Effects of child abuse and neglect for adult survivors
by Cathryn Hunter, Senior Research Officer with the Child Family Community Australia information exchange at the Australian Institute of Family Studies.
Experiencing abuse and neglect in childhood can lead to adverse outcomes in adulthood. The purpose of this blog is to indicate the potential long-term effects of child abuse and neglect that may extend into adulthood.
Types of abuse and neglect
Child abuse and neglect refers to any behaviour by parents, caregivers, other adults or older adolescents that is outside the norms of conduct and entails a substantial risk of causing physical or emotional harm to a child or young person. Such behaviours may be intentional or unintentional and can include acts of omission (i.e., neglect) and commission (i.e., abuse) (Bromfield, 2005; Christoffel et al., 1992; Gilbert et al., 2009). The five main subtypes of child abuse and neglect are physical abuse, emotional maltreatment, neglect, sexual abuse and witnessing family violence.
For more information on the definitions of child abuse and neglect see What is Child Abuse and Neglect?
Factors affecting the consequences of abuse and neglect
The consequences of experiencing child abuse and neglect will vary considerably. For some adults, the effects of child abuse and neglect are chronic and debilitating, other adults have less adverse outcomes, despite their histories (Miller-Perrin & Perrin, 2007). Critical factors that may influence the way child abuse and neglect affects adults include the frequency and duration of maltreatment and if more than one type of maltreatment has occurred.
Chronic maltreatment defined as “recurrent incidents of maltreatment over a prolonged period of time” (Bromfield & Higgins, 2005, p. 39) has been linked to worse outcomes than transitory or isolated incidents of maltreatment (e.g., Ethier, Lemelin, & Lacharite, 2004; Graham et al., 2010; Johnson-Reid, Kohl, & Drake, 2012).
Research suggests that maltreatment types are interrelated, that is, a large proportion of adults who experience childhood abuse or neglect are exposed to more than one type of abuse (known as multi-type maltreatment). Further to this, other forms of victimisation (known as poly-victimisation) such as bullying or assault by a peer have often been found to co-occur with child maltreatment (Finkelhor, Ormrod, & Turner, 2007). Research indicates that those who experience multi-type maltreatment and/or poly-victimisation are more likely to experience high levels of trauma symptoms and worse outcomes as adults than those who are exposed to no maltreatment or only one type (Finkelhor et al., 2007; Higgins & McCabe, 2001; Richmond, Elliot, Pierce, Aspelmeier, & Alexander, 2009).
In attempting to explain some of the adverse outcomes associated with chronic and multi-type maltreatment a concept that is often employed is complex trauma. Complex trauma reflects the multiple and interacting symptoms, disorders and multiple adverse experiences and the broad range of cognitive, affective and behavioural outcomes associated with prolonged trauma, particularly if occurring early in life and involving an interpersonal element (e.g., sexual abuse; Price-Robertson, Rush, Wall, & Higgins, 2013).
For further details on the chronic maltreatment, the interrelatedness of sub-types child abuse and neglect, and complex trauma, see Rarely an Isolated Incident: Acknowledging the Interrelatedness of Child Maltreatment, Victimisation and Trauma (Price-Robertson et al., 2013).
Other factors that may affect the consequences of child abuse and neglect on adult survivors include:
- the age and developmental stage at which maltreatment occurred: some evidence suggests that the younger the child was at the time of the onset of the maltreatment, the more likely they are to experience problems later in life;
- the severity of maltreatment: the greater the severity of abuse or neglect, the higher the likelihood of negative outcomes;
- the type/s of abuse and/or neglect: different sub-types of maltreatment may be related to different negative outcomes;
- the victim/survivor’s perceptions of the abuse: worse outcomes are likely if there is the victim/survivor experiences feelings of self-blame, shame or stigmatisation;
- the relationship the victim/survivor had (or has) with the perpetrator: for example, in child sexual abuse increased negative affects tend to be associated with the perpetrator being a father, father-figure or someone with whom the child has an intense, emotional relationship;
- whether the abuse or neglect was detected and action taken to assure the safety of the child (e.g., child protection intervention);
- positive or protective factors that may have mitigated the effects of maltreatment (e.g., family support, perpetrator readiness for change); and
- whether victims/survivors received therapeutic services to assist them in recovery (Bromfield & Higgins, 2005; Miller-Perrin & Perrin, 2007; Price-Robertson et al., 2013).
Long-term consequences of child abuse and neglect
The remainder of this blog explores the major negative physical, cognitive, psychological, behavioural and social consequences of child abuse and neglect that extend into adulthood. The research reviewed included high quality literature reviews/meta-analyses and primary research in English speaking countries. The negative consequences associated with past histories of abuse and neglect are often interrelated, as one adverse outcome may lead to another (e.g., substance abuse problems or engaging in risky sexual behaviour may lead to physical health problems). Adverse consequences are broadly linked to all abuse types, however, where appropriate, associations are made between specific types of abuse and neglect and specific negative outcomes.
Adverse outcomes of abuse and neglect often emerge in childhood and adolescence and may continue in adults with histories of abuse and neglect (Miller-Perrin & Perrin, 2007). For a more detailed discussion of the impact of child abuse and neglect on children see, The Effects of Child Abuse and Neglect for Children and Adolescents.
Intergenerational transmission of abuse and neglect
Although most survivors of child maltreatment do not go on to maltreat their own children, some evidence suggests that adults who were abused or neglected as children are at increased risk of intergenerational abuse or neglect compared to those who were not maltreated as children (Kwong, Bartholomew, Henderson, & Trinke, 2003; Mouzos & Makkai, 2004; Pears & Capaldi, 2001). In a study by Pears and Capaldi (2001), parents who had experienced physical abuse in childhood were significantly more likely to engage in abusive behaviours toward their own children or children in their care. Oliver (1993), in a review of the research literature, concluded that an estimated one-third of children who are subjected to child abuse and neglect go on to repeat patterns of abusive parenting towards their own children. Although this is a significant number, it is also important to note that Oliver’s estimations indicate that a majority of maltreated children do not go on to maltreat their own children. Kwong and colleagues (2003) determined that growing up in abusive family environments can teach children that the use of violence and aggression is a viable means for dealing with interpersonal conflict, which can increase the likelihood that the cycle of violence will continue when they reach adulthood.
