{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T16:39:15Z","timestamp":1793896755604,"version":"4.8.0"},"reference-count":37,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"unspecified","delay-in-days":104,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epidemiol Psychiatr Sci"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S2045796026100572_sec1a\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Prevention of child maltreatment \u2013 incorporating physical abuse, sexual abuse, emotional abuse, neglect and exposure to domestic violence \u2013 is a clearly defined global policy priority. Global Burden of Disease studies have focused on estimating burden attributable\u00a0to childhood sexual abuse omitting other forms of child maltreatment. This study aims to estimate burden attributable\u00a0to child maltreatment using data from the first comprehensive national study, the Australian Child Maltreatment Study (ACMS), accounting for the co-occurrence of multiple forms, the complex impact of multi-type maltreatment and the contribution of interrelated factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2045796026100572_sec2b\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We estimated burden attributable\u00a0to child maltreatment by age and gender for Australia in 2021. Risk\u2013outcome pairs that met criteria for sufficient evidence for a causal relationship were included. Relative risks were estimated as a function of exposure based on data from the ACMS incorporating increased risk with multi-type maltreatment and adjustment for confounding. Levels of exposure in each of the 32 mutually exclusive combinations or patterns of child maltreatment were estimated based on ACMS data by age and gender. The theoretical minimum risk exposure level was determined as no exposure to child maltreatment in the population and population attributable\u00a0fractions (PAFs) were calculated. Attributable\u00a0mortality, years of life lost, years lived with disability and disability-adjusted life years (DALYs) were estimated by multiplying PAFs by the relevant burden of disease estimates by age and gender for Australia in 2021. Sensitivity analyses were conducted to assess the robustness of the results. Uncertainty was propagated into attributable\u00a0burden estimates using Monte Carlo simulation methods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2045796026100572_sec3c\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, child maltreatment accounted for 6.6% (95% uncertainty interval (UI), 6.2\u20136.9%) of all DALYs for women and 6.4% (95% UI, 6.0\u20136.7%) of all DALYs for men in Australia in 2021. An estimated 71.2% of self-harm, 57.1% of anxiety disorders and 49.3% of major depressive disorder (MDD) DALYs in women, and 63.8% of self-harm, 55.9% of anxiety disorders and 42.9% of MDD DALYs in men were attributable\u00a0to child maltreatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2045796026100572_sec4d\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Child maltreatment contributes to a substantial proportion of burden of disease in Australia, equivalent to leading lifestyle-related risk factors such as high body mass index, high blood pressure and smoking. This research significantly advances knowledge of the disease burden attributable\u00a0to child maltreatment and provides novel methodology for measuring the impact of all five forms of child maltreatment combined on mental health and health risk behaviours nationally and globally.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s2045796026100572","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T08:42:43Z","timestamp":1776242563000},"source":"Crossref","is-referenced-by-count":1,"title":["Estimating burden of disease attributable\u00a0to child maltreatment using findings from the Australian Child Maltreatment Study"],"prefix":"10.1017","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9742-1957","authenticated-orcid":false,"given":"Rosana","family":"Pacella","sequence":"first","affiliation":[{"name":"University of Greenwich"},{"name":"Queensland University of Technology (QUT)"},{"name":"Queensland University of Technology (QUT)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben","family":"Mathews","sequence":"additional","affiliation":[{"name":"Queensland University of Technology (QUT)"},{"name":"Queensland University of Technology (QUT)"},{"name":"Johns Hopkins University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Lawrence","sequence":"additional","affiliation":[{"name":"Curtin University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Madzoska","sequence":"additional","affiliation":[{"name":"Curtin University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Malacova","sequence":"additional","affiliation":[{"name":"QIMR Berghofer, Medical Research Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holly E.","family":"Erskine","sequence":"additional","affiliation":[{"name":"Queensland Centre for Mental Health Research"},{"name":"The University of Queensland"},{"name":"University of Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7897-7821","authenticated-orcid":false,"given":"Hannah J.","family":"Thomas","sequence":"additional","affiliation":[{"name":"QIMR Berghofer, Medical Research Institute"},{"name":"Queensland Centre for Mental Health Research"},{"name":"The University of Queensland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0268-8243","authenticated-orcid":false,"given":"Daryl J.","family":"Higgins","sequence":"additional","affiliation":[{"name":"Australian Catholic University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Divna","family":"Haslam","sequence":"additional","affiliation":[{"name":"Queensland Centre for Mental Health Research"},{"name":"The University of Queensland"},{"name":"The University of Queensland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franziska","family":"Meinck","sequence":"additional","affiliation":[{"name":"University of Edinburgh"},{"name":"University of the Witwatersrand"},{"name":"North-West University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0744-0688","authenticated-orcid":false,"given":"James G.","family":"Scott","sequence":"additional","affiliation":[{"name":"Queensland Centre for Mental Health Research"},{"name":"The University of Queensland"},{"name":"Children\u2019s Health Queensland Hospital and Health Service"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,4,15]]},"reference":[{"key":"S2045796026100572_ref21","doi-asserted-by":"crossref","first-page":"e047074","DOI":"10.1136\/bmjopen-2020-047074","article-title":"The Australian Child Maltreatment Study (ACMS): Protocol for a national survey of the prevalence of child abuse and neglect, associated mental disorders and physical health problems, and burden of disease","volume":"11","author":"Mathews","year":"2021","journal-title":"BMJ Open"},{"key":"S2045796026100572_ref29","volume-title":"SAS","year":"2013"},{"key":"S2045796026100572_ref37","volume-title":"Responding to Child Maltreatment: A Clinical Handbook for Health Professionals","year":"2022"},{"key":"S2045796026100572_ref19","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1016\/S0924-9338(97)83296-8","article-title":"The Mini International Neuropsychiatric Interview (MINI). 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