The impact of child abuse - greater than we might imagine

It became one of those quick national stories that flips onto the front pages for a day and is then lost. But that surely should not be the case with this one. A Canadian study soon top be published in the Canadian Medical Association Journal reports on the prevalence of child abuse and mental disorders. The results are profound.

The sample is based on just over 25,000 Canadians in 10 provinces (The 3 Northern Territories of Canada were not included).The authors looked at physical abuse, sexual abuse and exposure to intimate partner violence.  The adult responders reported on experiences before the age of 16.  Here's what they found:

1. The prevalence of any of the 3 types of child abuse was 32.1%, with physical abuse being the most common (26.1%), followed by sexual abuse (10.1%) and exposure to intimate partner violence (7.9%).
2. All child abuse types were associated with increased odds of all mental conditions (such as depression, bipolar disorder, generalized anxiety disorder, substance abuse and dependence, suicidal ideation and attempts, ADHD, Eating Disorders, PTSD, learning disabilities). 

These are quite profound numbers. It is highly probable that this data would be replicated in many Western countries that share similar family and parenting patterns. The costs (emotional, physical and financial) are astounding. Society is also paying a very large price for this through the health care, child protection, criminal justice and education systems. The strongest linkages that the authors found was between exposure to these 3 types of abuse and suicidal ideation, and attempts as well as substance abuse and dependence. 

Even more profound is the "…the least severe type of physical abuse (being slapped on the face, head or ears, or hit or spanked with something hard) showed a strong association with all mental conditions in models adjusting for sociodemographic covariates." In other words, even mild abuse has long term implications. 

This also brings us back to the spanking debate - minor abuse seems to be harmful. This research comes at a time when a study just published in the Journal of Family Psychology notes that in 73% of the cases where there was corporal punishment, the child misbehaved again within 10 minutes. That research is based on a small sample but it adds the very large body of research that tells us that spanking remains an ineffective form of parenting. The Canadian data also suggests that the impact may be long term and not what most parents would hope for - a greater risk of mental illness.

This research should help social workers and others working with families to underline why other forms of parenting and discipline are better for the child.

Child abuse statistics - what's real

In the United States, child protection services have been indicating that the rates of child physical abuse have been decreasing. Critics of child protection services, as well as those who are focused on prevention services, have trumpeted these numbers. Reason to celebrate whenever there are indications that child physical abuse is decreasing.

However, a new study published on October 1 through the online version of the journal, Paediatrics, suggests that there is another way to look at the data. They focused on serious child abuse which included head injuries, burns and fractures. The data showed a modest increase of 5%.

Both sets of data are useful. The first looks at the broader picture, although it may represent a number of differences in how cases are reported to child protection agencies. Thus, it might be report affected as opposed to being a true me sure of frequency. The more recent data tells us though, that the serious cases remain a growing problem. Public policy should focus on that truth.

A question now opens - to what degree is this trend true in other countries.

Leventhal, J.M. & Gaither, J.R.. (2012)  Incidence of serious injuries due to physical abuse in the United States: 1997 to 2009. Pediatrics, online, DOI:10.1542/peds.2012-0922