Thursday, May 20, 2010

Child abuse is not always obvious


            Not all child abuse is obvious.  Child abuse is not always disclosed to the public.  Child abuse does not necessarily include physical violence.  As in the recent case regarding the starvation of a 1 year old boy to death, abuse was by way of maladaptive behaviors on behalf of the caretakers, mistreatment, and extreme neglect.   http://www.wbaltv.com/news/        
            But not all abuse consists of serious crime or overt violent behavior.  Many cases of abuse occur by way of neglect, sexual maltreatment, psychological and physical harm, or combination.  Abuse is ongoing maltreatment to a child by a caretaker. 
            Child abuse, mild through fatal, can be defined as harm, injury, or death to a child’s physiological or psychological well being.  Neglect of a child’s basic needs, causing fear, exploitation, or guilt, could be a form of child abuse.  Abuse can be intentional, though it can also be considered unintentional.  Sexual abuse perpetrators might report that they believe the child enjoys the sexual contact at some point during the abuse.  Mentally ill perpetrators inflicting emotional distress might believe that they are disciplining or teaching a child appropriate behavior.  There have been cases when perpetrators believed they were performing the will of God.  Some perpetrators might report no recall or understanding that abuse was inflicted.  Common forms of child abuse are inflicted by a familiar person, such as, family or caretakers.  Abuse by stranger occurs in abduction, war crimes, sex slavery, or imprisonment. 
            Children can be traumatized as a result of direct abuse, but also by witnessing, being threatened, or experiencing disaster, accidents, or horrific crime.  These types of trauma can have a different than being harmed by a familiar or trusted person with an intention for maltreatment.  Maltreatment by a caretaker is more likely to result with permanently deformed development of attachments, self esteem, socialization, and other aspects of personality.
Types of abuse
            Neglect can result from basic needs not being met.  Children left to fend for themselves regarding food, safety, shelter, and support, could be considered neglected.  Children lacking stable nurturance, supervision, structure, discipline, or stimulation, can be considered neglected.
            Physical abuse could include spanking, smacking, hitting, burning, shaking, torture, starvation, drowning among other forms of corporal punishment or physical harm.    Sexual abuse can entail any number of familiar perpetrators involved in any array of sexual behaviors over any duration of time.  Sexual perpetrators coerce their victims by threatening consequences, ranging from causing harm or death to the victim, victim’s parents, caretakers, or pets.  Guilt can also be powerful leverage for perpetrators to persuade their victims.
            Emotional abuse can be difficult to identify when it occurs independently from others types of abuse.  Emotional abuse could be physical threats, belittlement, or vulgarity.  Emotional abuse usually coincides with other forms of maltreatment.
Psychological aftermath of child abuse
            During brain development neural pathways are created.  Every experience teaches children and contributes to brain development.  Predictable stress assists in learning however prolonged, unpredictable, or severe stress can alter brain development.
A child focusing on getting their basic needs met or survival instead of the normal childhood thoughts and behaviors can inhibit normal development.  Brain development of this type allows children to prepare for a world which is unpredictable and dangerous.  These children remain in a chronic state of alertness, overreact to triggers, and have other anxiety related symptoms and disorders.  Some disorders might include sleep disturbances, panic, separation issues, and hyperactivity.  These children may also be prone to aggressive behavior because of the fight response from real or perceived threats.   These children can also be easily misdiagnosed as a result of their brains being conditioned to monitor non verbal cues of perpetrators and are less skilled at interpreting verbal cues of non threatening communication.  Children who have locked their focus on how to endure abuse could have severe difficulty with organization of their psychological framework.
            The task of an abused child is to formulate a desired wholesome personality and healthy attachments in the midst of cruelty, unexplainable behaviors, confusing circumstances, and an unhealthy environment.
            Abused children are in constant combat between acceptance of feeling they are bad and having the determination and underlying hope that they are good.  They do not want to believe the perpetrators are bad so they must assume, the abuse is because they are bad.
            Whether or not a child’s needs are met can affect personality, intelligence, cognition, emotions, and ultimately how a child behaves.  Abused children often demonstrate an inability to manage their emotions and can have aggressive or explosive reactions to others.  Some children may respond by being withdrawn or not responsive to affection.  Social settings might present challenges because abused children may not interact appropriately due to emotionally immaturity.  Other issues could include learning disabilities, eating and sleeping disturbances.
Long term effects
            Abused children can have repercussions into adolescents and adulthood.  In adolescence, abused children can be promiscuous, develop eating disorders, have difficulty with intimacy, or sexuality.   Adolescence, just like childhood, is a time for continued development in the brain.  If teenagers were abused or continue to be abused this abuse distracts the psychological normal development.  Reason, logic, and abstract thinking are examples of cognition that are interrupted when abuse occurs.  Brain development and the skills that help adolescents think and make good decisions can be prolonged, delayed even further than normal, or prevented by abuse. 
            In adulthood, abuse victims continue to demonstrate maladaptive behaviors.  Basic trust, initiative, and autonomy are problematic for adult survivors.  These interpersonal conflicts among others keep adult survivors at risk for repeated victimization.  Self fulfilling prophecy seems sustained and they cannot imagine themselves other than being a victim.  Other long term effects include suicidality, depression, inability for conflict resolution, anxiety, fear of abandonment, exploitation, domination, or betrayal.  Gender differences indicate men to be more aggressive toward others while women tend to injure themselves.  Adult survivors of child abuse may struggle or may never be able to establish normal cognitive, social, emotional, and behavioral skills even with intensive interventions.
Prevention and education
            There are too many reported cases of child abuse. The number of reported child abuse is staggering.  If the number of unreported cases were included, it could be epidemic.  Awareness, health and parent education, and early intervention could help prevent child abuse and the aftermath.  Child abuse victimizes more than children. Report child abuse. http://www.dhr.state.md.us/cps/address.php  
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