Child abuse

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Child abuse is the physical, psychological or sexual maltreatment of children. While most child abuse happens in the child's home, a significant portion also occurs in organizations involving children, such as churches, schools, child care businesses, and residential schools.[1][2]

There are many forms of abuse and neglect and many governments have developed their own legal definition of what constitutes child maltreatment for the purposes of removing a child and/or prosecuting a criminal charge. In the United States, the Federal Government puts out a full definition of child abuse and neglect and creates a summary of each State definition.[3] The Centers for Disease Control and Prevention (CDC) defines child maltreatment as any act or series of acts or commission or omission by a parent or other caregiver that results in harm, potential for harm, or threat of harm to a child. Examples of acts of commission include physical, sexual, and psychological abuse. Examples of acts of omission include failure to provide (physical, emotional, medical/dental, or educational neglect) or failure to supervise (inadequate supervision, or exposure to violent environments.)[4]

Contents

[edit] Prevalence

Neglect represents 54% of confirmed cases of child abuse, physical abuse 22%, sexual abuse 8%, emotional maltreatment 4%, and other forms of maltreatment 12%.[5]

According to a recent UNICEF report on child well-being[6] in the United States and the United Kingdom ranked lowest among first world nations with respect to the well being of their children. This study also found that child neglect and child abuse are far more common in single-parent families than in families where both parents are present. Recently a study conducted by the Center for Disease Control and Prevention found that 1 in 50 infants in the United States are victims of nonfatal neglect or abuse.[7] In the US, neglect is defined as the failure to meet the basic needs of children including housing, clothing, food and access to medical care. Researchers found over 91,000 cases of neglect over the course of one year (from October 2005- September 30, 2006) with their information coming from a database of cases verified by protective services agencies. [8]

[edit] Effects

Children with a history of neglect or physical abuse are at risk of developing psychiatric problems,[9][10] including a disorganized attachment style.[11][12][13] Disorganized attachment is associated with a number of developmental problems, including dissociative symptoms,[14] as well as anxiety, depressive, and acting-out symptoms.[15][16] A study by Dante Cicchetti found that 80% of abused and maltreated infants exhibited symptoms of disorganized attachment.[17][18]

The effects of child abuse vary, depending on its type. A 2006 study found that childhood emotional and sexual abuse were strongly related to adult depressive symptoms, while exposure to verbal abuse and witnessing of domestic violence had a moderately strong association, and physical abuse a moderate one. For depression, experiencing more than two kinds of abuse exerted synergetically stronger symptoms. Sexual abuse was particularly deleterious in its intrafamilial form, for symptoms of depression, anxiety, dissociation, and limbic irritability. Childhood verbal abuse had a stronger association with anger-hostility than any other type of abuse studied, and was second only to emotional abuse in its relationship with dissociative symptoms.[19]

[edit] Treatment

There are a number of treatments available to victims of child abuse.[20] Trauma-focused cognitive behavioral therapy, while developed to treat sexually abused children, is now used for victims of any kind of trauma. It targets trauma-related symptoms in children including Posttraumatic Stress Disorder (PTSD), clinical depression, and anxiety. It also includes a component for non-offending parents. Several studies have found that sexually abused children undergoing TF-CBT improved more than children undergoing certain other therapies. Data on the effects of TF-CBT for children who experienced only non-sexual abuse was not available as of 2006.[20]

Abuse-focused cognitive behavioral therapy was designed for children who have experienced physical abuse. It targets externalizing behaviors and strengthens prosocial behaviors. Offending parents are included in treatment, to improve parenting skills/practices. It is supported by one randomized study.[20]

Child-parent psychotherapy was designed to improve the child-parent relationship following the experience of domestic violence. It targets trauma-related symptoms in infants, toddlers, and preschoolers, including PTSD, aggression, defiance, and anxiety. It is supported by two studies of one sample.[20]

