• Child Physical Abuse
  A diagnosis of child physical abuse may be applied when a person causes physical injury to a child, ranging from minor bruises to severe fractures.  Injuries are considered abuse regardless of whether the caregiver intended to hurt the child. Physical discipline, such as spanking or paddling, is not considered abuse as long as it is reasonable and causes no bodily injury to the child.
  
  Physically abused children may be affected by depression, conduct disorder, ADHD, oppositional defiant disorder, dissociation, and PTSD. The psychological consequences of physical abuse and neglect include insecure and atypical attachment patterns, impaired peer relationships involving increased aggression or social withdrawal, academic underachievement, and impaired ability to regulate negative emotional states. Abused children may be unusually fearful, docile, distrustful, and guarded. They may be wary of physical contact and show no expectation of being comforted by adults. They may be on the alert for danger and may be afraid to go home.
  
• Child Sexual Abuse
  Child sexual abuse includes any sexual act involving a child that is intended to provide sexual gratification to a parent, caregiver, or another individual who has responsibility for the child. Sexual abuse includes activities such as fondling a child’s genitals, penetration, incest, rape, sodomy, and indecent exposure. Sexual abuse also includes noncontact exploitation of a child by a parent or caregiver, such as forcing, tricking, enticing, threatening, or pressuring a child to participate in acts for the sexual gratification of others, without direct physical contact between the child and abuser.
  
  Sexually abused children may experience anxiety symptoms, depression, dissociative reactions, hysterical symptoms, disturbances in sexual behaviors, and somatic complaints. Anxiety symptoms may include fearfulness, phobias, insomnia, nightmares that portray the abuse, somatic complaints, and PTSD. Depression may be demonstrated by low self-esteem and suicidal and self-mutilative behaviors. Dissociative reactions may include amnesia, daydreaming, translate states, hysterical seizures, and symptoms of dissociative identity disorder. Approximately one-third of sexually abused children have no apparent symptoms.
  
• Child Neglect
  Child neglect is defined as any confirmed or suspected egregious act or omission by a child’s parent or another caregiver that deprives the child of having basic age-appropriate needs mentor has reasonable potential to result in physical or psychological harm to the child. Child neglect includes abandonment; lack of appropriate supervision; failure to attend to necessary emotional or psychological needs; and failure to provide necessary education, medical care, nourishment, shelter, and/or clothing.
  
• Child Psychological Abuse
  Child psychological abuse is nonaccidental verbal or symbolic acts by a child’s parent or caregiver that result, or have reasonable potential to result, in significant psychological harm to the child. Examples include berating, disparaging, or humiliating the child; threatening the child with harm or abandonment; physically confining the child; scapegoating of the child; coercing the child to inflict pain on himself or herself, and disciplining the child excessively through physical or nonphysical means.

What are treatments for child abuse or neglect?

Cognitive-behavioral therapy is the leading evidence-based treatment for children and adolescents who have experienced child abuse or neglect. Treatment should include education about trauma and its impact (e.g, PTSD); emotional management skills, such as relaxation and controlled breathing; gradual exposure to trauma memories; and cognitive processing to address unhelpful or inaccurate thoughts, such as guilt or self-blame.

For children who have severe or persistent symptoms despite psychotherapy, medications may be warranted, both to help with symptoms and to generate a more positive treatment response to psychotherapy.

The American Academy of Child and Adolescent Psychiatry (AACAP) suggests selective serotonin reuptake inhibitors (SSRIs) for the treatment of children and adolescents with PTSD but cautions that these medications should be considered only after an adequate trial of evidence-based psychotherapy alone is ineffective. For children with PTSD and coexisting disorders such as depression and anxiety, support for the use of medication in children is much stronger, and pharmacotherapy should be considered based on the degree of severity and impairment. In such cases, the AACAP recommends using medications as part of a more comprehensive treatment plan, as an adjunct to psychotherapy, and for simultaneous treatment of comorbid psychiatric diagnoses.

Resources to help parents deal with child abuse are available from the American Academy of Child & Adolescent Psychiatry. 

To report child abuse or neglect in Florida, go to the Florida Department of Children and Families Florida Child Abuse Hotline.

What diagnoses relate to adult abuse and neglect?

Spouse or Partner Violence – Physical
This diagnosis is used when nonaccidental acts of physical force result in or have reasonable potential to result in, physical harm to an intimate partner in the past year. In place of physical harm, the behavior could cause significant fear in the partner.

Spouse or Partner Violence – Sexual
This diagnosis is used when forced or coerced sexual acts with an intimate partner have occurred during the past year. Sexual violence may involve the use of physical force or psychological coercion to make the partner engage in a sexual act against his or her will. Also included in this category are sexual acts with an intimate partner who is unable to consent.

Spouse or Partner Neglect
Partner neglect is any egregious act or omission in the past year by one partner that deprives a dependent partner of basic needs, resulting in, or having the potential to result in, physical or psychological harm to the dependent partner. This category is used in the context of relationships in which one partner is extremely dependent on the other partner for care or for assistance in navigating ordinary daily activities. This would typically involve a partner who is incapable of self-care due to substantial physical, psychological/intellectual, or cultural limitations (e.g., inability to communicate with others and manage everyday activities due to living in a foreign culture).

Spouse or Partner Abuse – Psychological
Partner psychological abuse includes non-accidental verbal or symbolic acts by one partner that result in or have the potential to result in, significant harm to the other partner. This category is used when psychological abuse has occurred during the past year. Acts of psychological abuse include berating or humiliating the victim; interrogating the victim; restricting the victim’s ability to come and go freely; obstructing the victim’s access to assistance (e.g., law enforcement; legal, protective, or medical resources); threatening the victim with physical harm or sexual assault; harming or threatening to harm people or things that the victim cares about; unwarranted restriction of the victim’s access to or use of economic resources; isolating the victim from family, friends, or social support resources; stalking the victim; or trying to make the victim think that he or she is crazy.

Adult Abuse by Nonspouse or Nonpartner

This diagnosis is used when an adult has been abused by another adult who is not an intimate partner. Such maltreatment may involve acts of physical, sexual, or emotional abuse. Examples of adult abuse include nonaccidental acts of physical force that have resulted – or have the potential to cause – physical harm or have caused significant fear; forced or coerced sexual acts; and verbal or symbolic acts with the potential to cause psychological harm. Examples of the latter include berating or humiliating the person; interrogating the person; restricting the person’s ability to come and go freely; obstructing the person’s access to assistance, threatening the person; harming or threatening to harm people or things that the person cares about; restricting the person’s access to or use of economic resources; isolating the person from family, friends, or social support resources; stalking the person; or trying to make the person think that he or she is crazy.