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Such experiences appear to result in tragic and costly outcomes for children, their families, and society as a whole.
Knowing more about the nature of the consequences of child abuse and neglect will help justify preventive interventions.
Such knowledge will also help improve treatment programs designed to expand the role of protective factors that may mitigate destructive consequences of maltreatment experiences.
Recommendation Research that simultaneously assesses consequences across multiple outcomes for multiple types of maltreatment should be supported.
Research is needed that assesses direct and subtle consequences across a broad range of domains cognitive and intellectual, medical and physiological, psychosocial, behavioral, and psychiatric.
The effects of different and multiple types of child maltreatment in a variety of cultural contexts should also be considered in future research programs.
The common practice of treating abused and neglected children together, or eliminating one type of maltreatment from study, may reveal only a partial portrait of childhood victims' risk for later consequences.
Existing research has focused on physical and sexual abuse, with relatively little attention to neglect or emotional maltreatment, yet the accumulation of stress associated with chronic neglect may produce consequences for young children similar to those produced through physical abuse.
This would seem particularly important given that the number of reported cases of child neglect far surpasses those of physical abuse in national statistics.
In particular, research on emotional maltreatment deserves to be expanded as a significant gateway in understanding its consequences and its role in stimulating other forms of child maltreatment.
Emotional maltreatment studies deserve support because they could provide insight into the development of severe forms of behavior disorders and developmental delays in children.
Recommendation The consequences of child abuse and neglect should be examined in a longitudinal developmental framework that examines the timing, duration, severity, and nature of effects over the life course in a variety of cultural environments.
One of the most promising developments in the field of child maltreatment studies has been the appearance of longitudinal studies.
In the case of child sexual abuse, most follow-up studies have been for approximately 12 to 18 months. While some relationships have extensive correlational support, relatively little is known about the temporal sequencing of outcomes such as low self-esteem or the use of alcohol or illicit drugs.
Further research to clarify the directionality of these potential linkages should be encouraged. It would be especially informative to know how the consequences of abuse differ depending on the developmental stage and cultural environment of the individual.
A few studies suggest the promise of an approach that can analyze specific age differences in the expression and nature of outcomes.
For example, if victims are assessed as children, the full extent of the consequences may not be manifest. As children grow and develop, new symptoms associated with their abuse may emerge that can be examined in prospective longitudinal studies.
Much can be learned from research on the processes by which other forms of parental unavailability and apparent rejection or neglect resulting from actions such as divorce, death, or chronic injury have psychological influences on the child.
The identification of specific effects of child maltreatment at certain ages may be an artifact of the existing state of knowledge. At present, there has not yet been sufficient research on the relationship between the age of onset of child abuse and subsequent symptomatology.
Longitudinal studies of the consequences of maltreatment are complicated by a variety of factors in the developmental process.
Certain problem behaviors manifest at one age may change as an individual ages. Adults may perceive their victimization as a child differently from earlier points in their lives.
In the absence of longitudinal research, well-designed, cross-sectional retrospective designs may be the most effective, immediate means of identifying the prevalence and effects of maltreatment in adults.
Cross-sectional studies conducted with techniques to minimize memory performance error using anchoring and boundary techniques , can provide retrospective information which can be verified in prospective longitudinal studies.
Recommendation Intergenerational studies require support to identify relevant cycles and key factors that affect intergenerational transmission of child maltreatment.
Generational studies of child abuse and neglect are needed to help identify the familial or cultural patterns passed on from generation to generation that society defines as abusive.
In addition, future research needs to: 1 emphasize family dynamics that serve as protective factors versus those that.
Recommendation Research needs to consider the co-occurrence of multiple forms of child victimization in the social context of child maltreatment behaviors.
The assessment of consequences for abused and neglected children is complicated by the co-occurrence of other problems or co-morbidity in the children and their parents.
Certain forms of childhood victimization constitute acute stressors, and child maltreatment often occurs against a background of chronic adversity.
The presence or absence of certain characteristics or other adverse events may influence a child's response to childhood victimization, and in some cases the combined effects of two stressors such as family environment and poor caretaking may be greater than the sum of the two considered separately.
Research in the area of childhood victimization has generally not examined interrelationships among problem behaviors and symptoms of dysfunction in other spheres of living.
Since childhood victims may be at risk for the development of multiple problem behaviors, an examination of the co-occurrence of problems should provide a fruitful direction for future research.
Research on complicated problem behaviors or multiple-risk environments is especially important at this time to identify whether clusters of problem behaviors or combined risks have common origins.
Research is also needed to determine whether certain types of problem behaviors represent discrete behaviors with different etiologies.
These contrasting models have different implications for intervention strategies. Researchers who emphasize syndromes believe that reducing problem behaviors depends on identifying and modifying a common underlying trait.
However, if specific problem behaviors represent specific etiologies, then a single general intervention strategy might fail to reduce the problems of most individuals.
