Lecture 1 full summary/notes - Child A&N
- Get the book: “the boy who was raised as a dog” (Perry & Szalavitz)
- Definition and prevalence of child abuse and neglect:
o 1st chapter of the book about Tina’s world sexual abuse +
behavioral problems later in life
o 3 papers all are review papers. Might be topics in the
papers that are coming back in later lecture weeks (genetics,
biological topics, etc.)
Last one is about child (sexual) abuse is actually the sort
of abuse that happens least likely WITHIN families. The
rest of the topics of this course are about other abuse
and neglect subjects, which are the sort of topics that
happing within families. Is a difference to keep in mind
In most of the course we will not haven sexual abuse as
a topic, but it is important to keep the consequences in
mind as it is a form of abuse.
o In clinical settings (with adults/young adults) it is not always
the practice to ask directly about possible childhood
maltreatment. Luckily, nowadays it is happening more, but
sometimes it is noticed within underlying questions.
o To learn about underlying psychopathology and to create
better interventions/preventions.
o Numerous findings that that childhood abuse and neglect can
have pervasive consequences for mental and physical health
o Importance of safe childhood:
Work that has started a long time ago: Freud, Harlow
(apes research – warmth/comfort), Bowlby (attachment
, research), Ainsworth (strange situation test / hoe
hechten kinderen).
It is important to stress on the ‘may have significant
(and irreversible) consequences’ Consequences
definitely come from maltreatment, but we hope that
the ‘may’ stresses that it can be prevented of reversed
with good treatment (psychological).
o There are many definitions of childhood maltreatment, but
the one that is most used (by Gilbert and colleagues in 2009)
is:
‘Any act of commission (abuse/mishandeling) or
omission (neglect/verwaarlozing) 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.’
You can hit a child (direct) or you can threaten to hit a
child. Both cause psychological damage
Harm does not need to be intended not enough
money to buy good/warm clothes for child in wintertime
(physical neglect) OR substance addiction of parent (has
effect on child’s life), ETC.
Ommission:
Failure to meet a child’s needs physical
neglect (not dressed or fed properly), emotional
neglect (not receiving love, attention, sensitive
care, f.e. = not being present at children’s
milestones, etc), Denial of access to education
Commission:
Actively doing something harmful Physical
abuse (hitting, etc, emotional abuse (calling
names, making child feel unworthy), sexual
abuse, shaken baby syndrome (in younger
years of baby being born)
- Types of maltreatment written out:
o Emotional neglect = failure to meet a child’s emotional
need and failure to protect a child from violence in the home
or neighborhood
o Physical neglect = failure to meet a child’s basic physical,
medical/dental, or educational needs; failure to provide
adequate hygiene, nutrition 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 other 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 conflict, sexual contact OR non-contact sexual
interaction with a child.
o Most studies take them all together and ask if someone has
experienced one or more of these categories. Some other
papers specifically look at consequences of each category
alone.
- Prevalence of childhood maltreatment: IT IS REALLY HIGH
(worldwide)
o Worldwide children report that they suffered some form of
violence in the past year.
o 23% = physical abuse
o 36% = emotional abuse
o 16% = physical neglect
o 18% GIRLS and 8% BOYS = sexual abuse
- In the Netherlands:
o Dutch National Prevelance Study: ‘Abuse of children and
adolescents’ (2017):
Professionals researched: 3% of children 0-18yrs
(abuse)
This is low, BUT: it is what has been assessed by
professionals. That is: cases that are actually known
Might be a really big underestimation of actual
prevalence
o Students on Maltreatment (SOM Studie 2017):
Self-report study among 1.908 children (age: 12-16yrs)
25% report one of more categories of abuse
Almost 10 times as high
Self-reports are always the highest forms of
outcomes when it comes to these types of
subjects
Maybe overestimate? But still, it is shocking
Emotional and physical abuse most frequent in this
report
o High comorbidity of types of abuse and neglect very clear
If a child is being hit by a parent, it is also often met with
parents swearing or other emotional abuse, and/or met
with neglection of child’s needs
, Important to figure out was it the physical abuse that
made the most consequences on the child, or was it the
comorbidity of emotional abuse or neglect?
