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Child Abuse in Community Institutions and Organizations:
Improving Public and Professional Understanding

A FRAMEWORK FOR UNDERSTANDING THE IMPACT OF CHILD ABUSE IN VARIOUS SETTINGS

Many of the consequences of institutional or organizational abuse are similar to those experienced by victims and survivors of abuse by family members. However, advocates and survivors of abuse in institutions and organizations have noted that there are additional and unique symptoms, which are sometimes related to the specific institution or organization in which the abuse occurred.

Theoretical explanations for understanding the immediate and enduring effects of child abuse on children's development take into account developmental processes and how they might interact with the particular pattern and trauma of maltreatment. Trauma theory and developmental psychopathology each consider how exposure to traumatic events or the use of inappropriate childrearing methods can affect children’s development diversely and progressively over time. These explanations, furthermore, place children’s experiences in a broader context that includes their perception of the emotional climate of their families or caregivers, their previous experiences with conflict and abuse, their interpretations of violence and maltreatment, and their available coping abilities and resources to countermand stress and inadequate caregiving.[i] The implication of this view is that children who have been abused experience more than isolated incidents of violence; rather, they live in a world that breaches their trust and intrudes on their normal developmental progress in numerous ways. It is these deviations in socialization practices that may be primarily responsible for disrupting the child's normal developmental progress, resulting in visible signs of emotional and behavioural problems.

An understanding of how the effects of abuse in institutions and organizations are similar to child abuse by family members is an important starting point in developing a conceptual framework. The scarcity of literature specifically addressing the etiology and consequences of abuse in institutions and organizations requires a beginning point of commonalities, as well as factors unique to this type of abuse.

EFFECTS OF INTRAFAMILIAL ABUSE

Over the past 25 years, researchers and clinicians have described the varied and severe ways in which children’s development and future mental health can be impaired by child abuse. Child abuse often results in cognitive and emotional distress or dysfunction. Children who have been abused may experience depression, anxiety, low self-esteem, [ii], [iii], [iv], [v], [vi], and somatic problems.[vii] They also may exhibit self-destructive[viii] or suicidal behaviour.[ix] Children who are physically abused also are at risk for developing poor impulse control[x], difficulties regulating their emotions, difficulties understanding others’ perspectives, lack of empathy[xi], and are more willing to use physical punishment. Adult survivors of childhood abuse display similar symptoms of depression and anxiety.[xii] ,[xiii], [xiv], [xv] The emotional distress experienced by adult survivors of childhood abuse can lead to a number of self-harming behaviours, including substance abuse,[xvi] bingeing and purging,[xvii] and self-injurious behaviour.[xviii] Adult survivors of sexual abuse often are plagued by feelings of guilt,[xix] self-blame,[xx] helplessness, anger, and may perceive life as dangerous or hopeless.[xxi] Adult survivors of childhood physical abuse are also at an increased risk for developing psychosis and paranoid ideation.xxii]

Childhood abuse increases the risk of developing a number of behaviour and interpersonal problems. Children who have been physically or sexually abused are more likely to have difficulties with aggression[xxiii] truanting, running away from home,[xxiv] bulimia,[xxv] alcohol and drug use,[xxvi] oppositional behaviour,[xxvii] and delinquent or criminal behaviours.[xxviii] Interpersonally, these children tend to be less socially competent,[xxix] withdrawn,[xxx] and have difficulty trusting those in their immediate environment.[xxxi] As adults, these interpersonal difficulties continue. Adult survivors of sexual abuse may find it difficult to learn to trust, act autonomously, or form a stable, secure relationship.[xxxii] These individuals are more likely to remain single, and if they do get married, they are more likely to get divorced or separated.[xxxiii] In general, adult survivors of childhood sexual abuse tend to have more maladaptive interpersonal patterns than non-survivors, and have been found to have fewer friends.[xxxiv] Adult survivors of physical abuse are more likely to be aggressive and violent towards others as well as their spouses and children.[xxxv]

Children who have been sexually abused are more likely than their non-abused peers to display a number of problematic sexual behaviours including phobic reactions, sexual inhibitions, sexual hyperarousal, impaired sexual impulse control,[xxxvi] sexual preoccupation, promiscuity, sexual aggression, inappropriate sexual behaviour, and excessive masturbation.[xxxvii] Adult survivors may display an avoidance of intimate and sexual relationships,[xxxviii] fear of sex,[xxxix] less interest in sex,[xl] less pleasure from sex,[xli] sexual phobias,[xlii] sexual preoccupation,[xliii] over-sexualized relationships,[xliv] sexual aggression,[xlv] and are more likely to become involved in abusive sexual or romantic relationships and experience revictimization.[xlvi] Children who have been physically abused are at risk for developing a number cognitive or intellectual deficits,[xlvii] language deficits,[xlviii] perceptual motor deficits, and academic difficulties.[xlix]

