maltreatment, or PM, is particularly challenging
to identify because of its intangible
nature. And while it can be perpetrated by
anyone, its most pernicious form is that
perpetrated by parents and/or caregivers.
The researchers note that “available evidence
and guiding theory suggest that PM inflicted by
a primary caregiver in early childhood, or
chronically throughout childhood and
adolescence, is more deleterious to a child’s
overall development.” Id., p.
researchers are careful to distinguish PM from
the “characteristics of dysfunctional parenting
(e.g., inconsistent, chaotic, emotionally
dysregulated parenting…).” Id. PM
is distinct from dysfunctional parenting in that
PM is characterized by a “chronic, severe and
escalating pattern of emotionally abusive and
neglectful parental behavior” combined with
increased risk of psychological harm to the
examining PM, the researchers looked to test
whether “[y]outh reporting PM will exhibit
equivalent or higher baseline levels of symptom
severity, risk behavior, and functional
impairment compared with physically or sexually
abused youth; and [whether] [t]he co-occurring
presence of PM with physical or sexual abuse
will be associated with worse clinical outcomes
compared with outcomes among other categories of
maltreated youth (i.e., those who report only
physical, only sexual, or combined physical and
sexual abuse).” Id., p. S20.
test these hypotheses, the researchers “examined
baseline assessment data from maltreated youth,
as archived in the National Child Traumatic
Stress Network (NCTSN) Core Data Set
Their study sample “consisted of 5,616 children,
comprised of 2,379 (42%) boys and 3,237
researchers’ findings “strongly support the
hypotheses that PM in childhood not only
augments, but also independently contributes to,
statistical risk for negative youth outcomes to
an extent comparable to statistical risks
imparted by exposure to physical abuse (PA),
sexual abuse (SA), or their combination (PA +
SA).” Id., p.
S24. Moreover, they found that “PM was the
strongest and most consistent predictor of
internalizing problems (e.g., depression, GAD,
SAD, attachment problems). With respect to
the prediction of externalizing problems, (e.g.,
behavioral problems, self-injury, criminal
activity), PM exhibited a strong association
comparable to that of PA and greater than that
of SA.” Id., p.
perhaps most concerning is that the researchers
found that PM “is the most prevalent form of
maltreatment in the NCTSN CDS. A history
of PM exposure was identified in the majority
(62%) of more than 5,000 maltreatment cases
examined in this study, with nearly one quarter
(24%) of maltreatment cases comprised
exclusively of PM.” Id., p.
S24. But this is in contrast to “official
reports of PM to child welfare agencies [which]
portray PM as a relatively rare
phenomenon: Only 7.6% of official reports
to child welfare agencies identified the
occurrence of PM in 2009.” Id., p.
S19. Perhaps “[t]he comparatively covert
nature of PM can … lead investigators to focus
on other more “tangible” forms of maltreatment,
as well as to adopt an apathetic or helpless
outlook regarding how best to intervene.”
study creates a powerful argument against
apathy, and encourages practitioners to engage
in “efforts to increase recognition of PM as a
potentially formidable type of maltreatment in
its own right [which] should be at the forefront
of mental health and social services training
efforts, including incorporation of education on
PM into graduate training curricula and
continuing education of child service
professionals.” Id., p.
S26. Furthermore, the researchers implore
practitioners to develop “theoretically grounded
interventions for the sizable subpopulation of
traumatized youth exposed to PM….
Appropriately constructed guiding theory,
assessment tools, interventions, and clinical
training methods are needed to support accurate
risk screening and case identification,
effective intervention, workforce development
and public policy.” Id.
strongly encourage you to download this article
and share it widely with your colleagues, team
members and agency partners. And I further
encourage you to engage in discussions regarding
this form of child maltreatment. By
recognizing it, we can take the first step
toward eradicating it.
always, I thank you for reading, and for all
that you do on behalf of the children you serve.
C Street, NE | Washington, DC 20002 US
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