Quantification of childhood adversity has typically involved a cumulative risk approach in which total number of discrete adversities serves as an index of overall risk. However, this approach fails to account for the growing evidence of differential outcomes following exposure to childhood adversities. An alternative approach adopts a dimensional perspective, with growing evidence for distinct developmental impacts associated with exposure to threat (violence/abuse) and deprivation (neglect). This study developed a framework for the classification of these dimensions through a thematic analysis of health practitioners' views and accounts of different forms of childhood adversity. Ten health practitioners experienced in working with children with challenging behaviours and neurodevelopmental disorders participated in semi-structured interviews regarding definitions and examples of six categories of adversity: physical/emotional/sexual abuse, physical/emotional neglect, and domestic and family violence. The qualitative analysis identified 23 themes across the six categories of adversity, along with two overarching themes regarding ambiguity of classifying exposures and non-specific outcomes of exposures. Themes were integrated to provide a framework and checklist for classifying indicators of exposure to threat and deprivation. The findings offer a framework and checklist for the assessment of threat and deprivation that will allow for further testing of the dimensional risk model.

中文翻译：

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儿童威胁和忽视分类框架的开发：一项定性研究

童年逆境的量化通常涉及累积风险方法，其中离散逆境的总数作为总体风险的指标。然而，这种方法无法解释暴露于童年逆境后不同结果的越来越多的证据。另一种方法采用维度视角，越来越多的证据表明与暴露于威胁（暴力/虐待）和剥夺（忽视）相关的不同发展影响。本研究通过对健康从业者的观点和对不同形式的儿童逆境的描述进行专题分析，为这些维度的分类制定了一个框架。十名在处理具有挑战性行为和神经发育障碍的儿童方面经验丰富的卫生从业者参加了关于六类逆境的定义和示例的半结构化访谈：身体/情感/性虐待、身体/情感忽视以及家庭暴力。定性分析确定了六类逆境中的 23 个主题，以及关于暴露分类模糊性和非特定暴露结果的两个总体主题。整合主题以提供一个框架和清单，用于对暴露于威胁和剥夺的指标进行分类。调查结果为评估威胁和剥夺提供了一个框架和清单，可以进一步测试维度风险模型。