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Social Work Child Neglect and Emotional Maltreatment
by
Cassandra Simmel, Svetlana Shpiegel
  • LAST MODIFIED: 25 March 2020
  • DOI: 10.1093/obo/9780195389678-0284

Introduction

Child maltreatment is a pervasive and widespread phenomenon in the United States. While the incidence of child maltreatment had been on the decline until approximately 2012, since that time, the rates have increased somewhat. Child maltreatment affects all age groups of children and youth, although infants and younger children are at the highest risk for victimization. In addition, for many years, all forms of child maltreatment were addressed collectively, with scant research on how distinct types might co-occur or individually present. Through many research, policy, and practice advances in recent years, there is growing awareness regarding how each abuse type is relatively unique in terms of the risks for manifestation, as well as in the outcomes from and interventions for their respective perpetration. Two types of maltreatment—child neglect and emotional abuse—reflect intriguing trends in this overall phenomenon. According to the US Department of Health and Human Services, across all types of maltreatment, child neglect is the most frequently reported form of abuse, while emotional abuse is among the least reported. These reports, however, are derived from statutory definitions and investigations and likely do not convey the true incidence of abuse that occurs in the United States. Moreover, these two types of maltreatment are all the more compelling because they can be perceived as not having visible signs of victimization, thereby making the recognition and verification of their harm difficult to discern. As such, for this and several other factors, research on neglect and emotional abuse have often been linked together. Since the 1990s, however, research has begun to highlight the unique contextual factors associated with their manifestation as well as the negative ramifications of each. Therefore, this chapter begins by presenting broad reference and resource information relevant to both types of abuse. Subsequently, the chapter diverges to focus solely on neglect and emotional abuse as distinct forms of child maltreatment.

Introductory Works (Encompassing Both Neglect and Emotional Abuse)

The exploration of child neglect and emotional abuse as discrete forms of child maltreatment began receiving increased attention by researchers, child welfare practitioners, and policymakers in the 1990s. This shift fostered a considerable surge in research exploring the distinct trajectories associated with the manifestation of each form of abuse, coupled with an exploration of the convergence in ecological risk conditions and outcomes. Several books provide a foundation for understanding each form of abuse, including neglect and emotional abuse, as well how they frequently co-occur with one another (American Professional Society on the Abuse of Children 2018; Cicchetti and Toth 2005; Institute of Medicine and National Research Council 2014; Feerick, et al. 2006; National Research Council 1993). In addition, Pecora et al. 2019 provides a comprehensive exploration of each type of maltreatment, which further informs the public policy landscape. However, this section is somewhat limited since there are few works that focus specifically on child neglect and emotional abuse. That is, most introductory works focus on all types of maltreatment, rather than on specific subtypes.

  • American Professional Society on the Abuse of Children. 2018. The APSAC handbook on child maltreatment. 4th ed. Los Angeles: SAGE.

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    Contains chapters (“Child Neglect,” and “Psychological Maltreatment of Children”) that outline specific subtypes of maltreatment as well as highlight different ecological factors (e.g., poverty) that are influential on their manifestation.

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  • Cicchetti, D., and S. Toth. 2005. Annual review of child psychology. Child Maltreatment 1.1: 409–438.

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    This article addresses definitional, epidemiological, and etiological aspects of all types of child maltreatment, including a specific focus on child neglect. A developmental psychopathology perspective is directed toward the discussion of the psychological and neurobiological sequelae of child maltreatment.

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  • Feerick, M. M., J. F. Knutson, P. K. Trickett, and S. M. Flanzer. 2006. Child abuse and neglect: Definitions, classifications, and a framework for research. Baltimore: Brookes.

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    Contains chapters on the complexity of defining child maltreatment and subtypes of distinct forms of abuse. Also provides chapters on specific forms of maltreatment, including child neglect and psychological maltreatment, as well as on research and policy progress and challenges in addressing these topics.

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  • Institute of Medicine and National Research Council. 2014. New directions in child abuse and neglect research. Washington, DC: National Academies Press.

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    This volume revisits the 1993 report and offers updated suggestions for how research funding and policy interventions can be directed in addressing all types of child maltreatment. This volume examines the uniqueness of neglect and emotional abuse in the context of all types of child maltreatment.

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  • National Research Council. 1993. Understanding child abuse and neglect. Washington, DC: National Academies Press.

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    This congressionally mandated report was one of the first volumes to comprehensively examine the current (at that time) research landscape on child maltreatment and the need for significantly enhancing the research focus on singular types of abuse and on how they diverge in terms of risks, prevalence, demographics, and outcomes.

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  • Pecora, Peter J., James K. Whittaker, Richard P. Barth, Sharon Borja, and William Vesneski. 2019. The child welfare challenge: Policy, practice, and research. New York: Routledge.

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    Provides a comprehensive discussion of the state statutes for recognizing, reporting, and intervening in occurrences of neglect and emotional abuse. Also delves into the research on the demographics, risk factors, and outcomes for the subtypes of neglect and emotional maltreatment. Explores the policy solutions for both types of abuse.

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Seminal Research Studies and Research Consortia (Both Neglect and Emotional Abuse)

Several large scale research initiatives commenced in recent decades, with a central aim to better understand the unique risk conditions, trajectories, and interventions for specific forms and subtypes of child maltreatment (Longitudinal Studies on Child Abuse and Neglect; National Incidence Study; National Survey of Child and Adolescent Well-Being). Many of these are sponsored by and/or coordinated by federal agencies, thereby signaling the importance of providing a strong empirical foundation for comprehensive examinations of child maltreatment. Boyce and Maholmes 2013 provides an overview.

  • Boyce, C., and V. Maholmes. 2013. Attention to the neglected: Prospects for research on child neglect for the next decade. Child Maltreatment 18.1: 65–68.

    DOI: 10.1177/1077559513480426Save Citation »Export Citation »

    The authors outline the research trajectory from the late 1990s onward in highlighting the need for a singular focus on the detection and prevention of child neglect as well as the need for evidence-based interventions for neglect. This research trajectory was supported by an “unprecedented partnership” across several federal agencies, culminating in a consortia of researchers working collaboratively to address all aspects of child neglect.

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  • Longitudinal Studies on Child Abuse and Neglect. 1990–.

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    This large-scale longitudinal study encompasses five study sites across the United States. The project began in 1990 and has systematically followed samples of children who were maltreated or at risk for maltreatment from age four until they reach adulthood. The data allow for the examination of neglect and/or emotional abuse, either independently or conjointly with other types of abuse.

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  • National Incidence Study. 1978–2011.

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    This congressionally mandated study was conducted across four distinct time periods to examine the incidence of all forms of child maltreatment. Results from specific waves convey differences in how professionals recognize and report of abuse, particularly for emotional abuse.

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  • National Survey of Child and Adolescent Well-Being 1997–2014, 2015–2022.

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    This longitudinal study provides nationally representative, longitudinal data on children and families that have been reported to Child Protective Services and/or involved with the child welfare system. Over several thousand children and families are involved in this study and have been followed over time. The data allow for the examination of neglect and/or emotional abuse, either independently or conjointly with other types of abuse.

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Government and Specialized Organizations (Both Neglect and Emotional Abuse)

Several federal agencies and research organizations compile and organize state administrative data on child abuse reports, involvement with child welfare agencies, and interventions for child maltreatment. Examination of these data sets contributes to the knowledge base about all types of child maltreatment, including neglect and emotional abuse. For example, these data are useful for examining the variation in state statutes for detecting and reporting on child abuse (Child Welfare Information Gateway); differences in risk conditions for the perpetration of maltreatment; demographics differences in risks, trajectories, and outcomes; and trends over time and/or in different regions of the United States (Annie E Casey Foundation; Child Trends DataBank; Children’s Bureau at the Office of the Administration for Children and Families, at the U.S. Department of Health and Human Services). Many of these organization issue annual reports based on their data. Again, this section is somewhat limited since there are few works that focus specifically on child neglect and emotional abuse.

Child Neglect Section

Addressing the scope of child neglect includes providing an understanding of how it is distinct from other types of child maltreatment. It is therefore important to address how neglect is defined and why state statutes of these definitions vary across the United States. It is also important to understand how neglect is manifested and understood in different cultural groups and in different environmental settings. Because neglect intersects with pervasive systemic issues such as poverty, substance abuse, and family discord, there is a vast body of research examining how these factors contribute to or exacerbate child neglect. The following sections address the complexities of defining neglect, including the cultural variation in recognizing neglect. Subsequent sections examine recent trends in the incidence and prevalence of neglect, how risk and protective factors influence its manifestation, and the childhood and adulthood effects of neglect. The final section outlines multiple intervention efforts aimed at preventing neglect from occurring and/or addressing the negative effects of neglect on children, families, and communities.

Defining Neglect

How child neglect is defined and measured is an enormously complex undertaking and has dominated the research literature for several decades. This section begins by providing references to landmark studies that were central in tackling this complexity as well as how child neglect is defined across the United States. Also included in this section are references to the complexity of defining neglect in different cultural communities and recent advances in understanding distinct subtypes or how neglect is present in specific subpopulations.

Overarching Framework for Conceptualizing Child Neglect

Distinguishing child neglect from other types of child maltreatment has evolved in recent decades. Child neglect is arguably the most vexing type of child abuse to define. The progression in developing or refining definitions of neglect is discussed in several research studies (Dubowitz, et al. 1993; Dubowitz, et al. 2005; English, et al. 2005; Hearn 2011), including how definitions correspond to state child welfare statutes and Child Protective Services reports (Katz, et al. 1976; Mennen, et al. 2010). Rebbe 2018 compares state definitions with the operationalization of neglect in the NIS-4 study. Several government reports, Child Welfare Information Gateway 2013, Child Welfare Information Gateway 2016, and Children’s Bureau 2018, are provided that outline the current statutory variation in recognizing and identifying neglect.

  • Child Welfare Information Gateway. 2013. What is child abuse and neglect? Recognizing the signs and symptoms. Washington, DC: US Department of Health and Human Services, Children’s Bureau.

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    This Child Welfare Information Gateway publication delves into specifying distinct types of neglect including: physical, medical, educational, and emotional (p. 3). It also notes that some state laws for neglect include abandonment and witnessing domestic violence.

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  • Child Welfare Information Gateway. 2016. Definitions of child abuse and neglect. Washington, DC: US Department of Health and Human Services, Children’s Bureau.

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    The Child Welfare Information Gateway is a service of the US Department of Health and Human Services’ Children’s Bureau and provides access to print and electronic materials and resources pertaining to the child welfare system. Drawing on state civil and criminal statutes for all fifty states and American territories, they provide the varying definitions of child neglect that guide state child welfare intervention.

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  • Children’s Bureau. 2018, June 8. What is child abuse and neglect? How does my State define child abuse and neglect?.

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    This website outlines the statutes in every state for identifying and substantiating all forms of child abuse, including child neglect.

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  • Dubowitz, H., M. Black, R. H. Starr Jr., and S. Zuravin. 1993. A conceptual definition of child neglect. Criminal Justice and Behavior 20.1: 8–26.

    DOI: 10.1177/0093854893020001003Save Citation »Export Citation »

    The authors advance a definition of child neglect that emphasizes ecological models as opposed to the intention or behaviors of caregivers. Moreover, Dubowitz and colleagues suggests that from a child’s perspective, a broad conceptual definition is a more meaningful and useful view than that of narrow definitions.

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  • Dubowitz, H., R. Newton, A. Litrownik, et al. 2005. Examination of a conceptual model of child neglect. Child Maltreatment 10.2: 173–189.

    DOI: 10.1177/1077559505275014Save Citation »Export Citation »

    This study provides empirical support for conceptual definitions of child neglect. Dubowitz and colleagues compared neglect definitions by Child Protective Services official codes with neglect defined by a review of Child Protective Services narrative data.

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  • English, D., R. Thompson, J. Graham, and E. Briggs. 2005. Toward a definition of neglect in young children. Child Maltreatment 10.2: 190–206.

