He child abuse It is a universal problem that has existed since ancient times, however, it is in the 20th century with the declaration of the rights of the child (UN 1959) when it is considered a crime and a problem with profound psychological, social, ethical, legal and medical. North American research marks the beginning of global awareness when researchers such as Kempe, Silverman, Steele, and others, in 1962, labeled the so-called battered child syndrome. In Psychology-Online, we explain all the information about Child abuse: types, causes, consequences and prevention.
What is child abuse and the different types
If you want to know what child abuse is, you should keep in mind that there is no single definition, nor a clear and precise delimitation of its expressions. However, the most accepted definition is all those actions that go against the adequate physical, cognitive and emotional development of the child, committed by people, institutions or society itself.
This supposes the existence of a physical abuse, neglect, psychological abuse or sexual abuseas well as the so-called Munchausen syndrome by proxy (NCCAN, 1988). This definition is in accordance with that existing in the DSM-IV psychiatry manual.
The types of child abuse that we can distinguish are the following:
physical abuse
This type of abuse encompasses a series of acts perpetrated using physical force in an inappropriate and excessive manner. 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 manifest illness. These include bumps, scratches, fractures, punctures, burns, bites, violent shakes, etc.
Child neglect or abandonment
Neglect is a lack of parental responsibility that results in omission of the children’s needs for their survival and that are not satisfied temporarily or permanently by parents, caregivers or guardians. It includes poor surveillance, neglect, food deprivation, non-compliance 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 the child to be unable in the early years and, in later years, to feel excluded from the family and social environment, affecting their self-esteem and 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 girl (under 18 years of age) has with an adult or with an older child, for which he or she is not evolutionarily prepared and in which a sexual relationship is established. relationship of submission, power and authority over the victim.
The most common forms of sexual abuse are: incest, rape, humiliation and sexual exploitation. It also includes indecent solicitation without physical contact or explicit verbal seduction, performing a sexual act 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, the mother’s romantic partner or another male known to the family), rarely the mother, caregiver or other woman known to the child.
Münchausen syndrome by proxy
Another type of childhood violence is Münchausen Syndrome by proxy, which consists of invent a disease in the child or produce it through the administration of non-prescribed substances and medications. Generally, this is a child of infant-preschool age (average age 3 years). The signs and symptoms appear only in the presence of the mother (usually the perpetrator of the abuse). They are of unexplained cause and complementary tests do not clarify the diagnosis.
This syndrome has a mortality rate 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, whenever there is voluntariness or negligence, which they negatively and pathologically influence pregnancy, childbirth and impact the fetus. Such as: rejection of pregnancy, lack of medical control and monitoring of pregnancy, personal negligence in nutrition 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, whether by action or omission, coming from public or private powers, by professionals under the protection of the institution, which violates the basic rights of the minorwith or without direct contact with the child.
Each of these types of child abuse present physical and behavioral indicators in the abused minor, as well as behavioral indicators and attitudes of the abuser, which helps in their diagnosis.
The causes of child abuse
Scholars of the subject of child abuse They have tried to explain its appearance and maintenance using various models, thus we have:
- He sociological modelwhich considers that physical abandonment is a consequence of situations of economic deprivation or situations of social isolation (Wolock and Horowitz, 1984).
- He cognitive modelwhich understands it as a situation of lack of protection that occurs as a consequence of cognitive distortions, expectations and inadequate perceptions of parents/caregivers in relation to the minors in their care (Larrance, 1983).
- He psychiatric modelwhich considers that child abuse is a consequence of the existence of psychopathology in the parents (Polansky, 1985).
- He information processing modelwhich suggests the existence of a peculiar style of processing in families with minors in situations of physical abandonment or child neglect (Crittender, 1993).
- He stress coping modelwhich refers to the way these families evaluate and perceive stressful situations and/or events (Hilson and Kuiper, 1994).
Comprehensive model of child abuse
Currently, 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 nested within each other, interacting in a temporal dimension. In this model, there are compensatory factors that would act according to a coping model, preventing the stressors that occur in families from triggering an aggressive response towards its members.
The progressive decrease in compensatory factors could explain the spiral that occurs in the phenomenon of child abuse. Among the compensatory factors are: 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 adequate health programs, etc. Stressor factors include: family history of abuse, family disharmony, low self-esteem, physical and psychological disorders in parents, drug dependence, unwanted children, non-biological father, non-protective mother, lack of prenatal care, unemployment, low social level and economic, promiscuity, etc.
Consequences of child abuse
Regardless of the physical consequences 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 depends 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 child victims.
- Access and competence of medical, psychological and social help services.
In the first moments of evolutionary development, negative repercussions are observed on the child’s attachment and relational capacities, as well as nightmares and sleep problems, changes in eating habits, loss of sphincter control, psychomotor deficiencies and psychosomatic disorders.
In schoolchildren and adolescents we find: running away from home, self-harming behavior, hyperactivity or isolation, poor academic performance, intellectual deficiencies, school failure, dissociative identity disorder, juvenile delinquency, drug and alcohol consumption, generalized fear, rejection of one’s own body, guilt and shame, aggression, interpersonal relationship problems.
In the following article, we explain in more detail the .
Various studies indicate that abuse continues from one generation to the next so that an abused child has a high risk of perpetuating abuse in adulthood.
Prevention of child abuse and actions of the pediatrician
Pediatricians, being the health professionals who are in greatest contact with children, are called upon 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 those under 5 years of age, the most vulnerable population). From this age, teachers begin to play a leading role in the prevention and diagnosis of abuse. In the kids.
The prevention of child abuse It is established in three levels:
1. Primary prevention
Aimed at the general population with the aim of avoiding the presence of stressor or risk factors and enhancing protective factors against child abuse. Are included:
- Awareness-raising and training of child care professionals.
- Intervene in obstetric psychoprophylaxis (preparation for childbirth).
- Intervene in parenting schools, promoting values of esteem towards childhood, women and parenthood.
- Prevent unwanted pregnancy, mainly in young women, through sexual education in schools and healthcare centers.
- Systematic search for risk factors in well-child consultations, as well as evaluating the quality of the parent-child emotional bond, child care, and parents’ attitude in the application of the authority-affection binomial.
- Intervene in consultations and explain 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…