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Nanay, Tatay gusto kong kalinga. Ate, Kuya wag nyo kong api:
Phenomenological Study of a Battered Child
Submitted to:
Submitted by:
Group 6
MH: 12:00-1:30pm
2
CHAPTER I
Problem and Context
INTRODUCTION
nation. Each year, approximately 800,000 children in the United States are victims of
and neglect (U.S. Department of Health and Human Services, 2010, p. xiii). The federal
law defines child abuse and neglect as a recent act or failure to act on the part of the
caregiver which results in death, serious physical or emotional harm, sexual abuse or
Child Abuse Prevention and Treatment Act (CAPTA) (U.S. Department of Health and
Human Services, 2003, p. 44). Child abuse as well as other forms of maltreatment, such
as neglect, is a severe issue in the United States, but the scope of the problem is much
more broad. Internationally, between 25-50% of children report being physically abused.
Statistics such as this illustrate how child maltreatment is a global crisis with the
potential for serious lifelong implications (World Health Organization [WHO], 2010).
behavioral, and emotional development and often well into adulthood. Recent research
has shown that childhood maltreatment is associated with negative health outcomes
and adolescent violent behaviors. Many individuals who experience maltreatment such
as neglect or abuse are greatly affected beyond childhood and adolescence; there is a
significant relationship between child abuse and psychological Early Childhood Abuse
3
and Neglect 2 disorders in adulthood (Hussey, Chang, & Kotch, 2006). Because of this,
it is important to recognize the severity of child maltreatment and its effects on the
psychological well-being of children and adults in order for progress regarding the
who experience abuse or neglect in early childhood was particularly important to me for
several reasons. Through my family members, I have seen the tremendous negative
impact child abuse can have on an individual, emotionally and developmentally. The
the San Luis Obispo Child Development Center (SLO CDC), an educational classroom
center for children at risk of abuse and neglect, would be most suitable and valuable to
me. After spending time with the children at the center, my interests blossomed and I
developed a desire to know more about the conditions that result from abuse and
Social Work, and it is likely that eventually I will work with individuals who have
experienced trauma of this sort or other situations that lead to negative behavioral or
psychological effects.
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Theoretical Framework
The Battered-Child Syndrome, transforming the way we see our society, has
inevitably made us all more suspicious of the world around us. Every medical student,
every police officer, every teacher, is fully aware of the dark side of family life, and the
possibility that children are victims and parents are perpetrators. Statistics gathered by
the U.S. Department of Health and Human Services (2010) show that younger children
are more victimized by maltreatment than older children and adolescents, in fact, infants
ages zero to one year old are the most targeted early childhood age group with 21.7%
of all maltreatment cases involving infants (Maestripieri & Carroll, 2009). The two most
common types of maltreatment are neglect and physical abuse; 71% and 16.1% of
maltreated children suffer from neglect and physical abuse, respectively (U.S. Dept. of
Health and Human Services, 2010, p. xiv). Because of these alarming numbers, there is
a great deal of research trying to uncover more about the incredible frequency at which
child maltreatment occurs as well as the detrimental effects the acts have on their
victims. Many theories have been formulated on this topic, and significant findings have
suggests that various levels of exposure to trauma, specifically pertaining to abuse, can
lead to the likelihood of involvement in a violent relationship later in life (Fox, Robson, &
who are victims of abuse, or witness family members being victims of abuse, develop
One study of the Intergenerational Transmission Early Childhood Abuse and Neglect 4
Theory found that women who reported experiencing abuse as children were two
to three times more likely to experience Intimate Partner Violence (IPV) than women
who did not report being abused as children (Alexander, 2009). Some children and
depending on the physical environment in which they live and grow. Those who
experience abusive situations during cognitive development are more likely to develop a
trauma can generate aggression and increases the likelihood of modeled abuse
behavior. The Mimetic Theory describes individuals who view a perpetrator of abuse as
powerful or admirable and therefore learn to act violently in order to imitate, or mimic,
acts of violence (Craig & Sprang, 2007). This theory is, in some ways, the reversal of
the Intergenerational Transmission theory of abuse because individuals who are victims
victims learn to accept violence. Many individuals in this situation witnessed family
members being victims of abuse or were victims themselves. This theory of mimicked
actions incorporates a basic longing for power. The victim sees the perpetrator as
powerful, and in order to assert his own power or to recapture power that was taken
from them, the witness or victim becomes a perpetrator of aggression or abuse himself
(Craig & Sprang, 2007). Environment also has a large impact on those who are
physical aggression can develop an unhealthy idea of aggression exertion. Some may
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think the Mimetic Theory only reveals a mimicking pattern of aggression for boys
because of the common general assumption is that males are more aggressive than
Early Childhood Abuse and Neglect 5 shows that aggression in boys is shown
relational. Therefore, it is possible that girls may also learn aggressive behavior and
isolation, but must be examined within the context of the family. Many situations that
take place within families lead to strong emotional stressors. These stressors are risk
factors for the occurrence of abuse and should be resolved as soon as possible.
