May 30

Be Human Stop Child Abuse : Vol 17, 29th May, 2013


Understanding child abuse

i. Child maltreatment is defined as intentional harm or threat of harm to a child by a person who is acting in the role of a caretaker.

ii. Health care providers should care for children

iii. Four types of child maltreatment are described:

  1. Physical abuse
  2. Sexual abuse
  3. Emotional abuse
  4. Child neglect.

iv.  Child neglect is most prevalent form of child abuse accounting for more than 50% of cases and is defined as failure to provide for a child’s basic, physical, emotional, educational and medical needs. The types are:

  1. Physical neglect which is failure to provide adequate cloth, food, hygiene, protection, inadequate supervision with risk of harm to the child.
  2. Emotional neglect is failure to provide love, affection, security, emotional support and failure to provide a psychological care when needed, spouse abuse in presence of the child.
  3.  Educational neglect which is failure to enroll a child in the school of ensure school attendance, home school, failure to address specific educational needs.
  4. Medical neglect which is refusal to seek or delay in seeking medical care resulting in damage or risk of child health.

v. Emotional abuse is defined as a child abuse that results in impaired psychological growth and development. It is a repeated pattern of damaging interactions between care giver and the child that becomes typical of the relationship and conveys to the child he is unheard or unwanted. Categories are rejecting (refusing to counsel), terrorizing (verbal assault or threat), ignoring (depriving essential interactions), corrupting (stimulating antisocial behavior), verbal assault (abusing or hammering), over pressuring (criticizing age appropriate behaviors as inadequate).

vi. Physical abuse and sexual abuse – Physical abuse invariably involves injury or trauma. Sexual abuse is defined as attempted sexual touching of another person without their consent and includes sexual act (rape, sodomi – oral genital and anal genital contact) or fondling. The generally accepted definition is when one engages in sexual activity in which he cannot give consent, unprepared for apprehension or an activity that violates law or social taboos of society. This includes fondling and all forms of oral genital, genital or anal contact with the child whether the child is clothed or unclothed as well as in touching abuses such as exhibitionism or voyeurism or involving the child in pornography.





Dr Vinay Aggarwal, President, Elect CMAAO

Dr K Vijayakumar (National President) IMA

Dr N Saini (Secretary General) IMA

Dr M Pillai (Chairman Organising Committee)

Dr D R Rai (Organising Secretary)

Dr S Arulrhaj (Chairman Scientific Committee)

Dr KK Aggarwal (Co-Chairman & Editor)


Developmental trajectory of sexual risk behaviors from adolescence to young adulthood.

This study examined the trajectories of sexual risk behaviors among adolescents from ages 15 to 23, and factors associated with those trajectories. The sample was 5,419 adolescents from the 1997 National Longitudinal Survey of Youth. Using group-based trajectory modeling, five distinctive trajectory groups were identified. The High group had a high and increased risk trajectory over the observed ages. The Decreased group had a risk trajectory that accelerated before age 19, but decreased afterwards. The risk trajectories of the Increased-Early and Increased-Late groups were low at age 15, but increased significantly starting at ages 16 and 18 for the groups, respectively. Participants in the Low group remained at low risk over time. Sexual risk behaviors were also positively associated with alcohol use, marijuana use, and delinquency. Results highlight the need for intervention efforts to consider developmental timing of sexual risk behaviors and their associations with other problem behaviors.

Source: Huang DY, Murphy DA, Hser YI. Youth Soc. 2012 Dec;44(4):479-499

Preventing the Recurrence of Maltreatment

In the context of the federal child welfare performance measurement system, recurrence of maltreatment refers to circumstances in which children that have previously been substantiated as victims of abuse or neglect experience another incident of substantiated maltreatment. Multiple episodes of maltreatment can lead to: (1) more serious short and long term negative consequences, (2) entry into the juvenile justice system, and (3) juvenile delinquency.

Source: Carnochan S, Rizik-Baer D, Austin MJ. J Evid Based Soc Work. 2013 May;10(3):161-178.

Childhood abuse is associated with structural impairment in the ventrolateral prefrontal cortex and aggressiveness in patients with borderline personality disorder

Volume reduction and functional impairment in areas of the prefrontal cortex (PFC) have been found in borderline personality disorder (BPD), particularly in patients with a history of childhood abuse. These abnormalities may contribute to the expression of emotion dysregulation and aggressiveness. In this study we investigated whether the volume of the PFC is reduced in BPD patients and whether a history of childhood abuse would be associated with greater PFC structural changes. Structural MRI data were obtained from 18 BPD patients and 19 healthy individuals matched for age, sex, handedness, and education and were analyzed using voxel based morphometry. The Child Abuse Scale was used to elicit a past history of abuse; aggression was evaluated using the Buss-Durkee Hostility Inventory (BDHI). The volume of the right ventrolateral PFC (VLPFC) was significantly reduced in BPD subjects with a history of childhood abuse compared to those without this risk factor. Additionally, right VLPFC gray matter volume significantly correlated with the BDHI total score and with BDHI irritability and negativism subscale scores in patients with a history of childhood abuse. Our results suggest that a history of childhood abuse may lead to increased aggression mediated by an impairment of the right VLPFC.

Source: Morandotti N, Dima D, Jogia J, Frangou S, Sala M, Vidovich GZ, Lazzaretti M, Gambini F, Marraffini E, d’Allio G, Barale F, Zappoli F, Caverzasi E, Brambilla P. Psychiatry Res. 2013 May 18.

Readers Response
  1. Dear Sir, Pls keep it up. Regards:Dr Sharad

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