Small Upswing in Child Abuse Despite Reports, Abuse of smallest babies may have risen, study finds

Small Upswing in Child Abuse Despite Reports
By Crystal Phend, Senior Staff Writer, MedPage Today
October 01, 2012

Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nurse Planner

A national study found that serious injuries from child abuse appear to have risen modestly over the past decade or so, and suggested that downward trends in other studies of abuse may reflect reporting changes rather than real improvement.

Hospitalization for abuse-related injury rose 4.9% overall among children 18 and under over the 12-year span from 1997 through 2009, wrote John Leventhal, MD, and Julie Gaither, RN, MPH, MPhil, both of Yale University in New Haven, Conn.

Children were increasingly likely to die from these injuries before discharge as well, they reported in the November issue of Pediatrics.

However, “these results are in sharp contrast to data from child protective services,” they noted. A national reporting system from these agencies indicated a 55% decline in substantiated child abuse cases from 1992 through 2009.

A second more extensive report by the Congress-mandated National Incidence Studies suggested a 23% decline in physical abuse.

While called evidence of “positive changes in the provision of services to children and families, there have been concerns that some of this decrease may be due to changes in reporting of cases to child protective services agencies and changes in which cases get investigated by child protective services and which cases are actually substantiated as physical abuse,” Leventhal and Gaither wrote….

http://www.medpagetoday.com/Pediatrics/DomesticViolence/35038

 

Abuse of smallest babies may have risen, study finds
By Maggie Fox, NBC News  9/30/12

A new look at child abuse reports suggests there may have been a small but worrying rise in injuries to babies over the past decade or so. While most research suggests child abuse is down overall, the report published on Monday in the journal Pediatrics shows infants are far from safe.

The study contradicts government data collected over the same time, and it shows that health officials need to take a better look at whether child abuse is getting better, worse or staying the same, experts said.

“I think it’s premature to make any conclusions about whether it is going up or down,” says Dr. James Anderst, chief of the section on child abuse and neglect at Children’s Mercy Hospitals and Clinics in Kansas City, Mo., who was not involved in the study. “Medical providers may be getting better at identifying abuse over time.”….

Child abuse is a serious problem in the United States. The Centers for Disease Control and Prevention says more than 740,000 children and youth are treated in hospital emergency departments for injuries resulting from violence every year.

“Child abuse, neglect or violence can actually affect the development of a child’s brain – impacting the child now and for years to come. Our Adverse Childhood Experiences (ACE) study shows a connection between child maltreatment and some of the nation’s worst health problems, including depression and heart disease,” CDC child abuse expert Linda Degutis says in a blog on the agency’s website….

http://vitals.nbcnews.com/_news/2012/10/01/14163696-abuse-of-smallest-babies-may-have-risen-study-finds?lite

Chronic Child Abuse Strong Indicator of Negative Adult Experiences

Chronic Child Abuse Strong Indicator of Negative Adult Experiences

ScienceDaily (May 15, 2012) — Child abuse or neglect are strong predictors of major health and emotional problems, but little is known about how the chronicity of the maltreatment may increase future harm apart from other risk factors in a child’s life.

In a new study published in the current issue of the journal Pediatrics, Melissa Jonson-Reid, PhD, child welfare expert and a professor at the Brown School at Washington University in St. Louis, looked at how chronic maltreatment impacted the future health and behavior of children and adults.

The study tracked children by number of child maltreatment reports (zero to four or more) and followed the children into early adulthood, by which time some of the children had become parents.

The study sought to determine how well the number of child maltreatment reports predicted poor outcomes in adolescence, such as delinquency, substance abuse in the teen years or getting a sexually transmitted disease.

“For every measure studied, a more chronic history of child maltreatment reports was powerfully predictive of worse outcomes,” Jonson-Reid says.

“For most outcomes, having a single maltreatment report put children at a 20 percent to 50 percent higher risk than non-maltreated comparison children….

In models of adult outcomes, children with four or more reports were about least twice as likely to later abuse their own children and have contact with the mental health system, even when controlling for the negative outcomes during adolescence.” Jonson-Reid says that there appears to be good reason to put resources into preventing ongoing maltreatment.

