Child abuse – the action or inaction of parents, trustees, tutors doing harm to health, a mental condition of the child. It is shown by psychological, physical, sexual abuse, neglect, ignoring of requirements, exploitation of the child in the mercenary purposes. Leads to negative consequences: to development violations, developing of mental disorders, deterioration in health, social disadaptation. Diagnostics of traumatic consequences is made by clinical, psychological methods. Treatment includes psychotherapy, reception of medicines.
Child abuse is a medical, psychological and legal problem. Any forms of violence, negligent attitude to the child are forbidden by the law, involve criminal liability. Statistically, the number of the children who underwent cruelty of parents grows annually. Acts of physical violation are tested by 25% of children and teenagers. 20% of girls, 7-8% of boys are exposed to sexual violence. Presumably, it is more victims of negligence, psychological pressure, however their exact quantity is unknown. 2 million children are beaten by parents, more than 10 thousand from them become disabled people, 1 thousand perish as a result of a beating, more than 2 thousand finish life with a suicide.
Reasons of child abuse
The relations in a family develop on the basis of moral values, the state of health, psychological features and the social status of her members, material conditions of accommodation. Risk factors of formation of child abuse are:
- Incomplete, conflict families. Quarrels of spouses, a beating, goings from the house, education by one parent, presence of the stepfather, stepmother increases probability of ill treatment.
- Asocial families. Low-security, heavy material living conditions, lack of permanent job, alcoholism, drug addiction of parents, occupation with criminal activity, prostitution are factors of the increased risk.
- Cultural and educational level of parents. Lack of knowledge of features of development and education of children, low moral, intellectual level become a basis for the disrespectful relation, humiliation of the child.
- Rejection of the child. Unwanted pregnancy, perception of the child as too active, disobedient, insufficiently clever is shown by the aggressive, pejorative address. Often the children having mental, physical diseases become "target".
- Transfer of behavior model. Cruel to be inclined the parents who were exposed to violence in the childhood. The education including threats, intimidations, humiliations, a beating is regarded as normal.
- Somatic, mental diseases. Frustration of the affective sphere of the parent – psychopathological changes of the personality, acute reactions on a stressful situation (a divorce, work loss), neurosises, psychoses, the long exhausting somatic diseases promoting isolation, an invalidization can be the cause of rigidity.
The destructive, pathological relation of parents is the cornerstone of child abuse. It develops on the basis of biological, psychological and social factors. The biological component is presented by features of temperament (irascibility, emotional instability, "jamming"), diseases influencing the affective sphere, reducing ability to adequate response to stressful events. Psychological features are formed during life. The parents inclined to violent, to ill treatment, have difficulties of forming of the productive relations, studies of negative emotional states. They compensate uncertainty, feeling of inferiority by domination, submission, demonstration of force. Social conditions often become the trigger for emergence of cruelty to children. Sexual, physical, psychological abuse, ignoring of the child arises at family, material unsettledness, lack of recognition of people around.
Classification of child abuse by contents is widespread. Allocate four forms:
- Physical abuse. Assumes deliberate drawing physical sufferings to the child. Consequences – bruises, injuries, disability, death.
- Sexual violence. The child is involved in actions of sexual character which purpose – physical satisfaction, material benefit. Consent to contact does not exclude a case from category violent as children have no ability to estimate consequences.
- Neglect needs. Lack of care of the child is shown by violations of the emotional sphere, deviations physical, mental development, somatic diseases.
- Mental violence. Includes periodic, long or continuous psychological influences which brake, distort personal development, form neurotic, psychopathic frustration. Treat this type of violence:
- Humiliation, criticism. Parents openly do not accept the child, speak about hostility, dislike, condemn actions, belittle, offend, sneer, forming a low self-assessment.
- Threats. The child is constantly subject to promises of physical violence, psychological rejection, deprivation of material benefits.
- Isolation. There is a rigid control over communication, movement of the child, "house arrests" practice. At psychological isolation parents deliberately show coldness, indifference, do not react to the speech, the child's acts.
- Use of privileges. Parents do not leave to the child of freedom of choice. "Maturity", ability to earn money is interpreted as the privilege to operate life: to choose clothes, food, ways of training, carrying out leisure.
- Single rough influence. The powerful psychological influence forming a psychotrauma is made.
Symptoms of child abuse
The children who are exposed to violence, growing in conditions of educational neglect have the deformed psychological development. Deviations are defined in the sphere of emotional reactions, behavior, social adaptation, self-understanding, self-perception. The arising frustration are various: delay of mental development, lack of affection for mother, antisocial acts, depression, neurosis of persuasive actions.
