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Section 5 (Web #19)
Some authors prefer to distinguish psychological abuse from emotional abuse based on the type of damage the abuse is thought to inflict (e.g., O'Hagan, 1993, 1995). However, it is clear from the literature that many use the term interchangeably, with American reports typically using the former term and British reports the latter (Edmundson & Collier, 1993). In the present discussion the two labels are not distinguished, but the term psychological abuse preferred.
A survey of psychological abuse by Thompson and Kaplan (1996) identified four key features common to definitions of psychological abuse: adverse parental behavior, a sustained pattern of negative interaction, child vulnerabilities, and damage in terms of emotional and psychological functioning. These features provide a useful framework for discussion of the components required for an adequate definition of psychological abuse. Each is discussed, and the implications in terms of the development of a new measure of psychological abuse are outlined.
The following types of parental behavior are viewed as constituting psychological abuse: rejecting, isolating, terrorizing, ignoring, and corrupting a child or youth (Garbarino, Guttman, & Seeley, 1986). To this list Baily and Baily (1986) have added excessive threats, refusal of psychological treatment, sexual exposure and exploitation, denial of opportunities to grow socially and emotionally, singling out one child in the family to punish or criticize, and unrealistic expectations. Glaser's scheme includes persistent negative attributions or misattributions to the child, failure to recognize the child's individuality, or inconsistent developmental expectations (Glaser & Prior, 1997). Combining these and other definitions, Burnett (1993) offered the following nine parental acts as constituting types of psychological abuse: confining to a small space, public humiliation, Cinderella syndrome, severe verbal abuse, coercing into delinquency, threatening a child, refusal of psychiatric treatment, not allowing social and emotional growth, and not providing a loving home.
Many of these adverse behaviors overlap extensively with alternative categories of child maltreatment, and the distinction between them requires clarification. For example, ignoring a child, denial of social opportunities, or refusal of psychiatric treatment cannot readily be distinguished from neglect as defined by other taxonomies of childhood maltreatment (e.g., Childhood Experience of Care and Abuse [CECA]; Bifulco, Brown, & Harris, 1994; Bifulco & Moran, 1998). Similarly, ongoing negative interaction involving unrealistic expectations, rejecting, or singling out one child for criticism cannot readily be distinguished from parental antipathy. In the same vein, Cinderella syndrome has clear overlaps with the exploitation involved in role reversal, where this child is pressured to take on adult roles. The extent to which the distinction between psychological abuse and other forms of maltreatment is one of severity/intensity or of the specific type of parental behavior needs to be clarified. The failure to reliably distinguish specific types of abuse can lead to difficulties when attempting to establish specificity of outcome of such experiences (Crittenden, 1985). In addition, some combinations of types of abusive experiences may be more damaging than others, and estimating the precise number of multiples of abusive experience may prove critical in explaining outcome (Claussen & Crittenden, 1991; Ney, Fung, & Wickett, 1994). In addition, precision about multiplicity of abuse may prove critical in child protection settings or in legal contexts. Hence a system of measurement is needed that assesses psychological abuse together with each other form of maltreatment separately in terms of perpetrator behaviors--this while recognizing that psychological and other forms of abuse commonly co-occur in the same settings and may at times exist as features of the same actions.
This point is developed by Barnett, Manly, and Ciccetti (1991) in seeking to define psychological abuse: "an adequate operational definition cannot be developed separately from definitions of other forms of maltreatment" (p. 20). They identify six types of child maltreatment, including psychological maltreatment, and allow for acts of maltreatment to be categorized more than once rather than forcing classification into a single category. This latter point is significant given that, for example, an instance of neglect that has psychologically abusive elements might prove to be more harmful in combination than an act that is solely one of "pure" neglect or "pure" psychological abuse. The ability to capture the difference between simple and compound abuses in a measurement system is therefore important. The new interview scale to be described allows for the classification of acts of psychological abuse separately, and in addition to, a range of other forms of maltreatment. It also allows for the same abusive act at times to be cross-referenced between categories of abuse.
In addition to controversy surrounding the types of acts to be included in an operational definition of psychological abuse, there is also much debate concerning the significance of the intentions of perpetrators. Some researchers argue that motive is highly relevant to the categorization of such abuse, whereas others take the view that it may be of clinical importance, but is probably not relevant to the severity of maltreatment (e.g., Hart & Brassard, 1991). McGee and Wolfe (1991) suggest that psychologically abusive behavior should be defined irrespective of parental motive. They suggest that parental behavior be measured on a continuum ranging from mild to dangerous forms, and that parental intent will typically influence the severity along this continuum. In addition, they suggest that the child's perceptions of parental intent will influence the impact of the parental act rather than its nature, and that such perceptions should be measured separately from the parental behavior itself.
