Topic Editor: Harriet MacMillan, MD, McMaster University, Canada
Generally, child maltreatment can be grouped into four main categories: physical abuse, sexual abuse, emotional abuse (including exposure to domestic violence), and neglect.
In some instances, the effects of maltreatment are seen immediately. From 7% to 30% of infants who are victims of Shaken Baby Syndrome (SBS) die, while 30% to 50% have serious cognitive or neurologic deficits, such as behavioural disturbances, developmental delay, motor and visual deficits.
However, the impact of maltreatment is not always so directly evident. Early life adversity or trauma may lead to a range of problems, including depression, aggression, substance abuse, health problems and general unhappiness, years after the end of maltreatment. As adults, victims of maltreatment have high rates of anxiety and post-traumatic stress disorder and are more likely to engage in criminal behaviours. Maltreatment during infancy can lead to insecure attachment with caregivers that carries over to future relationships.
Children who witness domestic violence are at risk of psychological, emotional, behavioural, social and academic problems. They show problems similar to children who themselves have been the victims of physical abuse. Children in abusive families are exposed to maladaptive forms of emotional communication and behaviour and receive poor models of adaptive self-regulation.
The precise mechanisms linking the experience of maltreatment with the development of these problems are for the most part unknown. Children may be more sensitive to certain emotions (e.g. anger) relative to other emotions important for their social behaviour, or high stress may affect the process by which they learn to regulate their emotions.
Research on the effects of maltreatment faces a number of challenges. Researchers do not agree on how best to define and measure maltreatment. It is also difficult to distinguish between the effects of different forms of maltreatment (often experienced by the same children), and between the effects of maltreatment and the effects of associated poverty or other associated adverse environmental factors and life events. Genetic predisposition may help to explain why some children are more resilient to child maltreatment than others.
* This topic is developed with the collaboration of the Centre of Excellence for Child Welfare.
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