Families that experience some of these severe life stressors such as severe or enduring
illnesses, unemployment, financial problems, and relational problems within the family
unit, usually have a higher rate of child abuse than families without such stressors
(Crosson-Towner, 2005). Abusive parents have been seen to have less enjoyment of
their children and of general parenting experiences. They also typically exert a more
(Mapp, 2006). Some cultures or families may find authoritarian parenting to work best,
but many problems have been seen when this style is used. Many families entangled in
find little support and are extremely isolated from others (Crosson-Towner, 2005).
Social isolation is a significant risk factor whether it is within the community, extended
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for family members both for parents dealing with many stressors as well as for the
Without intervention and treatment, children that experience abuse within the
family system can likely develop some of the same social and psychological risk factors
A Social Support Theory of abuse and neglect and the lack of support given to
above, but it also suggests why mothers are statistically shown to be the most common
general household duties may have become more balanced between couples in recent
decades, mothers are still the primary caregivers and are given very little direct
childrearing support. Since mothers are likely to spend the most amount of time with
their children, it provides them with the most opportunity to exert abusive behavior
toward children (Chang, Theodore, Martin, & Runyan, 2008). As well as abuse, mothers
also are most likely to neglect their children because they are largely responsible for the
daily necessary care and protection children should receive and have the control to
constructive environment, but in order to do so they need social support. Women who
Theory, are at least twice as likely to exhibit abuse towards their children than those
women who have a healthy, supportive relationship with their partner (Mapp, 2006).
Women who are depressed have a diminished ability to parent effectively; these
mothers have difficulty communicating with their children and have more naturally
negative interactions with them. The family environment of a depressed mother is often
hostile, aggressive, and rejecting (Mapp, 2006). These factors are an Early Childhood
Abuse and Neglect 7 example of how unstable family systems can lead to a higher risk
involving abuse as well as neglect. Attachment Theory states that either secure or
insecure bonds may form between infant and mother in the first several months of the
infants life for the purposes of safety and security. The bond formed between infant and
mother influences the quality of the relationships a child has throughout his or her life.
One major assumption of the Attachment Theory is that the parents are a sanctuary of
safety throughout all of early childhood. Secure attachments cause children to develop
(Tarabulsy, Pascuzzo, Moss, St-Laurent, Bernier, & Cyr, 2008). Research shows that
maltreatment during infancy can often lead to insecure attachment relationships in the
insecure-ambivalent, but a forth style has recently been recognized. The newly
2008). In the disorganized attachment style, parents act frightened or frightening in the
presence of their child, causing distress for the child. Parents might appear to be
frightened at how to properly manage their child if they do not feel capable or supported
in their responsibilities. A parent frightening their child might occur if the parent is
extremely harsh or authoritarian in their parenting style or if the parent has a strong or
associated with Early Childhood Abuse and Neglect 8 high levels of risk of future
probability of future problems of all the different attachment styles (Tarabulsy et al.,
2008). Unhealthy attachments not only lead to poor child-caregiver relationships, but
Similar to the Attachment theory, the Parental Investment Theory suggests that
parents sometimes decreases or completely cease investment in their young when the
opportunity costs outweigh parental benefits (Maestripieri & Carroll, 1998). Children who
have abnormal physical features or a physical or mental disability are at risk for
because the parent may not feel the child is what they expected him or her to be or
because the child has failed to fulfill the expectations of the parents, whether realistic or
unrealistic (WHO, 2010). A lack of parental investment can also occur because of an
unhealthy attachment between parent and child; if a significant amount of bonding did
not occur between the parent and the child, parental investment is likely to be lower
(WHO, 2010). Another opportunity cost of parenting that could affect parental
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different use of their finances than investment in their children, they are likely to take
The study attempts to appraise and ascertain different effects of child abuse to
A. Age
B. Gender
C. Educational Attainment
D. Family Structure
3. What are the physical, mental, emotional, and social effects of child abuse to
children?
individual?
Research Paradigm
Research paradigm is consists of three parts: the Input, the Process, and the
Output. The Input box contains the participants profile according to age, gender,
The Process box includes the tools they used by the researchers that are
analysis and direct observation in obtaining their data. It also contains interpretation of
the results gathered through semi-structured interview about how they face their lives.
Lastly, the output box includes the knowledge, understanding and awareness on
they face their everyday lives. It also aims to know the probable solution to help
battered children.
