Child abuse: types, causes, consequences and prevention

The child abuse It is a universal problem that has existed since ancient times, however, it is in the twentieth century with the declaration of the rights of the child (U.N.U. 1959) when it is considered as a crime and a problem with profound psychological, social, ethical, legal and medical. The North American research places the beginning of global awareness when Researchers such as Kempe, Silverman, Steele, and others, in 1962 labeled the so-called syndrome of abused child. In Psychology-Online, we explain all the information about child abuse: types, causes, consequences and prevention.

Index

1. What is child abuse and the different types
2. The causes of child abuse
3. Consequences of child abuse
4. Prevention of child abuse and performance of the pediatrician
5. Report child abuse

If you want to know what child abuse is, you should bear in mind that there is no single definition, nor a clear and precise delimitation of their expressions. However, the most accepted definition is all those actions that go against an adequate physical, cognitive and emotional development of the child, committed by people, institutions or one's own society.

This supposes the existence of a physical abuse, neglect, psychological abuse, or sexual abuse, as well as the so-called Münchausen syndrome by proxy (NCCAN, 1988). This definition is in accordance with the one in the DSM-IV psychiatric manual.

The types of child abuse that we can distinguish are the following:

Physical abuse

This type of abuse includes a series of acts perpetrated using physical force in an inappropriate and excessive way. That is, it is that set of non-accidental actions caused by adults (parents, guardians, teachers, etc.) that cause physical harm to the child or overt disease. This includes bumps, scratches, fractures, punctures, burns, bites, violent shaking, etc.

Child neglect or neglect

Negligence is a lack of parental responsibility that results in a omission to those needs of children for their survival and that are not temporarily or permanently satisfied by parents, caregivers or guardians. It includes poor vigilance, neglect, food deprivation, failure to comply with medical treatment, impediment to education, etc.

Emotional abuse

It is that set of chronic, persistent and very destructive manifestations that threaten the normal psychological development of the child. These behaviors include insults, contempt, rejection, indifference, confinement, threats, in short, all kinds of verbal hostility towards the child. This type of child abuse causes that in the early years of the child, this can not properly develop attachment and, in later years, he feels excluded from the family and social environment, affecting his self-esteem and his social skills.

Sexual abuse

It is one of the types of abuse that implies greater difficulties when studying. It consists of those sexual relations that a boy or a girl (under 18 years of age) has with an adult or with an older child, for which he is not prepared evolutionarily and in which a relationship of submission, power and authority over the victim.

The most common forms of sexual abuse are: incest, rape, harassment and sexual exploitation. It also includes indecent solicitation without explicit physical contact or verbal seduction, performing sexual intercourse or masturbation in the presence of a child and exposing sexual organs To a child. The abuser is usually a man (father, stepfather, another relative, romantic partner of the mother or other male known to the family), it is rarely the mother, caregiver or other female known to the boy.

Münchausen syndrome by proxy

Another type of violence against children is the Münchausen Syndrome by Proxy, which consists of invent a disease in the child or produce it by the administration of non-prescribed drugs and substances. Generally, this is a child of infant-preschool age (mean age 3 years). Signs and symptoms appear only in the presence of the mother (usually the perpetrator of the abuse) are inexplicable and complementary tests do not clarify the diagnosis.

This syndrome has a mortality between 10-20 and its long-term impact can lead to psychological, emotional and behavioral disorders.

Prenatal abuse

In addition, prenatal abuse must be included, defined as those circumstances of the mother's life, provided there is willfulness or negligence, which they negatively and pathologically influence pregnancy, childbirth and affect the fetus. Such as: rejection of pregnancy, lack of medical control and monitoring of pregnancy, personal negligence in the diet and hygiene, excessive or non-prescribed medications, consumption of alcohol, drugs and tobacco, exposure to radiation and others.

Institutional child abuse

In recent times, there is talk of institutional abuse, which consists of any legislation, program or procedure, either by action or omission, coming from public or private powers, by professionals under the protection of the institution, who violate the basic rights of the minor, with or without direct contact with the child.

Each of these types of child abuse present physical and behavioral indicators in the minor abused, as well as behavioral indicators and attitudes of the abuser, which helps in their diagnosis.

Scholars of the subject of child abuse They have tried to explain its appearance and maintenance using various models, thus we have:

1. The sociological model, which considers that physical abandonment is a consequence of situations of economic deprivation or situations of social isolation (Wolock and Horowitz, 1984).
2. The cognitive model, which understands it as a situation of vulnerability that occurs as a result of cognitive distortions, Inadequate expectations and perceptions of parents / caregivers in relation to the minors in their care (Larrance, 1983).
3. The psychiatric model, which considers that child abuse is a consequence of the existence of psychopathology in the parents (Polansky, 1985).
4. The information processing model, which raises the existence of a peculiar style of prosecution in families with minors in situations of physical abandonment or child neglect (Crittender, 1993).
5. The stress coping model, which refers to the way of evaluating and perceiving stressful situations and / or events by these families (Hilson and Kuiper, 1994).

