The impact of institutional child abuse: A systematic review using Reflexive Thematic Analysis.

Institutional child abuse has several negative impacts, including effects on mental health, well-being and interpersonal relationships. There is a need to understand this complex form of abuse occurring in an out-of-home setting. The current review aims to understand the literature base regarding the impact of institutional child abuse and to identify areas where further research is needed. Consequently, a systematic review was conducted, which captured quantitative and qualitative methods. This resulted in 58 papers being included. The papers captured the impacts of institutional abuse, covering physical abuse, sexual abuse, emotional abuse and neglect (i.e., a failure to be adequately cared for). These were then analysed using a qualitative methodology, specifically Reflexive Thematic Analysis. Several factors, such as prior abuse, were reported to exacerbate the impact of institutional abuse, whereas secure attachment was noted as a protective feature. Responses to disclosure appear to have an important role in recovery. Areas important for further research included understanding the role of protective factors and how they impact future outcomes, but to do so alongside an acknowledgement and greater exploration of negative impacts. • Diversity in impact is clearly evidenced, alongside complexity in presentation. • Pre-existing factors, including availability of protective factors, appear as important correlates with later mental health challenges. • A role for disclosure as a unique feature is indicated. • An absence of longitudinal research into impacts is evidenced. • The research field uses considerable diversity in method, with resulting varied quality. [ABSTRACT FROM AUTHOR]