FREQUENTLY ASKED QUESTIONS
WHAT IS PSYCHOLOGICAL MALTREATMENT?
According to APSAC guidelines (Hart, Brassard, Baker, & Chiel, 2017), psychological maltreatment is defined as a repeated pattern or extreme incident(s) of caretaker behavior that thwart the child’s basic psychological needs (e.g., safety, socialization, emotional and social support, cognitive stimulation, respect) and convey that a child is worthless, defective, damaged goods, unloved, unwanted, endangered, primarily useful in meeting another’s needs, and/or expendable. This definition is recommended for use by social scientists, clinicians, and researchers. We recognize that child protection workers and mandated reporters are required to report and act on concerns about child abuse and neglect based on the definitions, regulations, and policies applied by their state, all of which can be informed by this definition. The full APSAC definition is available here and a brief description of the various subtypes are provided below.
Spurning includes verbal and nonverbal caregiver acts that reject and degrade a child such as saying mean things to the child, singling the child out for poor treatment, and shaming the child.
Terrorizing is caregiver behavior that threatens or is likely to physically hurt, kill, abandon, or place the child or child’s loved ones/objects in recognizably dangerous or frightening situations. Examples include subjecting a child to frightening or chaotic circumstances, threatening to abandon or abandoning the child, and setting rigid or unrealistic expectations with threat of loss, harm, or danger if they are not met.
Exploiting/corrupting is defined as caregiver acts that encourage the child to develop inappropriate behaviors and attitudes. Examples include modeling, permitting, or allowing the child to engage in anti-social activities, criminal activities, developmentally inappropriate activities, or cruelty to others; undermining the child’s important relationships; and coercing the child’s submission.
Emotional unresponsiveness embodies caregiver acts that ignore the child’s attempts and needs to interact (failing to express affection, caring, and love for the child) and showing little or no emotion in interactions with the child.
Isolating embodies caregiver acts that consistently and unreasonably deny the child opportunities to meet needs for interacting/communicating with peers or adults inside or outside the home. It includes confining the child or placing unreasonable limitations on the child’s freedom of movement within his/her environment; and placing unreasonable limitations or restrictions on social interactions with family members, peers or adults in the community.
Mental Health, Medical, and Educational Neglect
Mental health, medical, and educational neglect embodies caregiver acts that ignore, refuse to allow, or fail to provide the necessary treatment for the mental health, medical, and educational problems or needs of the child.
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 five categories.
Problems with Intrapersonal Thoughts and Feelings
Specific outcomes include anxiety, depression, negative self-concept, and negative cognitive styles that increase susceptibility to depression and suicidal thoughts and behaviors (e.g., pessimism, self-criticism, catastrophic thinking, immature defenses).
Emotional Problems and Symptoms
This outcome domain includes problems such as substance abuse and eating disorders, emotional instability, impulse control problems, borderline personality disorder, and more impaired functioning among those diagnosed with bipolar disorder and schizophrenia.
Social Competency Problems
Specific effects have been found for social phobia, impaired social competency, lack of empathy for others, attachment insecurity/disorganization, self-isolating behavior, non-compliance, extreme dependency, sexual maladjustment, aggressive and violent behavior, and delinquency or criminality.
Learning Problems and Behavioral Problems in Schools
Specific effects have been found for area such as impaired learning despite adequate ability and instruction, academic problems and lower achievement test results, decline in IQ over time, lower measured intelligence, and school problems due to non-compliance and lack of impulse control.
Physical Health Problems
This includes delays in almost all areas of physical and behavioral development; allergies, asthma, headaches, sleep complaints, and other respiratory ailments; as well as lifestyle risk behaviors in adolescence including tobacco smoking and risky sexual behavior that increases the risk of HIV and other sexually transmitted diseases; and the increased risk of disease and risk factors for commons diseases and health problems and mortality.
WHAT ARE RISK FACTORS FOR PSYCHOLOGICAL MALTREATMENT?
Risk factors for psychological maltreatment occur within the child, caregiver, family, and community.
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 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 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 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.