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Psychological and Neurological consequences of child abuse lectures
- Instelling
- Universiteit Leiden (UL)
Lectures of Psychological and Neurological consequences of child abuse
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Psychological and Neurobiological Consequences of Child Abuse LecturesWeek 1: Introduction (H1)
1. Introduction
Importance of safe childhood
“The infant and young child should experience a warm, intimate, and continuous
relationship with his mother (or permanent mother substitute) in which both find satisfaction
and enjoyment” and that not to do so may have significant (still studying) and irreversible
(still studying) mental health consequences” John Bowlby, 1951 (1907–1990)
● Sigmund Freud (1856 – 1939)
● Mary Ainsworth (1913-1999)
● Harry Harlow (1905 –1981)
Title?
● Psychological and Neurobiological Consequences of Child MALTREATMENT
= ABUSE AND NEGLECT
Psychological Consequences of Child Abuse & Neglect
● Background (Terminology, Prevalence)
● Psychological Disorders after Maltreatment
Why?
… learn about the long term consequences of childhood abuse and neglect?
→ Empirical evidence: numerous findings that childhood abuse and neglect have pervasive
consequences for mental and physical health. This was already mentioned by researchers and
clinicians in the 1950s. Evidence has built up that this is indeed the case, that what happens in
your childhood has long term consequences for your physical and mental health.
Reading material week 1
Article 1: Child Maltreatment and Risk for Psychopathology in Childhood and Adulthood
Article 2: Maltreatment in childhood substantially increases the risk of adult depression and
anxiety in prospective cohort studies: Systematic review, meta-analysis, and proportional
attributable fractions
Definition childhood maltreatment (thus, abuse and neglect)
Any act of commission 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 (Gilbert et
al., 2009).
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,→ There are a lot of different definitions, but the commonality is that there is threat or
harm to a child. So also threatening that you will hit your child, if the child does not do
something properly, is also concerned as childhood maltreatment. Also the harm does not
have to be intended. The parent can be trying to do his/hers best, but in the heat of the
moment or in cases of stress it can say or do things to the child without any real
attention, but it happens anyways.
Omission Commission
Failure to meet a child’s needs Actively doing something harmful
Physical neglect Physical abuse
(e.g. dressing kids properly for Hitting your child
cold weather, feeding enough. Can
happen if parents live in poverty)
Emotional neglect Emotional abuse
= when a child is not feeling the love e.g yelling at your kids
that every love deserves. e.g. call your children names
(e.g. cheering them up when they are sad) e.g. make your child responsible for something
→ this is a children’s right and everyone they did not do
universal thinks that children deserve this
Denial of access to education Sexual abuse
E.g. parents do not think that school Most often not perpetrated within family,
is important usually someone from outside
90% of the cases it is an uncle, neighbour or
someone from sports team
Least often the case in terms of parents
Shaken Baby Syndrome: example
Types of maltreatment
● Emotional neglect
‘Failure to meet a child's emotional needs and failure to protect a child from violence
in the home or neighbourhood’
● Physical Neglect
‘Failure to meet a child's basic physical, medical/dental, or educational needs; failure
to provide adequate nutrition, hygiene, or shelter’
● Emotional abuse
‘Intentional behaviour that conveys to a child that he/she is worthless, flawed,
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, unloved, unwanted, endangered, or valued only in meeting another's needs’
● Physical abuse
‘Intentional use of physical force or implements against a child that results in, or has
the potential to result in, physical injury’
● Sexual abuse
‘Any completed or attempted sexual act, sexual contact, or non-contact sexual
interaction with a child by a caregiver’
These are the 5 types of maltreatment that are often studied. Sometimes people for example
only study neglect or physical abuse. When you read a paper you can also look at what type
of maltreatment they actually are studying? Are they studying all the types together or are
they studying one specific type of maltreatment?
Prevalence of childhood maltreatment
● The World Health Organisation
does a lot of research into the
prevalence of childhood
maltreatment. It is really striking
and horrible how often this
happens. When we look at these
percentages, for example
physical abuse: 23%, is a quarter
for all children in the world.
When we look at emotional
abuse, it is more than ⅓. This is
not in the countries where you
expect this, thus in countries
with low economic status or countries with a lot of stress. It also occurs in high
economic countries.
Studies in the Netherlands
● Dutch National Prevalence study “Abuse of children and adolescents” (NPM-2005;
NPM-2010)
○ Professionals: 34 out of 1.000 children (±3.5%)
● “Students on Maltreatment” (SOM studie)
○ Self-report among 1.800 children 12-16 years:
○ 37% report one of more forms of abuse
○ Emotional and Physical Abuse most frequent
These are confirmed cases of childhood maltreatment, so children who are in the system of
Child Care. So if someone noticed it. When we look at a study that was done among students
(12-16) and if we asked them how many of them were abused, 37% reported one that they
were abused. When you as children or young children there is a big difference in whether
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, they were actually abused and if you look at the confirmed cases. This is worrying. Only a
small percentage of cases get noticed. Emotional and physical abuse were reported ost
frequently.
Psychological consequences of childhood abuse and neglect
When we talk about these consequences, as a psychologist you are being educated about the
DSM. Because in the Dutch system, if you want to get paid help by the insurance, you need
to have a disorder. To have a disorder you need to have a certain amount of criteria, so a
doctor can say that you have one.
● Classification system for psychological Disorders based on standard criteria
● Published by American Psychiatric Association (APA)
First Edition in 1950 (military)
● Focus on objective description of symptoms with no theoretical framework:
→ Decreased focus on aetiology (i.e., cause) of disorders
● When you diagnose someone, you are not going to see if this was due to abuse for
example. This of course comes up during treatment, but when you classify someone
according to their psychological symptoms, you only will look at the current
symptoms.
● Neurodevelopmental Disorders
● Schizophrenia Spectrum and Other Psychotic Disorders
○ For this and all the other blue disorders, there has been experience in the last
years that people who are diagnosed with these disorders have experienced
childhood maltreatment. For quite a few disorders, a third to a half have
experienced childhood maltreatment. The blue ones were the first that were
discovered with a link of childhood abuse, but actually all the disorders have a
correlation with childhood maltreatment.
● Bipolar and Related Disorders
● Depressive Disorders
● Anxiety Disorders
● Obsessive-Compulsive and Related Disorders
● Trauma- and Stressor-Related Disorders
○ This is one exception. Here you will not only look at the current symptoms,
because to have this kind of disorder, there has to have been a traumatic
situation before. And ofcourse, childhood maltreatment is also a trauma.
● Dissociative Disorders
● Somatic Symptom Disorders
● Feeding and Eating Disorders
● Elimination Disorders
● Sleep-Wake Disorders
● Sexual Dysfunctions
● Gender Dysphoria
● Disruptive, Impulse Control and Conduct Disorders
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