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Emotional abuse strongly related to post-traumatic stress

Children and young people who are victims of emotional abuse at the hands of their parents often report the symptoms of severe post-traumatic stress. These are generally even worse than after other forms of child abuse, such as physical abuse. These are the results of research by Leiden psychologists, which is to be published in Child Abuse & Neglect.

Did you grow up in a safe and loving family? Unfortunately, this is not the case for around 25% of Dutch children, who claim to have experienced some form of child abuse – sexual abuse, physical abuse, neglect or emotional abuse, for example. Children who experience the latter are abused at home by their parents or carers.

Differences between trauma symptoms

Researchers from Leiden University and the Rivierduinen mental healthcare organisation (GGZ) in Leiden investigated whether the severity of post-traumatic stress symptoms in young people depends on the degree of abuse they experienced. The research shows that children and young people who are victims of emotional abuse by their parents usually report the most severe post-traumatic stress symptoms. This means that these symptoms are more severe than those experienced by victims of other types of abuse, including physical abuse and neglect. This also proved to be the case for young people who came for treatment for a completely unrelated trauma. ‘For example, a child might come for trauma treatment following a car accident, but the emotional abuse that goes on at home can have a major impact on the severity of the trauma symptoms,’ said Professor Bernet Elzinga, principal investigator of the study.

The researchers came to this conclusion after conducting a survey of 287 young people who had registered for trauma treatment at the GGZ. Their average age was about 15 to 16 years. At the start of treatment they completed a survey indicating whether, among other things, they had experienced any trauma or abuse, and if so, what type. They also answered questions about their psychological symptoms, including post-traumatic stress symptoms. Just under half completed this questionnaire again six and twelve months later in order to gauge whether the treatment was successful.

Consistently more symptoms

‘The research shows that the post-traumatic stress symptoms did in fact become milder as a result of the treatment,’ says Chris Hoeboer, psychologist and first author of the article (which was originally his master’s thesis). ‘This also applies to young people who were emotionally abused. However, this group consistently reported more trauma symptoms than children who had experienced other types of abuse, even after treatment.’ 

The researchers hope that this study will mean more attention is paid to children who suffer emotional abuse – a group that remains relatively overlooked compared to victims of, for example, physical or sexual abuse. ‘It is essential that practitioners question the children thoroughly about their home situation and that parents are more involved in the treatment process and receive good information.’

Help the parents

According to the researchers, we need to remember that the parents or carers of emotionally abused children do not always intend to hurt their child. These parents often have problems of their own and are unaware of the impact that hurtful remarks can have. To prevent child abuse, you need to educate parents about this and help them to deal more effectively with their own powerlessness and inability. Hoeboer: ‘Sometimes it helps if the child and the parents go into therapy.’

This research was funded by a ZonMW implementation grant.

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