Psychological Abuse: More Common, as Harmful as Other Child Maltreatment

Psychological abuse — including demeaning, bullying and humiliating — may be the most prevalent form of child maltreatment. Yet it's among the hardest to identify or to treat

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It may be the most common kind of child abuse — and the most challenging to deal with. But psychological abuse, or emotional abuse, rarely gets the kind of attention that sexual or physical abuse receives.

That’s the message of a trio of pediatricians, who write this week in the journal Pediatrics with a clarion call to other family doctors and child specialists: stay alert to the signs of psychological maltreatment. Its effects can be every bit as devastating as those of other abuse.

Psychological maltreatment can include terrorizing, belittling or neglecting a child, the pediatrician authors say.

(MORE: Child Abuse Pediatricians Recommend Basic Parenting Classes to Reduce Maltreatment and Neglect)

“We are talking about extremes and the likelihood of harm, or risk of harm, resulting from the kinds of behavior that make a child feel worthless, unloved or unwanted,” Harriet MacMillan, one of the three pediatrician authors, told reporters.

What makes this kind maltreatment so challenging for pediatricians and for social services staff, however, is that it’s not defined by any one specific event, but rather by the nature of the relationship between caregiver and child. That makes it unusually hard to identify.

Keeping a child in a constant state of fear is abuse, for example. But even the most loving parent will occasionally lose their cool and yell. Likewise, depriving a child of ordinary social interaction is also abuse, but there’s nothing wrong with sending a school-aged boy to stew alone in his room for an hour after he hits a younger sibling. All of this means that, for an outsider who observes even some dubious parenting practice, it can be hard to tell whether a relationship is actually abusive, or whether you’ve simply caught a family on a bad day.

(MORE: How Child Abuse Primes the Brain for Future Mental Illness)

Psychological abuse can also include what you might call “corrupting a child” — encouraging children to use illicit drugs, for example, or to engage in other illegal activities.

In their Pediatrics paper, MacMillan and co-authors say that 8% to 9% of women and 4% of men reported severe psychological abuse in childhood when the question was posed in general-population surveys of the U.S. and Britain. A number of U.S. surveys have also found that more adults claim they faced psychological maltreatment as kids than claim they experienced any other form of abuse. This suggests that psychological maltreatment may be the most common form of abuse inflicted on kids.

Because of that, pediatricians must be as sensitive to signs of emotional maltreatment as they are to signals of sexual or physical abuse, the authors say. And while it may be possible in the event of psychological abuse to intervene to improve the child’s home life — especially where the root cause is a parent’s own mental-health issue — the authors stress:

Consideration of out-of-home care interventions should not be restricted to cases of physical or sexual abuse; children exposed to psychological maltreatment may also require a level of protection that necessitates removal from the parental home.

MORE: Home Visits: A Powerful Weapon Against Child Abuse

35 comments
johndt41
johndt41

Based on my experience I think that abuse like woes comes not in ones and twos but in threes.  Based on my experience I was not only physically and sexually abused but also suffered ongoing verbal abuse, humiliation etc.  I think that abuse is an entire  environment and to treat the entire experience the therapy needs to address not just the physical and sexual abuse but all the other abuses that go along with these as well as the total neglect of the child's needs.  Among these needs are abused children are not taught coping skills.  Coping skills are important because dealing with one's abuse is in itself traumatic which requires coping skills which the survivor does not have.  The child is not taught any of the skills the child will need to become a functioning adult etc. etc.  The list goes on.

Tara Green
Tara Green

This article is timely and relevant. Such abuse can manifest on such a broad spectrum of behaviors. I also believe that one child can thrive in a given environment, while another will whither. Ultimately, when the well-being of all children becomes our primary focus as a society, the rest will follow. 

Tim Logie
Tim Logie

Logged in with Facebook .

It used my real name.

Can't edit out my name, so No Comment. :)

Paleoman1
Paleoman1

Psychological abuse is obviously not good and should be minimized.  But how do you scientifically study something like this with adequate controls?   Do you take two groups of kids and randomly assign one group to be psychologically abused and study the outcomes?  Obviously not.   Do you unscientifically assume that correlation is the same as causation?   Do you simply correlate outcomes of those believed to be abused by their parents with those who were not?    If so, how do you know that the bad outcomes are not simply the result of bad genetics passed from the abusive and dysfunctional parents to predictably genetically dysfunctional kids?