    DOI: 10.1177/1077559505275178Save Citation »Export Citation »

    Using data from Longitudinal Studies on Child Abuse and Neglect, authors examine conceptual definitions of neglect with multiple psychosocial and behavioral outcomes for children at four years of age. The approach was informed by child development theory.

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  • Hearn, J. 2011. Unmet needs in addressing child neglect: Should we go back to the drawing board? Children and Youth Services Review 33.5: 715–722.

    DOI: 10.1016/j.childyouth.2010.11.011Save Citation »Export Citation »

    Addresses the challenges in defining child neglect, including the lack of a cohesive, encompassing framework, coupled with the tensions involving macro influential factors.

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  • Katz, S. N., R. A. W. Howe, and M. McGrath. 1976. Child neglect laws in America. Chicago: American Bar Association, Section of Family Law.

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    Provides a comprehensive summary of the history of child neglect and the evolution of how neglect has been recognized and addressed in the United States. This body of work is situated in the legal research literature.

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  • Mennen, F., K. Kim, J. Sang, and P. Trickett. 2010. Child neglect: Definition and identification of youths’ experiences in official reports of maltreatment. Child Abuse & Neglect 34.9: 647–658.

    DOI: 10.1016/j.chiabu.2010.02.007Save Citation »Export Citation »

    Investigates the nature of neglect in child welfare clients to understand how different types of neglect co-occur with each other and with other types of maltreatment. Using the Maltreatment Case Record Abstraction Instrument in an urban, ethnically diverse sample of youth, they found higher rates of neglect in the sample compared with Child Protective Services records.

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  • Rebbe, R. 2018. What is neglect? State legal definitions in the United States. Child Maltreatment 23.3: 303–315.

    DOI: 10.1177/1077559518767337Save Citation »Export Citation »

    Using data from Fourth National Incidence Study of Child Abuse and Neglect, compares states’ regulations for neglect with the definitions provided in the National Incidence Study. Developed three categories of neglect across the states.

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Cross-Cultural Perspectives

Several studies over the past three decades have explored cultural relativity in understanding caregiving practices and the potential perpetration of neglect in numerous cultural communities. Distinguishing caregiving practices from neglect adds to the overall complexity in defining child neglect. This topic is explored in the following research articles (Elliott and Urquiza 2006; Evans-Campbell 2008; Fox 2003; Friedman and Billick 2015; Korbin 1991; Nadan, et al. 2015; Rose and Meezan 1993; Rose and Meezan 1996).

  • Elliott, K., and A. Urquiza. 2006. Ethnicity, culture, and child maltreatment. Journal of Social Issues 62.4: 787–809.

    DOI: 10.1111/j.1540-4560.2006.00487.xSave Citation »Export Citation »

    This article addresses the complexity of defining and recognizing child maltreatment in different cultural communities. Offers recommendations for examining cultural relativity in defining child maltreatment.

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  • Evans-Campbell, T. 2008. Perceptions of child neglect among urban American Indian/Alaska Native parents. Child Welfare 87.3: 115–142.

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    Examines caregivers’ perceptions and understanding of child neglect, especially among American Indian/Alaska Native families. According to survey respondents, substance abuse by parents is the most severe factor in determining child neglect.

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  • Fox, K. 2003. Collecting data on the abuse and neglect of American Indian children. Child Welfare 82.6: 707–726.

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    This article addresses the complexity of recognizing abuse and neglect in American Indian communities and the role that the US government should play in developing an intervention infrastructure for attending to maltreatment reporting.

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  • Friedman, E., and S. Billick. 2015. Unintentional child neglect: Literature review and observational study. Psychiatric Quarterly 86.2: 253–259.

    DOI: 10.1007/s11126-014-9328-0Save Citation »Export Citation »

    Discusses the complexity in recognizing and defining child maltreatment, especially the need to consider culturally relative intentions in caregiving. Also examines the debate about whether child neglect is indeed distinct from child abuse.

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  • Korbin, J. E. 1991. Cross-cultural perspectives and research directions for the 21st century. Child Abuse & Neglect 15:67–77.

    DOI: 10.1016/0145-2134(91)90010-BSave Citation »Export Citation »

    Emphasizes the importance of incorporating cross-cultural perspectives to better understand the context in which child neglect occurs and the need to address neglect in a culturally appropriate manner. Suggests that the emic perspective, which is viewpoint of the members of the culture in question, as well as the etic, the outside perspective, must be considered.

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  • Nadan, Y., J. Spilsbury, and J. Korbin. 2015. Culture and context in understanding child maltreatment: Contributions of intersectionality and neighborhood-based research. Child Abuse & Neglect 41.C: 40–48.

    DOI: 10.1016/j.chiabu.2014.10.021Save Citation »Export Citation »

    The authors advance the inclusion of culture and community contextual factors in the recognition of all types of child maltreatment. By implementing an ecological framework, the authors further emphasize the recognition of child neglect.

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  • Rose, S., and W. Meezan. 1993. Defining child neglect: Evolution, influences, and issues. Social Service Review 67.2: 279–293.

    DOI: 10.1086/603982Save Citation »Export Citation »

    The authors trace the evolution of child neglect in state statutes and in the research literature and discuss two competing perspectives in defining child neglect: caregiver behavior and potential or actual harm to child. Literature regarding cultural group variation in defining neglect is also included as well as variation in the definition based on social roles.

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  • Rose, S., and W. Meezan. 1996. Variations in perceptions of child neglect. Child Welfare 75.2: 139–160.

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    This study examines the comparative differences of specific subtypes of neglect by exploring the perceptions of mothers from different cultural backgrounds with those of child welfare workers.

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Specific Subtypes of Child Neglect

In recent years, our understanding of child neglect has progressed to encompass unique subtypes of neglect as discussed in Dubowitz, et al. 2004, including dental neglect, which is covered by Fisher-Owens, et al. 2017; Harris 2018; and Kellogg 2005. Moreover, Fullerton, et al. 2011 has also honed in on understanding how neglect is manifested in specific populations such as in the military community and how it is intertwined with other types of violence in families (Kantor and Little 2003; Miccio 1995).

  • Dubowitz, H., S. Pitts, and M. Black. 2004. Measurement of three major subtypes of child neglect. Child Maltreatment 9.4: 344–356.

    DOI: 10.1177/1077559504269191Save Citation »Export Citation »

    Examines specific subtypes of child neglect and how they correspond to definitions of neglect determined by Child Protective Services. The authors also examine the definitions’ correspondence with children’s behavioral health difficulties.

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  • Fisher-Owens, S., J. Lukefahr, A. Tate, and S. Fisher-Owens. 2017. Oral and dental aspects of child abuse and neglect. Pediatric Dentistry 39.4: 278–283.

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    This article summarizes the connection between dental and oral health and all types of child maltreatment, including child neglect. The authors support the inclusion of pediatric dental care providers in recognizing and reporting child abuse and neglect.

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  • Fullerton, C., J. Mccarroll, M. Feerick, J. Mckibben, S. Cozza, and R. Ursano. 2011. Child neglect in Army families: A public health perspective. Military Medicine 176.12: 1432–1439.

    DOI: 10.7205/MILMED-D-11-00135Save Citation »Export Citation »

    This article examines definitions and domains of child neglect, specifically for children in military families serving in the US Army. The authors align their work with the Institute of Medicine’s framework and also focus on risk and protective factors for this population.

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  • Harris, J. 2018. The mouth and maltreatment: Safeguarding issues in child dental health. Archives of Disease in Childhood 103.8: 722–729.

    DOI: 10.1136/archdischild-2017-313173Save Citation »Export Citation »

    This articles supports the inclusion of pediatric dental care providers in recognizing and reporting child abuse and neglect.

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  • Kantor, G., and Little, L. 2003. Defining the boundaries of child neglect: When does domestic violence equate with parental failure to protect? Journal of Interpersonal Violence 18.4: 338–355.

    DOI: 10.1177/0886260502250834Save Citation »Export Citation »

    This article examines the connection between child maltreatment and intimate partner violence. At the time this article was written, many states were considering amending statutes to encompass witnessing interpersonal violence as a type of child neglect.

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  • Kellogg, N. 2005. Oral and dental aspects of child abuse and neglect. Pediatrics 116.6: 1565–1568.

    DOI: 10.1542/peds.2005-2315Save Citation »Export Citation »

    This article outlines the effects of dental health neglect in children and how pediatric dental care providers should be involved in the recognition of child neglect, including dental neglect.

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  • Miccio, K. 1995. In the name of mothers and children: Deconstructing the myth of the passive battered mother and the “protected child” in child neglect proceedings. (New York) (Symposium on Reconceptualizing Violence Against Women by Intimate Partners: Critical Issues). Albany Law Review 58.4: 1087–1107.

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    Provides a comprehensive review of how female caregivers view and are viewed vis-à-vis allegations of child neglect.

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Prevalence Rates

Child neglect is the most prevalent form of child maltreatment in the United States. This trend has remained consistent for several decades. Literature on overall trends, as well as trends in different cultural communities and the specific subpopulation of military families is included in this section.

Overall Trends

Prevalence rates for child neglect are examined in several studies. Four studies convey patterns of neglect and its subtypes for discrete time periods (Connell-Carrick 2003; Jonson-Reid, et al. 2003; Stoltenborgh, et al. 2013), while three studies—Behl, et al. 2003, Coulton, et al. 2018, and Jones, et al. 2006—explore the longitudinal trends in prevalence.

  • Behl, L., H. Conyngham, and P. May. 2003. Trends in child maltreatment literature. Child Abuse & Neglect 27.2: 215–229.

    DOI: 10.1016/S0145-2134(02)00535-5Save Citation »Export Citation »

    This article summarizes the trends in child maltreatment research across a twenty-two-year period, from 1977 to 1998. The authors highlight that, during this time period, research articles about child neglect and child emotional abuse were comparatively low. This article underscores the importance of the emerging research literature on distinct maltreatment types.

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  • Connell-Carrick, K. 2003. A critical review of the empirical literature: Identifying correlates of child neglect. Child and Adolescent Social Work Journal 20.5: 389–425.

    DOI: 10.1023/A:1026099913845Save Citation »Export Citation »

    Explores re-reports of child maltreatment following reunification with caregivers. Findings indicate younger children are more likely to experience maltreatment following reunification, and child neglect was the primary type of recurrent maltreatment.

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  • Coulton, C., F. Richter, J. Korbin, D. Crampton, and J. Spilsbury. 2018. Understanding trends in neighborhood child maltreatment rates: A three-wave panel study 1990–2010. Child Abuse & Neglect 84:170–181.

    DOI: 10.1016/j.chiabu.2018.07.025Save Citation »Export Citation »

    Evaluates how the influence of neighborhood dynamics associated with child maltreatment reports evolves over time.

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  • Jones, L., D. Finkelhor, and S. Halter. 2006. Child maltreatment trends in the 1990s: Why does neglect differ from sexual and physical abuse? Child Maltreatment 11.2: 107–120.

    DOI: 10.1177/1077559505284375Save Citation »Export Citation »

    Conveys the results of a trend study of child maltreatment cases in the 1990s. Results were mixed with sexual and physical abuse rates declining in this time period, while rates of neglect fluctuated. The authors discuss the complexities in determining the prevalence and incidence of neglect.

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  • Jonson-Reid, M., B. Drake, S. Chung, and I. Way. 2003. Cross-type recidivism among child maltreatment victims and perpetrators. Child Abuse & Neglect 27.8: 899–917.

    DOI: 10.1016/S0145-2134(03)00138-8Save Citation »Export Citation »

    This study used a single state’s administrative data to examine reports of different types of maltreatment over time, also referred to as cross-type recidivism. The authors examined characteristics of cross-type of recidivism based on the initial type of maltreatment at the first report. Child neglect is the most common type of maltreatment associated with recidivism.

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  • Stoltenborgh, M., M. Bakermans-Kranenburg, and M. IJzendoorn. 2013. The neglect of child neglect: A meta-analytic review of the prevalence of neglect. Social Psychiatry and Psychiatric Epidemiology 48.3: 345–355.

