Child Abuse and Neglect: Effects on Development and Relationships

This article describes the effects of chronic maltreatment, such as can occur in an orphanage, on a child’s psychological development, brain development, and later relationships. There are clear links between maltreatment and later psychological, emotional, behavioral, and interpersonal issues. The basis for this linkage is the impact that maltreatment has on brain development. Daniel Siegel, medical director of the Infant and Preschool Service at UCLA, has found important links between interpersonal experiences and neurobiological development.

Neglect, physical abuse, and sexual abuse have profound immediate and long-term effects on a child’s development. The long-term effects of abuse and neglect of a child can be seen in higher rates of psychiatric disorders, increased rates of substance abuse, and a variety of severe relationship difficulties. Child abuse and neglect is an inter-generational problem. Most frequently the perpetrators of abuse and neglect are profoundly damaged people who have been abused and neglected themselves.

We know that a child uses the parent’s state of mind to regulate the child’s mental processes. The child’s developing capacity to regulate emotions and develop a coherent sense of self requires sensitive and responsive parenting. The National Adoption Center found that 52% of adoptable children have attachment issue symptoms. In another study, by Cicchetti and Barnett, 80% of abused or maltreated infants exhibited attachment issue symptoms. The best predictor of a child’s attachment classification is the state of mind with respect to attachment of the birth mother. A birth mother’s attachment classification before the birth of her child can predict with 80% accuracy her child’s attachment classification at six years of age. That is a remarkable finding. Finally, recent research by Mary Dozier, PhD, found that the attachment classification of a foster mother has a profound effect on the attachment classification of the child. She found that the child’s attachment classification becomes similar to that of the foster mother after three months in placement. These findings strongly argue for a nongenetic mechanism for the transmission of attachment patterns across generations.

Children who have been sexually abused are at significant risk of developing anxiety issues (2.0 times the average), major depressive issues (3.4 times average), alcohol abuse (2.5 times average), drug abuse (3.8 times average), and antisocial behavior (4.3 times average).

Generally, the left hemisphere of the brain is the site of language, motor activity on the right side of the body, and logical thought based on language. The right hemisphere of the brain is responsible for motor activity on the left side of the body, context perceptions, and holistic perception. The orbito-frontal cortex (the part of the brain directly behind the eyes) is responsible for integrating emotional responses generated in the limbic system with higher cognitive functions, such as planning and language, in the cerebral cortex’s prefrontal lobes. The left orbito-frontal cortex is responsible for memory creation, while the right orbito-frontal cortex is responsible for memory retrieval. Healthy functioning requires an integrated right and left hemisphere.

A substantial number of synaptic connections among brain cells develop during the first year of life. An integrated brain requires connections between the hemispheres by the corpus callosum. Abused and neglected children have smaller corpus callosum than nonabused children. Abused and neglected children have poorly integrated cerebral hemispheres. This poor integration of hemispheres and underdevelopment of the orbito-frontal cortex is the basis for such symptoms as difficulty regulating emotion, lack of cause-effect thinking, inability to accurately recognize emotions in others, inability of the child to articulate the child’s own emotions, an incoherent sense of self and autobiographical history, and a lack of conscience.

The brains of abused and neglected children are not as well integrated as the brains of non-abused children. This helps explain why abused and neglected children have significant difficulties with emotional regulation, integrated functioning, and social development. Conscience development and the capacity for empathy are largely functions of the orbito-frontal cortex. When development in this area of the brain is hindered, there are important social and emotional difficulties. It is very interesting that the orbito-frontal cortex is sensitive to face recognition and eye contact. Abused and neglected children frequently have disorders of attachment because of their birth-parents lack of sensitive responsive interactions with the child.

Early interpersonal experiences have a profound impact on the brain because the brain circuits responsible for social perception are the same as those that integrate such functions as the creation of meaning, the regulation of body states, the regulation of emotion, the organization of memory, and the capacity for interpersonal communication and empathy. Stressful experiences that are overtly traumatizing or chronic cause chronic elevated levels of neuroendocrine hormones. High levels of these hormones can cause permanent damage to the hippocampus, which is critical for memory. Based on this, we can assume that psychological trauma can impair a person’s ability to create and retain memory and impede trauma resolution.

Abused and neglected children exhibit a variety of behaviors that can lead to any number of diagnoses. However, the effect of early abuse and neglect on the child can be seen in just a few critical areas of development. These areas include emotional regulation, response flexibility, a coherent integrated sense of self across time, the ability to engage in affect attunement with significant others (empathy and emotional connectedness), and conscience development.