“Successfully interrupting chronic child maltreatment may well reduce risk of a wide range of other costly child and adolescent health and behavioral problems,” she says.

Jonson-Reid cites a recently published Centers for Disease Control and Prevention study estimating lifetime costs for a single year’s worth of children reported for maltreatment at $242 billion….

The study also found that maltreatment predicts a range of negative adolescent outcomes, and those adolescent outcomes then predict poor adult outcomes.

http://www.sciencedaily.com/releases/2012/05/120515131321.htm

Child and Adult Outcomes of Chronic Child Maltreatment
Melissa Jonson-Reid, PhD, Patricia L. Kohl, PhD, and Brett Drake, PhD
Abstract

….RESULTS: Child maltreatment chronicity predicted negative childhood outcomes in a linear fashion (eg, percentage with at least 1 negative outcome: no maltreatment = 29.7%, 1 report = 39.5%, 4 reports = 67.1%). Suicide attempts before age 18 showed the largest proportionate increase with repeated maltreatment (no report versus 4+ reports = +625%, P < .0001). The dose-response relationship was reduced once controls for other adverse child outcomes were added in multivariate models of child maltreatment perpetration and mental health issues. The relationship between adult substance abuse and maltreatment report history disappeared after controlling for adverse child outcomes.

CONCLUSIONS: Child maltreatment chronicity as measured by official reports is a robust indicator of future negative outcomes across a range of systems, but this relationship may desist for certain adult outcomes once childhood adverse events are controlled. Although primary and secondary prevention remain important approaches, this study suggests that enhanced tertiary prevention may pay high dividends across a range of medical and behavioral domains.

http://pediatrics.aappublications.org/content/129/5/839.abstract

Lessons from Penn State: Training Mandated Reporters

Lessons from Penn State: Training Mandated Reporters
By James R. Marsh on May 8, 2012

From a special edition of Centerpiece, the official newsletter of the National Child Protection Training Center:

The recent child sexual abuse scandal at Penn State University, in which multiple, well-educated professionals declined to report clear evidence of maltreatment, is not an isolated instance. Twenty years of research documents what every child protection professional in America already knows—that most people most of the time won’t report even clear evidence of maltreatment or otherwise intervene to save a child.

Although less clear, the Penn State scandal also draws attention to an equally disturbing problem—that even when reports of abuse are made, these reports are often handled ineffectually if not incompetently. According to media reports of the Penn State scandal, investigators and prosecutors did review a 1998 report of inappropriate intimate contact with a boy.

The alleged perpetrator, Jerry Sandusky, even admitted to two university detectives that he hugged the boy while both were naked….

Although this recorded admission of Sandusky’s is an incriminating if not out-right confession of indecent contact with a boy, no charges or additional actions were taken.

The inability, even failure of criminal justice authorities to take meaningful action to protect a child is also not an isolated anecdote.
http://www.childlaw.us/2012/05/lessons-from-penn-state-traini.html

Severe abuse in childhood may treble risk of schizophrenia, 30-60% overlap of child maltreatment and domestic violence

Severe abuse in childhood may treble risk of schizophrenia – Research links sexual, physical and emotional abuse, school bullying and parental neglect to schizophrenia in adulthood – Alok Jha, science correspondent  guardian.co.uk, Wednesday 18 April 2012

Children who experience severe forms of abuse are around three times as likely to develop schizophrenia and related psychoses in later life compared with children who do not experience such abuse, according to a study that has brought together psychiatric data from almost 80,000 people.

The results add to a growing body of evidence that childhood maltreatment or abuse can raise the risk of developing mental illnesses in adulthood, including depression, personality disorders and anxiety.

Prof Richard Bentall of the University of Liverpool’s Institute of Psychology, Health and Society, who led the study, showed that the risk of developing psychosis increased in line with the amount of abuse or trauma a child had gone through, with the most severely affected children having a 50-fold increased risk compared with children who had suffered no abuse. He also showed that the type of trauma experienced in childhood affected the subsequent psychiatric symptoms later in life….

Bentall’s team analysed 36 published studies that contained data on childhood maltreatment (including sexual, physical and emotional abuse, death of a parent, school bullying and neglect) and psychiatric symptoms in almost 80,000 people, collected over the course of 30 years. People who experienced these types of trauma in childhood were between 2.7 and 3 times as likely to develop schizophrenia as adults, the team found. The research is published in the journal Schizophrenia Bulletin….

