Psychological Maltreatment

PEDIATRICS (Impact Factor: 5.47). 07/2012; 130(2):372-8. DOI: 10.1542/peds.2012-1552
Source: PubMed


Psychological or emotional maltreatment of children may be the most challenging and prevalent form of child abuse and neglect. Caregiver behaviors include acts of omission (ignoring need for social interactions) or commission (spurning, terrorizing); may be verbal or nonverbal, active or passive, and with or without intent to harm; and negatively affect the child's cognitive, social, emotional, and/or physical development. Psychological maltreatment has been linked with disorders of attachment, developmental and educational problems, socialization problems, disruptive behavior, and later psychopathology. Although no evidence-based interventions that can prevent psychological maltreatment have been identified to date, it is possible that interventions shown to be effective in reducing overall types of child maltreatment, such as the Nurse Family Partnership, may have a role to play. Furthermore, prevention before occurrence will require both the use of universal interventions aimed at promoting the type of parenting that is now recognized to be necessary for optimal child development, alongside the use of targeted interventions directed at improving parental sensitivity to a child's cues during infancy and later parent-child interactions. Intervention should, first and foremost, focus on a thorough assessment and ensuring the child's safety. Potentially effective treatments include cognitive behavioral parenting programs and other psychotherapeutic interventions. The high prevalence of psychological abuse in advanced Western societies, along with the serious consequences, point to the importance of effective management. Pediatricians should be alert to the occurrence of psychological maltreatment and identify ways to support families who have risk indicators for, or evidence of, this problem.

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    • "Finally, it seems plausible that emotion regulation problems and attachment difficulties, which are also considered to be central features of borderline personality disorder, mediate the association of maltreatment and AD. These deficits are not only considered to be consequences of child maltreatment (Hibbard et al., 2012; Sroufe, 1997), but are also associated with typical drinking motives such as situations with unpleasant emotions or conflicts with others (cf. Inventory of Drinking Situations [IDS; Annis, Graham, & Davis, 1987]). "
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    ABSTRACT: Studies reporting a link between child maltreatment and addiction have typically focused on physical and sexual abuse. In contrast, emotional maltreatment has rarely been studied in substance-abusing samples although it is associated with a wide range of dysfunction. The current study aimed to determine the specific impact of different types of maltreatment and peer victimization on alcohol dependence and to examine the potentially mediating role of psychopathology. A sample of treatment seeking adults with alcohol dependence (N = 72) underwent an extensive clinical examination including both a standardized interview and self-report measures. Child maltreatment, peer victimization, severity of alcohol dependence, and general psychopathology were assessed. Regression analyses revealed that emotional maltreatment was the strongest predictor of alcohol dependence severity whereas a unique contribution of peer victimization was not found. Our findings suggest that emotional maltreatment might have a major role in the etiology of AD that seems to exceed the contribution of other abuse and victimization experiences. Thereby, the study underscores the need for considering child maltreatment experiences in the prevention and treatment of AD.
    Full-text · Article · May 2014 · Addictive behaviors
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    • "Psychological maltreatment poses many challenges for researchers and professionals. Among them are the diffi culties to defi ne, identify, and assess its severity, or to establish the threshold for Child Protection Services (CPS) intervention (Baker, 2009; Brassard & Donovan, 2006; Glaser, Prior, Auty, & Tilki, 2012; Hart et al., 2011). Literature about evidence-based preventive or treatment interventions is also scarce (Barlow & Schrader- MacMillan, 2009; Hart et al., 2011), particularly when compared to other forms of maltreatment (e.g., Guastaferro, Lutzker, Graham, Shanley, & Whitaker, 2012; Olds, 2012; Urquiza & Timmer, 2012). "
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    ABSTRACT: Background: Psychological maltreatment (PM) is probably the most difficult child maltreatment form to detect and evaluate. The objective of this research was to determine the effect of an instrument developed to improve accuracy in the assessment of PM severity in Child Protection Services (CPS). Method: Case vignettes representing different severity levels of PM situations were used. 146 CPS psychologists participated in the study. A first group was made up of 115 psychologists who had been trained in the use of the instrument for 4 hours. The second group was made up of 31 psychologists who had been using the instrument for more than 12 months at the time of the study. Psychologists from the first group rated the severity of the vignettes in two ways: applying their own daily work criteria and applying the instrument after the training. Results: Accurate ratings clearly improved when psychologists used the instrument criteria. However, only psychologists who had used the instrument for more than 12 months at the time of the study obtained more than 80% of accurate ratings. Conclusions: Results support the importance for CPS psychologists to use psychological maltreatment severity assessment instruments and show the conditions under which they could be effective.
    Full-text · Article · Nov 2013 · Psicothema
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    ABSTRACT: Case: Mrs. Forrest brought Jackie, her 11-year-old adopted daughter, to her pediatrician with a range of concerns, including problems with attention, school performance, anxiety, and frequent oppositional behaviors. Jackie was removed from school because of her mother's concern that the "school was not doing enough" to help Jackie. School reports were not available at this visit. Her mother reported going to great lengths to seek help for Jackie, including individual and family therapy, a psychological evaluation, academic tutoring, and a variety of home-school curricula. She planned to enroll Jackie in a residential treatment program. Little is known about Jackie's early childhood experience. She may have been exposed to alcohol and drugs during the pregnancy. Jackie lived with her biological mother until age 3 years, at which time she was placed in foster care because of allegations of abuse and neglect. She was in multiple foster homes until she was adopted by Mr. and Mrs. Forrest at 6 years of age. Mrs. Forrest's description of Jackie's oppositional behaviors was vague, and when asked to cite specific examples of these behaviors, Mrs. Forrest replied, "Unless you live with her you will have no idea how she really is." With Jackie present in the room, Mrs. Forrest stated that Jackie "is wrecking our family," and that she and Jackie "have never been attached to each another."When interviewed alone, Jackie was noticeably upset by what her mother had said; she displayed a sad affect. She expressed remorse for "being bad" and a desire "to get along with my family" and "to go back to school." She drew a picture of herself and her adoptive mother smiling and eating ice cream together.Over the next several months, Jackie's mother insisted that the pediatrician prescribe medication to manage Jackie's behaviors; she became upset when he expressed reluctance. She was resistant to a recommendation for family therapy, although she did place Jackie in individual therapy. At this point, Jackie's pediatrician became aware of his feelings of anger and resentment directed toward Mrs. Forrest.
    No preview · Article · Jan 2013 · Journal of developmental and behavioral pediatrics: JDBP
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