Summary of Child Abuse and Neglect: neurobiological aspects and intervention
Week 1: General Introduction and Consequences of CAN
Today:
Information about this course
Prevalence and types of maltreatment
Consequences of child abuse and neglect
**these numbers are estimates as it is based on self-reports -> might not be truthful, may be ashamed,
etc.
Second graph: There are different prevalence rates for different types of maltreatment: emotional
neglect is one of the highest ranking types of child abuse and neglect, and sexual abuse is less often the
case. Emotional neglect became higher over the years, difficult to know why: maybe measure it better?
Ask better questions?
Types:
Sexual abuse: Involvement of children in sexual activities that they do not fully understand, are unable
to give informed consent to (maybe because they do not understand what is happening), for which they
are not developmentally prepared (too young), or that violate the standards of the society in which
these children live.
Physical abuse: Any non-accidental injury to a child under the age of 18 by a parent or caretaker. These
injuries may include beatings, shaking, burns, human bites, strangulation, or immersion in scalding
water, with resulting bruises and welts, broken bones, scars, burns, retinal hemorrhage, or internal
injuries.
Emotional abuse: A repeated pattern of caregiver behavior or extreme incident(s) that convey to
children that they are worthless, flawed, unloved, unwanted, endangered, or only of value in meeting
another's needs.
,E.g. telling your child that they always make mistakes, he is not good enough, that you wish he wasn’t
there because he is difficult, or any other way that undermines the healthy development of mental parts
of the child.
Physical neglect: The chronic failure of a parent or caretaker to provide a child under 18 with basic
needs such as food, clothing, shelter, medical care, educational opportunity, protection, and
supervision.
e.g. child needs to visit the doctor but parents don’t take them, don’t take children to school, etc. also in
families with economic difficulties so can’t provide the child with food and clothing.
Emotional neglect: The consistent failure of a parent or caretaker to provide a child with appropriate
support, attention, and affection.
Emotional abuse is more active saying to your child that they are worthless, always makes mistake =
emotionally abusive
Emotional neglect is more passive e.g. parents involved in their phone and ignoring the child, being
very unresponsive when child falls down, etc.
Structural neglect
Institutional rearing characterized by:
–regimented nature (all very strictly planned, individual children don’t take the space
and attention they need)
–high child-to-caregiver ratio (one caregiver is responsible for many children so not
enough time to give the attention each child needs)
–multiple shifts (so different caregivers every day, difficult to attach, bond with the
caregivers)
–frequent change of caregivers
These factors deprive children of continuous and reciprocal interactions with stable caregivers,
necessary to respond to their developmental needs.
*is it better to place children in rearing institutions or foster care?
Overview of the course:
Lecture 1: basis of child maltreatment in families and
the relationship with psychosocial functioning and
somatic health. Can child maltreatment make you sick
mentally and physically?
Lecture 2: relationship between child maltreatment
and negative outcomes in neurobiological functioning
and maladaptive behavior, emotion processing,
regulation what kind of mechanisms can explain
the relationship between child maltreatment and
having health issues.
Lecture 3: animal research because cannot do
research on humans (random allocation to maltreated
vs. nonmaltreated)
,Lecture 4: gene expression, epigenetics = how genes are expressed to explain the relationship between
maltreatment and negative outcomes
Lecture 5: child maltreatment and the effect of timing: does it matter how old you are when you are
abused/ neglected? And also structural neglect in lecture 5
Lecture 6: Resilience
Lecture 7: Interventions
Consequences of child abuse and neglect
These are the questions asked in the lecture:
Still exam material:
Looked at different types of maltreatment
e.g. physical maltreatment in childhood
so prospective measure. They identified it
from interviews with parents and asking
questions to child’s teachers. Also about
emotional neglect and abuse through self-
report (measured in adulthood).
Living standards
They wanted to examine the relationship between child
maltreatment and SES
Maltreatment related to lower SES
Long-term sickness absence did the people who were abused or neglected in childhood show
more long-term sickness absence?
, Not in employment, education or training were there more abused/neglected people who
did not have a job or education?
Fewer assets
Income-related support
Lower educational level
Financial insecurity
Poor qualifications
Manual labor
Adjusted for maternal age, birth weight, birth order, poor childhood health, social class in 1958,
parental education, household amenities, crowding, and tenure
They found a significant association between experiencing
child maltreatment at an early age and their SES when they were adults (45 years old). They saw that
the variables listed here, were lower for the people who experienced child abuse and neglect.
So there is a significant relationship between child maltreatment and low SES but don’t know yet how to
explain this relationship. What kind of mechanisms or factors influence this relationship? How can it be
that if you are maltreated in childhood you have a low SES in adulthood?
Article 1: David, Vachon, Krueger, Rogosch & Cicchetti (2015): Assessment of the Harmful Psychiatric
and Behavioral Effects of Different Forms of Child Maltreatment
Importance: some assumptions about CAN may be incorrect. Some assume that some forms of abuse
(e.g. physical and sexual abuse) are more harmful than others (e.g. emotional abuse and neglect), while
others assume that each form of abuse has specific consequences and that the effects of abuse differ
across sex and race.
There are at least 4 assumptions on CM:
(1) Harmfulness CM causes substantial harm. This is the strongest assumption. In a meta-
analysis, nonsexual forms of CM (physical abuse, emotional abuse, and neglect) were associated
with a wide range of mental health problems (depression, anxiety, eating disorders, substance
use, and suicidal behavior). Evidence on sexual abuse is less consistent.
(2) Nonequivalence some forms of CM are more harmful than others. Evident in the legal
system: some forms of CM = felonies (treated as crime/very serious) vs. others are legal.
(3) Specificity each form of CM has specific consequences. Evidence suggests that various forms
of CM may have nonspecific, widespread effects on mental health.
(4) Nonuniversality the effects of CM differ across sex and race
Hypothesis: Support the assumption of harm, otherwise, contradict the other assumptions
(nonequivalence, specificity and nonuniversality) hypothesized that different forms of CM would
have equivalent, broad and universal consequences.
AIM/OBJECTIVE: To determine whether widely held assumptions about child abuse and neglect are
valid by testing the hypothesis that different types of child maltreatment (CM) actually have equivalent,
broad, and universal effects.
