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Child Maltreatment in Foster Care More Severe Than in Household Setting

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According to a review by the World Health Organization, about 25 percent of adults reported having been physically abused as children. Child maltreatment includes all forms of physical and/or emotional ill treatment, sexual abuse, and negligence, resulting in actual or potential harm to the child. 

Child maltreatment is not exclusive to households, it can happen even in foster care settings. A team of researchers from the University of Vienna in Austria published a study that analyzed the effects of CM among survivors. The researchers examined and compared the extent of different CMs, such as physical, emotional, and sexual abuse, and physical and emotional negligence. They also examined the degree of lifetime traumatization with respect the mental health of the survivors of CM in foster care or institutional abuse. 



When a child is subjected to maltreatment, the damage or harm can affect the child's health, development, and dignity. Such maltreatment occurs often every day across the globe. In fact, one in every five women and one in every 13 men reported experiences of sexual abuse during their childhood. Even with a single instance of maltreatment, children are likely to suffer long-lasting impairment in physical and psychological health, and difficulty in social and occupational aspects of their lives. The adverse effects contribute to the slow progress of a country, economically and socially. 

- Abuse and negligence of infants and children can result in impaired child development, such as issues with cognitive, communication, and speech skills, and difficulty in developing social skills. 

- Abuse can lead to psychological disorders, such as anxiety and depression, post-traumatic stress disorder, eating disorders, and learning and memory difficulties. 

- Children who experience CM are likely to have risky behaviors, such as alcoholism, smoking, and substance abuse. They are also more susceptible to delinquency, teen pregnancy, poor academic performance, and criminal acts. 

- Children who suffered from abuse and neglect have a higher risk of developing chronic illnesses later in life, such as cardiovascular diseases, certain cancers, chronic respiratory problems, liver diseases, hypertension, and high blood cholesterol. 



In the Vienna study, the researchers recruited 220 adults who survived IA in Viennese foster care institutions. The researchers also recruited 234 adults, including people who were exposed to CM in their families, from the Viennese population for the comparison group. The participant was asked a series of questions about child abuse and neglect, about traumatic events, about experiences that could lead to PTSD, and about mental distress. The researchers also conducted a structured clinical interview with each participant. 

The findings showed that participants who had been in the foster care system experienced more CM incidents than the comparison group. The IA adult survivors reported 57.7 percent exposure to all types of CM. Furthermore, the survivor group had a higher prevalence rate of mental disorders, such as personality disorders, anxiety, depression, dissociation, somatization, and PTSD.  

Even with the traumatic experiences, child maltreatment doesn't end in tragedy. Many survivors of horrific events grew up to be healthy and happy adults who redirected their negative experiences to develop themselves. The child's outcome depends on the degree of maltreatment and level of resilience. Another factor to consider is the relationship between the maltreatment and attachment style. 



In a study conducted by Widom and colleagues in 2017, a total of 650 participants were recruited to determine the effect of attachment style to the outcome of the maltreated children. The participants were composed of 50 percent women and 60 percent white with an average age of 40 years old. The results implicated that child neglect is related to greater depression, while physical abuse is related to low self-esteem. Child physical abuse indicated anxious attachment style, and anxious and avoidant attachment styles indicated anxiety, depression, and lower self-esteem. 

Prevention is the key to prevent children from experiencing harmful effects of child maltreatment. When taking action, it is best to allow a multi-sectoral approach that involves the social services, police department, and trauma experts. The approach can be an effective tool to minimize the consequences of trauma from CM. 

Risk factors should also be considered to prevent CM on both the child and their caregivers: 

- Children under four years old or adolescents often suffer from maltreatment. 

- Inability to fulfill expectations or the feeling of being unwanted puts the child at risk. 

- Having abnormal physical attributes, special needs or persistent crying will likely increase maltreatment. 

- Caregivers who maltreat their children can make bonding significantly more difficult and the child is not nurtured well. 

Any child maltreatment for the first decade has effects that are carried into adulthood. According to WHO, child sexual abuse accounts for about six percent of total cases of depression, six percent of alcohol and drug dependence cases, 10 percent of panic disorders, and 27 percent of PTSD cases in the world. 

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