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CHILD AND ADOLESCENT PSYCHIATRY
Minerva Psichiatrica 2011 March;52(1):37-50
Copyright © 2011 EDIZIONI MINERVA MEDICA
language: English
Child abuse and its prevention
Braquehais M. D. 1, Picouto M. D. 2, Matalí J. L. 2
1 Department of Psychiatry and Legal Medicine, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, Spain 2 Department of Child Psychiatry and Psychology, Sant Joan de Deu University Hospital Universitat Autònoma de Barcelona, Spain
Child abuse prevention is recognized as a critical clinical and social issue. Child abuse or maltreatment can be considered a type of childhood trauma that is known to affect psychobiological states through a complex matrix of behavioral, emotional, and cognitive factors. Countries vary in the number and size of the layers of child maltreatment that are recognized and reported. That is why the most popular metaphor used to analyze child abuse prevalence data it is that of an iceberg where only a portion is visible. Risk and protective factors for child abuse can be dissected in a theoretical framework that differentiates: 1) the child; 2) the family; 2) the community; and 4) the society. Though not all exposed individuals demonstrate the same altered responses, there is an increasing evidence of the negative immediate and long-term effects of child abuse in the developing brain of children and adolescents. It also elevates the risk of psychiatric and medical diseases in the future. Primary, secondary, and tertiary prevention strategies are described in this paper although only a few preventive programs have demonstrated evidence of effectiveness. Despite the great effort made in the last decades to improve the quality of preventing programs for child maltreatment, there is still a lack of proper assessment of current interventions and of sufficient empirical information to establish specific standards of intervention. However, available evidence supports a superior effectiveness of the primary prevention policies over the second and tertiary strategies.