Vol. 20, No. 3
July 2015

Recognizing Emotional Maltreatment

Most parents, at one time or another, "lose it" with their kids and are less than attentive, say hurtful things, or scare them unintentionally (American Humane Association, n.d.). Experts generally agree this is not emotional maltreatment. But if it's not, what is?

Definition
There is growing agreement among child welfare professionals, researchers, and other stakeholders about what separates emotional maltreatment from suboptimal parenting: chronicity, severity, and potential harm to the child (English, et al., 2015).

These three traits are reflected in one of the most commonly used definitions of emotional maltreatment: "a repeated pattern of caregiver behavior or extreme incidents that convey to children that they are worthless, flawed, unloved, unwanted, endangered, or only of value in meeting another's needs" (APSAC, 1995).

Emotional maltreatment is a phenomenon that is highly relevant to all child welfare professionals because it threatens children's sense of safety and their long-term well-being. Click here for a discussion about emotional abuse, a concept that is important in North Carolina law and policy.

Prevalence
Emotional maltreatment seems to be relatively common. Gilbert and colleagues (2009) found around 8% to 9% of women and 4% of men said they were exposed to severe psychological abuse as children. In another large study of 4,549 children and youth, researchers found 6.4% had experienced emotional maltreatment in the past year. Of the 14 to 17-year-olds in the study, almost a quarter (22.6%) said they had experienced emotional maltreatment at some point in their lives (Finkelhor, et al., 2009).

Emotional maltreatment may be under-identified. For example, when Everson and colleagues (2008) interviewed 350 early adolescents known to CPS, they reported having had emotional maltreatment experiences at six times the rate found in these same youth's CPS records.

There are big differences in the rate of emotional maltreatment substantiations from state to state. In 2012, emotional maltreatment victims accounted for:

Less than 1% of child victims in 18 states
More than a 25% of child victims in six states
More than 40% of child victims in two states.

These differences are probably due to differences in the way this form of maltreatment is defined and assessed as opposed to a variation in actual rates of emotional abuse (NCANDS, 2012 cited in English, et al., 2015).

Emotional maltreatment can occur on its own. However, it often co-occurs with other forms of child abuse or neglect (Trickett, et al., 2011). This is one of the factors that can make it difficult to identify.

Recognizing Emotional Maltreatment
Sometimes we're forewarned: the CPS report explicitly alleges emotional maltreatment alone or in combination with another form of abuse or neglect.

Other times emotional maltreatment is present but not mentioned in the CPS report. In these instances it is up to child welfare staff to recognize the signs. This can be difficult. There are no obvious, specific physical manifestations of emotional abuse--it is all about a negative parent-child relationship, a long-standing pattern of parental behavior, and the harm this causes the child.

Difficult, but not impossible. Whether you are doing CPS assessments, in-home services, or foster care, signs of emotional maltreatment can be found in the child and the caregiver.

Possible Child Indicators
Emotional maltreatment can cause a wide variety of symptoms in children, including attachment disorders, developmental, educational, and socialization problems, and disruptive behavior (Hibbard, et al., 2012). These difficulties can have many causes, so their presence does not necessarily mean that emotional maltreatment is present. However, particularly if you find children struggling with low self-esteem, poor self-concept, and insecure attachment, gather additional information to ascertain whether these symptoms are the result of caregiver behaviors.

Possible Caregiver Behaviors
Emotional maltreatment can involve a number of caregiver behaviors. The box below outlines six of the most common categories of behaviors and gives examples of each.

Emotional Maltreatment: Types of Caregiver Behaviors

Denying Emotional Responsiveness or Ignoring
Includes ignoring the child's attempts and needs to interact and showing no emotion in interactions with the child. Other behaviors include:

Being detached and uninvolved due to incapacity or lack of motivation
Interacting only when necessary
Failing to express affection, caring, and love for the child.

Spurning (or Hostile Rejecting/Degrading)
Includes verbal and nonverbal acts that reject and degrade the child, including:

Belittling, degrading, and non-physical forms of overt hostility or rejection
Shaming and/or ridiculing the child for showing normal emotion
Consistently singling out one child to criticize, punish, perform most of the household chores, receive fewer rewards, etc.
Public humiliation.

Isolating
Includes consistently denying the child chances to interact/communicate with peers or adults inside or outside the home. Isolation can come from a variety of caregiver motivations, but the resulting behavior prevents children from having opportunities for social relations with both adults and peers. Isolating includes:

Confining the child or placing unreasonable limitations on the child's freedom of movement within the child's environment
Placing unreasonable limitations or restrictions on child's social interactions.

Terrorizing
Includes behavior that threatens or is likely to physically hurt, kill, abandon, or place the child or the child's loved ones or love objects in recognizably dangerous situations. Includes:

Placing a child in unpredictable or chaotic circumstances
Placing a child in recognizably dangerous situations
Setting rigid or unrealistic expectations with threat of loss, harm, or danger if they are not met
Threatening or perpetrating violence against the child
Threatening or perpetrating violence against a child's loved ones or objects.

Exploiting or Corrupting
Includes:

Modeling, permitting, or encouraging antisocial behavior (e.g., prostitution, performance in pornographic media, initiation of criminal activities, substance abuse, violence to or corruption of others)
Modeling, permitting, or encouraging developmentally inappropriate behavior (e.g., parentification, infantalization, living the parent's unfulfilled dreams)
Encouraging or coercing abandonment of developmentally appropriate autonomy through extreme over-involvement, intrusiveness, and/or dominance (e.g., allowing little or no opportunity or support for the child's views, feelings, and wishes; micromanaging child's life)
Restricting or interfering with cognitive development.

Mental, Medical, and Educational Neglect
Includes unwarranted caregiver acts that ignore, refuse to allow, or fail to provide the necessary treatment for the mental health, medical, and educational concerns or needs of the child. Includes ignoring the need for or failing or refusing to allow or provide treatment for:

The child's serious emotional/behavioral problems or needs
The child's serious educational problems or needs.

Adapted from Hart, et al., 2002; Brassard & Donovan, 2006; PA Child Welfare Resource Center, 2014

While emotional maltreatment can occur in many different kinds of families, it may be more common in families facing multiple stressors, such as family conflict, parental mental illness, or parental substance abuse. Research has shown that children are not only susceptible to direct emotional maltreatment when there is domestic violence, parental conflict, or custody battles; they are also negatively affected by witnessing emotional maltreatment between caregivers (Sturge-Apple, et al., 2012).

To Learn More
Read on to learn more about the impact emotional maltreatment can have on children and for ideas about how to help families struggling with this problem.

References for this and other articles in this issue