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Effect of Child Maltreatment Polyvictimization on Human Capabilities While Controlling for Sociodemographic Risk Factors

The statement: Original material authorized for its first publication in the Journal de Ciencias Sociales, the Academic Journal of the Social Sciences School of Universidad de Palermo.

Abstract: Studies locate the adverse impact of child maltreatment using a biopsychosocial perspective of childhood development. However, little is known about the effects of maltreatment on human development when conceptualized within the Capability Approach, a formative and evaluative framework that captures quality of life. This study examines the impact of child maltreatment polyvictimization on 10 human capabilities as a measurement of human development while controlling for sociodemographic risk factors. Data was derived from the Children's Human Capabilities and Maltreatment National School Survey conducted in Aruba, with 895 children aged 12 – 17 from 73 randomly selected classes of 11 secondary schools in 2019. Chi-square test of independence reveals that high poly-victims were more likely to be girls living with single mothers and those who perceive their economic status as average. ANOVA results indicated that high poly-victims were consistently less likely to enjoy 9 out of the 10 capabilities when compared with children who were single and low poly-victims. Controlling for sociodemographic factors, polyvictimization was a significant positive predictor of human capabilities. The study concludes that poly-victims of child maltreatment suffer significant harm to their wellbeing and the ability to live flourishing lives. Recommendations are made for intervention and development of capabilities-based child protection assessment and policy checklist to safeguard children’s human development.

Keywords: Child maltreatment, polyvictimization, risk factors, Capability Approach.

Efecto de la polivictimización por maltrato infantil sobre las capacidades humanas mientras se controlan los factores de riesgo sociodemográficos

Resumen: Los estudios localizan el impacto adverso del maltrato infantil utilizando una perspectiva biopsicosocial del desarrollo infantil. Sin embargo, se sabe poco sobre los efectos del maltrato en el desarrollo humano cuando se conceptualizan dentro del Enfoque de Capacidades, un marco formativo y evaluativo que capta la calidad de vida. Este estudio examina el impacto de la polivictimización del maltrato infantil en 10 capacidades humanas como medida del desarrollo humano, controlando al mismo tiempo los factores de riesgo sociodemográficos. Los datos se derivaron de la Encuesta Escolar Nacional sobre Maltrato y Capacidades Humanas de los Niños realizada en Aruba, con 895 niños de entre 12 y 17 años de 73 clases seleccionadas al azar de 11 escuelas secundarias en 2019. La prueba de independencia de Chi-cuadrado revela que las víctimas múltiples eran más Es probable que sean niñas que viven con madres solteras y aquellas que perciben su situación económica como media. Los resultados de ANOVA indicaron que un alto número de víctimas tenían consistentemente menos probabilidades de disfrutar de 9 de las 10 capacidades en comparación con los niños que eran solteros y con un bajo número de víctimas. Al controlar los factores sociodemográficos, la polivictimización fue un predictor positivo significativo de las capacidades humanas. El estudio concluye que las múltiples víctimas de maltrato infantil sufren un daño significativo a su bienestar y a su capacidad de vivir una vida próspera. Se hacen recomendaciones para la intervención y el desarrollo de una evaluación de protección infantil basada en capacidades y una lista de verificación de políticas para salvaguardar el desarrollo humano de los niños.

Palabras clave: Maltrato infantil, polivictimización, factores de riesgo, Enfoque de Capacidades.

Sociodemographic risk factors of child maltreatment in Aruba are older age, being a girl, having a lower economic status, and parental employment. Given the high prevalence rate of child maltreatment in Aruba at 78.4% (name deleted to maintain the integrity of the review process), this study examines the relationship between lifetime child maltreatment, polyvictimization, and children’s human capabilities while controlling for sociodemographic risk factors. The effect of child maltreatment polyvictimization on children’s mental health and psychosocial development is well documented in the literature (Dierkhising et al., 2019; Duckworth et al., 2020; Grasso et al., 2016; Haadr-Pedersen et al., 2020; Kavanaugh et al., 2017; Turner et al., 2017). These studies predominantly utilize data from North America and Western Europe. This study is conducted in the Dutch Caribbean Island of Aruba, which is often silent in child maltreatment literature. Moreover, the effect of child maltreatment polyvictimization on children’s development using the Human Development Capability Approach (HDCA) as a broader measurement of children’s wellbeing has not been fully explored.

The effect of child maltreatment polyvictimization on children’s mental health and psychosocial development is well documented in the literature (Dierkhising et al., 2019; Duckworth et al., 2020; Grasso et al., 2016; Haadr-Pedersen et al., 2020; Kavanaugh et al., 2017; Turner et al., 2017). These studies predominantly utilize data from North America and Western Europ.

A plethora of studies shows that polyvictimization has detrimental lifelong biopsychosocial impacts (Caballero-Dominguez et al., 2022; Duckworth et al., 2020; Grasso et al., 2016; Haadr-Pedersen et al., 2020; Kim et al., 2023; Turner et al., 2017). For example, some studies focussed on the neurobiological impact of various types of maltreatment on different regions of the brain, consequently affecting neurological and social development (Bick & Nelson, 2016; Kavanaugh et al., 2017; Leeb et al., 2011; Teicher & Samson, 2016). Other studies have found that children who experienced multiple victimizations are at higher risk for revictimization and experiencing trauma symptoms such as anxiety, depression, dissociation, anger, aggression, and health risk behaviours (Caballero-Dominguez et al., 2022; Finkelhor et al., 2009; Ford & Delker, 2020; Grasso et al., 2016; Lee et al., 2021/2022; Segura et al., 2016). Studies by Song et al., 2022 found that adults who experienced polyvictimization in childhood were more likely to perpetrate child abuse. Studies also show that polyvictimization in childhood was associated with perpetration and victimization of spousal abuse (Song et al., 2022; Wolfe, 2018). Sexual abuse appears to be the most reliable predictor of adult sexual victimization (Walker et al., 2019). Meanwhile, a study by Dierkhising et al. (2019) focused on the developmental timing of polyvictimization, citing that “the greater the number of developmental periods in which adolescents were classified as poly victims, the greater the severity of PTSD, externalizing and internalizing problems” (p. 40).

As regards gender, poly-victims are primarily boys (Finkelhor et al., 2009; Song et al., 2022), older children, children of medium socioeconomic status, and children in single-parent, stepparent, and older adult caregiver families (Finkelhor et al., 2009; Finkelhor et al., 2011). Polyvictimization studies in the Caribbean are limited. One study in Jamaica revealed that for both genders, polyvictimization had a direct negative effect on children’s intellectual functioning (Samms-Vaughan & Lambert, 2017). However, polyvictimization had a direct negative impact on behavioural risk for boys. The Jamaica study also found that children from the lowest socio-economic groups are more likely to be exposed to polyvictimization.

