Synthesize and integrate what you have learned and highlight some of the followings:
(1) what is known about your topic,
(2) what the gaps are in knowledge, or
(3) how this literature is relevant for your topic.
***Consider creating headings and subheadings as you organize your review of literature and conclude with a short paragraph about how your proposed study will improve or extend research that has already been done.
If little or no empirical research has been done, indicate this.For example, your review of the literature may suggest that: 1) the topic you have selected has not been studied with the population you intend to study, and/or; 2) you are addressing a research question that no one else has yet examined.
References
Follow the American Psychological Association’s (APA) Publication Manual citation styles and provide full citations in the reference section.Include only last name(s) of authors and year of publication for in-text citation.
Attachment Issues in Child Abuse and Neglect
Question: How are attachment issues experienced by survivors of child abuse and neglect?
Background
The tragedy of child abuse and neglect is one of the social problems that affect society due to the lasting effects that can persist to adulthood. Unfortunately, it is a crisis that many children continue to face in their communities, including families where they are supposed to feel safe and protected. Secure childhood and attachment with caregivers protect children from the impact of childhood trauma. Although protected children have positive emotional and psychological development; millions of children worldwide experience a traumatic childhood. Child abuse and neglect is a problem that leaves a long-term trauma, potentially affecting the ability to establish healthy relationships with other people, such as partners, peers, and even children (Erozkan, 2016). Although the social problem affects early attachment, which influences future relationships, understanding the problem can help social workers and policy-makers to create a safe environment for children to ensure positive attachment and healthy relationships as they grow into adulthood.
Research Relevance
Social work practice involves attempting to address social problems, including those that affect children as they grow and develop in their communities. Thus, child abuse and neglect are essential for the profession since it relates to children’s physical, emotional, and psychological well-being. The current study will address how young adults deal with their relationship issues or with their family members following a history of child abuse and neglect. Understanding the impact will help social workers to create mechanisms to prevent the problem and interventions to help those who are already victims. The study is necessary to inform evidence-based interventions to prevent the long-term impact of child abuse and neglect in children. The outcome will also inform policies and programs targeting the problem to create healthy relationships in society regardless of child abuse and neglect history.
Literature Review
Significant studies have been conducted regarding the impact of child abuse and neglect in society. Erozkan (2016) explored the relationship between different types of attachments and childhood trauma. The study indicates the role of attachment in mediating childhood trauma and the impact of physical, emotional, and sexual abuse and physical and emotional neglect on future attachment patterns. Child abuse and neglect cause considerable trauma that takes years to recover, while some individuals experience the impact even in adulthood manifested as problematic relationships. Childhood trauma related to the different types of abuse and neglect has a lasting effect on victims, as evidenced in Strathearn et al. (2020). Thus, interventions to address the impact should focus on the emotional and mental changes that occur due to the trauma and might last a lifetime.
Sexual abuse is one of the most studied types of child abuse. Ensink et al. (2020) reveal that victims of childhood sexual abuse experience challenge navigating relationships with others in the short- and long-term. The abuse affects the victim’s developmental course with long-term impacts, such as the inability to trust or maintain healthy relationships as they grow. According to Ensink et al. (2020), since children depend on attachment figures in traumatic experiences, creating attachment organizations could help them to overcome the negative impact of sexual and other types of abuse and neglect. The focus should be on supporting the victims’ adaptation to child abuse and neglect. Attachment in victims is necessary since it might help them trust and maintain healthy relationships with others.
Variables
The prevalence of child abuse and neglect in society creates a complex scenario for social workers. Over the years, studies have established a relationship between the impact of attachment and the extent of child abuse (Roazzi et al., 2016). National Child Maltreatment Statistics reveal that over 4.4 million children across the world face various forms of abuse. Out of this number, only 3.4 million children receive social services, post response services, and prevention (American SPCC, n.d). Understanding the relationship between attachment and child abuse relies on two variables. The variable in this relationship includes the physical child abuse and the child’s attachment, which form the controlling element of all child support modelis. From these variables, social support is an association between attachment anxiety and physical abuse. The history of child abuse is a significant element in understanding the intimate parent-child or caregiver-child relationship. Social support acts as a possible factor of trust and protection for the child.
Measurement
The measurement of child abuse is significant in identifying the relationship that insecure child attachment style has with physical, sexual, and emotional abuse. The process relied on Patient Health Questionnaire-9 (PHQ-9) as the measurement tool that helped social workers examine and assess depression, fear, and guiding prevention decisions. Patient Health Questionnaire-9 (PHQ-9) is a self -administered tool for diagnostic of mentally disordered. The measurement tool is a depression model that scores each of the DSM-IV criteria as 0 to 3. Over 60000 patients in primary clinics completed the PHQ-9 to help construct validity of self- reported depression and difficulty obtaining social care after abuse. (Strathearn et al.; 2020). All populations from children of 12 years and above can use the PHQ-9 to determine that increased severity of their fears.
