Motivation and emotion/Book/2014/Child emotional abuse

Overview
Child emotional abuse can exist independently of other forms of abuse. Due to its only recent analysis, it has become increasingly hard to identify and define. This book chapter aims to provide the readers with an understanding of what child emotional abuse is, how and why child emotional abuse comes about, and what consequences it can have on a child's cognitive, social and psychological development.

The problem
Statements like "this child was badly verbally abused" are only recently termed phrases, expressed systematically by clinicians. According to Hornor (2012), these children are the victims of emotional abuse. However, despite the scope of the problem, the recognition of emotional abuse as a social issue is relatively recent. According to Egeland (2009), emotional abuse is viewed as less severe when compared to other forms of abuse, but may actually be the most prevalent form of child abuse, and sadly, it is also the most under-reported, hidden and least studied form of abuse.

Why is this so?
You just have to open the newspaper or browse the Internet to read about cases of horrific physical or sexual abuse against children, but emotional abuse on the other hand, has been slow to receive recognition as a serious problem (Hornor, 2012). This is because emotional abuse is very difficult to identify and to define, compared to those of physical or sexual abuse. As emotional abuse has only recently begun to be explored, the long-term effects of emotional abuse are not entirely clear, and there is not a wide variety of epidemiological data available regarding it.

Definition
Child emotional abuse causes severe adverse effects on children's emotional development (Hornor, 2012). This method of abuse, which usually comes in the form of specific behaviours that are done so by parents, adults, caregivers or older adolescents. The behaviour may be intentional or unintentional, and can include acts of omission —neglect, and also commission —abuse (Bromfield, 2005; Cristofel et al., 1992; Gilbert et al., 2009).

There are a number of terms, which are used to define emotional abuse. These include psychological abuse, psychological maltreatment, and emotional maltreatment. (Hornor, 2012).

Doyle (1997) defined these acts of emotional abuse as "abuse of the child, as a sole or main form, which consists of acts of omission and commission which are judged on the basis of a combination of community standards and professional expertise to be psychologically damaging". According to Doyle, such acts are usually committed by parental and/or authoritative figures that are in a position of power over the child; this therefore leaves the child in a vulnerable position. Such acts of emotional abuse on children cause immediate damage, and have significant impact on the child's behaviour, cognitive abilities, social interactions and ultimately the psychological functioning of that child.

What constitutes emotional abuse?
Emotional abuse is subject to controversy and, as it is the most recent form of identified mistreatment, has just begun to be understood and treated by professionals (Hornor, 2012), though relative research on the topic began in the 1980's. There have been a number of contradicting views on the issue due to the difficulty of defining child emotional abuse and a lack of relavant data due to the lack of observational studies.

McGee & Wolfe (1991) argued that, damaging parental behaviour should be considered as the primary indicator for emotional abuse. Conversely, other researchers have stated that parental behaviour alone cannot be the sole predictor of emotional damage in children, and that the emphasis should be placed on child outcomes arising from consequences of abuse and neglect (Aber & Zigler, 1981; Kavanagh, 1982). These conflicting views show that further research needs to be undertaken in this area.

Risk factors that are associated with poor outcomes for children who are exposed to emotional abuse include but are not limited to:
 * Socio-economic disadvantages
 * Larger families with a number of children
 * Social isolation or living in dangerous neighbourhoods
 * A parent or caregiver with depression or a drug or alcohol related dependence
 * A child with a disability
 * Duration and the frequency of the emotional abuse
 * The age and developmental stage of the child when the abuse first occurred, with the younger the age of the child the more likely it is they will experience the long-term consequences of the abuse later in life
 * The severity of the emotional abuse
 * The type/s of emotional abuse
 * The child's perception of the person and the relationship he or she has with who is perpetrating the emotional abuse (Iwaniec, 2003).

What are the consequences of emotional abuse?
Emotional abuse has specific and independent consequences and might, in fact, be the most pervasive and damaging type of abuse (Hornor, 2012). Children who undergo emotional abuse suffer from a unique form of treatment. The weapons which are used against them are not visible and do not consist of things such as belts, cords or sexual acts —those of which constitute physical and sexual abuse. Rather, these children are tormented with harsh words or uncaring silence (Hornor, 2012). Although these children don't suffer from any form of physical pain, the consequences are far longer lasting. This form of abuse is well known to serve as a risk factor for the development of mental illness later in life. Studies provide strong associations between emotional abuse and
 * Post-traumatic stress disorder
 * Depression
 * Substance abuse
 * Obesity
 * Suicide (Hart, Brassard & Karlson, 1996).

Although the long-term impacts are yet to be fully explored, Hornor (2012) stated that recent studies have begun to examine effects including: depression, anxiety and difficulties with interpersonal relationships.