Comprehensive model of child abuse

At present, the etiopathogenic model that best explains child abuse is the comprehensive model of child abuse. This model considers the existence of different ecological levels that are embedded within each other interacting in a temporal dimension. There are compensatory factors in this model that would act according to a coping model, preventing stressors that occur in families from triggering an aggressive response towards its members.

The progressive decrease in compensatory factors could explain the spiral of domestic violence that occurs in the phenomenon of child abuse. Compensatory factors include: marital harmony, family planning, personal satisfaction, few stressful life events, family therapeutic interventions, maternal / paternal attachment to the child, social support, good financial condition, access to health programs suitable, etc. Stressors include: family history of abuse, family disharmony, low self-esteem, physical and mental disorders in parents, drug dependence, unwanted children, non-biological father, non-protective mother, absence of prenatal care, unemployment, low social and economic level, promiscuity, etc.

Regardless of the physical sequelae that directly triggers the aggression produced by physical or sexual abuse, all types of child abuse give rise to behavioral, emotional and social disorders. The importance, severity and chronicity of these sequelae depend on:

• Intensity and frequency of abuse.
• Characteristics of the child (age, sex, susceptibility, temperament, social skills, etc.).
• The use or not of physical violence.
• Relationship between the kid and the aggressor.
• Intra-family support for the child victim.
• Access and competence of medical, psychological and social assistance services.

In the early stages of developmental development, negative repercussions are observed on attachment relational capacities and on the self-esteem of the child, as well as nightmares and sleep problems, changes in eating habits, loss of toilet training, psychomotor deficiencies and psychosomatic disorders.

In schoolchildren and adolescents we find: running away from home, self-injurious behaviors, hyperactivity or isolation, poor academic performance, intellectual deficiencies, school failure, dissociative identity disorder, juvenile delinquency, drug and alcohol use, fear widespread, depression, rejection of one's own body, guilt and shame, aggressiveness, interpersonal relationship problems.

In the following article, we explain in more detail the sequelae of child abuse in adults .

Various studies indicate that abuse continues from one generation to the next so that an abused child has a high risk of being a perpetrator of abuse in adulthood.

Pediatricians, being the health professionals who are in greater contact with children, are called to carry out prevention when there are cases of child violence, in addition to establishing diagnoses and together with a multidisciplinary team collaborating in their treatment.

Pediatricians are in a favorable position to detect children at risk (especially in children under 5 years of age, the population most vulnerable), from this age on, teachers begin to play a leading role in the prevention and diagnosis of abuse in kids.

The child abuse prevention is established on three levels:

1. Primary prevention

Aimed at the general population with the aim of avoiding the presence of stressor or risk factors and enhancing the protective factors of child abuse. Are included:

• Awareness and training of professionals in childcare
• Intervene in obstetric psychoprophylaxis (preparation for childbirth).
• Intervene in schools for parents, promoting values ​​of esteem towards childhood, women and fatherhood.
• Prevent unwanted pregnancy, mainly in young women, through sex education in schools and care centers.
• Systematic search for risk factors in well-child consultations, as well as evaluating the quality of the bond affective parents-children, child care, parents' attitude in the application of the authority-affection binomial.
• Intervene in consultations and expose the rights of children and the inconvenience of physical punishment. Offer the alternative of the application of behavioral punishment.
• Identify the values ​​and strengths of parents, reinforcing their self-esteem.

2. Secondary prevention

Aimed at the population at risk with the aim of making an early diagnosis of child violence and immediate treatment. Mitigate the risk factors present and enhance the protective factors. Are included:

• Recognize situations of child abuse, establishing treatment strategies.
• Recognize situations of child, domestic violence or abuse of women and seek solutions.
• Recognize parental behaviors of physical or emotional abuse, considering the referral of the family to specialized help in managing anger and frustration.
• Refer parents with drug and alcohol addictions to mental health centers.

3. Tertiary prevention

It consists of the rehabilitation of child abuse, both for child victims and for abusers. For this, an interdisciplinary team must be available (pediatricians, psychiatrists, psychologists, social workers, family counselors, therapists, juvenile judges, police forces, etc.).

In the case of suspecting that a child is being a victim of child violence, our obligation is to act in such a situation and transfer this information to the agencies in charge of child protection.

To report a situation of child abuse, you must go to basic social services or care primary, specialized services competent in the protection of minors or body and security forces of condition.

This article is merely informative, in Psychology-Online we do not have the power to make a diagnosis or recommend a treatment. We invite you to go to a psychologist to treat your particular case.

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