The purpose of the PHQ-9 was to help social workers in constructing validity and assisting data reliability. In case, the tool uses self-reported sick days. Short-form General Health Survey, clinic visits, and symptom-related reports. The measurement tool helps assess the criterion validity against the independent fear and depression among the 580 patients. The likely result from PHQ-9 was to indicate the increase in depression severity. There was a substantial decrease among children whose functional states were on 0-3 subscales from this perspective. Health utilization, social work support, and child abuse monitoring increased under the criterion standard (Strathearn et al., 2020). PHQ-9 is a reliable tool for measuring depression severity in the association between attachment and child abuse. The characteristics of the tool make it a helpful research and clinical instrument.
Discussion
Association between child abuse and attachment is common. For instance, those children who have suffered various forms of abuse and neglect present changes in their processes of growth. Roazzi et al. (2016) indicate that children adopt a way of control their thinking as a response to the hostile treatment, lack of warmth, and unpredictability that their parents used on them when growing up. Attachment presents psycho-social and emotional bonds towards caregivers and parents. From this context, Word Health Organization reveals that nearly 3 in 4 children aged between 2 to 4 suffer physical and psychological abuses at the hands of their caregivers and parents. The cumulative number of these children stands at 300 million children across the ages of 2 to 12 years who have suffered one form of physical and emotional abuse (World Health Organization, 2020). Attachment theory reveals that a child and the abuser establish a means of keeping their relationship to improve survival chances. Evidence shows that child abuse affects social, emotional, and behavioral development (Wilkinson & Bowyer, 2017). Many children who have suffered child abuse manifest severe behavioral and emotional difficulties, which leads to poor mental health and educational progress. The avoidance-insecure attachment has a tremendous impact throughout the life of a child.
Child abuse is the most significant source of trauma. Erozkan (2016) confirms that the primary causes of childhood vulnerability to trauma include abuse from caregivers, lack of consistent care from caregivers or parents, and different forms of neglect. Attachment to the parent is a product of different types of attachments experienced when growing up. As a result, children with attachment disorder are likely to establish intimate relationships with their caregivers and parents. The outcome of the abuse relates to various symptoms that adults manifest. Attachment-based relationships start early and gradually grow to become more complex. Insecure attachment is a generic risk factor for different psychological difficulties (Ensink et al., 2020). For instance, abused children tend to manifest insecure attachment. Disorganized attachment occurs as a result of experiencing and internalizing problems of abuse. Children that show insecure attachment have a 2.9 times risk of continuing to trust their abusers (Ensink et al., 2020). Reports on the impacts of attachment reveal how the child reported depression, anxiety and become a risk factor for social care.
Different factors of the relationship between the child and the abuser influence the development of attachment. A case in point is children growing up in dysfunctional families who fail to develop trust but cannot dissociate with their abusive parents. Problems with attachment in child abuse and neglect occur in cases of insecurity. Research indicates that some of these problems include operational defiant, conduct disorder, and post-traumatic stress disorder (Ensink et al., 2020). Most of the children attached to their abusers suffer a wide range of negative impacts throughout their life. To illustrate, children who are securely attached to their parents developed a sense of self-esteem and had lasting relationships, unlike children in insecure attachment. Early attachment portends a severe impact on the child’s future relationship.
Physical abuse takes a broad scope of violence where parents, relatives, strangers, or caregivers physically assault a child. NSPCC research indicates that 1.3% of children under eleven years and 6.9% of children between twelve to seventeen years go through different kinds of abuse (Strathearn et al., 2020). Most perpetrators in these abuses are trusted members of the social circle of the child. Children going through abuse at the hands of their parents or guardians reported having shown grave danger to their psycho-social well-being instead of when they suffered abuse from strangers. The effect that child abuse has on the child starts early with chronic conditions and extends into the child’s future. Therefore, most of the impact range between short-term and long-term due to the triggers of attachment. The attachment patterns that the child establishes with their parents lead to a series of outcomes. Attachment, therefore, is a critical factor that determines whether the child will manifest self-reliance or undergo depression. All these depend on factors that determine how and to what level attachment develops.
The relationship between child abuse and attachment dwell on the impact in adulthood. According to Brenner (2019), the U.S Department of Health and Human Services reported 3.25 million abuse to Child Protection Services. Over 20 percent of this maltreatment has a persistent psycho-social impact on the life of the child. The long-term effects of child abuse require secure attachment styles to reverse the health outcomes. Therefore, attachment manifests as a significant factor for showing how child abuse is a detrimental issue in a child’s life and how social services can foster care for the victims of child abuse. Infants in foster care who suffered child abuse and early caregiving disruptions tend to develop attachment disorders (Child Welfare Information Gateway, 2019). These disorders can affect positive relationships. Hence, attachment and social difficulties are behavioral responses that the child develops in early life stages, exposing them to more likelihood of showing antisocial traits as they grow up.
