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Psychological Abuse of Children May Be Common

Neglect as Damaging as Physical Abuse, Report Finds
By
WebMD Health News
Reviewed by Louise Chang, MD

July 30, 2012 -- Psychological child abuse is common but underreported in the U.S., the nation's largest pediatric health group says.

Like physical and sexual abuse, psychological abuse can cause devastating and lifelong harm.

In a new report, the American Academy of Pediatrics (AAP) is calling on pediatricians to be alert to signs of such abuse in young patients.

"Psychological maltreatment often occurs with other forms of abuse, but this isn't always the case," says co-author Roberta Hibbard, MD, of Riley Hospital for Children at Indiana University Health in Indianapolis.

"It is one of the most devastating forms of abuse," she says. "Broken bones heal, but being belittled, terrorized, or neglected by a parent can impact self-esteem, attachments, and other aspects of development for a lifetime."

What Is Psychological Abuse?

There is no universally agreed upon definition of psychological abuse. But most cases involve a pattern of behaviors by a parent or other caregiver that leads a child to believe he or she is unloved or unwanted.

Specific types of psychological abuse identified in the report include these actions by a parent or caregiver:

Ridiculing a child. Comments or actions, especially in public, that:

  • Belittle a child
  • Criticize a child in a derogatory way

Terrorizing a child. For example, if you:

  • Place a child in a dangerous situation
  • Threaten to harm a child if unrealistic expectations aren't met

Isolating a child. For example, if you:

  • Confine or imprison a child
  • Restrict a child's social interactions

Exploiting a child. For example, if you take steps that exploit or corrupt a child, such as:

  • Encourage or be a model for anti-social behavior
  • Encourage behavior that's not appropriate for the child's age

Being detached from your child. For example, if you:

  • Interact with your child only when necessary
  • Don't nurture your child
  • Fail to praise your child

"All parents do things they may regret from time to time. But a chronic pattern of belittling, denigrating, or neglecting a child constitutes psychological abuse," says Harriet MacMillan, MD. She is a professor of psychiatry and behavioral sciences at McMaster University in Ontario, Canada.

Brandi's Story

As director of Riley Hospital's Child Protection Program, Hibbard and her team evaluate about 2,000 cases of suspected child abuse every year.

She remembers the cases of Brandi Zachary and her older brother as among the worst examples of neglect she has ever seen.

The two were victims of psychological neglect and malnourishment at the hands of their parents until a friend became suspicious and called child protective services.

The children were kept in a filthy, locked closet day and night for at least a year.

When the abuse was discovered Brandi was 2 1/2 years old and weighed just 14 pounds. She had not yet learned to walk or talk.

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