Understanding Child Abuse and Neglect (1993) / Chapter Skim
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6 CONSEQUENCES OF CHILD ABUSE AND NEGLECT
6 CONSEQUENCES OF CHILD ABUSE AND NEGLECT
Pages 208-252
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From page 208... ...
The relationship between the causes and consequences of child maltreatment is particularly problematic, since some factors (such as low intelligence in the child) may help stimulate abusive behavior by the parent or caretaker, but low intelligence can also be a consequence of abusive experiences in early childhood.
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From page 209... ...
In recent years, much attention has been focused on the consequences of child sexual abuse, especially the adolescent and adult sexual behavior of the victim. Less attention has been given to the short- and long-term consequences of child neglect and physical abuse.
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From page 210... ...
Few studies have found consistent differences in the reaction of boys and girls to molestation, although one popular report found boys to have more externalizing and girls to have more internalizing symptoms (Friedrich et al., 1988~. The lack of attention to gender differences may result from the small number of male victims of sexual abuse in most studies and lower rates of reporting of childhood sexual abuse in males.
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From page 211... ...
A particularly serious biological consequence of child and adolescent sexual abuse is the risk of sexually transmitted diseases, including human immunodeficiency virus, gonorrhea, and syphilis. Cognitive and Intellectual Consequences Cognitive and language deficits in abused children have been noted clinically (Augoustinos, 1987; Azar et al., 1988; Fantuzzo, 1990; Kolko, 19921.
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From page 212... ...
The findings for sexually abused children are inconsistent. Dodge and colleagues (1990)
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From page 213... ...
These mothers were detached and unresponsive to their children's bids for care and attention. Children from this group were compared with physically abused, neglected, verbally rejected, and control groups from the same high-risk sample.
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From page 214... ...
were based on a large study that included many well-functioning and older children. While sexualization seems relatively specific to sexual abuse, inappropriate sexual behavior has been noted in nonsexually abused children.
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From page 215... ...
(1993) found that sexually abused children were often more symptomatic than their nonabused counterparts in terms of fear, nightmares, general post-traumatic stress disorder, withdrawn behavior, neurotic mental illness, cruelty, delinquency, sexually inappropriate behavior, regressive behavior, running away, general problem behaviors, and self-injurious behavior.
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From page 216... ...
Maltreated children may also be less competent in their social interactions with peers (Straus and Gelles, 1990; Howes and Espinosa, 1985~. For some physically abused children, this may manifest in withdrawal or avoidance (Kaufman and Cicchetti, 1989)
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From page 217... ...
. Although the majority of abused children do not become delinquent, and the majority of delinquents are not abused as children, this research indicates that abused and neglected children are at increased risk for juvenile delinquency.
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From page 218... ...
did not find that abused and neglected children had significantly higher rates of arrest as juveniles for violent crimes than controls (4 versus 3 percent) although abused or neglected females appeared to be at increased risk of arrest for violent crimes during adolescence (Widom, l991b)
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From page 219... ...
In two studies, sexual abuse victims were found to have run away from home more often during adolescence than clinical controls (Herman, 1981; Meiselman, 1978~. In the 1988 National Survey of Missing, Abducted, Runaway, and Thrownaway Children in America, approximately 3 percent of the runaways reported having been sexually abused and 1 percent physically harmed (Finkelhor et al., 1990~.
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From page 220... ...
Indeed, in a review of research on the impact of child sexual abuse, Browne and Finkelhor (1986:66) cautioned that "although clinical literature suggests that sexual abuse during childhood plays a role in the development of other problems ranging from anorexia nervosa to prostitution, empirical evidence about its actual effects is sparse." Female victims of child sexual abuse are often thought to be at increased risk of becoming pregnant as teenagers, an important outcome of child sexual abuse because of the theoretical link between early parenting and inadequate childrearing practices.
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From page 221... ...
One study found that physical abuse was significantly related to alcohol use in a cohort of high-risk youth prior to the initial interview, but not during the follow-up period about one year later (Dembo et al., 19901. In addition, parental alcohol problems may be antecedent to child maltreatment and may have an important role in influencing the parent's maltreating behavior.
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From page 222... ...
significantly differentiated adolescent inpatients with a history of sexual abuse from those with no history of sexual abuse, although it was not clear whether these behaviors came before or after the abusive experiences. Prospective and longitudinal research appears warranted to assess the extent to which this self-destructive and negative life trajectory characterizes abused and neglected children.
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From page 223... ...
Significantly less is known about connections between childhood victimization and other problem behaviors, such as teenage pregnancy, alcohol and illicit drug use and abuse, self-destructive behavior, and suicide. Alcohol and illicit drug use are both illegal for teenagers, creating a natural confounding of alcohol or substance use with delinquency.
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From page 224... ...
. Long-term Consequences of Child Maltreatment Over the last decade, there has been a dramatic recent increase in the number of clinical and research reports retrospectively linking childhood sexual abuse to specific forms of adult psychopathology.
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From page 225... ...
Beitchman et al., (1991) recently concluded that the child sexual abuse literature "has been vague in separating effects directly attributable to sexual abuse from effects that may be due to preexisting psychopathology in the child, family dysfunction, or to the stress associated with disclosure" (p.
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From page 226... ...