The HDCA conceptualizes human development by the United Nations Development Program (UNDP) as “the expansion of people's (children’s) freedoms to live long, healthy, and creative lives, to advance other goals they have reason to value and to engage actively in shaping development equitably and sustainably on a shared planet” (UNDP, Human Development Report, 2010, p. 2). Capabilities and functionings are two fundamental concepts of the HDCA. Capabilities refer to “the opportunity to achieve valuable combinations of human functionings” (Sen, 2005, p. 153). In contrast, functionings represent what an individual (a child) does and exemplify a person's (a child’s) wellbeing or achievements (Robeyns, 2017).

This conceptualization of human development emerging from HDCA, and was inspired by Amartya Sen (1999, 2005), with subsequent contributions by Martha Nussbaum (2007, 2008, 2011) and other scholars. They argue that economic-based measurements like Gross Domestic Product say nothing about quality of life, and they have developed new approaches to measure human development. At the core of HDCA is a normative and evaluative framework to measure human development that captures the quality of life, human dignity, and flourishing (Foster & Handy, 2008). The HDCA considers what an individual (child) does, as well as the extent to which an individual (child) has the freedom and opportunity to flourish, live a valuable life, and be an active agent in their lives (Deneulin & Shahani, 2009).

For this study, capabilities refer to Nussbaum's 10 central human capabilities, for which she argues that a minimally just society will endeavour to nurture and support a well-lived life; without them, we cannot flourish (Nussbaum, 2011). The list includes (1) life, (2) bodily health, (3) bodily integrity and safety, (4) senses, imagination, and thought, (5) emotions, (6) practical reason, (7) affiliation, (8) other species, (9) play and (10) control over one’s environment (Nussbaum, 2008, 2011). Table 1 describes the 10 human capabilities from Nussbaum (2008, 2011) matched with relevant articles of the Convention on the Rights of the Child (CRC) and survey items used in the current study. Each capability represents an opportunity and ability to achieve a certain doing or being, referred to as functioning. This list distinctly differs from characteristic development features from human growth and psychological perspectives that dominate childhood studies. The research question for this study is therefore, what is the relationship between lifetime child maltreatment polyvictimization and the 10 human capabilities (as a measurement of human development) while controlling for sociodemographic risk factors?

Table 1. 10 Central Human Capabilities Matched with CRC and Survey Items (Note: Author compiled and adapted Eugene et al., 2022)

10 Central Capabilities

Nussbaum (2008, 2011)

Convention on the Rights
of the Child

Survey items

Adapted from Anich et al. (2011); Biggeri & Mehrotra (2011); Biggeri & Libanora, (2011); Eugene et al., (2022).

Life

Art. 6: Life, survival, and development
Art. 7: Birth, registration, name, nationality, and care

Life and physical health.

Bodily health

Art. 24: Health
Art. 27: Adequate standard of living

Feeling happy.
Feeling self-love and worthy.
Inner peace and spirituality.
Living in a comfortable and safe home.

Bodily integrity and safety

Art. 19: Protection from violence, abuse, and neglect
Art. 34: Protection from sexual abuse
Art. 35: Abduction, sale, and trafficking
Art. 36: Exploitation
Art. 37: Inhumane treatment and detention

Moving freely visiting relatives or friends.
Being free from discrimination.
Being free from any form of abuse and neglect.

Senses, imagination, and thought

Art. 12: Respect the views of the child
Art. 13: Freedom of expression
Art. 14: Freedom of thought, belief, and religion
Art. 17: Access to information
Art. 28 & 29: Education

Being able to make sense of the most important things that are happening to me in my life.
Having a say in decisions about myself.
Having access to information that I need.
Attending school.
Communicating in a language of my choice.
Freely expressing who I am.

Emotions

Art. 9: Separation from parents
Art. 10: Family reunification

Art. 18: Parental responsibilities and state assistance

Love and care from parents.
Love and care from brother(s) and sisters(s)
Love and care from teacher(s).
Love and care from friends.

Practical reason

Art. 5: parental guidance and a child’s evolving capacities

Being able to plan or imagine my life in the future.

Affiliation

Art. 15: Freedom of association

Participating in activities with family or neighbours.
Receiving respect and consideration from everybody.
Attending religious celebrations.
Attending social and cultural activities.

Other species

Art. 29: Respect for the natural environment

Living in a clean environment.
Spending time in nature.
Being with animals and pets.
Engaging in activities to protect the environment.

Play

Art. 31: Leisure, play, and rest

Having enough time to play.
Participating in leisure activities that matter.

Control over one’s environment

Art. 12: Respect the views of the child
Art. 13: Freedom of expression

Have enough time to do what I like.
Expressing personal opinions and ideas and being listened to.
Participating in decisions regarding the environment.
Participating in the big political decisions about Aruba.

T he capabilities are aligned with the CRC, which has universal acceptance for realizing children's development (Peleg, 2013). Bonvin and Stoecklin (2014) compare the CRC and the Capability Approach. First, they acknowledge that both are normative and prescriptive and promote social arrangements and policies that enhance respect for human dignity. Secondly, "the CRC is a legally binding instrument, and the Capability Approach is a paradigmatic perspective" (Bonvin & Stoecklin, 2014, p. 9). The Capability Approach, as a perspective, creates opportunities to inspire us about the multiple dimensions to look at when implementing the CRC (Bonvin & Stoecklin, 2014). Meanwhile, Dixon and Nussbaum (2012) noted that the Capability Approach is closely allied to the human rights approach and, despite their differences, it is a species of the human rights approach.

Polyvictimization refers to exposure to multiple types of victimization (Finkelhor et al., 2011) that occur across multiple years and impact various stages of development (Duckworth, 2020). Studies show that children who experience at least one type of maltreatment are likely to have experienced other types of violence (Duckworth et al., 2020; Wolfe, 2018).

A body of research has already described the characteristic profile of poly-victims and the impact of polyvictimization on childhood development, and it predicts the extent to which other problems will be suffered during adulthood. Investigating the complete burden of polyvictimization in a much broader context of human development has not been thoroughly studied. This study aims to examine the effects of polyvictimization of child maltreatment on human capabilities while controlling for sociodemographic risk factors in Aruba.

As written in (name deleted to maintain the integrity of the review process), the study was conducted from 73 randomly selected classes in 11 secondary schools in Aruba. The children were between 12 – 17 years with a mean age of 14.5 years (SD = 1.5), in which the lifetime prevalence rate was at 78.4% (n= 702) and year prevalence was at 50.2% (n = 449). This study used lifetime prevalence data instead of past year for the following reasons: first, whereas the lifetime prevalence rate was measured for emotional abuse, sexual abuse, physical abuse, neglect, and children witnessing interparental violence, for the past year, neglect was not measured. Secondly, lifetime prevalence makes it possible to capture the cumulative burden of child maltreatment, which is better suited to measure the effect of polyvictimization on human capabilities.

