A 12-year prospective study of the long-term effects of early child physical maltreatment on psychological, behavioral, and academic problems in adolescence.

OBJECTIVE To determine whether child physical maltreatment early in life has long-term effects on psychological, behavioral, and academic problems independent of other characteristics associated with maltreatment. DESIGN Prospective longitudinal study with data collected annually from 1987 through 1999. SETTING AND PARTICIPANTS Randomly selected, community-based samples of 585 children from the ongoing Child Development Project were recruited the summer before children entered kindergarten in 3 geographic sites. Seventy-nine percent continued to participate in grade 11. The initial in-home interviews revealed that 69 children (11.8%) had experienced physical maltreatment prior to kindergarten matriculation. MAIN OUTCOME MEASURES Adolescent assessment of school grades, standardized test scores, absences, suspensions, aggression, anxiety/depression, other psychological problems, drug use, trouble with police, pregnancy, running away, gang membership, and educational aspirations. RESULTS Adolescents maltreated early in life were absent from school more than 1.5 as many days, were less likely to anticipate attending college compared with nonmaltreated adolescents, and had levels of aggression, anxiety/depression, dissociation, posttraumatic stress disorder symptoms, social problems, thought problems, and social withdrawal that were on average more than three quarters of an SD higher than those of their nonmaltreated counterparts. The findings held after controlling for family and child characteristics correlated with maltreatment. CONCLUSIONS Early physical maltreatment predicts adolescent psychological and behavioral problems, beyond the effects of other factors associated with maltreatment. Undetected early physical maltreatment in community populations represents a major problem worthy of prevention.