    DOI: 10.1007/s00127-012-0549-ySave Citation »Export Citation »

    This study uses a meta-analytic approach to measure the prevalence of physical and emotional abuse and neglect.

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Trends in Distinct Cultural Communities

The patterns and trends in prevalence of child neglect in distinct cultural communities are described in Carter 2010; Chang, et al. 2008; Finno-Velasquez, et al. 2017; Fischler 1985; and Nelson, et al. 1996. This includes how neglect is associated with involvement with child welfare systems in different states.

  • Carter, V. 2010. Factors predicting placement of urban American Indian/Alaskan Natives into out-of-home care. Children and Youth Services Review 32.5: 657–663.

    DOI: 10.1016/j.childyouth.2009.12.013Save Citation »Export Citation »

    This article summaries a study using National Survey of Child and Adolescent Well-Being data to examine the association between abuse types and placement in out-of-home care for American Indian/Alaskan Native children. The author found that American Indian/Alaskan Native families are more likely to be investigated for physical neglect.

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  • Chang, J., S. Rhee, and S. Berthold. 2008. Child abuse and neglect in Cambodian refugee families: Characteristics and implications for Practice. Child Welfare 87.1: 141–160.

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    Examines Cambodian refugee families’ experiences in child maltreatment reports and involvement with Los Angeles County’s child welfare agency. Findings suggest differences in reports for neglect for Cambodian families compared with Asian Pacific families.

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  • Finno-Velasquez, M., L. Palmer, J. Prindle, C. C. Tam, and E. Putnam-Hornstein. 2017. A birth cohort study of Asian and Pacific Islander children reported for abuse or neglect by maternal nativity and ethnic origin. Child Abuse & Neglect 72:54–65.

    DOI: 10.1016/j.chiabu.2017.07.009Save Citation »Export Citation »

    Using used state administrative data from California, examines comparisons of child welfare involvement for Asian and Pacific Islander children based on maternal nativity and ethnic origin.

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  • Fischler, R. S. 1985. Child abuse and neglect in American Indian communities. Child Abuse & Neglect 9.1: 95–106.

    DOI: 10.1016/0145-2134(85)90097-3Save Citation »Export Citation »

    This article examines the context of the perpetration of child abuse and neglect in American Indian communities, along with the intervention and treatment strategies for this population. The author outlines the historical policy landscape for addressing child maltreatment in the American Indian communities.

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  • Nelson, K., T. Cross, M. Landsman, and M. Tyler. 1996. Native American families and child neglect. Children and Youth Services Review 18.6: 505–521.

    DOI: 10.1016/0190-7409(96)00020-5Save Citation »Export Citation »

    This study examines associated characteristics of neglect in American Indian families in two states: Iowa and Oregon. The authors identified several associated factors with perpetration of neglect in these communities.

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Trends in Military Families

Prevalence and patterns of neglect in military families are described in a collection of articles (see Gibbs, et al. 2011; Gibbs, et al. 2007; Mccarroll, et al. 2008; Mccarthy, et al. 2015; Rentz, et al. 2006; Thomsen, et al. 2014). These studies cover both cross-sectional and longitudinal explorations of trends.

  • Gibbs, D. A., S. L. Martin, M. Clinton-Sherrod, J. L. H. Walters, and R. E. Johnson. 2011. Child maltreatment within military families. In Risk and resilience in US military families. Edited by S. M. Wadsworth & D. Riggs, 111–130. New York: Springer.

    DOI: 10.1007/978-1-4419-7064-0_6Save Citation »Export Citation »

    Highlights the incidence of neglect in military families, including the elevated rates of fatal child maltreatment in this population. The authors focus on the specific unique contextual circumstances associated with neglect in military families. This chapter also includes a description of the Family Advocacy program in the US military and the role this program plays in prevention and intervention of all types of child maltreatment in the military community.

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  • Gibbs, D. A., S. L. Martin, L. L. Kupper, and R. E. Johnson. 2007. Child maltreatment in enlisted soldiers’ families during combat-related deployments. JAMA 298.5: 528–535.

    DOI: 10.1001/jama.298.5.528Save Citation »Export Citation »

    This article examines the association between substantiated reports of child maltreatment and combat-related deployments for soldiers enlisted in the US Army. The rates of neglect were nearly twice as great during deployment compared with predeployment.

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  • Mccarroll, J., Z. Fan, J. Newby, and R. Ursano. 2008. Trends in US Army child maltreatment reports: 1990–2004. Child Abuse Review 17.2: 108–118.

    DOI: 10.1002/car.986Save Citation »Export Citation »

    The authors present the results of a trend study of maltreatment rates in the US Army across a fourteen-year period: 1990 to 2004. During active deployment, the rates of neglect increased. The demographics of children affected by neglect in military families are described.

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  • Mccarthy, R., M. Rabenhorst, C. Thomsen, et al. 2015. Child maltreatment among civilian parents before, during, and after deployment in United States Air Force families. Psychology of Violence 5.1: 26–34.

    DOI: 10.1037/a0035433Save Citation »Export Citation »

    The authors conducted a population-based study of Air Force families before, during, and after combat-related deployments. The largest increase in maltreatment perpetrated by civilian parents during deployments was for child neglect, which increased by 124 percent compared with predeployment rates.

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  • Rentz, E. D., S. L. Martin, D. A. Gibbs, M. Clinton-Sherrod, J. Hardison, and S. W. Marshall. 2006. Family violence in the military: A review of the literature. Trauma, Violence, & Abuse 7.2: 93–108.

    DOI: 10.1177/1524838005285916Save Citation »Export Citation »

    Systematic review of the studies on child maltreatment and intimate partner violence in military families. Neglect and physical abuse account for the majority of reported and substantiated abuse reports in military families.

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  • Thomsen, C. J., M. M. Rabenhorst, R. J. McCarthy, et al. 2014. Child maltreatment before and after combat-related deployment among active-duty United States Air Force maltreating parents. Psychology of Violence 4.2: 143.

    DOI: 10.1037/a0031766Save Citation »Export Citation »

    This population-bases study examines rates of all child maltreatment incidents in US Air Force families before and after deployment. While incidents of most types of child maltreatment were lower after deployment compared with predeployment, the rates of severe child neglect and child sexual abuse were higher, especially when the child neglect reports involved caregiver alcohol use/abuse.

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Risk and Protective Factors

Several works explore the risk and protective factors associated with child neglect. As the understanding of how neglect is defined has progressed, research has also grown on understanding the vast array of risk factors associated with the manifestation of neglect. There is no single pathway that explains the root causes of neglect. And, neglect is also frequently intertwined with broad systemic factors in communities such as poverty, unemployment, and lack of resources. In this section, the literature is divided into several domains of risk factors, from broad systemic issues to individual and interpersonal risk characteristics and situations. While none of these domains operate in isolation from one another, research often emphasizes certain domains or aspects of these domains over others.

Macro Systemic Factors

Zuravin 1989 was one of the first to comprehensively examine the ecological risk factors for the display of child neglect. Since then, a collection of studies have examined broader systemic factors associated with neglect, including poverty, unemployment, community discord, and neighborhood structure (see Freisthler, et al. 2004; Freisthler, et al. 2006; Guterman, et al. 2009; Maguire-Jack and Font 2017; Maguire-Jack and Klein 2015; Mcleigh, et al. 2018; Slack, et al. 2004). In addition, Slack, et al. 2011 also examines protective factors associated with neglect and Schumacher, et al. 2001 examines the dual complexity of both defining neglect and measuring the accompanying characteristics that precipitate it.

  • Freisthler, B., D. Merritt, and E. Lascala. 2006. Understanding the ecology of child maltreatment: A review of the literature and directions for future research. Child Maltreatment 11.3: 263–280.

    DOI: 10.1177/1077559506289524Save Citation »Export Citation »

    Systematically reviews the research literature about the ecological context for understanding the relationship between structural issues such as unemployment and the display of abuse and neglect.

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  • Freisthler, B., L. Midanik, and P. Gruenewald. 2004. Alcohol outlets and child physical abuse and neglect: Applying routine activities theory to the study of child maltreatment. Journal of Studies on Alcohol 65.5: 586–592.

    DOI: 10.15288/jsa.2004.65.586Save Citation »Export Citation »

    This cross-sectional ecological study examined the relationship between the number of bars and alcohol outlets and the manifestation of physical abuse and neglect. Findings reveal that the geographic areas with higher densities of bars are related to higher rates of neglect.

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  • Guterman, N., S. Lee, C. Taylor, and P. Rathouz. 2009. Parental perceptions of neighborhood processes, stress, personal control, and risk for physical child abuse and neglect. Child Abuse & Neglect 33.12: 897–906.

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    Examines the influence of community environmental factors on caregivers’ stress levels and how the perceptions of these factors may play a role in the manifestation of neglect.

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  • Maguire-Jack, K., and S. Font. 2017. Community and individual risk factors for physical child abuse and child neglect: Variations by poverty status. Child Maltreatment 22.3: 215–226.

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    Examines the differential effects of individual and neighborhood level poverty and the display of child neglect for high income and impoverished families.

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  • Maguire-Jack, K., and S. Klein. 2015. Parenting and proximity to social services: Lessons from Los Angeles County in the community context of child neglect. Child Abuse & Neglect 45:35–45.

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    Through a social disorganization lens, this study examines the effect of proximity to social support and community resources in decreased self-reports of neglect.

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  • Mcleigh, J., J. Mcdonell, and O. Lavenda. 2018. Neighborhood poverty and child abuse and neglect: The mediating role of social cohesion. Children and Youth Services Review 93:154–160.

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    Examines the relationship between neighborhood social cohesion, poverty, and rates of child abuse and neglect. Findings indicate a differential influence of these factors such that social cohesion did not reduce rates of neglect.

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  • Schumacher, J., A. Slep, and R. Heyman. 2001. Risk factors for child neglect. Aggression and Violent Behavior 6.2: 231–254.

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    The authors explore the difficulties associated with study risk conditions associated with neglect given the complexities in defining and recognizing neglect. Summarizes the research to date (at that time) on the extant literature of risk factors specific to neglect.

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  • Slack, K., L. Berger, K. Dumont, et al. 2011. Risk and protective factors for child neglect during early childhood: A cross-study comparison. Children and Youth Services Review 33.8: 1354–1363.

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    Examines risk and protective factors neglect across three large scale studies. Explores the role of economic resources, parent well-being, and parenting. Suggests how the findings can influence targeted prevention and intervention strategies.

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  • Slack, K., J. Holl, M. Mcdaniel, J. Yoo, and K. Bolger. 2004. Understanding the risks of child neglect: An exploration of poverty and parenting characteristics. Child Maltreatment 9.4: 395–408.

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    Using administrative data in one state, the authors explore the connection between poverty and parenting attributes and subsequent child neglect. Results convey there is a combined effect between these factors and neglect.

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  • Zuravin, S. 1989. The ecology of child abuse and neglect: Review of the literature and presentation of data. Violence and Victims 4.2: 101–120.

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    This was one of the earliest studies to examine risk factors for distinct types of child maltreatment. Finds unique clusters of risk factors and conditions for neglect.

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Risks Primarily Associated with Caregiving or Household Environment

In this domain, the literature on risk factors specific to the caregiving and/or household environment are described. Although they may be intertwined with broader systemic factors, these studies primarily examine a range of risk factors specific to the caregiving environment (Bartlett, et al. 2013; Burke, et al. 1998; Dong, et al. 2004; Mulder, et al. 2018; Simmel 2011; Simmel, et al. 2016). Dubowitz, et al. 2000 explores factors specially associated with fathers as caregivers. A recent study, Turner, et al. 2019, examines specific types of neglect and associated risk factors.

  • Bartlett, J., M. Raskin, C. Kotake, K. Nearing, and M. Easterbrooks. 2013. An ecological analysis of infant neglect by adolescent mothers. Child Abuse & Neglect 38.4: 723–734.

