Physical abuse | |
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Boy violently slapping another boy's head | |
Specialty | Emergency medicine |
Differential diagnosis | Accidental injury Self-injury |
Physical abuse is any intentional act causing injury or trauma to another person or animal by way of bodily contact. In most cases, children are the victims of physical abuse, but adults can also be victims, as in cases of domestic violence or workplace aggression. Alternative terms sometimes used include physical assault or physical violence, and may also include sexual abuse. Physical abuse may involve more than one abuser, and more than one victim.
Physical abuse means any non-accidental act or behavior causing injury, trauma, or other physical suffering or bodily harm. Abusive acts toward children can often result from parents' attempts at child discipline through excessive corporal punishment. [1] [2]
A number of causes of physical abuse against children have been identified, the most common of which, according to Mash and Wolfe, being: [3]
Physically abused children are at risk for later interpersonal problems involving aggressive behavior, and adolescents are at a much greater risk for substance use disorders. In addition, symptoms of depression, emotional distress, and suicidal ideation are also common features of people who have been physically abused. Studies have also shown that children with a history of physical abuse may meet DSM-IV-TR criteria for post traumatic stress disorder (PTSD). [3] As many as one-third of children who experience physical abuse are also at risk to become abusive as adults. [4]
Researchers have pointed to other potential psycho-biological effects of child physical abuse on parenting, when abused children become adults. These recent findings may, at least in part, be carried forward by epigenetic changes that impact the regulation of stress physiology. [5]
Evidence-based interventions for physical abuse include cognitive behavioral therapy (CBT) as well as video-feedback interventions and child-parent psychodynamic psychotherapy; all of which specifically target anger patterns and distorted beliefs, and offer training and/or reflection, support, and modelling that focuses on parenting skills and expectations, as well as increasing empathy for the child by supporting the parent's taking the child's perspective. [6] [7] [8]
These forms of treatment may include training in social competence and management of daily demands in an effort to decrease parental stress, which is a known risk factor for physical abuse. Although these treatment and prevention strategies are to help children and parents of children who have been abused, some of these methods can also be applied to adults who have physically abused. [3]
Physical abuse has also been observed among Adélie penguins in Antarctica. [9]
Violence is the use of physical force to cause harm to people, or non-human life, such as pain, injury, death, damage, or destruction. Some definitions are somewhat broader, such as the World Health Organization's definition of violence as "the intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community, which either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment, or deprivation."
Psychological abuse, often known as emotional abuse or psychological violence, is a form of abuse characterized by a person subjecting or exposing another person to a behavior that may result in psychological trauma, including anxiety, chronic depression, clinical depression or post-traumatic stress disorder amongst other psychological problems.
Reactive attachment disorder (RAD) is described in clinical literature as a severe disorder that can affect children, although these issues do occasionally persist into adulthood. RAD is characterized by markedly disturbed and developmentally inappropriate ways of relating socially in most contexts. It can take the form of a persistent failure to initiate or respond to most social interactions in a developmentally appropriate way—known as the "inhibited form". In the DSM-5, the "disinhibited form" is considered a separate diagnosis named "disinhibited attachment disorder".
Psychological trauma is an emotional response caused by severe distressing events that are outside the normal range of human experiences. It must be understood by the affected person as directly threatening the affected person or their loved ones with death, severe bodily injury, or sexual violence; indirect exposure, such as from watching television news, may be extremely distressing and can produce an involuntary and possibly overwhelming physiological stress response, but does not produce trauma per se. Examples of distressing events include violence, rape, or a terrorist attack.
A form of child abuse, child neglect is an act of caregivers that results in depriving a child of their basic needs, such as the failure to provide adequate supervision, health care, clothing, or housing, as well as other physical, emotional, social, educational, and safety needs. All societies have established that there are necessary behaviours a caregiver must provide for a child to develop physically, socially, and emotionally. Causes of neglect may result from several parenting problems including mental disorders, unplanned pregnancy, substance use disorder, unemployment, over employment, domestic violence, and, in special cases, poverty.
Child abuse is physical, sexual, emotional and/or psychological maltreatment or neglect of a child, especially by a parent or a caregiver. Child abuse may include any act or failure to act by a parent or a caregiver that results in actual or potential wrongful harm to a child and can occur in a child's home, or in organizations, schools, or communities the child interacts with.
The term cycle of violence refers to repeated and dangerous acts of violence as a cyclical pattern, associated with high emotions and doctrines of retribution or revenge. The pattern, or cycle, repeats and can happen many times during a relationship. Each phase may last a different length of time, and over time the level of violence may increase. The phrase has been increasingly widespread since first popularized in the 1970s.
Complex post-traumatic stress disorder is a stress-related mental disorder generally occurring in response to complex traumas, i.e., commonly prolonged or repetitive exposures to a series of traumatic events, within which individuals perceive little or no chance to escape.
Sibling abuse includes the physical, psychological, or sexual abuse of one sibling by another. More often than not, the younger sibling is abused by the older sibling. Sibling abuse is the most common of family violence in the US, but the least reported. As opposed to sibling rivalry, sibling abuse is characterized by the one-sided treatment of one sibling to another.
Childhood trauma is often described as serious adverse childhood experiences (ACEs). Children may go through a range of experiences that classify as psychological trauma; these might include neglect, abandonment, sexual abuse, emotional abuse, and physical abuse, witnessing abuse of a sibling or parent, or having a mentally ill parent. These events have profound psychological, physiological, and sociological impacts and can have negative, lasting effects on health and well-being such as unsocial behaviors, attention deficit hyperactivity disorder (ADHD), and sleep disturbances. Similarly, children whose mothers have experienced traumatic or stressful events during pregnancy have an increased risk of mental health disorders and other neurodevelopmental disorders.