Prof. Cees Hamelink, PhD, the Research School Coordinator at the University of Aruba, independently approved the research proposal on ethical grounds. Children were informed by teachers that their class had been randomly chosen to participate in a national school survey on child maltreatment. Children were issued a consent letter to their parents. On the data collection day, the children's ascent was also solicited. School Social Workers and Social Work Students were on standby to support children should they become distressed. An information card with resources was issued to every child. Children who chose not to participate in the survey remained in the classroom and worked on school assignments. Children could complete the online survey anonymously in English, Papiamento, Spanish, or Dutch. A linguistics committee facilitated the forward and backward translation of the survey. The survey was conducted within 25 to 90 minutes, with a completion rate of 85.0%. Students completed the survey during class hours, either in the school's computer lab or using their phones or laptops.

The self-administered digital Children’s Human Capabilities and Maltreatment National School Survey consisted of 7 parts with 138 questions. Parts 1, 2, 3, 4, 5, and 6 were used to measure maltreatment prevalence and sociodemographic risk factors and derived from The Netherlands' Prevalence Study on the Maltreatment of Children and Youth (Euser et al., 2013). Part 7 was used to measure children's human capabilities. The questions were adapted from the studies of Anich et al. (2011), Biggeri and Libanora (2011), and Biggeri and Mehrotra (2011) (see Table 1). To measure Nussbaum‘s 10 capabilities, there were 33 sub-items. Children’s enjoyment of these items was used to measure the extent to which they had the opportunity to achieve them. From the list of questions, children were required to indicate to what extent they enjoyed them on a 4-point Likert scale ranging from 1 (fully) to 4 (not at all). Cronbach's alpha was used to measure the internal consistency of the HCs scales and subscales. The general rule of thumb is that Cronbach's alpha of < .60 is poor; .60 to < .70 is moderate; .70 to < .80 is good; .80 to < .90 is very good, and < .90 is excellent (Hair et al., 2016). The Cronbach's alpha of the whole human capabilities scale was .93. The Cronbach's alpha of the HCs 10 subscales was also adequate, ranging from .70 to .83.

There were 20 questions about the sociodemographic characteristics of children and their parents. The chosen sociodemographic factors are (1) age, (2) gender, (3) ethnicity; (4) socioeconomic status (a) children’s perception of their economic status, (b) parent’s employment status, and (5) family type (a) living with mother only, (b) living with father only, (c) living with both parents. These factors derive from Belsky’s (1980, 1993) developmental and ecological framework for child maltreatment. Morevoer, studies in the Caribbean region have found these factors to be associated with child maltreatment (Devries et al., 2019; Gardner et al., 2008; Henry-Lee, 2020; Magurie, 2013).

The measure of polyvictimization was the number of victimization types experienced by a child over a lifetime. To explore the characteristics of poly-victims and to contrast them with each other, categories ranged from (1) single victim to (2) low poly-victim and (3) high poly-victim. Single victims were children who experienced one type of maltreatment, low poly-victims experienced 2 - 3 types of maltreatment, and high poly-victims 4 – 6 types of maltreatment.

First, descriptive statistics were computed to describe the characteristic profile of poly-victims. The Chi-square test of independence was performed to investigate relationship between sociodemographic and polyvictimization. Secondly, 10 one-way analyses of variance (ANOVA) were computed to investigate the association between polyvictimization and the 10 human capabilities. Polyvictimization was used as a measure of lifetime experiences with maltreatment, and not in the past year, to capture better the cumulative impact of maltreatment on childhood human development. “For HCs, low scores represent a greater achievement of HCs, and high HC scores represent capability deprivation or lack of enjoyment of the HCs” (name deleted to maintain the integrity of the review process). Thus, a positive correlation indicates that child maltreatment polyvictimization is associated with high HC total or deprivation of the HCs. Dependent variables were HC1 - Life, HC2 - Bodily health, HC3 - Bodily integrity and safety, HC4 - Senses, imagination, and thought, HC5 - Emotions, HC6 - Practical reason, HC7 - Affiliation, HC8 - Other species, HC9 - Play and HC10 - Control over one’s environment.

Thirdly, a hierarchical linear regression analysis was performed to measure the association between polyvictimization and the 10 capabilities while controlling for the five sociodemographic risk factors. Polyvictimization was used as a continuous measure of lifetime experiences with maltreatment.

Within the sample of children who experienced lifetime maltreatment, 10.8% (n = 67) experienced only one type of maltreatment. Low polyvictimization was 68.1% (n = 422), and high was 21.1% (n=131). The mean number of lifetime victimizations was 2.10 (SD = .556), and the median was 2.0. Results also revealed that most children who experienced neglect were in the high poly-victim category (58.5%, n = 72). Two-thirds of the children (60.9%, n = 243) who experienced physical abuse were in the low poly-victim category. Most of the children who experienced emotional abuse were also in the low poly-victim category at 74.3% (n = 380). Half of the children (50.8%, n =121) who witnessed interparental violence were low poly-victims. Two-thirds of the children (60.9%, n = 81) who experienced extra-familial sexual abuse were high poly- victims. Similarly, those children who experienced intra-familial sexual abuse were also found to be high poly-victims at 77.6% (n = 52). (Table 2).

Table 2. Children’s Experiences with Lifetime Child Maltreatment Polyvictimization (Note: Author compiled from National School Survey, 2019)

Type of victimization	Single I type		Low 2 – 3 types		High 4 – 6 types
	%	n	%	n	%	n
Neglect*	1.6	2	39.8	49	58.5	72
Physical abuse*	12.0	48	60.9	243	27.1	108
Emotional abuse*	1.9	10	74.3	380	24.7	128
Extra-familial sexual abuse*	0.8	1	38.3	51	60.9	81
Intra-familial sexual abuse*	0.0	0	22.4	15	77.6	52
Witnessing Interparental violence*	2.9	7	50.8	121	46.2	110

Poly-victims in the categories were more likely to have specific demographic characteristics. The Chi-square test of independence was performed to test the association between demographic variables and polyvictimization. Table 3 shows that more girls than boys experienced low and high polyvictimization of child maltreatment, while more boys were single victims.