Although all of these problems have been associated with childhood abuse, no single symptom or pattern of symptoms is present in all victims of childhood abuse. In fact, in their review of the effects of childhood sexual abuse, Kendall-Tackett, Williamson and Finkelhor[l] concluded that 20 per cent to 50 per cent of children were asymptomatic at initial assessment, and only 10 per cent to 25 per cent became symptomatically worse during the two years following the victimization. Why some victims seem devastated by the abuse while others show no obvious signs of harm has sparked considerable debate, and a general recognition that the harmful effects of abuse depend on other positive and negative events in the child’ s life.[li]

FACTORS INFLUENCING THE EFFECTS OF INTRAFAMILIAL CHILD ABUSE

Certain aspects of abusive experiences and the environment in which they occur may attenuate or accentuate adjustment difficulties over the life course. Factors that have received the most empirical support in terms of affecting the degree of harm or the pace of recovery from intrafamilial child abuse include: (1) Characteristics of the abusive experiences (e.g., earlier age of onset and the severity and chronic nature of child abuse are associated with more negative outcomes[lii], [liii], [liv], [lv]); (2) Relationship to the offender (e.g., abuse perpetrated by fathers, father figures, or individuals having an intense emotional relationship with the victim is associated with more severe consequences,[lvi]); (3) Methods to reduce resistance and disclosure (i.e., the use of coercive or forceful methods to ensure the child’s compliance or overcome resistance, whether through violence or threats by the offender, is related to increased distress and dysfunction[lvii]); (4) Post-abuse events (e.g., how the family and others, such as teachers or relatives, respond to disclosure of child abuse[lviii]); and (5) the child’s or adolescent’s psychological make-up. Importantly, many of these same factors emerge in clinical studies of the impact of abuse in institutions and organizations, although with some degree of alteration, as described below.

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i. Wolfe, D. A., & Jaffe, P. (1991). Child abuse and family violence as determinants of child psychopathology. Canadian Journal of Behavioural Science, 23, 282-299. [hereinafter Wolfe and Jaffe (1991)]

ii. Beitchman, J.H., Zucker, K.J., Hood, J.E., DaCosta, G.A., & Akman, D. (1991). A review of the short-term effects of child sexual abuse. Child Abuse & Neglect, 15 (4), 537-556. [hereinafter Beitchman et al (1991)]

iii. Berliner, L., & Elliot, D. (1996). Sexual abuse of children. In J. Briere, L. Berliner, J. A Bulkley, C. Jenny, & T. Reid (Eds.), The APSAC Handbook on Child Maltreatment (pp. 51-71). Thousand Oaks, CA, USA: Sage Publications. [hereinafter Berliner and Elliot (1996)]

iv. Green, A. (1993). Child sexual abuse: Immediate and long-term effects and intervention. Journal of the American Academy of Child and Adolescent psychiatry, 32(5), 890-902. [hereinafter Green (1993)]

v. Ammerman, R. T., Cassisi, J. E., Hersen, M., Van Hasselt, V. B. (1986). Consequences of physical abuse and neglect in children. Clinical Psychology Review, 6, 291-319. [hereinafter Ammerman et al (1986)]

vi. Kolko, D. J. (1996). Child physical abuse. In J. Briere, L. Berliner, J. A Bulkley, C. Jenny, & T. Reid (Eds.), The APSAC Handbook on Child Maltreatment (pp. 21-50). Thousand Oaks, CA, USA: Sage Publications. [hereinafter Kolko (1996)].

vii. Perring (1992), supra note 22.

viii. Wolfe and Jaffe (1991), supra note 24; Beitchman et al (1991), supra note 25

ix. Panhale (1999), supra note 21; Perring (1992), supra note 22; Wolfe and Jaffe (1991), supra note 24; Beitchman et al (1991), supra note 25.

x. Perring (1992), supra note 22; Wolfe and Jaffe (1991) supra note 24.

xi. Wright, S. (1994). Physical and emotional abuse and neglect of preschool children: A literature review. Australian Occupational Therapy Journal, 41, 55-63.

xii. Penhale (1999), supra note 21; Perring (1992), supra note 22; Wolfe and Jaffe (1991), supra note 24; Beitchman et al (1991), supra note 25.

xiii. Beitchman, J.H., Zucker, K.J., Hood, J.E., DaCosta, G.A., Akman, D., & Cassavia, E. (1992). A review of the long-term effects of child sexual abuse. Child Abuse & Neglect, 16 (1), 101-118.