Re-victimisation
Research suggests that adults, particularly women, who were victimised as children are at risk of re-victimisation in later life (Cannon, Bonomi, Anderson, Rivara, & Thompson 2010; Mouzos & Makkai, 2004; Whiting, Simmons, Havens, Smith, & Oka, 2009; Widom, Czaja, & Dutton, 2008). Findings from the Australian component of the International Violence Against Women Survey (IVAWS) indicated that 72% of women who experienced either physical or sexual abuse as a child also experienced violence in adulthood, compared to 43% of women who did not experience childhood abuse (Mouzos & Makkai, 2004). Further to this, a review of approximately 90 sexual victimisation studies found that over 30 studies had reported a link between child sexual assault and sexual re-victimisation in adulthood (Classen, Gronskaya Palesh, & Aggarwal, 2005). In a prospective study by Widom and colleagues (2008), all types of childhood victimisation (physical abuse, sexual abuse and neglect) measured were associated with increased risk of lifetime re-victimisation. Findings indicated that childhood victimisation increased the risk for physical and sexual assault/abuse, kidnapping/stalking, and having a family friend murdered or commit suicide (Widom et al., 2008). Women who experience childhood violence or who have witnessed parental violence could be at risk of being victimised as adults as they are more likely to have low self-esteem and they may have learnt that violent behaviour is a normal response to dealing with conflict (Mouzos & Makkai, 2004).
Physical health problems
Adults with a history of child abuse and neglect are more likely than the general population to experience physical health problems including diabetes, gastrointestinal problems, arthritis, headaches, gynaecological problems, stroke, hepatitis and heart disease (Felitti et al., 1998; Sachs-Ericsson, Cromer, Hernandez, & Kendall-Tackett, 2009; Springer, Sheridan, Kuo, & Carnes, 2007). In a review of recent literature, Sachs-Ericsson et al. (2009) found that a majority of studies showed that adult survivors of childhood abuse had more medical problems than non-abused counterparts. Further to this, a US meta-analysis of 78 total effect sizes from 24 studies found that child maltreatment was related to an increased risk of neurological, musculoskeletal, respiratory, cardiovascular and gastrointestinal problems but contrary to some other studies, not gynaecological problems (Wegman & Stetler, 2009). Using survey data from over 2,000 middle-aged adults in a longitudinal study in the United States, Springer et al. (2007) found that child physical abuse predicted severe ill health and several medical diagnoses, including heart and liver troubles and high blood pressure. Finally, in a study of the adult health and relationship outcomes of child abuse and witnessing intimate partner violence that utilised a large random sample of women, researchers reported that those who had experienced child abuse only, intimate partner violence only, and the group exposed to both forms of maltreatment were all more likely to report a range of negative physical and mental health outcomes as well as a higher utilisation of health care services in adulthood than those who were not exposed to either type of abuse (Cannon, Bonomi, Anderson, Rivara, & Thompson, 2010).
It is unclear exactly how maltreatment experiences are related to physical health problems, although it seems likely there are a number of different causal mechanisms and mediating factors. For instance, some researchers suggest that poor health outcomes in adult survivors of child abuse and neglect could be due to the direct effects of physical abuse in childhood, the impact early life stress has on the immune system or to the greater propensity for adult survivors to engage in high-risk behaviours (e.g., smoking, alcohol abuse and risky sexual behaviour) (Sachs-Ericsson et al., 2009; Watts-English, Fortson, Gilber, Hooper, & De Bellis, 2006; Wegman & Stetler, 2009).
Mental health problems
Persisting mental health problems are a common consequence of child abuse and neglect in adults. Mental health problems associated with past histories of child abuse and neglect include personality disorders, post-traumatic stress disorder, dissociative disorders, depression, anxiety disorders and psychosis (Afifi, Boman, Fleisher, & Sareen, 2009; Cannon et al., 2010; Chapman et al., 2004; Clark, Caldwell, Power, & Stansfeld, 2010; Maniglio; 2012; McQueen, Itzin, Kennedy, Sinason, & Maxted, 2009; Norman et al., 2012; Springer et al., 2007). Depression is one of the most commonly occurring consequences of past abuse or neglect (Kendall-Tackett, 2002). In an American representative study based on the National Co-morbidity Survey, adults who had experienced child abuse were two and a half times more likely to have major depression and six times more likely to have post-traumatic stress disorder compared to adults who had not experienced abuse (Afifi et al., 2009). The likelihood of such consequences increased substantially if adults had experienced child abuse along with parental divorce (Afifi et al., 2009).
In a prospective longitudinal study in the United States, Widom, DuMont, and Czaja (2007) found that children who were physically abused or experienced multiple types of abuse were at increased risk of lifetime major depressive disorder in early adulthood. Further to this, a large, nationally representative study in the US reported that those who had experienced child physical abuse were at a higher risk for a range of psychiatric disorders in adulthood than those not reporting such abuse (Sugaya et al., 2012). Disorders included (in descending order of strength of association) attention-deficit hyperactivity disorder, post-traumatic stress disorder, bipolar disorder, panic disorder, drug abuse, nicotine dependence, generalised anxiety disorder, and major depressive disorder. The same study reported that many adults reporting child physical abuse also reported child sexual abuse and neglect and, importantly, the study found a dose-response relationship with those experiencing a higher frequency of abuse at higher risk of psychiatric disorder than those reporting lower frequency of abuse.