The latest results add to recent evidence that childhood abuse can lead to serious problems in later life. In 2011, scientists at the Institute of Psychiatry (IoP) at King’s College London found that people with a history of abuse or maltreatment during childhood were more than twice as likely to have recurrent episodes of depression in adulthood and also 43% more likely to experience a poor outcome when it came to psychological or drug-based treatment. They examined data from 16 epidemiological studies involving more than 23,000 people in total and 10 clinical trials involving more than 3,000 people

The mechanisms behind the link between childhood maltreatment and schizophrenia are not yet understood. Earlier this year, psychiatrists at Harvard University found that being sexually or emotionally abused as a child correlated with reduced volumes of three important areas of the hippocampus, which is involved in the control of memory and regulation of emotions. Volumes were reduced by up to 6.5%. http://www.guardian.co.uk/science/2012/apr/18/severe-abuse-childhood-risk-schizophrenia

http://www.rawstory.com/rs/2012/04/21/severe-abuse-in-childhood-may-triple-risk-of-schizophrenia/

Childhood Adversities Increase the Risk of Psychosis: A Meta-analysis of Patient-Control, Prospective- and Cross-sectional Cohort Studies

Filippo Varese,  Feikje Smeets, Marjan Drukker, Ritsaert Lieverse, Tineke Lataster, Wolfgang Viechtbauer, John Read, Jim van Os and Richard P. Bentall

Abstract

Evidence suggests that adverse experiences in childhood are associated with psychosis. To examine the association between childhood adversity and trauma (sexual abuse, physical abuse, emotional/psychological abuse, neglect, parental death, and bullying) and psychosis outcome, MEDLINE, EMBASE, PsychINFO, and Web of Science were searched from January 1980 through November 2011. We included prospective cohort studies, large-scale cross-sectional studies investigating the association between childhood adversity and psychotic symptoms or illness, case-control studies comparing the prevalence of adverse events between psychotic patients and controls using dichotomous or continuous measures, and case-control studies comparing the prevalence of psychotic symptoms between exposed and nonexposed subjects using dichotomous or continuous measures of adversity and psychosis. The analysis included 18 case-control studies (n = 2048 psychotic patients and 1856 nonpsychiatric controls), 10 prospective and quasi-prospective studies (n = 41?803) and 8 population-based cross-sectional studies (n = 35?546). There were significant associations between adversity and psychosis across all research designs, with an overall effect of OR = 2.78 (95% CI = 2.34–3.31). The integration of the case-control studies indicated that patients with psychosis were 2.72 times more likely to have been exposed to childhood adversity than controls (95% CI = 1.90–3.88). The association between childhood adversity and psychosis was also significant in population-based cross-sectional studies (OR = 2.99 [95% CI = 2.12–4.20]) as well as in prospective and quasi-prospective studies (OR = 2.75 [95% CI = 2.17–3.47]). The estimated population attributable risk was 33% (16%–47%). These findings indicate that childhood adversity is strongly associated with increased risk for psychosis.http://schizophreniabulletin.oxfordjournals.org/content/early/2012/03/28/schbul.sbs050

full article  http://schizophreniabulletin.oxfordjournals.org/content/early/2012/03/28/schbul.sbs050.full

The 30-60% overlap of child maltreatment and domestic violence in families indicates a need for child protection policy and practice that reflects this co-occurrence. In 2009, the NRCCPS collaborated with the Family Violence Prevention Fund (FVPF) and the National Council of Juvenile and Family Court Judges (NCJFCJ) to publish Child and Family Service Review Outcomes: Strategies to Improve Domestic Violence Responses in CFSR Program Improvement Plans to help child protection agencies develop and implement policy and best practice respond to the need for improving and deepening the child pro identified in the CFSR process.  http://nrccps.org/special-initiatives/domestic-violence/

Child abuse and neglect cost US $124 billion, Scouts Canada, school staff replaced

articles:
- Child abuse and neglect cost the United States $124 billion
- The economic burden of child maltreatment in the United States and implications for prevention
- Study: Child abuse bigger threat than SIDS
- Convicted leader continued with Scouts movement
- Entire staff to be replaced at LA school where 2 teachers were arrested

Child abuse and neglect cost the United States $124 billion
Rivals cost of other high profile public health problems

Press Release
For Immediate Release: February 1, 2012
Contact :CDC Division of News and Electronic Media

The total lifetime estimated financial costs associated with just one year of confirmed cases of child maltreatment (physical abuse, sexual abuse, psychological abuse and neglect) is approximately $124 billion, according to a report released by the Centers for Disease Control and Prevention, published in Child Abuse and Neglect, The International Journal.

