2012 AAP 精神虐待：临床报告
Psychological Maltreatment: Clinical Report
2012-08-07
Psychological or emotional maltreatment of children may be the mostchallenging and prevalent form of child abuse and neglect. Caregiverbehaviors include acts of omission (ignoring need for social interactions)or commission (spurning, terrorizing); may be verbal or nonverbal,active or passive, and with or without intent to harm; andnegatively affect the child’s cognitive, social, emotional, and/or physicaldevelopment. Psychological maltreatment has been linked withdisorders of attachment, developmental and educational problems,socialization problems, disruptive behavior, and later psychopathology.Although no evidence-based interventions that can prevent psychologicalmaltreatment have been identified to date, it is possiblethat interventions shown to be effective in reducing overall types ofchild maltreatment, such as the Nurse Family Partnership, may havea role to play. Furthermore, prevention before occurrence will requireboth the use of universal interventions aimed at promoting the type ofparenting that is now recognized to be necessary for optimal childdevelopment, alongside the use of targeted interventions directed atimproving parental sensitivity to a child’s cues during infancy andlater parent-child interactions. Intervention should, first and foremost,focus on a thorough assessment and ensuring the child’s safety.Potentially effective treatments include cognitive behavioral parentingprograms and other psychotherapeutic interventions. The high prevalenceof psychological abuse in advanced Western societies, alongwith the serious consequences, point to the importance of effectivemanagement. Pediatricians should be alert to the occurrence of psychologicalmaltreatment and identify ways to support families whohave risk indicators for, or evidence of, this problem.
