Background
Childhood maltreatment has pronounced negative effects on mental health. It leads to disruptions in interpersonal relationships and psychological problems, including low self-efficacy, lack of positive task orientation, and social information processing deficits [
1,
2], and it interferes with the development of emotional self-regulation [
3]. It is not surprising that child maltreatment has also been linked to a variety of psychiatric disorders and mental-health problems in adulthood, such as suicidality, depression, substance abuse, psychotic disorders, and the perpetration of violence. Although the mechanism linking childhood maltreatment and adverse mental-health outcomes has remained unclear, it is known that childhood maltreatment influences brain maturation and serotonergic functioning [
4‐
7]. Serotonergic function is crucial for the regulation of emotional responses, impulsivity, and aggression [
8,
9]. Possibly, this epigenetic change leads to the perpetuation of poor mental-health outcomes and social adjustment in adults, as has been emphasized in studies of psychiatric patients as well as the general population [
10‐
14].
One of the most detrimental consequences of childhood maltreatment is that victims are likely to exhibit several socio-behavioral difficulties, and subsequently become perpetrators of crime. A substantial number of studies have suggested that childhood maltreatment significantly increases the risk of criminality in adolescence and adulthood. Prior prospective studies have reported that maltreated children are 2 – 6 times more likely to develop criminal behavior in young adulthood, compared to non-maltreated controls [
15‐
18]. For example, a study exploring the relationship between child maltreatment and criminal behavior over three developmental periods (i.e., adolescence, early adulthood, adulthood) in the National Youth Survey, found that childhood maltreatment was significantly associated with involvement in criminal behavior that continued into adulthood across crime types, including index offenses and intimate partner violence [
19]. Given that childhood maltreatment is strongly associated with delinquent behavior, there is sufficient evidence to expect childhood maltreatment to be associated with recidivism [
10,
20,
21]. Moreover, it has been suggested that the specific types of childhood maltreatment (i.e. abuse and neglect) might have differential effects on recidivism, and that neglect might be a stronger predictor of recidivism than the other different types of abuse in adolescence, after controlling for a wide range of family, peer, academic, mental health, and substance-abuse covariates [
22‐
24]. These studies have been facilitated in recent years by the introduction of measures of different types of trauma, such as the Childhood Trauma Questionnaire (CTQ), which provides a more sensitive measure of abuse and neglect than official records [
25].
Although many investigations have focused on the association between childhood maltreatment and recidivism, most of the findings have been reported in studies of juvenile offenders or specific clinical populations, such as Attention-Deficit/Hyperactivity Disorder (ADHD) [
10,
22‐
24,
26]. Furthermore, few studies have investigated the relationship between child maltreatment and criminal recidivism in high-risk populations, such as probationers. Probationers are responsible for less severe and destructive crimes and lead their lives in the community under the supervision of the justice system. As such, they might be the most relevant target population for interventions to prevent recidivism, promote social adjustment, manage underlying psychosocial problems, and ultimately minimize the impact of crimes on individuals, families, and society. The identification of probationers’ risk factors for recidivism has clinical and policy implications for the development of risk-management interventions for repeat offenders.
The aim of this study was to investigate: (1) the relationships between a history of childhood maltreatment and mental-health problems, and (2) the independent contribution of specific types of maltreatment and mental-health problems to recidivism, based on epidemiological data of adult probationers in South Korea. Given the findings discussed previously, we hypothesized that specific types of childhood maltreatment would be associated with an increased risk of recidivism and that maltreatment would independently contribute to the risk, over other mental-health problems.
Discussion
The main objectives of this study were to examine the relationship between a history of childhood maltreatment and the development of later mental-health problems, and to examine the unique contribution of specific types of child maltreatment to the prediction of criminal recidivism, over mental-health problems in adult probationers. The study’s results indicated that childhood maltreatment was significantly associated with psychiatric disorders, especially a major depressive episode, and with lower resilience and higher emotional dysregulation. Among the types of childhood maltreatment, physical neglect was significantly related with the recidivism, even after controlling for the presence of psychiatric disorders. Our finding of the association between physical neglect and recidivism is consistent with prior studies, but is, to our knowledge, the first demonstration of this relationship among adult probationers. This finding may clarify the risk profile to guide interventions targeting desistance from crime in high-risk populations (i.e. probationers).
The rate of childhood maltreatment in this study’s adult probationers was 58.5 %, which is higher than the rate in the general population; the rates of childhood maltreatment were reported to be 24–32 % globally [
42,
43] and 40.8 % in a South Korean study using the same CTQ cut-off score [
30]. Among the types of childhood maltreatment, emotional neglect and physical neglect were 24 % and 39.9 % respectively, which is far higher than what has been found in healthy adults (14.6 % and 13.6 %, respectively). The other types of childhood maltreatment rates in our sample of probationers are comparable to the rates reported in a previous study [
30]. Therefore, an overall higher rate of childhood maltreatment in adult probationers may result from a higher rate of neglect victimization, compared to the general population.