Table 3. Sociodemographic Characteristics of Poly-victims (Note: Author compiled from National School Survey, 2019)

Sociodemographic Characteristics	Victimization Categories
	Single (n=67)	Low 2 – 3 types (n=422)	High 4 – 6 types (n=131)
Age
12 years	11.9 (8)	9.2 (39)	6.9 (9)
13 years	20.9 (14)	19.7 (83)	10.7 (14)
14 years	19.4 (13)	19.2 (81)	22.9 (30)
15 years	22.4 (15)	21.6 (91)	16.8 (22)
16 years	14.9 (10)	17.3 (73)	26.0 (34)
17 years	10.4 (7)	13.0 (55)	16.8 (22)
Gender*
Girls	48.5 (32)	56.1 (235)	66.7 (86)
Boys	51.5 (34)	43.9 (184)	33.3 (43)
Ethnicity
Born in Aruba	76.9 (50)	80.9 (326)	84.5 (109)
Born in other countries	23.1 (15)	19.1 (77)	15.5 (20)
Economic Status**
Not rich at all	0.0 (0)	3.3 (14)	9.9 (13)
Not rich	15.2 (10)	18.1 (76)	29.0 (38)
Average	53.0 (35)	56.3 (236)	44.3 (58)
Quite rich	25.8 (17)	19.1 (80)	15.3 (20)
Very rich	6.1 (4)	3.1(13)	1.5 (2)
Parent’s Employment Status
Father Employed	96.9 (63)	95.0 (364)	95.0 (114)
Father Unemployed	3.1 (2)	5.0 (19)	5.0 (6)
Mother Employed	94.0 (63)	83.8 (346)	88.2 (112)
Mother Unemployed	6.0 (4)	16.2 (67)	11.8 (15)
Family Type
Lived with Mother Only*
Yes	32.8 (22)	34.4 (145)	45.8 (60)
No	67.2 (45)	65.6 (277)	54.2 (71)
Lived with Father Only
Yes	3.0 (2)	8.3 (35)	6.1 (8)
No	97.0 (65)	91.7 (387)	93.9 (123)
Lived with Mother and Father**
Yes	62.7 (42)	49.1 (207)	37.4 (49)
No	37.3 (25)	50.9 (215)	62.6 (82)

Regarding family type, single victims were more likely to be living with both parents, while those who were high poly-victims were not. Children who live with single mothers are generally less inclined to be the victims of polyvictimization overall. However, those who do experience polyvictimization were more likely to be in the high category than the single and low poly-victim categories. Most children who perceived their economic status as very rich and quite rich were more likely to be single victims. In contrast, those who described their economic status as not rich or not rich at all were more likely to be high poly-victims. The Chi-square test of independence results were not statistically significant for children living with single fathers, regarding children’s age, parent’s employment status, and ethnicity.

5.3. Relationship Between Lifetime Child Maltreatment Polyvictimization and Human Capabilities

Ten one-way ANOVA was conducted to determine if there was a significant difference in the 10 human capability scores among three categories of child maltreatment polyvictimization. The independent variable was the polyvictimization categories, and the dependent continuous variables were human capability scores. Higher scores represent lower levels of enjoyment, or deprivation of human capabilities, and lower scores represent higher levels of enjoyment, or achievement of human capabilities.

Levene’s test of homogeneity of variance was conducted to evaluate the assumption of equality of variances. The results of Levine's indicated no violation in the assumption of homogeneity of variance, F(2, 603) = 2.13, p = .119). The one-way analysis of variance was statistically significant F(2, 603) = 23.25, p = <.001, η2 = .072). Using conventional guidelines, the eta-squared effect size was .072, indicating that polyvictimization moderately affected HC Life (Cohen, 1988). Based on the effect size value, 7.2% of the variance in HC Life was accounted for by polyvictimization.

Post-hoc comparisons using the Scheffe test were conducted. The results indicated that the mean scores for HC Life amongst the children who experience high polyvictimization of child maltreatment (M = 2.28, SD = .87) were significantly higher than the HC Life mean scores for children who experience single victimization of maltreatment (M = 1.59 SD = .68) (p, <.001) as well as those who experience low polyvictimization (M =1.79, SD = .79), (p, <.001). There was no significant difference in HC Life between those with single victimization and low polyvictimization (see Table 4 & Figure 1).

Levene’s test of homogeneity of variance was conducted to evaluate the assumption of equality of variances. The results of Levine's indicated no violation in the assumption of homogeneity of variance, F(2, 607) = 2.16, p = .116). The one-way analysis of variance was statistically significant F(2, 607) = 34.36, p = <.001, η2 = .10). The eta squared effect size was .10, indicating that polyvictimization had a moderate effect on HC Bodily health. Based on the effect size value, 10% of the variance in HC Life was accounted for by polyvictimization.

Post-hoc comparisons using the Scheffe test were conducted. The results indicated that the mean scores for HC Bodily health amongst the children who experienced high polyvictimization of child maltreatment (M = 2.38, SD = .76) were significantly higher than the HC Bodily health mean scores for children who experienced single victimization of maltreatment (M = 1.69 SD = .61), (p, <.001) as well as low polyvictimization mean scores (M =1.87, SD = .65), (p, <.001). There was no significant difference in HC Bodily health between those with single and low polyvictimization categories (see Table 4 & Figure 2).

Levene’s test of homogeneity of variance was conducted to evaluate the assumption of equality of variances. The results of Levine's indicated no violation in the assumption of homogeneity of variance, F(2, 604) = 1.70 p = .184). The one-way analysis of variance was statistically significant F(2, 604) = 18.39, p = <.001, η2 = .06). The eta squared effect size was .06, indicating that polyvictimization had a small to moderate effect on HC Bodily integrity and safety. Based on the effect size value, 6% of the variance in HC Bodily integrity and safety was accounted for by polyvictimization.

Post-hoc comparisons using Scheffe test were conducted. The results indicated that the mean scores for HC Bodily integrity and safety amongst the children who experienced high poly victimization of child maltreatment (M = 2.02, SD = .71) were significantly higher than the HC Bodily integrity and safety mean scores for children who experienced single victimization of maltreatment (M = 1.51 SD = .61), (p, <.001) as well as those who experience low polyvictimization mean scores (M =1.67, SD = .64), (p, <.001). HC Bodily integrity and safety did not differ significantly between single and low polyvictimization categories (see Table 4 & Figure 3).

Levene’s test of homogeneity of variance was conducted to evaluate the assumption of equality of variances. The results of Levine's indicated no violation in the assumption of homogeneity of variance, F(2, 603) = 2.30, p = .101). The one-way analysis of variance was statistically significant F(2, 603) = 16.83, p = <.001, η2 = .05). The eta squared effect size was .05, indicating that polyvictimization had a small effect on HC Senses, imagination and thought. Based on the effect size value, 5% of the variance in HC Senses, imagination and thought was accounted for by polyvictimization.

Post-hoc comparisons using the Scheffe test were conducted. The results indicated that the mean scores for HC Senses, imagination, and thought amongst the children who experienced high poly victimization of child maltreatment (M = 1.92, SD = .57) were significantly higher than the HC Senses, imagination, and thought mean scores for children who experience single victimization of maltreatment (M = 1.52, SD = .43), (p, <.001) and low polyvictimization mean scores (M =1.65, SD = .53), (p, <.001). The HC Senses, imagination, and thought scores were not significantly different between those in the single and low polyvictimization categories (see Table 4 & Figure 4).

Levene’s test of homogeneity of variance was conducted to evaluate the assumption of equality of variances. The results of Levine's indicated no violation in the assumption of homogeneity of variance, F(2, 597) = 2.74, p = .066). The one-way analysis of variance was statistically significant F(2, 597) = 20.19, p = <.001, η2 = .06). The eta squared effect size was .06, indicating that polyvictimization had a small to moderate effect on HC Emotions. Based on the effect size value, 6% of the variance in HC Emotions was accounted for by polyvictimization.