Assumptions
2. The respondents will fully understand the questions they will be asked
This study is limited only to the children at DSWD Marikina ages 2-10 who
happen to be a battered child to be able for them to express themselves and for us to
To battered children this study will help the battered children be able to express their
To family this study will help the families to become aware of the feelings and
To community this can benefit the community and become an instrument for them to
To government authority this research could not be just an aid for the government to
take action on helping battered children but will also illuminate the issue
To future researchers this study will benefit the future researchers to gain additional
and important information that they can use as a basis for furtherance of their research
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Definition of terms
Battered child syndrome the set of symptoms, injuries and signs of mistreatment
seen on a severely or repeatedly abused child
Intervention is the act of inserting one thing between others, like a person trying to
help
Psychological growth means different things to different people. For some people it
means greater freedom to do what they want, live as they want and pursue their
interests
Psychotherapy is a general term for treating mental health problems by talking with a
psychiatrist, psychologist or other mental health provider
Treatment the manner in which someone behaves toward or deals with someone or
something.
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CHAPTER II
Child abuse and neglect is a social and public health problem, as well as a
children's rights issue in Australia. Abuse and neglect can lead to a wide range of
adverse consequences for children and young people. This paper provides an overview
of the possible effects of child abuse and neglect and explores whether different types
adolescence.
Child abuse and neglect refers to any behavior by parents, caregivers, other
adults or older adolescents that is outside the norms of conduct and entails a
substantial risk of causing physical or emotional harm to a child or young person. Such
behaviors may be intentional or unintentional and can include acts of omission (i.e.,
neglect) and commission (i.e., abuse) (Bromfield, 2005; Cristofel et al., 1992; Gilbert et
al., 2009). The five main subtypes of child abuse and neglect are physical abuse,
Not all children exposed to similar experiences of abuse and neglect are affected
in the same way. For some children and young people, the effects of child abuse and
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neglect may be chronic and debilitating; others may experience less adverse outcomes
(Miller-Perrin & Perrin, 2007). A range of other life experiences and family
in the face of maltreatment, resilience refers to the ability of a child to cope and even
Gateway, 2008; Hunter, 2012). When a child who has experienced abuse or neglect
has few protective factors such as positive relationships with extended family and
friends, the risk of more serious adverse outcomes increases a risk factors that may
contribute to poorer outcomes for children exposed to abuse and neglect include socio-
families, a caregiver with depression or alcohol or drug dependence, and whether the
child has a disability (Dubowitz & Bennett, 2007; Jaffee & Maikovich-Fong, 2011).
Factors that contribute to a child's resilience include child attributes (e.g., self-esteem
and independence), features of the family environment (e.g., parenting quality), and
extra-familial and community resources (e.g., high quality peer relationships and school
Critical factors that influence the way child abuse and neglect affect children and
young people include the frequency and duration of maltreatment and the co-
prolonged period of time" (Bromfield & Higgins, 2005, p. 39) has been linked to worse
outcomes than transitory or isolated incidents of maltreatment (e.g., Ethier, Lemelin, &
Lacharite, 2004; Graham et al., 2010; Johnson-Reid, Kohl, & Brett, 2012).
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Research suggests that maltreatment types are interrelated, that is, a large
proportion of children and young people who experience childhood abuse or neglect are
exposed to more than one type of abuse (known as multi-type maltreatment). Further to
this, other forms of victimization such as bullying or assault by a peer have often been
Ormrod, & Turner, 2006). Research indicates that those who experience multi-type
trauma symptoms and worse outcomes than those who are exposed to no maltreatment
or only one type (Finkelhor et al., 2006; Higgins & McCabe, 2001).
Complex trauma reflects the multiple and interacting symptoms, disorders, multiple
adverse experiences, and the broad range of cognitive, affective and behavioral
outcomes associated with prolonged trauma, particularly if occurring early in life and
involving an interpersonal element (e.g., sexual abuse) (Price-Robertson, Rush, Wall, &
Higgins, 2013). Complex trauma affects the developing brain and may interfere with a
child's capacity to integrate sensory, emotional and cognitive information, which may
cognitive, behavioral, physical and mental health problems (National Scientific Council
on the Developing Child [NSCDC], 2007; Perry, 2001; Streeck-Fischer & van der Kolk,
2000).
