Child abuse does occur more to families
that live in poverty

• Poverty is not neglect, BUT-Child neglect and the conditions of poverty often overlap
• Financial problems, work related stress, homelessness can lead to difficulty coping as a parent
• Parents, esp. under the stress of poverty,
  can react inappropriately or unintentionally
• Domestic violence may result
  because of a feeling of powerlessness over a situation

chicken or egg?

• Children whose parents abuse substances are almost three times more likely to be abused and four times more likely to be neglected than other children
(National Center on Addiction and Substance Abuse at Columbia University [CASA], 1999).
• Substance abuse is a contributing factor to the abuse of at least one third of the children in the child welfare system
(DHHS, 1999).
• (nearly) two-thirds of all adults entering treatment for drug abuse report being victims of child abuse or neglect
(National Institute on Drug Abuse)

Factors That Influence The Effect
Of Abuse

• presence of a support system
• age of child (coping mechanisms differ)
  chronic vs. single incident
• who committed the abuse (trusted adult vs. stranger)
• was the child able to talk about it
• response of the person the child told (doubting, ignoring, blaming or shaming could be worse then the abuse itself!)
• cultural expectations

An infant's brain develops in response to experience

While experience effects the behaviour of an adult, it directly determines the actual framework of the brain of a young child or infant.

Traumatic experiences activate fear responses, which, when persistent and chronic, result in a maladaptive state of continued fear. This causes hyper-vigilance for perceived threats,increased muscle tone, & anxiety

repeated trauma in early childhood
causes:

• attention deficits
• sleep disorders
• mood disorder

Types of Abuse

There are different types of abuse and many factors that determine it's effect on a child.

• Neglect
• Physical abuse
• Sexual abuse
• Emotional abuse

Neglect is the most common form of abuse defined as: failure to provide adequate food clothing shelter medical care or supervision appropriate for age to prevent child from hazards

Physical Abuse

• Physical injury that was not accidental (though abuser may deny intent)
• Punishment that is inappropriate for child's age, size, or condition (normal discipline does not leave marks)


• hitting with a closed fist, kicking, burning, or throwing a child irregardless of any injury received.

Sexual Abuse and Incest

• all forms of oral-genital, genital or anal contact exhibitionism or voyeurism sexual penetration
• exploitation through prostitution or production of pornography
• sex acts not only committed by the abuser but which the child is forced to perform

Survivors of Child Sexual Abuse may suffer as adults with:

• depression
• anxiety
• dissociation
• sexual dysfunction
• eating disorders
• personality disorders
• substance abuse

Emotional Abuse

• less obvious then other forms of abuse
• also present when there's other forms of abuse.
• includes repeated verbal abuse such as unreasonable, degrading or humiliating criticism, belittling, ridiculing, name calling, disrespect.
• includes unreasonable confinement or social isolation (i.e. shutting child in a dark closet, refusing them friends)

Emotional Abuse or Neglect

• results when a parent or guardian is cold, distant or unaffectionate
• when a child is allowed to witness chronic or severe domestic violence
• when a child is allowed to use alcohol, drugs or engage in delinquent behavior
• when a child's education is neglected

Overall the Results of Child Abuse

• avoidance of relationships and fear of intimacy
• being cold and critical
• an inability to connect with others
• feelings of isolation and loneliness
• communication problems(professional and personal)
• may lessen effective parenting skills

• Adult survivors also may have trouble with trust, either trusting too easily or not at all,
• are more likely to experience rape or abuse from their partner
• may have a poor sense of boundaries
• a pattern of withdrawing from couple interaction during times of high emotion

Domestic Violence

• Children may grow up to be batterers because that's what they saw as acceptable behavior in their childhood home.
• Children are also much more likely to become the victim of domestic violence as an adult, because that is the role with which they are familiar.

