Psychological Maltreatment
http://pediatrics.aappublications.org/content/early/2012/07/25/peds.2012-1552.full.pdf+html
abstract
Psychological or emotional maltreatment of children may be the most
challenging and prevalent form of child abuse and neglect. Caregiver
behaviors include acts of omission (ignoring need for social interactions)
or commission (spurning, terrorizing); may be verbal or nonverbal,
active or passive, and with or without intent to harm; and
negatively affect the child’s cognitive, social, emotional, and/or physical
development. Psychological maltreatment has been linked with
disorders of attachment, developmental and educational problems,
socialization problems, disruptive behavior, and later psychopathology.
Although no evidence-based interventions that can prevent psychological
maltreatment have been identified to date, it is possible
that interventions shown to be effective in reducing overall types of
child maltreatment, such as the Nurse Family Partnership, may have
a role to play. Furthermore, prevention before occurrence will require
both the use of universal interventions aimed at promoting the type of
parenting that is now recognized to be necessary for optimal child
development, alongside the use of targeted interventions directed at
improving parental sensitivity to a child’s cues during infancy and
later parent-child interactions. Intervention should, first and foremost,
focus on a thorough assessment and ensuring the child’s safety.
Potentially effective treatments include cognitive behavioral parenting
programs and other psychotherapeutic interventions. The high prevalence
of psychological abuse in advanced Western societies, along
with the serious consequences, point to the importance of effective
management. Pediatricians should be alert to the occurrence of psychological
maltreatment and identify ways to support families who
have risk indicators for, or evidence of, this problem. Pediatrics
2012;130:372–378
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