Specific effects of neglect and physical abuse on adolescent aggressive behaviors by gender: A multicenter study in rural China

Abstract Background Neglect and physical abuse may be typical risk factors for aggressive behavior in adolescents. However, findings on their specific effects and sex differences are still unclear. This study aimed to examine the specific effects of neglect and physical abuse on adolescent aggressive behaviors and to further explore the potential sex-specific effect. Methods A multicenter school-based survey was conducted in rural China. A total of 15,957 students aged 11–20 years completed self-report questionnaires to record aggressive behaviors, neglect and physical abuse, and other related information. Participants were grouped into those who experienced none, one of, or both neglect and physical abuse for statistical analyses. Results Of the participants, 37.0% experienced both neglect and physical abuse, 30.0% experienced neglect only, and 9.8% experienced physical abuse only. Higher risk for physical aggression (OR=1.24, 95% CI=1.06–1.45), and lower risk for verbal aggression (OR=0.83, 95% CI=0.72–0.94) and hostility (OR=0.81, 95% CI=0.69–0.94) were found in the physical abuse only group as compared to the neglect only group. No sex difference was found between neglect or physical abuse and general aggressive behaviors (P>0.05), except that females were more likely to exert physical aggression than males when exposed to neglect and physical abuse (P Limitations Cross-sectional design, retrospective self-report data, and not including other maltreatment subtypes. Conclusions Neglect and physical abuse may each have distinct sensitivity for different subtypes of aggression. Targeted treatment for diverse aggressive symptoms is suggested, and strategies to prevent both neglect and physical abuse across gender would yield comprehensive benefits.