Post-hoc comparisons using the Scheffe test were conducted. The results indicated that the mean scores for HC Emotions amongst the children who experienced high polyvictimization of child maltreatment (M = 2.02, SD = .63) were significantly higher than the HC Emotions mean scores for children who experienced single victimization of maltreatment (M = 1.53, SD = .44), (p, <.001) as well as those with low polyvictimization mean scores (M =1.71, SD = .57), (p, <.001) on HC Emotions. Those with low polyvictimization scores significantly differed from those in the single polyvictimization category. (See Table 4 &Figure 5).

Levene’s test of homogeneity of variance was conducted to evaluate the assumption of equality of variances. The results of Levine's indicated no violation in the assumption of homogeneity of variance, F(2, 593) = 0.940, p = .391). The one-way analysis of variance was not statistically significant F(2, 593) = 2.812, p = .061, η2 = .009). No further analyses were performed on HC Practical reasoning. (See Table 4 & Figure 6).

Levene’s test of homogeneity of variance was conducted to evaluate the assumption of equality of variances. The results of Levine's indicated no violation in the assumption of homogeneity of variance, F(2, 599) = 2.95, p = .053). The one-way analysis of variance was statistically significant F(2, 599) = 11.60, p = <.001, η2 = .04). The eta squared effect size was .04, indicating that polyvictimization had a small effect on HC Affiliation. Based on the effect size value, 4% of the variance in HC Affiliation was accounted for by polyvictimization.

Post-hoc comparisons using the Scheffe test were conducted. The results indicated that the mean scores for HC Affiliation amongst the children who experienced high polyvictimization of child maltreatment (M = 2.35, SD = .85, (p, <.001)) were significantly higher than the HC Affiliation, mean scores for children who experienced single victimization of maltreatment (M = 1.85, SD = .68), (p, <.001) as well as those with low polyvictimization mean scores (M =2.0, SD = .77), (p, <.001). The scores on HC Affiliation did not differ significantly between those in the single and low polyvictimization categories (see Table 4 & Figure 7).

Levene’s test of homogeneity of variance was conducted to evaluate the assumption of equality of variances. The results of Levine's indicated no violation in the assumption of homogeneity of variance, F(2, 594) = .21, p = .812). The one-way analysis of variance was statistically significant F(2, 594) = 7.59, p = <.001, η2 = .03). The eta squared effect size was .03, indicating that polyvictimization had a small effect on HC Other species. Based on the effect size value, 3% of the variance in HC Other species was accounted for by polyvictimization.

Post-hoc comparisons using the Scheffe test were conducted. The results indicated that the mean scores for HC Other species, amongst the children who experienced high polyvictimization of child maltreatment (M = 2.20, SD = .70) were significantly higher than the HC Other species, mean scores for children who experienced single victimization of maltreatment (M = 1.88 SD = .69), (p = .010) as well as those in the low polyvictimization category (M =1.95, SD = .68), (p = .002). The HC Other species scores were not significantly different between those in the single polyvictimization category and those in the low category (see Table 4 & Figure 8).

Levene’s test of homogeneity of variance was conducted to evaluate the assumption of equality of variances. The results of Levine's indicated no violation in the assumption of homogeneity of variance, F(2, 593) = 1.08, p = .339). The one-way analysis of variance was statistically significant F(2, 593) = 13.27, p = <.001, η2 = .04). The eta squared effect size was .04, indicating that polyvictimization had a small effect on HC Play. Based on the effect size value, 4% of the variance in HC Play was accounted for by poly victimization.

Post-hoc comparisons using the Scheffe test were conducted. The results indicated that the mean scores for HC Play amongst the children who experience high polyvictimization of child maltreatment (M = 2.16, SD = .82) were significantly higher than the HC Play mean scores for children who experience single victimization of maltreatment (M = 1.63 SD = .65), (p, <.001) as well as those who experience low polyvictimization mean scores (M =1.84, SD = .74), (p, <.001). The mean scores on HC Play were not significantly different between those in the single polyvictimization and the low category (see Table 4 & Figure 9).

Levene’s test of homogeneity of variance was conducted to evaluate the assumption of equality of variances. The results of Levine's indicated no violation in the assumption of homogeneity of variance, F(2, 593) = .773, p = .462). The one-way analysis of variance was statistically significant F(2, 593) = 9.04, p = <.001, η2 = .03). The eta squared effect size was .03, indicating that polyvictimization had a small effect on HC Control Over one’s environment. Based on the effect size value, 3% of the variance in HC Life was accounted for by poly victimization.

Post-hoc comparisons using the Scheffe test were conducted. The results indicated that the mean scores for HC Control Over One’s Environment amongst the children who experience high polyvictimization of child maltreatment (M = 2.42, SD = .74) were significantly higher than the HC Control Over One’s environment mean scores for children who experience single victimization of maltreatment (M = 1.98 SD = .67), (p, <.001) as well as those who experience low polyvictimization mean scores (M =2.17, SD = .72), (p =.003. HC Control Over one’s environment was not significantly different between those in the single and low polyvictimization categories (see Table 3 & Figure 10).

Table 4. One-way Analysis of Variance (n = 620), (Note: Author compiled from National School Survey, 2019)

Poly Victimization Group	Single Poly Victim		Low Poly Victim		High Poly Victim		F(2)	η2
Human Capabilities	M	SD	M	SD	M	SD
Life*	1.59^a	.68	1.79^a	.79	2.28^b	.87	603	.07
Bodily health*	1.69^a	.61	1.87^a	.65	2.38^b	.76	607	.10
Bodily Integrity and safety*	1.51^a	.61	1.67^a	.64	202^b	.71	604	.06
Senses, imagination and thought*	1.52^a	.42	1.65^a	.53	1.92^b	.57	603	.05
Emotions*	1.53^a	.44	1.71^a	.57	2.02^b	.63	597	.06
Practical reason	1.58^a	.75	1.81^a	.89	1.91^b	.96	593	.01
Affiliation*	1.85^a	.68	2.01^a	.77	2.35^b	.85	599	.04
Other species*	1.87^a	.69	1.94^a	.68	2.2^b	.70	594	.03
Play*	1.63^a	.65	1.84^a	.74	2.16^b	.82	593	.04
Control over one’s environment*	1.98^a	.67	2.17^a	.72	2.41^b	.74	593	.03

Figures 1 – 10 illustrate that children who experience high victimizations, i.e., four to six types of maltreatment, were consistently less likely to enjoy the human capabilities necessary for their flourishing than the children who were single and low poly-victims.

