McKesson Clinical Reference Systems: Pediatric Advisor 2002.1

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The statistics on physical child abuse are alarming. It is estimated hundreds of thousands of children battered each year by a parent or close relative. Thousands die. For those who survive, the emotional trauma remains long after the external bruises have healed. Communities and the courts recognize that these emotional "hidden bruises" can be treated. Early recognition and treatment is important to minimize the long-term effect of physical abuse.

Children who have been abused may display:

• a poor self-image
• sexual acting out
• an inability to trust or love others
• aggressive, disruptive, and sometimes illegal behavior
• anger and rage
• self-destructive or self-abuse behavior, suicidal thoughts
• passive or withdrawn behavior
• fear of entering into new relationships or activities
• anxieties and fears
• school problems or failure
• feelings of sadness or other symptoms of depression
• flashbacks, nightmares
• drug and alcohol abuse.

Often the severe emotional damage to abused children does not surface until adolescence or later, when many abused children become abusing parents. An adult who was abused as a child has trouble establishing intimate personal relationships. These men and women may have trouble with physical closeness, touching, intimacy, and trust as adults. They are also at higher risk for anxiety, depression, substance abuse, medical illness, and problems at school or work. Without proper treatment, physically abused children can be damaged for life.

Child and adolescent psychiatrists can provide comprehensive evaluation and care for children who have been abused. The family can be helped to learn new ways of support and communicating with one another. Through treatment, the abused child begins to regain a sense of self-confidence and trust.

Physical abuse is not the only kind of child abuse. Many children are victims of neglect, or sexual or emotional abuse. In all kinds of child abuse, the child and the family can benefit from the comprehensive evaluation and care of a professional trained to deal with such problems.