, the World Health Organization distinguishes four types of<unk>  maltreatment: physical abuse; sexual abuse; emotional (or psychological) abuse; and neglect. Physical abuse Among professionals and the general public, there is disagreement as to what behaviors constitute physical abuse of a<unk> . Physical abuse often does not occur in isolation but as part of a constellation of behaviors including authoritarian control, anxiety-provoking behavior, and a lack of parental warmth. The WHO defines physical abuse as: Overlapping definitions of physical abuse and physical punishment of<unk> ren highlight a subtle or non-existent distinction between abuse and punishment, but most physical abuse is physical punishment "in intent, form, and effect". As of 2006, for instance, Paulo Sergio Pinheiro wrote in the UN Secretary-General's Study on Violence Against<unk> ren: Most nations with<unk>  laws deem the deliberate infliction of serious injuries, or actions that place the<unk>  at obvious risk of serious injury or death, to be illegal. Bruises, scratches, burns, broken bones, lacerations — as well as repeated "mishaps," and rough treatment that could cause physical injuries — can be physical abuse. Multiple injuries or fractures at different stages of healing can raise suspicion of abuse. The psychologist Alice Miller, noted for her books on<unk> , took the view that humiliations, spankings, and beatings, slaps in the face, etc. are all forms of abuse, because they injure the integrity and dignity of a<unk> , even if their consequences are not visible right away. Physical abuse as a<unk>  can lead to physical and mental difficulties in the future, including re-victimization, personality disorders, post-traumatic stress disorder (PTSD), dissociative disorders, depression, anxiety, suicidal ideation, eating disorders, substance use disorders, and aggression. Physical abuse in<unk> hood has also been linked to homelessness in adulthood. Sexual abuse<unk>  sexual abuse (CSA) is a form of<unk>  in which an adult or older adolescent abuses a<unk>  for sexual stimulation. Sexual abuse refers to the participation of a<unk>  in a sexual act aimed toward the physical gratification or the financial profit of the person committing the act. Forms of CSA include asking or pressuring a<unk>  to engage in sexual activities (regardless of the outcome), indecent exposure of the genitals to a<unk> , displaying pornography to a<unk> , actual sexual contact with a<unk> , physical contact with the<unk> 's genitals, viewing of the<unk> 's genitalia without physical contact, or using a<unk>  to produce<unk>  pornography. Selling the sexual services of<unk> ren may be viewed and treated as<unk>  rather than simple incarceration. Effects of<unk>  sexual abuse on the victim(s) include guilt and self-blame, flashbacks, nightmares, insomnia, fear of things associated with the abuse (including objects, smells, places, doctor's visits, etc.), self-esteem difficulties, sexual dysfunction, chronic pain, addiction, self-injury, suicidal ideation, somatic complaints, depression, PTSD, anxiety, other mental illnesses including borderline personality disorder and dissociative identity disorder, propensity to re-victimization in adulthood, bulimia nervosa, and physical injury to the<unk> , among other problems.<unk> ren who are the victims are also at an increased risk of sexually transmitted infections due to their immature immune systems and a high potential for mucosal tears during forced sexual contact. Sexual victimization at a young age has been correlated with several risk factors for contracting HIV including decreased knowledge of sexual topics, increased prevalence of HIV, engagement in risky sexual practices, condom avoidance, lower knowledge of safe sex practices, frequent changing of sexual partners, and more years of sexual activity. As of 2016, in the United States, about 15% to 25% of women and 5% to 15% of men were sexually abused when they were<unk> ren. Most sexual abuse offenders are acquainted with their victims; approximately 30% are relatives of the<unk> , most often brothers, sisters, fathers, mothers, uncles or cousins; around 60% are other acquaintances such as friends of the family, babysitters, or neighbours; strangers are the offenders in approximately 10% of<unk>  sexual abuse cases. In over one-third of cases, the perpetrator is also a minor. In 1999 the BBC reported on the RAHI Foundation's survey of sexual abuse in India, in which 76% of respondents said they had been abused as<unk> ren, 40% of those stating the perpetrator was a family member. United States federal prosecutors registered multiple charges against a South Korean man for reportedly running the world's "largest dark web<unk>  porn marketplace." Reportedly, the English translated website "Welcome to Video", which has now been taken consisted of more than 200,000 videos or 8TB of data showing sexual acts involving infants,<unk> ren and toddlers and processed about 7,300 Bitcoin, i.e. $730,000 worth of transactions. Psychological abuse There are multiple definitions of<unk>  