[edit] See also

[edit] Footnotes

  1. ^ B.A. Robinson (2001 October 25) Abuse at Canadian Native Residential Schools ReligiousTolerance.org Accessed 2007-09-13.
  2. ^ "Getting Away with Murder—Of children" and "Missed Clues—Lost Lives : TORONTO STAR, 1998"
  3. ^ Definitions of Child Abuse and Neglect: Summary of State Laws, that is part of the 2005 State Statute series by the Child Welfare Information Gateway.
  4. ^ Leeb, RT, Paulozzi, Melanson, C, Simon, T, Arias, I. Child Maltreatment Surveillance: Uniform Definitions for Public Health and Recommended Data Elements, Version 1.0. Atlanta (GA) Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2008.
  5. ^ National Committee to Prevent Child Abuse, "Child Abuse and Neglect Statistics," April 1998
  6. ^ Child Poverty in Respective: An Overview of Child Wellbeing in Rich Countries, UNICEF: Innocenti Research Center, Report Card 7
  7. ^ Centers for Disease Control and Prevention. Nonfatal Maltreatment of Infants – United States, October, 2005--September 2006. MMWR 2008;57:[336-339].
  8. ^ Centers for Disease Control and Prevention. Nonfatal Maltreatment of Infants – United States, October, 2005--September 2006. MMWR 2008;57:[336-339].
  9. ^ Gauthier, L., Stollak, G., Messe, L., & Arnoff, J. (1996). "Recall of childhood neglect and physical abuse as differential predictors of current psychological functioning," Child Abuse and Neglect, 20, 549-559
  10. ^ Malinosky-Rummell, R. & Hansen, D.J. (1993). "Long term consequences of childhood physical abuse," Psychological Bulletin, 114, 68-69
  11. ^ Lyons-Ruth K. & Jacobvitz, D. (1999). "Attachment disorganization: unresolved loss, relational violence and lapses in behavioral and attentional strategies." In J. Cassidy & P. Shaver (Eds.) Handbook of Attachment. (pp. 520-554). NY: Guilford Press
  12. ^ Solomon, J. & George, C. (Eds.) (1999). Attachment Disorganization. NY: Guilford Press
  13. ^ Main, M. & Hesse, E. (1990) Parents’ Unresolved Traumatic Experiences are related to infant disorganized attachment status. In M.T. Greenberg, D. Ciccehetti, & E.M. Cummings (Eds), Attachment in the Preschool Years: Theory, Research, and Intervention (pp161-184). Chicago: University of Chicago Press
  14. ^ Carlson, E.A. (1988). "A prospective longitudinal study of disorganized/disoriented attachment," Child Development, 69, 1107-1128
  15. ^ Lyons-Ruth, K. (1996). "Attachment relationships among children with aggressive behavior problems: The role of disorganized early attachment patterns," Journal of Consulting and Clinical Psychology, 64, 64-73
  16. ^ Lyons-Ruth, K., Alpern, L., & Repacholi, B. (1993). "Disorganized infant attachment classification and maternal psychosocial problems as predictors of hostile-aggressive behavior in the preschool classroom," Child Development, 64, 572-585
  17. ^ Carlson, V., Cicchetti, D., Barnett, D., & Braunwald, K. (1995). "Finding order in disorganization: Lessons from research on maltreated infants’ attachments to their caregivers." In D. Cicchetti& V. Carlson (Eds), Child Maltreatment: Theory and research on the causes and consequences of child abuse and neglect (pp. 135-157). NY: Cambridge University Press.
  18. ^ Cicchetti, D., Cummings, E.M., Greenberg, M.T., & Marvin, R.S. (1990). An organizational perspective on attachment beyond infancy. In M. Greenberg, D. Cicchetti, & M. Cummings (Eds), Attachment in the Preschool Years (pp. 3-50). Chicago: University of Chicago Press.
  19. ^ Teicher, M. H., Samson, J. A., Polcari, A, & McGreenery, C. E. (2006). "Sticks, stones, and hurtful words: Relative effects of various forms of childhood maltreatment," American Journal of Psychiatry, 163, 993-1000.
  20. ^ a b c d Cohen, J.A.; Mannarino, A.P.; Murray, L.K.; Igelman, R. (2006). "Psychosocial Interventions for Maltreated and Violence-Exposed Children". Journal of Social Issues 62 (4): 737–766. doi:10.1111/j.1540-4560.2006.00485.x. 

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