Suicidal behaviour
Consistent evidence shows associations between child abuse and neglect and risks of attempted suicide in young people and adults (Felitti et al., 1998; Gilbert et al., 2009; Norman et al., 2012). In the Adverse Childhood Experiences (ACE) study in the United states, Felitti et al. (1998) indicated that adults exposed to four or more adverse experiences in childhood were 12 times more likely to have attempted suicide than those who had no adverse experiences in childhood. In a meta-analysis by Gilbert et al. (2009), retrospective studies (which record participants recollections of past traumatic events) showed a strong association between child abuse and neglect and attempted suicide in adults. Prospective studies (which trace participant’s experiences of traumatic events over several years) indicated a more moderate relationship (Gilbert et al., 2009). The higher rates of suicidal behaviour in adult survivors of child abuse and neglect has been attributed to the greater likelihood of adult survivors suffering from mental health problems.
Eating disorders and obesity
Eating disorders and obesity are common among adult survivors of child abuse and neglect (Johnson, Cohen, Kasen, & Brook, 2002; Kendall-Tackett, 2002; Rodriguez-Srednicki & Twaite, 2006; Rohde et al., 2008; Thomas, Hypponen, & Power, 2008). Prospective research studies have consistently shown links between child abuse and neglect and obesity in adulthood (Gilbert et al., 2009). Using a large population-based survey, Rohde and colleagues (2008) found that both child sexual abuse and physical abuse were associated with a doubling of the odds of obesity in middle-aged women. In a prospective longitudinal study in the United Kingdom, results indicated that severe forms of childhood adversity, such as physical abuse, witnessing domestic violence and neglect were associated with increased risk of obesity in middle adulthood by 20 to 40% (Thomas et al., 2008). In a community based study, Johnson and colleagues found (2002) that adolescents and young adults with a history of child sexual abuse or neglect were five times more likely to have an eating disorder compared to individuals who did not have a history of abuse. Stress and mental health problems such as depression may increase the likelihood of adults with a history of abuse and neglect becoming obese or having an eating disorder (Rodriguez-Srednicki & Twaite, 2006).
Alcohol and substance abuse
Associations have often been made between childhood abuse and neglect and later substance abuse in adulthood (Gilbert et al., 2009; Simpson & Miller, 2002; Widom, White, Czaja, & Marmorstein, 2007). In a systematic review of 224 studies, a strong relationship was found between child physical and sexual abuse and substance abuse problems in women (Simpson & Miller, 2002). Less of an association was found among men, although men with child sexual abuse histories were found to be at greater risk of substance abuse problems. The authors suggested that it is possible that men are less likely to disclose childhood abuse due to social values and expectations (Simpson & Miller, 2002). A recent meta-analysis of 124 studies of non-sexual child abuse and neglect reported that there was robust evidence of an association between these types of maltreatment and an increased risk of drug use (Norman et al., 2012). In the Adverse Childhood Experiences Study in the United States, adults with four or more adverse experiences in childhood were seven times more likely to consider themselves an alcoholic, five times more likely to have used illicit drugs and ten times more likely to have injected drugs compared to adults with no adverse experiences (Felitti et al., 1998). The higher rates of substance abuse problems among adult survivors of child abuse and neglect may, in part, be due to victims using substances to self-medicate from trauma symptoms such as anxiety, depression and intrusive memories caused by an abusive history (Whiting et al., 2009).
Aggression, violence and criminal behaviour
Violence and criminal behaviour is another frequently identified long-term consequence of child abuse and neglect for adult survivors, particularly for those who have experienced physical abuse or witnessed domestic violence (Gilbert et al., 2009; Kwong et al., 2003; Miller-Perrin & Perrin, 2007). Widom (1989) compared a sample of adults with a history of substantiated cases of child abuse and neglect in the United States with a sample of matched comparisons and found that adults with a history of abuse and neglect had a higher likelihood of arrests, adult criminality, and violent criminal behaviour. In a study of 36 men with a history of perpetrating domestic violence, Bevan and Higgins (2002) found that child maltreatment (particularly child neglect) and low family cohesion were associated with the frequency of physical spouse abuse. Witnessing domestic violence (but not physical abuse) as a child had a unique association with psychological spouse abuse and trauma symptomology. Adults with a history of child physical abuse or witnessing domestic violence may be more likely to be violent and involved in criminal activity as they have learned that such behaviour is an appropriate method for responding to stress or conflict resolution (Chapple, 2003). Substance abuse problems are also associated with higher rates of criminal behaviour (e.g., theft, prostitution) to support addiction (Dawe, Harnett, & Frye 2008).
High-risk sexual behaviour
Adults who have experienced childhood abuse and neglect, particularly child sexual abuse, are more likely to engage in high-risk sexual behaviour. This can lead to a wide range of sexually transmitted diseases or early pregnancy (Cohen et al., 2000; Hillis, Anda, Felitti, Nordenberg, & Marchbanks, 2000; Norman et al., 2012; Steel & Herlitz, 2005; Young, Deardorff, Ozer, & Lahiff, 2011). Using a random population sample in Sweden, Steel and Herlitz (2005) found that a history of child sexual abuse was associated with a greater frequency of unintended pregnancy, younger age at first diagnosis of a sexually transmitted disease, greater likelihood of participation in group sex and a greater likelihood of engaging in prostitution. In a large retrospective study in the United States, the prevalence of sexually transmitted diseases was three and a half times higher for men and women who were exposed to three to five adverse childhood experiences compared to adults who had no adverse childhood experiences (Hillis et al., 2000). Steel and Herlitz (2005) determined that factors that may increase the likelihood of engaging in risky sexual behaviours include: the inability to be assertive and prevent unwanted sexual advances, feeling unworthy, and having competing needs for affection and acceptance. These are all feelings that may occur as a consequence of child abuse and neglect.