The effects of early maltreatment on a child’s development are profound and lasting. It is the impact of maltreatment on a child’s developing brain that causes effects seen in a wide variety of domains including social, psychological, and cognitive development. The ability to regulate emotions and become emotionally attuned with another depends on early experiences and the development of specific regions of the brain. Early maltreatment causes deficits in the development of these brain regions, primarily the orbito-frontal cortex and corpus callosum, because of the toxic effects of stress hormones on the developing brain.

These findings strongly suggest that effective treatment requires an affectively attuned relationship. Siegel stated, “As parents reflect with their securely attached children on the mental states that create their shared subjective experience, they are joining with them in an important co-constructive process of understanding how the mind functions. The inherent feature of secure attachment—contingent, collaborative communication—is also a fundamental component in how interpersonal relationships facilitate internal integration in a child.” This has implications for the effective treatment of maltreated children. For example, when in a therapeutic relationship the client is able to reflect upon aspects of traumatic memories and experience the affect associated with those memories without becoming dysregulated, the client develops an expanded capacity to tolerate increasing amounts of affect. The client learns to self-regulate. The attuned resonant relationship between client and therapist enables the client to make sense (a left-hemisphere function) out of memories, autobiographical representations, and affect (right hemisphere functions).

© Copyright 2008 by Arthur Becker-Weidman, Ph.D., therapist in Williamsville, New York. All Rights Reserved. Permission to publish granted to GoodTherapy.org.

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

  • 32 comments
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  • Steve H

    August 4th, 2008 at 11:44 AM

    Some of this information is quite fascinating. No really all of it is. It just emphasizes even more the need for sex ed classes for information to kids thinking of having children and providing resources for parents across every income level to make sure that the needs of mother and child are always met.

  • Dr. Arthur Becker-Weidman

    Dr. Arthur Becker-Weidman

    August 4th, 2008 at 3:01 PM

    Steve,

    Thank you. I am hopeful that this article will help people understand the pervasive and lingering effects of chronic early maltreatment within a caregiving relationship (aka complex trauma) on brain function and how this causes problems for later development. This, of course, leads to certain implications regarding treatment. In some empirical research I’ve done I’ve found that Dyadic Developmental Psychotherapy is an effective treatment for such children, while “usual care” was found to be ineffective. See, for example, Becker-Weidman, A., & Hughes, D., (2008)“Dyadic Developmental Psychotherapy: An evidence-based treatment for children with complex trauma and disorders of attachment,” Child & Adolescent Social Work, 13, pp.329-337.

  • Michael

    August 5th, 2008 at 2:59 PM

    It is an article such as this that should serve to remind us all how things can become continuous cycles of poor behavior until someone in a family is able to break the pattern and therefore break the unhealthy patterns that reside therein. I am so dismayed to read about innocent children that it seesm do not stand a chance due to the abusive relationships that they have had while growing up and this seems so unfair! They did not ask to be treated this way and to be brought into uncaring and unfit families. That is why I feel it is the responsibility of everyone to step in when we see cases such as this and madate that changes be made and that the abuse end so that these kids stand a fighting chance for a healthy survival and future.

  • Dr. Arthur Becker-Weidman

    August 6th, 2008 at 2:51 PM

    A wonderful book that, on the other hand, shows the resiliency of children and how, even with the negative effects of early trauma on brain development and later behavior, is three Little Words: A memoir by Ashley Rhodes-Courter 2008.

    regards

  • AMH

    August 7th, 2008 at 5:17 AM

    This is a little off topic perhaps but a great message that I saw somewherethe other day was that children need models, not critics. This is so true. We need to pay more attention to how we treat the children of the world, in the womb and once they are here, because we really have no idea just how much we influence their lives through not just words but our actions too.

  • Dr. Arthur Becker-Weidman

    August 7th, 2008 at 10:16 AM

    Dear AMH,

    your comment is not off topic at all. The idea that what we do is often more important than what we say is especially important in helping children with histories of complex trauma and disorders of attachment. Experience, in and of itself, can be quite therapeutic. In fact, that is one of the essential elements in Dyadic Developmental Psychotherapy, which is an evidence-based treatment for such children with demonstrated effectiveness (see various professional peer-reviewed publications for details).
    Thanks for your comment

  • Kyle

    August 10th, 2008 at 4:28 AM

    It still just baffles me that there are people out there who can treat children in this way.

