Childhood abuse and neglect produce severe emotional and social dysfunction in adulthood, researchers said Saturday.
Children who are abused or neglected grow up to have lower IQs and lower reading scores, three different research groups reported here at a meeting of the American Assn. for the Advancement of Science. They are also more likely to suffer from alcohol and drug abuse, to suffer clinical depression or to attempt suicide. Finally, they are more likely to be unemployed or to be arrested, both as juveniles and in adulthood.
The new results confirm much of the conventional wisdom about the disastrous effects of childhood abuse, but they indicate that the problem is more severe than was previously believed.
The results also dispel at least two well-ingrained notions: that temperamental children are more likely to be abused and that sexual abuse of girls leads directly to prostitution.
In a fourth study, New York researchers found that the incidence of abuse could be dramatically reduced in high-risk families by in-home visits from trained nurses.
“The harm to children from abuse and neglect can have enormous long-term consequences,” said psychologist Cathy Spatz Widom of the State University of New York at Albany. But the knowledge gained from these studies should also identify characteristics of children who survive or thrive under these stressful conditions and “should help others living through these experiences,” she said.
Abuse of children is widespread. A recent study showed that, in 1986, about six children per 1,000 suffered physical abuse, two suffered sexual abuse and 16 suffered neglect, which is defined as severe omission of adequate food, clothing and medical attention. But such cases are often hard to identify, according to social scientist Roy C. Herrenkohl of Lehigh University in Bethlehem, Pa., so those numbers may be underestimates.
Widom is the director of a National Institute of Justice study in which 1,575 children, about half of them abused or neglected, were traced for a 20-year period after the incidents of abuse.
Previously published results of this study have shown that being abused or neglected as a child increases a person’s risk of arrest as a juvenile by 53%, as an adult by 38% and for a violent crime by 38%. Abused and neglected children are also involved in delinquency and criminality at earlier ages, commit more offenses, more often become chronic or repeat offenders and are more likely to commit violent behavior, the study found.
The new results extend this study to non-criminal behaviors. Widom’s preliminary results are based on interviews with 500 of the original subjects, most of whom are now in their 20s.
Widom found that about 18% of the adults who had been victims of childhood abuse or neglect had attempted suicide, compared to 7.5% of their nonvictimized counterparts and 3% of the general population. Abused or neglected girls were more apt to attempt suicide than boys, she said.
About 45% of the abused and neglected group mistreated alcohol, and 25% were drug users, she said, compared to 35% and 23%, respectively, for the controls. About 22% of the victimized group did not have jobs, compared to about 12% of the controls.
For the girls, she noted, “there is no direct connection between being sexually abused and becoming an adult prostitute.”
The victimized group had an average IQ of 87--10 points lower than the control group and 13 points below the general average of 100. Standard tests also found “severely depressed” reading ability among the abused and neglected, Widom said.
Widom could not determine whether abuse and neglect lowered the subjects’ IQs or whether they had lower IQs to begin with. But earlier studies of children in high-risk families suggest that neglect lowers IQ, said child psychologist Byron Egeland of the University of Minnesota.
Infants in earlier studies were found to have a Bayle score--which is roughly equivalent to an IQ--of 120 at age 1. In those who were neglected, the average Bayle score dropped to 80 by age 2. “They simply lost interest in exploring their environment,” he said.
Egeland reported on a study of 23 children who were physically abused during their early school years. He made a special effort to separate the effects of low socioeconomic status, which is known to increase the likelihood of abuse. When those effects were eliminated, he found “abuse had an effect on every variable we looked at.”
The abused children were more likely than others to be retained in grade or placed in special education programs, and they compiled lower achievement scores. They had difficulty following directions and working independently and were less likely to be socially accepted by their peers. All of the abused children, but especially the boys, also exhibited “acting out” problems, such as aggressiveness, angriness and distractibility.
The children’s problems became especially evident when they were asked to make up stories about scenes shown on specially prepared cards. “They tended to describe the acts, but couldn’t give a reason for them,” Egeland said. A normal child, for example, might see a picture of a boy falling down and say he slipped on a banana peel; the abused child would simply say the boy was falling down without ascribing a cause.
These results suggested that the children had a very strong feeling of helplessness, Egeland said.
Egeland also said that his and earlier studies show temperamental children were no more likely to be abused than other children. “I’m amazed at what little effect temperament has,” he said.
Herrenkohl and his associates found results similar to those of Widom and Egeland in a study of 457 abused and normal children followed since 1976. They found that the severity of discipline administered to children was directly related to their social dysfunction. Those who received the most severe discipline, such as beatings, were most likely to grow into problem adolescents and adults.
Some hope for the future was offered by pediatrician David L. Olds of the University of Rochester. He studied 400 high-risk women, half of whom received in-home visits from nurses during the pregnancy and until the infant reached age 2. The visits were designed to promote the health of the women and their children.
The program produced improvements in the women’s health-related behaviors, such as smoking and diet, increased their use of community services and led to longer gestations and higher birth weights. “We also found an 80% reduction in verified cases of child abuse and neglect for women at greatest risk . . . poor, unmarried teen-agers,” Olds said.
The women were monitored for an additional two years after the nurse visits ended. The researchers found that the visited women had fewer subsequent pregnancies and were more likely to be employed. Emergency room visits for injuries and ingestion of dangerous materials for the children were 43% lower among the visited families.
Finally, visits to all the homes at the end of four years showed that the homes visited by the nurses previously had fewer hazards for the children and more objects, such as books and games, to provide intellectual stimulation. As a result, those children showed greater development of language abilities.