Homelessness
Strong associations have been made between histories of child abuse and neglect and experiences of homelessness in adulthood. A study by Herman, Susser, Struening, and Link (1997) found that the combination of lack of care and either physical or sexual abuse during childhood was strongly associated with an elevated risk of adult homelessness. Adults who experienced a combination of a lack of care and either child physical or sexual abuse were 26 times more likely to have been homeless than those with no experiences of abuse. In a study examining whether adverse childhood events were related to negative adult behaviours among homeless adults in the United States, 72% of the sample had experienced one or more adverse childhood events (Tam, Zlotnick, & Robertson, 2003). Higher rates of homelessness among adult survivors of abuse and neglect could be due to difficulties securing employment or experiences of domestic violence. Although evidence associating past histories of child abuse and neglect and unemployment is limited, a small body of research suggests that children and adolescents affected by abuse and neglect risk poor academic achievement at school, which may lead to difficulties finding employment in adulthood (Gilbert et al., 2009). The relationship between homelessness and adult survivors of abuse and neglect may also be connected to other adverse outcomes linked to child abuse and neglect such as substance abuse problems, mental health problems and aggressive and violent behaviour. These consequences may make it difficult to achieve stable housing.
Research limitations
Research investigating the effects of child abuse and neglect in adulthood is extensive. However, in most research studies it is difficult to make casual links between abuse and neglect and adverse consequences due to several limitations. Many research studies are unable to control for other environmental and social factors. This makes it difficult to rule out influences such as socio-economic disadvantage, disability and social isolation when associating abuse and neglect with negative consequences.
Most research studies on adult survivors are based on retrospective reporting of events and are therefore reliant on participants’ recollection of events over long periods. This can limit the data in that participants’ recollections may have changed over time. Prospective longitudinal studies have the advantage of tracing participants with reported experiences of child abuse or neglect over several years. However prospective studies alone are not completely representative of the population, as a high proportion of child abuse and neglect goes undetected and those experiencing abuse and neglect are less likely to participate or remain in a longitudinal study (Kendall-Tackett & Becker-Blease, 2004). Kendall-Tackett and Becker-Blease (2004) argued that there should be a mix of prospective and retrospective studies as both types of research can provide insight into the long-term consequences of child abuse and neglect.
Other limitations in the research included:
Studies focused solely on one type of abuse (particularly sexual abuse).
Focusing research on only one type of abuse or neglect overlooks the effects of children experiencing chronic and multiple types of abuse and neglect. Without assessing chronicity and the effects of other forms of child abuse and neglect, bias and misleading conclusions are often made on the specific impact of that form of maltreatment (Bromfield, Gillingham, & Higgins, 2007; Higgins & McCabe, 2001).
Reliance on recruiting participants already involved in clinical services.
Only including participants involved in clinical services excludes adult survivors who have not sought clinical services. This can make negative outcomes appear worse than in reality as participants are only those who have presented with a problem.
Far more studies focused on the effects of child abuse and neglect in women compared to men.
Having more research on the effects of child abuse and neglect in women makes it difficult to compare differences between men and women as less is known on the effects of child abuse and neglect on men (Springer et al., 2007; Widom, DuMont et al., 2007).
In spite of the various limitations, research consistently indicates that adults with a history of child abuse and neglect are more likely to experience adverse outcomes.
Conclusion
The effects of child abuse and neglect can lead to a wide range of adverse outcomes in adulthood. Adverse outcomes associated with past histories of child abuse and neglect are often inter-related. Experiencing chronic and multiple forms of maltreatment or victimisation can increase the risk of more severe and damaging adverse consequences in adulthood.
Further resources
Tarczon, C. (2012). Mothers with a history of child sexual abuse: Key issues for child protection practice and policy. Melbourne: Australian Centre for the Study of Sexual Assault, Australian Institute of Family Studies.
Victim/Survivor Further Resources – Australian Centre for the Study of Sexual Assault
Child Sexual Abuse Research Adult Survivors – Australian Institute of Family Studies
Protecting Children – Child Family Community Australia
References
Afifi, T., Boman, J., Fleisher, W., & Sareen, J. (2009). The relationship between child abuse, parental divorce, and lifetime mental disorders and suicidality in a nationally representative adult sample. Child Abuse & Neglect, 33, 139-147.
Bevan, E. & Higgins, D. (2002). Is domestic violence learned? The contribution of five forms of child maltreatment to men’s violence and adjustment. Journal of Family Violence, 17(3), 223-245.
Bromfield, L. M. (2005). Chronic child maltreatment in an Australian statutory child protection sample (Unpublished doctoral dissertation). Deakin University, Geelong.
Bromfield, L., & Higgins, D. (2005). National comparison of child protection systems (Child Abuse Prevention Issues No. 22). Melbourne: Australian Institute of Family Studies. Retrieved from <www.aifs.gov.au/nch/pubs/issues/issues22/issues22.html>
Bromfield, L. M., Gillingham, P., & Higgins, D. J. (2007). Cumulative harm and chronic child maltreatment. Developing Practice, 19, 34-42.
Cannon, E. A., Bonomi, A. E., Anderson, M. L., Rivara, F. P., & Thompson, R. S. (2010). Adult health and relationship outcomes among women with abuse experiences during childhood. Violence and Victims, 25(3), 291-305.
Chapman, D., Whitfield, C., Felitti, V., Dube, S., Edwards, V., & Anda, R. (2004). Adverse childhood experiences and the risk of depressive disorders in adulthood. Journal of Affective Disorders, 82, 217-225.
Chapple, C. (2003). Examining intergenerational violence: violent role modelling or weak parental controls? Violence & Victims, 18(2), 143-162.
Clark, C., Caldwell, T., Power, C., & Stansfeld, S. A. (2010). Does the influence of childhood adversity on psychopathology persist across the lifecourse? A 45-year prospective epidemiologic study. Annals of Epidemiology, 20(5), 385-394.
Classen, C. C., Gronskaya Palesh, O., Aggarwal, R. (2005). Sexual revictimisation: A review of the empirical literature. Trauma, Violence & Abuse, 6(2), 103-129.