Incarceration

• more than 50% of the women in jail said they had been physically or sexually abused in the past, and more than 10% of the men.
• 75% of men in prison have a personality disorder
• half the women in prison have a personality disorder

Personality Disorders in Prison

• People with Axis 2 personality disorders which result in serious problems in thinking, feeling, interpersonal relations, and impulse control often end up in prison.
• People with personality disorders may appear "normal" (just obnoxious or difficult) these mental disorders are very real and drive those who have them to behave the way they do.
• Failure to diagnose and properly attend to prisoners' personality disorders can lead to inappropriate responses by correctional staff that aggravate the prisoners' conduct and heighten the incidence of self-mutilation and suicide attempts.

antisocial personality disorder
traits and spectrum

• superficial & shallow little or no empathy
• little or no conscience or moral reasoning
• grandiose and self-centered
• lack of impulse control

NARCISSIST- Denigrating, demeaning, exploitative
MALIGNANT NARCISSIST- Rebellious, deviant, criminal
PSYCHOPATH: Malicious, Predatory, serial murder, torture

It is important to distinguish APD from
other personality disorders

more to come on other relevant personality disorders especially BPD

Narcissists, given knowledge of the consequences, have enough control over their behavior to avoid prison in the future. In that sense, they can be rehabilitated.

Narcissist, however, are terrible parents (lack of empathy, self-centered) and best not raise children.
Society needs to be protected from malignant narcissists, sociopaths, psychopaths. They do not change and belong in prison. You will not likely see SEASCAT representing anyone with Antisocial Personality Disorder

SEASCAT plans to assist anyone serious about recovery and whose diagnosis of PTSD, DID and/or other personality disorder, eating disorder or substance abuse disorder results from abuse during childhood

Residents will be supported while working full time toward recovery. Residence will provide the nurturing, safety and support that was lacking during childhood

• many with personality disorders
• dissociative identity disorders
• many with post traumatic stress disorder
• many with mood disorders
• anxiety disorders
• eating disorders
• many with substance abuse disorders

PTSD & C-PTSD

When experiences lead a child to feel that events are unpredictable and not under their control they have an increased likelihood of developing Post Traumatic Stress Disorder.

Symptoms of this disorder often include:

extreme anxiety, flashbacks, nightmares, emotional numbness, irritability, startle reflex

DID Dissociative Identity Disorder

• is a coping skill which is used to allow a very young child to survive unbelievable abuse.
• formerly known as multiple personality disorder, terminology more familiar to the layperson.
• People who develop this coping skill will likely continue to use it whenever they encounter a traumatic event.

• they may experience sudden shifts in consciousness, identity, and memory. identity may appear fragmented.
• have different personalities.
• They may lose time, as one identity takes control of the “host”.
• Differing personalities may be at war and seriously cause harm to the “host” or other personalities.
• the “alters” or “personalities” may be extremely protective of the “host”.

The experience of DID

The term was changed to better express the belief that rather then the personality of the “host” having split into parts (i.e. “alters” or alternate personalities), the personality of the “host” never developed at all. In other words the person with a dissociative identity disorder does not have more then one personality but has less then one, or an incomplete personality.

• Personality disorders
• anxiety disorders
• mood disorders
• substance abuse disorders
• eating disorders
• ADHD
• attachment disorders

ADD/ADHD

• inattention & memory problems:inability to maintain focus on routine things, losing things/forgetting things
• impulsivity/emotional lability/interrupting others
• hyperactivity/restlessness/talking excessively
• Problems with Self-Concept

Adult Attachment Disorder

• Unresolved childhood attachment issues leave an adult vulnerable to difficulties in forming adult relationships.
• New relations are affected by expectations developed from past experiences.
• If an adult does not trust or feel safe with others, they may destroy any current relationship through rejection or by becoming overly clingy.
• As a parent, an insecurely attached adult may lack the ability to form a healthy attachment to their own child thus continuing dysfunction through generations.

• Insecurely attached adults may become intensely angry, hostile, critical of others.
• They may be sensitive to blame, lack empathy, views others as untrustworthy or undependable, views self as unlovable or "too good" for others.
• They may be self critical. They may have difficulty getting along with co-workers, avoid or fear personal relationships, intimacy.... or they may idealize love.
• Or- they may become a compulsive caregiver, feel over involved and unappreciated They may over invest their emotions and suffer terrible loss when this sabotages the relationship.