Figure 1. HC 1 Life Scores Across Victim Groups (Note: Author compiled from National School Survey, 2019)

Figure 2. HC 2 Bodily Health Mean Scores Across Victim Groups (Note: Author compiled from National School Survey, 2019)

Figure 3. HC 3 Bodily Integrity and Safety Mean Scores Across Victim Groups (Note: Author compiled from National School Survey, 2019)

Figure 4. HC 4 Senses, Imagination, and Thought Mean Scores Across Victim Groups (Note: Author compiled from National School Survey, 2019)

Figure 5. HC 5 Emotions Mean Scores Across Victim Groups (Note: Author compiled from National School Survey, 2019)

Figure 6. HC 6 Practical Reason Mean Scores Across Victim Groups (Note: Author compiled from National School Survey, 2019)

Figure 7. HC 7 Affiliation Across Mean Scores Across Victim Groups (Note: Author compiled from National School Survey, 2019)

Figure 8. HC 8 Other Species Mean Scores Across Victim Groups (Note: Author compiled from National School Survey, 2019)

Figure 9. HC 9 Play Mean Scores Across Victim Groups (Note: Author compiled from National School Survey, 2019)

Figure 10. HC 10 Control Over One’s Environment Mean Scores Across Victim Groups (Note: Author compiled from National School Survey, 2019)

5.4. Relationship Between Lifetime Child Maltreatment Polyvictimization and Human Capabilities While Controlling for Sociodemographic Risk Factors

To answer the research question about the relationship between lifetime child maltreatment polyvictimization and human capabilities while controlling for sociodemographic risk factors, a hierarchical linear regression analysis was performed. In interpreting the linear hierarchical regression, it is essential to remember that “for HCs, low scores represent a greater achievement of HCs, and high HC scores represent capability deprivation or lack of enjoyment of the HCs” (name deleted to maintain the integrity of the review process). The analysis indicated no violations of normality or homoscedasticity in the assumptions of residuals. The control variables, age, gender, ethnicity, socioeconomic status (i.e., parent's employment status and children's perception of their economic status), and family constellation, explain 10.1% of the variance in HC total, F(9, 559) = 6.95, p<.001. Polyvictimization adds another 6.6% (F(1, 538) = 44.44, p<.001). In total, this combination of variables explains 16.7 % of the variance in the dependent variable. Based on these results, gender is a significant predictor of HC total, so girls had a significantly higher score on HC total B = -.193, p <.001, as was economic status, B = -.075, p = .004. Higher economic status was associated with a lower HC total. Those children with unemployed fathers have a significantly higher score on HC total B= 0.199, p = 0.042. Controlling for the demographic variables, polyvictimization was a significant positive predictor of HC total B = .132, p<.001.

High polyvictimization children consistently reported significantly higher mean scores on 9 of the 10 human capabilities when compared with children who were single victims and from the low polyvictimization group. This suggests that children's capability to flourish in these nine domains of the capabilities that are used to operationalize human development is adversely impacted by experiences of co-occurrences of maltreatment over a lifetime. These findings are parallel to other polyvictimization studies that focus on the biopsychosocial impact of child maltreatment. For example, studies have found poly-victim children to be adversely affected in the areas of psychological wellbeing, health, and social outcomes compared with single victims (Arata et al., 2005; Haadr-Pedersen et al., 2020; Witt et al., 2016). Additionally, the study of Finkelhor et al., 2009 found that high poly victims had significantly higher scores for symptoms of trauma when compared with single and low victims. Finkelhor et al., 2007 went on to state that when polyvictimization was considered to measure the role of multiple victimizations in explaining trauma symptomatology, "it substantially eclipsed the influence of individual victimizations" (p. 19).

Notwithstanding the similarities of the findings of this study with other studies, the Capability Approach presents unique effects for maltreatment poly-victims, depriving them of opportunities to flourish. These include children's lack of opportunities to participate in society, freedom of expression, being listened to, inability to make sense of things happening in their lives, and having a say in decisions about their lives. In other words, child maltreatment undermines children's sense of agency. Other effects include children's ability to enjoy nature, be with animals and pets, and limited opportunities to play, laugh, and engage in recreational activities. Additionally, poly-victims are also deprived of feeling self-love, worthy, inner peace, and happiness.

In the hierarchical linear regression, controlling for sociodemographic factors to examine the association between polyvictimization and human capabilities, poly-victims were more likely to be girls, children who perceived themselves to have low economic status, and those with unemployed fathers. Studies in Latin America and the Caribbean found that girls were also more likely to be on the spectrum of poly-victims than boys (Fry et al., 2021; Pinto-Cortez et al., 2020). In contrast, studies conducted in Western countries have found that boys were more likely to be poly-victims than girls (Finkelhor et al., 2007; Finkelhor et al., 2011; Ford et al., 2020). The different results in the case of Aruba about gender can be explained by the marianismo and the macho or toxic masculinity culture in Latin America and Caribbean societies (Fry et al., 2021; Martina, 2024; Stevens, 1973). A culture has been created in Latin America and Caribbean countries in which there are stereotypical attitudes of male toughness versus female socialization of being obedient, compliant, and submissive (Fry et al., 2021; Stevens, 1973), thus increasing girls' vulnerabilities to maltreatment, more than that of boys.

Whereas this study found low economic status to be a predictor for polyvictimization of child maltreatment and human capabilities, other studies both within the Caribbean and in Western countries (Dierkhising et al., 2019; Duckworth et al., 2020; Ford et al., 2020; Finkelhor et al., 2009; Finkelhor et al., 2011; Kavanaugh et al., 2017; Samms-Vaughan & Lambert, 2017) have also found low economic status to be a predictor of biopsychosocial factors related to maltreatment.

The strengths of this study on child maltreatment polyvictimization are its large and nationally representative sample of children 12 - 17 years old, and capabilities-based assessment, to the best of our knowledge, has yet to be fully explored in child maltreatment studies. Another strength is its contribution to literature from the Dutch Caribbean perspective, which is often silent in child maltreatment studies. One limitation is that the findings on socioeconomic status should be interpreted with caution because only two items were used to measure it: children’s perception of their economic status and their parent’s employment status. This study did not control for resilience, but its findings challenge us to understand more about how polyvictimization child maltreatment interferes with children’s quality of life and wellbeing from a Human Development Capability Approach.

Over two-thirds of the children in Aruba have experienced at least two to three types of maltreatment during their lifetime. This indicates that child protection workers should review child maltreatment risk assessments to ensure polyvictimization is included and addressed. Future research on co-occurring patterns of maltreatment in Aruba is worth exploring for younger children and with incidence data. High poly-victims were consistently less likely to enjoy the human capabilities necessary for their flourishing than the children who were single and low poly-victims. Controlling for sociodemographic risk factors, the results indicate that child maltreatment polyvictimization is likely to constrain children's opportunities to enjoy the full set of capabilities required for their human development. Child protection interventions need to consider multiple victimizations and as many sociodemographic risk factors as possible to ensure significant therapeutic outcomes.

