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Effects of Abuse
Potential Effects of Maltreatment1,2
The effects of maltreatment differ across situations and by individuals. Each person responds differently to maltreatment and each person is different in how they cope with stressful events. Those who are resilient are more likely to come out of abusive environments with little or no damage, but perhaps with unwanted memories. Others may be severely affected the rest of their lives, especially if the form of maltreatment was constant and continuous and the individual was unable to cope or had no support from outsiders. The harsher the maltreatment, the more devastating the affects can be. Yet, it still depends on the person, their support system, their coping strategies, and the treatment they may receive.

Child maltreatment will not affect all children in the same way. Some factors that influence the effects of maltreatment include:
  • Age of the child at the time of neglect or abuse
  • They type of abuse
  • Frequency and duration of abuse
  • Severity of abuse (mild, moderate, or severe)
  • The relationship between the victim and the perpetrator

Estimates indicate that there were over 3 million victims of child sexual abuse and almost 40 million survivors of sexual abuse in the United States during 1999. Not only is abuse traumatic at the time of maltreatment, but for the 40 million survivors, the trauma still may have lasting effects.

Short-term Effects of Child Maltreatment3
Short-term consequences for child maltreatment may be hard to pinpoint.
  • Children may not be aware of emotional problems they are having or that they are connected to neglect. Since neglect is sometimes very difficult to detect the short-term consequences may also not be easily noticed.
    • For example, if a mother neglects to interact with her children, the child may be suffering from a lack of an emotional bond with his mother. As a short-term consequence, they child may be distant from playmates or a teacher, possibly effecting their happiness, which may turn into depression. Temporarily, the child may not have made a bond with a parent, but in the long-term they may not be able to intimately bond with another adult and form adult relationships.

  • A short-term effect of physical abuse could be something like a broken bone that heals over time. Other examples include bruises, bloody noses, or burns.

  • A short-term effect of sexual abuse could be the anxiety of the future (which again may turn into adult anxiety if it is constant). Another short-term consequence of sexual abuse is having a sexually transmitted infection (STI).

  • A short-term effect of emotional abuse could be a child crying constantly or a child who is needy. Another possible consequence is the self-fulfillment prophecy where the child begins to believe what the abuser says about them. For instance, if the abuser constantly tells the child that they are stupid, the child's grades in school may suffer and they may begin to believe that they are stupid and will act accordingly. This effect may become a long-term consequence if no one steps in to tell the child that they are not what the abuser says they are.

Other short-term consequences may derive from any of the maltreatment types. These include experiencing a poor self-image or poor self-esteem. They may begin to have anger problems and act out or even turn to self-damaging behavior or self-injury. In severe cases, children may have suicidal thoughts or severe depression.

Long-term Effects of Child Maltreatment4,5,6,7
Early intervention of child maltreatment is critical in order for the child to have a chance at living a life without long-term effects like developmental delays, cognitive disturbances, and psychological dysfunctions. Children are especially at risk for any of these problems if they are abused prior to the age of 3. Recent research suggests that the consequences of child maltreatment prior to age 3 that does not receive early intervention may have the most negative impact on the child's development. Some of the most prominent effects include:
  • Developmental Problems:
    • 20% of abused children have significantly slower brain growth or a smaller overall brain size than non-maltreated children.
    • 11% of maltreated children demonstrate failure to thrive in which the child is unable to obtain or utilize the calories needed for growth sometimes due to malnutrition. If the child is suffering from failure to thrive, they are unlikely to reach certain developmental milestones like crawling, sitting, or walking.

  • Cognitive Disturbances:
    • Speech and language delays
    • Poor academic performance because cognitive delays become prominent when the maltreated children reach school age.
    • Maltreated children are more likely to be held back in school than non-maltreated children
    • Deficiencies due to malnutrition, like protein or iron deficiencies, can also prohibit cognitive development as well as inhibiting the ability to control impulsive behavior.

  • Social Disturbances:
    • Abused children are more likely to have hostile attribution bias, in which they interpret actions or stimuli that are ambiguous, harmless, or unintentional as angry, harmful, and intentional.
    • Maltreated children, especially physically abused children, tend to display more aggressive behaviors than non-maltreated children.
    • These effects lead to maltreated children being disliked or having few friends, as well as having poor attachments and relationships through adulthood.

