The Invisible Bruise: Complexities of Protecting Children from Emotional Abuse and Psychological Maltreatment

The purpose of this paper is to provide a framework for understanding the complexities associated with determining the occurrence of emotional abuse and psychological maltreatment on children by a primary caregiver. Specifically, the paper addresses how professionals faced with the responsibility of making these determinations assess the child-caregiver relationship; possible explanations for why assessing emotional abuse and psychological maltreatment tends to be much more subjective and difficult to prove compared to other forms of child maltreatment; and lastly, potential policy recommendations for enhancing the consistency and legitimacy of emotional abuse and psychological maltreatment findings across cases.

The long-term effects of emotional abuse and psychological maltreatment on children are the least researched yet possibly the most deleterious when compared to the other common types of child maltreatment investigated by child protective services and heard by juvenile, family, or dependency courts – namely, physical abuse, sexual abuse, and neglect. This disconnect between research and policy results in many vulnerable children being left in unsafe home environments.

Current Research

The available research and data pertaining to emotional abuse is limited. This subset of child welfare studies is narrowed even further when looking for information related to emotional abuse independently, as opposed to the comorbidity between emotional abuse and either physical or sexual abuse. To illustrate this void in research, one only needs to look at the actual counts of research articles. The number of articles focusing on child maltreatment in general rose 647% from 1977, when 54 articles had been published up to that time, to 1998, when 344 articles had been published (Iwaniec 2006). Although this increase is certainly something to be celebrated, only 4.2% of all of the research articles published by 1998 were devoted independently to emotional abuse or neglect (Iwaniec 2006, p. 10).

This low rate is startling when compared to the potential high rate of the actual prevalence of emotional abuse as acknowledged in Iwaniec’s earlier discussion of a 2001 study conducted by Binggeli, Hart and Brassard. They “estimated that psychological maltreatment may have been significantly present in the childhood histories of more than one-third of the general adult population of the United States” (Iwaniec 2006, p. 5). As later stated, this gap can potentially be explained by a number of problems. Primarily, emotional abuse has, until very recently, been perceived to have fewer longitudinal effects on its’ victims, and the effects that it does have, were thought to be less serious when compared to the outcomes of physical abuse, sexual abuse, or neglect (Iwaniec 2006).

This inconsistency between the prevalence of emotional abuse on children and the research available on the subject is parallel to the enormous variation in rates of substantiated emotional abuse by child protective agencies across the country. By using the data collected from the National Child Abuse and Neglect Data System (NCANDS) established by the federal Child Abuse Prevention and Treatment Act of 1974 (CAPTA), Hamarman, Pope and Czaja (2002) present the wide range of rates of substantiated reports of emotional abuse to children. They found that the national mean number of victims of emotional abuse per 10,000 children was 11.7, compared to 15.1 and 29.4 for sexual and physical abuse, respectively. What is more telling, however, is the range and variance of the data for each type of maltreatment. For physical abuse, the lowest and highest reported means per 10,000 children were 7.6 (from Hawaii) and 94.7 (from Alaska), resulting in a 12-fold difference across the United States and a variance of 342.

The data for sexual abuse revealed a mean minimum of 3.1 (from Arizona) and 40.2 (from Alaska), resulting in a 13-fold difference and a variance of only 89. These ranges both seem minimal when compared to those of the emotional abuse findings. Hamarman et. al (2002) reported the minimum of victims per 10,000 children in Pennsylvania at 0.37, and a maximum of 113.02 in Connecticut. This results in a 300-fold difference across the country and a variance of 451 (Hamarman et. al 2002, p. 306). These marked discrepancies illustrate that a significant amount of children are most likely victims of emotional abuse and are not being protected by child protection agencies as they ought to be, specifically in the states with the lowest amounts of substantiated reports.

The findings of the Hamarman et. al study are especially concerning for two main reasons. When explaining what constitutes emotional abuse, Shull (1999) states that “emotional abuse is, simply, all the rest, the excess within child abuse after physical abuse and sexual abuse are specifically defined. Any imaginative form of cruelty visited on a child that is not a beating or a sexual contact is psychological abuse” (p. 1667). Additionally, Veith (2004) reports that emotional abuse is embedded in all other types of maltreatment, including physical and sexual abuse.

