Causes of Child Abuse
There are four common types of child abuse: physical abuse, sexual abuse, neglect, and emotional abuse.
Children who have been physically abused present with a multitude of psychiatric disturbances: anxiety, aggressive behavior, paranoid ideation, and post-traumatic stress disorder, depressive disorders, suicidal risks are increased, poor self-esteem, depression, dissociative disorders, substance abuse, and violent behavior/outbursts.
High risk parents/care givers:
- Over 90% of abusive parents do not have a psychotic or criminal personality.
- The single parent is the sole reasonable care giver of the child, and they usually have little or no family or friends to assist them.
- They are lonely, did not plan the pregnancy, have little or no knowledge of child care and child development, and have unrealistic beliefs of child behavior.
- Substance abuse is a common finding in families of abused children.
Groups living in poverty.
- Increased number of crises in their lives.
- They have limited access to economic or social resources for support during times of stress.
- Increased violence in the communities where they live.
- Association with poverty and teenage mothers, substance abusers.
- Other high-risk parents are those where spousal abuse occurs in the home. A parent with limited education or mentally handicapped parents who perceive what is normal child behavior as misbehaving and punish the child severely.
- Mentally retarded children.
- Premature infants.
- Infants with chronic medical problems.
- Colicky babies.
- Children with behavioral problems.
Ten to forty percent of abusive parents have experienced physical abuse as children.
Neglect accounts for more deaths than physical abuse, such as medical needs neglect which occurs when the parents’ belief system runs against the medical needs of the child. Neglect to provide adequate nutrition, clothing, heat, basic shelter, and protection from environmental hazards are other forms of neglect leading to failure to thrive or the direct cause of injury to a child.
Emotional abuse includes intentional verbal or behavioral acts that result in adverse emotional consequences, emotional neglect occurs when a caretaker intentionally does not provide nurturing verbal and behavioral actions that are needed for healthy development. Emotional abuse can include: rejection, scapegoating, isolation, criticism, and terrorizing a child.
Sexual abuse is defined as involving any minor child that is intended for the sexual gratification of an adult. In studies of juvenile offenders, younger perpetrators tend to have younger victims, but are more likely to have intercourse with older victims. Sex acts by young children, between young children is a learned behavior and are associated with sexual abuse or expose to adult sex or pornography.
Sexual abuse most commonly occurs by an individual known by the victim, parent or other family member. Rarely is the abuser a stranger. Intrafamilial and incest sexual abuse is difficult to document and manage because the child must be protected from additional abuse and coercion to not reveal or deny the abuse, while attempts are made to preserve the family unit.
Clinical manifestation of sexual abuse:
- Vaginal, penile, or rectal pain, redness of area, or a discharge with or without bleeding.
- Chronic painful urination, constipation.
- Premature puberty in a female (nonspecific to abuse).
Behaviors associated with sexual abuse:
- Sexualized activity with peers, animals, or objects.
- Seductive behavior.
- Age-inappropriate sexual knowledge and curiosity.
Nonspecific behaviors to sexual abuse.
- While these behaviors are nonspecific to abuse, they do need further investigation for the needs of the child.
- Suicide gesture, fear of an individual or place, nightmares, sleep disorders, regression, aggression, withdrawn behavior, post traumatic stress disorder, poor self-esteem, depression, poor school performance (especially when previously good), running away, self-mutilation, anxiety, fire setting, multiple personalities, somtization, phobias, prostitution, drug abuse, eating disorders.
- Most of the increased numbers of child abuse is in the increase in the reporting of sexual abuse and the publicity surrounding sexual abuse. Rates increased between 1976 to 1984 from 1.4/10,000 to 17/10,000.
- Female abuse:
- 12-38% were sexually abused by age 18.
- 8% incidence of extra familial sexual abuse is actually reported.
- 2% incidence of intrafamilial sexual abuse is actually reported.
- Male abuse:
- 3-9% of males in the population were sexually abused by age 18.
- Males constitute 20% of the reports.
- Pedophiles show a predilection for boys. Theory suggests that the number of males who are sexually abused is higher.
- Boys may refrain from reporting the incident due to homophobic social stigma. Also, males are “expected” to be able to protect themselves from assault; thus, boys may feel guilty if they are victimized.
Sex, age of offenders, and who they are:
- 97% are male who are on the average 10 years older than their victims.
- Females are more often perpetrators in child-care settings, including babysitting.
- Abuse by females may be higher than reported due to young children confusing sexual abuse with normal hygiene care and adolescent males may not be trained to recognize sexual activity with an older female as a form of abuse.
- Sexual abuse by stepfathers is 5 times higher than among natural fathers, the most common age for onset of abuse is age 10.
- Abuse of daughters by fathers and stepfathers is the most common form of reported incest. Commonly the mother is unavailable to the father and is usually chronically ill or depressed. The mother is commonly the victim of child abuse when young.
- Incestuous fathers: rigid, patriarchal, emotionally immature, alcoholic or drug abuse common, and usually do not engage in extramarital affairs.
- Mothers in the home where father-daughter or son incest: chronically depressed, chronically ill, work takes them away on business trips overnight, and show little or no interest in their husbands sexually.
- Pedophiles: Pedophiles become sexually attracted to children in their adolescence. Pedophiles seek opportunities that place them in and around children.
- Common victim of a pedophile: mental and physical handicaps, unloved, unwanted, previously abused, children of single parent families, children of drug abusing parents, children with low self-esteem, and children who are poor achievers.