child abuse and neglect, and complex trauma, see rarely an Isolated Incident:
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Other factors that can affect the consequences of child abuse and neglect on
children and adolescents include: The age and developmental stage at which
maltreatment occurred: some evidence suggests that the younger the child was at the
time of the onset of the maltreatment, the more likely they are to experience problems
later in life; the severity of maltreatment: the greater the severity of abuse or neglect, the
higher the likelihood of negative outcomes; the type/s of abuse and/or neglect: different
young person's perceptions of the abuse: worse outcomes are likely if the
relationship the child or young person had (or has) with the perpetrator: for example, in
child sexual abuse increased negative affects tend to be associated with the perpetrator
being a father, father-figure or someone with whom the child has an intense, emotional
relationship (Bromfield & Higgins, 2005; Miller-Perrin & Perrin, 2007; Price-Robertson et
al., 2013).
serious effects on the developing brain (McCrory, De Brito, & Viding, 2010; Streeck-
Fischer & van der Kolk, 2000). The Center of the Developing Child at Harvard
University has released a range of working papers that critically review the literature on
brain development (NSCDC, 2007; 2010; 2012). They have noted several key
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messages: Brains develop over time and through interaction with the environment.
Chronic, toxic stress of the sort experienced by maltreated children, and particularly in
the absence of consistent, supportive and interactive relationships with adult caregivers,
has been found to have an especially deleterious effect on young children's growing
brains (NSCDC, 2007; 2012). Exposure to complex and chronic trauma can result in
also plays a role in how the brain develops, particularly during the early developmental
Child abuse and neglect can affect all domains of development - physical,
psychological, emotional, behavioral, and social - all of which are interrelated. The
remainder of this paper discusses the possible consequences of child abuse and
neglect identified in the research literature. The research reviewed included high-quality
systematic reviews and primary studies with large representative samples in English-
speaking countries. Adverse consequences are broadly linked to all abuse types;
Babies and young infants exposed to abuse and neglect are more likely to
(Baer & Martinez, 2006; Cyr, Euser, Bakermans-Kranenburg, & Van Ijzendoorn, 2010;
Jordan & Sketchley, 2009; Meadows, Tunstill, George, Dhudwar, & Kurtz, 2011;
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Schore, 2002; Streeck-Fischer & van der Kolk, 2000). Patterns of child-caregiver
attachment are extremely important for a child's early emotional and social
should be the primary source of safety, protection and comfort, becomes a source of
danger or harm (Cyr et al., 2010; Hildyard & Wolf, 2002). Without the security and
support from a primary caregiver, babies and infants may find it difficult to trust others
when in distress, which may lead to persistent experiences of anxiety or anger (Streeck-
Insecure attachments alter the normal developmental process for children, which
can severely affect a child's ability to communicate and interact with others and form
healthy relationships throughout their life (Bacon & Richardson, 2001). Reviews of the
literature have reported that child maltreatment is associated with problematic peer
relationships in childhood and adolescence (Meadows et al., 2011; Trickett, Negriff, Ji,
& Peckins, 2011). Further to this, difficulties in peer relations may be a precursor to
Strong associations have been made between child maltreatment and learning
difficulties and/or poor academic achievement (Gilbert et al., 2009; Mills, 2004; Veltman
& Browne, 2001). Abuse and neglect in the early years of life can seriously affect the
have lower educational achievement than other groups of children (Gilbert et al., 2009).
abuse and neglect was related to poor school achievement and 36 of 42 (86%)
studies associating child abuse and neglect with learning problems are problematic in
that most studies do not know the intellectual status of children before maltreatment. A
more recent longitudinal study of maltreated children in the United States found that
affected reading scores negatively but higher intelligence and daily living skills (e.g.,
ability to dress oneself, ability to perform household tasks) were protective factors
against poor math and reading performance (Coohey, Renner, Hua, Zhang, & Whitney,
2011).
disorder (PTSD) often reported (Gilbert et al., 2009; Greeson et al., 2011; Kearney,
Wechsler, Kaur, & Lemos-Miller, 2010; Schore, 2002; Streeck-Fischer & van der Kolk,
2000). Recent research suggests that diagnosing children with PTSD does not capture
the full developmental effects of chronic child abuse and neglect and as noted
previously, many researchers now prefer the term "complex trauma" (Cook et al., 2005;
and anxiety, mood, psychotic, and adjustment disorders (Kearney, Wechsler, Kaur, &
Lemos-Miller, 2010).
consistently been linked with child abuse and neglect, particularly for adolescents
(Brown, Cohen, Johnson, & Smailes, 1999; Gilbert et al., 2009; Harkness & Lumley,
2008; Kaufman, 1991). In a review of seven large-scale studies, all studies showed a
& Lumley, 2008). For example, the authors cited a longitudinal study by Brown and
colleagues which found that children and adolescents who reported a history of abuse
or neglect were three times more likely to exhibit a depressive disorder than non-
to a therapeutic health service for children who had been abused or neglected (the Take
Two Program), 62% of children met the criteria for at least one mental health diagnosis
also be associated with child abuse and neglect (Brewerton, 2007). Sexual abuse has
experiencing other maltreatment types or multiple forms of abuse and neglect has also
been shown to increase the risk of developing an eating disorder (Brewerton, 2007).