This study looked at confirmed child maltreatment cases, 1,740 fatal and 579,000 non–fatal, for a 12–month period. The lifetime cost for each victim of child maltreatment who lived was $210,012, which is comparable to other costly health conditions, such as stroke with a lifetime cost per person estimated at $159,846 or type 2 diabetes, which is estimated between $181,000 and $253,000.  The costs of each death due to child maltreatment are even higher….

Child maltreatment has been shown to have many negative effects on survivors, including poorer health, social and emotional difficulties, and decreased economic productivity.  This CDC study found these negative effects over a survivor’s lifetime generate many costs that impact the nation’s health care, education, criminal justice and welfare systems.

Key findings:

The estimated average lifetime cost per victim of nonfatal child maltreatment includes:
$32,648 in childhood health care costs
$10,530 in adult medical costs
$144,360 in productivity losses
$7,728 in child welfare costs
$6,747 in criminal justice costs
$7,999 in special education costs

….Child maltreatment can also be linked to many emotional, behavioral, and physical health problems. Associated emotional and behavioral problems include aggression, conduct disorder, delinquency, antisocial behavior, substance abuse, intimate partner violence, teenage pregnancy, anxiety, depression, and suicide. http://www.cdc.gov/media/releases/2012/p0201_child_abuse.html

The economic burden of child maltreatment in the United States and implications for prevention     Xiangming Fanga, Derek S. Brownb,
Curtis S. Florencea, James A. Mercya

Results

The estimated average lifetime cost per victim of nonfatal child maltreatment is $210,012 in 2010 dollars, including $32,648 in childhood health care costs; $10,530 in adult medical costs; $144,360 in productivity losses; $7,728 in child welfare costs; $6,747 in criminal justice costs; and $7,999 in special education costs. The estimated average lifetime cost per death is $1,272,900, including $14,100 in medical costs and $1,258,800 in productivity losses. The total lifetime economic burden resulting from new cases of fatal and nonfatal child maltreatment in the United States in 2008 is approximately $124 billion. In sensitivity analysis, the total burden is estimated to be as large as $585 billion.
Conclusions

Compared with other health problems, the burden of child maltreatment is substantial, indicating the importance of prevention efforts to address the high prevalence of child maltreatment. http://www.sciencedirect.com/science/article/pii/S0145213411003140

Study: Child abuse bigger threat than SIDS
4,600 children hospitalized with serious injuries
By Frederik Joelving 2/6/2012

Nearly 4,600 U.S. children were hospitalized with broken bones, traumatic brain injury and other serious damage caused by physical abuse in 2006, according to a new report.

Babies younger than one were the most common victims, with 58 cases per 100,000 infants. That makes serious abuse a bigger threat to infant safety than SIDS, or sudden infant death syndrome, researchers say in the report….

Based on data from the 2006 Kids’ Inpatient Database, the last such numbers available, Leventhal’s team found that six out of every 100,000 children under 18 were hospitalized with injuries ranging from burns to wounds to brain injuries and bone fractures. http://www.msnbc.msn.com/id/46281207/ns/health-childrens_health

Convicted leader continued with Scouts movement
CBC 2/7/12 A man who was twice-convicted of sex offences against children was welcomed as a member of a Scouts alumni association for decades, even after officials became aware of at least one of his convictions, a CBC News investigation has found.

Even though the organization says there was no contact with youth, Scouts Canada, in a recent interview with the CBC, now admits it was a mistake.

But a Lillooet, B.C., family that suffered damage caused by the abuse, says the acknowledgement gives them little solace.