Child abuse and neglect cause attachment avoidance and anxiety. The relationship calls for social support as a critical factor in addressing attachment anxiety and avoidance. Difficulties in managing children suffering from physical, sexual, and emotional abuse create more danger for the victims (Brenner, 2019). Without prompt social support, children with anxious attachments will fall into low self-esteem, depression, and anxiety in the history of a victim suffering from physical abuse and childhood neglect. Avoidances of attachment styles determine negative health indicators. Social support, counseling, and secure attachment emerge as practical means of addressing the damages that child abuse and neglect cause in a victim.
Caregivers, parents, and all people responsible for taking care of the child should develop lasting and meaningful attachment. The self-report from the measurement tool indicated the need for providing social support through secure attachment. Secure attachment is an effective intervention that supports the victims of child abuse. Research maintains that secure attachment was critical in helping victims of substance abuse where caregivers and parents became attentive and responsive to the child (Child Welfare Information Gateway, 2019). Intervention mechanisms should incorporate lifelong approaches where social workers, caregivers, parents, and guardians recognize the children’s needs and meet them most sensitively. The secure attachment style originates from fostering trust among the parties to a relationship. The emotions between caregivers and the children need to be synchronized to instill the values of empathy. In some cases, there is a need for an empathetic response to the child’s fears, struggles, and joys. Insecure attachment style, the caregiver intervenes to correct the effects of child abuse through emotional and physical availability. For this reason, the child tends to feel secure in the home environment and thus allow themselves to bond in more cordial interactions.
As is evident from the analysis, the behavioral patterns tend to inhibit or promote warm relationships. The effect of attachments between mental health outcome and child abuse indicate the need for a consistent intervention approach that focuses on promoting the child’s self-esteem. Attachment styles offer a partial mediation role in intervening between behavioral manifestations of the victim. Health Assessment Survey showed how parents with risk behaviors impose a constant demand and thus worsen child abuse and neglect (Child Welfare Information Gateway, 2019). Therefore, to address a wide range of attachment disorders, social support agencies need to offer a counter attachment style that promotes a positive image in the victim.
Scope of the Topic
Empirical and theoretical research on the relationship between attachment and child abuse and neglect has focused on aggression. Most scholars focused on examining children who have experienced emotional abuse. The age group of subjects in most empirical research has been chiefly infants or toddlers. The outcome of the studies indicates research bias towards aggressive behavior. Studies showed that children show externalizing symptoms once they reach school-going age. The indicators of such aggressive behavior capture the history of child abuse and neglect. Little research has been on understanding the extent to which attachment issues that survivor children experience.
Data available in most scholarly literature fails to underscore how children develop secure attachment to parents and caregivers’ responsiveness to their needs. Most researchers reinforce the argument that indicates the harmful effect of physical abuse, sexual abuse, and neglect on the child. A strong relationship exists between the children’s child protection facilities and their history of abuse and neglect. Research shows that while the number of children receiving services in child protection facilities has increased, the number of young persons in juvenile delinquency facilities has also been up-trending. The findings indicate the association between child abuse and difficulties of these children forming attachments in their future relationships. Existing data reveal that cases of attachment issues increase with an increase in child neglect.
Empirical evidence suggests a limited scope of child abuse. Existing research confines itself to defining child neglect depending on their field, socialization, persuasion, and different social cultures. However, scholars indicate universal elements that contribute to child neglect. These include the failure to provide a child with the physical, health, and psychological needs required for a child’s growth are crucial. Research condemns the lack of basic needs. Most cases of child abuse occur in societies that experience absolute poverty. All these make child neglect a severe problem. Despite the intense gravity of the problem, child neglect remains the most widespread form of abuse in children. In America, for instance, it is estimated at 70 percent or over.
The gaps are in knowledge
Research suggests the relationship between short terms relationship abilities and the history of child abuse. Considerable debate on using the principles of attachment to overcome the effects of child abuse experiences lacks from the majority of literature. Ongoing scholarly debate aligns with child victimization at the childhood level, adolescents and adults. Studies have failed to connect the causes of child abuse and the consequences in their later years. The problematic assessment limits the scope of existing research and scholars’ ability to synthesis elements of abusive behavior from the parents or caretaker.
Little research has examined the gender difference in responding to child abuse and neglect. Early reports of violence described aggression when addressing the male child. Although research indicates that most aggressors are boys who suffered child abuse, little research indicates the impact of child abuse on boys and girls. Scientific studies on child abuse have targeted children from infancy to adolescence. In this case, the problem with this gap rests on the assumption that adults do not show attachment issues following their traumatic childhood experiences. Most of the studies primarily focus on the retrospective impact of abuse of children and adolescents. The studies are subject to research bias and clinical incurrence. Existing theories are weak in explaining the inert causes of attachment issues that dissociate from parental abuse. Therefore, these studies do not acknowledge that child abuse can occur in social environments that face high poverty levels and unemployment.
