Impact of Child Neglect and Abuse on Adult Mental Health

Abstract

Child neglect and abuse is a public health priority. Adverse conditions in early life are associated with higher risk of mental disorders. Family conditions and quality of parenting have a significant impact on risk of mental and physical health. Children's exposure to neglect, direct physical and psychological abuse, and growing up in families with domestic violence was particularly damagin. The current review covers four aspects, namely, (i) prevalence of child neglect and abuse in South Asian Association Regional Cooperation (SAARC) countries; (ii) evidence of the lifetime impact of child neglect and abuse on the mental health in the general population and in specific population groups; (iii) the biological changes due to the impact of child neglect and abuse; and (iv) implications of the findings for research and interventions at the level of children, families and community. There is poor documentation of child neglect and abuse. A recent Tata Institute of Social Sciences (TISS) and Action Aid study (2014) in Mumbai city’ covered over 37,059 children, of whom 728 were studied in depth. Torture, beating, forced starving and sexual abuse were observed or heard by (among the) children. Threats from police, theft, hurt, displacement, kidnapping and ghosts were perceived mostly at nights, especially in the sleeping places. In total, 44% had observed abuse, which included torture, beating, forced starving and sexual abuse. In an another report, ‘The Republic's Lost Children’, it was reported that 38% were forced into sex trade; 23% forced into domestic servitude; 4% routed to work at hotels or hospitals; and 3% at the sweetmeat and garment units. The evidence of the long-lasting effects of ‘child neglect and abuse’ are increased rates of mental disorders. Physically abused, emotionally abused and neglected individuals have a higher risk, two to three times, of developing depressive disorders than non-abused individuals. Children with a history of bullying, 40–50 years later, had an increased risk for depression and suicidal thoughts and were likely to have lack of social relationships, lower educational levels and also more likely to be unemployed and earning less. Other significant associations between childhood adversities are occurrence of first-onset and recurrent mania, fatigue syndromes, adult violent offending, and criminality. There is growing evidence of the mediation of the effects of child neglect and abuse are biologically based with associated changes at the level of stress response, changes in brain structures, inflammatory response and neurocognitive functions. There is need for interventions at many levels, starting from documenting the problem, the longitudinal study of neglected children, interventions to remedy the disadvantages at the level of individual children, their families, communities and government policies. This is an urgent need in the SAARC countries.