  • WBR

    August 10th, 2008 at 5:43 PM

    Thank you so much for sharing this with the world. I find it most fascinating to learn.
    I am a thirty six year old woman who was horrendously abused for twenty years of my life by a drug addicted, alcohlic mother. She abuses me to this day, except I can now come and go as I please, being an adult.
    I have suffered, right back as far as I can recall from this, many times, wanting to take my own life to end the pain.
    It is sites such as this that help me understand more about what is going on inside my own mind and the reasons I do what I do.
    When I read that my behaviours and thought processes are not so unusual after all, it makes it that little bit more bearable.
    One day I will be free; that day is not far away, I am sure.

    In the meantime, thank you sincerely for all that you do in helping many others, including me, understand some of these issues so much more.

  • Arthur Becker-Weidman, Ph.D.

    Arthur Becker-Weidman, Ph.D.

    August 11th, 2008 at 4:43 AM

    WBR,

    You are welcome. I’m glad that this helped. If you wanted to read more about Dyadic Developmental Psychotherapy, you can look at Creating Capacity For Attachment, 2005, Wood N Barnes publishers.

  • Shannon

    August 11th, 2008 at 10:04 AM

    WBR, I am so sorry to hear that this is something you have had to deal with in your life. I certainly am glad that being a part of this forum is helping you see that you are not alone and that what you are feeling is normal in your situation. I hope that one day you will be free of your past abuse and feel hope when you look toward your future. Blessings.

  • tina

    August 12th, 2008 at 10:51 AM

    I too was abused as a child by a family member and I cannot tell you how emotionally draining the whole experience has been for me over the years. There have been others in my family who have refused to talk to me because I had the need to get everything out in the open and to start anew with a clean slate. It has taken me years to deal with my past and I still do every day but there is something so great about just getting it all out in the open and choosing to live life for the present and not in the past.

  • Dr. Arthur Becker-Weidman

    Dr. Arthur Becker-Weidman

    August 13th, 2008 at 6:43 AM

    You are both brave. Resolving trauma requires that the trauma be revisited and integrated into a coherent sense of self. This can be difficult and painful, and is necessary to resolve trauma.

    regards

  • Doyle

    August 28th, 2008 at 9:56 AM

    Isn’t it sad that there are still people who abuse their children because of their own issues with anger? Either they do not know what kind of lasting damage they can do to a child or they do not care.

  • Dr. Arthur Becker-Weidman

    Dr. Arthur Becker-Weidman

    August 28th, 2008 at 2:20 PM

    Doyle,

    It is quite sad and also quite true. There is an “inter-generational” dimension to child abuse. Mary Main and others have written extensively about how this is communicated via the attachment relationship and how it perpetuates the cycle of violence. I tend to think of it this way. What is means to be a woman, mother, spouse…man, father, spouse is learned by observing, experiencing, and relating to the models ones grows up with. How can we expect someone to act differently if their only experience is with abuse…that is the model in their head…the model of relationships that they then enact. Good treatment, such as Dyadic Developmental Psychotherapy, acts to change these internal working models (Bowlby) through the intersubjective sharing of experience and the creation of new and reparative experiences (See Becker-Weidman, A., & Shell, D., Creating Capacity for Attachment (2005), Wood N Barnes, Oklahoma City, OK for details on this treatment).

    regards

    art

  • AK

    October 29th, 2008 at 6:20 AM

    I’m completing some research work on the effects of child abuse/neglect on development, particularly educational achievement (this is for a master’s class, but I currently work in child protection)… for reference, do you have any additional works or studies you could recommend regarding this specific subject (education)?

  • Dr. Arthur Becker-Weidman

    Dr. Arthur Becker-Weidman

    October 29th, 2008 at 9:17 AM

    There are several ways you could find resources.

    Two books that may be helpful are
    Attachment in The Classroom by H. Geddes
    Inside I’m Hurting by Bombier
    both books are published by Worth Publishing, 2007.

    alternatively, you can go to your reference librarian and find the reference that lists articles that cite articles of interest. So, for example, if there is one particular article I cite in my material you found helpful, look to see what other more recent articles cite that one. You could also just brouse the current issues of journals that seem in the right area.

    I hope this helps.

    regards
    Art

  • Wendy

    November 23rd, 2008 at 8:19 AM

    Thanks so much for this article. It is well needed. so many people go through abuse whether it be substance, verbal or physical. I believe that verbal is just as bad as physical because it is implanted in a child’s memory and once they get older, they recall back on this if something triggers it. It is sad to see children go through any kind of abuse and the abusers really need to get help on controlling this.

