Psychology Wiki

Assessment | Biopsychology | Comparative | Cognitive | Developmental | Language | Individual differences | Personality | Philosophy | Social |
Methods | Statistics | Clinical | Educational | Industrial | Professional items | World psychology |

Clinical: Approaches · Group therapy · Techniques · Types of problem · Areas of specialism · Taxonomies · Therapeutic issues · Modes of delivery · Model translation project · Personal experiences ·

Child abuse or child maltreatmentis an umbrella term for the physical or psychological maltreatment of a child by an adult. It includes:

There are many forms of abuse and neglect and many governments have developed their own legal definition of what constitutes child maltreatment for the purposes of removing a child and/or prosecuting a criminal charge. In the United States, the Federal Government puts out a full definition of child abuse and neglect and creates a summary of each State definition. To view, go to Definitions of Child Abuse and Neglect: Summary of State Laws [2] that is part of the 2005 State Statute series by the National Clearinghouse on Child Abuse and Neglect Information.


in England and Wales an average of one to two children are killed at the hands of another person every week, . In 2008, figures show that in England nearly 27,900 children and young people were the subject of a child protection plan (CPP) because of suffering abuse or being at risk of abuse. But there are probably many many more in similar circumstances who go unnoticed or unreported. A large-scale survey of young adults by the NSPCC showed that seven per cent had, as children, suffered serious physical abuse, defined as violence causing injury or occurring regularly throughout childhood. [citation needed]

Effects of child abuse on the child and development

The effects of child abuse to children vary according to the type of abuse and how long it has been inflicted but can be profound and can include:

Abused children can become withdrawn, introverted and depressed, making it more difficult for others to help. Children who have been abused often suffer from low self-esteem. When children are treated as worthless, they begin to believe they are worthless.

Thinking that they cannot be helped, they can withdraw into their own social isolation.

The effects of abuse can be long lasting and many victims retain a sense of guilt, believing that they caused the abuse to happen.

Psychological effects

The U.S. National Adoption Center found that 52% of adoptable children (meaning those children in U.S. foster care freed for adoption) had symptoms of attachment disorder. A study by Dante Cicchetti found that 80% of abused and maltread infants exhibited attachment disorder symptoms (disorganized subtype). [1]

Children with histories of maltreatment, such as physical and psychological neglect, physical abuse, and sexual abuse, are at risk of developing severe psychiatric problems [2] [3]. These children are likely to develop Reactive attachment disorder [4] [5]. These children may be described as experiencing trauma-attachment problems. The trauma experienced is the result of abuse or neglect, inflicted by a primary caregiver, which disrupts the normal development of secure attachment. Such children are at risk of developing a disorganized attachment [4] [6] [7]. Disorganized attachment is associated with a number of developmental problems, including dissociative symptoms [8], as well as depressive, anxiety, and acting-out symptoms [9] [10].

Physical effects

Micheal Meaney compared suicide subjects with a history of child abuse to suicide subjects without a history of child abuse. Similarly to his rat study on glucocorticoid receptors, Meaney found that abuse victims had less expression of hippocampal glucocorticoid receptors than both non-abused suicide victims and non-suicidal subjects. This suggests that childhood abuse alters the hippocampus in a way that is related to suicidal behavior.[11]

Understanding and preventing child abuse and neglect


Many factors may contribute to family stress that results in child abuse or neglect. Understanding the root causes of abuse can help better determine the best methods of prevention and treatment. Most parents don't hurt or neglect their children intentionally. Many were themselves abused or neglected. Very young or inexperienced parents might not know how to take care of their babies or what they can reasonably expect from children at different stages of development. Circumstances that place families under extraordinary stress - for instance, poverty, divorce, sickness, disability - sometimes take their toll in child maltreatment. Parents who abuse alcohol or other drugs are more likely to abuse or neglect their children.


Given these possible causes, most professionals agree that there are three levels of prevention services; primary prevention, secondary prevention, and tertiary prevention.

Primary Prevention

Primary prevention consists of activities that are targeted toward the community at large. These activities are meant to impact families prior to any allegations of abuse and neglect. Primary prevention services include public education activities, parent education classes that are open to anyone in the community, and family support programs. Primary prevention can be difficult to measure because you are attempting to impact something before it happens, an unknown variable.

Secondary Prevention

Secondary prevention consists of activities targeted to families that have one or more risk factors including families with substance abuse, teen parents, parents of special need children, single parents, and low income families. Secondary prevention services include parent education classes targeted for high risk parents, respite care for parents of a child with a disability, or home visiting programs for new parents.

Tertiary Prevention

Tertiary prevention consists of activities targeted to families that have confirmed or unconfirmed child abuse and neglect reports. These families have already demonstrated the need for intervention, either with or without court supervision.


Main article: Complex post-traumatic stress disorder
Main article: Dyadic Developmental Psychotherapy
Main article: Cognitive Behavioral Therapy

Treatment for those experiencing Complex post-traumatic stress disorder, which is caused by early chronic maltreatment, should address each dimension. Often treatment must be multi-modal. Children who have experienced complex trauma caused by chronic maltreatment can be treated effectively with Dyadic Developmental Psychotherapy[12] [13]. In addition Cognitive Behavioral Therapy interventions, education, EMDR and other approaches can be effectively used.