O'Hagan (1993) also recommends that psychological abuse be defined independently of the perpetrator's intentions. He suggests that failure to do so could lead to the dangerous position whereby if perpetrators deny an intention to abuse or awareness of the abuse (e.g., if drunk), their actions could be argued to be nonabusive. Yet the same argument is rarely applied to physical abuse, where the practice of harsh physical discipline is condemned whether or not the perpetrators construe it as beneficial to the child, or whether injuries inflicted on the child occur while the parent is drunk. The physical risks to the child hold equally in both scenarios, and the same could be concluded with psychological abuse. In the proposed new measure, therefore, perpetrator intention is not regarded as a necessary characteristic of psychological abuse. However, evidence of perpetrator behavioral strategies that have all the appearance of premeditation and hence intent can be used in deciding on inclusion of incidents as psychological abuse.
Many definitions of psychological abuse also limit the inclusion of abusive acts to those committed by parents. Limiting the category of those included as perpetrators omits a host of potential perpetrators, such as other caregivers, relatives, teachers, siblings, and even peers (O'Hagan, 1995; Shaver, Goodman, Rosenberg, & Orcutt, 1991; Whipple & Finton, 1995). Avoiding this definitional limitation has proved critical in the field of sexual abuse, where abuse from nonrelated adult males is common (Bifulco & Moran, 1998). Although the perpetrators most likely to be influential are primary caregivers such as parents, it is possible that significant short- and long-term damage may occur at the hands of others in the wider social network. Hence the proposed new measure of psychological abuse, while routinely assessing abuse from parents and surrogate parents, also considers abusive acts from other sources.
Another feature of the definition under debate is whether the adverse parental behavior typically involves a sustained pattern of interaction (Thompson & Kaplan, 1996). Some studies stress that repeated exposure to instances of adverse parental acts is required before an act can be defined or included as psychologically abusive (e.g., Burnett, 1993; O'Hagan, 1993, Glaser & Prior, 1997). Others allow single instances of adverse behavior to qualify as psychological abuse (e.g., Baily & Bally, 1986) and suggest that the isolated nature of these instances should be taken into account in rating its severity (McGee & Wolfe, 1991). Rather than decide on a priori grounds where the frequency threshold for inclusion lies, the new measure includes single adverse acts in addition to those of a more sustained nature. However, frequency (in addition to intensity and variety of modes of psychological abuse) is implicated in assessing severity.
The third element common to psychological abuse definitions involves features of the child that may make the child particularly vulnerable to damage: "low IQ, absence of nurturing adults, a child's attribution of parental misdeeds as being malevolent and a child's particular developmental level" (Thompson & Kaplan, 1996, p. 144). These are indeed factors that might render a child more vulnerable to the effects of psychologically abusive acts. However, Garbarino (1991) argues that psychological abuse, as with other abuses such as sexual abuse, should be defined independently of child characteristics. In defining sexual abuse, standards of behavior that are deemed appropriate or inappropriate are delineated by society. Thus, performing sexual acts with a minor is seen as inappropriate adult behavior, regardless of the child's characteristics. Garbarino argues that taking into account the child's vulnerabilities in a definition of abuse implies that a hardier child subjected to the same abusive act as a more vulnerable child would be considered less abused. He (1991) finds such a position untenable: "The logical (and ethically appalling) implication is that the standards for dealing with a resilient child offer less protection than the standards of care for a vulnerable child (the former can absorb more psychic assault than the latter)" (p. 47). The new measure to be described in the present report therefore makes no reference to specific child vulnerabilities and limits its definition to a description of perpetrators' acts rather than child characteristics.
- Moran, P., Bifulco, A., Ball, C., Jacobs, C., & Benaim, K. (2002). Exploring psychological abuse in childhood: developing a new interview scale. Bulletin of the Menninger Clinic, 66(3).
"Personal Reflection" Journaling Activity #5
The preceding section contained information regarding psychological abuse in childhood. Write three case study examples regarding how you might use the content of this section of the Manual in your practice. Affix extra paper for your Journaling entries to the end of this Manual.
What are four key features common to definitions of psychological abuse?
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