Long-term consequences of child abuse and neglect

February 2005

What are some of the long-term consequences of child abuse and neglect?

The impact of child abuse and neglect is most often discussed in terms of the physical and possible psychological damage to the child. However, there are physical, psychological, behavioral, and societal consequences for children and families that can last a lifetime, or generations. It is also impossible to completely separate the consequences. Physical consequences (such as damage to a child's growing brain) can have psychological implications (cognitive delays or emotional difficulty). Psychological problems often manifest as high-risk behaviors. Depression and anxiety, for example, may make a person more likely to smoke, abuse alcohol or drugs, or overeat. High-risk behaviors, in turn can lead to long-term physical health problems such as sexually transmitted diseases, cancer, and obesity.

Not all abused and neglected children will experience long-term consequences. Outcomes vary widely and are affected by a number of circumstances including:

• The child's age and developmental status at the time the abuse or neglect occurred;

• The type of maltreatment (physical abuse, sexual abuse, neglect);

• Frequency, duration, and severity of maltreatment;

• Relationship between the victim and the abuser.

Researchers are also beginning to look at “resilience”, the ability of a child to cope and even thrive after having been maltreated. A number of protective factors have been identified that may contribute to that resilience. They may include optimism, self-esteem, intelligence, independence, and social supports in both family and community.

Physical Health Consequences

The immediate physical effects of child abuse and neglect can be relatively minor (bruises or cuts) or severe (broken bones, hemorrhage, burns, or death). In some cases the physical effects are temporary; however, the accompanying pain and suffering cannot be discounted. Several studies of children who use HMOs have found long-term health problems such as sexually transmitted diseases, heart disease, cancer, chronic lung disease, skeletal fractures, and liver disease. Researchers are just beginning to study the long-term physical effects of shaken baby syndrome and impaired brain development.

Psychological Consequences

The immediate emotional consequences of abuse and neglect – isolation, fear, and inability to trust – can translate into life-long consequences including low self-esteem, depression, and relationship difficulties. In other cases, the stress of chronic abuse may result in hyperactivity, sleep disturbances, and anxiety as well as increased vulnerability to post traumatic stress disorder, attention deficit/hyperactivity disorder, conduct disorder, and learning and memory difficulties. ORC Macro evaluation data (2004) on children referred to systems of care by child welfare support these findings.

Behavioral Consequences

Not all victims of child abuse and neglect experience behavioral consequences; however, child abuse and neglect appear to make the following more likely:

• Abusive behavior – Abusive parents have often experienced abuse during their own childhoods. This accounts for about 1/3 of abusive parents.

• Alcohol and drug abuse – National Institute on Drug Abuse report that as many as 2/3 of people in drug treatment programs reported being abused as children.

• Difficulties during adolescence – Teen pregnancy, low academic achievement, drug use, and serious emotional disturbances are reflected in numerous studies of adolescents who have been maltreated.

• Juvenile delinquency and adult criminality – A National Institute of Justice Study indicated that being abused or neglected as a child increased the likelihood of adult criminal behavior by 28% and violent crime by 30%.

An increasing amount of research is being conducted about the consequences of child abuse and neglect. The effects vary depending on the circumstances of the maltreatment, personal characteristics of the child, and the child's environment. Consequences may be mild or severe; disappear after a short period or last a lifetime, and affect the child physically, psychologically, behaviorally, or in some combination of all three ways. Ultimately, due to related costs to public entities, such as health care, human services, and education systems, abuse and neglect impact not just the child and family, but society as a whole.

Excerpted from: National Clearinghouse on Child Abuse and Neglect Information
Available online at: http://nccanch.acf.hhs.gov/pubs/factsheets/long_term_consequences.cfm

Technical Assistance Partnership for Child and Family Mental Health

Child Welfare Frequently Asked Questions

February 2005

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	February 2005 What are some of the long-term consequences of child abuse and neglect? The impact of child abuse and neglect is most often discussed in terms of the physical and possible psychological damage to the child. However, there are physical, psychological, behavioral, and societal consequences for children and families that can last a lifetime, or generations. It is also impossible to completely separate the consequences. Physical consequences (such as damage to a child's growing brain) can have psychological implications (cognitive delays or emotional difficulty). Psychological problems often manifest as high-risk behaviors. Depression and anxiety, for example, may make a person more likely to smoke, abuse alcohol or drugs, or overeat. High-risk behaviors, in turn can lead to long-term physical health problems such as sexually transmitted diseases, cancer, and obesity. Not all abused and neglected children will experience long-term consequences. Outcomes vary widely and are affected by a number of circumstances including: • The child's age and developmental status at the time the abuse or neglect occurred; • The type of maltreatment (physical abuse, sexual abuse, neglect); • Frequency, duration, and severity of maltreatment; • Relationship between the victim and the abuser. Researchers are also beginning to look at “resilience”, the ability of a child to cope and even thrive after having been maltreated. A number of protective factors have been identified that may contribute to that resilience. They may include optimism, self-esteem, intelligence, independence, and social supports in both family and community. Physical Health Consequences The immediate physical effects of child abuse and neglect can be relatively minor (bruises or cuts) or severe (broken bones, hemorrhage, burns, or death). In some cases the physical effects are temporary; however, the accompanying pain and suffering cannot be discounted. Several studies of children who use HMOs have found long-term health problems such as sexually transmitted diseases, heart disease, cancer, chronic lung disease, skeletal fractures, and liver disease. Researchers are just beginning to study the long-term physical effects of shaken baby syndrome and impaired brain development. Psychological Consequences The immediate emotional consequences of abuse and neglect – isolation, fear, and inability to trust – can translate into life-long consequences including low self-esteem, depression, and relationship difficulties. In other cases, the stress of chronic abuse may result in hyperactivity, sleep disturbances, and anxiety as well as increased vulnerability to post traumatic stress disorder, attention deficit/hyperactivity disorder, conduct disorder, and learning and memory difficulties. ORC Macro evaluation data (2004) on children referred to systems of care by child welfare support these findings. Behavioral Consequences Not all victims of child abuse and neglect experience behavioral consequences; however, child abuse and neglect appear to make the following more likely: • Abusive behavior – Abusive parents have often experienced abuse during their own childhoods. This accounts for about 1/3 of abusive parents. • Alcohol and drug abuse – National Institute on Drug Abuse report that as many as 2/3 of people in drug treatment programs reported being abused as children. • Difficulties during adolescence – Teen pregnancy, low academic achievement, drug use, and serious emotional disturbances are reflected in numerous studies of adolescents who have been maltreated. • Juvenile delinquency and adult criminality – A National Institute of Justice Study indicated that being abused or neglected as a child increased the likelihood of adult criminal behavior by 28% and violent crime by 30%. An increasing amount of research is being conducted about the consequences of child abuse and neglect. The effects vary depending on the circumstances of the maltreatment, personal characteristics of the child, and the child's environment. Consequences may be mild or severe; disappear after a short period or last a lifetime, and affect the child physically, psychologically, behaviorally, or in some combination of all three ways. Ultimately, due to related costs to public entities, such as health care, human services, and education systems, abuse and neglect impact not just the child and family, but society as a whole. Excerpted from: National Clearinghouse on Child Abuse and Neglect Information Available online at: http://nccanch.acf.hhs.gov/pubs/factsheets/long_term_consequences.cfm