psy341 - chapter 14 child maltreatment notes (entire chapter).doc

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31 Mar 2012
Chapter 14: Child Maltreatment and Non-Accidental Trauma
Child maltreatment – generic term that refers to four primary acts:
ophysical abuse
osexual abuse
oemotional abuse
-non-accidental traumawide-ranging effects of maltreatment on child’s ongoing
physical and emotional development
- children are highly dependent on adults victimization – abuse/maltreatment of
someone whose ability to protect him- or herself is limited
- victims face paradoxical dilemmas:
owants to stop violence but also longs to belong to family
oaffection and attention may coexist with violence and abuse
ointensity of violence tends to increase over time, although in some cases,
physical violence may decrease or even stop all together
History and Family Context
- history
ochildren view as exclusive property of father who had full discretion of how
to administer punishment
absolute authority over family by husband
right to family privacy
Healthy Families
- earliest and most enduring social relationships
- determinants of healthy parent-child relationships and family roles derive from
carefree environment that balances need for control and direction
-expectable environment – for infants; requires protective and nurturing adults, as
well as opportunities for socialization with a culture
- responsible parenting involves gradual shifting of control from parents to child and
Family Stress and Disharmony
- child’s method of adapting to immediate environmental demands may later
compromise his/her ability to form relationships with others
- child maltreatment = stress, ongoing and unpredictable, often result of actions and
inactions of people the child is supposed to trust and depend on
- prime factor to stress response – degree of support and assistance
Continuum of Care
- child-centered end of continuum – appropriate and healthy forms of child-rearing
actions that promote child development; encouragement; matching demands and
expectations to child’s needs and abilities
- borderline actions – greater degrees of irresponsible and harmful child care
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- inappropriate/abusive/neglectful
Types of Maltreatment
- DSM-IV-TR does not consider specific types of child maltreatment, but considers
severe maltreatment (of either adult or child) under Axis I “other conditions that
may be a focus of clinical attention”
oIf suffering another condition due to abuse; i.e. depression on Axis I, then
abuse is on Axis IV (psychosocial and environmental problems)
Physical abuse
- multiple acts of aggression that include punching, beating, kicking, biting, burning,
shaking, or otherwise physically harming a child
- most cases, injuries are not intention but rather a result of overdiscipline or severe
physical punishment
- these children often more disruptive and aggressive
-physical neglect – refusal or delay in seeking health care, expulsion from home or
refusal to allow a runaway to return home, abandonment and inadequate
-educational neglect – allowing chronic truancy, failing to enrol child who is of
mandatory school age, failing to attend to a child’s special educational needs
-emotional neglect – marked inattention to child’s need for affection, refusal or
failure to provide needed psychological care, spousal abuse in child’s presence,
permission of drugs/alcohol use by child
- neglected children know health problems, limited growth
- undisciplined activity, extreme passivity due to way of adapting to unresponsive
- toddlers show little persistence and enthusiasm
- preschoolers show poor impulse control are highly dependent on teachers for
support and nurturance
- fearful, somatic signs of stress
- older boys aggressive towards peers and dating partners
- girls more passive, withdrawn, and low in self-esteem
Sexual abuse
- incest, rape, sodomy, exhibitionism, commercial exploitation through prostitution
or the production of pornographic materials
- underreported due to “conspiracy of silence
- common for children to regress temporarily—becoming enuretic or easily upset, or
having problems sleeping
- acting-out, delinquency, promiscuity, drug use, self-destructive behaviour
- no connection to child rearing, discipline, or inattention to developmental needs;
constitutes breach of trust, deception, intrusion, and exploitation of child’s
innocence and status
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Emotional abuse
- repeated acts or omissions by parents/caregivers that caused or could cause, serious
behavioural, cognitive, emotional, or mental disorders
- verbal threats, put-downs, belittling, name-calling, scape-goating
- child prostitution, pornography, etc
- poverty is greatest factor
Prevalence and Context
- decline in sexual and physical abuse since 1992 due to economic improvement, law
enforcement and child protection resources, and more aggressive prosecution and
incarnation policies
-lifetime prevalence – estimates of maltreatment derived by asking adults if they
experienced particular forms of maltreatment in childhood
Characteristics of Victimized Children
- rate of victimization inversely related to age of child (with the exception of sexual
- maltreatment of boys and girls equal—except sexual abuse where girls account
- boys more likely abused by male non-family member, girls more likely sexually-
abused by male family members
- half of victims are white
- all races: largest group suffered from neglect
- Alaska Native children and children of multiple races had highest rates of
- Racial differences believed to be a function of disproportionate impact of poverty,
stress, and disadvantage
Characteristics of Family and Perpetrator
- poverty and advantage
- single parent—greater risk of physical abuse and neglect
otwice as likely if single father than mother
- more common in large families where additional children in household mean
additional tasks, responsibilities, and demands
- 80% are victimized by one or both parents
o50% by non-parent in sexual abuse
o90% by males in sexual abuse
o90% of neglect by mothers
oMost common (for maltreatment in general): single mother under the age of
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