“I ended up doing nine prison sentences, and having drinking and drug and all those other problems,” Christopher Jones told CBC News.

Decades ago, in 1976, his Grade 4 teacher and Scout leader, Michael David Henley, began molesting him….

It took Jones, who was known as Christopher Aaron as a child, 10 years to tell anyone what Henley did to him….

Henley eventually pleaded guilty to indecent assault and received a year’s probation. In 1994, Moore wrote to Scouts officials to be certain they were aware of what happened.

Moore says the letter she got back made her sick. Henley was still involved in Scouting as part of an adult alumni group for leaders called the Baden Powell Guild. The provincial commissioner wrote that Henley had no direct contact with youth, was undergoing counselling, and appeared determined to stay clear of situations that could result in a recurrence of his crime.

After Henley was convicted of sex assaults against six boys in 1999, he stepped down from his position as editor of the Baden Powell Guild’s newsletter, but returned as editor until 2005. http://ca.news.yahoo.com/convicted-leader-continued-scouts-movement-000842148.html

Entire staff to be replaced at LA school where 2 teachers were arrested
By msnbc.com staff and news services

2/7/12 The Los Angeles Unified School District is replacing the entire staff of Miramonte Elementary following the arrest of two teachers on lewd conduct charges last week, Superintendent John Deasy told parents at a meeting Monday night, the Los Angeles Times reported.

Positions will be filled by qualified teachers and other workers already on a placement or rehiring list, the Times report stated. But the displacement of the current staff could be temporary, according to the report.

Teacher Mark Berndt was charged last week with committing lewd acts on 23 children. Another teacher, Martin Springer, was arrested Friday on suspicion of fondling two girls in his classroom.

Deasy said staffers are being replaced because a full investigation of allegations is disruptive, and staffers require support to get through the scandal. http://usnews.msnbc.msn.com/_news/2012/02/06/10332533-entire-staff-to-be-replaced-at-la-school-where-2-teachers-were-arrested

Child abuse increased as economy crashed, study shows

Child abuse increased as economy crashed, study shows
Poverty, stress lead to harsher parenting and abuse, researchers say   By Frederik Joelving 9/19/2011

As the U.S. economy began to tank, the number of abused kids landing in the hospital with severe brain injuries spiked, a new study shows. Anecdotes linking child abuse to the recession have surfaced before, but there had been no hard data to back the connection until now.

“It’s definitely disturbing,” said Elizabeth Gershoff, a psychologist who studies parenting but was not involved in the study.

Although there is no proof that financial hardship itself is causing the uptick in abuse, earlier research has tied parental stress to child maltreatment.

“Living in poverty for parents can be very stressful,” Gershoff, of the University of Texas at Austin, told Reuters Health. “And that in turn leads to harsher parenting.”

….In the three years leading up to the crash in December 2007, the rate of abusive head injuries was 8.9 per year per 100,000 kids. After the crash, the number jumped to 14.7 per 100,000.

“If what we are seeing is even close to generalizable, that is a lot of excess children,” said Dr. Rachel P. Berger, a child abuse expert at Children’s Hospital of Pittsburgh who co-authored the study.

http://www.msnbc.msn.com/id/44573194/ns/health/

US Child Maltreatment 2009 Statistics

US Child Maltreatment 2009 Statistics

Child Maltreatment 2009
U.S. Department of Health & Human Services
Administration for Children and Families
Administration on Children, Youth and Families
Children’s Bureau

….Victims in the age group of birth to 1 year had the highest rate of victimization at 20.6 per 1,000 children of the same age group in the national population.

Victimization was split between the sexes with boys accounting for 48.2 percent and girls accounting for 51.1 percent. Less than 1 percent of victims had an unknown sex.

Eighty-seven percent of victims were comprised of three races or ethnicities—African-American (22.3%), Hispanic (20.7%), and White (44.0%).

What were the most common types of maltreatment?

As in prior years, the greatest proportion of children suffered from neglect. A child may have suffered from multiple forms of maltreatment and was counted once for each maltreatment type. CPS investigations or assessments determined that for unique victims:

More than 75 percent (78.3%) suffered neglect;
More than 15 percent (17.8%) suffered physical abuse;
Less than 10 percent (9.5%) suffered sexual abuse; and
Less than 10 percent (7.6%) suffered from psychological maltreatment.