Cohen, M., Deamant, C., Barkan, S., Richardson, J., Young, M., Holman, S. et al. (2000). Domestic violence and childhood sexual abuse in HIV-infected women and women at risk of HIV. American Journal of Public Health, 90(4), 560-565.
Christoffel, K. K., Scheidt, P. C., Agran, P. F., Kraus, J. F., McLoughlin, E., & Paulson, J. A. (1992). Standard definitions for childhood injury research: Excerpts of a conference report. Pediatrics, 89(6), 1027-1034.
Dawe, S., Harnett, P., & Frye, S. (2008). Improving outcomes for children living in families with parental substance misuse: What do we know and what should we do (Child Abuse Prevention Issues No. 29). Retrieved from: <www.aifs.gov.au/nch/pubs/issues/issues29/issues29.html>
Ethier, L., Lemelin, J. P., & Lacharite, C. (2004). A longitudinal study of the effects of chronic maltreatment on children’s behavioral and emotional problems. Child Abuse & Neglect, 28, 1265-1278.
Felitti, V., Anda, R., Nordenberg, D., Williamson, F., Spitz, A., Edwards, V. et al. (1998). Relationship of childhood abuse and household dysfunction in many of the leading causes of death in adults. American Journal of Preventive Medicine, 14(4).
Finkelhor, D., Ormrod, R. K., & Turner, H. A. (2007). Poly-victimization: A neglected component in child victimization. Child Abuse & Neglect, 31, 7-26.
Gilbert, R., Spatz Widom, C., Browne, K., Fergusson, D., Webb, E., & Janson, J. (2009). Burden and consequences of child maltreatment in high-income countries. Lancet, 373, 68-81.
Graham, J. C., English, D. J., Litrownik, A. J., Thompson, R., Briggs, E. C., & Bangdiwala, S. I. (2010). Maltreatment chronicity defined with reference to development: Extension of the social adaptation outcomes findings to peer relations. Journal of Family Violence, 25, 311-324.
Herman, D., Susser, E., Struening, E., & Link, B. (1997). Adverse childhood experiences: Are they risk factors for adult homelessness? American Journal of Public Health, 87(2), 249-255.
Higgins, D., & McCabe, M. (2001). Multiple forms of child abuse and neglect: Adult retrospective reports. Aggression and Violent Behaviour, 6, 547-578.
Hillis, S., Anda, R., Felitti, V., Nordenberg, D., & Marchbanks, P. (2000). Adverse childhood experiences and sexually transmitted diseases in men and women: A retrospective study. Pediatrics, 106(1), 1-6.
Johnson, J., Cohen, P., Kasen, S., & Brook, J. (2002). Childhood adversities associated with risk for eating disorders or weight problems during adolescence or early adulthood. American Journal of Psychiatry, 159(3), 394-400.
Jonson-Reid, M., Kohl, P. L., & Drake, B. (2012). Child and adult outcomes of chronic child maltreatment. Pediatrics, 129(5), 839-845.
Kendall-Tackett, K. (2002). The health effects of childhood abuse: four pathways by which abuse can influence health. Child Abuse & Neglect, 26(6-7), 715-729.
Kendall-Tackett, K., & Becker-Blease, K. (2004). The importance of retroseppctive findings in child maltreatment research. Child Abuse & Neglect, 28, 723-727.
Kwong, M., Bartholomew, K., Henderson, A., & Trinke, S. (2003). The intergenerational transmission of relationship violence. Journal of Family Psychology, 17(3), 288-301.
Maniglio, R. (2012). Child sexual abuse in the etiology of anxiety disorders: A systematic review of reviews. Trauma, Violence & Abuse, 14(2), 96-112.
McQueen, D., Itzin, C., Kennedy, R., Sinason, V., & Maxted, F. (2009). Psychoanalytic psychotherapy after child abuse. The treatment of adults and children who have experienced sexual abuse, violence, and neglect in childhood. London: Karnac Books Ltd.
Miller-Perrin, C., & Perrin, R. (2007). Child maltreatment: An introduction. Thousand Oaks: Sage Publications.
Mouzos, J., & Makkai, T. (2004). Women’s experiences of male violence. Findings from the Australian component of the International Violence Against Women Survey (IVAWS) . Canberra: Australian Institute of Crimonology. Retrieved from <www.aic.gov.au/publications/current%20series/rpp/41-60/rpp56.html>
Norman, R. E., Byambaa, M., De, R., Butchart, A., Scott, J., & Vos, T. (2012). The long-term health consequences of child physical abuse, emotional abuse and neglect: A systematic review and meta-analysis. Public Library of Science Medicine, 9(11), 1-31.
Oliver, J. (1993). Intergenerational transmission of child abuse: Rates, research and clinical implications. American Journal of Psychiatry, 150(9), 1315-1324.
Pears, K., & Capaldi, D. (2001). Intergenerational transmission of abuse: A two-generational prospective study of an at-risk sample. Child Abuse & Neglect, 25, 1439-1461.
Price-Robertson, R., Rush, P., Wall, L., & Higgins, D. (2013). Rarely an isolated incident: Acknowledging the interrelatedness of child maltreatment, victimisation and trauma (CFCA Paper No. 15). Melbourne: Child Family Community Australia, Australian Institute of Family Studies. Retrieved from <www.aifs.gov.au/cfca/pubs/papers/a144788/index.html>
Richmond, J. M., Elliot, A. N., Pierce, T. W., Aspelmeier, J. E., & Alexander, A. A. (2009). Polyvictimization, childhood victimization, and psychological distress in college women. Child Maltreatment, 14(2), 127-147.
Rodriguez-Srednicki, O., & Twaite, J. (2006). Understanding, assessing, and treating adult victims of childhood abuse. Lanham: Rowman & Littlefield Publishers Inc.
Rohde, P., Ichikawa, L., Simon, G., Ludman, E., Linde, J., Jeffrey, R. et al. (2008). Associations of child sexual and physical abuse with obesity and depression in middle-aged women. Child Abuse & Neglect, 32, 878-887.
