Child Psychopathology Abuse and neglect Reading: Chapter 14

Classification of maltreatment n All states and provinces have mandatory reporting laws n Maltreatment would be noted under Axis I “Other conditions that may be a focus of clinical attention and/or Axis IV psychosocial stressors n As children are protected by statute, maltreatment is defined in law

Definitions n Physical abuse is active form of maltreatment, usually not intentional, but result of overdiscipline or punishment n Neglect may be physical (esp. toddlers), educational, or emotional n Sexual abuse involves sexual contact or exploitation of any kind (80% girls) –under-reported because of “conspiracy of silence” –males: non-family perpetrators; females: family n Emotional abuse pervasive to all forms of maltreatment

SEXUAL ABUSE of CHILDREN - DEFINING the PROBLEM in New York State “The sexual exploitation of a child by a parent, relative, caretaker or other person, which may range from non-touching offenses such as exhibitionism to fondling, intercourse or use of child in the production of pornographic materials. Summary of Legal Definition in NYS. A sexually abused child is a child less than eighteen years of age whose parent- or other person legally responsible for his/her care- commits or allows to be committed a sex offense against such child, as defined in the Penal law; commits incest; allows, permits or encourages such child to engage in acts or conduct which constitute prostitution or a sexual performance.

Physical Indicators of Neglect Failure to thrive (physically or emotionally) Positive indicator of toxicology, esp. in newborns; drug withdrawal symptoms, tremors, etc. Lags in physical development consistent hunger, poor hygiene (skin,teeth, ears, etc.) Inappropriate dress for the season Speech disorders Consistent lack of supervision, especially in dangerous activities or for long periods Unattended physical problems or medical needs Chronic truancy Abandonment

Types of victimization n Pandemic vcitimizations: Everyday events experienced by most children –assaults by siblings & friends, parental punishment n Acute victimizations: Less frequent but more severe and discrete –e.g., discrete incidence of severe physical punishment, neglect, family abduction n Extraordinary victimization: Infrequent but great degree of public attention –Examples?

Prevalence n Reported cases: 3/million U.S. children/year n Awareness and definitions causes this to increase n Lifelong prevalence rates Sexual AbusePhysical Abuse Males4.3%31.2% Females12.8%21.1%

Negative consequences n Insecure-disorganised attachment n Hypervigilence & poor emotional regulation n Internalising (esp. girls) and externalising (esp. boys) behavior problems n Poor self esteem, helplessness, distrust, betrayal n Internal attributions of blame

Physical abuse Sexual abuse n Little empathy, react with fear & anger to others n Physically and verbally aggressive n Academic and behavior problems at school n Neglected children can be withdrawn from others n May be anxious, inattentive, and unpopular with peers n Sexuality can be affected teen as either withdrawn/avoidant or erotisized/precocious n PTSD symptoms may leave them as unresponsive to peers n Risk for revictimisation Peer Interactions

Causes of physical abuse and neglect n Few parent-child interactions n Parents mislabel child behavior n Stress can cause disengagement (in neglect) or emotionality/anger (in physical abuse) n Neglect related to poor parental education of child need, insularity, personality disorders in parents n Coercive family interactions lead to physical abuse as “only way” to control child n Family/marital conflict is a risk factor

Causes of sexual abuse n Most offenders are males who indoctrinate their children into sexual activity n Offenders have a sense of entitlement and privilege, no sense of consequences n Some perpetrators themselves were abused n Failure to maintain healthy, trusting adult relationships n Insularity, control, obedience are stressed, and this gets confounded with sexuality n Sexualisation of children in media, most deviant sexualities are in video store

Physical abuse Sexual abuse n Parent education on child needs and disciplinary practices n Anger management and correcting distorted cognitions n Strengthening child compliance and self- control n Having children more involved in the community n Outcome less predictable, therefore treatments less systematic n Child’s sense of trust, safety, guiltlessness through cognitive- behavioral methods is crucial n Feelings need to be expressed, PTSD symptoms Prevention