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Abusing parents are not always criminals. Deficient rearing during childhood deprived them of ego controls that could prevent them from injuring their children as projections of their own anger. Psychoanalytic therapy and ancillary measures can rehabilitate the crisis family. Methods are under study to identify and check potential abusing parents.
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Child abuse is one of the difficult social phenomena with which the technologist directly deals as a part of his professional responsibilities. To be able to respond to all of the child's needs, radiologic technologists need to understand not only the physical effects, but also the psychological effects of the child. Understanding also helps the technologist deal with his own feelings when interacting with either the abused child or the child's parents. The Draw-A-Person test (DAP) was utilized in this study to illustrate visually the effect of abuse on the child's self-image. The subsequent personality characteristics of these children include low self-esteem, withdrawal, extreme forms of impulse control, and self-destructive behavior. Using the DAP, the abused child's self-portrait frequently showed body distortion, lack of detailing and poor sexual identification. In addition, the personality pattern of abusing parents was found to have many of the same characteristics as the personalities of abused children, because many times abusing parents were themselves abused as children.
Child abuse is an emotional topic, and one which features frequently in newspapers. Newspapers, however, tend to report only the most serious cases and those which have been the subject of court hearings. The reporting tends to concentrate on lurid details. In fact, there is a wide spectrum of child abuse encompassing physical abuse, sexual abuse, emotional abuse and neglect, and ranging in severity from the most minor incident through to injuries sufficient to cause death.
Child abuse encompasses many facets aside from the acts of physical violence which have generally attracted attention. Sexual misuse of children often goes unrecognized, yet its effect on the mental health of the victim may be considerable; it may or may not be accompanied by violence, and it generally occurs within a setting of serious disturbance in the family. Clinical details of nine sexually abused children are described, and they serve to illustrate how this form of abuse may prevent. The management of these cases is discussed. Sexual abuse of children is a family problem and therefore must be the concern of the family doctor.
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Child abuse, a problem that has plagued societies for centuries, has been largely ignored by psychiatrists, the author asserts. He traces the relatively recent interest in the problem of other medical specialists such as pediatricians and radiologists and maintains that it is time for psychiatrists to become more involved. He explains how problems of confidentiality, the patient's lack of motivation for treatment, and other factors have discouraged many psychiatrists from treating child abusers. He demonstrates ways psychiatrists can treat both the abused child and his family if they are willing to use non-traditional services such as home intervention.
A 17-yr-old female, classified as retarded educable, was found to have uncorrected visual acuity of 20/800 in both eyes, unimproved by a pinhole disc. A low myopic correction determined objectively did not improve her visual acuity. Tangent-screen studies uncovered neurasthenic spiral fields superimposed on hysterical tubular contractions of both eyes. Investigation uncovered a history of child abuse since infancy. To rule out organic lesions of the oculocalcarine visual pathways, the patient was referred for electrodiagnostic evaluation. Her visual evoked responses were found to be normal. With the use of strong suggestion, her visual fields were brought out to normal limits and her visual acuity with correction was improved to 20/20 in each eye. With the cooperation of her school counselor, the patient was referred for psychiatric evaluation and therapy.
Many child abusing parents are unemployed, but others who work may bring their job-related frustrations home, where they explode into violent child abuse.
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The authors review the literature on child abuse and present evidence demonstrating that children who are born prematurely or who are sickly or handicapped are at high risk for child abuse. The authors describe ways to identify such children and suggest a number of primary prevention techniques that can reduce parental stress and help prevent child abuse. The techniques include day-care programs for handicapped children, mothers' social clubs, and lay health visitors to give support and impart proper maternal attitudes.
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