Contamination bias in the estimation of child maltreatment causal effects on adolescent internalizing and externalizing behavior problems

Background When unaddressed, contamination in child maltreatment research, in which some proportion of children recruited for a nonmaltreated comparison group are exposed to maltreatment, downwardly biases the significance and magnitude of effect size estimates. This study extends previous contamination research by investigating how a dual-measurement strategy of detecting and controlling contamination impacts causal effect size estimates of child behavior problems. Methods This study included 634 children from the LONGSCAN study with 63 cases of confirmed child maltreatment after age 8 and 571 cases without confirmed child maltreatment. Confirmed child maltreatment and internalizing and externalizing behaviors were recorded every 2 years between ages 4 and 16. Contamination in the nonmaltreated comparison group was identified and controlled by either a prospective self-report assessment at ages 12, 14, and 16 or by a one-time retrospective self-report assessment at age 18. Synthetic control methods were used to establish causal effects and quantify the impact of contamination when it was not controlled, when it was controlled for by prospective self-reports, and when it was controlled for by retrospective self-reports. Results Rates of contamination ranged from 62% to 67%. Without controlling for contamination, causal effect size estimates for internalizing behaviors were not statistically significant. Causal effects only became statistically significant after controlling contamination identified from either prospective or retrospective reports and effect sizes increased by between 17% and 54%. Controlling contamination had a smaller impact on effect size increases for externalizing behaviors but did produce a statistically significant overall effect, relative to the model ignoring contamination, when prospective methods were used. Conclusions The presence of contamination in a nonmaltreated comparison group can underestimate the magnitude and statistical significance of causal effect size estimates, especially when investigating internalizing behavior problems. Addressing contamination can facilitate the replication of results across studies.
© 2024 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health. This is an open access article under the terms of the Creative Commons Attribution License (, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
child maltreatment, contamination, synthetic control method, causal estimation, internalizing behaviors, externalizing behaviors
Felt, J.M., Chimed-Ochir, U., Shores, K.A., Olson, A.E., Li, Y., Fisher, Z.F., Ram, N. and Shenk, C.E. (2024), Contamination bias in the estimation of child maltreatment causal effects on adolescent internalizing and externalizing behavior problems. J Child Psychol Psychiatr.