Sachs-Ericsson, N., Cromer, K., Hernandez, A., & Kendall-Tackett, K. (2009). A review of childhood abuse, health, and pain-related problems: The role of psychiatric-disorders and current life stress. Journal of Trauma and Dissociation, 10(2), 170-188.
Simpson, T., & Miller, W. (2002). Concomitance between childhood sexual and physical abuse and substance use problems. A review. Clinical Psychology Review, 22, 27-77.
Springer, K., Sheridan, J., Kuo, D., & Carnes, M. (2007). Long-term physical and mental health consequences of childhood physical abuse: Results from a large population-based sample of men and women. Child Abuse & Neglect, 31, 517-530.
Steel, J., & Herlitz, C. (2005). The association between childhood and adolescent sexual abuse and proxies for sexual risk behavior: A random sample of the general population of Sweden. Child Abuse & Neglect, 29, 1141-1153.
Sugaya, L., Hasin, D. S., Olfson, M., Lin, K-H., Grant, B. F., & Blanco, C. (2012). Child physical abuse and adult mental health: A national study. Journal of Traumatic Stress, 25, 384-392.
Tam, T., Zlotnick, C., & Robertson, M. (2003). Longitudinal perspective: Adverse childhood events, substance use, and labor force participation among homeless adults. American Journal of Drug and Alcohol Abuse, 29(4), 829-846.
Thomas, C., Hypponen, E., & Power, C. (2008). Obesity and type 2 diabetes risk in mid-adult life: The role of childhood adversity. Pediatrics, 121, 1240-1249.
Watts-English, T., Fortson, B., Gilber, N., Hooper, S., & De Bellis, M. (2006). The psychobiology of maltreatment in childhood. Journal of Social Issues, 62(4), 717-736.
Wegman, H. L., & Stetler, C. (2009). A meta-analytic review of the effects of childhood abuse on medical outcomes in adulthood. Psychosomatic Medicine, 71, 805-812.
Whiting, J., Simmons, L. A., Havens, J., Smith, D., & Oka, M. (2009). Intergenerational transmission of violence: The influence of self-appraisals, mental disorders and substance abuse. Journal of Family Violence, 24, 639-648.
Widom, C. (1989). Child abuse, neglect, and violent criminal behaviour. Criminology, 27(2), 251-271.
Widom, C., Czaja, S., & Dutton, M. (2008). Childhood victimization and lifetime revictimization. Child Abuse & Neglect, 32, 785-796.
Widom, C., DuMont, K., & Czaja, S. (2007). A prospective investigation of major depressive disorder and comorbidity in abused and neglected children grown up. Archives of General Psychiatry, 64, 49-56.
Widom, C., White, H., Czaja, S., & Marmorstein, N. (2007). Long-term effects of child abuse and neglect on alcohol use and excessive drinking in middle adulthood. Journal of Studies on Alcohol and Drugs, 317-325.
Young, M.D., Deardorff, J., Ozer, E., & Lahiff, M. (2011) Sexual abuse in childhood and adolescence and the risk of early pregnancy among women ages 18-22. Journal of Adolescent Health, 49, 287-293.
Acknowledgements
This paper was prepared by Cathryn Hunter, Senior Research Officer with the Child Family Community Australia information exchange at the Australian Institute of Family Studies.
Copied from http://www.aifs.gov.au
Previous editions have been compiled by Alister Lamont.
Thank you for this. Reading it through has helped me to understand a few things about myself that I have heard before but never believed. Seeing it in print adds more depth somehow.
As I am reading this, I get more and more discouraged because my question is, what can a survivor do? What I mean is that there seems to be very little hope for survivor to have a fair chance in life, and a chance to have a good life.
I’ve been through it all, sexual abuse, psychological abuse, physical abuse and emotional abuse for more than 20 years starting when I was born. I have been hurt in ways that are unimaginable so I won’t go into details but I do know the pain, hurt and all the ramification of that abuse. I have to say that I call myself a survivor because I really think that I’ve done extremely well with my life considering the situation I was in. And I would even say that I got myself out of my past and I mostly did it on my own as I never told anyone (except at age 28 to my husband). That implies that I had to take a good look at myself and analyse what I liked about me and what I didn’t. So it was my life journey to relearn and teach myself who I want to be. I think I have succeeded doing this but there is one problem that remains. I thought by doing all the hard work of undoing the brainwashing and going to take back what was taken from me that I would be free. The problem is that I realized that I will never be free of the pain. It always creeps up no matter what. There is always a trigger, there is always a moment where it hurts. Especially that my life is very bad. Not by my doing but my bad hand in life seems to continue no matter what I do to make it good.
What can survivor hope for? Please don’t tell me the same as the others because it’s not true. We live with a deep pain that made us who we are and that is part of us. But that pain is a killer. So what’s the best scenario?
The best scenario is that you decide for yourself to heal. Stop looking for an ‘answer’ and start the process yourself. The only person who can start the healing process, continue the healing process and stop the healing process is YOU. There are no easy fixes or generic paths to follow. You have to accept, acknowledge and action the journey.
It may sound harsh and in a way it is. You arent owed anything. Survivors, victims and thrivers all have one thing in common, the abuse, but that is where it stops. What makes one person an eternal victim can make another person the strongest thriver.
First, I just wanted to thank you for taking the time to anwser me. Second, I wanted to clarify a few things since I think that I didn’t explain properly my thoughts and processes.
