CHILDHOOD ABUSE AND MALTREATMENT AND ITS LIFELONG CONSEQUENCES

Although conditions of child health and education have improved significantly over the last century, child abuse and maltreatment continues to be a priority for action by the World Health Organization (WHO) because of the increased risk of disability, physical and mental illness, and social inequality over the life course, constituting a multidimensional problem that requires legal, social, and public health responses.

Among the sequelae associated with exposure to childhood abuse and maltreatment are mental health disorders, including post-traumatic stress disorder and other mood and anxiety disorders, but also exposure to subsequent potentially traumatic situations, such as accidents or risky sexual behavior. The possible transmission between generations has also been investigated.

However, it is important to emphasize that being exposed does not equal being the bearer of negative repercussions. Many are the situations in which victims of abuse and maltreatment manage to develop functional strategies to deal with a less favorable past, and even turn it into a factor of increased resistance to current adversity.

Prevention actions during childhood have become more widespread, but abuse continues to occur, and sometimes appears in new forms, including in the digital context. In general, the secrecy and private sphere in which it occurs, and the inability of children and adolescents to recognize abuse, make it difficult to identify it early.

The community in general has become more aware of this reality through the media coverage of several cases, such as the involvement of members of the Catholic Church in situations of sexual abuse. It is worth reflecting on whether this public discussion benefits in any way the victims of abuse, to what extent they can be relieved of their suffering, and enhance access to health care for the affected population.

It should be noted that although media coverage focuses on seemingly more serious cases involving physical and/or sexual abuse, scientific literature indicates that other forms of abuse, such as emotional abuse or neglect, can also be harmful.

Health care facilities should be equipped to understand and respond effectively to the problems associated with lifetime abuse, not only by direct action in cases of illness, but by identifying and intervening in response patterns common to various diagnoses of mental illness, such as problems of social functioning and emotional regulation.

For those who want to explore the subject in more depth: "Mitigar - Consequences of child maltreatment in adults in Portugal and public health actions".

Aida Dias

Clinical psychologist, Researcher Trauma Observatory/CES, Member of the Scientific Committee of the ESTSS Belfast 2023 Conference

Child maltreatment, revictimization and Post-Traumatic Stress Disorder among adults in a community sample

Aida Dias, Luísa Sales, Trudy Mooren, Rui Mota-Cardoso e Rolf Kleber

International Journal of Clinical and Health Psychology (2017)

Childhood maltreatment has been associated with revictimisation and post-traumatic stress disorder (PTSD). However, this relationship is poorly studied in Southern European countries and in community samples. We tested these associations in a sample of 1200 Portuguese adults.

Public health actions to mitigate long-term consequences of child maltreatment

Aida Dias, Trudy Mooren e Rolf J. Kleber

J Public Health (2018)

Child maltreatment is very frequent and one of the worst situations that children can experience. As they are often hidden, it is difficult to ensure that prevention and treatment mechanisms that do exist reach those who need them. The consequences of abuse during childhood can take a long time to be acknowledged and manifested. We discuss the need for increased public health measures to mitigate the consequences of these experiences during adulthood.

Reducing consequences of child maltreatment during adulthood by public health actions: a Delphi study

Aida Dias, Trudy Mooren e Rolf J. Kleber

European Journal of Public Health (2018)

Childhood maltreatment is associated with prolonged health problems, as well as increased levels of disability and use of health services throughout life. However, little is known about how the consequences of childhood maltreatment can be lessened during adulthood. Professional opinions on how to mitigate the long-term consequences of child maltreatment from a public health perspective were analysed.