Towards cause priotisation estimates for child abuse
Closest community background reading: http://www.givewell.org/labs/causes/criminal-justice-reform
Scale
prevalence
Back of the envelope estimate of the number of abused excluding those who are emotionaly abused and neglected (because those stats aren’t on the wikipedia page for child abuse):
>Despite these limitations, international studies show that a quarter of all adults report experiencing physical abuse as children, and that and 1 in 5 women and 1 in 13 men report experiencing childhood sexual abuse. Emotional abuse and neglect are also common childhood experiences (“Child maltreatment: Fact sheet No. 150”. World Health Organization. December 2014)
If all those physically abused are the same as those sexually abused (most conservative estimate) then 0.2 of all people are abused as children. If they are completely seperate populations then ((1/5 + 1⁄13)/2) + (1/4) = 0.39 (~0.4) of all people are abused as children. So, 0.2-0.4 of all people are abused.
>A long-term study of adults retrospectively reporting adverse childhood experiences including verbal, physical and sexual abuse, as well as other forms of childhood trauma found 25.9% of adults reported verbal abuse as children, 14.8% reported physical abuse, and 12.2% reported sexual abuse
More likely ¼ of all people are abused as children in some way or another
Harm (qualitatively)
>reduction in lifespan of 7 to 15 years (Kolassa, Iris – Tatjana. “Biological memory of childhood maltreatment – current knowledge and recommendations for future research” (PDF). Ulmer Volltextserver – Institutional Repository der Universität Ulm. Retrieved 30 March 2014.)
>more likely to suffer from physical ailments such as allergies, arthritis, asthma, bronchitis, high blood pressure, and ulcers (Dolezal, T.; McCollum, D.; Callahan, M. (2009). Hidden Costs in Health Care: The Economic Impact of Violence and Abuse. Academy on Violence and Abuse.)
>emotional abuse has been linked to increased depression, anxiety, and difficulties in interpersonal relationships (“Reactive attachment disorder”)
>One long-term study found that up to 80% of abused people had at least one psychiatric disorder at age 21, with problems including depression, anxiety, eating disorders, and suicide attempts.[95] One Canadian hospital found that between 36% and 76% of women mental health outpatients had been abused, as had 58% of women and 23% of men schizophrenic inpatients.[96] A recent study has discovered that a crucial structure in the brain’s brain’s reward circuits is compromised by childhood abuse and neglect, and predicts Depressive Symptoms later in life.[9]
Exponential growth, externalities or diminishment of the problem
>90 percent of maltreating adults were maltreated as children (Starr RH, Wolfe DA (1991). The Effects of Child Abuse and Neglect (pp. 1–33). New York: The Guilford Press. ISBN 978-0-89862-759-6)
>children who experience child abuse and/or neglect are 59% more likely to be arrested as juveniles, 28% more likely to be arrested as adults, and 30% more likely to commit violent crime (“Child Abuse Statistics”. Childhelp. Retrieved 5 March 2015.)
> A study by Dante Cicchetti found that 80% of abused and maltreated infants exhibited symptoms of disorganized attachment. When some of these children become parents, especially if they suffer from posttraumatic stress disorder (PTSD), dissociative symptoms, and other sequelae of child
Shut up, stop dumping qutes and give me the QALY’s
>The combined strata-level effects of maltreatment on Short Form–6D utility was a reduction of 0.028 per year (95% confidence interval=0.022, 0.034; P<.001). (www.ncbi.nlm.nih.gov/pmc/articles/PMC2377283/)
0.028per year * world population * 0.25 = 51800000 QALY’s per year
Neglectedness
>In the U.S. in 2013, of the 294,000 reported child abuse cases only 81,124 received any sort of counseling or therapy. (“National Statistics on Child Abuse”. National Children’s Alliance. Archived from the original on 2 May 2014.)
It’s likely to be more neglected in low and middle income countries.
