Child Abuse - The Hidden Bruises | American Academy of Child & Adolescent Psychiatry

Child Abuse - The Hidden Bruises

No. 5; Updated March 2011
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The statistics on physical child abuse are alarming. It is estimated hundreds of thousands of children are physically abused each year by a parent or close relative. Thousands actually die as a result of the abuse. For those who survive, the emotional trauma remains long after the external bruises have healed. Communities and the courts recognize that these emotional “hidden bruises” can be treated. Early recognition and treatment is important to minimize the long term effect of physical abuse. Whenever a child says he or she has been abused, it must be taken seriously and immediately evaluated.

Children who have been abused may display:

a poor self image
sexual acting out
inability to trust or love others
aggressive, disruptive, and sometimes illegal behavior
anger and rage
self destructive or self abusive behavior, suicidal thoughts
passive, withdrawn or clingy behavior
fear of entering into new relationships or activities
anxiety and fears
school problems or failure
feelings of sadness or other symptoms of depression
flashbacks, nightmares
drug and alcohol abuse
sleep problems

Often the severe emotional damage to abused children does not surface until adolescence or even later, when many abused children become abusing parents. An adult who was abused as a child often has trouble establishing lasting and stable personal relationships. These men and women may have trouble with physical closeness, touching, intimacy, and trust as adults. They are also at higher risk for anxiety, depression, substance abuse, medical illness, and problems at school or work.

Early identification and treatment is important to minimize the long-term consequences of abuse. Qualified mental health professionals should conduct a comprehensive evaluation and provide treatment for children who have been abused. Through treatment, the abused child begins to regain a sense of self-confidence and trust. The family can also be helped to learn new ways of support and communicating with one another. Parents may also benefit from support, parent training and anger management.

Physical abuse is not the only kind of child abuse. Many children are also victims of neglect, or sexual abuse, or emotional abuse. In all kinds of child abuse, the child and the family can benefit from evaluation and treatment from a qualified mental health professional.

See Facts for Families:
#9 Child Sexual Abuse
#28 Responding to Child Sexual Abuse
#43 Discipline
#81 Fighting and Biting
#00 Definition of a Child and Adolescent Psychiatrist

See also: Your Child (1998 Harper Collins) / Your Adolescent (1999 Harper Collins)

Click here to order Your Child from Harper Collins
Click here to order Your Adolescent from Harper Collins

Excerpts from Your Child on the Traumatic Effects of Child Abuse

In the view of some experts, child abuse in this country has reached almost epidemic proportions. According to a recent report, more than two million children are subjected to neglect and physical, emotional, or sexual abuse every year.

There is no standard definition of what constitutes child abuse, but each state has statutes that describe the forms of child abuse. Regardless of distinctions in legalistic terminology, however, experts agree that the abuse cases reported represent a small percentage of the actual number of children who are victims of sever abuse.

Causes and Consequences

Most parents prefer to think of chronic child abuse as something that happens to other people’s children. While it is evident that certain kinds of stress make abuse statistically more likely – poverty, job loss, marital problems, extremely young and poorly educated mothers – abuse also occurs across all economic lines and in seemingly good homes. Many people blame the prevalence of violence on TV and in the movies, and while that theory has not as yet been fully substantiated, media violence may contribute to our acceptance of physical aggression toward children, It is worth noting that cultures in which corporal punishment is not sanctioned have much lower rates of child abuse.

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The American Academy of Child and Adolescent Psychiatry (AACAP) represents over 8,500 child and adolescent psychiatrists who are physicians with at least five years of additional training beyond medical school in general (adult) and child and adolescent psychiatry.

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