The consequences of maltreatment can be devastating. For over 30 years, clinicians have described the effects of child abuse and neglect on the physical, psychological, cognitive, and behavioral development of children. Physical consequences range from minor injuries to severe brain damage and even death. Psychological consequences range from chronic low self-esteem to severe dissociative states. The cognitive effects of abuse range from attentional problems and learning disorders to severe organic brain syndromes. Behaviorally, the consequences of abuse range from poor peer relations all the way to extraordinarily violent behaviors. Thus, the consequences of abuse and neglect affect the victims themselves and the society in which they live.
Many complexities challenge our understanding of factors and relationships that exacerbate or mitigate the consequences of abusive experiences. The majority of children who are abused do not show signs of extreme disturbance. Research has suggested a relationship between child maltreatment and a variety of short- and long-term consequences, but considerable uncertainty and debate remain about the effects of child victimization on children, adolescents, and adults. The relationship between the causes and consequences of child maltreatment is particularly problematic, since some factors (such as low intelligence in the child) may help stimulate abusive behavior by the parent or caretaker, but low intelligence can also be a consequence of abusive experiences in early childhood.
In particular, research on emotional maltreatment deserves to be expanded as a significant gateway in understanding its consequences and its role in stimulating other forms of child maltreatment. Emotional maltreatment studies deserve support because they could provide insight into the development of severe forms of behavior disorders and developmental delays in children.
Research is needed that assesses direct and subtle consequences across a broad range of domains (cognitive and intellectual, medical and physiological, psychosocial, behavioral, and psychiatric). The effects of different and multiple types of child maltreatment in a variety of cultural contexts should also be considered in future research programs. The common practice of treating abused and neglected children together, or eliminating one type of maltreatment from study, may reveal only a partial portrait of childhood victims' risk for later consequences. Existing research has focused on physical and sexual abuse, with relatively little attention to neglect or emotional maltreatment, yet the accumulation of stress associated with chronic neglect may produce consequences for young children similar to those produced through physical abuse. This would seem particularly important given that the number of reported cases of child neglect far surpasses those of physical abuse in national statistics.
Research on the consequences of child abuse and neglect can offer significant insights in the development of interventions. In particular, research on consequences can help improve our understanding of the nature, magnitude, and significance of abusive and neglectful experiences in childhood. Such experiences appear to result in tragic and costly outcomes for children, their families, and society as a whole. Knowing more about the nature of the consequences of child abuse and neglect will help justify preventive interventions. Such knowledge will also help improve treatment programs designed to expand the role of protective factors that may mitigate destructive consequences of maltreatment experiences.
Trickett, P.K., and F.W. Putnam
in press The impact of child sexual abuse on females: Toward a developmental, psychobiological integration.
Stein, J.A., J.M. Golding, J.M. Siegel, M.A. Burnam, and S.B. Sorenson
1988 Long-term psychological sequelae of child sexual abuse. The Los Angeles Epidemiologic Catchment Area Study. In G. Wyatt and G. Powell, eds., Newbury Park, CA: Sage.
Silver, L.B., C.C. Dublin, and R.S. Lourie
1969 Does violence breed violence? Contributions from a study of the child abuse syndrome. 126(September):404-407.
Robinson, D.H., and G.M. Stevens
1992 Child Abuse and Neglect Fatalities: Federal and State Issues and Responses. Congressional Research Service Report for The United States Congress. April 16.
1984 The Relationship Between Childhood Sexual Victimization and Adult Depression Among Afro-American and White Women. Unpublished doctoral dissertation, University of California, Los Angeles.
1988 Child sexual abuse and later psychological problems. In G.E. Wyatt and G.J. Powell, eds., . Newbury Park, CA: Sage Publications.
Morrow, K.B., and G.T. Sorell
1989 Factors affecting self-esteem, depression, and negative behaviors in sexually abused female adolescents. 51:677-786.
McLeer, S.V., E. Deblinger, M.S. Atkins, E.B. Foa, and D.L. Ralphe
1988 Post-traumatic stress disorder in sexually abused children: A prospective study. 27(5):650-654.
McCurdy, K., and D. Daro
1992 Current Trends in Child Abuse Reporting and Fatalities: The Results of the 1991 State Survey. August 31. Presented at the Ninth International Congress on Child Abuse and Neglect. Chicago, IL.
McClain, P.W., J.J. Sacks, R.G. Froehlke, and B.G. Ewigman
1993 Estimates of fatal child abuse and neglect, United States, 1979 through 1988. 91(2):338-343.
1990 Somatoform disorders in victims of incest and child abuse. Pp. 75-111 in Kluft, R.P., ed., . Washington, DC: American Psychiatric Press.