Child Abuse Prevention Organizations

Childhelp USA

Founded in 1959 by Sara O'Meara and Yvonne Fedderson, Childhelp USA is one of the largest and oldest national nonprofit organizations dedicated to the prevention of child abuse, neglect as well as to the treatment of its victims in the United States. Childhelp's programs, which directly serve abused children and their families, focus on meeting the children's physical, emotional, educational and spiritual needs. In 2005, Sara and Yvonne were both nominated for the Nobel Peace Prize.

Prevent Child Abuse America(PCA America)

Established in 1972, Prevent Child Abuse America works to bring awareness to and educate the public about child abuse and neglect. PCA America works on the National, State and Local levels with chapters in 40 States which work alongside the local councils in each State. The mission statement of PCA America is: "To prevent the abuse and neglect of our nation's children."

Reporting of Child Abuse


Main article: Child Protective Services

Depending on the country, the agencies responsible for investigating child abuse may be run nationally, regionally, or locally. These agencies may be called Child Protective Services (CPS), Department of Children and Family Services (DCFS), or by other similar names. In the U.S., these agencies are usually listed in the state government section of the telephone book under "Children" or "Health" or "Human Services". In a few instances in the U.S., some of the functions of these agencies are outsourced to private individuals or companies.

People who investigate claims of child abuse may be called a "children's social worker" (CSW) or a case worker.

Reporting abuse and neglect in Australia

Child abuse and neglect is the subject of mandatory reporting in most Australian jurisdictions. Usually professional people such as doctors, nurses and teachers are bound to report strong evidence of abuse or neglect. State authorities, such as the Child Protection Unit of the Department of Human Services (Victoria), have statutory authority to investigate and deal with child abuse.

Reporting abuse and neglect in United Kingdom

Childline is a telephone contact agency provided for children to discuss any concerns they have with a team of trained volunteers.

NSPCC is the umbrella organization now funding this project. The NSPCC also provides a telephone helpline for anyone to contact professionally trained social workers regarding concerns about children, as well as a variety of other projects.

The NSPCC forward any concerns they receive on to the relevant Local Authority (where the child concerned lives) which would then make inquiries regarding those concerns.

Reporting abuse and neglect in Canada

The Childrens' Help Line can be reached toll-free for either parents with questions and concerns, or children, at +1-(800)-668-6868, 24/7.

Symptoms and signs

From Medline [3]


  • Adult brings an injured child to an emergency room with an improbable explanation of the cause of the injury, or the injury is not recent
  • Unusual and unexplained bone fractures
  • Bruise marks shaped like hands, fingers, or objects (such as a belt), or unexplained bruises in areas where normal childhood activities would not usually result in bruising
  • Specific patterns of scalding, seen when a child is immersed in hot water as a punishment -- particularly "glove" or "sock" burn patterns
  • Burns from an electric stove, radiator, heater or other hot objects, usually seen on the child's hands, arms or buttocks
  • Cigarette burns on exposed areas or the genitals
  • Black eyes in an infant or a similar, unexplained injury in a child
  • Human bite marks
  • Lash marks
  • Choke marks around neck
  • Circular marks around wrists or ankles (indicating twisting or tying up)
  • Separated sutures
  • Bulging fontanelle
  • Evidence of unexplained abdominal injury (such as bruised or ruptured intestines due to punching)
  • Unexplained unconsciousness in infant
  • Survivors of childhood abuse often report feelings of anger and helplessness towards their abusers.

Signs and tests

Typical injuries in abused children include:

  • Erectile dysfunction
  • Compulsive masturbation
  • Evidence of fractures at the tip of long bones or spiral-type fractures that result from twisting
  • Fractured ribs, especially in the back
  • Evidence of skull fracture (multiple fractures of different ages may be present)
  • Subdural hematoma (collection of blood in the brain) without plausible explanation
  • Multiple bruises of different ages, especially in unusual areas of the body (e.g., not the shins) or in patterns suggesting choking, twisting, or severe beating with objects or hands
  • Other unusual skin damage, including burns or burn scars
  • Inability to speak
  • Torn / dirty clothing
  • anal warts
  • Bleeding from the anus
  • Dark circles under the eyes
  • holes in penis