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Youth suicide
Research suggests that abuse and neglect significantly increases the risk of
suicidal ideation and attempted suicide for young people (Brodsky & Stanley, 2008;
Evans, Hawton, & Rodham, 2005; Miller, Esposito-Smythers, Weismoore, & Renshaw,
2013; Thompson et al., 2012). A systematic review by Evans and colleagues (2005)
found a strong link between physical and sexual abuse and attempted suicide/suicidal
literature, Miller and colleagues (2013) found that although all forms of maltreatment
were associated with adolescent suicidal ideation and suicide attempts, child sexual
abuse and emotional abuse might be more important than physical abuse or neglect.
Supporting this, Brodksy and Stanley (2008) found that risks of repeated suicide
attempts were eight times greater for youths with a sexual abuse history. The authors
suggested that sexual abuse could be specifically related to suicidal behavior because it
is closely associated with feelings of shame and internal attributions of blame (Brodsky
The psychological effects of child abuse and neglect may lead to alcohol and
drug abuse problems in adolescence and adulthood (Fergusson & Lynskey, 1997;
Harrison, Fulkerson, & Beebe, 1997; Perkins & Jones, 2004). Evidence suggests that all
types of child maltreatment are significantly related to higher levels of substance use
(tobacco, alcohol and illicit drugs) (Moran, Vuchinich, & Hall, 2004). It is less clear if
particular types of maltreatment are more closely linked to substance misuse and what
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factors, if any, may mediate the relationship although physical abuse and combinations
2011). In surveying public school students in Grades 6, 9 and 12 in the United States,
Harrison and colleagues (1997) found that experiences of physical or sexual abuse
increased the likelihood of students using alcohol, marijuana and other drugs. A further
study in the United States found that 28% of physically abused adolescents used drugs
22% of the non-abused group, 36% of physically abused adolescents also had high
Behavioral problems
Researchers have found that child abuse and neglect is associated with behavior
problems in childhood and adolescence (Ethier et al., 2004; Mills, 2004; Shaffer,
Huston, & Egeland, 2008). The earlier children are maltreated the more likely they are
have often associated maltreatment with internalizing behaviors (being withdrawn, sad,
throughout childhood (Mills, 2004). Longitudinal studies have shown that exposure to a
large, nationally representative study in the United States reported that children who
years and early school years) displayed more problem behaviors than children
maltreated in only one developmental period and children who were chronically
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maltreated tended to display more problem behaviors than children suffering situational
and neglect are at increased risk of inflicting pain on others and developing aggressive
and violent behaviors in adolescence (Gilbert et al., 2009; Haapasalo & Pokela, 1999;
Maas, Herrenkohl, & Sousa, 2008; Trickett et al., 2011). Research suggests that
physical abuse and exposure to family violence are the most consistent predictors of
youth violence (Gilbert et al., 2009; Maas et al., 2008). In a meta-analysis by Gilbert and
between child abuse and neglect and criminal behavior. A National Institute of Justice
study in the United States predicted that abused and neglected children were 11 times
more likely to be arrested for criminal behavior in adolescence (English, Widom, &
Brandford, 2004). Eighty three per cent of children in the Take Two program in Victoria
demonstrated repeated and severe violence towards others (Frederico et al., 2008).
Research investigating the effect child abuse and neglect has on overall physical
health has largely focused on outcomes in adulthood. However, data from the
Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) in the United States has
children/adolescents (Flaherty et al., 2006, 2009). Flaherty et al. (2006) found that
exposure to one adverse experience doubled the odds of children having overall poor
physical health at the age of 6 years, and tripled them if children had experienced four
or more adverse experiences. A further study by Hussey, Chang, and Kotch (2006)
found that all types of abuse and neglect were associated with 8 of 10 major adolescent
health risks.
syndrome. Health problems resulting from shaken baby syndrome may include brain
damage, spinal cord injuries, hearing loss, speech difficulties and even death (Child
Teenage pregnancy
Adverse consequences of teenage pregnancy and risky sexual activity may also
be associated with experiences of abuse and neglect (Fergusson, Horwood, & Lynskey,
1997; Gilbert et al., 2009; Hillis et al., 2004; Mendes & Moslehuddin, 2006; Noell,
Rohde, Seeley, & Ochs, 2001). Research has consistently linked teenage pregnancy
with experiences of sexual abuse (Hillis et al., 2004; Paolucci, Genuis, & Violato, 2001).
