introduction for chapter 12


Summarize the content of Chapter 12.Kemp Page i Tuesday, October 11, 2016 2:51 PM
An Introduction
Alan R. Kemp
Pierce College
Long Grove, Illinois Page ii Tuesday, October 11, 2016 2:44 PM
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About the Author xii
Preface xiii
Introduction xix
PART I The Nature of Abuse and Neglect
1 The Abuse Landscape
Professional Attention 5
What Is Maltreatment? 7
Basic Human Needs 8
Ambiguous Boundaries 9
Continuums of Abuse 10
Family Abuse Spillover 11
Theory, Research, and Practice
The Theory-Research Cycle 11
Research Methods 13
Theory and Practice 18
The Complex Nature of Abuse 33
PART II Child Maltreatment
2 Child Physical Abuse
Historical Context 43
Defining Physical Abuse
Intent and Result 45
Considering Culture 46
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The Child Abuse Prevention and Treatment Act (CAPTA)
A Working Definition of Child Physical Abuse 47
Continuum of Physical Abuse 47
Major Types of Physical Injuries
Head Injuries 48
Visceral Injuries 48
Bone Injuries 49
Burns 49
Eye Injuries 50
Skin Injuries 50
Psychological Impacts
Impacts of Child Abuse in General 51
Psychological Impacts Specific to Child Physical Abuse 52
Impact on Social Development 53
Intergenerational Transmission
Risk and Resiliency 58
Risk Factors 58
Blending of Factors 61
Protective Factors 63
Fabricated or Induced Illness
Summary 64
3 Child Neglect
The Nature of Neglect
Care as a Basic Human Need 71
Basic Types of Neglect 74
Neglect of Neglect
Seriousness of the Problem 78
Failure to Thrive 79
Possible Explanations for the Inattention 80
Impact on Children 81
Social Costs 83
Explanations and Risk Factors
Resiliency 86
Combating Child Neglect
Prevention 87
Assessment 88
Intervention 89
Innovation 90
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Implications 91
Summary 93
4 Child Psychological Maltreatment
What Is Psychological Maltreatment?
Controversy Surrounding the Issue 100
Some Definitions 101
Explaining the Impact of Child Psychological Maltreatment
Theory of Basic Human Needs 104
Attachment Theory 105
Theory of Human Development 105
Research on Child Psychological Maltreatment
Pioneering Research 109
Minnesota Longitudinal Study 110
The Contemporary Literature 111
Explanations and Risk Factors
The Macro Level: Broad Social and Cultural Influences 113
The Meso Level: Family and Relationship Influences 115
The Micro Level: Individual Factors 115
Resiliency: The Ability to Bounce Back
Summary 118
5 Child Sexual Abuse
The Problem
Historical Neglect 125
Rediscovering Child Sexual Abuse 127
How Big Is the Problem?
Incidence 129
Prevalence 130
Relevance of Incidence and Prevalence Estimates 132
The Nature of Child Sexual Abuse
Defining Child Sexual Abuse 132
Severity of Abuse 133
Relationship between Victim and Perpetrator 135
Frequency of Abuse 135
The Impact of Child Sexual Abuse 136
Conceptualizing Victimization 138
The Biomedical Model 138
The Four-Factor Traumagenic Model
Trauma Theory 144
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On the Horizon
Summary 148
6 Sexual Offenders
Types of Offenders 156
Psychiatric Diagnosis 157
Profile Models 159
Fixated-Regressed Profile Model 159
Situational-Preferential Profile Model 161
A Caution on Using Profile Models 162
The Four-Factor Offender Model 162
The Dynamic Opposition Model 164
The Addiction Model 165
Youthful Offenders 166
Intervention 169
Federal Initiatives 169
State Initiatives 170
Local Initiatives 171
Treatment for Sex Offenders
Traditional Approaches 172
Emerging Trends 175
Does Sex Offender Treatment Work?
Traditional Approaches to Relapse Prevention 178
Risk-Need-Responsivity (RNR) and Good Lives Approaches 180
Concluding Comments
Summary 181
7 Bullying and Sibling Abuse
The Nature of Bullying 190
Suspected Causes 193
Intervention 196
Assessment 198
Sibling Abuse
Sibling Rivalry vs. Sibling Abuse 200
Forms of Sibling Abuse 202
Prevalence 203
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Suspected Causes 204
Impact 206
Intervention 206
8 Legal and Ethical Issues in Child Maltreatment
Reporting Child Maltreatment 216
CPS Investigation 217
Investigative Interviewing 218
Interviewing Procedures 219
Multiple Interviews 221
Recording Interviews 221
Risk Assessment 222
Emergency Intervention 224
Dependency Proceedings 224
Criminal Cases 227
Coordinated Response 228
Criminal Prosecution 229
Testimony in Criminal Cases 230
Sentencing 235
Civil Suits 236
Repressed Memory/False Memory Debate
Issues and Trends 239
The Impact of Out-of-Home Care 239
Helping Children and Families 241
Resilience 245
Intimate Partner Violence
9 Courtship Violence and Date Rape
Courtship Violence
Overview 256
Context 259
Suspected Causes 259
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Types of Stalking 264
Anti-Stalking Legislation
Cyberstalking 266
Intervention 268
Date Rape
Definition, Characteristics, and Statistics 269
Risk Factors 271
Drug-Facilitated Sexual Assault 274
Impact of Sexual Assault 275
Acknowledging Victim Needs 276
10 Domestic Violence
Historical Context 285
What Is Domestic Violence?