Often: the emotional consequences have the most effect
o This is the framework that we will work from: happens to
often, happens most within families, etc.
- Psychological and social consequences of childhood maltreatment
o In this course we will talk about many different consequences:
Mental health outcomes (emotional (depression, etc.),
social (interactions), cognitive, behavioural)
Physical health outcomes (stress system, brain, disease,
genes)
o Psycho-social consequences:
Interpersonal problems how do you act amongst your
peers, specifically toward authority figures or towards
children?
Can be on different levels: how comfortable you
feel, and if you have experienced maltreatment,
how do you deal with an authority figure like your
boss at work OR how do you raise your own
children.
It might be hard to do it totally different
Can lead not only to problems at work or with
friendships, but also might lead to other
psychological problems
Often intertwined
Often, we see problems with self-image low self
esteem
Can result in different outcomes: someone can
become quite anxious or someone that always
puts themselves behind others and other one’s
need before their own.
This can also result in problems at work of
physical problems (stress related)
This can also result in people that really feel the
need to show themselves and/or pretend that
everything is at the best it is (think about the
narcissistic spectrum people that NEED to feel
seen)
We also see: re-victimization In two ways, this
means
, First: that people that have been
abused/neglected in their childhood are more
often being abused/neglected in their relationships
later in life something in what happened in your
childhood makes you more vulnerable later in life
Also intertwined with interpersonal problems If
you feel that you have to do everything for
someone else to keep them happy, because that
is what you needed to do for your parent, then
that is also what can result in neglect/abuse used
by other partner
OR (second) what we also might see people might
show abuse themselves towards others, or their
own children.
This latter part we call: Inter-generational
transmission
In about 30% of cases of childhood maltreated
people, we see they maltreat their own children
later in life.
o Can be that you suffered physical abuse but
show emotional neglect/abuse
(maltreatment) towards child. People might
say (or think) that their child is already
better of than they were.
o It is not one-on-one the same type of
maltreatment, but it can be a prevalence
By whom and why is it transmitted?
o Who is more at risk of preceding with that
behaviour later on?
o See also week 2 and 6 consequences that
might be risk factors AND the resilience
factors (see below)
One of the main subjects is that we think that
possible consequences of abuse/neglect can be a
risk factor for abusive/neglectful behaviour later
in life
o Think of aggression problems a child might
have adapted in their childhood years, as a
consequence of home-abuse. This can be a
risk factor for later child abuse later in life
(on own child)
o Another one might be depression. If you
have experienced mostly emotional
, maltreatment in your childhood, onset of
depression is high. This might then be a risk
factor for post-natal depression, which can
lead to emotional neglect later in life less
sensitive to child’s needs
We also know that some people (30%) are more at
risk of inter-generational transmission, but others
are not Resilience factors are therefore at
play. These resilience factors, we see, rest a lot in
the social scene Sociaal vangnet. Are there
other important factors/people in your life that
might help you confront, work on past childhood
trauma and overcome past childhood experiences.
Making you more resilient later in life
This also stresses the importance of timely
intervention and preventing abuse itself, but also
of its consequences
o Psychological consequences of childhood abuse and neglect:
DSM-V = classification system for psychological
disorders, based on standard criteria
Published by APA (first edition 1950)
Focus on objective description of symptoms (that
people have at that moment), with no theoretical
framework
This actually has a risk consequence Decreased focus
on aetiology (f.e. cause) of disorders
EXCEPT for one type of disorder: Trauma- and
Stressor-Related Disorders
Post-traumatic stress disorder
Accute stress disorder
To be able to be classified as having this disorder,
you have to have experienced past trauma or
severe stressors.
BUT: childhood maltreatment doesn’t only result in
these types of disorders (PTSD). Think about
Anxiety disorders, depression, etc.