psychological abuse: * In 2013, the American Psychiatric Association (APA) added<unk>  Psychological Abuse to the DSM-5, describing it as "nonaccidental verbal or symbolic acts by a<unk> 's parent or caregiver that result, or have reasonable potential to result, in significant psychological harm to the<unk> ." * In 1995, APSAC defined it as: spurning, terrorizing, isolating, exploiting, corrupting, denying emotional responsiveness, or neglect" or "A repeated pattern of caregiver behavior or extreme incident(s) that convey to<unk> ren that they are worthless, flawed, unloved, unwanted, endangered, or only of value in meeting another's needs" * In the United States, states laws vary, but most have laws against "mental injury" * Some have defined it as the production of psychological and social defects in the growth of a<unk>  as a result of behavior such as loud yelling, coarse and rude attitude, inattention, harsh criticism, and denigration of the<unk> 's personality. Other examples include name-calling, ridicule, degradation, destruction of personal belongings, torture or killing of a pet, excessive criticism, inappropriate or excessive demands, withholding communication, and routine labeling or humiliation. In 2014, the APA stated that: *<unk> hood psychological abuse is as harmful as sexual or physical abuse." * "Nearly 3 million U.S.<unk> ren experience some form of psychological maltreatment annually." * Psychological maltreatment is "the most challenging and prevalent form of<unk>  and neglect." * "Given the prevalence of<unk> hood psychological abuse and the severity of harm to young victims, it should be at the forefront of mental health and social service training" In 2015, additional research confirmed these 2014 statements of the APA. Victims of emotional abuse may react by distancing themselves from the abuser, internalizing the abusive words, or fighting back by insulting the abuser. Emotional abuse can result in abnormal or disrupted attachment development, a tendency for victims to blame themselves (self-blame) for the abuse, learned helplessness, and overly passive behavior. Neglect<unk>  neglect is the failure of a parent or other person with responsibility for the<unk> , to provide needed food, clothing, shelter, medical care, or supervision to the degree that the<unk> 's health, safety or well-being may be threatened with harm. Neglect is also a lack of attention from the people surrounding a<unk> , and the non-provision of the relevant and adequate necessities for the<unk> 's survival, which would be a lack of attention, love, and nurturing. Some observable signs of<unk>  neglect include: the<unk>  is frequently absent from school, begs or steals food or money, lacks needed medical and dental care, is consistently dirty, or lacks appropriate clothing for the weather. The 2010<unk>  Maltreatment Report (NCANDS), a yearly United States federal government report based on data supplied by state<unk>  Protective Services (CPS) Agencies in the U.S., found that neglect/neglectful behavior was the "most common form of<unk>  maltreatment ". Neglectful acts can be divided into six sub-categories: *Supervisory neglect: characterized by the absence of a parent or guardian which can lead to physical harm, sexual abuse, or criminal behavior; *Physical neglect: characterized by the failure to provide the basic physical necessities, such as a safe and clean home; *Medical neglect: characterized by the lack of providing medical care; *Emotional neglect: characterized by a lack of nurturance, encouragement, and support; *Educational neglect: characterized by the caregivers lack to provide an education and additional resources to actively participate in the school system; and *Abandonment: when the parent or guardian leaves a<unk>  alone for a long period of time without a babysitter or caretaker. Neglected<unk> ren may experience delays in physical and psychosocial development, possibly resulting in psychopathology and impaired neuropsychological functions including executive function, attention, processing speed, language, memory and social skills. Researchers investigating maltreated<unk> ren have repeatedly found that neglected<unk> ren in the foster and adoptive populations manifest different emotional and behavioral reactions to regain lost or secure relationships and are frequently reported to have disorganized attachments and a need to control their environment. Such<unk> ren are not likely to view caregivers as being a source of safety, and instead typically show an increase in aggressive and hyperactive behaviors which may disrupt healthy or secure attachment with their adopted parents. These<unk> ren seem to have learned to adapt to an abusive and inconsistent caregiver by becoming cautiously self-reliant, and are often described as glib, manipulative and disingenuous in their interactions with others as they move through<unk> hood.<unk> ren who are victims
Child abuse
Physical abuse
Developmental regression
Psychological abuse
Sexual violence
Craniodiaphyseal dysplasia
Vitamin A deficiency
Substance abuse