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The Exceedingly Serious Psychological Effects of Child Abuse

The Psychological Effects of Child Abuse
While there is no overlooking the fact that abuse is severely damaging to children, physically and emotionally, it also affects the health of a nation because in many cases its definition is blurred and its signs are difficult to identify. Here, we try to identify the psychological impact of child abuse and how its identification may help arrest the damage as early as possible.
Reshma Jirage
Last Updated: Jun 3, 2018
Most trauma begins at home: the vast majority of people (about 80%) responsible for child maltreatment are the children's own parents.
Bessel A. van der Kolk, MD
Developmental Trauma Disorder: Towards a rational diagnosis for children with complex trauma histories (Psychiatric Annals, 2005)

Child abuse is intentional or unintentional harm or maltreatment of a child by another person, who may be his/her parents, relatives, guardians, teachers, or other children. It may happen in homes, schools, organizations, or communities. There are five major categories of child abuse.
  • Physical Abuse: Hitting, pushing, injuring, using implements (such as belts) to punish the child
  • Emotional/Psychological Abuse: Verbally assaulting, causing grief, belittling, yelling, and limiting affection
  • Sexual Abuse: Fondling, creating contact with genitalia, forcing the child to engage in sexual acts, exposing the child to sexual acts
  • Neglect: Failing to provide for the child's basic needs such as hygiene, food, clothing, medical care, as well as emotional needs like attention, care, and affection
  • Witnessing Domestic Violence: Exposing the child to episodes of domestic violence (e.g., among parents) regularly
Child abuse is one of the largely unreported crimes, due to which, research statistics and data about its effects (physical, psychological, and behavioral) are limited. However, some amount of research into this area has revealed a list of fairly common traits among abused children.

How Abuse Affects Individuals Psychologically
Abuse can have a severe impact on a child for years. It can cause several problems in her/his physical and emotional development. The effects of abuse can vary from child to child, depending upon factors such as:
  • Severity and frequency of abuse
  • Age of the child
  • Child's relationship with the abuser
  • Availability of emotional support
  • Child's capacity to cope
Research suggests that a small number of abused children remain unaffected and grow into adults who lead normal lives. However, several others develop certain problems in varying degrees, the effects of which are described below.

In his work, Developmental Trauma Disorder: Towards a rational diagnosis for children with complex trauma histories (2005), van der Kolk talks about developmental trauma disorder as a condition that affects victims of child abuse. Here, he describes the direct effect severe trauma (which may occur in the form of child abuse) may have on children. This is a summary of his findings.
  • Intolerable distress in the absence of the caregiver
  • Insecurity and increased need for attention characterized by clinging and compliance or defiance
  • Inability to express emotion and communicate feelings
  • Increased aggression due to the inability to recognize suppressed emotions
  • Shutting down first and then experiencing trauma in case of recurrence of the incident or an incident that is reminiscent of it
  • Confusion, disorientation, and dissociation when faced with stressful situations
  • Social isolation due to distrust, suspicion, and lack of intimacy with others
  • Poor self-esteem
  • Trouble paying attention
  • Likelihood of developing post-traumatic stress disorder (PTSD), separation anxiety disorder, phobic disorders, oppositional defiant disorder, and attention deficit hyperactivity disorder (ADHD)
  • Hatred for self and blaming oneself for the events that ensued
  • Substance abuse, violent behavior, eating disorders, sexual disorders, and suicidal tendencies
He further adds that individuals who have been victims of multiple forms of abuse in infancy may show delayed development (language, sensory, motor, etc.). Brodsky and Stanley, in their work titled "Adverse childhood experiences and suicidal behavior" (Psychiatric Clinics of North America, Volume 31, Issue 2, 2008), suggested that individuals who were victims of sexual abuse had a greater tendency towards suicide because of the feelings of shame and blame associated with the act.

The Effects of Child Abuse on the Brain
A study conducted by Martin Teicher (MD, PHD), associate professor of psychiatry at Harvard Medical School, has concluded that child abuse (physical, verbal, and sexual) affects brain activity and may be the cause of certain behaviors. This study was made by comparing images of human brains (without history of abuse or psychological conditions) with those of individuals who have been victims of abuse. Here's a summary of the findings of this study.
  • Victims of abuse have a smaller corpus callosum (a thick nerve cell cable connecting the left and right brain). This was found smaller in boys who were victims of neglect and girls who were victims of sexual abuse. This shrinking of the connector may also be linked to mood and personality switches.
  • Instability was seen in the cerebellar vermis, a part of the brain the regulates emotions and attention. It has been found that this part of the brain is affected more by the external environment than by genetic factors.
  • Due to extensive abuse, the brain experiences an overflow of stress hormones that affects brain signals, and it learns to overreact in all stressful situations (minor or major).
  • Right-handed victims of abuse showed altered/unusual activity in the left side of the brain. This may result in depression and memory trouble in victims.
  • Altered electrical activity in the brain also created seizure-like states without the presence of epilepsy.
  • This state of the brain also correlates with the thoughts of suicide that victims of abuse have had, with it occurring four to five times more than in healthy individuals.
The sooner child abuse is identified, the easier it is to prevent the psychological damage that ensues and only perhaps worsens with time. Because even now several cases go unreported, it is difficult to arrest the damage it can cause at an earlier stage. However, whenever identified, therapy, medication, and engagement in different types of stress-release and relaxation activities is known to help cope with the trauma to a certain extent.