Emotional Child Abuse

What is it?
Emotional child abuse is maltreatment which results in impaired psychological growth and development. It involves words, actions, and indifference. 2 Abusers constantly reject, ignore, belittle, dominate, and criticize the victims.1,3 This form of abuse may occur with or without physical abuse, but there is often an overlap. 4

Examples of emotional child abuse are verbal abuse; excessive demands on a child's performance; penalizing a child for positive, normal behavior (smiling, mobility, exploration, vocalization, manipulation of objects); discouraging caregiver and infant attachment; penalizing a child for demonstrating signs of positive self-esteem; and penalizing a child for using interpersonal skills needed for adequate performance in school and peer groups. 1,3 In addition, frequently exposing children to family violence and unwillingness or inability to provide affection or stimulation for the child in the course of daily care may also result in emotional abuse.3

How is it identified?
Although emotional abuse can hurt as much as physical abuse, it can be harder to identify because the marks are left on the inside instead of the outside.4 Not surprising, there exist few well-validated measures of childhood emotional abuse. Clinicians can use a revised version of the Child Abuse and Trauma Scale (CATS) which targets measures for emotional abuse. Caregivers can also closely observe children's behaviors and personalities. Children suffering from emotional abuse are often extremely loyal to the parent, afraid of being punished if they report abuse, or think that this type of abuse is a normal way of life.3

Behavioral indicators of an emotionally abused child include inappropriate behavior that is immature or more mature for the child's age, dramatic behavioral changes (disruption of activities, clinging or compulsively seeking affection and attention), aggressiveness, uncooperativeness, bedwetting or loss of bowel control (after a child has been trained), and destructive or antisocial behavior (being constantly withdrawn and sad). Furthermore, poor relationships with peers, lack of self confidence, unusual fears for the child's age (fear of going home, being left alone, specific objects), or inability to react with emotion or develop an emotional bond with others are also indicators. Realistically, any of the above behaviors may also be seen in normal children, but a change in pattern of these behaviors is a strong indicator of emotional abuse. 3

Who are the perpetrators?
Almost any adult involved in a relationship with a child is a potential perpetrator. Parents, teachers, pastors, social workers, neighbors, lawyers, or judges may all be capable of emotional maltreatment. 1 Common characteristics of the abusing adult include blaming or belittling the child in public, describing the child negatively, always assuming the child is at fault, having unrealistic expectations of the child, openly admitting to disliking or hating the child, threatening the child with severe punishment, withdrawing comfort as a means of discipline, being emotionally cold and un-supportive, suffering from alcohol and drug abuse, and possessing a violent nature. 3

Why does this happen?
Most emotional abuse occurs for many of the same reasons that physical abuse occurs. Parents are vulnerable to becoming involved in maltreatment if stresses in their lives build up or if they are unable to manage these stresses. They may also have diminished capacity for understanding and dealing with children (mental retardation, psychopathology, alcoholism, drug abuse), false ideas about children's needs, or sadistic psychosis. 1 Also, the abuser's goal may be to control. 2 Nevertheless, a single factor may not lead to abuse, but in combination they can create the social and emotional pressures that lead to emotional abuse. Specific types of problems that can contribute to emotional abuse are social problems that can contribute to family stress (unemployment, poverty, isolation from relatives and friends, divorce, death, immature parents), health crises (illness of a family member, disability of a family member, drug and alcohol abuse within the family), and mental health problems (mental disability, depression).3

What are the effects?
The consequences of emotional child abuse can be serious and long-term. 3,6 Many research studies conclude that psychopathologic symptoms are more likely to develop in emotionally abused children. These children may experience a lifelong pattern of depression, estrangement, anxiety, low self-esteem, inappropriate or troubled relationships, or a lack of empathy.1,2,3,6,7 During their childhood, victims may fail to thrive or their developmental progress may be halted. Some may also become poorly adjusted emotionally and psychologically. 3 As teenagers, they find it difficult to trust, participate in and achieve happiness in interpersonal relationships, and resolve the complex feelings left over from their childhoods. As adults, they may have trouble recognizing and appreciating the needs and feelings of their own children and emotionally abuse them as well.1

What can be done for the victims?
To effectively identify and confirm emotional abuse, it is necessary to observe the abuser-child interaction on varied and repeated occasions. If emotional abuse is suspected, action can be taken regardless of whether the suspected offender is within the child's home, child care setting, or elsewhere in the community. It is the caregiver's responsibility to report and not investigate suspicions of child abuse. It is the child protection agency's responsibility to investigate reports of any type of abuse. A careful evaluation of those involved and the sources of stress should be completed by appropriate and skilled professionals. Usually, a team consisting of a child protection worker, a physician, a psychiatrist or psychologist, a public health nurse, a childcare staff, and a teacher will become involved.3

What can be done to prevent it?
Health care professionals and concerned individuals need to increase awareness for and education in emotional child abuse in the community and among parents. Secondly, parents and guardians need to be encouraged to develop strong attachments with their children and learn to express warmth and positive regard for them. Finally, families have to be encouraged to form relationships with support systems available to them. In addition, more research in topics related to emotional child abuse and parent-child relationships must be undertaken. 1