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Tuesday, September 2, 2014

Is it psychological abuse? What parents need to know

Experts admit that not much is known about ways to intervene with parents who psychologically abuse their children.

But psychological maltreatment can scar children for a lifetime. Severe emotional distress, developmental problems and disruptive behavior can be the result, says an updated clinical report from the American Academy of Pediatrics (AAP).

What is emotional or psychological abuse? The AAP defines it as a repeated pattern of behavior by a parent or caregiver that can be verbal or nonverbal, active or passive, intentional or unintentional, but is interpreted negatively by a child.

This abuse can lead to developmental, social, emotional and academic problems. It can exist in absence of other forms of abuse (physical, sexual, etc.) though it also commonly overlaps and coexists with these other forms.

Although this abuse can occur in many types of families, it is more common in homes with multiple stresses. Family conflicts, mental health issues, physical violence, depression or substance abuse tend to increase the odds that a child will suffer.

AZAAAP member Dr. Chan Lowe, a pediatric hospitalist and associate professor of pediatrics at the University of Arizona Health Sciences Center and Diamond Children’s Medical Center in Tucson, answers a few questions about what parents need to know.

What are the warning signs of this kind of abuse? Could a parent or caregivers treat a child this way without even realizing it?

Psychological maltreatment is one of the most common forms of child abuse, but also one of the most difficult to identify and prevent. Psychological abuse can range from neglect (ignoring the child’s needs) to more aggressive forms of abuse such as constantly criticizing a child, belittling the child and even punishing the child for doing well. It can harm a child’s self esteem and make them feel worthless and unimportant.

Who is most at risk of being abusive? 

Often, this can happen by parents or caregivers treating the child the way they were raised. We know that those who were abused as a child have a much higher likelihood of abusing their own children as adults. Caregivers may simply not realize that they way they are treating the child or talking to the child is damaging.

How would a parent know if they, or another parent or caregiver, has crossed the line from just being grumpy or cross with the child to being abusive?

Parents or caregivers who are concerned this may be happening can take the first step to recognizing it by stopping to ask themselves how much of the time interacting with the child is focused on praising and uplifting the child vs. more negative interactions.

Recognizing that most of the day is spent speaking negatively to the child can be a warning sign of potential abuse. Some behaviors in children may indicate emotional trauma, and that there could be a problem:

  • Inappropriately immature or overly mature behavior
  • Bedwetting in a previously potty-trained child
  • Emotional outbursts
  • Becoming very angry/destructive, or suddenly becoming very “clingy”
  • Constantly seeking affection or attention

These behaviors also can be seen in children who are not suffering from psychological abuse; but sudden or significant changes in usual behavior are often a marker.

What should a parent do if they feel that another parent or caregiver is slipping into psychologically abusive patterns? 

One of the most difficult issues with parents and caregivers is to recognize that psychological abuse is actually occurring.  Often getting the abusing caregiver and even the non-abusing partner to recognize the abuse is occurring can be the most difficult part of the entire situation.

If one parent is seeing signs of abuse by another parent, pointing this out to the offending parent is important but may not necessarily be effective. It may take turning to an outside entity to help. The family pediatrician often can recommend a good family counselor who can be of tremendous help and can even help with strategies to help get the abusive parent to come to counseling.

As a pediatrician, what are your thoughts on what parents need to know about psychological abuse?  

I think it is incredibly important for parents to recognize that psychological abuse can be just as devastating to children as physical abuse. Psychological abuse has long-lasting effects on children and can take years of treatment to recover from.

First and foremost, parents need to be aware that psychological abuse exists and be vigilant to watch for warning signs of abuse.  If parents are seeing signs of abuse they need to feel empowered to act on this and seek out help.  Doing so may be able to prevent untold amounts of damage to the child.

More on the types of emotional abuse from the American Humane Association.

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Vicki Louk Balint

Vicki Louk Balint is a multimedia journalist who covers health issues for RAISING ARIZONA KIDS.

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