Child Abuse & Neglect
Lecture 1: Introduction & Consequences
Maltreatment = Abuse & neglect
Sexual abuse: Involvement of children in sexual activities that they do not fully understand, are
unable to give informed consent to, for which they are not developmentally prepared, or that
violate the standards of the society in which these children live.
Physical abuse: Any non-accidental injury to a child under the age of 18 by a parent/caretaker.
These injuries may include beating, shaking, burns, human bites, strangulation, or immersion in
scalding water, with resulting bruises and welts, broken bones, scars, burns, retinal
haemorrhage or internal injuries.
Emotional abuse: A repeated pattern of caregiver behaviour or extreme incident(s) that convey
to children that they are worthless, flawed, unloved, unwanted, endangered, or only of value in
meeting another’s needs.
Physical neglect: Chronic failure of a parent/caretaker to provide a child under 18 with basic
needs such as food, clothing, shelter, medical care, educational opportunity, protection, and
supervision
Emotional neglect: Consistent failure of parent/caretaker to provide a child with appropriate
support, attention, and affection.
Structural neglect:
- Institutional rearing characterized by
o Regimented nature
o High child-to-caregiver ratio
o Multiple shifts
o Frequent change of caregivers
- These factors deprive children of continuous and reciprocal interactions with stable
caregivers, necessary to respond to their developmental needs.
Estimate of how many children are maltreated – It is a much bigger group than is thought
127.000 children every year in the Netherlands
4-16% physical abuse
10% Neglect/emotional abuse
5-10% sexual abuse
Sources:
- Official records
- Self-report → parent/teacher/professional/child report
o Not reliable
- Retrospective – When asking adults about their childhood
Case:
Mother ate raw vegan food and also gave this to her baby.
Parents can choose how they raise their child
Went to paediatrician because baby was not growing good – was underweight
Maltreatment or not? → very grey area
,Quiz (exam questions of last year)
2 = medical neglect (part of
physical neglect)
4 = Physical abuse
Somatic health in adulthood – ACE study (Adverse childhood experiences)
- Looking at people with overweight/obesity in a medical sense
- CAN is related to many aspects of physical and mental health
- Cumulative effect – if you experienced more negative things in your childhood you have
more negative consequences.
- Looked a different ACE
o Psychological abuse
o Physical abuse
o Sexual abuse
o Substance abuse in household
o Mental illness in household
o Mother treated violently
o Criminal behaviour in household
- When people had 4 ACEs or more they had more negative health outcomes (Diseases
not mental health)
o What happens in body that this might be a relationship? → next lectures
ACEs are related to (from different literature):
- Physical and mental health
- Social development
- Educational outcomes
- Child’s developing brain structure
- Neuroendocrine system – stress system
PCEs – Positive childhood experiences
- National Survey of Children’s health
- Wide age range: 6-17 years
- Used parents reports
- Wanted to look at mental health disorders
- Added ACE’s – divorce, discrimination, broader violence in household
- PCE:
o Supportive relationships – Family communication/resilience, mentorship
o Safe, stable environment – neighbourhood safety and support
o Opportunities for constructive social engagement – sports, other
lessons/activities → extracurricular activities
- Found accumulative effects – with more Ace you have more mentally health problems.
- Ace outcome and PCE – Was a moderation effect of positive experiences.
The relationship between ACE and mental health outcomes differed for how many
, positive experiences you had. With more positive outcomes you have less mental health
problems
- Side effect: Children who experienced >4 Ace, PCE were less ‘effective’
- Critical view
o Parental reports → Not always that reliable – can also look at case files for more
objective values, can also ask other people
o Causality → Everything was measured at same time point – no causality
o More PCE’s could be added
CAN subtypes & health
- Randomization of households
- Older participants who look back of what happened to them
- Childhood trauma questionnaire (CTQ)
- Effects are different for 1 subtype → Sexual abuse – Significance level is different – not
all effects are there, there is not always a relation in some diseases. No effect of
hypertension and at stroke also lower.
- Critical view
o Retrospective design → have to think back about their childhood
o Only used 1 questionnaire – could have used more
o Mechanisms?
▪ Biological: HPA-axis dysregulation, chronic inflammatory processes
▪ Socioeconomic
▪ Behavioural
Mater-University of Queensland Study of Pregnancy – MUSP
- Longitudinal study – 40 years
- Self-reports & cognitive testing
- Looked at children at 14 years and 21 years
- Used substantiated maltreatment – know that maltreatment actually happened
- 46 outcomes – clusters
o Cognition & education
o Psychological & mental health
o Addiction & substance abuse
o Sexual health
o Physical health
- Outcomes
o Lower cognitive scores
o Negative educational/employment outcomes
o Mental health problems
o Substance abuse & addiction
o Sexual health problems
o Physical health problems
o Emotional abuse & neglects the most associations were most prominent
- Critical view
o Only part of sample experienced maltreatment
o Self-report
Lecture 1: Introduction & Consequences
Maltreatment = Abuse & neglect
Sexual abuse: Involvement of children in sexual activities that they do not fully understand, are
unable to give informed consent to, for which they are not developmentally prepared, or that
violate the standards of the society in which these children live.
