Abuse is a complex psychosocial problem that affects large numbers of adults as well as children throughout the world. It is listed in the Diagnostic and Statistic Manual of Mental Disorders (DSM-IV-TR) under the heading of “Other Conditions That May Be a Focus of Clinical Attention.” Although abuse was first defined with regard to children when it first received sustained attention in the 1950s, clinicians and researchers now recognize that adults can suffer abuse in a number of different circumstances. Abuse refers to harmful or injurious treatment of another human being that may include physical, sexual, verbal, psychological/emotional, intellectual, or spiritual maltreatment. Abuse may coexist with neglect, which is defined as failure to meet a dependent person’s basic physical and medical needs, emotional deprivation, and/or desertion. Neglect is sometimes described as passive abuse.
The costs of abuse to society run into billions of dollars annually in the United States alone. They include not only the direct costs of immediate medical and psychiatric treatment of abused people but also the indirect costs of learning difficulties, interrupted education, workplace absenteeism, and long-term health problems of abuse survivors.
Types of abuse
Physical abuse refers to striking or beating another person with the hands or an object, but may include assault with a knife, gun, or other weapon. Physical abuse also includes such behaviors as locking someone in a closet or other small space, depriving someone of sleep, burning, gagging, or tying them up, etc. Physical abuse of infants may include shaking them, dropping them on the floor, or throwing them against the wall or other hard object.
Sexual abuse refers to inappropriate sexual contact between a child or an adult and someone who has some kind of family or professional authority over them. Sexual abuse may include verbal remarks, fondling or kissing, or attempted or completed intercourse. Sexual contact between a child and a biological relative is known as incest, although some therapists extend the
term to cover sexual contact between a child and any trusted caregiver, including relatives by marriage. Girls are more likely than boys to be abused sexually; according to a conservative estimate, 38% of girls and 16% of boys are sexually abused before their eighteenth birthday.
Verbal abuse refers to regular and consistent belittling, name-calling, labeling, or ridicule of a person; but it may also include spoken threats. It is one of the most difficult forms of abuse to prove because it does not leave physical scars or other evidence, but it is nonetheless hurtful. Verbal abuse may occur in schools or workplaces as well as in families.
Emotional/psychological abuse covers a variety of behaviors that hurt or injure others even though no physical contact may be involved. In fact, emotional abuse is a stronger predictor than physical abuse of the likelihood of suicide attempts in later life. One form of emotional abuse involves the destruction of someone’s pet or valued possession in order to cause pain. Another abusive behavior is emotional blackmail, such as threatening to commit suicide unless the other person does what is wanted. Other behaviors in this category include the silent treatment, shaming or humiliating someone in front of others, or punishing them for receiving an award or honor.
Intellectual/spiritual abuse refers to such behaviors as punishing someone for having different intellectual interests or religious beliefs from others in the family, preventing them from attending worship services, ridiculing their opinions, and the like.