IN EVERY OTHER DISORDER from the DSM-V, we
see a higher abundance of people that have
experienced childhood maltreatment (higher
chances)
To categorize (as in research papers about childhood
maltreatment):
- Get the book: “the boy who was raised as a dog” (Perry & Szalavitz)
- Definition and prevalence of child abuse and neglect:
o 1st chapter of the book about Tina’s world sexual abuse +
behavioral problems later in life
o 3 papers all are review papers. Might be topics in the
papers that are coming back in later lecture weeks (genetics,
biological topics, etc.)
Last one is about child (sexual) abuse is actually the sort
of abuse that happens least likely WITHIN families. The
rest of the topics of this course are about other abuse
and neglect subjects, which are the sort of topics that
happing within families. Is a difference to keep in mind
In most of the course we will not haven sexual abuse as
a topic, but it is important to keep the consequences in
mind as it is a form of abuse.
o In clinical settings (with adults/young adults) it is not always
the practice to ask directly about possible childhood
maltreatment. Luckily, nowadays it is happening more, but
sometimes it is noticed within underlying questions.
o To learn about underlying psychopathology and to create
better interventions/preventions.
o Numerous findings that that childhood abuse and neglect can
have pervasive consequences for mental and physical health
o Importance of safe childhood:
Work that has started a long time ago: Freud, Harlow
(apes research – warmth/comfort), Bowlby (attachment
, research), Ainsworth (strange situation test / hoe
hechten kinderen).
It is important to stress on the ‘may have significant
(and irreversible) consequences’ Consequences
definitely come from maltreatment, but we hope that
the ‘may’ stresses that it can be prevented of reversed
with good treatment (psychological).
o There are many definitions of childhood maltreatment, but
the one that is most used (by Gilbert and colleagues in 2009)
is:
‘Any act of commission (abuse/mishandeling) or
omission (neglect/verwaarlozing) 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.’
You can hit a child (direct) or you can threaten to hit a
child. Both cause psychological damage
Harm does not need to be intended not enough
money to buy good/warm clothes for child in wintertime
(physical neglect) OR substance addiction of parent (has
effect on child’s life), ETC.
Ommission:
Failure to meet a child’s needs physical
neglect (not dressed or fed properly), emotional
neglect (not receiving love, attention, sensitive
care, f.e. = not being present at children’s
milestones, etc), Denial of access to education
Commission:
Actively doing something harmful Physical
abuse (hitting, etc, emotional abuse (calling
names, making child feel unworthy), sexual
abuse, shaken baby syndrome (in younger
years of baby being born)
- Types of maltreatment written out:
o Emotional neglect = failure to meet a child’s emotional
need and failure to protect a child from violence in the home
or neighborhood
o Physical neglect = failure to meet a child’s basic physical,
medical/dental, or educational needs; failure to provide
adequate hygiene, nutrition 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 other 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 conflict, sexual contact OR non-contact sexual
interaction with a child.
o Most studies take them all together and ask if someone has
experienced one or more of these categories. Some other
papers specifically look at consequences of each category
alone.
- Prevalence of childhood maltreatment: IT IS REALLY HIGH
(worldwide)
o Worldwide children report that they suffered some form of
violence in the past year.
o 23% = physical abuse
o 36% = emotional abuse
o 16% = physical neglect
o 18% GIRLS and 8% BOYS = sexual abuse
- In the Netherlands:
o Dutch National Prevelance Study: ‘Abuse of children and
adolescents’ (2017):
Professionals researched: 3% of children 0-18yrs
(abuse)
This is low, BUT: it is what has been assessed by
professionals. That is: cases that are actually known
Might be a really big underestimation of actual
prevalence
o Students on Maltreatment (SOM Studie 2017):
Self-report study among 1.908 children (age: 12-16yrs)
25% report one of more categories of abuse
Almost 10 times as high
Self-reports are always the highest forms of
outcomes when it comes to these types of
subjects
Maybe overestimate? But still, it is shocking
Emotional and physical abuse most frequent in this
report
o High comorbidity of types of abuse and neglect very clear
If a child is being hit by a parent, it is also often met with
parents swearing or other emotional abuse, and/or met
with neglection of child’s needs
, Important to figure out was it the physical abuse that
made the most consequences on the child, or was it the
comorbidity of emotional abuse or neglect?