I did decide to heal and I did do all the work to heal and I succeeded, I am mostly a thriver. But unfortunately, even after doing all the healing, I find that the pain still exists. I still live a happy life and I’m very grateful for what I have but there will always be pain in my heart because what was done do me was just to damaging and that in itself changes who we are regardless if we decide to heal or not be a victim. I’m far from being a victim and I absolutely don’t think that anyone owes me anything. I know that what was done to me is in the past and I alone choose my present and future. I take advantage of that fact as I chose a long time ago that I was going to be happy. But that doesn’t mean in any way that I’m totally free of the pain because there are consequences for having been a victim at a young age. What I mean is that you have to fight all your life for things that most people don’t have to. Nothing comes easy even if you decide to heal. Most people won’t even succeed in healing in their lifetime. I would say that it is naive thinking you can have a normal life. And again, I explain myself, not that you can’t have a normal life once you have healed as the one I’m living now, I consider it normal. But there are struggles, it’s impossible to get rid of all the bad that was done to me in the past and that doesn’t mean I play the victim, I’m just realistic about my situation.
Also, it’s not always a question of choosing. I chose to be happy, I chose to heal but there are circumstances that have nothing to do with choosing: loosing a job, loosing a child, being a victim of child abuse are not our choices. That’s what’s in my life. Not only did I have a bad childhood but my normal life is very difficult yet I continue to fight and try to be happy. I’m not only fighting for a chance in life, I’m fighting for a good life. Although I keep getting a bad hand and being knocked off my feet, I know now that I have the tools and strength to get back up.
I think I see where you are coming from. I agree that it healing is a continual process. It never ends. It requires constant work. I often liken it to a messy back yard or garden. A victim emerges from the abuse like an over grown untidy and messy patch of land. Slowly over time the land is cleared, debris moved, and shrubs are planted. The piece of land grows and is maintained. Grass is seeded and cut. Borders are tidied and weeded regularly. And the land thrives into a beautiful oasis. Eventually though the maintenance subsides. The owner has new things to do and new ventures to tackle. One by one the weeds and brambles re-emerge. The flowers die and wilt. The land becomes more and more untidy.
The journey is very much like that. We will always have the pain. It will always be there. But like you say ‘I know now that I have the tools and strength to get back up.’
Thanks for leaving a comment.
I find that the best thing for me was learning that abused children do NOT (most of the time) abuse their own children–with sources! I’m 70, and for at least 40 years I’ve lived with either hiding the fact that I was brutally abused for many years, or been labeled an abuser myself by anyone who knows it. It’s great to see writing now on the phenomenon that actually did happen to me–and still happens–and the information that a victim is NOT an abuser in most cases (but must be vigilant not to be re-abused herself). In time perhaps I won’t be convicted of abuse by associates and strangers alike as an additional pain to suffer as soon as people know I was abused throughout my childhood. It’s very liberating!
I really like your analogy! Thank you for taking the time to answer me!
To Hints of Hope
My response will be in two separate posts. I can COMPLETELY relate to what you are saying exactly. You are not alone, there are many who travel a path like yours. I would love to write twenty pages here, but I won’t.
Heart of the matter: the pain, the ongoing fight to live “normally”, haunting reoccurring memories and the feelings associated with those memories, and the trying to thrive rather than just survive. And, the constant self-questioning and over analyzing by wondering “is my past influencing my thoughts, feelings and behaviors right now in this current situation” (whatever it may be at the time)?
It becomes exhausting. Especially since you know deep down inside that the answer many times truly is yes – in varying degrees. What to do?
Infuriating. Here’s another feeling: Why do I have to be a 24/7 self analyzing psychologist When Iv’e done nothing wrong? It’s like being a victim twice, once having endured the abuse, and twice perpetually having to be onguard to “fix” yourself and your life. It’s enough to make you cry sometimes (for me its a feeling of overwhelming mental exhaustion). to be continued……….
Cont……..
Lastly, yes, I wish all the memories and the pain associated with the memories could just “go away permanently”. But, they don’t. Life circumstances and experiences often trigger memories to the forefront of our minds and correspondingly what follows is our mental and emotional responses (which are sometimes easier and sometimes harder to deal with).
Only someone who has experienced abuse/trauma can truly, truly understand how difficult it is to try to forge ahead in life while trying to cope with the seemingly never ending mental aftermath of abuse.
I am a survivor of sexual abuse, I have chosen the wrong way as many have to move one, by forgetting. My memory is horrible, short and long term. I know many people in my life ( I am a female age 51) who have been abused one way or another. We have all struggled but have lived life as best as possible. I have a niece who has chosen to take the role of victim and use it as a way of hurting others. She is all over Facebook stating what she has been through, that she has PTSD, that we all must understand her. It is as if she can only see her own abuse and not acknowledge anyone elses. She takes everything out of context and chooses to feel sorry for herself. I know many who have been through worst that do not treat others like this. I have decided that I do not deserve to be bullied, nor do I deserve her being so mean and vindictive all the time. Am I wrong? Many others that have been through abuse feel the same way about this person. I posted 10% is what happens to you and 90% is how you react. I did this because I reacted immaturely to a situation and was just trying to admit it. She decided to make it about her and said I was “victim shaming”. I feel bad for not wanting anything to do with her. I am at a cross road. she is my niece and I love her. Any suggestions?
Unconditional love doesn’t mean the recipient cant hurt you. Of course, all of these responses are exaggerated by your past issues. You can never forget abuse, you can try to deny it ever happened or that it didn’t affect you but in reality that doesn’t work – not in the long term anyway. Have you considered getting professional help?
I am a survivor of severe child abuse and domestic abuse .. I just need to know if the pain ever stop?? Does the self doubting ever subside? Will I evebe able to look into a mirror and actually like the person I see? Will I ever feel anything more than anger? Will I always feel damaged and broken?
Yes, absolutely and categorically, yes. You have to take responsibility for your own healing and the journey it will take to get there. Stay strong and positive. Healing is possible.
