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Social Psychiatry and Psychiatric Epidemiology

Published in:

01-02-2015 | Review

Prevalence of childhood abuse among people who are homeless in Western countries: a systematic review and meta-analysis

Authors: Eva C. Sundin, Thom Baguley

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 2/2015

Abstract

Purpose

This article systematically reviews studies of prevalence of childhood experience of physical and sexual abuse in adult people who are homeless in Western countries.

Methods

Medline, PsychInfo, and the Cochrane Library were searched using the keywords: homeless*, child* abuse, child* trauma, and child* adversity and the bibliographies of identified articles were reviewed. Sources of heterogeneity in the prevalence rates were explored by meta-regression analysis.

Results

Twenty-four reports published between January 1990 and August 2013 in three countries provided estimates obtained from up to 9,730 adult individuals who were homeless. Prevalence of reported childhood physical abuse ranged from 6 to 94 % with average prevalence of 37 %, 95 % CI [25, 51]. Reported sexual abuse ranged from 4 to 62 %, with average prevalence estimated as 32 %, 95 % CI [23, 44] for female and 10 % for male, 95 % CI [6, 17]. Substantial heterogeneity was observed among the studies (I ² ≥ 98 %). Including moderators greatly reduced but did not eliminate this heterogeneity. Moderator analyses suggested that reported physical abuse tended to be higher for predominately white samples and tended to be lower for younger samples. Sexual abuse was far more prevalent in predominately female samples and slightly higher in non-US samples and convenience samples.

Conclusions

The findings of this study suggest that childhood physical and sexual abuse is more prevalent among the homeless in Western countries than in the global population. Physical abuse appears to be particularly prevalent in younger samples and sexual abuse rates are higher in predominately female samples. Further investigation is needed to advance our understanding of how trauma informed treatment and care for the homeless effectively can take into account the service user’s experiences of childhood abuse.

The protocol is available from: http://www2.ntupsychology.net/~baguley/Sundin_Baguley_protocol_160813.doc.

Unless otherwise stated subsequent reference in the text is to n _CSA (which is generally the larger of the two sample sizes). All statistical models use n _CPA or n _CSA as appropriate.

The non-white category included any sample or subsample identified as not of white European origin (e.g., Afro-Caribbean, Asian, and Latino or Hispanic as well as Aborigine and Native American individuals). In most cases this information was taken from published reports (including other studies using the same data), but for a few samples was taken from relevant census data for the location and year of data collection.

Age data are taken from published reports or estimated from available information (e.g., the median or the proportion of the sample falling into different age categories).

These estimates were obtained from the final model with all other covariates except the indicator for convenience sampling centred. Thus the estimates reflect the average estimate for a random or stratified sample rather than for a convenience sample.

Note however that the definitions of CPA and CSA used in general populations research are less strict than implied by the strict criterion implied by a moderate to severe cut-off with the CTQ [see 26, Table 1].

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Title: Prevalence of childhood abuse among people who are homeless in Western countries: a systematic review and meta-analysis
Authors: Eva C. Sundin
Thom Baguley
Publication date: 01-02-2015
Publisher: Springer Berlin Heidelberg
Published in: Social Psychiatry and Psychiatric Epidemiology / Issue 2/2015
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI: https://doi.org/10.1007/s00127-014-0937-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Prevalence of childhood abuse among people who are homeless in Western countries: a systematic review and meta-analysis

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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