Psychological maltreatment can be as harmful to kids as physical abuse: report

A piece by Sheryl Ubelacker, for The Canadian Press which went in to newspapers across the country over the last 24hrs: The Vancouver Sun to The Montreal Gazette. It’s in the Globe and Mail today [under a different title].

The article is about a new report and position paper by the American Academy of Pediatricians; recognising that psychological harm in early years can be more difficult to spot, do more harm  and take much longer to heal than any physical harm.

Of course, we know that the harm caused appears – sooner or later a- s emotional, behavioural and relational difficulties that  often get labelled “mental illness”.



.Chemical imbalance my ass, indeed.


By Sheryl Ubelacker, THE CANADIAN PRESSJuly  30, 2012

Psychological maltreatment can be as harmful to kids as physical abuse:  report

Children who are persistently belittled, humiliated or  made to feel unworthy are considered to be experiencing psychological  maltreatment, which can take the form of abuse or neglect, according to the  latest position from a leading pediatric body.

TORONTO — There may be no visible bruises or broken bones, but that doesn’t  mean a child isn’t suffering abuse. This kind of abuse is psychological — and a  new report says it can be just as harmful to a youngster’s mental, physical and  emotional health as a slap, punch or boot to the body.

Children who are persistently belittled, humiliated or made to feel unworthy  are considered to be experiencing psychological maltreatment, which can take the form  of abuse or neglect, according to the latest position from a leading pediatric  body.

“For the most part we are talking about chronic, repetitive types of parental  behaviour,” said Dr. Harriet MacMillan, a pediatrician and psychiatrist at  McMaster University in Hamilton, Ont.

“Any caregiver can commit acts of psychological abuse or, through what we  call acts of omission, psychological neglect.”

MacMillan is a co-author of an American Academy of Pediatrics (AAP) updated  position statement on psychological maltreatment of children published Monday in  the journal Pediatrics.

“An example of psychological abuse would be a parent repeatedly saying to  their child that they don’t love the child, that they wish they’d never been  born, that they wish they’d never been a parent … such that the child has a  high likelihood of feeling unloved and unwanted,” MacMillan said in an  interview.

Children who are repeatedly left alone to fend for themselves, particularly at a young age, are also being mistreated, she said, citing the example of a parent “who just leaves an eight-month-old in a crib all day. Basically the child would be fed and occasionally changed, but otherwise is just left in a crib.

“That’s psychological neglect. It’s also physical neglect and this is where  the definitions overlap as well.”

The report is intended as a reminder to doctors to be on the look-out for  this kind of maltreatment, which it suggests is under-recognized and  under-reported.

There are no definitive statistics available on the proportion of kids  subjected to ongoing emotional denigration. But some large population-based  studies in the U.K. and U.S. found almost nine per cent of women and four per  cent of men reported being exposed to severe psychological abuse during  childhood.

MacMillan emphasizes that parents or caregivers who on occasion exchange  sharp words with a child related to discipline are not engaging in abuse.

“Even repeated yelling like ‘Get your shoes on’ or ‘C’mon we’re going to be  late’ — that’s not what we’re talking about in terms of psychological abuse,” she said. “Many parents really try to be very thoughtful and respectful in their  interactions with their children, but certainly these types of things do  happen.”

MacMillan said emotional maltreatment is more likely to occur when there are  multiple family stressors, including adult mental health problems, substance  abuse or intimate partner violence.

It can be an isolated practice or part of a larger pattern of physical and/or  sexual abuse. But for some children, the scars left by attacks on their psyches  can run as deep as those perpetrated on their bodies.

“I remember one little boy I was interviewing,” said MacMillan. “He was  referred and the (child-protection) agency was focusing on the physical abuse he  experienced. But he said to me, ‘You know, I didn’t like the hitting I was  getting, but what my dad said about me made me feel way worse.”‘

Exposure to repeated disparagement from a parent or caregiver can interfere  with a child’s emotional and physical development, Dr. Marcella Donaruma, a  member of the Child Abuse Pediatric (CAP) team at Texas Children’s Hospital in  Houston, said in an email interview.

“Early psychological abuse is associated with significant later-life  difficulties, such as social withdrawal, angry non-compliant behaviour and lower  academic achievement,” said Donaruma, lauding the AAP for its position  paper.

“It is also an adverse child experience that can contribute not only to  social and psychological problems in adulthood, but also to poor physical  health, such as increased risk for heart disease, increased risk for certain  types of cancers, increased risk of substance abuse, and an overall diminished  life span compared to those who have not suffered adverse experiences in  childhood.”

John Bickel, a clinical social worker and community outreach co-ordinator  with CAP, said signs of psychological maltreatment can vary significantly from  one child to another and even with the same child over time.

Some indicators might include:

— Dramatic changes in mood and the ability to relate to others: for  instance, “the docile and quiet child, who becomes defensive, angry and lashes  out at other children due to internal feelings of (poor) self-worth or  self-image.”

— Injurious behaviours, including delinquency, disordered eating or  cutting.

“In particular, the first three years are crucial,” Bickel said by email. “For example, an infant that does not get nurturing and adequate quantity and  quality social interaction may not bond with caregivers … The result is an  inability to form meaningful and healthy social relationships into the  future.

“The effects of this are difficult or impossible to completely erase. Bruises  will usually heal, psychological scars might not.”

MacMillan said pediatricians and other clinicians working with children need  to be sensitive to the signs of psychological abuse and should take the time to  speak to a young patient alone if they suspect emotional maltreatment.

“We need to interview the child and hear from the child what their life is  like, what are their relationships with their caregivers are like,” she said

“We need to really be alert to what children are experiencing. And  professionals need to make it clear to parents that they’re available to help  discuss parent-child interactions and what is helpful for  kids.”

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1 Response to Psychological maltreatment can be as harmful to kids as physical abuse: report

  1. MSkillz says:

    I am not surprised to read this…Psychological/emotional/verbal mistreatment can really eat away at you. Especially tough for little kids who don’t understand it, and tend to internalize such negative messages because they cannot react to them 😦
    Be nice to the kids, I say! 😉


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