child maltreatment

what can child maltreatment include?

• Physical

• Sexual

• Emotional

• Exposure to dv

• Neglect

• Fabricated or induced illness

uk definition of child maltreatment

includes any abuse or neglect of a young person/child,

caused by inflicting harm or by failing to act to prevent harm,

classified as physical, sexual or emotional abuse; neglect; and fabricated illness

WHO definition of child maltreatment

all forms of physical and or emotional ill-treatment,

sexual abuse, neglect or negligent treatment or commercial or other exploitation,

resulting in actual or potential harm to the child, in the context of a relationship or trust of power

areas of uncertainity in defining

• Do all forms of violence count as CM

• Is CM only perpetrated by caregivers?

• Is power differential necessary?

uk prevelance of CM

29% of adults (18-74) experienced CM before 18 years

44% of adults who experience abuse before age 16, experienced multiple types of abuse

however- not acceptable survey tool

outcomes across the lifespan due to CM

physical- neurological, metabolic etc

mental- PTSD, anxiety etc

psychosocial functioning- self-harm, school attainment etc

variation in outcomes due to the type of maltreatment

assumed:

Sexual and physical abuse is more harmful

Found:

Equivalence in the type of severity of outcomes across different types of abuse

risk and protective factors- risk

• increase the probability of a poor outcome,

•  probability vs deterministic

• cumulative impact

risk and protective factors- protective

• Act as buffer in context of risk

• Lessens the impact of harm

• Still no guarantees

River analogy- risk and protective factors

• Rain is the risk factor- increases river flow, leading to rougher conditions

• Rocks, leaves, etc, are the protective factors- slow the flow and can lead to a stream( less harmful pathway)

 

Bronfenbrenner's ecological systems theory

biopsychsocial model

latent vulnerability

how CM causes subtle brain changes that help a child survive in a dangerous environment

but creates a hidden, long-term risk for future mental health problems in adulthood, even if the child seems fine initially

levels of prevention

top

treatment

indicated prevention

selective prevention

universal preventative

primordial prevention- prevents emergence of risk factors in 1st place