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Week 1Part 2 Psychological consequences of childhood maltreatment
- Maltreatment = abuse AND neglect
- Why? Learn about the long term consequences of childhood abuse and neglet
- Empirical evidence: numerous findings that childhood abuse and neglect have pervasive
consequences for mental and physical health
- Papers summarise the consequences
- Definition childhood maltreatment: any act o commissdion or omission by a parent or other
caregiver that results in harm, potential for harm, or threat of harm to a child. Harm does
not need to be intended
- Omission
o Failure to meet a childs needs
Physical neglect
Emotional neglect (when a kid is not feeling the love every child deserves,
basic right; right to be loved)
Denial of access to education (not willing to send their kids to school, let
them work etc.)
- Commission
o Actively doing sth harmful
Physical abuse (hitting)
Emotional abuse (yelling, calling names, make them feel responsible,
threathens child in their being)
Sexual abuse (mostly not by the parents)
Shaken baby syndrome
- Types of maltreatment
o Emotional neglect
‘Failure to meet a child's emotional needs and failure to protect a child from
violence in the home or neighbourhood’
o Physical Neglect
‘Failure to meet a child's basic physical, medical/dental, or educational
needs; failure to provide adequate nutrition, hygiene, or shelter’
o Emotional abuse
‘Intentional behaviour that conveys to a child that he/she is worthless,
flawed, unloved,unwanted, endangered, or valued only in meeting another's
needs’
o Physical abuse
‘Intentional use of physical force or implements against a child that results
in, or has the potential to result in, physical injury’
o Sexual abuse
‘Any completed or attempted sexual act, sexual contact, or non-contact
sexual interaction with a child by a caregiver’
- World health organisation
o Prevalence
, o
o Dutch national prevalency study
Professionals: 3.4%
o Students on maltreatment (SOM studie)
Self-report among 1800 children 12-16 years:
37% report one of more forms of abuse
Emotional and physical abuse most frequent
- Classification system for psychological disorders based on standard criteria
o Published by APA, first edition in 1950
o Focus on objective description of symptoms with no theoretical framework
o Decreased focus on aetiology of disorders
-
- Red: does look at the cause
- Blue: higher prevalence of childhood maltreatment
- Disorders:
o Internalizing and externalizing disorders
o Personality disorders (BPD/anti-social)
o Psychotic symptoms
o Suicide and self-injury
o Often earlier onset, more severe/chronic, and harder to treat with a history of
childhood maltreatment
, o
o Look more at the symptoms instead of just disorder
- To conclude:
o Childhood abuse and neglect important transdiagnostic risk factors for development
of psychological problems, including depression and aniety and drug & alcohol
addiction, agression
o Consequences of emotional abuse and neglect at least as pervasive as physial or
sexual abuse
o Indications for subtypes of depression and anxiety, with or wothout maltreatment
history
o Depressed patient with a history of maltreatment have more severe problems, more
chronic, more suicidalitu, more comorbidity and profit less from treatment
o Not everyone develops long-term health problems: resilience
- Internalizing and externalizing disorders
- Personality disorders
o Related to development during childhood
- Psychotic symptoms
o More often and more severe in people who have experienced abuse
- Suicide and self-injury
- Often earlier onset, more severe/chronic, and harder to treat with a history of childhood
maltreatment
- 18-25
- Might not fully classify as having a disorder, or have multiple symptoms from different
disorders
Psycho-social consquences
- Interpersonal problems
- Self-image
o Low self-esteem because brought up with the idea that you weren’t good enough
- Re-victimization
o Someone that has been abused, often gets involved in an abusive relationship later
on
o Because boundaries are less clear
o People with similar experiences
o Risk of intergenerational transmission
Inter-generational transmission
, - 30%
- Consequences of abuse can often be a risk factor for abusive behavior
- Stresses importance of timely preventing abuse itself, but also of its consequences
- To make sure it doesn’t transmit to the next generation
Research in leiden
- NESDA
- 8-year longitudinal controlled community study
- Emotional abuse and emotional neglect had the greatest risk of developing a disorder
Week 2 psychological consequences and methods
- Psychological disorders
o Lots of comorbidity
o Sometimes many symptoms without a specific disorder
o Higher risk for earlier onset and more severe symptopms
- Interpersonal problems
o Attachment at younger and later age
o Epistemic trust
If you cannot trust your parents – emotionally maltreatment
Documentary; vergeten/verloren kind
o Social exclusion
e.g. lviing in a children’s home and classmates/friends not being allowed to
play with the kid according to the parents
More bulllying
Leads to trust issues
- Self –image
o Self-esteem
- Re-victimization
- Intergenerational transmission
Who reports on what?
- Self vs informant
- Parent vs child (perpetrator – victim)
o If the child is old enough to speak
o Underreport when you ask parents
o Don’t want to be seen as treating their child bad
o Some parents want to have help
- Retrospective vs prospective
- Subjective report vs observing
- Important what kind of questions you ask
o Some children think it’s normal the way they are being treated
Maltreatment & anxiety/depression
- Self-report vs informant
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