The newborns, babies abuse, children of early age forms the general arrest of development: cognitive, psychomotor, speech, social skills lag behind. Interest in toys is reduced, motivation to interaction with the adult weak. Children are emotionally unstable, reactions are hypertrophied, inadequate: crying, shout, howl, aggression, a motive rastormozhennost. In process of a growing the behavior becomes oppositional and demonstrative, antisocial, disturbing, disturbing and depressive, bipolar disorder, a syndrome of deficiency of attention and a hyperactivity develops. Children badly adapt to school, kindergarten, seldom establish friendly relations, are incapable them to support. The educational motivation the weak, school program accustoms hardly.
At teenagers deficiency of personal development develops: there is no constancy of self-perception and feeling own "I", understanding of a body, understanding of as individual is broken. Young men, girls experience difficulties of definition, detection of own feelings, cannot describe emotion, control them. The behavior is dysfunctional, inconsistent. Requests are substituted for impulsive actions. Inability to come into contact, to discuss the desires, experiences promotes social isolation. Constant tension is supported by assessment of any new events as menacing.
Complications of ill treatment are social isolation, disability, the death of children. According to the Ministry of Health, 70% of children's injuries, accidents, poisonings are result of a carelessness of parents. 10-12% of the children who are exposed to various forms of violence perish from hands of parents or make a suicide. Consequences of ill treatment are shown at young and mature age. At adults various violations of social functioning (drug addiction, prostitution, criminal activity), mental disorders develop (violations of food behavior, maniac-depressive psychosis, a depression, somatizirovanny frustration, a psychopathia).
Diagnostics of child abuse is complicated by the aspiration of parents to deny acts of violence and negligence. Whenever possible examination of the child is conducted separately. Diagnostic process includes:
- Poll of parents. The psychiatrist, the psychologist ask questions of the family relations, features of behavior, mood of the child. Ill treatment is supposed if the condition of the child does not correspond to answers of mother, the father; parents are hostile, refuse to cooperate with experts; ignore, in a wrong way interpret the conclusions of doctors (the traumatologist, the pediatrician); easily become excited, do not control the behavior; tested rigidity from the parents; disprove attestations of eyewitnesses (neighbors, passersby); have alcoholic, drug addiction.
- Conversation with the child. After establishment of productive contact the doctor asks the child on hobbies, the relations with mother, the father, specifies the frequency of violent acts, refusals in the help, estimates emotional, behavioural changes at discussion of the injuring situations, finds out whether the child has close people – friends, relatives. Results of a conversation are interpreted together with the conclusion of the pediatrician, psychologist, traumatologist, characteristics of teachers, protocols of employees of police.
- Psychodiagnostics. The children's psychologist uses questionnaires, projective methods for identification of emotional deviations, komorbidny mental violations, the symptoms associated with a sharp and chronic psychotrauma. By results the level of uneasiness, a depression, aggression, impulsiveness, risk of asocial behavior is defined. Pictural tests, interpretative techniques, questionnaires are used: "List of children's behavior", "A children's scale for diagnosis of a post-traumatic stress", "The check list of traumatic symptoms".
Treatment at child abuse
Medical and psychological assistance are necessary for elimination of a chronic complex trauma of development. The combination of various methods of psychotherapy and drug treatment is used. The purpose – correction of emotional, behavioural, cognitive deviations, improvement of public functioning. Therapy begins after safety of the child. Treatment consists of a number of stages:
- Selection of medicines. Medicamentous therapy is appointed to children with the expressed emotional frustration, behavioural violations. Taking into account a clinical picture the doctor selects antidepressants, tranquilizers, sedatives, neuroleptics.
- Self-control training. The child learns to regulate excitement process, to restore emotional balance after frustration.
- Formation of skill of processing of information. The mismatch of interrelation of cognitive, touch systems is eliminated through a training of concentration of attention. The speech is used as the instrument of creation of the stories about itself helping to develop self-understanding, consciousness.
- Integration of the injuring experience. Technology of acceptance, designing of sense, experience of the suppressed emotions transform traumatic memoirs to productive experience.
- Restoration of social communications. Group occupations allow to fulfill skills of confidence, communication, cooperation, ability to establish physical, emotional proximity.
- Fixing of result. The favorable forecast of the future is formed. Creative activity, a support on the previous achievements is used. The child studies planning, statement of the purposes.
Forecast and prevention
The forecast of consequences of ill treatment is defined by age of the beginning of a travmatization, degree of dysfunctionality, asociality of a family. The minimum positive dynamics is observed at the children subject to violence since the birth. If ill treatment began after three-five-year age and there is an opportunity to restore, keep the close child maternal relations, then the forecast favorable. Preventive measures are directed to the prevention of the reasons of ill treatment. Parents need to ask in due time for psychological, social assistance in difficult situations, not to transfer anger, irritation to the child. From health, social services prevention consists in timely identification and monitoring of families of risk groups: incomplete, living in the adverse conditions abusing alcohol.