My entire life I’ve been avoiding people, never knowing how to interact, never having had normal interactions with people and being entirely reclusive. I can’t understanding people and people have a hard time understanding me and in this whole thing there is a lot of tension and problems stemming from not fitting in. So I just stay by myself and prefer animals and nature to people. I don’t need other people to give me validation and it’s pretty much when things get rough, I will ask for advice or another opinion just to gain some perspective. In the final analysis been trying to figure out the mechanisms of these maladies and disorders. I have issues with angers and have major issues with anxiety and depression. My biological blueprint is also problematic because I have generational trauma as well so I’m carrying a lot of residue from others that isn’t even mine but my inheritance. So how to undo the damage that was done en-vitro and through my childhood, growing up feral and disconnected from nurturing is and was always the quest. I do want to heal like so many here. The only issue is – who knows the way to actually go about doing this – because the earlier the trauma, the more complicated the undoing and healing is.
I suffered violence and neglect as a child and it was in my 40s that my mental health deteriorated to such an extent that I am no longer living in the outside world ,I have shut myself away for 15 yrs to stop adults continuing to abuse me ,I still seem to have gone into every relationship wanting to help make their lives better but only end up being a victim yet again ,I dont know how to stop the cycle ,I am receiving what little mental health help is on offer but I just want to be loved treated well and stop being a victim ,is there any hope for me or advice that may help ,I have been suicidal and dont want to walk that path again but hold little hope of being a happy normal person again.
I just want to say thank you for a wonderful site. Its really encouraging to find volunteers who give up their time to try and help those who need it the most. Thank you.
Although I was able to break the cycle of child abuse and my children never experienced or even saw abuse or neglect (nor do they show any symptoms toward their children), I have never been able to escape the daily abuse and extreme neglect of my own childhood. I was widowed when they were toddlers, was never welcomed among other families, and when my children reached adulthood two of them and their spouses shut me out of their lives. …… I have been looking for resources that address possible risk factors beyond history of abuse– perhaps characteristics of the victim that are only incidentally related to the abuse and that alienate people other than the abusing parent. Is there a body of research including this?
Bernadette–you can’t make anyone’s life “better” because that power is theirs, not yours. You can effect them positively for a moment, a day, even. But no matter what you do, they have the choice to make as to whether they accept your efforts, others’ efforts, or ignore them. They can make the most of their circumstances (or try to) or not (for a myriad of reasons they may try to fail or fail to try).
I think you may be projecting behavior onto others that you wish had been demonstrated to you. Understandable, but needs to stop.
Enter into relationships because you enjoy who someone is, not because you think you can fix them. Because they like who you are. Because they want you, not because they need you.
Oh, everyone needs someone sometimes, but if your partner needs you all the time, you have effectively become their parent. And the only parent-child relationship a person should have is with their parents or children. Never their friends or partners, because such relationships become unequal and burdensome. There is no joy in them.
Unhealthy people will try to latch into you to be their enabler. Recognizing this kind of behavior early will help you avoid wasting your time and energy.
This is really going to help me write my research paper for English!! Thanks so very much…
Survivors of Abuse – Sexual Abuse is the easiest understood and most treated apparently as cause and effect are understood by many. But chronic physical abuse by parents who are war Veterans and survivors of trauma either mental or physical should be better documented. These men -and women- come back from war with varying levels of shock and PTSD and are left to recover on their own. They are often young and beginning their own families. The level of change in their coping abilities are often not understood or investigated. Communities counsel police when they are involved in a single shooting incident but Veterans are rarely counseled at all unless they display immediate maniacal tendencies. Adult children of these Trauma victims are subjected to above ordinary Physical abuse and have this additional emotional baggage inserted into their psyche that manifests in anxiety,depression,lack of self esteem, alcohol and/or drug abuse along with low self worth that causes one to withdraw into themselves and/or act out violently in response to perceived real or not threats and/or tendencies to fail to cope to any perceived failure due to a constant state of low self confidence being told they are never good enough and that physical pain and violence is just a second or two away.
These symptoms can be helped thru self hypnosis guided meditations on the specific symptoms themselves and/or help from a knowledgeable psychiatrist or help group. Unfortunately social skills are also lost as a symptom of low self esteem. Acknowledge your cause with hating the perpetrator and learn to slow down when faced with challenge, value yourself, and respond in your best thought out manner. Love to you all. Take a chill meditation – Don’t over-medicate.
Long term effects of abuse is worse then the abuse for me. I had good coping skills and could just bounce back because it usually wasn’t understood and now it’s a battle in my head. Against myself and there’s no relief in sight and I am my worst critic. Just want it to go away already
The best part about the abuse I have endured is that I am constantly subjected to each of my failures twice but have never been given good advice on how to move forward. Life for me has been a never ending cycle of someone looking over my shoulder waiting to crush me for mistakes I was not warned about ahead of time.
I thank HAVOCA for your e-mails to me. I have not signed on to forums. I just can’t handle that. And if there are others who can’t handle some of the memories you have to know it is not for everyone.Don’t let anyone tell you how to deal with your past abuses and traumas. For me ,if I push too hard and try to face too much I become suicidal. Listen to advice and guidance but let you be the one who decides how far you go and what you can handle.I was severely abused from the time of infancy to much much later in life. I will never be normal and I am o.k. with that. Who is normal anyway? I believe seeking friendship with a caring community of people is healing. I believe developing a spiritual side of ourselves is healing.I believe practicing gratitude every day is healing. i believe in the good in myself and the good in others.
People like you and me are not so special as far as suffering in life goes. All human beings suffer. i would like to communicate with people with backgrounds like me because unless you expereince it yourself. I am very lonely in a way without you all. I hope to make some friends here. Hope to hear from you all.
*HUGS*
Apparently, I do not know how to make sense ^^^^
*Note: This definitely puts perspective out there. This makes alot of sense. This is a great article, especially for the internet. Behavorial health individuals are too quick to label someone bi-polar or some other untrue diagnosis. This article shows the difference. ***** 5 Stars -JP
I need help for an adult who has been abused & still suffers greatly . Is there anything that can be done?
Its never too late to heal! Use our contact form to chat directly.
I am still from This Day am Affected by Child Abuse Done By My Father; Danny Wilson when he Hit me and Physically Tried to Fight me for Not Reading an Adult Level Book.