  • Dr. Arthur Becker-Weidman

    Dr. Arthur Becker-Weidman

    November 23rd, 2008 at 3:50 PM

    Dear Wendy,

    You are welcome. In addition, neglect can be as damaging as physical abuse. The effects can be quite insidious: low self-esteem, problems with behavioral and emotional regulation, attachment, biology, etc. On the other hand, it is sometimes amazing how resilient some children are; that can be heartening. I also find it encouraging that there is an effective treatment for children who have experienced chronic early maltreatment within a caregiving relationship; Dyadic Developmental Psychotherapy being an evidence-based approach for this.

    regards
    Art

  • terri

    February 24th, 2009 at 7:18 PM

    I am a female, 62 years old. When I was born, I only weighed 2.5 pounds. This was a very small midwest town. Back then, babies that small just did not survive. I was put in an incubator, and someone had to manually pump on a tiny bellows placed in my mouth, to breathe for me, s my lungs did not work. Other than that, and for feedings, no onw ws allowed to see me or touch me or look at me. I was in that incybator for three months. I have memories of it. Then, I went home. I was raised in a horribly abusive household, abused sexually, vebally, physically, by both parents. I was raped when I was five, and my mother yelled at me and blamed me for it. Since this was an army post, I had to testify in a court martial. No support ot emotional empathy from anyone. I was just a terrified and forlorn neglected five year old waif. I also have deeply imbedded memeories of these events. I have been in therapy continously for most of my adult life. I am permanently disabled with PTSD. Dr. Balswim’s traum pages have been very enlightening. His specialty is PTSD, but he also has a subspeciality about PTSD in infants, and the kind of neglect I suffered at birth predisposes children to PTSD, especially when it is then compounded by being raised in a hostile environment. I have scars on my body from where my dad used to beat me with his army belt, buckle first. My mother used her fists and broom handle, and kicked us as we lay on the floor. When my father was beating me, I had to be nude, and my mother stood in the corner and laughed.

  • Jk

    November 26th, 2012 at 12:27 AM

    Hi Terri,

    I am sorry to here that these terrible things happened to you from childhood. Your parents and my parents should hook up and go bowling! I am serious, there should be a corner of the earth for people like this, people who abuse children should be banned into isolation on some shitty island where there is no fresh drinking water just salt water to dehydrate their miserable bodies! Your story regarding your past made me feel physically sick, how could anyone abuse a child that is 2.5 pounds, a kid like this should get even more love and caring then a full term child. Your mother is an ” A” hole for not protecting you, you should tell her that everyday first thing in the morning, on the phone before you start your day! Trust me it will make you feel better. People think that if you just let the past be the past and say nothing to the person who hurt you then you will heal, but that is BS! Actually that is what is wrong with society, why there is so much bullying in the school system, why there are handfuls of sexual predators per square foot in every city, it’s because people today don’t speak their minds and direct their anger to the person who deserves it. Instead we go to a shrink to vent, a person who was not even there at the time that we were being abused! I don’t know if your parents are still around, but if not you should scream at their grave sites if they are not alive today. You will feel better inside. BTW, I am not telling you this to be cruel, you should have no love for a person who does the terrible things your parents have done to you.

  • Wendy

    May 25th, 2010 at 4:22 PM

    Thank you so much for this article! I am doing a project in college that has to do with a correlation and I chose Child Abuse and Interpersonal Skills. This article carried me through my whole project, very informative and true. Helped me understand all the damage that abuse has in the brain of a child and the sad effects that follow along as they grow to be adults. Thanks.

  • Dr. Arthur Becker-Weidman

    Dr. Arthur Becker-Weidman

    May 25th, 2010 at 4:47 PM

    Wendy & Terri,

    I am glad that you found my article of value. You may want to read my book, Creating Capacity for Attachment, as it provides a lot more details.

    regards

  • Jim

    November 27th, 2010 at 9:05 AM

    Thanx for the interesting discussion here. I grew up with a mentally ill mother and an uninvolved father. Me and my brother and sister all have mental health issues in adulthood. My sister is a nun living in New Mexico and has recently sought help for anger issues. I work with my brother who is very self-defensive and has no friends outside of work. I have these same issues to a lesser degree. I find it sad that my two older sisters knew of our situation and yet did nothing. I harbour a lot of anger towards them and my mother. It is very refreshing to read online about the problems that effect other adults and to know that we aren’t alone. I can’t help but feel like we have been cheated out of a “normal” adult life. It’s something that we, as siblings, have to work through everyday.

  • Arthur Becker-Weidman, Ph.D.

    Arthur Becker-Weidman, Ph.D.