….Child fatalities are the most tragic consequence of maltreatment. Yet, each year children die from abuse and neglect. Forty-nine States reported a total of 1,676 fatalities. Based on these data, a nationally estimated 1,770 children died from abuse and neglect.

….Four-fifths (80.9%) of duplicate perpetrators of child maltreatment were parents, and another 6.3 percent were other relatives of the victim;

Of the duplicate perpetrators who were parents, four-fifths (84.7%) were the biological parents of the victim;

Women comprised a larger percentage of all unique perpetrators than men, 53.8 percent compared to 44.4 percent;

and Four-fifths (83.2%) of all unique perpetrators were between the ages of 20 and 49 years.

….Forty-four States reported that more than 3 million children received preventive services;
http://www.acf.hhs.gov/programs/cb/pubs/cm09/cm09.pdf

Casey Anthony Case Overshadows Widespread Abuse and Neglect of America’s Kids

Casey Anthony Case Overshadows Widespread Abuse and Neglect of America’s Kids  By Kristi Murphy July 15, 2011

The Casey Anthony trial and the terrible story of the death and dismemberment of 8-year-old Leiby Kletsky in Brooklyn this week has captivated our nation like so many high profile cases in the past. While many might believe that cases like this will bring attention to the issue of protecting our children, at the end of the day these individual stories only highlight the tip of the iceberg. The reality is that 150 children, most under the age of four, die every month from abuse or neglect. While high profile cases do bring awareness, they take our focus off the real issue of suffering children and instead keep us embroiled in speculation and legalities.

Despite intense public and media scrutiny of cases such as Susan Smith in 1994, JonBenet Ramsey in 1996, Andrea Yates in 2001 and Baby Gabriel in 2009, the number of child deaths from abuse keeps rising and these abused children become tabloid fodder. According to the Department of Health and Human Services (HHS), more than 3.3 million reports of child abuse are made every year, or about one every 10 seconds. The 2009 Child Maltreatment report from HHS estimates that 1,770 child abuse deaths occurred in 2009, averaging to five per day and this number is on the rise. Child abuse occurs at every socioeconomic level, across ethnic and cultural lines, within all religions and at all levels of education. Child abuse is an epidemic and brutal deaths happen every day in neighborhoods just like those in which we all live….
http://www.foxnews.com/opinion/2011/07/15/casey-anthony-case-overshadows-widespread-abuse-and-neglect-americas-kids/

Why and how people forget sexual abuse. The Role of Traumatic Memories

includes:
Intergenerational associations between trauma and dissociation.
Dissociation in middle childhood among foster children with early maltreatment experiences.

Trauma Articles, Chapters, & Commentaries – Articles and commentaries on this site are all authored or co-authored by Jennifer J. Freyd.
http://dynamic.uoregon.edu/~jjf/traumapapers.html

Becker-Blease, K.A., DePrince, A.P., & Freyd, J.J. (2011). Why and how people forget sexual abuse.  The Role of Traumatic Memories  In V. Ardino (Ed.),Posttraumatic Syndromes in Children and Adolescents. (pp 135-155)  West Sussex, UK:  Wiley/Blackwell.
http://dynamic.uoregon.edu/~jjf/articles/bbdf2011.pdf

Hulette, A.C., Kaehler, L.A., & Freyd, J.J. (2011).  Intergenerational associations between trauma and dissociation.  Journal of Family Violence, 26, 217-225.

Abstract. The purpose of this study was to investigate intergenerational relationships between trauma and dissociation. Short and long term consequences of betrayal trauma (i.e., trauma perpetrated by someone with whom the victim is very close) on dissociation were examined in a sample of 67 mother-child dyads using group comparison and regression strategies. Experiences of high betrayal trauma were found to be related to higher levels of dissociation in both children and mothers.

Furthermore, mothers who experienced high betrayal trauma in childhood and were subsequently interpersonally revictimized in adulthood were shown to have higher levels of dissociation than non-revictimized mothers. Maternal revictimization status was associated with child interpersonal trauma history. These results suggest that dissociation from a history of childhood betrayal trauma may involve a persistent unawareness of future threats to both self and children.