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    Explores the association between young motherhood and perpetration of neglect. Discusses the influence of young mothers’ own histories of experiencing physical abuse in childhood.

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  • Burke, J., J. Chandy, A. Dannerbeck, J. Watt, and J. Burke. 1998. The parental environment cluster model of child neglect: An integrative conceptual model. Child Welfare 77.4: 389–405.

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    Explores the relationship between caregiving environment and the manifestation of child neglect. Identifies three categories in the caregiving environment: parenting skills, social support, and resources.

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  • Dong, M., R. Anda, V. Felitti, et al. 2004. The interrelatedness of multiple forms of childhood abuse, neglect, and household dysfunction. Child Abuse & Neglect 28.7: 771–784.

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    This study examined the extent to which multiple distinct types of child abuse and neglect co-occurred, along with other forms of adverse childhood experiences. This was a retrospective study of adults’ reports of these experiences, with the aim of examining patterns, conditions, and dynamics of these co-occurrences.

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  • Dubowitz, H., M. Black, M. Kerr, R. Starr, and D. Harrington. 2000. Fathers and child neglect. Archives of Pediatrics & Adolescent Medicine 154.2: 135–141.

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    Explores the association between father involvement and child neglect. Findings emphasize the importance of fathers’ sense of efficacy as a parent is associated with lower rates of neglect.

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  • Mulder, T., K. Kuiper, C. van Der Put, G. Stams, and M. Assink. 2018. Risk factors for child neglect: A meta-analytic review. Child Abuse & Neglect 77:198–210.

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    Systematic review of risk factors associated with manifestation of child neglect. Findings were most pronounced for caregiver risk factors (e.g., mental health challenges; parents’ own histories of child abuse). Suggests intervention efforts directed at caregivers.

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  • Simmel, C. 2011. Demographic profiles of children reported to the child welfare system. Journal of Public Child Welfare 5.1: 87–110.

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    Uses National Survey of Child and Adolescent Well-Being data to explore systemic and caregiver-related risk factors associated with each type of child maltreatment. Examines risks for each type based on developmental stage, gender, and race/ethnicity.

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  • Simmel, C., D. Merritt, H. Kim, and S. Kim. 2016. An exploratory study of neglect and emotional abuse in adolescents: Classifications of caregiver risk factors. Journal of Child and Family Studies 25.8: 2372–2386.

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    Explores clusters of caregiver risk factors uniquely associated with neglect and with emotional abuse.

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  • Turner, H. A., J. Vandermiden, D. Finkelhor, and S. Hamby. 2019. Child neglect and the broader context of child victimization. Child Maltreatment 24.3: 265–274.

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    Uses the National Surveys of Children’s Exposure to Violence to examine risk factors associated with distinct types of neglect (supervisory and physical). Also examined the co-occurrence of distinct types of abuse along with other forms of child maltreatment.

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Interpersonal Risk Factors

In this domain, research that primarily focuses on caregiver risk factors such as mental health challenges and/or substance abuse is conveyed in Carter and Myers 2007; Chaffin, et al. 1996; Fontaine and Nolin 2012; and Lee, et al. 2012. The risk factor of interpersonal violence is described in Hartley 2002. These risk factors may also be influenced by or intertwined with risk factors in the aforementioned domains. Li, et al. 2011 describe protective factors at the caregiver level.

  • Carter, V., and M. Myers. 2007. Exploring the risks of substantiated physical neglect related to poverty and parental characteristics: A national sample. Children and Youth Services Review 29.1: 110–121.

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    Explores the connection between poverty, mental health difficulties, and substance abuse with substantiated incidences of child neglect.

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  • Chaffin, M., K. Kelleher, and J. Hollenberg. 1996. Onset of physical abuse and neglect: Psychiatric, substance abuse, and social risk factors from prospective community data. Child Abuse & Neglect 20.3: 191–203.

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    Uses longitudinal data to examine self-reported physical abuse and neglect in large sample of caregivers. Findings reveal that substance abuse disorders are a strong predictor of neglect.

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  • Fontaine, D., and P. Nolin. 2012. Personality disorders in a sample of parents accused of physical abuse or neglect. Journal of Family Violence 27.1: 23–31.

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    Examined the association between caregivers’ personality disorders and the perpetration of neglect. Authors suggest a connection between caregivers own childhood abuse or neglect, personality disorders in adulthood, and the display of neglect and/or physical abuse.

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  • Hartley, C. C. 2002. The co-occurrence of child maltreatment and domestic violence: Examining both neglect and child physical abuse. Child Maltreatment 7.4: 349–358.

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    Comparison of similarities and differences in risk conditions for neglect and physical; abuse in homes where interpersonal violence between caregivers was present. Findings reveal a distinction in risk factors in homes where neglect occurs with interpersonal violence, in comparison with interpersonal violence and physical abuse.

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  • Lee, S., C. Taylor, and J. Bellamy. 2012. Paternal depression and risk for child neglect in father-involved families of young children. Child Abuse & Neglect 36.5: 461–469.

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    Explores the extent to which paternal depression is associated with neglect of young children. Suggests screening and intervention efforts to interrupt this risk cycle.

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  • Li, F., M. Godinet, and P. Arnsberger. 2011. Protective factors among families with children at risk of maltreatment: Follow up to early school years. Children and Youth Services Review 33.1: 139–148.

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    The authors used Longitudinal Studies on Child Abuse and Neglect data to better understand the risk and protective factors associated with perpetration of child abuse and neglect. Experiencing maltreatment in childhood as well as adverse life events were associated with perpetration of abuse and neglect.

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Outcomes/Effects of Child Neglect

The research on the impact of child neglect suggests that the effects are enduring and can manifest in childhood and adolescence and in adulthood. Moreover, the impacts vary from biological to behavioral and interpersonal to extensive difficulties in adulthood with caregiving and managing employment and economic matters. In this section, the material is divided between effects in childhood and effects in adulthood.

Effects on Children and Adolescents

Several studies examine the effects of neglect on children. In two reports—the first, Center on the Developing Child at Harvard University 2012 and then Child Welfare Information Gateway 2013—outline the broad developmental impact of neglect. Bruce, et al. 2009 and De Bellis, et al. 2009 convey the specific biological or neurobiological effects, while behavioral (McGuigan, et al. 2018; Ryan, et al. 2013), substance abuse difficulties (Lalayants and Prince 2016), and cumulative risk effects (Ney, et al. 1994; O’Hara, et al. 2015; Tyler, et al. 2006) are described.

  • Bruce, J., P. Fisher, K. Pears, and S. Levine. 2009. Morning cortisol levels in preschool‐aged foster children: Differential effects of maltreatment type. Developmental Psychobiology 51.1: 14–23.

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    This study examines the impact of distinct types of maltreatment types on cortisol levels in foster children. Comparisons were made with nonfoster children who had not been maltreated.

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  • Center on the Developing Child at Harvard University. 2012. The science of neglect: The persistent absence of responsive care disrupts the developing brain. Working Paper No. 12.

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    This report examines the harmful effects of child neglect on children when in the earliest stages of child development. The authors further discuss the need for effective interventions targeted toward infants and toddlers.

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  • Child Welfare Information Gateway. 2013. Long-term consequences of child abuse and neglect. Washington, DC: US Department of Health and Human Services, Children’s Bureau.

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    This report outlines the physical, psychological, behavioral, and psychosocial consequences of all types of child abuse and neglect.

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  • De Bellis, M. D., S. R. Hooper, E. G. Spratt, and D. P. Woolley. 2009. Neuropsychological findings in childhood neglect and their relationships to pediatric PTSD. Journal of the International Neuropsychological Society 15.6: 868–878.

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    This article explores the differential neurocognitive effects of child neglect. The authors further examine the influence of trauma and posttraumatic stress disorder in combination with incidents of neglect and how this combination affects neurocognitive outcomes.

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  • Lalayants, M., and J. Prince. 2016. Child neglect and onset of substance use disorders among child welfare‐involved adolescents. Child Abuse Review 25.6: 469–478.

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    The differential association between substance use disorders and child abuse and neglect was explored. The authors found that neglect, but not other forms of child abuse, were related to onset of substance use disorders.

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  • McGuigan, W., J. Luchette, and R. Atterholt. 2018. Physical neglect in childhood as a predictor of violent behavior in adolescent males. Child Abuse & Neglect 79:395-400.

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    The impact of childhood neglect on adolescent males’ likelihood of violent behavior was examined. Childhood neglect, in relation to other environmental and interpersonal risk factors, was the strongest predictor of violent adolescent conduct.

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  • Ney, P., Fung, T., and A. Wickett. 1994. The worst combinations of child abuse and neglect. Child Abuse& Neglect 18.9: 705–714.

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    This was a central study in examining specific types of maltreatment and detailed that the majority of maltreatment cases involve more than one maltreatment type. The authors further explored the “worst” combinations of abuse types, showing that neglect is evident in the worst outcomes.

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  • O’Hara, M., L. Legano, P. Homel, I. Walker-Descartes, M. Rojas, and D. Laraque. 2015. Children neglected: Where cumulative risk theory fails. Child Abuse & Neglect 45.C: 1–8.

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    The authors examine the cumulative risk model to examine the differential and combined effects of child neglect and physical abuse. Using Longitudinal Studies on Child Abuse and Neglect data, the authors report that children victimized by “neglect only” had worse outcomes in some psychosocial domains compared with those children who had endured both neglect and physical abuse.

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  • Ryan, J., A. Williams, and M. Courtney. 2013. Adolescent neglect, juvenile delinquency and the risk of recidivism. Journal of Youth and Adolescence 42.3: 454–465.

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    How abuse and neglect affect youths’ involvement with the juvenile justice system was examined. Results show that neglect was a significant predictor of juvenile offenses, while controlling for myriad other environmental and psychosocial factors.

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  • Tyler, S., K. Allison, and A. Winsler. 2006. Child neglect: Developmental consequences, intervention, and policy implications. Child and Youth Care Forum 35.1: 1–20.

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    Critically examines risk factors, outcomes, and interventions for children who have been victimized by neglect. Supports enhancing multidisciplinary approaches to preventing and intervening with child neglect.

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Outcomes in Adulthood

Several studies examine outcomes of neglect on several domains of functioning in adulthood. Outcomes in adulthood include: Intergenerational transmission of neglect (Bartlett and Easterbrooks 2015; Dunn, et al. 2001; Widom, et al. 2015), mental health (Horwitz, et al. 2001; Nikulina, et al. 2011; Spertus, et al. 2003), and economic circumstances (Currie and Spatz Widom 2010). Three studies, Ben-David and Jonson-Reid 2017; DuMont, et al. 2007; and McGloin and Widom 2001, examine resiliency in adults who experienced neglect in childhood.

  • Bartlett, J., and M. Easterbrooks. 2015. The moderating effect of relationships on intergenerational risk for infant neglect by young mothers. Child Abuse & Neglect 45.C: 21–34.

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    Examines the research on interrupting the intergenerational risk for infant neglect by young mothers. Explores the protective factors that can contribute to interrupting this negative cycle.

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  • Ben-David, V., and M. Jonson-Reid. 2017. Resilience among adult survivors of childhood neglect: A missing piece in the resilience literature. Children and Youth Services Review 78:93–103.

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    The authors examine the research literature on the long-term resiliency to of all types of child maltreatment. They found that most studies of resiliency focus on survivors of sexual or physical abuse, and very few examine neglect.

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  • Currie, J., and C. Spatz Widom. 2010. Long-Term consequences of child abuse and neglect on adult economic well-being. Child Maltreatment 15.2: 111–120.

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    Examines the long-term consequences of abuse and/or neglect on adults’ economic outcomes. Differences were observed by gender and by type of maltreatment.

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  • DuMont, K., C. Widom, and S. Czaja. 2007. Predictors of resilience in abused and neglected children grown-up: The role of individual and neighborhood characteristics. Child Abuse & Neglect 31.3: 255–274.