Relevance of the Research
The literature is relevant to the topic because it underscores the consequences of child abuse on future relationships. The current gap in knowledge is about factors that differentiate abuse and normal withdrawal tendencies with a child. This research fills the existing gap by building salient themes of early parent-child interaction. The research is critical in informing the ongoing efforts by social work practitioners, children psychologists, and scholars to define child abuse and the relationship with attachment. The literature connects the behavioral factors and poor peer relationships as indicators of violent behaviors. Thus, the impact of child abuse and neglect on the child and the society they live.
The study’s findings will bridge the knowledge gap by developing different perspectives of understanding child abuse and neglect. For instance, alcohol and drug abuse, unemployment, teenage and unwanted pregnancies, many children in a family, domestic conflicts, and mental problems of the parents have a high probability of creating situations of child neglect. The research will show the high rates of child neglect among households with low living standards while lower in families with high living standards. The connection is linking the problem of child neglect to poverty.
Moreover, the research will contribute to the body of knowledge by showing that child neglect leads to many problems that affect the child and the general society. A neglected child may become weak physically more so if there is a failure in providing the child with nutritious foods and healthcare. A neglected child suffers more psychologically and may have stress-related problems, making the child not have functional relationships. The self-esteem of the neglected child reduces as they feel worthless of being cared for, which reduces their confidence and, consequently, their self-efficacy. Such a child may also portray behavioral problems which legally can only emerge from the angle of juvenile delinquency. All these points to the significance of understanding how survivors of child abuse experience attachment issues.
Speech Presentation
Ladies and gentlemen,
It is an honor for me to present our research on the question, How do survivors of child abuse and neglect experience attachment issues? To answer this research question, we understood to limit the scope of our study by using children between the age of three years to 16 years. We understood that this is a critical age in human development.
The research progressed from searching for available data from Ebscohost, Google Scholar, PubMed, and other credible databases. The search criteria followed our research question, the variables of our study, and the focus on attachment, child abuse, and the outcome of child abuse. We also emphasized examining the literature that used the Patient Health Questionnaire-9 (PHQ-9) measurement tool to understand the impact of child abuse on mental health. All these are significant in helping social workers create better intervention frameworks to show how attachment manifests from prolonged child abuse.
Research showed that child neglect connotes the failure of the parents or caregivers to provide basic needs to the child. It also manifests through physical abuse, emotional abuse, and psychological abuse. There is a belief in society that children are to be cared for by the elder members. Even if the parents are not alive, there should be someone who should be available to cater to their basic needs, especially the people who are their close relatives.
References
Brenner, G (2019). Attachment Style, Adult Well-Being, and Childhood Trauma. Retrieved from https://www.psychologytoday.com/intl/blog/experimentations/201801/attachment-style-adult-well-being-and-childhood-trauma
Child Welfare Information Gateway (2019). Long-Term Consequences of Child Abuse and Neglect. Retrieved from https://www.childwelfare.gov/pubPDFs/long_term_consequences.pdf
Ensink, K., Borelli, J. L., Normandin, L., Target, M., & Fonagy, P. (2020). Childhood sexual abuse and attachment insecurity: Associations with child psychological difficulties. American Journal of Orthopsychiatry, 90(1), 115.
Ensink, K., Borelli, J. L., Normandin, L., Target, M., & Fonagy, P. (2020). Childhood sexual abuse and attachment insecurity: Associations with child psychological difficulties. American Journal of Orthopsychiatry, 90(1), 115.
Erozkan, A. (2016). The Link between Types of Attachment and Childhood Trauma. Universal journal of educational research, 4(5), 1071-1079.
Erozkan, A. (2016). The Link between Types of Attachment and Childhood Trauma. Universal journal of educational research, 4(5), 1071-1079.
Roazzi, A., Attili, G., Di Pentima, L., & Toni, A. (2016). Locus of control in maltreated children: the impact of attachment and cumulative trauma. Psicologia: Reflexão e Crítica, 29(1), 1-11.
Strathearn, L., Giannotti, M., Mills, R., Kisely, S., Najman, J., & Abajobir, A. (2020). Long-term cognitive, psychological, and health outcomes associated with child abuse and neglect. Pediatrics, 146(4).
Wilkinson, J., & Bowyer, S. (2017). The impacts of abuse and neglect on children; and comparison of different placement options. RIP/DfE (DFE-RR663).
World Health Organization (n.d). Child maltreatment. Retrieved from https://www.who.int/news-room/fact-sheets/detail/child-maltreatment