Abuse and neglect as indicators of unhealthy behaviours among 15-year-old schoolchildren in Albania

Objective: We assessed the independent associations of lifetime child abuse and neglect indices with behavioural characteristics of children. Study design: A cross-sectional study was conducted in Albania in 2022. Methods: Participants consisted of a nationwide representative sample of 1877 schoolchildren aged 15 years (55 % girls; response: 96 %). Data on lifetime child abuse and neglect were collected, along with behavioural factors and sociodemographic characteristics. Binary logistic regression was used to assess the independent associations of child abuse and neglect with behavioural factors of schoolchildren. Results: Irrespective of sociodemographic characteristics, lifetime physical abuse was positively related to lifetime smoking (OR = 1.8, 95%CI = 1.4–2.3), lifetime alcohol consumption (OR = 2.4, 95%CI = 1.9–2.9), and breakfast skipping (OR = 1.3, 95%CI = 1.0–1.6). Furthermore, positive independent factors associated with emotional abuse included lifetime alcohol intake (OR = 1.7, 95%CI = 1.3–2.1) and breakfast skipping (OR = 1.4, 95%CI = 1.0–1.8). Additionally, positive factors associated with lifetime emotional neglect consisted of lifetime smoking (OR = 2.2, 95%CI = 1.6–3.0) and alcohol intake (OR = 2.0, 95%CI = 1.5–2.6), and a lower fruit consumption (OR = 1.7, 95%CI = 1.3–2.3). Positive factors associated with lifetime sexual abuse included lifetime alcohol consumption (OR = 2.4, 95%CI = 1.4–4.1) and especially smoking (OR = 4.3, 95%CI = 2.6–7.3). Also, lifetime witnessing of family violence was positively related to lifetime smoking (OR = 2.7, 95%CI = 1.8–4.1) and alcohol intake (OR = 1.7, 95%CI = 1.2–2.6). Conclusions: We evidenced strong and consistent links between child maltreatment indices and unhealthy behavioural practices among 15-year-old children in Albania. These findings underscore the potential impact of early trauma on developmental trajectories. The association between child abuse and the adoption of detrimental behaviours highlights the urgent need for comprehensive support and intervention strategies to break the cycle of harm.