By Rita Brhel, managing editor and attachment parenting resource leader (API)

In the United States alone, there are 3.2 million referrals to social services on allegations of child maltreatment each year — one-quarter of which are found to have a substantiated case of physical or sexual abuse or severe neglect. Seventy-five percent of these founded cases of abuse or neglect had no prior history. It’s an astounding number of children who aren’t living in safe, loving homes — especially knowing that these numbers don’t count the abused and neglected children living around the world. It’s a number that child maltreatment prevention researcher David Zielinski, PhD, wants to stick in your mind.

“I can highlight this, I can underline this — we’re talking about a huge number of children,” said Zielinski, who works with the National Institute of Mental Health. Earlier this year, he addressed a wide audience of researchers, social workers, and other professionals in the field of child abuse prevention and treatment through a webinar hosted by the Quality Improvement Center on Early Childhood.

That “huge number of children” Zielinski was describing translates into another sizable group – 25 million to 30 million adults, just in the U.S., who were abused or neglected as children. Research has shown us that individuals who experienced abuse and neglect have a higher risk of depression, post-traumatic stress disorder and other anxiety disorders, antisocial personality disorder, substance abuse, and other addictions. And it’s well known that adults who were abused or neglected as children are more likely to become abusers themselves.

“You learn what’s appropriate based on imitation,” Zielinski said.

But the effects of this abuse tend to focus on treatment, rather than prevention — on the individual, rather than society.

“We need to pay attention to not just the biology, temperament, and behavior of the individual who was abused as a child, but also how the individual now interacts with others in the community,” Zielinski said. “Research is now trying to fill the gaps in knowledge and answer the question, what happens after child abuse beyond age 18? To be frank, it’s not receiving the attention that is needed from policymakers, those who decide where the funding goes.”

Abuse Effects on Physical Health

Research has shown the effects of child abuse and neglect on adult mental health, but there is more and more evidence that maltreatment also has effects on adult physical health.

“We don’t know the mechanisms of how abuse at two years old affects physical health at 40 years old,” Zielinski said, but we do know that individuals who were abused as children are at higher risk of diabetes, heart disease, cancer, gastrointestinal problems, and chronic pain. It’s evident, he said: “Early experiences have long-term physical outcomes.”

Zielinski explained a 2009 study that shows how sexually abused girls develop considerably less visual memory than their peers. An example of poor visual memory is if a child is sitting in a class room listening to the teacher but unable to take notes — her auditory memory is normal, but her visual memory is impaired as she can’t remember what is written on the board long enough to write it down in her notebook.

“Think of an infant that has gone through a significant amount of sexual abuse, and years later, she’s having problems in school,” he said. “It’s not just that she’s acting out — there are biological reasons for this.”

And a 2010 study links child maltreatment with telomere shortening. Telomeres are the end caps of chromosomes, and the shortening of these telomeres are a result of stress. The result is premature cellular aging.

“Those who experience high levels of stress have shorter telomeres for their age,” Zielinski said — a fact that pertains to all segments of society, not just those who were abused as children. “On a biological scale, they are much older chromosomally than they are chronologically.”

Research connecting child maltreatment with physical health effects has been exploding this past decade, and what’s been found so far has shown that early childhood stress has an impact on our biology. Recovering from childhood maltreatment isn’t a matter of “just getting over it.” There are impacts on cognition and memory; it is consistently associated with delinquent and disruptive behaviors as well as conditions such as Attention Deficit Disorder.

Socio-Economic Effects of Child Abuse

Child maltreatment is consistently associated with lower academic performance, but effects are much more long-term. A 2000 study shows that child maltreatment increases college drop-out rates. Another 2000 study focused on the economic consequences of child sexual abuse for adult lesbian women and found a significant correlation between abuse and income. A third study found twice the unemployment rate and a 65% increase in the risk for being on public assistance in adolescent victims of violence.

“If you do have deficits in grade school, it may affect high school and later on in life. They build on top of one another,” Zielinski said. In fact, according to the U.S. Labor Economic Research division, there are three indicators predicting individual employment status and income: level of education, physical health, and psychopathology — all of which research shows is affected by childhood maltreatment.

Zielinski believes there needs to be more communication between social services and economics, as one certainly affects the other. “Interdisciplinary work is really what you need to do if you want to understand this on a holistic level,” he said.

Socio-Economic Outcomes Vary with Type of Abuse

According to a 1993 study, there are different adult outcomes for different types of child maltreatment, and other factors such as duration and the relationship with the abuser also play into a very complex formulation of what will happen as that abused child grows up. That’s exactly what Zielinski has found in his research.

For his paper, Zielinski chose to concentrate on how child maltreatment histories affect adults’ socio-economic status. What he found was that adults who were physically abused as children had high unemployment rates, high rates for job loss occurring in their immediate families, and were likely to live under the poverty line. Physical abuse correlates with employment instability more than anything else, which naturally follows the general finding of instability in life that likely began with school attendance. Sexual abuse correlates with family job loss, but not necessarily personal job loss, suggesting that the issue is more the selection of the spouse. And severe neglect correlates with lower income potential. While none of the types of abuse are “better” than the others, it’s evident that physical abuse has the most severe effects.