CONSEQUENCES OF CHILD ABUSE
Week 1
pervasive consequences for mental and physical health
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.
Omission (neglect) vs Comission (actively doing sth harmful)
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
“Students on Maltreatment” (SOM study) - Self-report among 1.800 children 12-16 years: -
37% report one of more forms of abuse - Emotional and Physical Abuse most frequent!
PAFS: Population Attributional Factors, proportional reduction of disorders without abuse
Psychological consequences: (in DSM under trauma- and stress-related disorders)
o Internalizing and Externalizing disorders
o Personality Disorders (BPD / anti-social)
o Psychotic symptoms
o Suicide and self-injury
Earlier onset more severe/chronic; harder to treat
Symptoms not bound to one disorder
Psycho-social consequences
o Interpersonal problems
o self-image
o Re-victimization
Intergenerational transmission: in about 30%
NESDA study
Childhood abuse as transdiagnostic risk factor for psych problems
Consequences of emotional abuse at least as pervasive as physical
Week 2
Broad Consequences:
o Psychological disorders (as classified by the DSM); Lots of comorbidities; sometimes
many symptoms without a specific disorder; Higher risk for earlier onset and more
severe symptoms (e.g., suicidality)
o Interpersonal problems (Attachment at younger and later age, Epistemic trust, Social
exclusion)
, o Self-image ´
o Re-victimization
Reports:
o Self versus informant
o Parent versus child (perpetrator – victim)
o Retrospective vs prospective
o Subjective report versus observing
Impact maltreatment on parenting
How can we study cause and effect?
o Experimental studies (analogue ‘acute stress’ studies)
Trier Social Stress Test (measure salivary control, heart rate, blood pressure, subjective
feelings depressed and ELS-experienced people perceive more stress BUT enhanced
cortisol only in SAD + Abuse (not only SAD)
Cold Pressor Test
animal research
Animal studies:
Maternal Care of rats (Licking and grooming)
ELS of rhesus monkeys results in enhanced sensitivity to reinforcing effects of cocaine
ELS affects HPA-axis (stress hormones), Brain (amygdala, hippocampus, neurogenesis) ´
Cognition and emotions, Diseases
HPA-Axis
acute stress response and adaptation of behaviour is “healthy” and adaptive Chronicity of
stress response can become maladaptive
Maltreatment reduced volume in hippocampal regions (High LG more dendritic
complexity & cognitive function)
We cannot learn everything from animal studies! (e.g. subjective emotions)
Cognitive Schemata of self and others (deeply engrained) (trauma-/schema-focused therapy)
(In)secure Attachment esp in emotional neglect (Attachment styles (insecure as risk factor,
children can also attach securely to another person)
Emotion regulation styles
Hypervigilance to threat
Low responsiveness to reward (ventral stratium and anterior cingulate cortex); (higher risk
depression; changes in dopamine (reward) system substance abuse
Childhood maltreatment affects quality of later intimate relationship
Childhood abuse and neglect are related to underlying psychological processes, such as
negative self-esteem, emotion regulation difficulties, and biased cognitions
Week 3
Early childhood: Threat & Safety learning: Limbic system
Puberty: Emotion Regulation: Prefrontal brain
Autonomic nervous system: Noradrenaline, directly after stressor
HPA: Cortisol, delay (20-30 min after stressor)
Fast (hypothalamus and amygdala) vs Slow Processing in brain (prefrontal cortex)
Dissociation = exception Detachment of trauma (-memory); Emotional disconnection
Memory problems prevalent after repeated and early trauma (particularly sexual abuse)
Dissociation associated with dampened amygdala in borderline personality disorder
Week 1
pervasive consequences for mental and physical health
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.
Omission (neglect) vs Comission (actively doing sth harmful)
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
“Students on Maltreatment” (SOM study) - Self-report among 1.800 children 12-16 years: -
37% report one of more forms of abuse - Emotional and Physical Abuse most frequent!
PAFS: Population Attributional Factors, proportional reduction of disorders without abuse
Psychological consequences: (in DSM under trauma- and stress-related disorders)
o Internalizing and Externalizing disorders
o Personality Disorders (BPD / anti-social)
o Psychotic symptoms
o Suicide and self-injury
Earlier onset more severe/chronic; harder to treat
Symptoms not bound to one disorder
Psycho-social consequences
o Interpersonal problems
o self-image
o Re-victimization
Intergenerational transmission: in about 30%
NESDA study
Childhood abuse as transdiagnostic risk factor for psych problems
Consequences of emotional abuse at least as pervasive as physical
Week 2
Broad Consequences:
o Psychological disorders (as classified by the DSM); Lots of comorbidities; sometimes
many symptoms without a specific disorder; Higher risk for earlier onset and more
severe symptoms (e.g., suicidality)
o Interpersonal problems (Attachment at younger and later age, Epistemic trust, Social
exclusion)
, o Self-image ´
o Re-victimization
Reports:
o Self versus informant
o Parent versus child (perpetrator – victim)
o Retrospective vs prospective
o Subjective report versus observing
Impact maltreatment on parenting
How can we study cause and effect?
o Experimental studies (analogue ‘acute stress’ studies)
Trier Social Stress Test (measure salivary control, heart rate, blood pressure, subjective
feelings depressed and ELS-experienced people perceive more stress BUT enhanced
cortisol only in SAD + Abuse (not only SAD)
Cold Pressor Test
animal research
Animal studies:
Maternal Care of rats (Licking and grooming)
ELS of rhesus monkeys results in enhanced sensitivity to reinforcing effects of cocaine
ELS affects HPA-axis (stress hormones), Brain (amygdala, hippocampus, neurogenesis) ´
Cognition and emotions, Diseases
HPA-Axis
acute stress response and adaptation of behaviour is “healthy” and adaptive Chronicity of
stress response can become maladaptive
Maltreatment reduced volume in hippocampal regions (High LG more dendritic
complexity & cognitive function)
We cannot learn everything from animal studies! (e.g. subjective emotions)
Cognitive Schemata of self and others (deeply engrained) (trauma-/schema-focused therapy)
(In)secure Attachment esp in emotional neglect (Attachment styles (insecure as risk factor,
children can also attach securely to another person)
Emotion regulation styles
Hypervigilance to threat
Low responsiveness to reward (ventral stratium and anterior cingulate cortex); (higher risk
depression; changes in dopamine (reward) system substance abuse
Childhood maltreatment affects quality of later intimate relationship
Childhood abuse and neglect are related to underlying psychological processes, such as
negative self-esteem, emotion regulation difficulties, and biased cognitions
Week 3
Early childhood: Threat & Safety learning: Limbic system
Puberty: Emotion Regulation: Prefrontal brain
Autonomic nervous system: Noradrenaline, directly after stressor
HPA: Cortisol, delay (20-30 min after stressor)
Fast (hypothalamus and amygdala) vs Slow Processing in brain (prefrontal cortex)
Dissociation = exception Detachment of trauma (-memory); Emotional disconnection
Memory problems prevalent after repeated and early trauma (particularly sexual abuse)
Dissociation associated with dampened amygdala in borderline personality disorder
