Emotional abuse and neglect (psychological maltreatment): a conceptual framework
Introduction
This article explores the place of emotional abuse or psychological maltreatment within the overall context of child abuse and neglect. It revisits definitional issues and briefly considers professional intervention. The focus in this article is on the relationship between the primary caregiver(s) and the child. It needs to be acknowledged that this relationship is invariably nested within the family which is, in turn, significantly influenced by the social environment in which the family is located, and influenced by family members’ own histories.
In considering child abuse and neglect in general, and psychological maltreatment in particular, a central premise is that responsibility for ensuring that the relationship between the parent and the child is nonabusive or neglectful lies with the parent. Children can be temperamentally difficult, provocative or, in some cases, have physical or psychological conditions that cause serious stress for the parent and challenge their ability to cope. However, if the parents are unable to cope, responsible action is to seek help. If the parents, for whatever reason, are unable to seek help, the responsibility lies with others to intervene on behalf of both the child and the parent.
It is now increasingly accepted that emotional abuse and neglect cause significant harm to the child’s development and that this harm extends into adult life (Hart, Binggeli, & Brassard, 1998). Evidence for this has come from a number of follow-up and longitudinal studies which consistently show that emotional abuse and neglect in childhood are associated significantly with a wide range of emotional, behavioral, and cognitive difficulties in later childhood (Erickson, Egeland, & Pianta, 1989), adolescence Herrenkohl et al 1991, Skuse et al 1998, and adulthood Briere and Runtz 1990, Mullen et al 1996. However, in these studies, emotional abuse has either been inferred from descriptions of parent-child interactions, or different operational definitions of the actual term have been used in the various studies.
O’Hagan (1995) has suggested that emotional and psychological abuse are usefully distinguished from each other. Psychological abuse is defined as impeding the mental (especially cognitive) and moral faculties. This distinction is not considered to be useful since cognition and emotion are not independent of each other, cognitive appraisal of experiences contributing to the affective experience and vice versa.
Section snippets
The place of psychological maltreatment in the overall context of child abuse & neglect
Not infrequently, different forms of child abuse and neglect coexist Briere and Runtz 1988, Ney et al 1994. In one study, psychological maltreatment, measured separately, was found in a majority (90%) of children who had also been physically abused and neglected (Claussen & Crittenden, 1991). Moreover, they found that the psychological maltreatment was more strongly predictive of subsequent impairments in the children’s development than the severity of physical abuse. Beyond the physical injury
Epidemiology
It is invariably stated in publications on the subject that emotional abuse or psychological maltreatment are difficult to define and, therefore, to recognize reliably. In the US, states differ in the inclusion or not of emotional abuse under their civil, criminal, and vicarious liability statutes, and there is considerable variation between different states in their rates of evaluation and reporting of emotional abuse (Hamarman, Pope, & Czaja, 2001). US national statistics indicate a rate of
Ill treatment by the parents or impairment of the child’s health and development?
There has been considerable debate about whether the definition of emotional abuse and neglect should refer to the maltreating behavior or to the consequences for the child, and whether evidence of both is required for its recognition. The cumulative conclusion in an issue of the journal Development and Psychopathology (1991), devoted to the discussion of emotional abuse and neglect, was that, for definitional purposes, evidence of the ill treatment rather than harm to the child should be
Effects on the child
The cumulative list of difficulties found in children subjected to emotional abuse and neglect reads like the index of a child psychiatric textbook. In a study of 94 children from 56 families whose names had been placed on the Child Protection Register under the category of Emotional Abuse, we found the following difficulties with which the children presented (Glaser, Prior, & Lynch, 2001). They are listed in Table 4 (missing data on 5 children). It is clear from the table that the children
Conclusions
Emotional abuse and neglect will continue to pose a challenge to professionals concerned with ensuring the well-being of children. When finding oneself involved in a case of psychological maltreatment, it is helpful to ask at what stage of the process one is:
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Is there suspicion of abuse which requires verification?
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Is this an assessment of the extent of harm to the child?
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Is this a time-limited trial for change?
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Is one in the process of preparing a case for moving the child to an alternative,
Acknowledgements
The author wishes to thank Vivien Prior who has over many years collaborated closely in the research and theoretical development of the framework; and to members of the Parent Interaction with the Child clinical team (PICT) who have contributed to the application and further development of the categories: Margaret Adcock, Hilary Davies, Dr. Jill Hodges, Marta Neal, and Libby Read.
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