The U.S. Department of Health and Human services estimated 906,000 children were victims of child abuse or neglect in 2003. While physical injuries may or may not be immediately visible, abuse and neglect can have consequences for children, families, and society that last lifetimes, if not generations.

The after affects of child abuse and neglect is discussed in terms of physical, psychological, behavioral, mental, behavioral, spiritual and societal consequences. In reality, however, it is impossible to separate them completely. Physical consequences (such as damage to a child’s growing brain) can have psychological implications (cognitive delays or emotional difficulties). Psychological problems often manifest as high-risk behaviors. Depression and anxiety compel a person more likely to smoke, abuse alcohol, use illegal or prescription drugs and/or eating disorders. High-risk behaviors, can lead to long-term physical health problems such as sexually transmitted diseases, cancer-vaginal, ovarian or ****** in women; prostate, testicular in men, MS, chronic fatigue, lupus, etc.

Physical or sexual abuse can weaken survivors’ immune systems according to Dr. Frank Putnam of the National Institute of Mental Health and Dr. Martin Teicher of Harvard Medical School. Putnam conducted studies on 170 girls, age 6-15-half had been abused, half had not-for seven years. The abused girls displayed symptoms such as:

o Abnormal high stress hormones, which can kill neurons in brain areas crucial for thinking and memory

o High levels of an antibody that weaken the immune system.
Teicher completed a series of brain studies on 402 children and adults, many of whom had been sexually or physically abuse. His findings revealed that sexual or physical abuse creates:

o Arrested growth of the left hemisphere of the brain which can hamper development of language and logic

o Growth of the right hemisphere of the brain (the site for emotion) at an abnormally early age

Physical Health after effects:

The immediate physical effects of abuse or neglect can be relatively minor (bruises or cuts) or severe (broken bones, hemorrhage, or even death). In some cases the physical effects are temporary; however, the pain and suffering they cause a child needs to be addressed. Meanwhile, the long-term impact of child abuse and neglect on physical health is just beginning to be explored.

Below are some outcomes researchers have identified:

o Shaken baby syndrome. The immediate effects of shaking a baby (child abuse in infants) can include vomiting, concussion, respiratory distress, seizures, and death. Long-term consequences can include blindness, learning disabilities, mental retardation, cerebral palsy, or paralysis (Conway, 1998).

o Impaired brain development. Child abuse and neglect have been shown, in some cases, to cause important regions of the brain to fail to form properly, resulting in impaired physical, mental, and emotional development (Perry, 2002; Shore, 1997). In other cases, the stress of chronic abuse causes a “hyperarousal” response by certain areas of the brain, which may result in hyperactivity, sleep disturbances, and anxiety, as well as increased vulnerability to post-traumatic stress disorder, attention deficit/hyperactivity disorder, conduct disorder, and learning and memory difficulties (Perry, 2001; Dallam, 2001).

o Poor physical health. A study of 700 children who had been in foster care for 1 year found more than one-quarter of the children had some kind of recurring physical or mental health problem (National Survey of Child and Adolescent Well-Being). A study of 9,500 HMO participants showed a relationship between various forms of household dysfunction (including childhood abuse) and long-term health problems such as sexually transmitted diseases, heart disease, cancer, chronic lung disease, skeletal fractures, and liver disease (Hillis, Anda, Felitti, Nordenberg, & Marchbanks, 2000; Felitti, Anda, Nordenberg, Williamson, Spitz, Edwards, Koss, & Marks, 1998).

Psychological after effects:

The immediate emotional effects of abuse and neglect-isolation, fear, and an inability to trust-can translate into lifelong consequences including low self-esteem, depression, and relationship difficulties. Researchers have identified links between child abuse and neglect and the following:

o Poor mental and emotional health. In one long-term study, 80 percent of young adults who had been abused met the diagnostic criteria for at least one psychiatric disorder at age 21. These young adults exhibited many problems, including depression, anxiety, eating disorders, and ******* attempts (Silverman, Reinherz, & Giaconia, 1996). Other psychological and emotional conditions associated with abuse and neglect include: panic disorder, dissociative disorders, attention-deficit/hyperactivity disorder, post-traumatic stress disorder, and reactive attachment disorder (Teicher, 2000).

o Cognitive difficulties. The National Survey of Child and Adolescent Well-Being recently found children placed in out-of-home care due to abuse or neglect tended to score lower than the general population on measures of cognitive capacity, language development, and academic achievement (2003).

o Social difficulties. Children who are abused and neglected by caretakers often do not form secure attachments to them. These early attachment difficulties can lead to later difficulties in relationships with other adults as well as with peers (Morrison, Frank, Holland, & Kates, 1999).

Behavioral after effects:

Not all victims of child abuse and neglect will experience behavioral consequences; however, child abuse and neglect appear to make the following more likely:

o Difficulties during adolescence. Studies have found abused and neglected children to be at least 25 percent more likely to experience problems such as delinquency, teen pregnancy, low academic achievement, drug use, and mental health problems (Kelley et al., 1997).

o Juvenile delinquency and adult criminality. A National Institute of Justice study indicated being abused or neglected as a child increased the likelihood of arrest as a juvenile by 59 percent. Abuse and neglect increased the likelihood of adult criminal behavior by 28 percent and violent crime by 30 percent (Widom & Maxfield, 2001).

o Alcohol and other drug abuse. Research consistently reflects an increased likelihood that abused and neglected children will smoke cigarettes, abuse alcohol, or take illicit drugs. According to the National Institute on Drug Abuse, as many as two-thirds of people in drug treatment programs reported being abused as children (2000).

o Abusive behavior. Abusive parents often have experienced abuse during their own childhoods. It is estimated approximately one-third of abused and neglected children will eventually victimize their own children (Prevent Child Abuse New York, 2001).

Societal after effects:

While child abuse and neglect usually occurs within the family, the impact does not end there. Society as a whole pays a price for child abuse and neglect, in terms of both direct and indirect costs.

o Direct costs. Direct costs include those associated with maintaining a child welfare system to investigate allegations of child abuse and neglect, as well as expenditures by the judicial, law enforcement, health, and mental health systems to respond to and treat abused children and their families. A 2001 Prevent Child Abuse America report estimates these costs are $24 billion annually.

o Indirect costs. Indirect costs represent the long-term economic consequences of child abuse and neglect. These include juvenile and adult criminal activity, mental and emotional dysfunction, substance abuse, and domestic violence; loss of productivity due to unemployment and underemployment; the cost of special education services, and increased use of the health care system. Prevent Child Abuse America recently estimated these costs are more than $69 billion per year (2001).

Summary

Of the research that has been done about the after effects of child abuse and neglect, the effects vary depending on the circumstances of the abuse or neglect, personal characteristics of the child, and the child’s environment. Consequences whether mild or severe lasts a lifetime, unless there is emotional and spiritual healing. Ultimately, due to related costs to public entities such as the health care, human services, and educational systems, abuse and neglect impact not just the child and family, but society as a whole. Total estimated Direct and Indirect cost to society for child abuse–verbal, physical/ sexual and neglect is $103 billion annually.

By: Dorothy M. Neddermeyer, PhD

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