Van Harmelen and colleagues (2010) aimed at identifying if this was in fact correct. His research supported the existence of the relationship between experiencing childhood emotional abuse and the development of depressive and/or anxiety disorder. Within his study, nearly 300 individuals with a current or previous diagnosis of an anxiety disorder or a major depressive disorder were interviewed in relation to whether they were subject to emotional abuse before the age of 16 years. Of these individuals, 93% reported that they had experienced emotional abuse of some form. These concerning results show the implication that being a victim of child emotional abuse can have serious adverse effects on their future development.

Reactive attachment disorder (RAD)
Reactive attachment disorder (RAD) is another possible consequence of child emotional abuse. According to Hornor (2012), RAD is defined as a markedly disturbed and developmentally inappropriate social relatedness that usually begins before the child reaches five years of age. This disorder is usually present in instances where the child will avoid, or have a cold watchfulness, when responding to different social situations and ultimately, the child has difficulty forming any type of relationship with anyone. However, RAD can also have a strange and contrasting effect where a child can attach to any individual including strangers. Such behaviours are a result of pathogenic care, which consists of persistent disregard to the child's basic emotional needs for stimulation, comfort and affection (Hornor, 2012). Emotional abuse in childhood can therefore threaten the security of attachment relationships and can produce maladaptive models of the self in relation to others.

A study by Wright, Crawford, and Del Castillo (2009) examined if an individual, who has experienced emotional abuse and was neglected by their parents, showed maladaptive long term negative outcomes including symptoms of depression, anxiety and dissociation. Sadly, findings of this research did in fact conclude that perceptions of childhood emotional abuse and neglect continued to exert an influence on later symptoms of anxiety and depression. Wright stated that how a person evaluates an experience is more important than the event itself. Therefore, a child, as they get older, are likely to suffer long-term impacts such as negative beliefs about the self.

When parents are emotionally abusive towards their children, this teaches children that aggression and hostility are an appropriate way of getting what you want. As a result children don’t learn appropriate ways to develop interpersonal behaviours and consequently, misinterpret the kind intention of others. Ensink (2012) explains this issue as reflective functioning – that is, the child does not have the ability to correctly interpret the feelings and thoughts of others and as a result these children learn aggressive tactics, and use this as a way to relate to those around them. This sense of shame that the child experiences when being emotionally abused can, during adolescence, interfere with their optimism and their ability to perform to the best of their ability in different aspects of their life. Children may feel that they don’t serve a purpose and once they reach adolescence, drug and alcohol dependence is likely to be a result (Moran et al. 2004).

There is no one way that a child, who is exposed to emotional abuse, will be affected. For some children the effects of emotional abuse may be long lasting and devastating, whereas for others the experience may have less aversive outcomes. According to Hornor (2012) there are a number of life experiences that can evidently influence a child’s vulnerability or resilience’s when faced with involvements of emotional abuse. That is, the ability this child will have in coping and thriving despite being exposed to such negative experiences. When a child has suffered from emotional abuse, if they discontinue to have few protective factors i.e. positive relationships, friends or other family members, the risk of serious adverse outcomes is very likely.

Relationship consequences


Relationship issues can arise as a consequence of emotional abuse. Rejection and subsequent shame have been identified as one of the most damaging consequences within adult relationships. Adults who have experienced emotional abuse in their childhood are likely to have problems with anger, emotional reactivity and increased loneliness in adult intimate relationships (Healey, 2006). Listed below is an example of a case study where the mother in this instant had emotionally abused her son, the consequences of her actions resulted in the son have difficulty understanding, identifying and feeling his emotions once he reached adulthood.

Developing brain
The developing brain is very sensitive to the trauma caused by experiences of child abuse and neglect. For children the brain develops over time and through interaction with the environment. Interaction between genes and environment also plays a role in how the brain develops, particularly during the early developmental period (Hornor, 2012). Therefore exposure to complex and chronic trauma can result in persistent psychological problems. When children do not receive consistent, supportive and interactive relationships with adult caregivers, it has been found to have an especially harmful effect on young children's growing brains. Recent research has demonstrated that traumatic events, particularly during the first decade in life while the brain is still rapidly developing, appear to leave the neuroendocrine stress response systems permanently supersensitive. Individuals are therefore at risk for the development mental illness when they encounter additional stressful events in adult life (Healey, 2006).

Basic human needs model
According to the basic human needs model, which has had significant support for explaining the heuristic value for emotional abuse postulates that this form of abuse prevents a fulfilment of basic human safety, love and belonging and self-esteem needs. This theoretical model is useful in determining which characteristics make an individual susceptible to psychological maltreatment (Iwaniec, 2003).

Attachment theories and models
Attachment theory proposes that a direct relationship between the quality of the relationship between a child in infancy, and their early experiences with their caregivers, influences their later experiences and relationships with peers. A child who experiences a secure attachment during infancy is said, according to Hornor (2012), to have different qualities and predispositions to the peers of someone whose attachment was insecure. The conceptual model which is grounded in attachment theory, suggests an intergenerational cycle if intervention does not occur.

