Absence of digital intervention: exploring the motivations behind self-harm adolescents' avoidance of psychological support techniques.
Authors: Ye H, Ye M
Journal: BMJ paediatrics open
mental health
psychology
open access
Abstract
Child maltreatment is increasingly being treated as a major public concern and addressed through an expanded government role in South Korea’s child protection system []. Nevertheless, physical discipline continues to be widely perceived as an effective child-rearing practice, often discussed in relation to Confucian-influenced norms, which may increase maltreatment risk []. A national survey in Korea reported that approximately 83% of child maltreatment perpetrators were parents, underscoring the need to identify parent-related determinants and inform family focused prevention efforts []. Among parent-related risks, adverse childhood experiences (ACEs) are critical for understanding the current maltreatment risk []. Parental ACEs have been linked to intergenerational risk processes that may compromise sensitive and responsive caregiving and increase the likelihood of child maltreatment and related adverse outcomes []. These patterns are broadly discussed in the literature as intergenerational transmission of child maltreatment (ITCM), defined as the continuity of maltreatment-related risk across generations, whereby parents’ childhood maltreatment histories or other adverse childhood experiences are associated with an increased likelihood of maltreatment-related parenting toward their children [,]. Theoretically, ITCM has been examined through multiple frameworks, with attachment theory and trauma-related models being particularly prominent, while ecological, social, developmental, and biological perspectives have also contributed to understanding how intergenerational risk is shaped by early caregiving experiences, learned relational patterns, and broader developmental and contextual processes []. Importantly, this continuity should not be understood as deterministic; rather, meta-analytic and review evidence indicates that parental maltreatment history is a consistent but non-uniform risk factor, underscoring substantial heterogeneity in ITCM [,,]. Such heterogeneity is reflected in variation in maltreatment subtypes, chronicity, developmental timing, and psychosocial risk and protective factors operating across individual, relational, contextual, and historical levels [,,]. Reported ITCM prevalence varies widely (approximately 7%–70%), likely due in part to methodological differences in the operational definition of ITCM, the measurement of parental adversity and child maltreatment, the maltreatment subtypes included, the potential for self-report bias, and the analytic strategies used [,]. To better address such heterogeneity, person-oriented analytic approaches have gained attention in child maltreatment research []. Unlike variable-oriented approaches, which estimate average associations across the full sample, person-oriented approaches are designed to identify subgroups of individuals who show distinct patterns within the phenomenon of interest []. In child maltreatment research, person-oriented methods such as latent class analysis and latent profile analysis have often been used to classify individuals according to patterns of maltreatment or adversity exposure []. By contrast, latent class regression was particularly appropriate for the present study because it enabled us to examine whether the associations between parental ACEs and current child maltreatment differed across subgroups, rather than assuming a single average pattern across the full sample [-]. However, many ITCM studies have relied primarily on variable-oriented approaches (e.g., linear regression or structural equation modeling) [,], which may obscure meaningful heterogeneity. In the present study, latent class regression was used to identify subgroups characterized by graded levels of maltreatment involvement and differential ACE-domain associations, rather than clearly distinct transmission pathways [].