Meta-analyses of 21 studies of child sexual abuse reported that this form of abuse more
than doubled the risk of adolescent pregnancy (i.e., prior to age 20 years) (Noll, Shenk,
& Putnam, 2009). Further to this, a study by Fergusson and colleagues (1997) found
that young women (18 years of age) exposed to child sexual abuse had significantly
and higher rates of multiple sexual partnerships and appeared to be more vulnerable to
Homelessness
however, the Australian Bureau of Statistics (ABS) estimated that approximately 25,503
children were homeless on Census night in 2011 (29% of the homeless population)
(ABS, 2012). The Australian Institute of Health and Welfare (AIHW) indicated that
Homelessness services in 2011-12. The main reason for accompanied children to seek
Young people who are removed from the care of their parents because of abuse
or neglect may also face homelessness and unemployment soon after leaving out-of-
home care (e.g., when they turn 18). A lack of social support networks and poor
academic achievement often contribute to the difficulties young people face in finding
Fatal abuse
The most tragic and extreme consequence of child abuse and neglect is abuse
that results in death. The World Health Organization (WHO) estimated 31,000 homicide
deaths of children aged 15 or younger around the world occur every year (WHO, 2010).
and neglect go unreported due to being misattributed to other causes such as falls or
In Australia, all deaths are registered at a state level by the Registrar for Births,
Deaths and Marriages. Statistics are compiled and reported by the ABS, and include
assault. No national data collection exists to describe deaths of Australian children due
to abuse and/or neglect. For further information on child deaths from maltreatment by
sexual abuse and adverse mental health consequences for many victims (Fergusson &
Mullen, 1999; Walsh, Fortier, & DiLillo, 2010). While much of the earlier research in this
area used cross-sectional studies with clinical or convenience samples, more recent
studies have increasingly used large random community samples, birth and twin
cohorts. These more rigorous studies have arguably generated more reliable and
generalisable findings, despite the assessment of child sexual abuse still being
Noteworthy is a series of twin studies conducted over the last decade, which
have consistently revealed a link between child sexual abuse and adverse mental
health and related outcomes for survivors. Kendler et al. (2000), in an epidemiological
and co-twin controlled analysis of 1,411 twin pairs, reported significant odds ratios for a
range of psychiatric disorders in sexually abused women after controlling for family
environment. The effects were strongest for drug and alcohol dependence and bulimia
nervosa. Dinwiddie et al. (2000), in an Australian twin study with 5,995 twin pairs, also
found significant odds ratios for child sexual abuse and major depression, panic
disorder, and alcohol dependence. Similarly, Nelson et al. (2002) in another Australian
study involving 1,991 twin pairs found that in twins where one had been sexually
abused and the other not, the abused twins had significantly higher rates of major
Negative mental health effects that have been consistently associated in the
research with child sexual abuse include post-traumatic symptoms (Canton-Cortes &
Canton, 2010; O'Leary & Gould, 2009; Ullman,Filipas, Townsend, & Starzynski, 2007);
depression (Fergusson et al., 2008; Nelson et al., 2002); substance abuse (Lynskey &
aggressive behaviours and conduct problems; eating disorders (Jonas et al., 2011); and
anxiety (Banyard, Williams, & Siegel, 2001; Nelson et al., 2002). More recently child
sexual abuse has also been linked to psychotic disorders including schizophrenia and
delusional disorder (Bendall, Jackson, Hulbert, & McGorry 2011; Lataster et al., 2006;
Wurr & Partridge, 1996) as well as personality disorders (Cutajar, 2010b). Child sexual
29
abuse involving penetration has, in particular, been identified as a risk factor for
At the most serious extreme of mental health problems, the findings related to
suicide ideation, suicide attempts and actual suicides are of particular concern,
especially since the Victorian Parliamentary Inquiry into the Handling of Child Abuse by
Religious and Other Organisations was instituted at least partly on the basis that 40
Victorian people allegedly abused by Catholic clergy had committed suicide in recent
years.5 A number of studies indicate that sexual victimisation, both in childhood and
beyond, is a significant risk factor for suicide attempts and for (accidental) fatal
overdoses, among both men and women. This evidence comes from community and
prospective longitudinal studies in various countries. Some earlier studies and reviews
(Briere & Zaidi, 1989; Fondacaro & Butler, 1995) reported mixed findings, but other
factors - such as co-existing child physical abuse, family dysfunction, depression, and
the consequences of disclosing child sexual abuse - were often not considered. Some
more recent and rigorous studies, however have used large-scale data sources or
longitudinal or follow-up designs, and reported significant links between child sexual
abuse and later suicidal behavior or ideation (Dube, Anda, & Whitefield 2005;
showed that exposure to childhood sexual abuse was related to "clear increases in the
risks of later mental health problems" (Fergusson et al., 2008, p. 617). These included
disorder, and substance use. This association, from age 16 to 25 years, persisted after
problematic parent-child attachment, and parental history of illicit drug use (Fergusson
et al., 2000, 2008). There was no significant association between child sexual abuse
and the family's socio-economic status. While physical abuse was also related to a
range of mental health disorders including suicide attempts, but not suicide ideation, the
long-term effects of child sexual abuse were generally larger than the long-term effects
of physical abuse. Overall, after adjusting for a range of other factors, children exposed
mental health disorders, including suicidal, that were 2.4 times higher than those of
children not so exposed. Estimates of the population attribute risk (PAR) suggested that
the elimination of child sexual abuse within the Christchurch cohort would have reduced
the overall rates of mental health disorder in adulthood by 13% (Fergusson et al., 2008,
p. 617).
