Lets not forget neglect in families when talking about PTSD and CSA.
Child Neglect and Adult PTSD
Child neglect is more common than you might think.
Published on February 9, 2011 by Susanne Babbel, Ph.D., M.F.T. in Somatic Psychology
Comfort, nourishment, shelter, and care should be things that a child can take for granted. Unfortunately, child neglect is a rampant problem that statistically exceeds child physical and sexual abuse in the U.S. 2006 reporting statistics by the U.S. Department of Health & Human Services concluded that:
Children in the U.S. were abused or neglected at the rate of 1.23%
Out of that number, 64.2% experienced neglect
1,530 children died of abuse or neglect that year
Roughly half the victims were of each sex, with only a slightly higher incidence of neglect victims being female1
Child neglect affects too many children
The National Child Abuse and Neglect Data System defines neglect as "a type of maltreatment that refers to the failure by the caregiver to provide needed, age-appropriate care although financially able to do so or offered financial or other means to do so." (USDHHS, 2007). Neglect is a unique type of trauma because only children (and, in some cases, dependant adults) are susceptible. In order to experience neglect, a person must be reliant on others for their physical and emotional wellbeing. This vulnerability means that victims of child neglect are predisposed to experiencing related trauma (including PTSD) later in life.
Types of Child Neglect:
Physical Neglect - Children need the same basic necessities as everyone: food, clothing, shelter. However, they are reliant on others to provide these necessities. If a provider is not ensuring that their trustee is given these essentials, it is considered neglect. Physical neglect might mean that a parent is neglecting to provide adequately nutritious meals consistently, or it might mean that a parent has literally abandoned their child.
Educational neglect - Failure to provide a child with adequate education in the form of enrolling them in school or providing adequate home schooling.
Emotional neglect - Consistently ignoring, rejecting, verbally abusing, teasing, withholding love, isolating, or terrorizing a child. Emotional neglect can also include subjecting a child to corruptive or exploitative situations (such as illegal drug use).
Medical neglect - American Humane.org cites Medical Neglect as "the failure to provide appropriate health care for a child (although financially able to do so), thus placing the child at risk of being seriously disabled or disfigured or dying." Of all the types of neglect, this is the trickiest to diagnose because religious or financial factors can play an adverse role in a child receiving appropriate medical care.
According to Child Welfare.gov, child neglect can lead to problems as an adult which may include:
Physical consequences - such as failure of the brain to develop properly due to malnutrition and other medical issues; also, poor physical health in general which can lead to an array of problems later on
Psychological consequences - low self-esteem, problems maintaining healthy relationships, depression, PTSD, eating disorders, suicide attempts, cognitive/learning disabilities, social disabilities, and other issues
Behavioral consequences - juvenile delinquency, alcohol and drug abuse, criminal or abusive behavior
The dangers of neglect can be dire for a child's healthy development. Without proper care, children are in danger of not developing properly due to malnutrition, physical injury, or illness. But the hidden danger of child neglect - the one that may not be apparent for many years but which can stick with a person for their lifetime - is the risk of Post Traumatic Stress Disorder that can affect them psychologically and emotionally in the long-term.
The psychological principle of attachment theory proposes that children become psychologically attached to their caregivers (and particularly their mothers) as infants in order to establish a vital sense of security. In nature's terms, keeping a child attached to the mother increases its chances of survival. So it stands to reason that being neglected is an affront to the "healthy, normal" sense of attachment that nature desires for children to have with their caregiver(s).
According to extensive research done by psychologist Mary Ainsworth in the 1970's (published in her groundbreaking study Strange Situation), "What happens to children who do not form secure attachments? Research suggests that failure to form secure attachments early in life can have a negative impact on behavior in later childhood and throughout the[ir] life. Children diagnosed with oppositional-defiant disorder (ODD), conduct disorder (CD), or post-traumatic stress disorder (PTSD) frequently display attachment problems, possibly due to early abuse, neglect, or trauma." In other words, children who experience neglect early in life may be at risk for a lifetime of trouble attaching properly in relationships.
Another reason that child neglect can lead to such a wide array of development and psychological problems is that children (particularly, infants) need a certain amount and type of input for their brain development to proceed normally through it's various growth states. When deprived of appropriate input and stimulation, the brain may not develop normally, and this can affect brain functioning later on, which can affect an individual in many ways.
Not all children who experience neglect will experience long-term reactions. Factors determining whether the effects of abuse will be long-term include:
The child's age when the neglect occurred
The type of neglect
The frequency and duration