Child Abuse: Staging of Injuries and Injury Patterns

Treatment. The first step after identification of suspected abuse is reporting to a child protective service (CPS) agency. The CPS will carry out a thorough investigation of the suspected person(s) abusing the child and their living situation. The CPS will engage a treatment team to support the child and his or her family. In instances where the child’s safety has been compromised and/or future abuse is suspected without intervention, then the child may be placed in a safe environment until the investigation is complete or sufficient supports are put in place for the child to return home. The primary treatment for child abuse includes psychotherapy, which can include components of cognitive-behavioral therapy (change behavior by addressing distorted cognitions), behavioral and learning therapy (modifying habitual responses to situations/stimuli), family therapy (explore patterns of family interactions), and developmental victimology (describes the processes involved in the onset and maintenance of abusive behavior).

Course. Child abuse is hypothesized to mediate response biases, resulting in impaired emotional and cognitive regulation. Adult victims of prior childhood abuse are found to have higher rates of sleep disorders, abdominal disorders, obesity, chronic pain (e.g., headache, back ache, premenstrual syndrome), fatigue, and exaggerated startle responses. Longitudinal studies indicate that adults continue to suffer from low self-esteem, maladaptive sexual behavior, and impaired interpersonal relationships (e.g., parenting, romantic/intimate). Despite these findings, not every child who experiences abuse develops these symptoms, indicating a role for protective factors, such as cognitive factors, meaningful relationships, and the impact of treatment interventions.

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