Open9
Open9

I'm glad we're finally starting to recognize psychological abuse of children as a real problem.

For too long, some have had to second guess their perception of being abused when society at large gave no term to it.

These people have not known where to turn or how to recover.

Others don't know how to treat these people because they have no training, no point of reference, and very little understanding of their condition.

To the uninitiated, these can seem overly-sensitive, withdrawn, unsociable, etc.

Human nature fails when the victims become objects of condemnation.

tuigim
tuigim

The stresses of motherhood are the subject of The Irish Times article today that is well worth reading.

http://healthland.time.com/201...

It's called

There is no best way of combining motherhood and jobs.

The frustrated mother tries to learn from all around her but concludes

"

Whatever you do, there will be angry voices in the media telling you

that your answer is wrong. But there is no need to listen to them when

there is an angrier adolescent at home telling you just the same thing

with even greater conviction."

It ain't easy.

I say let's get all we can right first. Meet basic needs and work our way up following Maslow's model and stop letting our government waste our money on wars causing more more problems than we can cope with.

poconos4slums
poconos4slums

my religious idiot father, who went to bars all saturday and never missed a day of church, and my just plain evil mom certainly made me feel like dirt.

thankfully, they're both dead, though only in my old age have I realized just how hateful and crazy they were. 

tuigim
tuigim

Maybe if we had Universal Health Care there would be more support systems in place.

Maybe if there was a genuine respect for the job of parenting that would help.

People talk of being pro-life and then support wars and ignorance and deny people their basic rights.

There are no perfect parents. Sometimes autistic people become parents and cannot give all the love the kids need.

Sometimes alcoholics become parents, as do the unemployed and the mentally ill.

Everyone has stresses and strains. Some manage in awful circumstances but others need help.

It's easy to say that those who can't cope are wrong when the kids bear the brunt of frustrations but it doesn't address the causes and America fails miserably in looking after her own people.

tuigim
tuigim

Society belittles as well and puts pressure on parents to conform.

Watch Killing Us Softly:  http://www.youtube.com/watch?v...

Parents often take their cues from the media. How do we interpret the world around us and what is expected of us as individuals and what is expected of our children?

Capitalism is fine. Unrestricted capitalism that exploits and abuses needs to be stopped.

tpkroger
tpkroger

It's also possible that the parent doesn't intend to keep the child in a constant state of fear. They could be overworked and stressed out to the point that they get home and blow up over the smallest thing. Though this still makes them a lousy parent and should be considered abuse.

mjb0891
mjb0891

Adults in positions of power also bully other adults (such as co-workers or employees), and it is also devastating, yet we fail to recognize the impacts of adult bullying. 

Rusty Gunn
Rusty Gunn

Religious indoctrination before the age of consent. 

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19 US states allow taxpayer funded school teachers, coaches and

administrators entrusted with the care and education of children to hit

them with no safety standards : AL, AZ, AR, CO, FL, GA, ID, IN, KS, KY,

LA, MS, MO, NC, OK, SC, TN, TX, WY, Some state laws do Not require

parental consent or notification for children to be hit in school

KidsRpeople2
KidsRpeople2

See Shocking Brutally Violent U.S. Public School Spanking/Corporal Punishment (Sexual Assault) Injuries to students Kindergarten through Twelfth Grade at YouTube Video Trailer for Documentary “The Board of Education” by Jared Abrams http://youtu.be/0vt4v7KsFi8

 

19 US states allow taxpayer funded school teachers, coaches and administrators entrusted with the care and education of children to hit them with no safety standards : AL, AZ, AR, CO, FL, GA, ID, IN, KS, KY, LA, MS, MO, NC, OK, SC, TN, TX, WY, Some state laws do Not require parental consent or notification for children to be hit in school!

 

"Teacher Immunity Laws" protect school employees (mandatory reporters of suspected child abuse) from criminal/civil action when students are injured by deliberate infliction of pain by school employees hitting them with wooden boards as punishment of minor infractions.