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    The authors examined the long-term patterns of resiliency in adolescents and young adults who had been abused or neglect. The findings offer support to sustaining resiliency across developmental stages.

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  • Dunn, M., A. Mezzich, S. Janiszewski, L. Kirisci, and R. Tarter. 2001. Transmission of neglect in substance abuse families: The role of child dysregulation and parental SUD. Journal of Child & Adolescent Substance Abuse 10.4: 123–132.

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    The authors examined the association between caregiver substance use disorders, caregivers’ own experiences with child maltreatment, and the current perpetration of child neglect. Analyses were conducted separately for male and female caregivers.

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  • Horwitz, A. V., C. S. Widom, J. McLaughlin, and H. R. White. 2001. The impact of childhood abuse and neglect on adult mental health: A prospective study. Journal of Health and Social Behavior 42.2: 184–201.

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    The comparative effects of child neglect and sexual and physical abuse on adulthood mental health were examined. The study examined the effects of these abuse in the context of other stressful life events.

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  • McCord, J. 1983. A forty-year perspective on effects of child abuse and neglect. Child Abuse & Neglect 7.3: 265–270.

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    This study is an examination of historical accounts of abuse and neglect (categorized as “neglected,” “abuse,” “rejected,” or “loved”) from 1939 to 1945 and then how these children were faring as adults in the 1970s. The long-term consequences of neglect were summarized.

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  • McGloin, J. M., and C. S. Widom. 2001. Resilience among abused and neglected children grown up. Development and Psychopathology 13.4: 1021–1038.

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    Examines resiliency in adults who had been abused or neglected as children in the 1960s and 1970s. The study supports a comprehensive definition of resiliency in adulthood.

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  • Nikulina, V., C. Widom, and S. Czaja. 2011. The role of childhood neglect and childhood poverty in predicting mental health, academic achievement and crime in Adulthood. American Journal of Community Psychology 48.3–4: 309–321.

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    The authors compared the long-term differential effects of neglect and childhood poverty on adults’ mental health and psychosocial functioning. Childhood neglect corresponded to negative outcomes in adulthood, though the authors support examining the effects of neglect in the context of other environmental conditions.

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  • Spertus, I., R. Yehuda, C. Wong, S. Halligan, and S. Seremetis. 2003. Childhood emotional abuse and neglect as predictors of psychological and physical symptoms in women presenting to a primary care practice. Child Abuse & Neglect 27.11: 1247–1258.

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    The authors explored the long-term effects of both emotional abuse and child neglect in the mental health functioning of adult women. Both types of abuse, compared to other types of child maltreatment, were significantly negatively associated with mental health outcomes in adulthood.

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  • Widom, C., S. Czaja, and K. DuMont. 2015. Intergenerational transmission of child abuse and neglect: Real or detection bias? Science 347.6229: 1480–1485.

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    Evaluates the extent to which abused and neglected children are at risk for perpetrating abuse of their own children. The results vary according to abuse or neglect type, but also convey that “detection or surveillance bias” may also contribute to relatively higher reports in these caregivers.

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Interventions

Several studies and reports address interventions for neglect. DePanfilis 2006 outlines intervention strategies for addressing multiple aspects of neglect. Access to mental health services by maltreatment type is examined in Garland, et al. 1996. Two studies focus on reducing or preventing child neglect (Green, et al. 2016; Howard and Brooks-Gunn 2009). Saldana 2015 examines interventions aimed at ameliorating neglect and risk factors for neglect, while Sykes 2011 addresses the stigma associated with being reported for neglect. Finally, Wald 2015 provides a critique of the child welfare system’s approach in addressing neglect.

  • DePanfilis, D. 2006. Child neglect: A guide for prevention, assessment, and intervention. Washington, DC: US Department of Health and Human Services, Administration for Children, Youth and Families.

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    Provides comprehensive overview of research and best practices for addressing risk factors for neglect and the negative effects of it.

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  • Garland, A., J. L. Landsverk, R. L. Hough, and E. Ellis-Macleod. 1996. Type of maltreatment as a predictor of mental health service use for children in foster care. Child Abuse & Neglect 20.8: 675–688.

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    Explores the association between distinct types of maltreatment subsequent utilization of mental health services for children and adolescents in foster care. Findings reveal stronger likelihood for mental health service use for children victimized by physical and sexual abuse versus neglect.

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  • Green, A., E. Trott, C. Willging, N. Finn, M. Ehrhart, and G. Aarons. 2016. The role of collaborations in sustaining an evidence-based intervention to reduce child neglect. Child Abuse & Neglect 53:4–16.

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    Outlines interventions specifically designed to address child neglect. Specifically focuses on collaborative structure of agencies who implement interventions.

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  • Howard, K., and J. Brooks-Gunn. 2009. The role of home-visiting programs in preventing child abuse and neglect. Future of Children 19.2: 119–146.

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    Examines the efficacy of home visiting programs as a means for addressing all types of abuse and neglect. Programs address many of the broad risk factors that are associated with child neglect.

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  • Saldana, L. 2015. An integrated intervention to address the comorbid needs of families referred to child welfare for substance use disorders and child neglect: Fair pilot outcomes. Child Welfare 94.5: 167–186.

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    Authors examine intervention programs specifically designed for caregivers with substance abuse disorders and child neglect.

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  • Sykes, J. 2011. Negotiating stigma: Understanding mothers’ responses to accusations of child neglect. Children and Youth Services Review 33.3: 448–456.

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    Explores mothers’ perceptions of involvement with child welfare agencies after being reported for child neglect. Using a symbolic interactionist lens, the authors convey how mothers navigate involvement with the child welfare system, while contending with feeling stigmatized for being reported for neglect.

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  • Wald, M. 2015. Beyond CPS: Developing an effective system for helping children in “neglectful” families: Policymakers have failed to address the neglect of neglect. Child Abuse & Neglect 41:49–66.

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    Discusses the role that child welfare agencies have in intervening in cases of reported neglect and outlines a system that would reduce families’ involvement with child welfare in cases of neglect. The author supports a comprehensive set of services that would “enable all parents provide basically adequate parenting.”

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Child Psychological/Emotional Maltreatment Section

Psychological/emotional maltreatment has received less attention in the research literature, in part, because it is notoriously difficult to define and quantify. Moreover, practitioners and advocates often consider it to be uncommon and not serious enough to warrant intervention. In recent years, however, evidence has accumulated that psychological/emotional maltreatment may be more prevalent than originally thought and equally or more harmful than other forms of maltreatment. Over the past three decades, significant advances have been made in defining psychological/emotional maltreatment; identifying its major subtypes; examining its prevalence in both the general population and child welfare samples; exploring the risk and protective factors associated with its occurrence; and evaluating its major consequences throughout the lifespan. The following sections include research literature on each of these components, providing a comprehensive overview of the current state of knowledge on this topic. Interventions to address psychological/emotional maltreatment are also discussed.

Definitions

Numerous investigations focus on defining psychological/emotional maltreatment and identifying its major subtypes and core definitional challenges. Several reports, book chapters, and articles provide an overview of common definitions and propose definitional frameworks for research and practice (American Professional Society on the Abuse of Children 2017; Brassard and Donovan 2006; Glaser 2002; Hart, et al. 2018). Other works explore the challenges related to defining and identifying this form of maltreatment and its unique subtypes (Baker 2009; Hamarman and Bernet 2000; Loue 2005). One study, Hamarman, et al. 2002, focuses on legal definitions of psychological/emotional maltreatment, and O’Hagan 1995 discusses the distinction between the terms “psychological” and “emotional”). Finally, Wolfe and McIsaac 2011 proposes a framework for differentiating emotional maltreatment from poor or dysfunctional parenting.

  • American Professional Society on the Abuse of Children. 2017. APSAC practice guidelines for the investigation and determination of suspected psychological maltreatment in children and adolescents. Chicago: American Professional Society on the Abuse of Children.

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    Provides information to understand the recognize child psychological maltreatment, including its definitions, prevalence, risk factors, and effects. The definition of psychological maltreatment includes the following subtypes: spurning, exploiting/corrupting, terrorizing, emotional unresponsiveness, isolating, and mental health, medical, and educational neglect. Examples of behaviors associated with each subtype are presented.

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  • Baker, A. J. L. 2009. Adult recall of childhood psychological maltreatment: Definitional strategies and challenges. Children and Youth Services Review 31.7: 703–714.

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    Discusses challenges in defining and identifying child psychological maltreatment. The author describes legal and conceptual definitions of psychological maltreatment and presents an overview of survey instruments for its retrospective recall. Suggestions for systematically addressing the challenges identified are provided.

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  • Brassard, M. R., and K. L. Donovan. 2006. Defining psychological maltreatment. In Child abuse and neglect: Definitions, classifications, and a framework for research. Edited by M. M. Freerick, J. F. Knutson, P. K. Trickett, and S. M. Flanzer, 151–197. Baltimore, MD: Paul H. Brookers.

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    Presents an overview of definitions for child psychological maltreatment, including a review of subtypes proposed by professional organizations, government agencies, and researchers. The empirical support for each subtype is discussed, and future directions for research are presented.

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  • Glaser, D. 2002. Emotional abuse and neglect (psychological maltreatment): A conceptual framework. Child Abuse & Neglect 26.6–7: 697–714.

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    Presents a range of definitional challenges, including the tension between definitions rooted in caregivers’ actions and those focused on the effects on victims. The relational nature is discussed, presenting five categories: emotional unavailability, unresponsiveness, and neglect; negative attributions and misattributions to the child; developmentally inappropriate or inconsistent interactions with the child; failure to recognize the child’s individuality and psychological boundary; and failure to promote the child’s social adaptation.

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  • Hamarman, S., and W. Bernet. 2000. Evaluating and reporting emotional abuse in children: Parent based, action-based focus aids in clinical decision-making. Journal of the American Academy of Child & Adolescent Psychiatry 39.7: 928–930.

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    Provides an operational definition of emotional abuse based on parental actions and proposes the following subtypes: rejecting, isolating, terrorizing, ignoring, corrupting, verbally assaulting, and overpressuring. Clinical examples for mild, moderate, and severe emotional abuse are presented.

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  • Hamarman, S., K. H. Pope, and S. J. Czaja. 2002. Emotional abuse in children: Variations in legal definitions and rates across the United States. Child Maltreatment 7.4: 303–311.

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    Discusses the challenges in legal definitions of emotional abuse and examines definitional variability across the states. The link between the inclusiveness of the state laws and the reported rates of emotional abuse are examined. Implications for policy and practice are discussed.

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  • Hart, S. N., M. R. Brassard, A. J. L. Baker, and Z. A. Chiel. 2018. Psychological maltreatment of children. In The APSAC handbook on child maltreatment. 4th ed. Edited by J. B. Klika and J. R. Conte, 145–162. Los Angeles: SAGE.

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    Presents an overview of definitions for emotional/psychological maltreatment. The definitional challenges are discussed, and the use of a uniform definitional framework is promoted, defining psychological maltreatment as spurning, exploiting/corrupting, terrorizing, emotional unresponsiveness, isolating, and mental health, medical, and educational neglect.

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  • Loue, S. 2005. Redefining the emotional and psychological abuse and maltreatment of children. Journal of Legal Medicine 26.3: 311–337.

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    Presents an overview of definitions for child emotional and psychological maltreatment and discusses common definitional challenges. The author discusses the tension between definitions based on the abuser’s actions and those focused on the resulting harm to child. An overview of causes and consequences of emotional maltreatment is presented.

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  • O’Hagan, K. P. 1995. Emotional and psychological abuse: Problems of definition. Child Abuse & Neglect 19.4: 449–461.

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    Explores the distinction between “emotional” and “psychological” abuse. The author reviews the commonly used definitions for these terms and suggests that they are not synonymous and should be explicitly differentiated.

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  • Wolfe, D. A., and C. McIsaac. 2011. Distinguishing between poor/dysfunctional parenting and child emotional maltreatment. Child Abuse & Neglect 35.10: 802–813.

