Psychological Maltreatment of Children: A Common Threat to Children’s Well-being?

Emotional abuse can be devastating. Photo by ▲ e-basak

Most people would agree that physical or sexual abuse of children is abhorrent; the outcry over the abuse of children by people in power has been consistent over time – but can verbal and emotional abuse be an equal threat to a child’s long-term mental health?

Dr. Roberta Hibbard, and her colleagues from the Committee on Child Abuse and Neglect, and the American Association of Child and Adolescent Psychiatry’s Child Maltreatment and Violence Committee, believe that not only sticks and stones, but words and  non-action may be an an equal threat to a child’s well-being.

Emotional Abuse: Identifying Psychological Maltreatment of Children

While no standard definition of psychological maltreatment exists, Hibbard et al. looked to earlier research in the field and identified six types of psychological maltreatment of children: spurning, terrorizing, isolating, exploiting/corrupting, denying emotional responsiveness,  and the neglect of a child’s  mental health/medical or educational needs. Specific actions cited included “[s]ingling out or humiliating in public” and “[m]odeling, permitting, or encouraging antisocial or developmentally inappropriate behavior.” Co-author Dr. Harriet MacMillan, in an exclusive interview with Decoded Science, noted that work on an assessment tool is underway, but still needs to be refined.

In their article, published today in the American Academy of Pediatrics journal, authors cited research that found “8% to 9% of women and 4% of men reported exposure to severe psychological abuse during childhood.”  Now, more attention is being paid to the behavior of caregivers instead of focusing only on the acting-out of the child.


Combating Child Abuse

As pediatricians, the authors foresee physicians as key players in the identification of psychological maltreatment. With the absence of an assessment tool, MacMillan told Decoded Science that the goal would be not to assess every patient, but to “develop appropriate interviewing skills that  include asking about relationships with caregivers and possible adverse  experiences.”

While acknowledging the burdens already placed on child-protective agencies, MacMillan states that, “psychological maltreatment is associated with similar types of impairment  as other types of maltreatment. In other words, we need to separate out  what is potentially harmful for children and then determine the resources needed  to address such adversities.”  Specifically, the authors suggest that programs that have been effective at lowering the rates of general maltreatment, such as the Nurse-Family Partnership, which targets first-time mothers, may provide a model for the education of caregivers at high risk for abusive behavior.

Click to Read Page Two: Identifying the Signs of Child Abuse – Increasing the Dialogue


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  • http://parentingworks.weebly.com Sheena Hill

    I am actually concerned by the proposal in this article to place more of an assessment responsibility on pediatricians. Pediatricians are not meant to be trained social workers and it is unrealistic to assume that they can handle this additional responsibility on top of their other work with families. As a Parent Education Specialist, I am aware that pediatricians are often asked for parenting advice and generally rely on misinformation. Pediatricians do not receive ANY training on parenting theories, research or techniques. In their training, the pediatricians I work with have over 20 specialties they focus on during residency. We cannot and should should expect them to add parent education and now social work to their repertoire. There are professionals in these fields who are competent and should be utilized as resources for families. Yes, we do need more assessment for recognizing emotional child abuse! We also need more resources for support and education for EVERY parent to help proactively address risk factors in new parents and work with parents before things become larger problems. We need more ways for parents to feel “safe” seeking the help that they need before things get out of control (criminalizing poor parenting choices is not always the best solution for families). What we need most is for parent education professionals and social workers to be present in-house at pediatric offices and other health care facilities (and businesses) that serve families. Let’s collaborate so we can truly empower parents instead of asking one set of professionals to “do it all.”

  • sakara

    My parents were crazy, drunken, hateful, lowlifes—-so I’m glad to see this article, after I’ve been obsessing about such stuff for the last couple years. The cliche of if only i was able to figure all this out when i was a kid.

    My worthless dad went to bars all day and night on Saturday, and then church on Sunday. Church and work was a lot more important than me—especially since they were a way to get away from my evil mom.

    My parents had only two emotions to show me; neglect and shame. I was an only child, with no relatives on my worthless dad’s side, but I was still ignored. My crazy, evil, mom only cared about giving away stuff, including my own stuff which I had to hide, to her relatives and various lowlifes. My parents kept me isolated, so I was too stupid to realize at the time that they reason I grew up thinking we were dirt poor is only because my parents wasted maybe half of the money they got.

    I’m middle-aged, my scumbag parents are, thankfully dead, and it feels good to reveal all this before I wind up in a paupers’ grave.

  • Gina Putt

    First, Sheena, I agree that it would be an extra burden for pediatricians, but the author did suggest media campaigns such as brochures and the like. Simply adding awareness would be a big help.

    And Sakara, I empathize a great deal. Some parents still defend physical punishment, let alone admit that words and emotional responses can be harmful. Name calling, coldness, neglect all exact real psychological tolls. Good for you for being able to see how it affected you. I am getting a lot of “likes” from mental health professionals, but not so much from the general public, which tells me that more education is needed.

    Gina Putt