Child Abuse ↓
Injury, or even death, of a child through abuse is frightfully common. Child abuse can result from physical, emotional, or sexual harm; and it can even result from neglect. There are multiple causes, including households that suffer alcoholism, anger issues, and substance abuse.
Child abuse is widespread and can occur in any cultural, ethnic, and income group. Child abuse can be physical, emotional, verbal, or sexual. It can also result from neglect. Abuse can result in serious injury to the child and possibly even death.
Studies show that one in four girls and one in eight boys are sexually abused before the age of 18, and that approximately one in 20 children are physically abused each year. Physical abuse involves harming a child by, for example, burning, beating, or breaking their bones. Child sexual abuse is the deliberate exposure of a minor child to sexual activity that the child cannot comprehend or consent to. This means a child is forced or talked into sex or sexual activities by another person. This behavior includes acts such as inappropriate touching of a child's breasts or genitalia, someone exposing their genitalia to a child, fondling, oral-genital contact, genital and anal intercourse, as well as exhibitionism, voyeurism, and exposure to pornography.
Child neglect occurs when someone does not provide the necessities of life to a child, either intentionally or with reckless disregard for the child's well being. This can include physical neglect, such as withholding food, clothing, shelter, or other necessities. Emotional neglect includes withholding love or comfort or affection. Medical neglect occurs when medical care is withheld.
It's not always easy to recognize when a child has been abused. Children who are abused are often afraid to complain because they are fearful that they will be blamed or that no one will believe them or because the person who abused them is someone they love very much. Parents are often unable to recognize symptoms of abuse because they may not want to face the truth.
If you suspect a child has been sexually abused, the child should be examined as soon as possible by a trained health care professional; it can't be stressed enough that an abused child needs access to special support and treatment as soon as possible. A doctor's exam should not be delayed for any reason. Many signs of injury related to sexual abuse are temporary. Ideally, the exam should occur within 72 hours of the event or discovery. A complete physical exam must always be performed, so that the examiner can look for any signs of physical and sexual abuse. The two forms of abuse may coexist. The longer the abuse continues, the less likely the child will make full recovery.
Watch out for unexplained changes in your child's body or behavior. Conduct a formal examination only if you have reason to suspect your child has been abused. Otherwise, the child may become fearful. Be alert to any of the following changes:
Signs of Physical Abuse: Any injury (bruise, burn, fracture, abdominal or head injury) that cannot be explained
Signs of Sexual Abuse: Fearful behavior (nightmares, depression, unusual fears, attempts to run away); abdominal pain, bedwetting, urinary tract infection, genital pain or bleeding, sexually transmitted disease; extreme sexual behavior that seems inappropriate for the child's age
Signs of Emotional Abuse: Sudden change in self-confidence; headaches or stomachaches with no medical cause; abnormal fears, increased nightmares or attempts to run away
Signs of Emotional Neglect: Failure to gain weight (especially in infants), desperately affectionate behavior, voracious appetite and stealing food
A combination of individual, relational, community, and societal factors contribute to the risk of child maltreatment and abuse. Although children are not responsible for the harm inflicted upon them, certain individual characteristics have been found to increase their risk of being maltreated. Risk factors are contributing factors—not direct causes.
Examples of risk factors:
* Disabilities or mental retardation in children that may increase caregiver burden
* Social isolation of families
* Parents' lack of understanding of children's needs and child development
* Parents' history of domestic abuse
* Poverty and other socioeconomic disadvantages, such as unemployment
* Family disorganization, dissolution, and violence, including intimate partner violence
* Lack of family cohesion
* Substance abuse in family
* Young, single non biological parents
* Poor parent-child relationships and negative interactions
* Parental thoughts and emotions supporting maltreatment behaviors
* Parental stress and distress, including depression or other mental health conditions
* Community violence
If you suspect a child has been abused, contact a pediatrician or a local child protective agency for help. Physicians are legally obligated to report all suspected cases of abuse or neglect to authorities. They can also recommend a therapist and provide the necessary information for investigators. Doctors may also testify in court to obtain legal protection for the child or to help criminally prosecute an individual suspected of engaging in child sexual abuse.
Whatever the nature of the abuse, steps should be taken immediately to report the abuse and obtain help. Delaying a report decreases the child's chances for full recovery.
If he or she has been abused, your child will benefit from the services of a qualified mental health professional. You and other members of the family may be advised to seek counseling so that you'll be able to provide the support and comfort your child needs. If someone in your family is responsible for the abuse, a mental health professional may be able to treat that person successfully, as well.
If your child has been abused, you may be the only person who can help him or her. Do not delay reporting your suspicions of abuse. Denying the problem will only worsen the situation; allowing the abuse to continue decreases the child's chance for full recovery. In any case of child abuse, the safety of the abused youngster is of primary concern. He or she needs to be in a safe environment free of the potential for continuing abuse.
In most cases, children who are abused or neglected suffer greater emotional than physical damage. A child who has been abused or otherwise severely mistreated may become depressed or develop suicidal, withdrawn, or violent behavior. An older child may use drugs or alcohol, try to run away, or abuse others. The younger the child is and the closer the child's relationship to the abuser, the more serious the emotional damage will be. As adults, they may develop marital and sexual difficulties, depression or suicidal behavior.
