Psychological Maltreatment

Psychological or emotional maltreatment of children may be the most challenging and prevalent form of child abuse and neglect. Caregiver behaviors include acts of omission (ignoring need for social interactions) or commission (spurning, terrorizing); may be verbal or nonverbal, active or passive, and with or without intent to harm; and negatively affect the child's cognitive, social, emotional, and/or physical development. Psychological maltreatment has been linked with disorders of attachment, developmental and educational problems, socialization problems, disruptive behavior, and later psychopathology. Although no evidence-based interventions that can prevent psychological maltreatment have been identified to date, it is possible that interventions shown to be effective in reducing overall types of child maltreatment, such as the Nurse Family Partnership, may have a role to play. Furthermore, prevention before occurrence will require both the use of universal interventions aimed at promoting the type of parenting that is now recognized to be necessary for optimal child development, alongside the use of targeted interventions directed at improving parental sensitivity to a child's cues during infancy and later parent-child interactions. Intervention should, first and foremost, focus on a thorough assessment and ensuring the child's safety. Potentially effective treatments include cognitive behavioral parenting programs and other psychotherapeutic interventions. The high prevalence of psychological abuse in advanced Western societies, along with the serious consequences, point to the importance of effective management. Pediatricians should be alert to the occurrence of psychological maltreatment and identify ways to support families who have risk indicators for, or evidence of, this problem.     

Maltreatment of children with disabilities

Widespread efforts are being made to increase awareness and provide education to pediatricians regarding risk factors of child abuse and neglect. The purpose of this clinical report is to ensure that children with disabilities are recognized as a population that is also at risk of maltreatment. Some conditions related to a disability can be confused with maltreatment. The need for early recognition and intervention of child abuse and neglect in this population, as well as the ways that a medical home can facilitate the prevention and early detection of child maltreatment, are the subject of this report.     

Child Maltreatment: Screening and Anticipatory Guidance

Child maltreatment is a problem of epidemic proportions in the United States. Given the numbers of children affected by child maltreatment and the dire consequences that can develop, prompt identification of child maltreatment is crucial. Despite support of the implementation and development of protocols for child maltreatment screening by professional organizations such as the National Association of Pediatric Nurse Practitioners and American Academy of Pediatrics, little is available in the literature regarding the screening practices of pediatric nurse practitioners and other pediatric health care providers. This Continuing Education article will help pediatric nurse practitioners incorporate this vital screening intervention into their practice. Practical examples of when and how to incorporate screening questions and anticipatory guidance for discipline practices, crying, intimate partner violence (domestic violence), physical abuse, and sexual abuse will be discussed.     

Maltreatment history and weapon carrying among early adolescents

This study examines the role of maltreatment in weapon carrying among 12-year-old youth (N = 797) interviewed as part of the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN), an ongoing study of the antecedents and consequences of child maltreatment. Participants reported their physical and sexual abuse history and provided responses to items assessing perceived need for a weapon and weapon carrying. There were no gender differences in rates of self-reported physical or sexual abuse. Males were more likely than females to report weapon carrying and perceived need for a weapon. A mediation analysis was conducted to examine the mediating effect of perceived need for a weapon on the association between abuse and weapon carrying. Results indicated that perceived need for a weapon fully mediated the effect of physical abuse and partially mediated the effect of sexual abuse. Results are discussed in the context of self-protection theory.     

Neighborhood Characteristics, Child Maltreatment, and Child Injuries

The study reported here aimed to advance research methods by demonstrating the utility of observational rating scale to measure neighborhood physical and social characteristics. In a related vein, the study clearly points to the need for additional, focused research on neighborhood effects on child safety. The need to identify or develop the best possible indicators of child well-being, especially at small areas of geography is one of the more pressing challenges for indicators research.