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    Provides a framework for differentiating between poor parenting and child emotional maltreatment. A range of factors that can be used to differentiate between these acts are considered, such as the child’s age, the frequency and severity of behavior shown by caregivers, cultural norms, and parental beliefs and goals in childrearing. Principles and practical criteria for distinguishing child emotional maltreatment from poor parenting are presented and discussed.

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Prevalence Rates

Prevalence rates for psychological/emotional maltreatment and its subtypes are examined in several investigations. Two government reports focus on prevalence rates in the United States, including cases that are reported to the authorities, as well as those that are not (Sedlak, et al. 2010; US Department of Health and Human Services 2019). Two studies explore prevalence rates based on official reports in Canada (Chamberland, et al. 2011; Malo, et al. 2016), and two meta-analytic reviews describe worldwide prevalence, including both self-report studies and informant studies (Stoltenborgh, et al. 2012; Stoltenborgh, et al. 2015). Two investigations describe prevalence rates based on samples from the US Air Force families (McCarthy, et al. 2018; Slep, et al. 2011), and Trickett, et al. 2009 compare the rates recorded using a research-based framework to those recorded at the time of a maltreatment investigation.

  • Chamberland, C., B. Fallon, T. Black, and N. Trocmé. 2011. Emotional maltreatment in Canada: Prevalence, reporting and child welfare responses (CIS2). Child Abuse & Neglect 35.10: 841–854.

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    Examines the prevalence and characteristics of emotional maltreatment reports in Canada, as well as the changes in these reports between 1998 and 2003. Emotional maltreatment investigations are categorized as emotional abuse, emotional neglect, and other (excluding exposure to intimate partner violence). Findings indicate that both emotional-abuse-only investigations and emotional-neglect-only investigations increased nearly threefold from 1998 to 2003.

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  • Malo, C., J. Moreau, C. Lavergne, and S. Hélie. 2016. Psychological maltreatment, the under-recognized violence against children: A new portrait from Quebec. Child Welfare 95.1: 77–99.

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    Examines the prevalence, co-occurrence, and common manifestations of psychological maltreatment in reported and substantiated cases in Quebec between 2007 and 2010. Findings reveal that psychological maltreatment reports are relatively common, although often accompanied by other forms of maltreatment. Manifestations most commonly include exposure to intimate partner violence.

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  • McCarthy, R. J., J. S. Milner, S. L. Coley, L. Ormsby, and M. Oliver. 2018. Child maltreatment re-offending in families served by the United States Air Force Family Advocacy Program. Child Abuse & Neglect 77:67–74.

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    Examines child maltreatment re-offending in the US Air Force families. Results reveal that 22 percent of the initial maltreatment incidents involve emotional abuse. Offenders whose initial incident is emotional abuse are more likely to perpetrate a subsequent incident of both emotional and physical abuse, but less likely to perpetrate a subsequent incident of neglect or sexual abuse.

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  • Sedlak, A. J., J. Mettenburg, M. Basena, et al. 2010. Fourth National Incidence Study of Child Abuse and Neglect (NIS-4): Report to Congress, Executive Summary. Washington, DC: US Department of Health and Human Services, Administration for Children and Families.

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    Provides updated estimates of the incidence of child abuse and neglect in the United States and measures changes in incidence from the earlier studies. Includes estimates of emotional abuse and emotional neglect, both under the Harm Standard and under the Endangerment Standard. Findings reveal that under the Harm Standard, about 27 percent of children are emotionally abused and 25 percent are emotionally neglected. In contrast, under the Endangerment Standard, about 36 percent are emotionally abused and 52 percent are emotionally neglected.

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  • Slep, A. M., R. E. Heyman, and J. D. Snarr. 2011. Child emotional aggression and abuse: Definitions and prevalence. Child Abuse & Neglect 35:783–796.

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    Describes the process of developing a set of field-tested criteria to operationally define emotional abuse in clinical settings and uses these criteria to design a measure of parental emotional aggression and child emotional abuse. Findings reveal that the prevalence of parents’ emotionally aggressive acts was higher than the prevalence of emotional abuse (acts plus impact); however, rates of parents’ emotional aggression were lower than those typically reported in the literature.

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  • Stoltenborgh, M., M. J. Bakermans-Kranenburg, L. R. A. Alink, and M. H. van IJzendoorn. 2012. The universality of childhood emotional abuse: A meta-analysis of worldwide prevalence. Journal of Aggression, Maltreatment & Trauma 21.8: 870–890.

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    A meta-analysis combining prevalence figures of child emotional abuse reported in twenty-nine studies, including forty-six independent samples with a total of 7,082,279 participants. Results indicate that the combined prevalence of emotional abuse for the total set of studies is 26.7 percent. A significant variation is detected between informant studies and self-report studies.

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  • Stoltenborgh, M., M. J. Bakermans-Kranenburg, L. R. A. Alink, and M. H. van IJzendoorn. 2015. The prevalence of child maltreatment across the globe: Review of a series of meta-analyses. Child Abuse Review 24.1: 37–50.

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    A review that combines and compares the results of a series of meta-analyses on the prevalence of many types of child maltreatment. The estimated prevalence rate for self-report studies is 363 per 1,000 for emotional abuse and 184 per 1,000 for emotional neglect. The estimated prevalence rate for studies using informants is 3 per 1,000 for emotional abuse (rates for emotional neglect are unavailable due to paucity of studies).

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  • Trickett, P. K., F. E. Mennen, K. Kim, and J. Sang. 2009. Emotional abuse in a sample of multiply maltreated, urban young adolescents: Issues of definition and identification. Child Abuse & Neglect 33.1: 27–35.

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    Applies an existing, research-based framework for defining emotional abuse to a sample of youth identified as maltreated by a large public child welfare agency. The rates of emotional abuse recorded using a research-based framework are compared to the rates recorded at the time of the investigation. Results indicate that the rates of emotional abuse increase dramatically when applying the research-based framework. The most frequently identified subtype of emotional abuse is terrorizing.

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  • US Department of Health & Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children’s Bureau. 2019. Child Maltreatment 2017.

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    An annual report which includes data on both alleged and substantiated child maltreatment in the United States, as well as some comparison data from previous years. Results indicate that approximately 6 percent of children were victims of psychological maltreatment in 2017.

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Risk and Protective Factors

Several works explore the risk and protective factors linked to psychological/emotional maltreatment. Some studies examine a wide range of risk/protective influences (Black, et al. 2001; Doyle 1997; Doidge, et al. 2017; Simmel and Shpiegel 2013), while others focus on specific risk effects, such as gender and sexual orientation (Corliss, et al. 2002), parental bonding (Baker and Verrocchio 2015), parental substance use (Kepple 2018), and maternal depression (Kohl, et al. 2011). Moreover, two studies, Doyle 2001 and Khambati, et al. 2018, focus on protective influences associated with positive adaptation following psychological/ emotional maltreatment.

  • Baker, A. J. L., and M. C. Verrocchio. 2015. Parental bonding and parental alienation as correlates of psychological maltreatment in adults in intact and non-intact families. Journal of Child and Family Studies 24.10: 3047–3057.

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    Examines the link between parental alienation, parental bonding, and psychological maltreatment in a sample of adults from southern Italy. Results indicate that parental alienation is associated with psychological maltreatment, over and above the effects of parental bonding.

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  • Black, D. A., A. M. Smith Slep, and R. E. Heyman. 2001. Risk factors for child psychological abuse. Aggression and Violent Behavior 6.2–3: 189–201.

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    Reviews risk and protective factors for child emotional abuse. Results point to several factors associated with this form of maltreatment, including sociodemographic factors, child parental characteristics, and marital relationship variables. Implications and directions for future research are discussed.

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  • Corliss, H. L., S. D. Cochran, and V. M. Mays. 2002. Reports of parental maltreatment during childhood in a United States population-based survey of homosexual, bisexual, and heterosexual adults. Child Abuse & Neglect 26:1165–1178.

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    Examines the nature and prevalence of child maltreatment experiences among lesbian, gay, and bisexual adults and compares findings to those obtained from similar heterosexual adults. Results reveal that homosexual/bisexual men report higher rates of emotional maltreatment by their mother or maternal guardian than heterosexual men; however, these effects are not significant for women. The overall rates of emotional maltreatment do not differ significantly by gender.

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  • Doidge, J. C., D. J. Higgins, P. Delfabbro, and L. Segal. 2017. Risk factors for child maltreatment in an Australian population-based birth cohort. Child Abuse & Neglect 64:47–60.

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    Examines a range of child, parent and family risk factors for childhood maltreatment in a population-based birth cohort of 2,443 Australians. Higher levels of economic disadvantage, poor parental mental health and substance use, and social instability are associated with increased risk of child maltreatment, including emotional maltreatment. The risk profiles are largely similar across the different maltreatment types.

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  • Doyle, C. 1997. Emotional abuse of children: Issues for intervention. Child Abuse Review 6:330–342.

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    Discusses childhood emotional abuse as a sole and co-occurring type of maltreatment and emphasizes issues of definition, prevalence, risk factors, manifestation, and intervention. Findings indicate that emotional maltreatment is found in a broad range of families, although it tends to be more prominent in families exposed to multiple stressors. A combination of socioeconomic deprivation, interpersonal distress, and caregiver changes appears to be a better predictor of emotional abuse than any variable in isolation.

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  • Doyle, C. 2001. Surviving and coping with emotional abuse in childhood. Clinical Child Psychology and Psychiatry 6.3: 387–402.

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    Through in-depth, unstructured interviews with fourteen adults who had survived significant emotional abuse, the author explores a range of environmental factors that may have helped victims cope with their abusive childhoods. Findings reveal that supportive members of extended family, as well as friends, teachers and other professionals, are generally considered to exert a positive influence. Nonhuman lifelines such as pets, toys, and books are also important to some children.

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  • Kepple, N. J. 2018. Does parental substance use always engender risk for children? Comparing incidence rate ratios of abusive and neglectful behaviors across substance use behavior patterns. Child Abuse & Neglect 76:44–55.

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    Examines the relationship between parental substance use behaviors and child maltreatment frequencies by type. Results indicate that past-year substance use behaviors are associated with higher frequency of emotional abuse as compared to nonusers. Implications from this work are discussed.

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  • Khambati, N., L. Mahedy, J. Heron, and A. Emond. 2018. Educational and emotional health outcomes in adolescence following maltreatment in early childhood: A population-based study of protective factors. Child Abuse & Neglect 81:343–353.

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    Examines key protective factors for good educational attainment and positive emotional health in adolescents who experienced physical or emotional maltreatment in early childhood. Among children who experienced emotional maltreatment, factors such as good communication skills, enjoyment of school, and extracurricular activities are particularly associated with resilience, with overlapping positive effects for both educational attainment and emotional health.

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  • Kohl, P. L., J. N. Kagotho, and D. Dixon. 2011. Parenting practices among depressed mothers in the child welfare system. Social Work Research 35.4: 215–225.

    DOI: 10.1093/swr/35.4.215Save Citation »Export Citation »

    Examines the prospective association between maternal depression and parenting practices in a sample of 1,536 mother–child dyads involved with the US child welfare system. Results reveal that depression is associated with increased risk of emotional maltreatment over a thirty-six-month period. Engaging in harsh parenting and neglect is also associated with increased risk of emotional maltreatment. Black mothers are more likely to self-report emotional maltreatment as compared to white mothers.

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  • Simmel, C., and S. Shpiegel. 2013. Describing the context and nature of emotional maltreatment reports in children. Children and Youth Services Review 35.4: 626–633.

    DOI: 10.1016/j.childyouth.2013.01.009Save Citation »Export Citation »

    Examines case-level characteristics of sole occurrences of emotional maltreatment allegations to understand how caregiver and child risk factors affect the substantiation of these allegations. Findings reveal that caregiver risk factors with the highest odds of predicting report substantiation include caregiver’s substance abuse and learning disabilities, as well as domestic violence.

