Although childhood emotional abuse is rarely addressed by clinicians, new research suggests psychological abuse among children may lead to more problems than sexual or physical abuse.

The finding that childhood emotional abuse and neglect is rarely addressed in prevention programs or in treatment victims is sobering.

“Given the prevalence of childhood psychological abuse and the severity of harm to young victims, it should be at the forefront of mental health and social service training,” said study lead author Joseph Spinazzola, Ph.D.

The study appears in a special online issue of the journal Psychological Trauma: Theory, Research, Practice, and Policy.

Researchers used a national data set of childhood traumatic stress to analyze data from 5,616 youths with lifetime histories of one or more of three types of abuse.

Abuse classifications included psychological maltreatment (emotional abuse or emotional neglect), physical abuse, and sexual abuse.

A majority of cases (62 percent) had a history of psychological maltreatment, and nearly a quarter (24 percent) of all the events were exclusively psychological maltreatment.

Researchers defined psychological maltreatment as care-giver inflicted bullying, terrorizing, coercive control, severe insults, debasement, threats, overwhelming demands, shunning, and/or isolation.

Investigators discovered children who had been psychologically abused suffered from anxiety, depression, low self-esteem, symptoms of post-traumatic stress, and suicidality.

An important discovery was that the residual trauma after psychological abuse occurred at the same rate, or in some cases, at a greater rate than children who were physically or sexually abused.

Conditions such as depression, general anxiety disorder, social anxiety disorder, attachment problems, and substance abuse occurred more often after psychological maltreatment, than physical or sexual abuse.

When psychological maltreatment accompanied physical or sexual abuse negative outcomes far exceeded what was found than when children were sexually and physically abused and not psychologically abused.

Moreover, sexual and physical abuse had to occur at the same time to have the same effect as psychological abuse alone on behavioral issues at school, attachment problems and self-injurious behaviors.

“Child protective service case workers may have a harder time recognizing and substantiating emotional neglect and abuse because there are no physical wounds,” said Spinazzola.

“Also, psychological abuse isn’t considered a serious social taboo like physical and sexual child abuse. We need public awareness initiatives to help people understand just how harmful psychological maltreatment is for children and adolescents.”

Nearly three million U.S. children experience some form of maltreatment annually, predominantly by a parent, family member, or other adult caregiver, according to the Children’s Bureau, part of the U.S. Department of Health and Human Services.

The American Academy of Pediatrics in 2012 identified psychological maltreatment as “the most challenging and prevalent form of child abuse and neglect.”

Source: American Psychological Association

For Kids, Mental Abuse Can Be Worse than Sexual, Physical Abuse