 

No Cover Up Here, Just Blatant Abuse and NO ONE CARES! US Lawmkers Turn Blind Eye to Immunity for Abuse of Students K-12 by Mandatory Child Abuse Reporters Public School Teachers Coaches and Administrators 2008 Report “A Violent Education” by Human Rights Watch and ACLU http://fb.me/VJqjF0kQ

 

223,190 Kids Legally Beaten in US Schools annually with Impunity, 20,000 students seek emergency medical treatment http://huff.to/deeCVl 

 

Federal Bill H.R. 3027 “The Ending Corporal Punishment in Schools Act” is languishing in U.S. Congress NOW, earlier version H.R. 5628 DIED in Congress last year! See http://donthitstudents.com/

metropika
metropika

Neglect is also a form of abuse.

poconos4slums
poconos4slums

The people who have such basic needs as food and shelter are the ones who have no problem wasting  money on wars...so no use dragging the recent wars into this.

poconos4slums
poconos4slums

Excuses, excuses; some parents are just plain scumbags.

Rich, good-looking, and famous Ryan O'Neal is notorious for punching some teeth out of Griffin O'Neal and coming onto daughter Tatum at Farrah Fawcett's funeral, and O'Neal/Fawcett's kid has been in rehab for heroin.

poconos4slums
poconos4slums

Joseph Stalin was such a scumbag parent that his own daughter fled to USA!

Occupy Wall Street college-educated protesters come off as spoiled, stupid, brats.

Mao's cultural revolution had teenagers throw adults out of 2nd floor windows.

tuigim
tuigim

Maybe if the culture values people, it gets easier. Take Sweden where you get your maternity and paternity leave. Take all the countries where the Mom has a week to recover in hospital after giving birth and doesn't have to stress about costs. Take companies that provide quality free childcare on site.

All these concepts are SO alien to American society. Parents sacrifice so much for their kids here but the stresses and strains on them are brutal.

poconos4slums
poconos4slums

Sounds like the typical Hollywood liberal!

Barbra Steisand, Alex Baldwin, Sean Penn, Courtney Love....

Debatable if Angelina Jolie a saint or a mommy dearest.

Sunjay
Sunjay

Is not emotional abuse unless there is use of threats and humiliation to force children to act in certain ways.

Amicus Curia
Amicus Curia

Yes, it's time the 8th Amendment applied to our children too. The U.S. is so regressive in this respect as to be embarrassing. 

tuigim
tuigim

Yes. It's Barbaric. It's shocking to many people even those who live in the U.S. to discover that so many states have corporal punishment in school.

The UNITED States is not united and it SHOULD be. It should be a level paying field in education. Basic human should be in place in all states.

Of course, African American kids are beaten far more often than white kids in those states that allows corporal punishment.

It's time to pull these states into the right century.

poconos4slums
poconos4slums

I was an only child, and my stay at home evil mom, and my dad who didnt even have any relatives found ways to neglect me.

Amicus Curia
Amicus Curia

Sounds like my Dad and Ryan would get on fabulously.

poconos4slums
poconos4slums

Having five kids from five different daddies is also SO alien to Sweden!

poconos4slums
poconos4slums

A parent having lots of time for church activities and no time for his kid is definately emotional abuse.

tuigim
tuigim

 Asking a small child to sing 'Deep in thy wounds Lord, hide and shelter me' is not at least not well thought out?

Such images!

poconos4slums
poconos4slums

"When I was a kid..." the teachers were able to slap a student right across the face----and I got slapped a number of times, right in front of other students.

Decades later, I wish I would had the common sense to punch my teachers back.

I still hate teachers, in my olde age.

Amicus Curia
Amicus Curia

It's a rotten job...but somebody's gotta do it.

poconos4slums
poconos4slums

for Amicus Curia:

In elementary school,  my 6th grade teacher flipped out from too many kids answering too many wrong questions---so he started throwing books off the shelves.

A high school teacher once slammed me against the hallway lockers, in front of everybody.

Yeah, teachers could beat a kid, like me,  into silence and submission.

And Pennsylvania teachers are notorious to this day for always going on strike.

(It feels sooo good to belatedly badmouth my teachers!)

Amicus Curia
Amicus Curia

I suffered physical abuse at the hands of a male public school teacher (Mr. Danny @ Emerson Elementary School in Long Beach, CA.) when he took me behind the bungalow classroom (where he couldn't be observed) and slammed me against the wall...a great teachable moment. I learned that state sponsored violence is acceptable. I began to wonder why what's sauce for the goose wasn't good for the gander. BTW, I was not a violent child. But kids can have that beat out of them.