Long Term Complications

  • Bleeding from the testicles or labias and uncontrolable diaheria

Physical Indicators Behavioral Indicators
Physical Abuse
  • Unexplained bruises and welts (in various stages of healing), marks in the shape of belt buckles or electrical cords, human bite marks, puncture marks, bald spots, regularly appearing after absensec or weekends
  • Unexplained burns, especially cigarette burns, burns in the shape of irons, rope burns, or immersion-burns (sock-like or glove-like)
  • Unexplained fractures, lacerations, or abrasions in various stages of healing
  • Injuries attributed to the child being "clumsy" or "accident-prone"
  • Awkward movements, complains of scoreness
  • withdrawn and aggressive-behavioral extremes
  • Uncomfortable with physical contact
  • Arrives at school early or stays late, as if afraid
  • Chronic runaway (adolescents)
  • Wears high neck, long sleeved clothing, not matching weather, to cover body
  • Frequent absences
Physical Neglect
  • Abandonment
  • Unattended physical problems or medical needs
  • Constant fatique, lack of energy
  • Little or no supervision
  • Often hungry, dressed inappropriately for weather, poor hygiene
  • Lice, distended stomach, emaciation
  • Falls asleep in class
  • Steals food, begs from classmates
  • Reports that no caretaker is at home
  • Frequently absent or tardy, or stays as long as possible at school
  • Self-destructive
  • Trouble with the law
Sexual Abuse
  • Difficulty walking or sitting
  • Pain or itching in genital area
  • Torn, stained, or bloodied underclothing
  • Bruises or bleeding in external genitalia
  • Venereal disease, especially in pre-teens
  • Frequent urinary or yeast infections
  • Pregnancy
  • Doesn't want to change for gym, PE
  • Withdraw, chronic depression
  • Role reversal, overly concerned for siblings
  • Promiscuity, excessive seductiveness
  • Peer problems, lack of involvement
  • Massive weight change
  • Suicide attempts (especially adolescents)
  • Inappropraite sex play or premature understanding of sex, frequent masturbation, sexual play with dolls or stuffed animals
  • Sudden school difficulties


See also


  1. Carlson, V., Cicchetti, D., Barnett, D., & Braunwald, K. (1995). Finding order in disorganization: Lessons from research on maltreated infants’ attachments to their caregivers. In D. Cicchetti & V. Carlson (Eds), Child Maltreatment: Theory and research on the causes and consequences of child abuse and neglect (pp. 135-157). NY: Cambridge University Press.
  2. Gauthier, L., Stollak, G., Messe, L., & Arnoff, J. (1996). Recall of childhood neglect and physical abuse as differential predictors of current psychological functioning. Child Abuse and Neglect 20, 549-559
  3. Malinosky-Rummell, R. & Hansen, D.J. (1993) Long term consequences of childhood physical abuse. Psychological Bulletin 114, 68-69
  4. 4.0 4.1 Lyons-Ruth K. & Jacobvitz, D. (1999) Attachment disorganization: unresolved loss, relational violence and lapses in behavioral and attentional strategies. In J. Cassidy & P. Shaver (Eds.) Handbook of Attachment. (pp. 520-554). NY: Guilford Press
  5. Greenberg, M. (1999). Attachment and Psychopathology in Childhood. In J. Cassidy & P. Shaver (Eds.). Handbook of Attachment (pp.469-496). NY: Guilford Press
  6. Solomon, J. & George, C. (Eds.) (1999). Attachment Disorganization. NY: Guilford Press
  7. Main, M. & Hesse, E. (1990) Parents’ Unresolved Traumatic Experiences are related to infant disorganized attachment status. In M.T. Greenberg, D. Ciccehetti, & E.M. Cummings (Eds), Attachment in the Preschool Years: Theory, Research, and Intervention (pp161-184). Chicago: University of Chicago Press
  8. Carlson, E.A. (1988). A prospective longitudinal study of disorganized/disoriented attachment. Child Development 69, 1107-1128
  9. Lyons-Ruth, K. (1996). Attachment relationships among children with aggressive behavior problems: The role of disorganized early attachment patterns. Journal of Consulting and Clinical Psychology 64, 64-73
  10. Lyons-Ruth, K., Alpern, L., & Repacholi, B. (1993). Disorganized infant attachment classification and maternal psychosocial problems as predictors of hostile-aggressive behavior in the preschool classroom. Child Development 64, 572-585
  11. McGowan, P.O., Sasaki, A., D’Alessio, A.C., Dymov, S., Labonte, B., Szyf, M., Turecki, G., Meaney, M.J. (2009) Epigenetic regulation of the glucocorticoid receptor in human brain associates with childhood abuse. Nat Neurosci 12(3), 342-348.
  12. Becker-Weidman, A., & Shell, D., (Eds.) (2005) Creating Capacity For Attachment, Wood 'N' Barnes, OK. ISBN 1885473729
  13. Becker-Weidman, A., (2006). Treatment for Children with Trauma-Attachment Disorders: Dyadic Developmental Psychotherapy, Child and Adolescent Social Work Journal. Vol. 13 #1, April 2006.
  14. U.S. Department of Health and Human Service [1]

Further reading

  • Google Scholar
  • Cook, J. & Bowles, R (eds) (1980). Child abuse:Commission and omission. Scarborough, Ontario:Butterworth
  • Briere, J. and Conte, J. R. (1993) Self-reported amnesia for abuse in adults molested as children, Journal of Traumatic Stress, 6, 21-31.
  • Kadushin, A. & Martin J. (1981). Child abuse: An interactional event. New York:Columbia Iniversity Press
  • McCormack, K., et. al. (in press). Maternal care patterns and behavioral development of rhesus macaque abused infants in the first 6 months of life. Developmental Psychobiology. Full text

External links