  • Behavioral Consequences
    • Maltreatment in late childhood and adolescence has been linked to antisocial behavior in adulthood including violent crimes and theft.
    • 59% more likely to be arrested as a juvenile
    • 30% more likely to be involved with violent crime as an adult
    • Maltreated children are 25% more likely to become involved with problems such as delinquency and teen pregnancy.
    • Over 60% of people in drug rehabilitation centers report being abused or neglected as a child.
    • About 30% of maltreated children will eventually abuse their own children.

  • Psychological Dysfunction:
    • 11% of maltreated children display internalizing behavior including anxiety and depression.
    • 79% of children maltreated before reaching school-age display problematic externalizing behaviors. 50% of these children meet the clinical criteria for conduct disorder.
    • Maltreatment that involves witnessing or experiencing violence is linked with posttraumatic stress disorder (PTSD).
    • About 80% of 21 year olds that were abused as children met criteria for at least 1 psychological disorder including eating disorders, anxiety, and depression.
    • Other conditions linked with child maltreatment include suicide attempts, panic disorder, and attention-deficit/hyperactive disorder.
Furthermore, a study done through the Centers of Disease Control and Prevention (CDC) found that adverse childhood events or trauma, including maltreatment, may lead to adult health problems such as heart disease.

It is important to note, however, that such effects have not been proven to be solely from the actual acts of maltreatment. They may be caused by other circumstances within that person or within their environment.

Neglect can have long-lasting effects that may not be evident until many years later or such problems may worsen as the child ages. Social, emotional, physical, and mental damage can be caused by neglect; these effects are often interrelated. It is difficult to determine the direct causes of such damage as interplay of environmental and other factors may occur. However, neglect typically has some damage whether it is short-term or long-term.

Infancy is an especially vulnerable time for children to be neglected. At this stage, which is considered to be a sensitive developmental period, neglect has a bigger impact on the child's development and well-being than children who are older or past this stage. One reason is the necessity to develop a bond with a caregiver and the inability to thrive due to a lack of a caregiver relationship.

Physical development can be impaired by the effects of neglect like malnourishment which interferes with physical growth. Other forms of physical neglect can affect cognitive, emotional, and social development. Learning may be stunted due to the lack of interaction between the caregiver and child in such cases where children are not given the emotional and physical affection they need. In some extreme cases, the brain does not develop properly. The hormone level of cortisone, a stress hormone, is usually quite high in neglected or abused children and results in a state of 'hyper-arousal.' Eventually, this may lead to anxiety, depression, over aggressiveness and/or withdrawal. Global neglect, which is defined as neglect in more than one area, may lead to significantly smaller brain size than that of normal children. Chronic or acute physical problems may occur and may consist of anything from heart disease or obesity to fractures and sever burns.

Sexual Abuse9,10,11,12
Children who are victimized by sexual abuse are susceptible to the potential effects that lead to a succession of sexual abuse, maltreatment and violence. It is often carried on from one sexual abuser to another within the family, especially those who are the receivers of such abuse.

In a recent study, 47% of child molesters polled reported being abused as a child and men who were severely molested as children had sexually abused three times the amount of victims as those were not. According to the American Psychological Association, short-term effects of sexual abuse surface within a 2 year period after the abuse has been stopped. Some of the short-term effects include:
  • Regressive behaviors (thumb-sucking or bed-wetting)
  • Sleep disturbances (insomnia, night terrors, or nightmares)
  • Eating problems
  • Poor performance in school
  • Nonparticipation in school or social activities
Long-term effects of sexual abuse so not only involve psychological dysfunction, but also increase the likelihood of other adverse events in the child's life. Research has shown that children who were sexually abused are more likely to be raped or in an abusive relationship in adulthood. Also, females that were sexually abused as children are twice as likely to attempt suicide as their non-maltreated peers. As well as, sexually abused children are three times more likely to develop a substance abuse problem. Another long-term effect of sexual abuse is sexual dysfunction in adulthood which may range from becoming a child sexual predator to the inability to be intimate with a partner.

Children that were sexually abused are four times more likely to develop a psychiatric disorder. Posttraumatic stress disorder (PTSD) is the most commonly experienced long-term effect of sexual abuse. About 30% of all sexually abused children meet diagnostic criteria for PTSD, while 50% of sexually abused children meet partial criteria for PTSD. Also, about 33% of sexual abuse victims meet diagnostic criteria for PTSD in adulthood. Other long-term effects of sexual abuse can be manifested in several different ways. Children may have severe depression or anxiety, others may act out sexually, and some may develop poor self-esteem. The following graph shows the rate of occurrence for the most common effects of sexual abuse on children.