….Betrayal Trauma Theory (Freyd 1994, 1996) posits that dissociation is most likely to occur when a trauma is perpetrated by someone with whom the victim has a close relationship. Research has shown that exposure to traumas high in betrayal is significantly associated with dissociation
(e.g., DePrince 2005; Freyd et al. 2001, 2005). In the case of child maltreatment, betrayal trauma theory suggests that a child who is dependent on his/her parent learns to dissociate the experience of parental betrayal and abuse from conscious awareness, in order to maintain an attachment to that parent.

Several studies have identified a link between the experience of maltreatment and heightened dissociation in children (Becker-Blease et al. 2004; Hulette et al. 2008a, b; Macfie et al. 2001a, b; Ogawa et al. 1997). For example, Hulette and colleagues (2008a, b) found that maltreated
preschool-age children in foster care had a significantly higher mean level of dissociation than non-maltreated children.

Children who experienced multiple forms of maltreatment were the most highly dissociative.  These findings are in accord with betrayal trauma theory (Freyd 1996), as children experiencing different kinds of abuse may have a greater need to be dissociative in order to preserve a relationship with caregivers.

Betrayal trauma seems to have long-term effects on  dissociation as well. In a prospective longitudinal study, Ogawa et al. (1997) found that maltreatment predicted dissociation across developmental
periods (i.e., infancy, preschool, elementary school, adolescence, and young adulthood). Dissociation is also present in adult survivors of childhood betrayal trauma (Coons et al. 1988; Loewenstein and Putnam 1990; Putnam 1997; Putnam et al. 1986; Ross et al. 1991)….
http://dynamic.uoregon.edu/~jjf/articles/hkf2011.pdf

Hulette, A.C., Freyd, J.J., & Fisher, P. A. (2011). Dissociation in middle childhood among foster children with early maltreatment experiences. Child Abuse & Neglect, 35, 123-126. Dissociation, defined as “a disruption in the usually integrated functions of consciousness, memory, identity, or perception of the environment” (American Psychiatric Association, 2000), has been hypothesized to develop in response to caregiver maltreatment and betrayal (e.g., Briere & Runtz, 1988; Chu & Dill, 1990; Freyd, 1994; Hornstein & Putnam, 1992; Liotti, 1999; Putnam, 1993; Sanders&Giolas, 1991; Terr, 1991).

Further, researchers have recently identified a link between maltreatment and the experience of high dissociation in early childhood (Becker-Blease, Freyd, & Pears, 2004; Hulette, Fisher, Kim, Ganger, & Landsverk, 2008; Hulette, Freyd, et al., 2008; Macfie, Cicchetti, & Toth, 2001a; Macfie, Cicchetti, & Toth, 2001b; Ogawa, Sroufe, Weinfeld, Carlson, & Egeland, 1997). Macfie et al. (2001a) found a significant increase in dissociation in preschoolaged children over a 1-year period, suggesting that early maltreatment has long-term effects on dissociation.

They also found that severity and chronicity of maltreatment were associated with dissociation and that physical abuse was associated with dissociation in the clinical range (Macfie et al., 2001b). Hulette, Freyd, et al. (2008) examined dissociation with the children in the current sample when they were preschool aged. In addition to the finding that maltreated preschool-aged foster children had significantly higher mean levels of dissociation than nonmaltreated children, they found the highest levels of dissociation in children who had experienced moderate–high physical abuse with emotional maltreatment and neglect.

In another sample of preschool-aged children, Hulette, Fisher, et al. (2008) found that children who had experienced multiple forms of maltreatment (i.e., neglect, and physical, sexual, and emotional abuse) showed the highest dissociation….In this study, we examined dissociation in school-aged foster children who had been maltreated in early childhood.

The finding that foster children continue to be highly dissociative years after maltreatment experiences supports previous research findings….

Summary – The findings from the current study suggest that the experiences of early maltreatment and foster care are related to later dissociative symptoms in school-aged children, and that girls are more susceptible to dissociative symptoms. It is important for practitioners to consider these factors to prevent pathological problems that could negatively impact other areas of such children’s lives.
http://dynamic.uoregon.edu/~jjf/articles/hff2011.pdf