Physical abuse: Any non-accidental injury to a child under the age of 18 by a parent/caretaker.
These injuries may include beating, shaking, burns, human bites, strangulation, or immersion in
scalding water, with resulting bruises and welts, broken bones, scars, burns, retinal
haemorrhage or internal injuries.
Emotional abuse: A repeated pattern of caregiver behaviour or extreme incident(s) that convey
to children that they are worthless, flawed, unloved, unwanted, endangered, or only of value in
meeting another’s needs.
Physical neglect: Chronic failure of a parent/caretaker to provide a child under 18 with basic
needs such as food, clothing, shelter, medical care, educational opportunity, protection, and
supervision
Emotional neglect: Consistent failure of parent/caretaker to provide a child with appropriate
support, attention, and affection.
Structural neglect:
- Institutional rearing characterized by
o Regimented nature
o High child-to-caregiver ratio
o Multiple shifts
o Frequent change of caregivers
- These factors deprive children of continuous and reciprocal interactions with stable
caregivers, necessary to respond to their developmental needs.
Estimate of how many children are maltreated – It is a much bigger group than is thought
127.000 children every year in the Netherlands
4-16% physical abuse
10% Neglect/emotional abuse
5-10% sexual abuse
Sources:
- Official records
- Self-report → parent/teacher/professional/child report
o Not reliable
- Retrospective – When asking adults about their childhood
Case:
Mother ate raw vegan food and also gave this to her baby.
Parents can choose how they raise their child
Went to paediatrician because baby was not growing good – was underweight
Maltreatment or not? → very grey area
,Quiz (exam questions of last year)
2 = medical neglect (part of
physical neglect)
4 = Physical abuse
Somatic health in adulthood – ACE study (Adverse childhood experiences)
- Looking at people with overweight/obesity in a medical sense
- CAN is related to many aspects of physical and mental health
- Cumulative effect – if you experienced more negative things in your childhood you have
more negative consequences.
- Looked a different ACE
o Psychological abuse
o Physical abuse
o Sexual abuse
o Substance abuse in household
o Mental illness in household
o Mother treated violently
o Criminal behaviour in household
- When people had 4 ACEs or more they had more negative health outcomes (Diseases
not mental health)
o What happens in body that this might be a relationship? → next lectures
ACEs are related to (from different literature):
- Physical and mental health
- Social development
- Educational outcomes
- Child’s developing brain structure
- Neuroendocrine system – stress system
PCEs – Positive childhood experiences
- National Survey of Children’s health
- Wide age range: 6-17 years
- Used parents reports
- Wanted to look at mental health disorders
- Added ACE’s – divorce, discrimination, broader violence in household
- PCE:
o Supportive relationships – Family communication/resilience, mentorship
o Safe, stable environment – neighbourhood safety and support
o Opportunities for constructive social engagement – sports, other
lessons/activities → extracurricular activities
- Found accumulative effects – with more Ace you have more mentally health problems.
- Ace outcome and PCE – Was a moderation effect of positive experiences.
The relationship between ACE and mental health outcomes differed for how many
, positive experiences you had. With more positive outcomes you have less mental health
problems
- Side effect: Children who experienced >4 Ace, PCE were less ‘effective’
- Critical view
o Parental reports → Not always that reliable – can also look at case files for more
objective values, can also ask other people
o Causality → Everything was measured at same time point – no causality
o More PCE’s could be added
CAN subtypes & health
- Randomization of households
- Older participants who look back of what happened to them
- Childhood trauma questionnaire (CTQ)
- Effects are different for 1 subtype → Sexual abuse – Significance level is different – not
all effects are there, there is not always a relation in some diseases. No effect of
hypertension and at stroke also lower.
- Critical view
o Retrospective design → have to think back about their childhood
o Only used 1 questionnaire – could have used more
o Mechanisms?
▪ Biological: HPA-axis dysregulation, chronic inflammatory processes
▪ Socioeconomic
▪ Behavioural
Mater-University of Queensland Study of Pregnancy – MUSP
- Longitudinal study – 40 years
- Self-reports & cognitive testing
- Looked at children at 14 years and 21 years
- Used substantiated maltreatment – know that maltreatment actually happened
- 46 outcomes – clusters
o Cognition & education
o Psychological & mental health
o Addiction & substance abuse
o Sexual health
o Physical health
- Outcomes
o Lower cognitive scores
o Negative educational/employment outcomes
o Mental health problems
o Substance abuse & addiction
o Sexual health problems
o Physical health problems
o Emotional abuse & neglects the most associations were most prominent
- Critical view
o Only part of sample experienced maltreatment
o Self-report
