Lecture 1
Importance of good (enough) parenting:
"Emotional interactions with caretaker fundament for later development" (Bowlby, 1969)
· Form attachment
· Establish sense of safety and security
· Learn to regulate own emotions
· Understand emotional states of others
· Learn to trust others
· Learn empathy
... BUT, WHY?
Empirical Evidence:
Numerous findings that childhood abuse and neglect have pervasive consequences for
mental and physical health.
ARTICLE: Maltreatment in childhood substantially increases the risk of adult depression and
anxiety in prospective cohort studies: systematic review, meta-analysis, and proportional
attributable fractions.
,ARTICLE: Childhood Adversities and Adult Psychiatric Disorders in the National Comorbidity
Survey Replication I.
Childhood Maltreatment
Definition: 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)
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, 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’
Psychological consequences of childhood abuse and neglect:
• Neurodevelopmental Disorders
• Schizophrenia Spectrum and Other Psychotic Disorders
• Bipolar and Related Disorders
• Depressive Disorders
• Anxiety Disorders
• Obsessive-Compulsive and Related Disorders
• Trauma- and Stressor-Related Disorders
• Dissociative Disorders
• Somatic Symptom Disorders
• Feeding and Eating Disorders
• Elimination Disorders
• Sleep-Wake Disorders
• Sexual Dysfunctions
• Gender Dysphoria
• Disruptive, Impulse Control and Conduct Disorders
• Substance Use and Addictive Disorders
• Neurocognitive Disorders
• Personality Disorders
• Paraphilic Disorders
• Other Disorders
, Symptoms not bound to (JUST) 1 disorder:
National Comorbidity Survey Replication (NCS-R), (Green et al., 2010):
- Lifetime prevalence of 20 DSM-IV anxiety, mood, disruptive behavior, and
substance disorders, assessed with the WHO Composite International Diagnostic Interview
(CIDI).
- Maladaptive family functioning (parental mental illness, substance disorder, and
criminal behavior; family violence; physical abuse; sexual abuse; neglect) were the
strongest correlates of disorder onset.
- Simulations suggest that CAs are associated with 44.6% of all childhood-onset
disorders and 25.9-32.0% of later-onset disorders.
- Depending on life course stage, prior disorders and recall period.
