Abuse Health Article

Causes of abuse

The causes of interpersonal abuse are complex and overlapping. Some of the most important factors are:

• Early learning experiences: This factor is sometimes described as the "life cycle" of abuse. Many abusive parents were themselves abused as children and have learned to see hurtful behavior as normal childrearing. At the other end of the life cycle, some adults who abuse their elderly parent are paying back the parent for abusing them in their early years.
• Ignorance of developmental timetables: Some parents have unrealistic expectations of children in terms of the appropriate age for toilet training, feeding themselves, and similar milestones, and attack their children for not meeting these expectations.
• Economic stress: Many caregivers cannot afford part-time day care for children or dependent elderly parents, which would relieve some of their emotional strain. Even middle-class families can be financially stressed if they find themselves responsible for the costs of caring for elderly parents before their own children are financially independent.
• Lack of social support or social resources: Caregivers who have the support of an extended family, religious group, or close friends and neighbors are less likely to lose their self-control under stress.
• Substance abuse: Alcohol and mood-altering drugs do not cause abuse directly, but they weaken or remove a person's inhibitions against violence toward others. In addition, the cost of a drug habit often gives a substance addict another reason for resenting the needs of the dependent person. A majority of workplace bullies are substance addicts.
• Mental disorders: Depression, personality disorders, dissociative disorders, and anxiety disorders can all affect parents' ability to care for their children appropriately. A small percentage of abusive parents or spouses are psychotic.
• Belief systems: Many men still think that they have a "right" to a relationship with a woman; and many people regard parents' rights over children as absolute.
• The role of bystanders: Research in the social sciences has shown that one factor that encourages abusers to continue their hurtful behavior is discovering that people who know about or suspect the abuse are reluctant to get involved. In most cases, bystanders are afraid of possible physical, social, or legal consequences for reporting abuse. The result, however, is that many abusers come to see themselves as invulnerable.

Aftereffects

Abuse affects all dimensions of human development and existence.

Physical and neurobiological

In addition to such direct results of trauma as broken bones or ruptured internal organs, physically abused children often display retarded physical growth and poor coordination. Malnutrition may slow the development of the brain as well as produce such dietary deficiency diseases as rickets. In both children and adults, repeated trauma produces changes in the neurochemistry of the brain that affect memory formation. Instead of memories being formed in the normal way, which allows them to be modified by later experiences and integrated into the person's ongoing life, traumatic memories are stored as chaotic fragments of emotion and sensation that are sealed off from ordinary consciousness. These traumatic memories may then erupt from time to time in the form of flashbacks.

Cognitive and emotional

Abused children develop distorted patterns of cognition (knowing) because they are stressed emotionally by abuse. As adults, they may suffer from cognitive distortions that make it hard for them to distinguish between normal occurrences and abnormal ones, or between important matters and relatively trivial ones. They often misinterpret other people's behavior and refuse to trust them. Emotional distortions include such patterns as being unable to handle strong feelings, or being unusually tolerant of behavior from others that most people would protest.

Social and educational

The cognitive and emotional aftereffects of abuse have a powerful impact on adult educational, social, and occupational functioning. Children who are abused are often in physical and emotional pain at school; they cannot concentrate on schoolwork, and consequently fall behind in their grades. They often find it hard to make or keep friends, and may be victimized by bullies or become bullies themselves. In adult life, abuse survivors are at risk of repeating childhood patterns through forming relationships with abusive spouses, employers, or professionals. Even though a survivor may consciously want to avoid re-abuse, the individual is often unconsciously attracted to people who remind him or her of the family of origin. Abused adults are also likely to fail to complete their education, or they accept employment that is significantly below their actual level of ability.

Treatment

Treatment of the aftereffects of abuse must be tailored to the needs of the specific individual, but usually involves a variety of long-term considerations that may include legal concerns, geographical relocation, and housing or employment as well as immediate medical or psychiatric care.