Child abuse can be a single incident, or can be a number of different incidents that take place over time. Childhood traumatic experiences are known to have strong and lasting consequences on the physical, mental and reproductive health of victims as well as confining them to low mental health in adulthood. For harm to be significant, the detrimental effect on a child's wellbeing must be substantial or serious, more than transitory and must be demonstrable in the child's presentation, functioning or behaviour.

Psychopathological outcomes of childhood abuse are related to the quality of early attachment relationship. Around 80% of physical and emotional abuses during childhood are perpetrated by parents or close relatives, whom are supposed to be the primary and the first external source of emotion and stress regulation. Indeed, the parentchild relationship represents a key feature for the long-term ability of auto-regulation and social support.

Child abuse can result in developmental problems and with many chronic physical and psychological effects, including subsequent ill-health, including higher rates of chronic conditions, high-risk health behaviors and shortened lifespan.

There are four different types of child abuse:

Physical abuse occurs when a child has suffered, or is at risk of suffering, non-accidental physical trauma or injury. Physical abuse can include:

  • hitting
  • shaking
  • throwing
  • burning
  • biting
  • poisoning

Physical abuse does not always leave visible marks or injuries. It is not how bad the mark or injury is, but rather the act itself that causes injury or trauma to the child.

Sexual abuse occurs when an adult, stronger child or adolescent uses their power or authority to involve a child in sexual activity. Sexual abuse can be physical, verbal or emotional and can include:

  • kissing or holding a child in a sexual manner
  • exposing a sexual body part to a child
  • having sexual relations with a child under 16 years of age
  • talking in a sexually explicit way that is not age or developmentally appropriate
  • making obscene phone calls or remarks to a child
  • sending obscene mobile text messages or emails to a child
  • fondling a child in a sexual manner
  • persistently intruding on a child's privacy
  • penetrating the child's vagina or anus by penis, finger or any other object
  • oral sex
  • rape
  • incest
  • showing pornographic films, magazines or photographs to a child
  • having a child pose or perform in a sexual manner
  • forcing a child to watch a sexual act
  • child prostitution

Emotional abuse occurs when a child's social, emotional, cognitive or intellectual development is impaired or threatened. It can include emotional deprivation due to persistent:

  • rejection
  • hostility
  • teasing/bullying
  • yelling
  • criticism
  • exposure of a child to domestic and family violence

Neglect occurs when a child's basic necessities of life are not met, and their health and development are affected. Basic needs include:

  • food
  • housing
  • health care
  • adequate clothing
  • personal hygiene
  • hygienic living conditions
  • timely provision of medical treatment
  • adequate supervision


A child who has been, or may be experiencing abuse may show behavioural, emotional or physical signs of stress and abuse.

Some general indicators of child abuse include:

  • showing wariness and distrust of adults
  • rocking, sucking or biting excessively
  • bedwetting or soiling
  • demanding or aggressive behaviour
  • sleeping difficulties, often being tired and falling asleep
  • low self-esteem
  • difficulty relating to adults and peers
  • abusing alcohol or drugs
  • being seemingly accident prone
  • having broken bones or unexplained bruising, burns or welts in different stages of healing
  • being unable to explain an injury, or providing explanations that are inconsistent, vague or unbelievable
  • feeling suicidal or attempting suicide
  • having difficulty concentrating
  • being withdrawn or overly obedient
  • being reluctant to go home
  • creating stories, poems or artwork about abuse

Some indicators of neglect include:

  • malnutrition, begging, stealing or hoarding food
  • poor hygiene, matted hair, dirty skin or body odour
  • unattended physical or medical problems
  • comments from a child that no one is home to provide care
  • being constantly tired
  • frequent lateness or absence from school
  • inappropriate clothing, especially inadequate clothing in winter
  • frequent illness, infections or sores
  • being left unsupervised for long periods

Associated diseases

  • vaginismus (recurrent or persistent involuntary tightening of muscles around the vagina whenever penetration is attempted)
  • post-traumatic stress disorder


Complex trauma, referring to children’s experiences of multiple traumatic events that occur within the caregiving system, has significant long-lasting effects on brain maturation. Structural and functional abnormalities are reported in abused children. Affected areas (namely the volume of the orbitofrontal cortex and amygdala) are of fundamental importance in emotional and stress responses, which display atypical functioning in abused children from the earliest stages of life.

Indeed, child abuse victims show significantl¢ higher rates of attachment insecurity (70–100%) compared to the general population (30%). In addition, fearful and angry-dismissive patterns are the most associated with interpersonal traumatic experiences.

As a consequence, the adverse childhood experiences shape the interpersonal strategies characterizing adult relationships. In particular, high levels of dependency or avoidance in social relationship as well as insecurity, suspiciousness, isolation, emotional distress and low intimacy in close relationships are reported as a consequence of traumatic experiences. 

