikhanovaInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Nádia VasconcelosFederal University of Minas Gerais, Belo Horizonte, Brazil.
Peng ZhengInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Emmanuela GakidouInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.ORCID http://orcid.org/0000-0002-8992-591X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The health toll of child maltreatment or violence against children (VAC) has not yet been comprehensively evaluated. Here, in our systematic review and meta-analyses, we focused on the health impacts of physical violence, psychological violence and neglect during childhood. Utilizing the Burden of Proof methodology, which generates conservative measures of association while accounting for heterogeneity between input studies, we evaluated 35 associations between VAC and adverse health outcomes, identifying 27 statistically significant links. The associations between physical violence and major depressive disorder, ischaemic heart disease, alcohol use disorder, eating disorders and drug use disorders were rated as moderately weak, reflecting a small effect size and/or inconsistent evidence. The minimum increased risk ranged from 16% for depression to 2% for drug use disorders. Psychological violence showed similar moderately weak associations with drug use disorders (8% minimum risk increase), migraine (7%) and gynaecological diseases (2%). Neglect was linked to at least a 15% increased risk for anxiety disorders. The other 18 associations were weaker due to smaller effect sizes and/or less consistent evidence. Despite the limitations of the existing evidence, our analysis highlights substantial health impacts for VAC survivors, underscoring the need for health system prioritization and continued efforts to eliminate all forms of VAC.

Indexed as

Child AbuseChildHumansSubstance-Related Disorders

Identifiers

PMID40210705
PMCPMC12185353

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.