Attachment-based therapy applies to interventions or approaches based on attachment theory, originated by John Bowlby. These range from individual therapeutic approaches to public health programs to interventions specifically designed for foster carers. Although attachment theory has become a major scientific theory of socioemotional development with one of the broadest, deepest research lines in modern psychology, attachment theory has, until recently, been less clinically applied than theories with far less empirical support. This may be partly due to lack of attention paid to clinical application by Bowlby himself and partly due to broader meanings of the word 'attachment' used amongst practitioners. It may also be partly due to the mistaken association of attachment theory with the pseudo-scientific interventions misleadingly known as attachment therapy. The approaches set out below are examples of recent clinical applications of attachment theory by mainstream attachment theorists and clinicians and are aimed at infants or children who have developed or are at risk of developing less desirable, insecure attachment styles or an attachment disorder.
Child-to-parent violence (CPV), also recognized as abuse of parents by their children, constitutes a manifestation of domestic violence characterized by the infliction of maltreatment upon parents. This mistreatment commonly manifests in verbal or physical forms.
Daniel S. Schechter is an American and Swiss psychiatrist known for his clinical work and research on intergenerational transmission or "communication" of violent trauma and related psychopathology involving parents and very young children. His published work in this area following the terrorist attacks on the World Trade Center in New York of September 11, 2001 led to a co-edited book entitled "September 11: Trauma and Human Bonds" (2003) and additional original articles with clinical psychologist Susan Coates that were translated into multiple languages and remain among the first accounts of 9/11 related loss and trauma described by mental health professionals who also experienced the attacks and their aftermath Schechter observed that separation anxiety among infants and young children who had either lost or feared loss of their caregivers triggered posttraumatic stress symptoms in the surviving caregivers. These observations validated his prior work on the adverse impact of family violence on the early parent-child relationship, formative social-emotional development and related attachment disturbances involving mutual dysregulation of emotion and arousal. This body of work on trauma and attachment has been cited by prominent authors in the attachment theory, psychological trauma, developmental psychobiology and neuroscience literatures
Disability abuse is when a person with a disability is abused physically, financially, sexually and/or psychologically due to the person having a disability. This type of abuse has also been considered a hate crime. The abuse is not limited to those who are visibly disabled or physically deformed, but also includes those with learning, intellectual and developmental disabilities or mental illnesses.
Institutional abuse is the maltreatment of a person from a system of power. This can range from acts similar to home-based child abuse, such as neglect, physical and sexual abuse, and hunger, to the effects of assistance programs working below acceptable service standards, or relying on harsh or unfair ways to modify behavior. Institutional abuse occurs within emergency care facilities such as foster homes, group homes, kinship care homes, and pre-adoptive homes. Children who are placed in this type of out of home care are typically in the custody of the state. The maltreatment is usually caused by an employee of the facility.
The effects of domestic violence on children have a tremendous impact on the well-being and developmental growth of children witnessing it. Children can be exposed to domestic violence in a multitude of ways and goes beyond witnessing or overhearing, although there is disagreement in how it should be measured. Children who are exposed to domestic violence in the home often believe that they are to blame, live in a constant state of fear, and are 15 times more likely to be victims of child abuse. Close observation during an interaction can alert providers to the need for further investigation and intervention, such as dysfunctions in the physical, behavioral, emotional, and social areas of life, and can aid in early intervention and assistance for child victims.
Early childhood is a critical period in a child's life that includes ages from birth to five years old. Psychological stress is an inevitable part of life. Human beings can experience stress from an early age. Although stress is a factor for the average human being, it can be a positive or negative molding aspect in a young child's life.
Transgenerational trauma is the psychological and physiological effects that the trauma experienced by people has on subsequent generations in that group. The primary mode of transmission is the shared family environment of the infant causing psychological, behavioral and social changes in the individual.
Out-of-home placements are an alternative form of care when children must be removed from their homes. Children who are placed out of the home differ in the types and severity of maltreatment experienced compared to children who remain in the home. One-half to two-thirds of youth have experienced a traumatic event leading to increased awareness and growing literature on the impact of trauma on youth. The most common reasons for out-of-home placements are due to physical or sexual abuse, violence, and neglect. Youth who are at risk in their own homes for abuse, neglect, or maltreatment, as well as youth with severe emotional and behavior issues, are placed out of the home with extended family and friends, foster care, or in residential facilities. Out-of-home placements aim to provide children with safety and stability. This temporary, safe environment allows youth to have their physical, mental, moral, and social needs met. However, these youth are in a vulnerable position for experiencing repeated abuse and neglect.
Adverse childhood experiences (ACEs) are identified as serious and traumatizing experiences, such as abuse, neglect, exposure to violence, substance use, and other harmful events or situations that occur within a child's household or environment. Unfortunately, exposure to ACEs within the child's community is all too common in low-income households and neighborhoods, with close to 43% of children in the United States (U.S.) living in low-income families. ACEs were first identified by the Centers for Disease Control and Prevention (CDC) and Kaiser Permanente's Adverse Childhood Experiences Study conducted from 1995 to 1997, where ACEs were examined and correlated with later-life well-being. With one in four children experiencing or witnessing a potentially traumatic event, children who grow up in an unsafe environment are at risk for developing adverse health outcomes, affecting brain development, immune systems, and regulatory systems.