Childhood trauma includes child abuse in all its forms, neglect, witnessing or experiencing domestic violence in childhood as well as other adverse childhood experiences.
What is child abuse? The World Health Organisation (1999) defines child abuse as:
Child abuse or maltreatment constitutes all forms of physical and/or emotional ill-treatment, sexual abuse, neglect or negligent treatment or commercial or other exploitation, resulting in actual or potential harm to the child's health, survival, development or dignity in the context of a relationship of responsibility, trust or power.
Child abuse can be a single incident, but usually takes place over time (Richardson, 2004).
As explained by the women participants in a study by Van Loon and Kralik (2005a):
We were told throughout our lives that we were ‘useless’, ‘good for nothing’ and ‘deserving of everything we got’. This was reinforced by ‘betrayal’ from our family and ‘manipulation’ from the perpetrator/s who ‘dominated’ us from their position of power and trust, making us feel ‘powerless’, ‘worthless’, ‘ashamed’, ‘guilty’ and ‘to blame somehow’. We were ‘used’ and treated as ‘objects’ or ‘meat’. When other children were developing ‘the building blocks for a strong identity’ and understanding that they were unique and worthwhile, ‘able and OK’. We were ‘stuck’ in a world that taught us ‘we would never amount to anything’. But worse, we still carry the burden of ‘shame’ and ‘guilt’, ‘confusion’ and ‘sadness’ which continually diminishes our ‘self-worth’ and ‘shatters our identity’.
While definitions of abuse remain ambiguous, some behaviours are objectively deleterious to healthy child development. All the same acceptability around behaviour varies widely from one social group to another (Tucci, Saunders, & Goddard, 2002) and from culture to culture.
Types of child abuse:
- Emotional abuse: The failure of caregivers and adults to nurture a child and provide them with the love and security that they require, and where a child's environment and relationships with caregivers are unstable, coercive or unable to support the child's healthy development.
- Neglect and negligent treatment: Where a child is deprived of essential needs, such as love, nutrition, clothing, warmth, shelter, security, protection, medical and dental care, education and supervision.
- Physical abuse: The infliction of bodily injury upon a child which is not accidental.
- Family violence: Where one partner uses violence, and the threat of violence, to control their partners, children and other family members.
- Sexual abuse: The involvement of a child in any sexual activity with an adult, or with another child who is in a relationship of responsibility, trust and power over that child. Sexual abuse includes, but is not limited to, the manipulation or coercion of a child into sexual activity, child prostitution and child pornography.
Organised abuse: This form is very complex and can involve multiple forms of abuse and occur in the context of abusive family groups and perpetrator networks. Different terms including 'organised abuse', 'sadistic abuse' and 'ritual abuse' have previously been used.
Other forms of childhood trauma:
The Adverse Childhood Experiences Study (Felliti and Anda, 1998) classifies childhood trauma in ten categories:
- Abuse of child: psychological, physical, sexual
- Trauma in child's household environment: substance abuse, parental separation and/or divorce, mentally ill or suicidal household member, violence to mother, imprisoned household member
- Neglect of child: abandonment, child's basic physical and/or emotional needs unmet
Domestic violence: Witnessing and experiencing family violence is a form of psychologically abusive behaviour and has been related to subsequent psychological disturbances (Briere, 1992).
Children are often exposed to harmful behaviours from one or more of these categories of abuse (Higgins & McCabe, 2000). The nature of the abuse and the duration of exposure of harmful behaviours may affect the long-term effects of the abuse into adulthood (Higgins, 2004). However, the type and duration of abuse are not the only factors determining the long-term effects of the abuse.