Aantekeningen colleges

Week 1

Part 2 Psychological consequences of childhood maltreatment

- Maltreatment = abuse AND neglect
- Why? Learn about the long term consequences of childhood abuse and neglet
- Empirical evidence: numerous findings that childhood abuse and neglect have pervasive
consequences for mental and physical health
- Papers summarise the consequences
- Definition childhood maltreatment: any act o commissdion 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
- Omission
o Failure to meet a childs needs
 Physical neglect
 Emotional neglect (when a kid is not feeling the love every child deserves,
basic right; right to be loved)
 Denial of access to education (not willing to send their kids to school, let
them work etc.)
- Commission
o Actively doing sth harmful
 Physical abuse (hitting)
 Emotional abuse (yelling, calling names, make them feel responsible,
threathens child in their being)
 Sexual abuse (mostly not by the parents)
 Shaken baby syndrome
- Types of maltreatment
o Emotional neglect
 ‘Failure to meet a child's emotional needs and failure to protect a child from
violence in the home or neighbourhood’
o Physical Neglect
 ‘Failure to meet a child's basic physical, medical/dental, or educational
needs; failure to provide adequate nutrition, hygiene, or shelter’
o 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’
o Physical abuse
 ‘Intentional use of physical force or implements against a child that results
in, or has the potential to result in, physical injury’
o Sexual abuse
 ‘Any completed or attempted sexual act, sexual contact, or non-contact
sexual interaction with a child by a caregiver’
- World health organisation
o Prevalence

, o
o Dutch national prevalency study
 Professionals: 3.4%
o Students on maltreatment (SOM studie)
 Self-report among 1800 children 12-16 years:
 37% report one of more forms of abuse
 Emotional and physical abuse most frequent
- Classification system for psychological disorders based on standard criteria
o Published by APA, first edition in 1950
o Focus on objective description of symptoms with no theoretical framework
o Decreased focus on aetiology of disorders




-
- Red: does look at the cause
- Blue: higher prevalence of childhood maltreatment
- Disorders:
o Internalizing and externalizing disorders
o Personality disorders (BPD/anti-social)
o Psychotic symptoms
o Suicide and self-injury
o Often earlier onset, more severe/chronic, and harder to treat with a history of
childhood maltreatment

, o
o Look more at the symptoms instead of just disorder
- To conclude:
o Childhood abuse and neglect important transdiagnostic risk factors for development
of psychological problems, including depression and aniety and drug & alcohol
addiction, agression
o Consequences of emotional abuse and neglect at least as pervasive as physial or
sexual abuse
o Indications for subtypes of depression and anxiety, with or wothout maltreatment
history
o Depressed patient with a history of maltreatment have more severe problems, more
chronic, more suicidalitu, more comorbidity and profit less from treatment
o Not everyone develops long-term health problems: resilience
- Internalizing and externalizing disorders
- Personality disorders
o Related to development during childhood
- Psychotic symptoms
o More often and more severe in people who have experienced abuse
- Suicide and self-injury
- Often earlier onset, more severe/chronic, and harder to treat with a history of childhood
maltreatment
- 18-25
- Might not fully classify as having a disorder, or have multiple symptoms from different
disorders

Psycho-social consquences

- Interpersonal problems
- Self-image
o Low self-esteem because brought up with the idea that you weren’t good enough
- Re-victimization
o Someone that has been abused, often gets involved in an abusive relationship later
on
o Because boundaries are less clear
o People with similar experiences
o Risk of intergenerational transmission

Inter-generational transmission

, - 30%
- Consequences of abuse can often be a risk factor for abusive behavior
- Stresses importance of timely preventing abuse itself, but also of its consequences
- To make sure it doesn’t transmit to the next generation

Research in leiden

- NESDA
- 8-year longitudinal controlled community study
- Emotional abuse and emotional neglect had the greatest risk of developing a disorder

Week 2 psychological consequences and methods

- Psychological disorders
o Lots of comorbidity
o Sometimes many symptoms without a specific disorder
o Higher risk for earlier onset and more severe symptopms
- Interpersonal problems
o Attachment at younger and later age
o Epistemic trust
 If you cannot trust your parents – emotionally maltreatment
 Documentary; vergeten/verloren kind
o Social exclusion
 e.g. lviing in a children’s home and classmates/friends not being allowed to
play with the kid according to the parents
 More bulllying
 Leads to trust issues
- Self –image
o Self-esteem
- Re-victimization
- Intergenerational transmission

Who reports on what?

- Self vs informant
- Parent vs child (perpetrator – victim)
o If the child is old enough to speak
o Underreport when you ask parents
o Don’t want to be seen as treating their child bad
o Some parents want to have help
- Retrospective vs prospective
- Subjective report vs observing
- Important what kind of questions you ask
o Some children think it’s normal the way they are being treated

Maltreatment & anxiety/depression

- Self-report vs informant