{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T19:42:51Z","timestamp":1790710971904,"version":"4.1.0"},"reference-count":50,"publisher":"SAGE Publications","issue":"17-18","license":[{"start":{"date-parts":[[2019,6,11]],"date-time":"2019-06-11T00:00:00Z","timestamp":1560211200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Interpers Violence"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:p>Childhood physical abuse can result in serious behavioral, mental health, and physical health conditions. There is a need for improved strategies to identify households in which childhood physical abuse occurs. This article explores three potential correlates of childhood physical abuse: childhood exposure to parental domestic violence, parental addictions, and parental mental illness. Secondary analyses were conducted using the regionally representative 2010 Brief Risk Factor Surveillance Survey (BRFSS) of adults ( n = 9,241 men, n = 13,627 women) and the analyses were replicated in the 2012 BRFSS ( n = 11,656 men, n = 18,145 women). Bivariate and logistic regression analyses were conducted. Approximately one-quarter of the sample was Hispanic and\/or Non-White. In 2010, 78.3% of men who had been exposed to all three of these early adversities reported that they had experienced childhood physical abuse compared with 7.5% of males who did not experience these adversities. Women reported similar levels of childhood physical abuse (66.9% for those reporting all three factors, 5.9% for those with zero risk factors). The 2012 BRFSS analyses resulted in comparable findings. Domestic violence, even in the absence of parental addictions and mental illness, was associated with a high prevalence of childhood physical abuse (between 34% and 38%). Currently, the World Health Organization cautions against routine screening for child abuse due to the high rate of false positives. We propose a two-step strategy to improve targeting: first, identifying households in which two or more adversities exist, and subsequently screening children in these households. Our findings will help improve the targeting of screening and outreach efforts to children most at risk, thereby minimizing the risk of false positives. Our data provide support for universal screening for childhood physical abuse in cases of domestic violence, particularly for those families where parental addictions and\/or parental mental illness also exist.<\/jats:p>","DOI":"10.1177\/0886260519853407","type":"journal-article","created":{"date-parts":[[2019,6,11]],"date-time":"2019-06-11T08:57:56Z","timestamp":1560243476000},"page":"NP9015-NP9034","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":16,"title":["The Toxic Triad: Childhood Exposure to Parental Domestic Violence, Parental Addictions, and Parental Mental Illness as Factors Associated With Childhood Physical Abuse"],"prefix":"10.1177","volume":"36","author":[{"given":"Esme","family":"Fuller-Thomson","sequence":"first","affiliation":[{"name":"Unviersity of Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jami-Leigh","family":"Sawyer","sequence":"additional","affiliation":[{"name":"Unviersity of Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3528-7753","authenticated-orcid":false,"given":"Senyo","family":"Agbeyaka","sequence":"additional","affiliation":[{"name":"Unviersity of Toronto, Ontario, Canada"},{"name":"University Health Network, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,6,11]]},"reference":[{"key":"bibr1-0886260519853407","doi-asserted-by":"publisher","DOI":"10.1001\/jama.282.17.1652"},{"key":"bibr2-0886260519853407","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.53.8.1001"},{"key":"bibr3-0886260519853407","doi-asserted-by":"publisher","DOI":"10.1037\/0893-3200.12.4.578"},{"issue":"2","key":"bibr4-0886260519853407","first-page":"55","volume":"12","author":"Balsa A. I.","year":"2009","journal-title":"Journal of Mental Health Policy and Economics"},{"key":"bibr5-0886260519853407","unstructured":"Centers for Disease Control and Prevention. (2013). BRFSS 2010 Survey Data and Documentation. Retrieved from https:\/\/www.cdc.gov\/brfss\/annual_data\/annual_2010.htm"},{"key":"bibr6-0886260519853407","unstructured":"Centers for Disease Control and Prevention. (2014). BRFSS 2010 survey data and documentation. Retrieved from https:\/\/www.cdc.gov\/brfss\/annual_data\/annual_2010.htm"},{"key":"bibr7-0886260519853407","doi-asserted-by":"publisher","DOI":"10.15288\/jsa.2005.66.66"},{"key":"bibr8-0886260519853407","unstructured":"Clark M. (2003). When to contact child protective services (CPS) in domestic violence cases: A guide for mandated reporters. Retrieved from