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Outcomes/Effects

The bulk of research on psychological/emotional maltreatment focuses on its harmful consequences across the lifespan. Existing investigations address effects on victims’ emotional and behavioral health, relationships, and cognitions and neurobiology. The studies below include child and adolescent samples, as well as adult samples.

Emotional and Behavioral Health

Numerous studies explore the consequences of psychological/emotional maltreatment on victims’ emotional and behavioral health. The most commonly researched effects are internalizing and externalizing problems and social functioning. Two studies, Hart, et al. 1997 and Maguire, et al. 2015, review and summarize findings across multiple investigations. Three focus on the unique effects of different subtypes (Allen 2008; Paul and Eckenrode 2015; Taussig and Culhane 2010), and two compare emotional abuse to emotional neglect (Shaffer, et al. 2009; Taillieu, et al. 2016). Gavin 2011 uses a mixed methods approach to assess the consequences of psychological/emotional maltreatment, and two compare the magnitude of its effects to those of other forms of child maltreatment (Rosenkranz, et al. 2012; Spinazzola, et al. 2014).

  • Allen, B. 2008. An analysis of the impact of diverse forms of childhood psychological maltreatment on emotional adjustment in early adulthood. Child Maltreatment 13.3: 307–312.

    DOI: 10.1177/1077559508318394Save Citation »Export Citation »

    Examines the link between caregiver terrorizing, degradation, ignoring, and isolating and self- reported occurrence of anxiety, depression, somatic complaints, and features of borderline personality disorder in a sample of 256 university students. Results reveal that terrorizing predicts anxiety and somatic concerns, ignoring predicts depression and features of BPD, and degradation predicts BPD features only.

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  • Gavin, H. 2011. Sticks and stones may break my bones: The effects of emotional abuse. Journal of Aggression, Maltreatment & Trauma 20.5: 503–529.

    DOI: 10.1080/10926771.2011.592179Save Citation »Export Citation »

    Uses a mixed-methods approach to examine the relationship between child psychological maltreatment and adult health and well-being. Quantitative analyses reveal an association between psychological maltreatment and decreased health and well-being in adulthood. Qualitative findings indicate that some responders who deny being abused report events that could be considered abusive and are prone to negative effects.

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  • Hart, S. N., N. J. Binggeli, and M. R. Brassard. 1997. Evidence for the effects of psychological maltreatment. Journal of Emotional Abuse 1.1: 27–58.

    DOI: 10.1300/J135v01n01_03Save Citation »Export Citation »

    Reviews research on the possible and probable consequences of psychological maltreatment, both as a sole type and when associated with other types of maltreatment. Findings are organized in several categories, such as intrapersonal thoughts, feelings and behaviors, emotional problem symptoms, social and antisocial functioning, learning problems, and physical health.

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  • Maguire, S. A., B. Williams, A. M. Naughton, et al. 2015. A systematic review of the emotional, behavioral and cognitive features exhibited by school-aged children experiencing neglect or emotional abuse. Child: Care, Health and Development 41.5: 641–653.

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    A systematic review of the features exhibited by children aged five to fourteen years who have experienced neglect or emotional abuse. Findings indicate that these children present a range of emotional and behavioral symptoms, such as externalizing and internalizing problems, poor academic performance, and peer difficulties.

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  • Paul, E., and J. Eckenrode. 2015. Childhood psychological maltreatment subtypes and adolescent depressive symptoms. Child Abuse & Neglect 47:38–47.

    DOI: 10.1016/j.chiabu.2015.05.018Save Citation »Export Citation »

    Examines how the subtypes and timing of psychological maltreatment contribute to adolescent depressive symptoms at age fourteen. The sample includes 638 youth from the Longitudinal Studies of Child Abuse and Neglect. For girls, caregiver degradation is the only maltreatment subtype that contributes uniquely to depressive symptoms. For boys, only caregiver isolating behaviors and chronic isolation predict depressive symptoms.

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  • Rosenkranz, S. E., R. T. Muller, and J. L. Henderson. 2012. Psychological maltreatment in relation to substance use problem severity among youth. Child Abuse & Neglect 36.5: 438–448.

    DOI: 10.1016/j.chiabu.2012.01.005Save Citation »Export Citation »

    Examines the extent to which emotional abuse and emotional neglect predict substance use problem severity among youth entering an outpatient treatment program for youths with substance use concerns. Results indicate that, when considering all types of maltreatment together, only emotional abuse and emotional neglect emerge as significant predictors of substance use problem severity, and this association is unchanged by the consideration of concurrent experiences of interpersonal violence.

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  • Shaffer, A., T. M. Yates, and B. R. Egeland. 2009. The relation of emotional maltreatment to early adolescent competence: Developmental processes in a prospective study. Child Abuse & Neglect 33.1: 36–44.

    DOI: 10.1016/j.chiabu.2008.12.005Save Citation »Export Citation »

    Examines the pathways between childhood emotional maltreatment and adaptation outcomes in middle childhood and early adolescence. Findings reveal that both emotional abuse and emotional neglect are associated with elevated aggression and social withdrawal in middle childhood, and with lower competence in early adolescence. A mediation model explaining these associations is examined and discussed.

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  • Spinazzola, J., H. Hodgdon, L. J. Liang, et al. 2014. Unseen wounds: The contribution of psychological maltreatment to child and adolescent mental health and risk outcomes. Psychological Trauma: Theory, Research, Practice, and Policy 6(Suppl 1): S18–S28.

    DOI: 10.1037/a0037766Save Citation »Export Citation »

    Examines the independent and additive predictive effects of psychological maltreatment on an array of behavioral problems, symptoms, and disorders in a large national sample of clinic-referred children and adolescents. Findings reveal that psychologically maltreated youth exhibit equivalent or greater baseline levels of behavioral problems, symptoms, and disorders compared with physically or sexually abused youth on the majority of the indicators.

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  • Taillieu, T. L., D. A. Brownridge, J. Sareen, and T. O. Afifi. 2016. Childhood emotional maltreatment and mental disorders: Results from a nationally representative adult sample from the United States. Child Abuse & Neglect 59:1–12.

    DOI: 10.1016/j.chiabu.2016.07.005Save Citation »Export Citation »

    Examines the association of emotional abuse, emotional neglect, and both emotional abuse and neglect with other types of child maltreatment, a family history of dysfunction, and lifetime diagnoses of several Axis I and Axis II mental disorders. Findings reveal that all categories of emotional maltreatment are associated with increased odds of almost every mental disorder assessed in this study. The effects appear to be stronger for emotional abuse than for emotional neglect.

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  • Taussig, H. N., and S. E. Culhane. 2010. Emotional maltreatment and psychosocial functioning in preadolescent youth placed in out-of-home care. Journal of Aggression, Maltreatment & Trauma 19.1: 52–74.

    DOI: 10.1080/10926770903476008Save Citation »Export Citation »

    Examines the impact of emotional maltreatment and its specific subtypes on interpersonal functioning, self-perception, mental health, and behavioral problems among youth placed in out-of-home care. Findings reveal that emotional maltreatment is significantly associated with a range of difficulties, even after other forms of maltreatment are accounted for. However, some effects are present only for specific subtypes of emotional maltreatment.

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Relationship Effects and Relationship Violence

Several studies examine relationship effects linked to experiencing psychological/emotional maltreatment. Some works focus on general couples’ adjustment (Bigras, et al. 2015; Perry, et al. 2007; Riggs, et al. 2011), while others examine various forms of relationship violence (Berzenski and Yates 2010; Crawford and Wright 2007; Madden and Shaffer 2019; Wekerle, et al. 2009; Zurbriggen, et al. 2010). Riggs 2010 describes a model for understanding the link between emotional/psychological maltreatment and the quality of romantic relationships, and Reyome 2010 summarizes the empirical literature on the connection between this type of maltreatment and characteristics of intimate relationships.

  • Berzenski, S. R., and T. M. Yates. 2010. A developmental process analysis of the contribution of childhood emotional abuse to relationship violence. Journal of Aggression, Maltreatment & Trauma 19.2: 180–203.

    DOI: 10.1080/10926770903539474Save Citation »Export Citation »

    Presents a developmental process analysis of the link between childhood emotional abuse and relationship violence in a sample of undergraduates. Results reveal that emotional abuse is a more powerful predictor of relationship violence than other maltreatment types. This relationship is partially mediated by emotional dysregulation, although the mediation model is significant for females only.

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  • Bigras, N., N. Godbout, M. Hébert, M. Runtz, and M. Daspe. 2015. Identity and relatedness as mediators between child emotional abuse and adult couple adjustment in women. Child Abuse & Neglect 50:85–93.

    DOI: 10.1016/j.chiabu.2015.07.009Save Citation »Export Citation »

    Examines the link between childhood emotional abuse and couple adjustment in a sample of 184 French Canadian women. The mediating role of identity and interpersonal conflicts is explored. Results indicate that emotional abuse is linked to poorer couple adjustment through its impact on dysfunctional self-capacities and the experience of greater conflicts in relationships.

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  • Crawford, E., and M. O. Wright. 2007. The impact of childhood psychological maltreatment on interpersonal schemas and subsequent experiences of relationship aggression. Journal of Emotional Abuse 7.2: 93–116.

    DOI: 10.1300/J135v07n02_06Save Citation »Export Citation »

    Examines the relationship between child psychological maltreatment, interpersonal schemas, and adult relationship aggression in college men and women. Results reveal that psychological maltreatment predicts both perpetration and revictimization of adult interpersonal aggression even after controlling for other childhood abuse experiences. A mediating role of interpersonal schemas is observed and discussed.

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  • Madden, A. R., and A. Shaffer. 2019. Childhood emotional abuse and young adulthood dating violence: The moderating role of stress reactivity. Journal of Aggression, Maltreatment & Trauma 28.3: 334–349.

    DOI: 10.1080/10926771.2018.1440452Save Citation »Export Citation »

    Examines the association between self-reported childhood emotional abuse and later self-reported interpersonal violence in young adult dating relationships, as well as the potential moderating effects of cortisol stress reactivity. Findings reveal that the association between childhood emotional abuse and young adult dating violence is stronger for those who demonstrate low levels of cortisol reactivity.

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  • Perry, A. R., D. Dilillo, and J. Peugh. 2007. Childhood psychological maltreatment and quality of marriage: The mediating role of psychological distress. Journal of Emotional Abuse 7.2: 117–142.

    DOI: 10.1300/J135v07n02_07Save Citation »Export Citation »

    Examines the link between psychological maltreatment and marital satisfaction in a sample of 65 newlywed couples and the possible mediating role of adult psychological distress. Findings reveal an association between psychological maltreatment and marital satisfaction. However, this association is mediated by global psychological distress, hostility, and depression, with some gender differences present.

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  • Reyome, N. D. 2010. Childhood emotional maltreatment and later intimate relationships: Themes from the empirical literature. Journal of Aggression, Maltreatment & Trauma 19.2: 224–242.

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    Summarizes and discusses the empirical literature on the link between childhood emotional maltreatment and characteristics of intimate relationships, such as relationship quality, codependency, and intimate partner violence. Implications for future research and clinical practice are addressed.

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  • Riggs, S. A. 2010. Childhood emotional abuse and the attachment system across the life cycle: What theory and research tell us. Journal of Aggression, Maltreatment & Trauma 19.1: 5–51.

    DOI: 10.1080/10926770903475968Save Citation »Export Citation »

    Reviews the literature on normative development regarding attachment and on the deviations in response to emotionally abusive parenting. The proposed model indicates that emotional abuse leads to insecure attachment, which impairs emotional regulation, fosters negative views of self and others, support maladaptive coping responses, interferes with social functioning and the capacity for intimate adult attachments, contributes to poor mental health, and, thus, shapes the quality of romantic relationships.

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  • Riggs, S. A., A. M. Cusimano, and K. M. Benson. 2011. Childhood emotional abuse and attachment processes in the dyadic adjustment of dating couples. Journal of Counseling Psychology 58.1: 126–138.

