Childhood emotional abuse is becoming a public health priority: Evidentiary support for a paradigm change

Abstract

A growing evidence base is demonstrating that childhood emotional abuse – often also referred to as psychological abuse – is a particularly harmful form of maltreatment compared with most other maltreatment types. Recent rigorous national surveys have generated epidemiological data indicating the prevalence of emotional abuse is substantial, and may be increasing. Theoretical analyses of the concept of emotional abuse, and major international policy documents, evince an emerging consensus about the proper conceptualisation and definition of this form of child maltreatment, and the need for societies to accelerate a public health approach to prevent it and respond to it. However, despite international advances in these domains, at the national level of domestic policy and child protection systems practice, the longstanding lesser priority afforded to emotional abuse continues. Emotional abuse does not yet receive the same attention in domestic policy and practice as physical abuse, sexual abuse, and neglect. This discussion article considers the nature of childhood emotional abuse generally, and verbal abuse in particular, and calls for a shift in domestic policy to afford greater priority to preventing and responding to this problem. In Part 1, we first identify the emerging consensus in science and international policy about the appropriate conceptual and definitional understanding of emotional abuse. In Part 2, we then highlight key research about the significance for health and development of emotional abuse in general, and verbal abuse in particular, and outline the pathways of its associated distress and injury. Part 3 summarises the prevalence of emotional abuse, both globally and in diverse countries, and draws on recent data from the USA and Australia to understand population-wide trends by age group, indicating that emotional abuse may be increasing in prevalence in some nations. Finally, in Part 4, we then situate this evidence within domestic child protection policy and practice and its traditional and continuing approach to different types of child maltreatment. We argue for intensified priority for investment and prevention of emotional abuse, using a rigorous, responsible public health model of child health promotion and child maltreatment prevention.