The findings of this study support the existing literature on the cumulative adverse consequences of maltreatment on children's development (Finkelhor et al., 2011; Letkiewicz et al., 2021; Mackenzie et al., 2011). Nonetheless, a capabilities-based perspective founded on a broader definition of human development adds a new dimension to existing literature that other childhood developmental approaches do not capture. Child protection interventions should consider children's participation and agency, opportunities to play, laugh, and engage in social interactions and recreational activities. Additionally, enjoying meaningful and healthy attachments with parents, caregivers, siblings, friends, and teachers, and feeling self-love, inner peace, and happiness. Intervention must also consider children's ability to enjoy nature, be with animals, and engage in activities that protect the environment. It is recommended that Nussbaum's list of capabilities be used to develop a capabilities-based child protection assessment and policy checklist to protect children from maltreatment and safeguard their human rights and flourishing. This is a matter of social justice.

Anich, R., Biggeri, M., Libanora, R., & Marian, S. (2011). Street children in Kampala and NGO’s Action: Understanding capabilities deprivation and expansion. In M. Biggeri, J. Ballet, F. Comim (Eds.), Children and the Capability Approach (pp. 107-136). Palgrave Macmillan. https://doi.org/10.1057/9780230308374_5

Arata, C. M., Langhinrichsen-Rohling, J., Bowers, D., & O’Farrill-Swails, L. (2005). Single versus Multi-Type Maltreatment: An Examination of the Long-Term Effects of Child Abuse. Journal of Aggression, Maltreatment & Trauma, 11(4), 29–52. https://doi.org/10.1300/J146v11n04_02

Belsky, J. (1980). Child maltreatment: An ecological integration. American Psychologist, 35, 320 – 335. https://doi.org/10.1037/0003-066X.35.4.320

Belsky, J. (1993). Etiology of child maltreatment: A developmental ecological analysis. Psychological Bulletin, 114, 413 – 434. https://doi.org/10.1037/0033-2909.114.3.413

Bick, J., & Nelson, C. A. (2016). Early adverse experiences and the developing brain. Neuropsy- chopharmacology, 41, 177–196. https://doi.org/10.1038/npp.2015.252

Bigerri, M. & Libanora, R. (2011). From valuing to evaluating: Tools and procedures to operationalize the capability approach. In M. Biggeri, J. Ballet, F. Comim (Eds.), Children and the Capability Approach (79-106). Palgrave Macmillan.

Bigerri, M. & Mehrotra, S. (2011). Child poverty as capability deprivation: How to choose domains of child wellbeing and poverty. In M. Biggeri, J. Ballet, F. Comim (Eds.), Children and the Capability Approach (pp. 46-75). Palgrave Macmillan.

Bonvin, J. M. & Stoecklin, D. (Eds.) (2014). Children’s Rights and the Capability Approach Challenges and Prospects. https://doi.org/10.1007/978-94-017-9091-8

Caballero-Dominguez, C., Campo-Arias, A., & Rodriguez, M. (2022). Prevalence and factors associated with polyvictimization in Colombian High School attending adolescents. Journal of Positive Psychology and Wellbeing, 6(2), 1165 - 1175. https://journalppw.com/index.php/jppw/article/view/10374

Cohen, J. (1988). Statistical power analysis for the behavioural sciences (2nd Ed.). Lawrence Erlbaum.

Deneulin, S. & Shanani, L. (Eds.). (2009). Introduction to human development and capability approach, Freedom and agency. Earthscan. IDRC.

Devries, K., Merril, K. G., Knight, L., Bott, S., Guedes, A., Butron-Riveros, B., Hege, C., Petzold, M., Peteman, A., Cappa, C., Maxwell, L., Williams, A., Kishor, S., & Abrahams, N. (2019). Violence against children in Latin America and the Caribbean: What do available data reveal about prevalence and perpetrators? Pan American Journal of Public Health. 43 – 66. https://doi.org/10.26633/RPSP.2019.66

Dierkhising, C. B., Ford, J. D., Branson, C., Grasso, D., J., & Lee, R. (2019). Developmental timing of polyvictimization: Continuity, change, and association with adverse outcomes in adolescence. Child Abuse & Neglect, 87,40 – 50. https://doi.org/10.1016/j.chiabu.2018.07.022

Dixon, R. & Nussbaum, M. C. (2012). Children’s rights and a capabilities approach: the question of special priority. Cornell Law Review, 97. https://scholarship.law.cornell.edu/cgi/viewcontent.cgi?article=3232&context=clr

Duckworth, M. P., Lezzi, T., Radenhausen, M., & Galarce, K. (2020). Impact of childhood maltreatment and polyvictimization on adult revictimization. In R. Geffner, J. W. White, L. K. Hamberger, A. Rosenbaum, V. Vaughan-Eden, V. I. Vieth (Eds.), Handbook of Interpersonal Violence Across the Lifespan (pp. 1-20). Springer. https://doi.org/10.1007/978-3-319-62122-7_236-1

Eugene, C., Graafsma, L. G., & Sanches, M. R. (2022). Child maltreatment and children’s human capabilities in Aruba. Caribbean Journal of Psychology, 15(2) 14, 98 - 131. doi: 10.37234/CJP.2022. 1502.A004

Euser, S., Alink, L. R. A., Pannebakke, F., Vogels, T., Bakermans-Kranenburg, M. J. & van IJzendoorn, M. H. (2013). The Prevalence of child maltreatment in the Netherlands Across a 5-year period. Child Abuse & Neglect, 37(10), 841- 851. https://doi.org/10.1016/j.chiabu.2013.07.004

Finkelhor, D., Ormrod, R. K., & Turner, H. A. (2007). Poly victimization and trauma in a

Finkelhor, D., Ormrod, R. K., & Turner, H. A. (2009). Lifetime assessment of poly victimization in a national sample of children and youth. Child Abuse & Neglect, 33(7), 403–411. https://doi.org/10.1016/j.chiabu.2008.09.012

Finkelhor, D., Turner, H., Hamby, S., & Ormrod, R. (2011). Polyvictimization: exposure of children to multiple types of violence, crime and abuse. OJJDP Juvenile Justice Bulletin. https://www.ncjrs.gov/pdffiles1/ojjdp/23550 4.pdf

Ford, J. D., & Delker, B. C. (Eds.). (2020). Polyvictimization: Adverse impacts in childhood and across the lifespan. Routledge. https://doi.org/10.4324/9780429280313

Foster, J. & Handy, C. (2008). "External capabilities", OPHI Working Papers. https://ophi.org.uk/sites/default/files/OPHI-wp08.pdf

Fry, D., Padilla K., Germanio A., Lu, M., Ivatury, S., & Vindrola, S. (2021). Violence Against Children in Latin America and the Caribbean 2015 – 2021. A systematic review. UNICEF & University of Edinburgh.