completed suicides and fatal drug overdoses. This study did not rely on self-report data
but was not able to take account of other contributory factors either early in life or closer
to the fatality. In this study, Cutajar et al. (2010b) linked the forensic medical records of
over 2,500 victims of child sexual assault in Victoria over a 30-year period with the
coronial data for a 44-year-span follow-up. They concluded that "child sexual abuse
victims are at increased risk of suicide and accidental fatal drug overdose" but that "it is
not possible to reliably attribute the association entirely to the experience of CSA"
31
(p.186), given the non-random nature of the children who come to the attention of child
protection services and the police as a result of child sexual abuse allegations.
Importantly, not all victims of child sexual abuse develop mental health or adjustment
difficulties in adulthood. Lynskey and Fergusson (1997), for example, reported that one-
quarter of those exposed to child sexual abuse in their cohort study, did not meet the
Walsh et al. (2010) have characterized child sexual abuse as a "non-specific risk
factor" (p. 2) for adjustment difficulties, since up to 25% of victims experienced no direct
symptomatology in adulthood. Green et al. (2010) also found that there was little
specificity for a range of childhood adversities, including sexual abuse and maladaptive
community survey. Further, while there was a cumulative impact, this was not a straight
Although a robust body of research demonstrates the link between child sexual
abuse and mental health problems, it is important to note that some studies fail to
include other childhood adversities, such as other forms of abuse, family functioning
and socio-demographic factors. The picture is complex, however, for two reasons. First,
there is evidence (see following section) that children who have already been victimized
32
adolescents and adults. Second, recent large-scale studies in the US have found
evidence of a stress sensitization effect - that is, being exposed to a range of childhood
adversities including sexual abuse exacerbates the impact of stressful life events in
adulthood (Kendler et al., 2004; Espejo et al., 2006). McLaughlin et al. (2010) found, for
example, that both men and women with such adversities in childhood were more likely
to have psychiatric disorders when exposed to stressful life events in adulthood than
those without such early adversities. Finkelhor, Ormrod, and Turner (2007) also found a
similar effect within childhood, with children revealing elevated risks of trauma
symptoms if they had been subjected to several kinds of victimization within the past
year. Maker, Kemmelmeier, and Peterson (2001) highlighted that victims of child sexual
abuse are at greater risk of adult sexual assault and that the negative psychological
outcomes attributed to child sexual abuse may in fact be more strongly associated with
sensitive to the effects of recent sexual trauma than the impact of more distal child
abuse" (p. 353). Importantly, more research is needed to examine the extent to which
interventions like counseling may improve the outcomes for survivors and mediate
Studies that have specifically examined the long-term mental health outcomes
for male survivors of child sexual abuse are limited. Overall, research findings have
indicated that women survivors either experience more severe problems following child
sexual abuse (Ryan, Kilmer, Cauce, Watanabe, & Hoyt, 2000) compared with men, or
that their experiences are largely comparable (Boudewyn & Huser Liem, 1995; Roesler
33
& McKenzie, 1994). However, some research findings suggest that male victims of child
sexual abuse may experience different and, in some respects, more adverse mental
health outcomes than female victims. For example, J. Hunter (1991) found that male
victims were more likely than women to experience anxiety, rumination and worry. Gold
et al. (1999) found that relative to their respective normative samples, male survivors
phobic anxiety. The picture, however, may be more complex than the findings using
various measures and diagnoses indicate. For example, Hillberg et al. (2011) concluded
consistent with research that suggests that male survivors of child sexual abuse are
more susceptible to internalizing effects, while women are more likely to experience
externalizing effects (Dorahy & Clearwater, 2012; Romano & De Luca, 2001). This
contrasts with findings from research in other areas indicating that men are more likely
to externalize their problems. The difference may be related to gender norms that make
it difficult for men to discuss sexual abuse, and possibly even to a cultural bias that sees
indicate that boys may be particularly susceptible to abuse of this type and to the effects
that play out in adulthood. A large-scale study on abuse allegations in the Catholic
Church in the US and a smaller study in Australia on allegations against Anglican clergy
34
found that the majority of these allegations involved male victims. In the US study by the
John Jay College Research Team (2004), 81% of the victims were male, and 40% of all
victims were males aged 11-14 years.6 In the Australian study, 75% of the 180 victims
in 191 complaints were male (Parkinson, Oates, & Jayakody, 2010). The average time