Risk for Major Depressive Disorder in Adulthood13
In a study conducted by Widom, DuMont, Czaja (2007), research indicated that child abuse and neglect were associated with an increased risk for major depressive disorder (MDD) in adulthood. This study used both men and women with documented cases of childhood maltreatment as neglect, physical abuse, or sexual abuse in comparison to a matched control group. In this study, 676 participants with childhood maltreatment were compared to 520 participants of equal age, race, sex, and SES who were not neglected or abused in childhood.

Their results show that neglect and physical abuse in childhood is related to an increased risk for lifetime MDD. For many of the participants in this study depression began during childhood. In light of this evidence, it is clear that intervention is needed as early as possible in order to prevent a lifetime of depression or other psychiatric problems.

The results from this study did not indicate sexually abused children to be at higher risk for lifetime of MDD. Although these individuals were no more at risk for MDD, the authors also report that the maltreated participants reported more depressive symptoms at a significantly level higher than those in the control group with no history of maltreatment.

The results show that there is a higher rate of comorbidity for individuals with childhood abuse and neglect. Compared to the control group, 86.4% of those with lifetime MDD who were abused and neglected met the criteria for at least one other current DSM-III-R disorder. However, it is impossible to determine whether or not neglect or abuse causes subsequent mental problems or whether mental problems are a factor of such an environment typical of such maltreatment.

1 Long-Term Consequences of Child Abuse and Neglect. Child Welfare Information Gateway. Washington, D.C.: U.S. Department of Health and Human Services, 2006. Retrieved August 22, 2007 from http://www.childwelfare.gov/pubs/factsheets/long_term_consequences.cfm

2 A bel, G.G., & Harlow, N. (2002). Child molestation prevention study excerpted from The stop child molestation book. Xlibris, 2001.http://www.childmolestationprevention.org/pdfs/study.pdf

3 http://www.focusas.com/abuse.html

4 Wiggins, C., Fenichel, E., & Mann, T. Literature Review: Developmental Problems of Maltreated Children and Early Intervention Options for Maltreated Children. Assessing the Developmental Needs of Children Investigated for Child Protective Services, Washington, D.C.: U.S. Department of Health and Human Services, 2007.

5 Long-Term Consequences of Child Abuse and Neglect. Child Welfare Information Gateway. Washington, D.C.: U.S. Department of Health and Human Services, 2006. Retrieved August 22, 2007 from http://www.childwelfare.gov/pubs/factsheets/long_term_consequences.cfm

6 Understanding the effects of maltreatment on early brain development. Child Welfare Information Gateway. (Oct 2001). Bulletin for professionals. Retrieved May 31, 2007 from http://www.childwelfare.gov/pubs/focus/earlybrain/index.cfm

7 Dominquez, R. Z., Nelke, C.F. & Perry, B.D. (2001). Child Sexual Abuse. Encyclopedia of Crime and Punishment, 1, 202-207. http://www.childtrauma.org/CTAMATERIALS/sexual_abuse.asp

8 DePanfilis, D. (2006). Child neglect: A guide for prevention, assessment and intervention. Dept. HHS, et al. http://www.childwelfare.gov/pubs/usermanuals/neglect/index.cfm

9 Dominquez, R. Z., Nelke, C.F. & Perry, B.D. (2001). Child Sexual Abuse. Encyclopedia of Crime and Punishment, 1, 202-207. http://www.childtrauma.org/CTAMATERIALS/sexual_abuse.asp

10 Finkelhor, D., Jones, L.M., (Jan 2004). Explanations for the decline in child sexual abuse cases. U.S. Department of Justice. 1-11.

11 Abel, G.G., & Harlow, N. (2002). Child molestation prevention study excerpted from The stop child molestation book. Xlibris, 2001. http://www.childmolestationprevention.org/pdfs/study.pdf

12 Understanding Child Sexual Abuse: Education, Prevention, and Recovery. APA Public Affairs. PsycNet 2001. Retrieved Aug 22, 2007 from: http://www.apa.org/releases/sexabuse/effects.html

13 Widom, C.S., DuMont, K., & Czaja, S.J. (2007). A prospective investigation of major depressive disorder and comorbidity in abused and neglected children grown up. Arch Gen Psychiatry, 64, 49-56.  
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