0.3 Health education course, chapter 4 - childhood psychological

Physical and psychological abuse

The Merck Manual defines physical abuse involves the physical battery of a child. Emotional abuse involves the emotional ormental battery of a child, which often damages the child's emotional growth and self-esteem. Sexual abuse or molestation includes exposure, genitalmanipulation, sodomy, fellatio, and coitus. Vaginal penetration by an unrelated person constitutes rape. Often, the adult is a close familyfriend. If the adult is biologically related, the offense is termed incest. When young children are involved, the offense most often is nonviolent andrepetitive and may be concealed within the family. Neglect includes failure to meet a child's basic physical and medical needs, emotionaldeprivation, and desertion.

Abuse: Generally, abuse is caused by the breakdown of impulse control in the parent or guardian. Four contributing factors arerecognized:

Parental personality features: The childhood experience of the parent may have lacked affection and warmth, oftenincluded abuse, and was not conducive to the development of adequate self-esteem or emotional maturity. Lacking an early loving environment,abusive parents may look toward their children as a source of the affection and support they never received. As a result, they may have unrealisticexpectations of what their child can supply for them; they are frustrated easily and lose control, unable to give what they never experienced. Drug oralcohol use may provoke impulsive and uncontrolled behaviors toward the child. Less commonly, a parent may be frankly psychotic.

A "difficult" child: Irritable, demanding, or hyperactive children may provoke parents' tempers, as may a handicappedchild, who often is more dependent for care. Premature or sick infants separated from parents early in infancy and biologically unrelatedchildren (eg, stepchildren) may not form strong emotional ties with their parents or guardians. Even in the absence of these conditions, parents mayhave unrealistic expectations of what a child's performance should be and may punish him severely with little justification.

Inadequate support: Parents may feel isolated, unprotected, and vulnerable without the physical and psychologic supportof relatives, friends, neighbors, or peers, particularly in times of stress.

A crisis: Situational stress may precipitate abuse, particularly when support is unavailable.

Neglect : Often, neglect is seen among families with physical, psychologic, or substance abuse problems. Acute or chronicdepression, especially maternal, is often present; chronic medical problems of a parent may also contribute. Drug or alcohol abuse by one or bothparents frequently results in chronic impoverishment and a distortion of priorities in family life. Desertion by the father, himself inadequate,unable or unwilling to assert a controlling influence in the family, may precipitate neglect. Children of cocaine-using mothers are particularlyat risk for desertion.