* American Psychiatric Association
* National Library of Medicine
* Administration for Children and Families
* American Academy of Pediatrics
* Department of Health and Human Services
* National Institutes of Health
Elder or Dependent Adult Abuse ↓
Each year hundreds of thousands of elderly people are abused, neglected and exploited. These victims are frail, vulnerable and cannot help themselves. They depend on others to meet their most basic needs. Elder abuse can fall under several categories:
* Physical abuse is the willful infliction of physical pain or injury, such as slapping, bruising, sexually molesting, or restraining.
* Psychological abuse is the infliction of mental or emotional anguish, such as humiliating or threatening.
* Financial or material exploitation is another improper act, using the resources of an elderly person without his consent.
* Neglect is the failure of a caretaker to provide goods or services necessary to avoid physical harm, mental anguish or illness.
While it is hard to estimate how many older persons are abused each year, one study suggests that 500,000 Americans are abused, neglected and exploited by family members and others. The study also estimated, however, that only about 16 percent of abuse cases are reported. The Senate Special Commission on Aging estimates that there may be as many as 5 million victims of elder abuse a year.
The study also found that domestic elder abuse has increased 150 percent. In addition:
* 551,011 people, age 60 and over, experience abuse, neglect, and/or self-neglect in a one-year period.
* The perpetrator was a family member in 90 percent of cases. Two-thirds of the perpetrators were adult children or spouses.
Legislatures in all 50 states have passed some form of elder abuse prevention laws. Laws and definitions of terms vary considerably from one state to another, but all states have set up reporting systems. Generally, adult protective services (APS) agencies receive and investigate reports of suspected elder abuse.
* Bruises and lacerations
* Broken or fractured bones
* Untreated injuries in various stages of healing
* Sprains, dislocations and internal injuries
* Laboratory findings of medication overdose or under-utilization of prescribed drugs
* Elder's report of being hit, kicked or mistreated
* Elder's sudden change in behavior, including becoming depressed, agitated, withdrawn and non-communicative
* Dehydration, malnutrition, untreated bedsores and poor hygiene
* Unattended or untreated health problems
* Unsafe or unclean living conditions
* Elder's report of mistreatment
* Caregiver's refusal to allow visitors to see an elder alone
Spouses and adult children of elders are the most common abusers of family members. Generally, a combination of psychological, social and economic factors, along with the mental and physical conditions of the victim and the perpetrator, contribute to the occurrence of elder maltreatment. Although the factors listed below cannot explain all types of elder maltreatment because it is likely that different types (as well as each single incident) involve different casual factors, some of the causes researchers cite as important are:
* Caregiver stress
* Impairment of dependent elder
* A family history of violence and substance abuse
In most jurisdictions, the APS, the Area Agency on Aging, or the county Department of Social Services is designated as the agency to receive and investigate allegations of elder abuse and neglect. If investigators find abuse or neglect, they make arrangements for services to help protect the victim.
The Area Agency on Aging operates an information and referral line for a wide range of services. If the elder is in immediate danger, call 911.
Older adults can take the following precautions to help keep themselves safe from abuse:
* Maintain a social life. Stay in touch with old friends and neighbors if you move in with a relative or change your address. Have a buddy outside the home check in with you at least once a week. Invite friends to stop by your house even if they only stay for a brief period.
* Stay open to opportunities. Make new friends. Continue participating in community activities.
* Retain control over your telephone and mail. If your mail is being intercepted, discuss the problem with postal authorities.
* Organize your belongings so you can keep track of everything. Make sure others are aware that you know where everything is kept.
* Try to be in control of attending to your personal needs. Keep regular appointments with your doctor, dentist, barber or hairdresser.
* Maintain financial control. Arrange to have your Social Security or pension check deposited directly to a bank account in your name.
* Maintain legal control. Obtain legal advice about possible future disability, including powers-of-attorney, guardianships, or conservatorships. Be sure to keep records, accounts, and property available for examination by someone you trust, as well as by the person you or the court has designated to manage your affairs. Review your will periodically. Only give up control of your property or assets at a time when you decide you cannot manage them.
* Be sure to ask for help when you need it. Discuss your plans with your attorney, physician or family members.
Other precautions to take to prevent elder abuse:
* Other precautions to take to prevent elder abuse:
* Don't live with a person who has a background of violent behavior or alcohol or drug abuse.
* Don't leave your home unattended, or if you do, don't leave signs that you are not home. Don't leave notes on the door; if you must be away for a long period, notify the police.
* Don't leave cash, jewelry or other valuables.
* Don't accept personal care in return for giving the caregiver transfer or assignments of your property or assets unless a lawyer, advocate or another trusted person acts as a witness to the transaction.
* Don't sign a document unless someone you trust has reviewed it, and don't allow anyone to keep details of your finances or property management from you.
* National Elder Abuse Incidence Study
* Adult Protective Services
* Elder Abuse Center
* U.S. Administration on Aging
* National Center on Elder Abuse
* Elder Mistreatment: Abuse, Neglect and Exploitation in an Aging America. 2003. Washington, DC: National Research Council Panel to Review Risk and Prevalence of Elder Abuse and Neglect.
* Wasik, John F. 2000. “The Fleecing of America’s Elderly,” Consumers Digest, March/April
Intermittent Explosive Disorder ↓
Intermittent Explosive Disorder
An inability to resist aggressive urges may be an indication of intermittent explosive disorder. Individuals with this disorder often seriously damage property or assault others, usually in stark contrast to the provocation involved in a situation.