    DOI: 10.1037/a0021319Save Citation »Export Citation »

    Investigates the association between childhood emotional abuse and later romantic relationships among heterosexual couples and explores the potential mediation effects of adult attachment processes. Results reveal that memories of childhood emotional abuse reported by both students and their partners are significantly associated with attachment strategies, as well as with romantic relationship quality. The hypothesized mediation effects of attachment anxiety and avoidance are supported.

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  • Wekerle, C., E. Leung, A.-M. Wall, et al. 2009. The contribution of childhood emotional abuse to teen dating violence among child protective services-involved youth. Child Abuse & Neglect 33.1: 45–58.

    DOI: 10.1016/j.chiabu.2008.12.006Save Citation »Export Citation »

    Examines the unique predictive value of childhood emotional abuse for understanding adolescent posttraumatic stress disorder (PTSD) symptomatology and dating violence in a sample of 402 youth involved with Child Protective Services. Findings indicate that emotional abuse is a significant predictor of PTSD symptomatology and dating violence among males and females. PTSD symptomatology emerges as a mediator of the link between emotional abuse and dating violence, with gendered patterns present.

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  • Zurbriggen, E. L., R. L. Gobin, and J. J. Freyd. 2010. Childhood emotional abuse predicts late adolescent sexual aggression perpetration and victimization. Journal of Aggression, Maltreatment & Trauma 19.2: 204–223.

    DOI: 10.1080/10926770903539631Save Citation »Export Citation »

    Examines the link between child emotional abuse and experiences of sexual aggression victimization and perpetration in a sample of college students. Findings reveal that for both men and women, childhood emotional abuse is positively correlated with sexual aggression victimization and perpetration. In most cases, this effect holds even after controlling for childhood sexual and physical abuse and social desirability.

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Cognitive and Neurobiological Effects

A few studies examine the link between psychological/emotional maltreatment and cognitive or neurobiological effects. Four studies focus primarily on cognitive manifestations, including cognitive styles (Gibb 2002), cognitive and emotional awareness (Goldsmith and Freyd 2005), self-associations (van Harmelen, et al. 2010), and cognitive schemas (Wright, et al. 2009). Two studies examine neurobiological effects, including changes in the prefrontal cortex (van Harmelen, et al. 2010) and amygdala reactivity (van Harmelen, et al. 2013). Yates 2007 reviews a range of neurodevelopmental processes linked to experiencing this type of maltreatment.

  • Gibb, B. E. 2002. Childhood maltreatment and negative cognitive styles: A quantitative and qualitative review. Clinical Psychology Review 22:223–246.

    DOI: 10.1016/S0272-7358(01)00088-5Save Citation »Export Citation »

    Reviews research on the link between childhood maltreatment and negative cognitive styles. Findings point to a small but significant association between emotional maltreatment and cognitive styles. This association is stronger in studies that include maltreatment committed by both family and nonfamily members, as compared to studies that include family member perpetrators only.

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  • Goldsmith, R. E., and J. J. Freyd. 2005. Awareness for emotional abuse. Journal of Emotional Abuse 5.1: 95–123.

    DOI: 10.1300/J135v05n01_04Save Citation »Export Citation »

    Examines the relationship between childhood emotional abuse and emotional awareness among eighty diversity students. Fins reveal that emotional abuse and neglect are significantly positively correlated with difficulty identifying feelings, after controlling for participants’ depression, anxiety, dissociation, and lifetime trauma.

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  • van Harmelen, A. L., P. J. de Jong, K. A. Glashouwer, P. Spinhoven, B. W. J. H. Penninx, and B. M. Elzinga. 2010. Child abuse and negative explicit and automatic self-associations: The cognitive scars of emotional maltreatment. Behaviour Research and Therapy 48.6: 486–494.

    DOI: 10.1016/j.brat.2010.02.003Save Citation »Export Citation »

    Examines the link between child maltreatment and automatic and explicit self-depression and/or self-anxiety associations in a large cohort study. Findings reveal that emotional maltreatment has the strongest association with enhanced automatic and explicit self-depression and self-anxiety associations. Moreover, automatic and explicit negative self-associations partially mediate the link between childhood emotional maltreatment and depressive or anxious symptomatology.

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  • van Harmelen, A. L., M. J. van Tol, L. R. Demenescu, et al. 2013. Enhanced amygdala reactivity to emotional faces in adults reporting childhood emotional maltreatment. Social Cognitive and Affective Neuroscience 8.4: 362–369.

    DOI: 10.1093/scan/nss007Save Citation »Export Citation »

    Examines the link between childhood emotional maltreatment and amygdala reactivity to emotional faces in a large sample of outpatients and healthy controls. Findings indicate that emotional maltreatment is associated with enhanced bilateral amygdala reactivity to emotional faces, independent of psychiatric status.

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  • van Harmelen, A. L., M. J. van Tol, N. J. A. van der Wee, et al. 2010. Reduced medial prefrontal cortex volume in adults reporting childhood emotional maltreatment. Biological Psychiatry 68.9: 832–838.

    DOI: 10.1016/j.biopsych.2010.06.011Save Citation »Export Citation »

    Examines the neurobiological correlates of childhood emotional maltreatment using high-resolution magnetic resonance imaging. Findings reveal that childhood emotional maltreatment is linked to a significant reduction in predominantly left dorsal medial prefrontal cortex volume, even in the absence of physical or sexual abuse. Moreover, reduced medial prefrontal cortex in individuals reporting emotional maltreatment is present in males and females, independent of co-occurring psychopathology.

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  • Wright, M. O., E. Crawford, and D. Del Castillo. 2009. Childhood emotional maltreatment and later psychological distress among college students: The mediating role of maladaptive schemas. Child Abuse & Neglect 33.1: 59–68.

    DOI: 10.1016/j.chiabu.2008.12.007Save Citation »Export Citation »

    Examines the mediating role of maladaptive schemas in the link between emotional abuse and neglect and subsequent internalizing and dissociative symptoms among college students. Findings reveal that both emotional abuse and emotional neglect are linked to later symptoms of anxiety and depression, although only emotional neglect is linked to symptoms of dissociation. A mediating effect of maladaptive schemas in the link between emotional maltreatment and later symptomatology is observed.

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  • Yates, T. M. 2007. The developmental consequences of child emotional abuse: A neurodevelopmental perspective. Journal of Emotional Abuse 7.2: 9–34.

    DOI: 10.1300/J135v07n02_02Save Citation »Export Citation »

    Reviews neurodevelopmental processes in understanding the developmental sequelae of child emotional abuse. Building on the evidence that child emotional abuse is likely to result in significant and enduring alterations in the neurobiology of stress response systems and, by extension, in neurodevelopment more broadly, specific suggestions for future research and practice are discussed.

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Intervention Strategies

Several studies discuss intervention strategies to address psychological/emotional maltreatment. Baker, et al. 2011 examines whether common parenting programs address psychological maltreatment, and Iwaniec 1997 explores the effects of a specific parent-training program on emotionally maltreating parents. Hart and Glaser 2011 proposes a public health approach as a guiding orientation for child protection, recognizing the importance of psychological aspects of all maltreatment. Hibbard, et al. 2012 and Leeson and Nixon 2010 suggest that interventions designed for other types of maltreatment may also play a role in addressing psychological maltreatment. Finally, Iwaniec and Herbert 1999 explores a range of therapeutic interventions, while both Palusci and Ondersma 2012 and English, et al. 2015 discuss the response of child protection systems.

  • Baker, A. J. L., M. R. Brassard, M. S. Schneiderman, L. J. Donnelly, and A. Bahl. 2011. How well do evidence-based universal parenting programs teach parents about psychological maltreatment? A program review. Child Abuse & Neglect 35.10: 855–865.

    DOI: 10.1016/j.chiabu.2011.05.013Save Citation »Export Citation »

    Evaluates the content of universal parenting programs to assess whether they include any content on psychological maltreatment. Findings reveal that content related to most types of psychological maltreatment is not included in the curricula, and no single program is rated as having content related to teaching all types of psychological maltreatment.

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  • English, D., R. Thompson, C. R. White, and D. Wilson. 2015. Why should child welfare pay more attention to emotional maltreatment? Children and Youth Services Review 50:53–63.

    DOI: 10.1016/j.childyouth.2015.01.010Save Citation »Export Citation »

    Describes the nature and characteristics of emotional maltreatment and examines the link between its subtypes and child trauma symptoms and risk behaviors at age eighteen. A discussion of possible interventions, including response from the child welfare system, is included.

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  • Hart, S. N., and D. Glaser. 2011. Psychological maltreatment—Maltreatment of the mind: A catalyst for advancing child protection toward proactive primary prevention and promotion of personal well-being. Child Abuse & Neglect 35.10: 758–766.

    DOI: 10.1016/j.chiabu.2011.06.002Save Citation »Export Citation »

    Discusses current difficulties in responding to various forms of violence against children, given the narrow scope of child protection. The authors suggest that a public health approach should become the guiding orientation of child protection, recognizing the importance of psychological aspects of maltreatment. The public health approach gives priority to determining the origins of violence and emphasizes a broad range of preventive approaches.

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  • Hibbard, R., J. Barlow, H. MacMillan, and the Committee on Child Abuse and Neglect and American Academy of Child and Adolescent Psychiatry, Child Maltreatment and Violence Committee. 2012. Psychological maltreatment. Pediatrics 130.2: 372–378.

    DOI: 10.1542/peds.2012-1552Save Citation »Export Citation »

    Presents an overview of definitions and prevalence rates of psychological maltreatment, as well as its assessment and major effects. The need for effective intervention strategies to respond to this type of maltreatment is also discussed. It is suggested that existing interventions, such as the Nurse Family Partnership, may play a role in preventing psychological maltreatment. Additional prevention and intervention approaches are discussed, such as cognitive behavioral parenting programs and psychotherapeutic interventions. Guidelines for pediatricians are presented.

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  • Iwaniec, D. 1997. Evaluating parent training for emotionally abusive and neglectful parents: Comparing individual versus individual and group intervention. Research on Social Work Practice 7.3: 329–349.

    DOI: 10.1177/104973159700700303Save Citation »Export Citation »

    Describes the principles and methods of parent training using cognitive and/or behavioral approaches. The author assesses and trains two groups of emotionally abusive and neglectful parents and follows them for two years. The parents who receive both individual both individual and group training exhibit improved outcomes in some domains.

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  • Iwaniec, D., and M. Herbert. 1999. Multidimensional approach to helping emotionally abused and neglected children and abusive parents. Children & Society 13:365–379.

    DOI: 10.1111/j.1099-0860.1999.tb00132.xSave Citation »Export Citation »

    Discusses definition issues concerning emotional maltreatment and emphasizes that its heterogeneous nature requires a multi-level, multidimensional approach to intervention. The authors discuss responses, from child protection systems, a range of interventions with parents and children, family therapy, and combined approaches.

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  • Leeson, F., and R. Nixon. 2010. Therapy for child psychological maltreatment. Clinical Psychologist 14.2: 30–38.

    DOI: 10.1080/13284207.2010.500311Save Citation »Export Citation »

    Summarizes the literature on treatments for childhood trauma including sexual and physical abuse. The application of these treatments to target outcomes secondary to psychological maltreatment is discussed. Given that there are no empirically supported interventions to address psychological maltreatment, the utility of interventions targeting other maltreatment type should be examined.

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  • Palusci, V. J., and S. J. Ondersma. 2012. Services and recurrence after psychological maltreatment confirmed by child protective services. Child Maltreatment 17.2: 153–163.

    DOI: 10.1177/1077559511433817Save Citation »Export Citation »

    Examines services provided and recurrence rates for psychological maltreatment. Findings indicate that less than one fourth of families are referred for services after a report of psychological maltreatment. Service referrals are more likely for families with poverty, drug or alcohol problems, or other violence. Controlling for these factors, counseling referral is associated with a 54 percent reduction in psychological maltreatment recurrence, but other services are not associated with statistically significant reductions.

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