https:\/\/www.sccgov.org\/sites\/cac\/Documents\/reporting\/dvcriteria.pdf"},{"key":"bibr9-0886260519853407","doi-asserted-by":"publisher","DOI":"10.1080\/10884600701698828"},{"key":"bibr10-0886260519853407","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.156.8.811"},{"key":"bibr11-0886260519853407","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2004.01.008"},{"key":"bibr12-0886260519853407","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2011.10.006"},{"key":"bibr13-0886260519853407","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-3797(98)00017-8"},{"key":"bibr14-0886260519853407","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291799002111"},{"key":"bibr15-0886260519853407","doi-asserted-by":"publisher","DOI":"10.1111\/cch.12024"},{"key":"bibr16-0886260519853407","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)61706-7"},{"key":"bibr17-0886260519853407","doi-asserted-by":"publisher","DOI":"10.1007\/s10567-010-0080-1"},{"key":"bibr18-0886260519853407","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.60.3.253"},{"key":"bibr19-0886260519853407","doi-asserted-by":"publisher","DOI":"10.1177\/107755902237264"},{"key":"bibr20-0886260519853407","doi-asserted-by":"publisher","DOI":"10.1177\/1524838008314797"},{"key":"bibr21-0886260519853407","doi-asserted-by":"publisher","DOI":"10.1097\/JFN.0000000000000136"},{"key":"bibr22-0886260519853407","doi-asserted-by":"publisher","DOI":"10.1001\/jama.281.7.621"},{"key":"bibr23-0886260519853407","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2007-0883"},{"key":"bibr24-0886260519853407","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.71.2.339"},{"key":"bibr25-0886260519853407","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4419-0338-9_65"},{"key":"bibr26-0886260519853407","doi-asserted-by":"publisher","DOI":"10.1177\/0886260502017002003"},{"key":"bibr27-0886260519853407","doi-asserted-by":"publisher","DOI":"10.1046\/j.1360-0443.2002.00238.x"},{"key":"bibr28-0886260519853407","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-7358(98)00100-7"},{"key":"bibr29-0886260519853407","first-page":"1451","volume":"163","author":"MacMillan H. L.","year":"2000","journal-title":"CMAJ: Canadian Medical Association Journal = Journal De L\u2019association Medicale Canadienne"},{"issue":"2","key":"bibr30-0886260519853407","first-page":"151","volume":"148","author":"MacMillan H. L.","year":"1993","journal-title":"The Canadian Task Force on the Periodic Health Examination"},{"key":"bibr31-0886260519853407","doi-asserted-by":"publisher","DOI":"10.15288\/jsa.1999.60.18"},{"key":"bibr32-0886260519853407","doi-asserted-by":"publisher","DOI":"10.1300\/J135v06n01_01"},{"key":"bibr33-0886260519853407","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2018.2537"},{"key":"bibr34-0886260519853407","unstructured":"National Conference of State Legislatures. (2017). Disproportionality and disparity in child welfare. Retrieved from http:\/\/www.ncsl.org\/research\/human-services\/disproportionality-and-disparity-in-child-welfare.aspx"},{"key":"bibr35-0886260519853407","doi-asserted-by":"publisher","DOI":"10.1370\/afm.113"},{"key":"bibr36-0886260519853407","doi-asserted-by":"publisher","DOI":"10.1300\/J029v13n04_06"},{"key":"bibr37-0886260519853407","doi-asserted-by":"publisher","DOI":"10.1177\/000992280604500201"},{"key":"bibr38-0886260519853407","volume-title":"World report on violence against children, United Nations Secretary-General\u2019s study on violence against children","author":"Pinheiro P. S.","year":"2006"},{"key":"bibr39-0886260519853407","doi-asserted-by":"publisher","DOI":"10.1111\/j.1465-3362.2012.00424.x"},{"key":"bibr40-0886260519853407","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.clinpsy.1.102803.144107"},{"key":"bibr41-0886260519853407","doi-asserted-by":"publisher","DOI":"10.1016\/S0145-2134(01)00261-7"},{"key":"bibr42-0886260519853407","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-018-5864-0"},{"key":"bibr43-0886260519853407","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2004.06.016"},{"key":"bibr44-0886260519853407","unstructured":"UNICEF. (2006). Behind closed doors, the impact of domestic violence on children (The Body Shop International). Retrieved from http:\/\/www.unicef.org\/protection\/files\/BehindClosedDoors.pdf"},{"key":"bibr45-0886260519853407","unstructured":"U.S. Department of Health & Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children\u2019s Bureau. (2018). Child maltreatment. Retrieved from https:\/\/www.acf.hhs.gov\/cb\/research-data-technology\/statistics-research\/child-maltreatment"},{"key":"bibr46-0886260519853407","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2017.09.016"},{"key":"bibr47-0886260519853407","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrimjus.2015.12.006"},{"key":"bibr48-0886260519853407","doi-asserted-by":"publisher","DOI":"10.1177\/0886260502238733"},{"key":"bibr49-0886260519853407","doi-asserted-by":"publisher","DOI":"10.1023\/A:1024910416164"},{"key":"bibr50-0886260519853407","volume-title":"Violence prevention: The evidence","author":"World Health Organization","year":"2010"}],"container-title":["Journal of Interpersonal Violence"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0886260519853407","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0886260519853407","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0886260519853407","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T23:16:23Z","timestamp":1777504583000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0886260519853407"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,6,11]]},"references-count":50,"journal-issue":{"issue":"17-18","published-print":{"date-parts":[[2021,9]]}},"alternative-id":["10.1177\/0886260519853407"],"URL":"https:\/\/doi.org\/10.1177\/0886260519853407","relation":{},"ISSN":["0886-2605","1552-6518"],"issn-type":[{"value":"0886-2605","type":"print"},{"value":"1552-6518","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,6,11]]}}}