INTERACTION OF RISK AND PROTECTIVE FACTORS Abused and neglected children appear to be at risk of a variety of negative outcomes, yet many studies show that not all abused and neglected children grow up to become dysfunctional adults. For example, a number of studies of sexual abuse victims have found a surprising proportion of them to be asymptomatic (Caffaro-Rouget et al., 1989; Conte and Schuerman, 1987; Kendall-Tackett et al., 1993: Mannarino and Cohen, 1986; Tong et al., 1987~.
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From page 227... ...
The level of marital and family violence (Cappell and Heiner, 1990; Trickett and Kuczynski, 1986) also deserves attention as a protective factor, one that may have a number of interactive effects on the consequences of child maltreatment.
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From page 228... ...
Research on the extent to which abused and neglected children's cognitive appraisal of events mediates the subsequent development of dysfunctional behaviors has been studied as part of a 14-year longitudinal study of 2,OOO families (Zimrin, 1986~. In this study, 35 families with abused children were identified, including a small group of abused children (n = 9)
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From page 229... ...
Placement Experiences and Foster Care Although placement outside the home may be a potentially protective factor affecting the long-term consequences of abused and neglected children, the role of placement and foster care remains controversial in studies of child maltreatment (Runyan et al., 1982~. Methodological problems in the research literature on the impact of placement experiences on abused
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From page 230... ...
. Studies have suggested that under certain conditions foster care placement experiments may protect abused and neglected children.
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From page 231... ...
Children who experience multiple placement experiences may require special services, and research is needed to identify particular resources for this subgroup of abused and neglected children. Summary Individual characteristics, such as high intelligence, certain kinds of temperament, the cognitive appraisal of victimization experiences, a relationship with a significant person, and some out-of-home placement experiences may serve as buffers for childhood victims.
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From page 232... ...
The common practice of treating abused and neglected children together, or eliminating one type of maltreatment from study, may reveal only a partial portrait of childhood victims' risk for later consequences. Existing research has focused on physical and sexual abuse, with relatively little attention to neglect or emotional maltreatment, yet the accumulation of stress associated with chronic neglect may produce consequences for young children similar to those produced through physical abuse.
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From page 233... ...
Recommendation 6-~: Intergenerational studies require support to identify relevant cycles and key factors that affect intergenerational transmission of child maltreatment. Generational studies of child abuse and neglect are needed to help identify the familial or cultural patterns passed on from generation to generation that society defines as abusive.
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From page 234... ...
Recommendation 6-4: Research needs to consider the co-occurrence of multiple forms of child victimization in the social context of child maltreatment behaviors. The assessment of consequences for abused and neglected children is complicated by the co-occurrence of other problems (or co-morbidity)
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From page 235... ...
Recommendation 6-6: Research is needed to improve the methodological soundness of child maltreatment studies, to test hypotheses, and to develop relevant theories of the consequences of childhood victimization. In the short term, research efforts to describe, document, and evaluate relationships suggested by the clinical literature are necessary.
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From page 236... ...
4. It is not clear whether there is a specific relationship between child sexual abuse and post-traumatic stress disorder because many other children have related symptoms such as fears, nightmares, somatic complaints, autonomic arousal, and guilt feelings (Kendall-Tackett et al., 1993)
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From page 237... ...
Ackman 1991 A review of the short-term effects of childhood sexual abuse. Child Abuse and Neglect 15:537-556.
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From page 238... ...
Zaidi 1989 Sexual abuse histories and sequelae in female psychiatric emergency room patients. American Journal of Psychiatry 146: 1602- 1606.
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From page 239... ...
Schuerman 1987 Factors associated with an increased impact of child sexual abuse. Child Abuse and Neglect 11:201 -211.
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From page 240... ...
Elmer, E., and G Gregg 1967 Developmental characteristics of abused children.
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From page 241... ...
1990 Early and long-term effects of child sexual abuse: An update. Professional Psychology: Research and Practice 21(5)
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Horowitz, and A Cardarelli 1990 Child Sexual Abuse: The Initial Effects.
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From page 243... ...
Cado, and M.J. Tarran 1990 Childhood sexual abuse: Long-term effects on psychological and sexual functioning in a nonclinical and nonstudent sample of adult women.
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From page 244... ...
Cicchetti, eds., New Directions for Child Development, Developmental Perspectives on Child Maltreatment 11. San Francisco: JosseyBass.
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From page 245... ...
1980 Emotional development in physically abused children. American Journal of Orthopsychiatry 50:686-696.
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From page 246... ...
Cohen 1986 A clinical-demographic study of sexually abused children. Child Abuse and Neglect 10(1)
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From page 247... ...
Foa, and D.L. Ralphe 1988 Post-traumatic stress disorder in sexually abused children: A prospective study.
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From page 248... ...
Powell, eds., Lasting Effects of Child Sexual abuse. Newbury Park, CA: Sage Publications.
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From page 249... ...
Boucher 1987 Childhood sexual abuse in the lives of sexually aggressive offenders. Journal of American Academy of Child and Adolescent Psychiatry 26:262-267.
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From page 250... ...
Powell, eds., Lasting Effects of Child Sexual Abuse. Newbury Park, CA: Sage.
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From page 251... ...
Putnam in press The impact of child sexual abuse on females: Toward a developmental, psychobiological integration. Psychological Science Visintainer, M.A., and J.A.
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From page 252... ...
1988. The relationship between child sexual abuse and adolescent sexual functioning in Afro-American and white American women.
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