Often: the emotional consequences have the most effect
o This is the framework that we will work from: happens to
often, happens most within families, etc.
- Psychological and social consequences of childhood maltreatment
o In this course we will talk about many different consequences:
Mental health outcomes (emotional (depression, etc.),
social (interactions), cognitive, behavioural)
Physical health outcomes (stress system, brain, disease,
genes)
o Psycho-social consequences:
Interpersonal problems how do you act amongst your
peers, specifically toward authority figures or towards
children?
Can be on different levels: how comfortable you
feel, and if you have experienced maltreatment,
how do you deal with an authority figure like your
boss at work OR how do you raise your own
children.
It might be hard to do it totally different
Can lead not only to problems at work or with
friendships, but also might lead to other
psychological problems
Often intertwined
Often, we see problems with self-image low self
esteem
Can result in different outcomes: someone can
become quite anxious or someone that always
puts themselves behind others and other one’s
need before their own.
This can also result in problems at work of
physical problems (stress related)
This can also result in people that really feel the
need to show themselves and/or pretend that
everything is at the best it is (think about the
narcissistic spectrum people that NEED to feel
seen)
We also see: re-victimization In two ways, this
means
, First: that people that have been
abused/neglected in their childhood are more
often being abused/neglected in their relationships
later in life something in what happened in your
childhood makes you more vulnerable later in life
Also intertwined with interpersonal problems If
you feel that you have to do everything for
someone else to keep them happy, because that
is what you needed to do for your parent, then
that is also what can result in neglect/abuse used
by other partner
OR (second) what we also might see people might
show abuse themselves towards others, or their
own children.
This latter part we call: Inter-generational
transmission
In about 30% of cases of childhood maltreated
people, we see they maltreat their own children
later in life.
o Can be that you suffered physical abuse but
show emotional neglect/abuse
(maltreatment) towards child. People might
say (or think) that their child is already
better of than they were.
o It is not one-on-one the same type of
maltreatment, but it can be a prevalence
By whom and why is it transmitted?
o Who is more at risk of preceding with that
behaviour later on?
o See also week 2 and 6 consequences that
might be risk factors AND the resilience
factors (see below)
One of the main subjects is that we think that
possible consequences of abuse/neglect can be a
risk factor for abusive/neglectful behaviour later
in life
o Think of aggression problems a child might
have adapted in their childhood years, as a
consequence of home-abuse. This can be a
risk factor for later child abuse later in life
(on own child)
o Another one might be depression. If you
have experienced mostly emotional
, maltreatment in your childhood, onset of
depression is high. This might then be a risk
factor for post-natal depression, which can
lead to emotional neglect later in life less
sensitive to child’s needs
We also know that some people (30%) are more at
risk of inter-generational transmission, but others
are not Resilience factors are therefore at
play. These resilience factors, we see, rest a lot in
the social scene Sociaal vangnet. Are there
other important factors/people in your life that
might help you confront, work on past childhood
trauma and overcome past childhood experiences.
Making you more resilient later in life
This also stresses the importance of timely
intervention and preventing abuse itself, but also
of its consequences
o Psychological consequences of childhood abuse and neglect:
DSM-V = classification system for psychological
disorders, based on standard criteria
Published by APA (first edition 1950)
Focus on objective description of symptoms (that
people have at that moment), with no theoretical
framework
This actually has a risk consequence Decreased focus
on aetiology (f.e. cause) of disorders
EXCEPT for one type of disorder: Trauma- and
Stressor-Related Disorders
Post-traumatic stress disorder
Accute stress disorder
To be able to be classified as having this disorder,
you have to have experienced past trauma or
severe stressors.
BUT: childhood maltreatment doesn’t only result in
these types of disorders (PTSD). Think about
Anxiety disorders, depression, etc.
IN EVERY OTHER DISORDER from the DSM-V, we
see a higher abundance of people that have
experienced childhood maltreatment (higher
chances)
To categorize (as in research papers about childhood
maltreatment):
