**4. Psychopathological consequences of the child abuse and neglect**

Child maltreatment can produce a decline in biological, psychological and social function in children and adolescents. Maltreatment in childhood and adolescence is recognised as an important psychopathological risk factor and is associated with poor psychological function in *childhood* [64-71] and in *adolescence* [68,72-75] and in *adulthood* [76-78].

As we have already mentioned, many different difficulties exist to adequately classify the phenomenon of child abuse and neglect. In this respect, it would be wrong to think that current knowledge has allowed us to identify clearly differentiated consequences for each type of child maltreatment. There is a high degree of co-morbidity between the different types, to the extent that many children experience more than one form of maltreatment and demonstrate common consequences [79-80]. Furthermore, it still needs to be clarified whether child maltreatment produces psychopathology in children or whether it generates general vulnerability towards psychopathology in such a way that other factors would be responsible for the type of psychopathological deviation eventually adopted.

Despite these limitations, many studies have found an association between different types of child maltreatment and various psychopathological symptoms in adolescence and at the beginning of adulthood. We will now briefly focus on the psychopathological consequences associated with each type of maltreatment.

### **4.1. Psychopathological consequences of physical abuse**

Being physically abused in childhood is a risk factor associated with psychopathological problems in adolescence and adulthood. Numerous research studies have demonstrated

that physically abused adolescents and adults who were subjected to physical abuse in childhood have a high risk of displaying mental health problems [81-88].

Definition, Incidence and Psychopathological Consequences of Child Abuse and Neglect 11

emotional dysregulation. In particular, it has be found that children who are the victims of sexual abuse show internalising and externalising difficulties, posttraumatic stress disorder symptoms, personality disorders and problems in interpersonal relations with peers [61,106-

One of the most worrying aspects for the physical and mental health of the abused adolescent in their childhood is the strong association that exists between sexual abuse and suicidal conduct in this evolutionary stage [99]. The percentage of attempted suicides in the adolescent population of victims of sexual abuse ranges between 7.3 and 11.2% in girls and

By way of example, in one of the most relevant research projects carried out recently in this field by Martin et al. [112], in which 2,485 adolescents participated, of which 7.4% had been the victim of sexual abuse, they discovered that 27.1% of the sample admitted having suicidal ideation (21.8% of boys and 33.6% of girls); 13.7% had planned to commit suicide (11.3% of boys and 16.4% of girls) and 4.5% of boys and 7.3% of girls had attempted suicide.

At present, sufficient evidence is available to confirm that emotional maltreatment in childhood is associated with mental health problems and adaptation problems in

Emotional maltreatment has been identified as a strong predictor of most psychological problems including personality disorders, anxiety, depression, dissociative symptoms, posttraumatic stress, physical symptoms, suicidal behaviour, sexual dysfunction, eating

*University of Mondragon Unibertsitatea, Department of Child Well Being, Eskoriatza, Spain* 

[1] Aber J., Zigler E. Developmental considerations in the definition of child maltreatment. In: Fitzgerald H. E., Lester B. M., Yogman M. (Eds.), Developmental perspectives on

[2] Besharov DJ. Toward better research on child abuse and neglect: Making definitional.

[3] Cicchetti D., Barnett D. Toward the development of a scientific nosology of child maltreatment. In Grove WM., Cicchetti D. (Eds.), Thinking clearly about psychology: Essays in honor of Paul E. Meehl. Vol. 2. Personality and Psychopathology.

**4.4. Psychopathological consequences of emotional maltreatment** 

110].

3.2 and 4.5% in boys [99,112].

adolescence and adulthood [95,113-116].

Alexander Muela, Elena López de Arana,

**Author details** 

**5. References** 

disorders and low self-esteem [32,74-75,95,114-123].

Child Abuse & Neglect 1981; 5(4) 383-390.

Alexander Barandiaran, Iñaki Larrea and José Ramón Vitoria

child maltreatment. San Francisco: Jossey-Bass; 1981. p. 1-29.

Minneapolis: University of Minnessota Press; 1991. p. 346-377.

By way of example, various studies have found that children and young people who are the victims of physical abuse and children and young people who are part of a violent family context, in comparison with children and young people who do not display these characteristics, display more emotional problems [69,84,89-91]. The research reveals that physical abuse is associated with a variety of emotional problems such as somatisation, depression, anxiety, hostility, paranoid ideation, psychosis, posttraumatic symptoms and dissociative disorder. This relationship is moderated by aspects such as the presence of multiple types of abuse and the gender of the perpetrator. The data obtained in the various research studies indicates that the combination of physical and sexual abuse has greater emotional consequences for the victims, generating above all, depression and anxiety [92-94].

An important association exists between being physically abused in childhood and an increase in the manifestation of self-harming behaviour and suicides in adolescence and adulthood [94-101]. However, different research studies have demonstrated that this correlation varies depending on the victim's gender, the type of abuse and the level of parental conflict. For instance, it has been suggested that physical abuse in itself does not produce suicidal behaviour; however, when physical and sexual abuse are experienced together, this behaviour seems to be produced more frequently [102].

Much of the literature on child abuse and neglect has related physical abuse with delinquency and aggressive behaviour in adolescence. A close relationship has also been found between physical abuse and conduct disorder which, in turn, has been associated with delinquency and aggressive behaviour [84].

## **4.2. Psychopathological consequences of child neglect**

Having suffered child neglect in childhood has been associated with poor psychological function in childhood, adolescence and adulthood.

The results of studies such as the *Minnesota Mother-Child Project* [103] verify that children who were victims of physical neglect displayed serious social-emotional problems, and most of these problems had an internalising nature. In the same way, in other studies, it has been found that physical neglect and a lack of supervision in childhood is associated with an increase in the risk of producing self-harming behaviour and suicidal tendencies [72,101], suffering from personality disorders with high symptoms of anxiety, depression [104] and dissociative disorders in adolescence and adulthood [105].

#### **4.3. Psychopathological consequences of sexual abuse**

Research on sexual abuse suggests that children and adolescents who develop in an abusive environment run the risk of suffering psychological difficulties that are characterised by emotional dysregulation. In particular, it has be found that children who are the victims of sexual abuse show internalising and externalising difficulties, posttraumatic stress disorder symptoms, personality disorders and problems in interpersonal relations with peers [61,106- 110].

One of the most worrying aspects for the physical and mental health of the abused adolescent in their childhood is the strong association that exists between sexual abuse and suicidal conduct in this evolutionary stage [99]. The percentage of attempted suicides in the adolescent population of victims of sexual abuse ranges between 7.3 and 11.2% in girls and 3.2 and 4.5% in boys [99,112].

By way of example, in one of the most relevant research projects carried out recently in this field by Martin et al. [112], in which 2,485 adolescents participated, of which 7.4% had been the victim of sexual abuse, they discovered that 27.1% of the sample admitted having suicidal ideation (21.8% of boys and 33.6% of girls); 13.7% had planned to commit suicide (11.3% of boys and 16.4% of girls) and 4.5% of boys and 7.3% of girls had attempted suicide.

### **4.4. Psychopathological consequences of emotional maltreatment**

At present, sufficient evidence is available to confirm that emotional maltreatment in childhood is associated with mental health problems and adaptation problems in adolescence and adulthood [95,113-116].

Emotional maltreatment has been identified as a strong predictor of most psychological problems including personality disorders, anxiety, depression, dissociative symptoms, posttraumatic stress, physical symptoms, suicidal behaviour, sexual dysfunction, eating disorders and low self-esteem [32,74-75,95,114-123].
