From a life course perspective, childhood is an important time for the development of cognitive ability, self-confidence, life opportunities, and future health. Therefore, parents should establish a good relationship with their children, including providing for their children’s physical, emotional and educational needs [
1‐
3]. Child maltreatment is any act of commission or omission that causes harm, the potential for harm, or a threat of harm to a child [
4]. Acts of commission, which can affect the child directly and/or indirectly, include physical, sexual, or psychological abuse directed towards the child or an intimate partner. In this study, we refer to such acts as family violence. The acts of omission include failure to meet a child’s basic physical, medical/dental, educational, or emotional needs [
4] which we refer to as parental unavailability in this study. Parents who do not fulfil their relational role increase the risk for their children to be affected by anxiety, posttraumatic stress, psychosis, self-inflicted injuries, suicide attempts, eating disorders, obesity, alcohol risk use, drug use, and criminality and arrests, with strong evidence for some outcomes and inconsistent evidence for others [
4‐
6]. By threatening the security of attachment, adverse interactions with parents (e.g., neglect of emotional needs) may contribute to the development of internal working models of self and self-in-relation to others (e.g., vulnerability to harm, shame, and self-sacrifice) that influence later cognitive schemas and psychological adjustment, which in turn increase the risk of mental disorders [
7]. Particularly, emotional neglect has been found to have severe short- and long-term harmful effects on children’s well-being and development [
8], such as mental disorders [
9], internalizing symptoms, substance use behaviors [
10], and lower health-related quality of life [
11,
12]. Although few studies have examined this issue, one study has found that more than 18% of all children internationally suffer from some kind of neglect during their childhood [
13], and a recent German study observed that more than 7% suffered from severe emotional neglect [
14]. Despite a high prevalence [
4,
13,
14] and connection to severe physical and sexual abuse [
4,
6], epidemiological research of neglected emotional needs during childhood and potential long-term consequences is lacking [
4,
13,
15]. Moreover, studies including emotional neglect often treat it as a by-product as few studies have focused on this outcome directly [
13]. In order to promote children’s positive development, health and wellbeing, it is important to early detect families that cannot meet children’s emotional needs.
Children’s basic emotional needs include attention, acceptance and accomplishment. Children need to be seen and heard, accepted for whom they are and feel that they attain some goals of success, and healthy attachment relationships early in life are necessary to provide for these emotional needs [
16,
17]. Neglecting the emotional needs of a child differs from neglecting physical needs (including failure to provide adequate nutrition, clothing, supervision, personal hygiene, and medical attention) and educational needs (including permitting chronic absence from school and ignoring special educational needs) [
13]. Glaser [
18] highlights the multidimensionality of emotional neglect and state that when defined it should be “based on the elements that comprise a child’s psychosocial being” [18, p.703]. He describes following five dimensions: 1) failure to promote the child’s social adaptation; 2) failure to recognize and acknowledge the child’s individuality and psychological boundary; 3) use of developmentally inappropriate or inconsistent interactions with the child; 4) use of negative attributions and misattributions directed at the child and finally; 5) emotional unavailability and unresponsiveness. Recognizing a child’s individual needs demands that parents are physically available during enough time in their child’s life and emotionally available to be able to acknowledge those needs. This is the dimension in focus of this study.
There exists different and potentially complementing causal models for why parents end up neglecting the needs of their children. Whereas psychological researchers have mainly focused on individual characteristics of the parents (e.g., the parental deficit model), sociological researchers have mainly focused on the parents’ social and economic situation (e.g., the environment deficit model) [
19]. As a combination of the above-mentioned models, the ecological-transactional model focuses on how familial and individual attributes interact with contextual factors in relation to neglect [
19]. Both perspectives have received some support. For example, Yaghoubi-Doust [
20] observed an association between neglect and parental substance abuse and Drake and Pandey [
21] observed an association between neglect and neighborhood poverty status. Further, Lacey et al. [
22] found poverty associated with all kinds of childhood abuse and neglect and Hartras [
23] claims that childhood maltreatment overall “mainly are manifestations of poverty, deprivation and gender inequality” [p. 440]. To prevent neglect (e.g., by providing support for parents who struggle in their parenting), more knowledge is needed about the conditions related to different aspects of emotional neglect. Although an association between parental socioeconomic position (SEP) and child maltreatment (i.e., using indicators like injuries and violent and un-intentional deaths) have been observed [
24], less is known about the relation to neglect of emotional needs. This knowledge gap includes both the mechanisms and existence of such an association. An empirical study from the UK has challenged the existence of an association between economic and educational disadvantage and emotional neglect: “Claims that families who are poor or are less well educated do not engage in high profile “good” parenting practices are misplaced” [
25] [p.138]. However, associations might include more indirect mechanisms than negative parental practices such as higher prevalence of mental adversities in parents. Although some studies have investigated the relationship between living conditions during childhood and emotional neglect, few have investigated the roles of psychological and socioeconomic struggles in the family and to our knowledge no epidemiological studies have been conducted in a Swedish context that focus on these issues.
Children’s living conditions in Sweden
In 1979, a law was passed in Sweden that prohibits all forms of corporal punishment, including by caretakers and parents, directed at children. In 1990, Swedish legislation ratified the United Nations Convention on the Rights of the Child, in which states accept an obligation to respect, protect and fulfil the rights of children. The Convention includes children’s right to physical, psychological, spiritual, moral and social development (article 6), for which parents have primary responsibility [
26]. In 1993, the Swedish government appointed an ombudsman to protect children’s rights and interests. As a result of these measures, in 2010, Sweden was ranked number one among developed countries on Save the Children’s “Children’s Index Rank”; the best country to be a child [
27]. Thus, in Sweden, like in many other countries, the official and public awareness of children’s rights has developed significantly during the last 40 years. Less is known about changes in the levels of child adversities in Sweden during these years. Despite this development 8.6% of Swedish men and 13.1% of Swedish women reported in 2011 that they had experienced physical or emotional neglect during their childhood [
5]. A higher proportion of young women (9.9%) than young men (4.9%) reported that they had experienced serious concerns or were sad or had worried that they did not have anyone in their lives that could help them, listen to them, comfort them, take their concerns seriously, and protect them against threats when they were a child [
5]. Although children in Sweden on average might have a positive living situation, inequalities exist and children with parents of lower socioeconomic position and/or with a migration background often face larger challenges [
28,
29]. However, researchers and society have yet to acknowledge these disparities, including the potential relationship between parental socioeconomic position, the psychosocial situation of families, and the risk for neglect of emotional needs. From a public health perspective, increased knowledge in this field might contribute to the design of future social policies and interventions that will decrease the number of children exposed to these kinds of adversities.
This study investigates the development over time of family violence and parental unavailability in childhood, among young adult women in Sweden. In addition, the aim was to investigate family violence and parental unavailability in relation to parental socioeconomic position and parental psychological problems.