In this study, childhood maltreatment was associated with psychiatric morbidity, especially major depressive disorder, as well as low resilience and a high degree of emotional dysregulation. Overall, these results are consistent with other studies showing that childhood maltreatment is associated with poor mental health and social adjustment [
12‐
14,
44]. The higher prevalence of major depressive disorder and suicidality in adult probationers with a history of childhood maltreatment was in agreement with previous studies [
14,
45‐
48]. However, we could not find any significant differences in the prevalence of each mental disorder between groups, including alcohol use disorder, which was possibly due to the small sample size.
Our results identified physical neglect as an independent predictor of criminal recidivism, after controlling for mental-health problems, which is generally in agreement with the results of previous studies. Childhood neglect has long been considered to be a significant predictor of criminal behavior [
13,
16,
49,
50]. However, many prior studies included only youths and they have categorized “neglect” as one type of maltreatment, rather than dividing it into “physical neglect” and “emotional neglect” with different measures to assess childhood trauma, instead of the CTQ [
22,
24,
26]. Dembo et al. found that neglect was a stronger predictor of recidivism than both physical and sexual abuse in juvenile offenders [
22]. Recently, a study found that neglect victimization was uniquely related to general recidivism, whereas physical abuse victimization was uniquely related to violent recidivism among male juvenile offenders, over and above the dynamic risk factors for recidivism [
26]. However, among female juvenile offenders, none of the types of maltreatment were uniquely related to general or violent felony recidivism [
26]. Although most of the participants included in our study consisted of males, our results were similar to that study. The results of our study contribute to the literature of adult probationers by showing the independent relationship between victimization by physical neglect and recidivism after controlling for several mental-health factors.
Interestingly, our results show the unique association between recidivism and physical neglect, but not with emotional neglect. To date, few studies have investigated the association between specific types of childhood neglect defined by the CTQ and criminal recidivism. In contrast to our results, Kingree at al. revealed that relatively high levels of emotional neglect, but not physical neglect, were associated with recidivism after controlling for single and multiple episodes of recidivism and the simultaneous influence of different socio-demographic, behavioral, and maltreatment variables among adolescent detainees [
23]. They stated that a conclusion should not be drawn from their data as to why emotional neglect and physical neglect were associated with recidivism in opposite ways. However, the discrepancy in the results might be partly due to cultural factors and differences in the study population. The CTQ defines physical neglect based on whether respondents had enough to eat, if their parents’ drinking interfered with their care, if they ever wore dirty clothes, and if there was someone to take them to a doctor. Physical neglect can be considered a failure to provide basic physical safety and security, including food, shelter, and clothing, which comprise the traditional list of immediate basic needs [
51]. On the other hand, emotional neglect can be defined based on whether the family made the respondent feel special and loved and if the family was a source of strength, support, and protection [
25]. Compared to physical neglect, the construct of emotional neglect can be operationalized differently across cultures because it is associated with personal perceptions of caregiver-child interactions. Additionally, child-rearing practices, such as parenting attitudes and parent-child relationships are very different across cultures. East Asian countries emphasize the establishment of both physical and emotional closeness so that a lifelong bond is assured and the maintenance of parental authority and children’s obedience through harsh discipline [
52]. In this context, the people of East Asia might have higher expectations of parent-child emotional interactions through their development, compared with those of Western cultures. They might also have a different view of an ideal caregiver-child interaction. All these factors may influence the evaluation of emotional neglect using the CTQ, and subsequently, its effect on recidivism. The differential effects of physical and emotional neglect on repeated crime and their possible moderating factors should be explored in future studies from a cross-cultural perspective. On the other hand, these differences might be related to the study population’s age. Whereas most of the previous studies have included adolescents, our study consisted of adults. The developmental consequences of adversity are neither restricted to the particular developmental period in which they occur, nor do they reflect a linear relationship between adversity and outcomes in adulthood. The processes underlying the consequences of childhood adversity are best viewed as developmental cascades, or the (nonlinear) cumulative consequences of interactions across multiple levels (i.e., brain to behavior) and contexts (i.e., internal and external environments) over one’s entire life [
53].
The present study has several limitations. First, the CTQ is a self-report questionnaire, which may raise a recall bias issue because responses might be incorrect due to forgetting, and/or the influence of mood at the time of its completion. For example, those who are mentally distressed may be more likely to recall their childhood as adverse. Second, crime data were obtained from a self-report questionnaire, which might be different from respondents’ actual criminality, making the reports less reliable than official data on the person’s criminal history. Third, this study uses a cross-sectional design, so a causal relationship between childhood maltreatment and recidivism cannot be inferred. A prospective longitudinal analysis with a larger sample will be necessary, controlling for socioeconomic status, psychiatric morbidity, and dynamic, modifiable risk factors.