Indeed, the core concept of the attachment theory is that childhood attachment quality constitutes the paradigm for forming the adult romantic relationship. Romantic attach ment represents a personal system of beliefs and expectations on the availability and the responsiveness of the partner. It is based on the childhood experiences of being loved and felt security in the relationship with the caregiver, and it guides the interactive exchanges between partners. People differentl experience and manage intimacy with the partner according to their own early experiences of caregiver’s proximity and responsiveness. In particular, insecure adults are worried of being abandoned or being too close to and dependent on the partner.

In addition, high levels of insecurity in adult attachments and romantic attachments are reported to be associated with increased distress and psychopathology, in particular depression, anxiety, substance abuse and post-traumatic stress disorder. 

Post-traumatic stress disorder

One of the most studied consequences of childhood trauma is the post-traumatic stress disorder (PTSD). 

Indeed, people suffering from PTSD report feelings of distrust and a state of anxious apprehension which impedes them from having satisfying interpersonal relationships. As a consequence, both the difficulties in emotion regulation and the lack of interpersonal security represent key variables in association with insecure romantic attachment and posttraumatic stress disorder in victims of childhood traumatic experiences. 

Risk factors

No single factor can be identified as to why some adults behave violently toward children. The World Health Organization (WHO) and the International Society for Prevention of Child Abuse and Neglect (ISPCAN) identify multiple factors at the level of the individual, their relationships, their local community, and their society at large, that combine to influence the occurrence of child maltreatment. 

At the individual level, such factors include age, sex, and personal history, while at the level of society, factors contributing to child maltreatment include cultural norms encouraging harsh physical punishment of children, economic inequality, and the lack of social safety nets. WHO and ISPCAN state that understanding the complex interplay of various risk factors is vital for dealing with the problem of child maltreatment.

Children with disabilities are more than three times more likely to have experienced violence in their lives than non-disabled children. More specifically, children with mental or intellectual impairments seem to have a higher prevalence and risk of violence than do children with other types of disability. 


Preventive means can be divided into individual and social means. The social means are characterized by handling a situation after the fact. As it is difficult to protect many and unspecified persons, an emphasis is placed on preventing the recurrence of crimes that center on ex-cons. However, it is difficult to protect victims prior to a crime. Individual means are characterized by prevention that is focused on self-protective instincts aimed to protect oneself and one’s family from many and unspecified persons.

The followings are current technologies used for crime prevention:

  1. SOS feature on mobile phones: Transmits the signal to five or six people who are registered by users in case of emergency and are available for only limited mobile phones.
  2. LBS (Location Based Service): Electronic Tagging of ex-convicts; this has been adopted in many different fields. The security company ADT uses LBS-based mobile service for crime prevention. Users can set up an ETA (Estimated Time of Arrival) and if the users do not arrive on time, the company dispatched their men. If users enter the plate number of a taxi, the company will do the background check. However, this is problematic because it is not a kid friendly interface.

It is concluded that mobile phone SOS features, LBS, Electronic Tagging are ineffective for luring and kidnapping because a child is not aware of it; however, it is effective for movement after kidnapping. In addition, to find a solution for preventing crimes against children, it is necessary to integrate mobile phone ubiquitous and LBS.

Less than 5% of the infertile couples have a physical cause for infertility, and this number is being reduced as medical knowledge evolved. The relationship between psychic states and physiological functions is highly complex, and there is not a simple and linear causal relation. It is also important to consider the conflicts present in couples that conceive naturally, since maybe similar conflicts can be found. People must be careful in order to avoid confounding causality with facts that can simply be related.

Sexual child abuse can lead to three main types of outcomes: physical, psychological/psychiatric sequences and the risk of revictimization (when a survivor of sexual abuse is sexually victimized again). It can cause gynaecological consequences such as chronic pelvic pain, dyspareunia (painful sexual intercourse) at the beginning of sexual activity, vaginismus and non-specific vaginitis and can cause inappropriate sexualized behaviour, such as repeated object insertion into vagina and/or anus, age-inappropriate knowledge of sex.

Finally, vaginismus refers to sexual pain disorders that create pain and involuntary spasms, respectively, in women, and thus make it painful to have sex and to conceive naturally.

New reproduction technologies are transforming the concepts of infertility, mainly with regards to the knowledge about psychogenic infertility.

Child maltreatment and adverse childhood experiences are a common occurrence.

The quality of early interactions between the caregiver and his/her child determines the child’s immediate emotional response to stress and plays a decisive and lasting role in the latter‘s emotion-regulation ability.

It has been found that women with vaginismus were twice as likely to have been sexually abused as children as compared to women who did not have vaginismus. In contrast, no correlation has been found in vaginismus and physical abuse.

PTSD represents the most frequent consequence of interpersonal trauma histories, with 48–85% of childhood abuse survivors developing PTSD symptoms across life. The exposure to traumatic experiences is a necessary but not sufficient condition for the development of PTSD. Consequently, it can be hypothesized that each individual who has experienced or is experiencing traumatic events will develop PTSD after reaching a certain threshold of traumatic exposure.

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