Borderline Personality Disorder DSM IV

• A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity
• beginning by early adulthood
• present in a variety of contexts, as indicated by five of the following:

Borderline Personality Disorder continued

• frantic efforts to avoid real or imagined abandonment
• a pattern of unstable and intense interpersonal relationships
• identity disturbance: persistently unstable sense of self
• impulsivity in at least two areas that are potentially self-damaging: $, sex, substance abuse, reckless driving, eating
• recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior
• affective instability due to a marked reactivity of mood
• chronic feelings of emptiness
• inappropriate, intense anger or difficulty controlling anger frequent displays of temper, recurrent physical fights
• transient, stress-related paranoid ideation or severe dissociative symptoms

Borderline Traits:

• Shifts in mood lasting only a few hours.
• Anger that is inappropriate, intense or uncontrollable
• Self-destructive acts, such as self-mutilation or
• suicidal gestures self-damaging impulsive behaviors
• identity?- may not feel like they know who they are
• Chronic feelings of emptiness

Borderline Traits continued

• relationships characterized by splitting
• (all good or all bad), black and white thinking with no in between!
• sensitive to criticism or rejection
• unusually high degree of empathy and in sight

Dependent Personality

• A chronic and pervasive pattern of dependent, submissive, and needy behavior
• Seek out excessive advice, approval, and encouragement
• Sensitivity to criticism or rejection
• Low self-confidence and self-esteem.
• An inability to make decisions without direction from others
• Feelings of helplessness when alone
• An inability to disagree with others
• An inability to disagree with others

DSM IV Important Note

• A personality disorder from the DSM IV is not sufficient to determine who should be referred to SEASCAT, as the DSM IV is inadequate to explain cause, and the overlap between PD diagnoses is substantial!

• It is, however, useful to look at personality traits that can relate as likely to result from child abuse, as with certain behaviors

• avoidance behavior
• paranoia (fear and lack of trust)?
• anxiety behaviors
• social and various other phobias
• emotional withdrawal and instability
• obsessive-compulsive traits
• moodiness
• irritability
• sadness.

• All health issues are effected or worsened by stress, adult survivors experience extreme stress for long periods
• Stress commonly causes nearly as many physiological disorders and illnesses as psychological disorders
• Constant stress can compromise the immune system to a great extent, making a person more susceptible to infections.
• Stress produces a response from the central nervous system. Continuous stress results in constant alertness, which adversely affects certain organs.

Physical Health Issues relative to child abuse

• All health issues are effected or worsened by stress, adult survivors experience extreme stress for long periods
• Stress commonly causes nearly as many physiological disorders and illnesses as psychological disorders
• Constant stress can compromise the immune system to a great extent, making a person more susceptible to infections.
• Stress produces a response from the central nervous system. Continuous stress results in constant alertness, which adversely affects certain organs

More Physical Health Issues

• Stress causes high blood pressure, and a constriction of blood vessels leads to cardiovascular illnesses
• Extreme stress can cause temporary cessation of the digestive system leading to bowel disorders like irritable bowel syndrome.
• Many questions are asked about fibromalgia's cause, chronic fatigue syndrome, etc. but ask any survivor?
• Migraines,
• Lyme's disease, etc.
• Sleep disorders, primarily insomnia!

• most obvious (even to narcissists) is $$$$$$$$
conservative est. cost to the nation well over $100 billion/yr. just to care for children/victims no est. available for long term cost of adult survivors as they apply for assistance with food, housing, unemployment, or prison costs, medical costs, results of inadequate parenting skills on the next generation, MH care.....
• the pain, suffering, and reduced quality of life that victims of child abuse and neglect experience throughout their entire lifetime if not provided help toward recovery!
• As victims, they continue to be victimized!

End of Presentation