xiv. Briere, J. N. (1992). Child abuse trauma: Theory and treatment of the lasting effects. Newbury Park, California: Sage Publications.

xv. Malinosky-Rummell, R., & Hansen, D. (1993). Long-term consequences of childhood physical abuse. Psychological Bulletin, 114 (1), 68-79.

xvi. Penhale (1999), supra note 21; Perring (1992), supra note 22; Ammerman et al (1986), supra note 28; Kolko (1996), supra note 2.

xvii. Penhale (1999), supra note 21; Ammerman et al (1986), supra note 29.

xviii. Perring (1992), supra note 22; Ammerman et al (1986), supra note 28; Kolko (1996), supra note 29.

xix. Beitchman et al (1991), supra note 25.

xx. Ibid; Penhale (1999), supra note 21.

xxi. Penhale (1999), supra note 21.

xxii. Kolko (1996), supra note 29.

xxiii. Wolfe and Jaffe (1991), supra note 24; Beitchman et al (1991), supra note 25; Ammerman et al(1986), supra note 28.

xxiv. Penhale (1999), supra note 21.

xxv. Penhale (1999), supra note 21.

xxvi. Perring (1992), supra note 22; Beitchman et al (1991), supra note 25.

xxvii. Beitchman et al (1991), supra note 25.

xxviii. Wolfe and Jaffe (1991), supra note 24; Beitchman et al (1991), supra note 25.

xxix. Penhale (1999), supra note 21.

xxx. Penhale ibid; Wolfe and Jaffe (1991), supra note 24.

xxxi. Penhale ibid.

xxxii. Penhale ibid; Beitchman et al (1991), supra note 25.

xxxiii. Penhale ibid

xxxiv. Penhale ibid

xxxv. Ammerman et al (1986), supra note 28; Kolko (1996), supra note 29.

xxxvi. Perring (1992), supra note 22.

xxxvii. Perring (1992), supra note 22.

xxxviii. Perring ibid; Berliner and Elliot (1996), supra note 26.

xxxix. Perring ibid; Wolfe and Jaffe (1991), supra note 24.

xl. Perring ibid; Wolfe and Jaffe ibid; Green (1993), supra note 27.

xli. Perring ibid; Green ibid.

xlii. Wolfe and Jaffe (1991), supra note 24.

xliii. Penhale (1999), supra note 21; Ammerman et al, supra note 28.

xliv. Wolfe and Jaffe (1991), supra note 24.

xlv. Ammerman et al, ibid.

xlvi. Penhale (1999), supra note 21; Perring (1992), supra note 22; Ammerman et al, ibid.

xlvii. Wolfe and Jaffe (1991), supra note 24; Beitchman et al (1991), supra note 25; Berliner and Elliot (1996), supra note 26.

xlviii. Perring (1992), supra note 22; Beitchman et al (1991) ibid.

xlix. Wolfe and Jaffe (1991), supra note 24.

l. Kendall-Tackett, K.A., Williams, L. M. & Finkelhor, D. (1993). Impact of sexual abuse on children: A review and synthesis of recent empirical studies. Psychological Bulletin, 113, 164-180. [hereinafter Kindall-Tacket (1993)]

li. Wolfe, D. A. (1999). Child abuse: Implications for child development and psychopathology (2nd Ed.). Thousand Oaks, CA: Sage. [hereinafter Wolfe (1999)]

lii. Erickson, M. F., Egeland, B., & Pianta, R. (1989). The effects of maltreatment on the development of young children. In D. Chichetti & V. Carlson (Eds.), Child maltreatment: Theory and research on the causes and consequences of child abuse and neglect (pp. 647-684). New York: Cambridge University Press.

liii. Kinard, E. M. (1982). Experiencing child abuse: Effects on emotional adjustment. American Journal of Orthopsychiatry, 52, 82-91.

liv. Wind, T. W., & Silvern, L. (1994). Type and extent of child abuse as predictors of adult functioning. Journal of Family Violence, 7, 261-281.

lv. Conte, J. R., & Schuerman, J. R., (1987). Factors associated with an increased impact of child sexual abuse. Child Abuse & Neglect, 11, 201-211.

lvi. Ammerman et al (1986), supra note 28; Briere, J., & Elliott, D. M. (1994). Immediate and long-term impacts of child sexual abuse. Future of Children, 4(2), 54-69.

lvii. Green (1993), supra note 27; Kendall-Tackett et al (1993), supra note 75; Wolfe (1999), supra note 76.

lviii. Wolfe (1999) ibid; Gomez-Schwartz, B., Horowitz, J. M. & Cardarelli, A. P. (1990). Child sexual abuse: The initial effects. Newbury Park, CA: Sage.

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