Published online April 1, 2008
PEDIATRICS Vol. 121 No. 4 April 2008, pp. 725-731 (doi:10.1542/peds.2006-3622)
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ARTICLE

Importance of Early Neglect for Childhood Aggression

Jonathan B. Kotch, MD, MPHa, Terri Lewis, PhDb, Jon M. Hussey, PhD, MPHa, Diana English, PhDc, Richard Thompson, PhDd, Alan J. Litrownik, PhDe, Desmond K. Runyan, MD, DrPHf, Shrikant I. Bangdiwala, PhDb, Benyamin Margolis, MPH, CHESg and Howard Dubowitz, MDh

Departments of a Maternal and Child Health
b Biostatistics
f Social Medicine
g Health Behavior and Health Education, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
c Washington State Department of Social and Health Services, Seattle, Washington
d Juvenile Protective Association, Chicago, Illinois
e Department of Psychology, San Diego State University, San Diego, California
h Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland

OBJECTIVE. The goal was to examine the association between early childhood neglect (birth to age 2 years) and later childhood aggression at ages 4, 6, and 8 years, compared with aggression's associations with early childhood abuse and later abuse and neglect.

METHODS. A prospective cohort of 1318 predominantly at-risk children, recruited from 4 US cities and 1 southern state, were monitored from birth to 8 years of age. Maltreatment was determined through review of local child protective services records. A hierarchical, linear model approach, a special case of general, linear, mixed modeling, was used to predict aggressive behavior scores, as reported by the child's primary caregiver at ages 4, 6, and 8 years.

RESULTS. Only early neglect significantly predicted aggression scores. Early abuse, later abuse, and later neglect were not significantly predictive in a controlled model with all 4 predictors.

CONCLUSION. This longitudinal study suggests that child neglect in the first 2 years of life may be a more-important precursor of childhood aggression than later neglect or physical abuse at any age.

Key Words: child neglect • child abuse • aggression • longitudinal studies

Abbreviations: CBCL—Child Behavior Checklist • CPS—child protective services • GLMM—general, linear, mixed model • LONGSCAN—Longitudinal Studies of Child Abuse and Neglect • MMCS—Modified Maltreatment Classification System

Accepted Aug 31, 2007.