Recommendation Research on the role of protective factors, including gender differences in vulnerability and manifestations of subsequent problem behaviors, needs further examination.
In many different studies of various types of maltreatment, researchers have identified a small but significant group who have few or no problems.
These "protected" children should be targeted for future study. What protective factors or interventions occur in the lives of the abused or neglected children that appear to lead to more positive outcomes?
Studies are needed with sample sizes and diverse cultures large enough to examine multiple outcomes, while simultaneously adjusting for relevant demographic characteristics.
For example, we have little evidence about similarities or differences in gender responses to experiences of early abuse and neglect. In studies of violence and sexuality, research on the nonsterotypic relationship violence: female and sexuality:male may yield important insights.
Large-scale studies assessing the consequences of child abuse and neglect for boys and girls are necessary to compare outcomes for different types of maltreatment.
Recommendation Research is needed to improve the methodological soundness of child maltreatment studies, to test hypotheses, and to develop relevant theories of the consequences of childhood victimization.
In the short term, research efforts to describe, document, and evaluate relationships suggested by the clinical literature are necessary.
However, in the long term, the field must develop and test hypotheses and build theory. For example, researchers might design research to test specific theories of the effects of child abuse physical and sexual against effects expected using a generalized stress model.
Studies also need to determine the influence of sample selection criteria on patterns of consequences. The absence of appropriate comparison groups is a severe methodological flaw in many studies of child maltreatment consequences.
Furthermore, a major controversy in the field concerns the extent to which researchers study different types of maltreated subjects. Existing research on the short-term effects of child maltreatment is often based on cases that have been reported to child protection services or law enforcement agencies.
Researchers need to select samples from nontraditional populations, such as community and pediatric samples, to improve generalizability of their findings and to avoid the biases inherent in the child protective services reporting system.
In , 79 percent of the children who died were under age 5, and 54 percent were under age 1 McCurdy and Daro, A recent study of cognitive abilities found that physically abused children showed lower receptive language scores than nonabused children Vondra et al.
This indicates that the children's cognitive deficits were related to their family backgrounds and living environments, rather than specifically to the abuse experience.
Overall, 18 percent of the sample met the criteria for major depression, and 25 percent met the criteria for dysthymia.
It is not clear whether there is a specific relationship between child sexual abuse and post-traumatic stress disorder because many other children have related symptoms such as fears, nightmares, somatic complaints, autonomic arousal, and guilt feelings Kendall-Tackett et al.
In research using a cohorts design study, children who were abused and neglected approximately 20 years ago were followed up through an examination of official criminal records and compared with a matched control group of children with no official record of abuse or neglect Widom, b.
When a subsample of incarcerated delinquents was compared with a matched sample of nondelinquents, neuropsychiatric vulnerabilities and histories of abuse distinguished the delinquents from the nondelinquents Lewis and Shanok, Within the comparison group, neuropsychiatric problems and abuse distinguished the more aggressive nondelinquents from their less aggressive nondelinquent peers.
In Lewis's original study Lewis et al. Data in the later follow-up study Lewis et al. These findings complicate the task of identifying the relative importance of different experiential variables.
Specifically, as adolescents before age 18 , abused and neglected children were significantly more likely to have an arrest as a runaway than controls 5.
Examinations of these potentially stage-specific effects Kagan, are difficult in research based on one-shot retrospective reports.
In a review of 29 studies that gathered data on fertility outcomes of maltreating families, Zuravin and Taylor concluded that neglectful families had more children than abusive families and began bearing children at an earlier age.
Zuravin , however, found that "abusive and neglectful mothers compared to control mothers space their first two children closer in years, have their first child at a younger age, and have more live births, more unplanned live births, and more children by different fathers" p.
The assessment of high intelligence and scholastic achievement should not be limited to the use of standardized measures of IQ, but should include a variety of other measures that comprehensively assess the child's ability to process information and to adapt to the world.
Abused children with more positive supports and fewer conflictual relationships were less likely to be depressed than the other maltreated children in the study.
The nondepressed maltreated children were also more likely to report that they felt more cared about by their supports than the depressed children.
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Pincus, S. Shanok, and G. Glaser Psychomotor epilepsy and violence in a group of incarcerated adolescent boys.
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Albrecht, E. Neuen-Jacob und M. Schneider geben an, dass kein Interessenkonflikt besteht. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.
Reprints and Permissions. Kernder, A. Z Rheumatol Download citation. Published : 27 May Search SpringerLink Search. Abstract Rheumatologists are often confronted by patients with muscle weakness and elevated creatine kinase CK levels.
Immediate online access to all issues from Subscription will auto renew annually. Literatur 1. Neuen-Jacob Authors Dr.
Kernder View author publications. View author publications. Ethics declarations Interessenkonflikt A. Additional information Redaktion M.
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