For this reason, he concludes that emotional abuse is “easily the most prevalent form of maltreatment in the United States” (Veith 2004). When understood in conjunction with the findings of Hamarman et al, it becomes even more apparent that child victims of emotional abuse are at a disadvantage for having their abuse identified, validated, and subsequently stopped by child protective services.

An additional reason to be concerned with the variation in substantiated reports of emotional abuse is the inconsistency in defining emotional abuse. Although CAPTA requires states to include emotional abuse as a type of maltreatment eligible for child protective intervention, there is currently no federal statute that specifically explains what constitutes emotional abuse to a child. For this reason, states create their own definition and can therefore be as inclusive as they see fit.

As explained by Glaser (2002), most of the variation in states’ definitions is related to whether emotional abuse is determined by the specific behaviors of the parents, by evidence of these behaviors impacting the child, or by both (p. 701). She continues to report that this disparity in identifying emotional abuse often results in child protective services delaying intervention when other types of maltreatment are not obvious. This delay puts children even further in harms way as the abuse persists and its’ effects become more detrimental to their healthy development (Glaser 2002, p. 701).

Although minimal, the case law that is available discusses the significant impact that emotional abuse can have on children and the need for child protection or criminal intervention in the most severe cases. As discussed in the opinions recorded in In re Shane T. 453 N.Y.S.2d 590, a teenage boy, Shane, was repeatedly berated, shamed and called degrading names by his father. Additionally, his mother failed to take any action to stop, or even attempt to stop, his father’s actions.

The court found that Shane had in fact been abused by both his mother, due to her failure to protect him, and his father, resulting in Shane being placed in to the custody of New York’s Department of Social Services. Although the most severe complaints did not include physical or sexual abuse, the court stated that “the behavior of this respondent father is as serious a form of abuse as if he had plunged a knife into the stomach of this child. In fact, it's probably worse since the agony and heartache suffered by Shane has already assailed him for several years and constitutes a grave and imminent threat to his future psychological development” (In re Shane T. 1982).

Discussion

A review of the material dedicated to understanding the complex framework of emotional abuse shines light on three primary shortcomings in research, policy, and practice. Firstly, the amount of academic research and rigorous investigations dedicated to the risk factors, potential outcomes, and treatment recommendations is severely unrepresentative of the prevalence of emotional abuse to children. This leaves practitioners and policy makers with an insufficient amount of tools and knowledge concerning this invisible type of maltreatment.

Secondly, the lack of a common definition of emotional abuse as developed by a federal statute or case law, results in too much flexibility for states to determine their own criteria. Although it would certainly not be an easy task to develop a universal framework for what constitutes emotional abuse, without it, we run the risk of delaying intervention and keeping children in unsafe situations.

Lastly, the lack of a generally accepted definition has resulted in a significant variation of substantiated cases of emotional abuse across the nation. When compared to the variation rates of physical abuse and sexual abuse, the wide range of report rates is alarming.

What remains to be answered, however, is how to develop this framework for identifying and stopping emotional abuse. As investigations outside of the scope of this report have proven, the short-term and long-term effects of emotional abuse on children are much more varied than they are for physical or sexual abuse. Additionally, they are often a combination of internalized or externalized behaviors that make it difficult to prove a causal relationship between the emotional abuse and the behaviors.

Furthermore, as discussed by Shull (1999), the creativity of parents to develop new and unusual ways of abusing their children that do not fit within the distinct frames of physical or sexual abuse will never come to an end. For all of these reasons, policy makers are hesitant to define what is and what is not emotional abuse at the fear of excluding criteria that may not be common for the majority of victims but may still occur for some.

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References

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Shull, J. R. "Emotional and Psychological Child Abuse: Notes on Discourse, History, and Change." Stanford Law Review 51, no. 6 (1999): 1665-701. Accessed April 2011. JSTOR.

Vieth, Victor. "When Words Hurt: Investigating and Proving a Case of Psychological Maltreatment." Reasonable Efforts 2, no. 1 (2004). 2004. Accessed April 2011. http://www.ndaa.org/reasonable_efforts_v2no1.html.