Child Abuse and Neglect

Child abuse and neglect, also called child maltreatment, refers to acts of commission or omission by a caregiver or other adult that cause, or risk causing, harm to a child. It encompasses physical abuse, sexual abuse, emotional or psychological abuse, and neglect. In child and adolescent psychiatry, maltreatment is a major contributor to trauma- and stressor-related disorders and to a broad range of later mental and physical health problems.

Definition

Child abuse and neglect comprises physical, sexual, and emotional abuse and neglect of a child by a parent, caregiver, or other person, representing acts of commission or omission that result in harm, potential harm, or threat of harm to the child's health, development, or dignity.

Scope

This entry covers child maltreatment as a context and risk factor for trauma-related psychopathology in young people: its principal forms, its documented links to later mental health outcomes, and its place within trauma- and stressor-related disorders. It is a reference overview of the concept and its evidence base rather than a clinical, forensic, or child-protection protocol.

Key concepts

• Physical abuse
• Sexual abuse
• Emotional or psychological abuse
• Neglect
• Acts of commission versus omission
• Adverse childhood experiences
• Maltreatment as a risk factor for later disorder
• Poly-victimisation and chronicity

Mechanisms

Maltreatment is understood as a developmental insult: chronic threat, deprivation, or the absence of consistent caregiving can disrupt attachment, stress-response regulation, and the developing capacity to manage emotion, raising the likelihood of trauma- and stressor-related disorders and other psychopathology. Effects scale with the type, severity, chronicity, and accumulation of exposures, and maltreatment often co-occurs with other adversities, so that pathways from maltreatment to later disorder are typically multiple and interacting rather than single.

Clinical relevance

Child abuse and neglect is one of the most important contexts that clinicians consider when a young person presents with trauma symptoms, and a maltreatment history bears directly on how trauma-related disorders are understood. It is also a safeguarding concern handled within legal and child-protection frameworks. This entry describes maltreatment as a concept and risk factor and is not a protocol for identifying, reporting, or responding to abuse in an individual case.

Epidemiology

Child maltreatment is common worldwide. International reviews of high-income countries estimate that a substantial minority of children experience physical, sexual, or emotional abuse or neglect, with official-agency figures capturing only a fraction of cases. Maltreatment is consistently associated with increased risk of depression, anxiety, post-traumatic stress disorder, substance use, and other adverse outcomes across the lifespan.

History

Systematic medical attention to child maltreatment is often dated to the description of the 'battered-child syndrome' in the 1960s, which reframed inflicted injury as a recognisable clinical and public-health problem. Subsequent decades broadened the concept beyond physical abuse to include sexual abuse, emotional abuse, and neglect, and large epidemiological studies established maltreatment's links to long-term mental and physical health outcomes.

Seminal works

• gilbert-2009
• norman-2012

Frequently asked questions

What counts as child maltreatment?

It includes physical abuse, sexual abuse, emotional or psychological abuse, and neglect — both harmful acts and harmful failures to provide care — by a parent, caregiver, or other responsible adult.

Why is child abuse covered within trauma- and stressor-related disorders?

Maltreatment is a leading source of childhood trauma and a major risk factor for post-traumatic and other stressor-related disorders, so it provides essential context for understanding how these conditions arise in young people.