    November 27th, 2010 at 2:54 PM

    Dear Jim,

    You do not have to continue to feel “cheated” out of a normal life. Trauma, neglect, and past negative experiences can all be come to terms with and resolved, with the right support, treatment, and help. I encourage you to seek out assistance and work this through so that it has less of a negative hold on your life.

    best wishes,

    Art Becker-Weidman

  • Jannie

    June 16th, 2012 at 1:44 PM

    My heart goes out to all those that have suffered abuse. I cried reading your stories, and pray that peace feels your heart and soul. I wish I could hug you all and tell you how special and wonderful you are and how you did nothing to deserve that kind of life, my heart hurts for you. I hope you find peace and healing in this life.

  • Arthur Becker-Weidman

    Arthur Becker-Weidman

    June 16th, 2012 at 6:10 PM

    thank you

  • Jk

    November 21st, 2012 at 12:23 AM

    What is the reason that people just don’t understand that if someone abuses you in anyway at all……..then you cut ties with them…..period!!!!! The second time is not a mistake it’s on purpose! My mother was so insane and abusive to me and my sisters when we were kids that I didn’t think I would make it to my sixteenth birthday. I really never expected to turn sixteen alive anyway. I am going to skip the things that my mother did to me because the few people that I have told still have a problem believing the abuse that went on in our home when I was a kid. I was completely isolated from society at times and your worst nightmare was the best day at our home, have you seen Halloween the movie? That was my mother without michael myers mask, I became good at hiding from her in our house as she looked for me with a large kitchen knife, going from room to room! Her face seemed to have been possessed or changed in some way when I saw her through a closet door when I was hiding from her one day. My mother was naturally crazy, but a functioning working person at the same time. She had a career believe it or not and she had finished medical school and is a doctor. So who is going to believe me? My father is a scientist who works for the government, all his time is spent at work and ignoring what was going on at home! I left at sixteen so that I had a chance to live, my mother told me that if I left that I would not get a dime from them and she meant it! My sisters get everything and I get nothing but my freedom which suits me fine, my point is that freedom is an asset most people don’t see it that way but freedom is as important as air,water,sunlight,food,shelter or love!

  • Arthur Becker-Weidman

    Arthur Becker-Weidman

    November 21st, 2012 at 6:05 AM

    Dear JK,

    Thank you for your sensitive and open comment. Living in constant fear and suffering chronic maltreatment by a caregiver or parent beginning at a young age leaves lasting and chronic scars. The effects on brain functioning is deeply embedded in neural pathways. As with so many thing, the “cure” requires the correct treatment. Attachment-focused treatment (see center4familydevelop for details) is an example of an evidence-based and effective treatment.

    When maltreatment begins early, it affects the “lens” through which one views self, other, the world, and one’s options. Often the child not only has not options for “freedom,” as you wonder about, but cannot even see that such might exist…think of it as a sort of “color-blindness.”

    Again, thank you for your comments.

    Best regards

    Art

  • Jk

    November 22nd, 2012 at 8:10 PM

    Hi Art,

    Thanks for your response, since my mother was like a bridge troll what can be done about my recovery now, other then not talking to her again. I feel like strangling her but she is such a miserable piece of work that I think she would go out with smile on her face, which would be like having the last word. What she I do to recover?

  • Arthur Becker-Weidman

    Arthur Becker-Weidman

    November 23rd, 2012 at 6:41 AM

    Dear JK,

    I’d suggest you locate a therapist who has an understanding of such relationship issues. You can find such a listing on this site and at center4familydevelopm.com or at the website for the Attachment-Focused Treatment Institute.

    best regards,

  • Jk

    November 25th, 2012 at 11:59 PM

    Hi Art,

    For many years, I have just ignored my feeling towards the subject of my mothers abuse towards me, I just thought that keeping my feelings inside would make them vanish someday! It did not work i guess. What I hate the most is when a person who has an important and valued job in the eyes of society is accused of something terrible, society frowns upon the victim that may not have such a pressing career! Thank you for your previous guidance on the subject, I will take your advice into consideration. JK

  • Aneri Okis

    May 31st, 2013 at 2:34 AM

    I grew up in a emotionally abusive environment. I witnessed my father hitting my mother and their verbal abuse was horrific at times. I was also sexually abused by my mother. This lead to me seeking out a man who treated me just as bad if not worse than what I grew up with. He also raped me and almost killed me at one point. I am now going to a support group and I recognize that the impact this has had on me has been significant. I tend not to deal well with intense emotions at all. I try to use logic to solve an intense emotional feeling but it makes it worse not better. I can’t seem to regulate my emotions effectively and I have not the best social skills. I grew up with anxiety and had a major panic attacks on and off for most of my life. My parents affected my development and now I trying to heal from it.

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