FREQUENTLY ASKED QUESTIONS
WHAT IS PSYCHOLOGICAL MALTREATMENT?
According to APSAC guidelines (APSAC, 2023), psychological maltreatment is defined as caregiver behaviors toward or involving a child (Excluding physical abuse, sexual abuse, and physical neglect) that cause or have a strong potential to cause serious harm to a child's emotional, cognitive, social, interpersonal, or physical wellbeing or development. To be psychological maltreatment the act must be non-accidental and have significant harmful impact on the child.
Emotional Unresponsiveness
Caregiver actions that ignore or deny the child's needs for affection and attention.
Spurning
Caregiver acts that reject and degrade a child, both verbally and nonverbally.
Developmentally Inappropriate Interactions
Treating children as if they were older or younger than they actually are - dictated by the parent's needs, not the child's needs.
Inappropriate Response to Perceived Behavior
Caregiver responses to real or perceived misbehavior that are extreme or out of proportion to the misdeed - and/or that are psychologically harmful to a child.
Terrorizing
Caregiver behaviors that hurt or threaten to hurt children or their loved ones.
Exploiting
Using children to fulfill a caregiver's needs at the expense of the children's needs.
Failure to Promote Socialization
Encouraging anti-social behavior.
HOW COMMON IS PSYCHOLOGICAL MALTREATMENT?
Research estimates vary based on whether the data is derived from self-reports or reports of observers. We believe that it is reasonable to estimate that between 10% and 30% of community samples experience moderate levels of psychological maltreatment in their lifetime and between 10% and 15% of all people (community and clinical samples) have experienced the more severe and chronic forms of this maltreatment.
HOW HARMFUL IS PSYCHOLOGICAL MALTREATMENT?
Psychological maltreatment has been associated with a host of negative outcomes for children, which fall into the following six categories.
Depression and Increased Likelihood of Suicide
Depression, suicide, and non-suicidal self-injury are more closely linked to PM than to other forms of child maltreatment.
Social Anxiety
PM can lead to intense fears of being rejected by friends, family, acquaintances, and to self-criticism and shame.
Conduct Disorders
Conduct disorders in youth (antisocial behaviors that may or may not be illegal, i.e., delingquent) are causally linked to co-occurring psychological abuse in the forms of spurning, terrorizing, and failure to socialize, as well as physical abuse .
Thought Problems
Thinking problems, disassociation, hallucinations, and diagnosed psychosis are all linked to PM. These may be a part of the trauma response to maltreatment.
Cognitive Decline in Infancy and Low Cognitive Functioning
Severe psychological neglect early in life can result in significant decline in cognitive functioning. Both psychological neglect and physical neglect can result in low cognitive functioning, poor academic achievement, and low occupational attainment.
Physical Health Problems
Physical health problems from PM can include: asthma, pain without a medical explanation, decreased grey matter in the auditory cortex (verbal abuse), shorter adult height resulting from psychological and physical abuse, or headaches.
WHAT ARE RISK FACTORS FOR PSYCHOLOGICAL MALTREATMENT?
Risk factors for psychological maltreatment occur within the child, caregiver, family, and community.
Child
Although children are never to blame for their own victimization, there are child characteristics that make them more likely to be treated in a psychologically maltreating manner by a caregiver. These characteristics include being at a challenging developmental stage (i.e., infancy, toddlerhood, adolescence), having a difficult temperament (being hard to sooth), having a disability, and having behavior problems.
Caregiver
Caregiver behaviors that have been identified in the research literature as increasing the likelihood of psychological maltreatment behaviors include being young, unprepared for parenthood, having low self-esteem and poor impulse control, lacking in empathy, difficulty appreciating the strengths of the child, having mental health problems, being a victim of interpersonal violence and their own maltreatment experiences as a child.
Family
Family factors associated with psychological maltreatment include a large ratio of children to adults in the home, presence of an aberrant parent figure in the home, insufficient support from extended family, and insufficient income and resources.
Community
Community factors include poverty, drugs, and violence as well as low expectations for the care of children, and mandated reporters not being aware and/or not acting on instances of psychological maltreatment.
WHAT ARE COMMON MISCONCEPTIONS ABOUT PSYCHOLOGICAL MALTREATMENT?
Words cannot cause harm to children
Many may recall the childhood song that sticks and stones can break our bones but words can never harm us. It turns out that words can actually cause harm, especially when the words are directed by an angry/rejecting parent towards a child. Although the brutality of physical abuse and the depravity of sexual abuse may be shocking, the harm caused by psychological maltreatment -- research tells us -- can be as if not more harmful to a child. The Adverse Childhood Experiences (ACE) study, and the subsequent related studies, demonstrate the unique and the additive impact of psychological maltreatment on a wide range of poor outcomes including eating disorders, physical ailments, depression, among others.
It is impossible to differentiate between psychological maltreatment and poor parenting
Unlike physical abuse and sexual abuse -- in which a single act is actionable -- psychological maltreatment is primarily assessed through a pattern of caretaker behaviors. This means that any specific behavior may represent poor parenting and not PM per se. In some instances there is no bright line between poor parenting and PM. It is the frequency, intensity, and duration that can tip the scale in one direction or another.
Psychological maltreatment is not as bad as other types of abuse
As noted above, research demonstrates that the effects of PM can be as bad if not worse than other forms of childhood maltreatment. The belief that it is "only words" and therefore cannot cause as much harm to a child is not supported by large-scale longitudinal research.