from the alleged abuse to making a complaint was 25 years for males, and 18 years for
females. Neither of these studies was designed to look at the impact of the abuse on
the victims, and as Fogler et al. (2008) pointed out, "our knowledge of the effects of
There are indications, however, that sexual abuse by clergy and other powerful
authority figures may have particularly devastating effects. Brady (2008) drew strong
parallels here with the features of abuse within the family that are deemed particularly
damaging and difficult for children to deal with. These include the fact that: the families
of many victims were closely allied with the life of their church - a spiritual family; the
abuse tended to occur over an extended period of time, similar to many cases of incest;
adults frequently did not believe reports of abuse when alerted to it, which often also
occurs in cases of incest; church leaders tried to silence victims to avoid scandal, also a
repeated theme in incest; and many victims did not disclose the abuse until adulthood,
again similar to many cases of incest. (Doyle, 2003, as cited in Brady, 2008, p. 360)
In the same special issue of the Journal of Child Sexual Abuse, which was
concerned with the trauma of clergy sexual abuse, Fogler et al. (2008) drew together
the literature and provided some theoretical foundations for their conclusion that clergy-
sexual, and spiritual development" (p. 330). Fogler et al. attributed the damaging impact
35
of sexual abuse by clergy, which commonly occurs around the ages of 11-14 years, to
the way in which it undermines the victims' trust, sense of self, sexual identity, and
abuse continues to grow, more sophisticated and focused research is needed to tease
out possible gender differences as well as the influence of potential mediating factors on
CHAPTER III
RESEARCH METHODOLOGY
Method
This study will be done for the purpose of knowing the experience of a battered
child at DSWD Marikina. The researchers will use descriptive method to answer the
specific problem formulated. The use of this method is needed to realize that the
objectives in this study will be accurately obtained. It will consists of a set of gathered
information about present existing condition. This method involves collection of data in
order to test hypotheses or to answer questions concerning the current status of the
subject of the study. It involves determining information about variables rather than
about individuals and deals only with a portion of the population (Baui, 2006).
Participants
compositions of the respondents will be 15 boys and 15 girls whose age will range from
4 to 10 years old.
37
Instrument
researchers also used audio and video recording devices, as well as paper-and-pencil
notes. The survey was created using suitable questions modified from related research
and individual questions formed by the researchers. The survey was comprised of 20
questions, which were related to the participant's experience of being a battered child
Data Collection
The data for this research were collected using a survey questionnaire. The
researchers gave time for the participants to respond then the researchers collected it
afterwards. Although the interview is recorded, the researchers took notes of the
interview using a small notebook and pencil/pen. These notes included information on
the effects of child abuse to the informant and responses by the informant on the topics.
The researchers also carefully noted the circumstances of the interviews. The
researchers also collected the personal characteristics of the participants such as age,
gender and family background. The questionnaire was distributed to the battered
children at DSWD Marikina ages 2 to 10 years old. The researchers assured the utmost
confidentiality of their survey sheets since the identities are important. There was no
money involved while conducting the survey. All the data and information collected from
the interview helped to answer and evaluate the research questions and were used only
FIELD EXPERIENCE
study "The Phenomenological Study of Battered Child" in Marikina City. The researcher
felt glad to meet those children at the very first time. It wasn't like they were conducting
a research study rather it was like having a good time playing and telling stories with the
young ones, feeling of being a child once more as if they were friends in a very long
time. It was fun and exciting to be with the children in the fact that the researchers
longed to be back again to the place of study. It was also a good feeling when the
children always wait for the researchers to arrive at the place, you could see in their
eyes the excitement they feel as the children saw the researchers coming. The parents
and guardians of the participants were also glad to what the researchers did to their
children. According to them the researchers were good persons who didn't discriminate
If there were a good times, of course there were also a bad times that the
researchers encountered in the research field. One of the huge problem of the
researchers was how would they get the children attention focusing on the interview
only and make sure they would answer the question correctly or relatively. In this
problem the two researchers come up with the simple group games to entertain the
other participants while one of them has been placed at the corner to be interviewed by