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Though rarely investigated or substantiated, more than one-third of children globally experience emotional abuse during childhood. Left untreated, experiencing childhood emotional abuse can lead to lifelong developmental, physical, mental and behavioral health difficulties. In order to identify strategies for child emotional abuse prevention, intervention and treatment, this systematic review identified, examined, and synthesized studies related to the predictors, associated experiences and consequences of childhood emotional abuse.
Methods
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol, electronic searches of four scholarly databases (Academic Search Complete, CINAHL Complete, APA PsychInfo, Social Work Abstracts) were completed and 24 target journals were hand-searched. Search terms included: emotional neglect/injury or mental injury/psychological aggression by caregiver/parent. Two reviewers screened articles for inclusion (published 2000-2021, English-language study, maltreatment occurred before age 18, qualitative or quantitative study) and exclusion criteria (study not empirical, findings not applicable to the causes/consequences and/or associated experiences of emotional abuse) for a total of 127 articles.
Findings
Studies reported data on different samples of youth: general population (n=47; e.g., high school students), low/moderate risk groups (n=50; e.g., hospital patients), or higher risk samples (n=107; e.g., child welfare). Studies also varied in use of retrospective recall (n=78) or current experiences (n=51). Data were collected in North America (n=67), Australia (n=5), Europe (n=33), Africa (n=14), and South America (n=13). Definitions of emotional abuse were compared across studies (e.g., witnessing domestic violence as maltreatment). Factors associated with emotional abuse were present at the child-, family-, and community-level. Child-level factors included race, gender, and thoughts/emotion regulation. Family-level factors included parental substance use, parental mental health, emotional warmth, and absence of co-occurring physical aggression. Community-level factors included child welfare involvement. Emotional abuse’s association with physical health (e.g., severe obesity, heart disease, diabetes, cancer), mental health (e.g., depression, anxiety, personality disorders, suicidality), and substance use (e.g., alcohol dependence, drug misuse) outcomes will be described.
Conclusions/ Implications
The prevalence of emotional abuse is high. Yet, less is understood about this form of maltreatment. provide significant evidence that experiencing emotional abuse as a child increases the risk for the development of behavioral and mental concerns in later childhood or adulthood, including substance use disorder, depression, anxiety, post-traumatic stress, and personality disorders. Notably, experiencing childhood emotional abuse increases the risk of relational and interpersonal difficulties throughout the lifespan. Variations in the definitions of emotional abuse indicate that more work is needed to better understand which experiences classified as emotional abuse (e.g., name calling, witnessing violence) are associated with poorer outcomes. Additionally, it is important that further research examine the severity and length of exposure and their relationship with outcomes. The findings of this systematic review have significant implications for social work research and practice, highlighting the need to improve measurement of child maltreatment, specifically emotional abuse, to better inform prevention and treatment protocols that address this form of maltreatment.