Tractability
>Most acts of physical violence against children are undertaken with the intent to punish.[106] In the United States, interviews with parents reveal that as many as two thirds of documented instances of physical abuse begin as acts of corporal punishment meant to correct a child’s behavior, while a large-scale Canadian study found that three quarters of substantiated cases of physical abuse of children have occurred within the context of physical punishment.[107] Other studies have shown that children and infants who are spanked by parents are several times more likely to be severely assaulted by their parents or suffer an injury requiring medical attention. Studies indicate that such abusive treatment often involves parents attributing conflict to their child’s willfulness or rejection, as well as “coercive family dynamics and conditioned emotional responses”.[16] Factors involved in the escalation of ordinary physical punishment by parents into confirmed child abuse may be the punishing parent’s inability to control their anger or judge their own strength, and the parent being unaware of the child’s physical vulnerabilities.[15]
>Some professionals argue that cultural norms that sanction physical punishment are one of the causes of child abuse, and have undertaken campaigns to redefine such norms.[108][109][110]
>Into the 21st century many countries have taken steps to eradicate domestic violence, such as criminalization of violence against women and other abuses. Organizations have been formed which provide assistance and protection of domestic abuse victims, laws and criminal remedies, and domestic violence courts (https://en.wikipedia.org/wiki/Management_of_domestic_violence)
What can we do about it?
Given that ‘’three quarters of substantiated cases of physical abuse of children have occurred within the context of physical punishment’’, (see tractability section) assuming that a ban on corporal punishment towards children could be enforced with just 10% compliance worldwide, we could save a minimum of 10% * ¾ * 51800000 QALY’s per year = 3885000 QALY’s per year.
Now how cost effective would it be? What could we use as a reference class for how much resources would need to be invested to outlaw and enforce bans on corporal punishment of children? I don’t have the subject matter experience to say, so if anybody can help me out here please do. If you can also estimate how much money would be saved from everything from healthcare costs to criminal justice aversion costs, please chime in.
Instead, let’s compare with one Open Philanthropy Project funded area [clearing the organ donation waitlist](http://www.givewell.org/labs/causes/organ-transplantation). They’ve simply funded trying to figure out the solution, whereas some steps are more obvious for child abuse. They decide to go ahead on that based on estimates for merely thousands of QALY’s. It should be overwhelmingly evident that averting child abuse probably dominates the organ donation waitlist problem.
Faced with such aberrant findings, I think it’s appropriate to hand this over to the community for input before collaboratively investigating this area. Could averting child abuse be the most important cause? If it is at least an important cause, what does it’s neglectedness from the cause prioritisation community thus far say about the methods by which potential important causes are identified?
The author of “What You Can Change and What You Can’t” did a well informed review of studies that measure influence of child abuse and traumas on adult life.
What he found is that there is barely any, and that studies that detect this influence have severely flawed methodology.
I can’t find any references to this online. Given its controversial I call bullshit.
Here are some relevant references from the book:
or
or
Your claim was that child abuse and trauma have barely any influence on adult life. This is clearly an extraordinary claim, that requires evidence to be taken seriously.
Your evidence are three quotations, two of which only contain more links, and the third is about the heritability of divorce, which has nothing to do with your claim.
So in other words you have given zero evidence for your claim. Maybe there is some evidence to be found in one of the many citations you gave, but without knowing which one or what to look for it would take many hours to investigate this. That is not a reasonable burden to place on your readers, given the prior unlikeliness of your initial claim. I’m not saying you should make an airtight case for your claim in a single post, but at the very least you should give us some reason to put in further effort.
There have been significant longitudinal studies that comprehensively measure many dimensions of well-being over an amazingly long time-frame and these also support this claim.
A good book on these studies and what we might learn from is Aging Well: Surprising Guideposts to a Happier Life from the Landmark Study of Adult Development by George E. Vaillant.
