Child Maltreatment

Characteristics of CSA

l. Victim age 2. Victim sex 3. Victim/perpetrator relationship 4. Perpetrator sex 5. Perpetrator age 6. Type of sexual activity 7. Dynamics of abuse

Psychological Maltreatment

A mother locks her 3-year-old son in a dark attic as a method of punishment. A father shackles his 7-year-old son to his bed at night to prevent him from getting out of bed repeatedly.

Mediators of Psychological Effects

Abuse Characteristics - sexual activity - level of aggression - relationship to offender Post Abuse Events - response by significant others - available social support Perceptions of Abuse - perceived severity - negative perceptions

Consequences of CSA

Behavioral: Social interaction, sexual behavior, eating disorders, substance abuse, self-mutilation Emotional: Anxiety, depression, anger/hostility Cognitive: Learning difficulties Physical: Bruises, enuresis, encopresis, headache, stomachache, chronic pain

National Center on Child Abuse and Neglect (1978)

Contacts or interactions between a child and an adult when the child is being used for the sexual stimulation of the perpetrator or another person. Sexual abuse may also be committed by a person under the age of 18 when that person is either significantly older than the victim or when the perpetrator is in a position of power over another l. Exploitation of authority and power 2. Includes children as well as adolescents as perpetrators 3. Includes both contact and noncontact offenses 4. Includes both intra- and extra-familial abuse

Prevalence

Incidence of Abuse and Neglect in North America Battered child syndrome, first described in early 1960s, was thought to be rare (fewer than 300 children in the U.S.) Today over 3.5 million suspected cases of abuse and neglect are investigated in the U.S. each year Over 900,000 cases were substantiated in 2006 (12.1 per 1000 children)

Assessment of CSA

Interviews with Anatomically Correct Dolls: Establish importance of honesty (no "right answer) Ask child to identify nonsexual characteristics of doll Ask child to identify body parts Ask child if anyone has ever touched their private parts Ask child if anyone has ever asked them to touch their private parts

3 Forms of Child Neglect

Physical Neglect Educational Neglect Emotional Neglect

Treatment of CSA

Trauma-Focused Cognitive Behavioral Therapy Psychoeducation Anxiety reduction techniques Affective Expression Exposure therapy Cognitive therapy techniques Parenting Skills

Types of Maltreatment

U.S. Child Abuse Prevention and Treatment Act (CAPTA): Acts that result in death, serious physical or emotional harm, sexual abuse or exploitation, or acts/failures to act that present imminent risk of serious harm DSM-IV-TR: Maltreatment is not a form of abnormal child behavior/psychological disorder Physical abuse Neglect Psychological maltreatment Sexual abuse