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P04 Child-parent separation during upbringing and later risk of violent criminality and self-harm: a population-based cohort study

Background Childhood experience of parental separation has been associated with subsequent increased risk for interpersonal and self-directed violence in offspring. However, conflicting and insufficient evidence exists regarding how links vary across age, duration, and types of separation. We conducted a large, detailed epidemiological study of the association between child-parent separation and later risk of violent criminality and self-harm in offspring. We investigated how risks varied by type of separation (from mother or father only, or both), offspring gender, age at separation, number and duration of separations, and by a range of separation scenarios. Methods Our study cohort was established using data from the Danish Civil Registration System and interlinked psychiatric and crime national registers. Persons born in Denmark 1971–1997 (n=1,346,772) were included. Residential addresses were used to determine if cohort members were living with either parent each birthday from birth to 15th. Members were followed up from reaching age 15 birthday until date of first violent offence conviction, date of first registered self-harm episode, or end of study (31 st December 2012). Incidence rate ratios (IRRs) were estimated using survival analyses techniques in SAS 9.4. Results All types of child-parent separation scenarios are linked with increased risks for later violent offending and self-harm. Even those who were separated from one parent, but subsequently lived with both, were at increased risk. Compared to persons who always lived with both parents, those who lived with both parents at birth but were subsequently separated from the father–the most common type of separation scenario–had a 2-fold increased risk (IRR for violent offending=1.99, 95% CI 1.94–2.05; IRR for self-harm=2.07, 2.01–2.14). Risks increased with rising number of parental changes, and a steep gradient in risk with increasing age at separation was observed if children were first separated from both parents between age 10 and 15 years. Strengths of associations were much greater for female than male offspring for violent offending, but no gender differentials in risks were found for self-harm. Conclusion Our study adds to existing published evidence that experience of child-parent separation may increase the risk for harmful psychosocial development in offspring. However, we had no information on the reasons of separation and aggregated risk estimates would have masked any heterogeneity in the associations observed. Interventions should be tailored toward those young people with the most complex trajectories who have lived through many family changes as they grew up.