Otherwise I wouldn’t dismiss claims from ‘What we can change and what we can’t’ easily just because not enough refs are quoted. Read for yourself. Also you migth want to look at lukeprogs http://lesswrong.com/lw/3nn/scientific_selfhelp_the_state_of_our_knowledge/
To be exact, the claim from the book is except for severe PTSD, there is little influence, and in case of PTSD the healing works the same way for adults as for children (and possibly slightly better in children) - so “childhood” trauma is not in any way “special” compared to adult traumas.
As for evidence, why don’t you just go and read the book itself? Reading that chapter is on the order of 20 minutes of easy reading. Sorry, but I have better things to do than repeat what is already written elsewhere.
The 1st and third quote blocks merely reference other sources without summarising them. This leads to a wealth of insubstantiated evidence and holds back efficient evaluation of its truth value.
The second claims something is heritable, but every human trait is heritable by definition. The wording implies the divorce is attributable to the status of having an identical twin that is divorced, which is underdetermined and moreover, twin studies aren’t interpreted so simply. So, I expect that the author is a poor biostatistician and wouldn’t take their word on the 1st and 3rd claims from these exerpts alone.
The book has summaries in the content (these were just footnotes). So I’d maybe recommend you just read that chapter from the actual book.
Arguing “By Definition”
Is living in Africa heritable? I’m sure if you try, you can understand what is the author is trying to say without picking on his words.
How sure are you that the answer is no?
I mean, obviously it “should” be no. But suppose you attempt to answer that question using the same machinery generally used to estimate heritability. What answer will come out? Bear in mind, e.g., that it is rather rare for identical twins to live on different continents. (C.f. Cosma Shalizi here and here. The former is long and discusses many other things; search for the heading “Cultural transmission”.)
(I agree that “every human trait is heritable by definition” is a pretty silly thing to say.)
I didn’t mean to suggest this question has a valid answer, but rather to point out that the phrasing is ambiguous.
The quote I gave above from the book says:
So I think the criticism from the article you linked doesn’t apply.
You might be generalizing from one example, e.g. if you were raised by middle-class parents you might not have realistic ideas about how fucked up lower-class parents can be.
There’s nothing rational about refusing to believe data you don’t like, and linking Eliezer doesn’t change that.
It’s good to have an absurdity filter. You can’t investigate every claim on the internet in great detail, so dismissing the more unbelievable ones out of hand is not a bad strategy. But you need some kind of reason. Either a known bias or untrustworthiness of the author, or knowledge that at least some of the claims made are false. Assuming you don’t have some personal beef with the author, I don’t see how you can dismiss this post out of hand. The numbers mentioned are quite reasonable and in line with what you find in other sources.
Also, there’s nothing wrong with conflating two things that are, in fact, identical. Not all child abuse is equally bad, and an occasional spanking won’t greatly harm a child. But it will harm a child. This has been shown often.
Perhaps it might be more productive to ask oath why they find the numbers unbelievable?
In a culture where spanking is regarded as normal and (say) starving your child or making them have sex with you is regarded as appalling, there is a very important difference between spanking and those more dramatic kinds of child abuse: that it’s widely regarded as acceptable. That doesn’t stop it harming the children it’s done to, but it makes a big difference to (for instance) what the fact that someone does it tells you about them.
No, if you can be right about numbers not adding up without being able to point to an explicit reason.
It has been shown often that homeopathy works and that telepathy works. That doesn’t mean it makes sense to believe that it works.
I’m not aware of randomized controlled trials for occasional spanking and it’s likely one of those shared enviroment effects where we know from twin-studies that they don’t have much effect.
Given that the abstract doesn’t say so, that’s very likely to be a misreading. My guess is that they report correlations but haven’t ruled out genetic effects. The same is true for the other studies you link for harm, they also seem to talk about correlations.
You don’t talk about the amount of government money that’s invested into the cause.
No, there no reason that a 10% compliance rate would be equally distributed among different risk groups. The parents who make a deliberate conscious choice to use corporal punishment are less likely to go into stronger abuse than parents who react because they can’t manage their emotions well. The parents who act because of deliberate conscious decisions are more likely to comply.