Gardner, J. M., Henry-Lee A., Chevannes, P., Thomas, J. Baker-Heningham, H., & Coore, C. (2008), Violence against Children in the Caribbean: A desk review. In Henry-Lee, A & Gardner, J. M., (Eds.), Promoting child rights through research: Proceedings of the Caribbean Child Research Conference 2006 (pp. 3 – 29). SALISES, UWI. https://www.researchgate.net/publication/300078841_Violence_against_Children_in_the_Caribbean_A_Desk_Review

Grasso, D. J., Dierkhising, C. B., Branson, C. E., Ford, J. D., & Lee, R. (2016). Developmental patterns of adverse childhood experiences and current symptoms and impairment in youth referred for trauma-specific services. Journal of Abnormal Child Psychology, 44(5), 871–886. https://doi.org/10.1007/s10802-015-0086-8

Haadr-Pedersen, I., Ershadi, A, E., Hyland, P., Hansen, M., Perera, C., Sheaf, G., Bramsen, R. H., Spitz, P., Vallières, F. (2020). Polyvictimization and psychopathology among children and adolescents: A systematic review of studies using the Juvenile Victimization Questionnaire. Child Abuse & Neglect, 107. https://doi.org/10.1016/j.chiabu.2020.104589

Hair, J. F., Celsi, M., Money, A., Samouel, P., & Page, M. (2016). The Essentials of Business Research Method (3rd Ed.). Routledge.

Henry-Lee, A. (2020). Endangered and transformative childhood in Caribbean Small Island Developing States. Palgrave Macmillan.

Kavanaugh, B. C., Dupont-Frechette, J. A., Jerskey, B. A., & Holler, K. A. (2017). Neurocognitive deficits in children and adolescents following maltreatment: Neurodevelopmental consequences and neuropsychological implications of traumatic stress. Applied Neuropsychology: Child, 6(1), 64–78. https://doi.org/10.1080/21622965.2015.1079712

Kim, C., Vasquez, L., & Rahah, V. (2023). The impact of child polyvictimization and cultural factors on lifetime intimate partner violence among Salvadoran women. Violence Against Women, 29(14), 2681 - 2698. https://doi.org/10.1177/10778012231199105

Lee, K. A., Bright, C. L., Sacco, P., & Smith, M. E. (2021/2022). The influence of Adverse Childhood Experiences on perpetration of intimate partner violence among black men: The moderating role of alcohol use. Journal of Interpersonal Violence, 37, (19-20), pp. NP17248–NP17275. https://doi.org/10.1177/08862605211027997

Leeb, R. T., Lewis, T., & Zolotor, A. J. (2011). A review of physical and mental health conse-sequences of child abuse and neglect and implications for practice. American Journal of Lifestyle Medicine, 5(5), 454-468. https://doi.org/10.1177/1559827611410266

Letkiewicz, A. M., Weldon, A. L., Tengshe, C., Niznikiewicz, M. A., & Heller, W. (2021). Cumulative Childhood Maltreatment and Executive Functioning in Adulthood. Journal of Aggression. Maltreatment & Trauma, 30(4), 547–563. https://doi.org/10.1080/10926771.2020.1832171

Mackenzie, M. J., Kotch, J. B., Lee, L. C. (2011). Toward a cumulative ecological risk model for the etiology of child maltreatment. Children and Youth Services Review, 33(9),1638-1647. https://doi.org/10.1016/j.childyouth.2011.04.018

Magurie, E. R. (2013). Exploring family risk and protective factors for adolescent problem behaviours in the Caribbean. Maternal and Child Health Journal, 17, 1488–1498. https://doi.org/10.1007/s10995-012-1156-y

Martina, K. (2024). “Sintimentunan Derá, Sla Eksprsá”: How Curaçaoans in the Netherlands Perceive Partner Violence. In R. M. Allen & S. Bala (Eds), Handbook of Gender Studies in the Dutch Caribbean (pp. 276 - 319). Brill.

Nussbaum, M. C. (2007) Frontiers of justice: disability, nationality, species membership. Cambridge, Harvard University Press.

Nussbaum, M. C. (2008). Women and Human Development: The Capabilities Approach. Cambridge University Press.

Nussbaum, M. C. (2011). Creating Capabilities: The Human Development Approach. The Belknap Press of Harvard University Press.

Peleg, N. (2013). Reconceptualizing the child’s right to development: Child and the capability approach. International Journal of Children’s Rights, 21, 523 - 542. https://doi.org/10.1163/15718182-02103003

Pinto-Cortez, C., Guerra, C., Barocas, B., & Pereda, N. (2020). Victimization and poly victimization in a nationally representative sample of children and youth: The case of Chile. Journal of Aggression, Maltreatment & Trauma, 31(1), 3-21.https://doi.org/10.1080/10926771.2020.1796873

Robeyns, I. (2017). Well-being, freedom, and social justice. The capability approach rexamined. Open Book Publishers.

Samms-Vaughan, M., & Lambert, L. (2017). The impact of polyvictimization on children in LMICs: the case of Jamaica. Psychology, Health, and Medicine, 22 (Suppl. 1), 67 - 80. https://doi.org/10.1080/13548506.2016.1274411

Segura, A., Pereda, N., Guilera, G., & Abad, J. (2016). Polyvictimization and psychopathology among Spanish adolescents in residential care. Child Abuse & Neglect, 55, 40–51. https://doi.org/10.1016/j.chiabu.2016.03.009

Sen, A. K. (2005). Human Rights and Capabilities. Journal of Human Development, 6(2). 151 – 166. https://doi.org/10.1080/14649880500120491

Song, A., Yoon, Y., & Cho, Y. (2022). The Association Between Polyvictimization in Childhood and Intimate Partner Violence and Child Abuse in Adulthood. Journal of Interpersonal Violence, 37(9–10), 6009–6033. https://doi.org/10.1177/08862605211073088

Stevens, E. (1973). Marianismo: The other face of machismo in Latin America. In A. Pescatello (Ed.), Female and male in Latin America (pp. 89-101). University of Pittsburgh Press.

Teicher, M. H., & Samson, J. A. (2016). Annual Research Review: Enduring neurobiological effects of childhood abuse and neglect [Looking beyond the horizon-innovation in child psychology and psychiatry]. Journal of Child Psychology and Psychiatry, 57(3), 241 – 266. https://doi.org/10.1111/jcpp.12507

Turner, H. A., Shattuck, A., Finkelhor, D., & Hamby, S. (2017). Effects of polyvictimization on adolescent social support, self-concept, and psychological distress. Journal of Interpersonal Violence, 32(5), 755-780. https://doi.org/10.1177/0886260515586376

Walker, H. E., Freud, J. S., Ellis, R. A., Fraine, S. M., & Wilson, L. C. (2019). The prevalence of sexual revictimization: A meta-analytic review. Trauma, Violence & Abuse, 20(1), 67–80. https://doi.org/10.1177/1524838017692364

Witt, A., Münzer, A., Ganser, H. G., Fegert, J. M., Goldbeck, L., & Plener, P. L. (2016). Experience by children and adolescents of more than one type of maltreatment: Association of different classes of maltreatment profiles with clinical outcome variables. Child Abuse & Neglect, 57,1–11. https://doi.org/10.1016/j.chiabu.2016.05.001