This model proposes that insecure attachment styles and emotional abuse in early caregiving relationships has a profound impact on the attachment system, which affects individual development at every phase of life. Childhood emotional abuse initially interferes with the ability to regulate emotions and contributes to insecure attachment characterised by negative perceptions of the self and others. As the child develops, such deficits may create interpersonal schemas that can interfere with their social functioning and their relations with other peers in adolescence. Psychological disorders and emotional disruptions occur in adulthood due to these insecure internal models of attachment and coping patterns (Healey, 2006). As a result, these cognitive factors and avoidance tactics produce fearful attachment styles.

Case study
Nathan, a 32 year old man from Casey in the Act, consulted his general practitioner when he was having problems at work. Nathan was feeling down more days then not and had problems concentrating on regular daily tasks. He told his GP that he felt unhappy and sometimes empty. He continued to say that although he knows his wife loves him very much he has difficulties in feeling that love. His GP prescribed him with antidepressants, which after a few months proved to be unsuccessful, following this he was referred to cognitive therapy.

Throughout his time in therapy, Nathan expressed how events in his life did not bring him joy like they once did. He knew he was unhappy but he could not identify the source of his unhappiness. It was not until the therapist asked Nathan about experiences and events from childhood where he described growing up as part of a broken family where his mother re-married and had 3 other children in her new relationship. Nathan began to tell the therapist of times where his mother had rejected him and he was overlooked by his stepfather. Nathan’s mother treated him with derision, she regularly shamed him and verbally denigrated him more often than not and on one occasion she had locked him in his room for a whole day without any food or water. He believed this treatment to be a consequence of being a constant reminder of his father, who was never present in life.

How can it be dealt with?
It is evident that emotional abuse of children can have serious consequences for those involved. Therefore, it is vital that cases of abuse are identified and an appropriate form of intervention be implemented to decrease the long-term effects on children (Hornor, 2012). There is no one direct way in which to help children and also their families, but a number of intervention strategies should apply and these should be based on comprehensive holistic assessment, addressing the needs of the children and also the parents. Such interventions methods and approaches should aid in healing the child and also help parents in better understanding a child’s developmental needs. Community based services can also provide families who are facing difficulties which include poverty, social isolation, family violence and substance abuse. Interventions and treatments should aim to repair the damage and strengthen the parent-child relationship, enhancing the child’s sense of security and belonging and acknowledging their basic human needs.

Cognitive approach
Characteristics of emotional abusive parents using include self-defeating thoughts, and the belief that they are incapability of dealing with different and difficult life tasks. Such dysfunctional thoughts and feelings consequently lead to negative outcomes for the parents and the child (Hornor, 2012). According to Beck (1976) dysfunctional thoughts and beliefs generate a sense of helplessness. Therefore, being in such a state of mind generates indifference and leads to serious neglect and a child’s emotional needs. Interventions that focus on dealing with the cognitive aspects of emotional abuse help parents focus on generating positive thoughts, beliefs and feelings about their capabilities and provide them with opportunities in learning new methods to deal with life stresses and caring for their children. The cognitive approach will help neglectful parents address attitudes and perceptions of parental responsibilities; ultimately the therapy aims to raise their awareness of the child’s developmental needs and help them reach their child’s potential to be a healthy and happy individual.

Attachment theory – What can a parent do?
There is a variety of different methods in which children with attachment disorders can be treated, and the parent-child bond be restored. Dot points. When the child is in infancy, Iwaniec (2003) suggests that a parent should take an approach that should involve proactive maternal behaviour during bathing, feeding, changing and responding to the child’s signals for need and act appropriately. To appreciate the bonding experience will create a secure attachment between the mother and child, if however the child shows anxiety or resistance the mother should hold the child close, this interaction should be done a few times a day. When a child is older, Iwaniec (2003) recommends being warm and reassuring when talking to the child, reading them a story or simply by doing an activity together. Such interactions should be done a few times a day as the child gets older they will begin to feel more relaxed and gradually overtime the child will seek contact with other people and begin to start to develop close relationships with others.

Conclusion
It is evident from research that emotional abuse is detrimental for children. Therefore, any individual, not just professionals, need to be open minded when dealing with children who have been emotionally abused. They also need to be open minded with parents. It would seem appropriate that a multidimensional approach should be applied when designing treatments and interventions as every case is going to have different circumstance. Many services are available to not only children of abuse, but also parents and caregivers who require assistance.

Test your knowledge
{Emotional abuse can also be referred to as?} - Emotional maltreatment - Psychological abuse - Psychological maltreatment + All are correct

{How is emotional abuse dealt with?} - By not strengthening the child-parent relationship - By not acknowledging a child's general needs - By giving the child chocolate + There is no one way as each case is different. A number of strategies for intervention therefore should be applied.

{True or false/Is depression and low self esteem a possible consequence of emotional abuse?} - False + True

{Emotional abuse in childhood can lead to?} - Lots of money + Relationship consequences - A happy life

= See also =


 * Emotional development
 * Relationships and happiness
 * Bullying and emotion
 * Parenting and emotional development in children