In the United States during 2002, approximately 1,400 children died as a result of child maltreatment.² Survivors are vulnerable to long-term emotional damage. Typically, children are abused at an age when they are not equipped with life experience and reasoning abilities to understand that it is not their fault. They suffer developmental setbacks, physical pain, and emotional anguish. Abuse and neglect in children younger than 7 years of age may lead to permanent behavior and personality changes.

Children who are abused or neglected are at increased risk for abusing other children and siblings and, later in life, their own children or elderly parents. They are also at increased risk for becoming involved in criminal acts as they get older. As adults, they will likely suffer from physical and emotional problems.

Physical effects

Prolonged and repeated physical abuse can permanently damage the body.

• Certain types of abuse, such as shaken baby syndrome (also called intentional head injury), can result in life-threatening brain injury. Children who survive may have permanent developmental disabilities or learning disabilities.
• A sexually abused child can become infected with a sexually transmitted disease, such as HIV, which can be life-threatening.
• Long-term (chronic) health problems, such as sexual dysfunction may occur. Other problems, such as not growing or developing normally, may happen as a result of being neglected as a child.

Emotional effects

All children who have been abused or neglected or who witness domestic violence are at risk for developing mental health disorders, emotional problems, and poor social skills. These problems may occur alone or in combination. The effects of abuse or neglect are determined by its severity, how frequently or for how long it occurs, and the relationship of the child to the abuser.

Mental health disorders that may result from abuse and neglect include:

• Anxiety.
• Depression.
• Borderline personality disorder. A person with this mental health condition may have difficulty controlling his or her anger and impulses, often has problems with unstable or intense relationships, may have a low sense of self-worth, and may feel frantic anxiety about being abandoned.
• Post-traumatic stress disorder.
• Suicide or suicidal thoughts.
• Dissociation. This is an unconscious attempt at self-protection against an overwhelming and traumatic experience. The mind separates itself from an event or the environment, such as blocking out the memory, so it can maintain some degree of order and sense.
• Eating disorders, such as severely limiting calories (anorexia) resulting in unhealthy weight loss.

Other emotional effects include:

• Low self-esteem, which is a person's core belief about himself or herself. Children cannot process or understand what has happened to them. They often unconsciously blame themselves and grow up with a poor self-image, which affects their relationships with others.
• Anger, hostility, defiance, antisocial tendencies, or criminal behavior.
• Negativity. A person with a history of abuse or neglect may have trouble adjusting to normal struggles.
• Substance abuse, such as using illegal drugs or drinking alcohol excessively.
• Emotional detachment. A person may have problems bonding, socializing, and developing friendships. This can result in isolation and a failure to learn and develop sympathy, empathy, and other important emotion-based concepts.
• Impulsiveness. The person fails to think and consider consequences before acting. Often, this results in reckless, risky, or antisocial activities, such as driving dangerously.
• Issues with sexuality. Abused or neglected children, especially those who are sexually abused, often have problems developing a healthy sexuality as they reach adolescence and adulthood. Some may be sexually promiscuous, and others may be fearful and unwilling to risk any intimacy.