Situational Couple Violence 288
Intimate Terrorism 288
Violent Resistance 289
Mutual Violent Control 290
Prevalence and Incidence
National Family Violence Surveys 291
National Intimate Partner and Sexual Violence Survey
National Violence Against Women Survey 291
National Crime Victimization Survey 292
Reporting Domestic Violence Fatalities 292
Male and Female Violence
Impact on Victims 295
Children Who Witness Domestic Violence 297
A More Client-Friendly Way to Understand Victims 298
Patterns of Domestic Violence
Cycle of Violence 300
Spiral of Violence 302
Why Victims Stay 304
Causes and Risk Factors
The Big Picture: The Macro Level 305
Family and Relationships: The Meso Level 307
Individual and Personality Factors: The Micro Level
Classifying Perpetrators
The Elephant in the Room 311
Expressive and Instrumental Violence 311
Cobras and Pit Bulls 311
A New Picture of Domestic Violence 313
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Intervention with Perpetrators
Assistance for Victims 320
11 Abuse in the Relationships of Sexual Minorities
Abuse among Sexual Minorities
Incidence and Fatalities 329
Prevalence of Physical Violence 331
Perpetrators of Intimate Partner Violence 333
Stalking, Sexual Violence, and Psychological Abuse 334
Contextualizing the Abuse
Challenges 336
Common Experiences and Risk Factors
Unique Issues for LGBTQ People 338
Nature of the Abuse
Abuse in Gay Male Relationships 339
Abuse in Lesbian Relationships 340
Abuse in the Lives of Transgender People 341
Programs and Services
Gaps in Services 342
Steps to Improve Care 342
Maltreatment of Elderly and Disabled People
12 Abuse of Elderly and Disabled People
Historical Context 355
Defining Elder Maltreatment 357
Incidence and Prevalence 358
Estimates of Domestic Abuse 359
Estimates of Institutional Abuse 360
Indicators of Elder Abuse
Indicators of Physical Abuse 363
Indicators of Neglect 363
Indicators of Financial or Material Exploitation
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Understanding the Problem
The Macro Level: Broad Cultural and Social Factors 368
The Meso Level: Family and Relationship Factors 370
The Micro Level: Individual and Personality Factors 373
Federal, State, and Local Initiatives 376
Intervention with Domestic Maltreatment 377
Intervention with Institutional Maltreatment 382
Emerging Issues
13 Abuse by Clergy
Sexual Misconduct by the Clergy
Context 395
Definition and Prevalence 395
Dynamics 396
Impact 398
The Ecological Perspective 401
Intervention 402
Clergy-Perpetrated Sexual Abuse
The Priest Abuse Scandal 404
Ecclesiastical Context 406
Current State of Affairs 419
Challenges and Reform 421
14 Abuse in Sports
Abuse in Youth Sports
Context 432
Sports Subculture 433
Hazing 434
Failure to Protect 439
Physical Abuse 441
Psychological Maltreatment
Sexual Exploitation 446
445 Page xi Tuesday, October 11, 2016 2:44 PM
Abuse in Adult Sports
Bullying 455
Locker Room Culture and the Absence of League Oversight 459
Disabling Injuries 460
Family Violence 466
Performance Drug Abuse 466
Gambling 468
15 The Road Ahead: An Epilogue and a Way Forward
Where We’ve Come From 478
How We’ve Responded 479
Child Abuse and Neglect 479
Intimate Partner Violence 480
Abuse of Elderly and Disabled People 481
Abuse by Clergy 482
Abuse in Sports 484
Trauma Theory: A Revolution 486
Intervention: What We’ve Done About It
Clinical Intervention 487
Social Intervention 489
The Road Ahead: Where We Go from Here
Glossary 499
References 521
Index 603
477 Page xii Tuesday, October 11, 2016 2:44 PM
About the Author
Alan R. Kemp is Professor of Sociology at Pierce College, Fort Steilacoom, where
he was named as the recipient of the Outstanding Faculty Award. In a previous
assignment at Pierce, he was the coordinator of, and a professor in, the college’s
social service educational programs. He is the author of two other published textbooks, Abuse in the Family: An Introduction (Thomson/Cengage) and Death, Dying,
and Bereavement in a Changing World (Pearson/Routledge). He holds master’s
degrees in divinity and social work. He earned his doctorate at the then amalgamated colleges of St. Stephen’s and St. Andrew’s, in Edmonton, Alberta, and Saskatoon, Saskatchewan, Canada. He is both an ordained member of the clergy and
a licensed mental health professional. The National Association of Social Workers recognizes him as a Diplomate in Clinical Social Work (DCSW). For five years
he worked with military families under contract with the U.S. Air Force, including work in its “family advocacy” program. He is himself a Vietnam veteran who
was among the last American advisors serving on patrol with Vietnamese forces
aboard Swift Boats (PCFs) operating from Hon Tre, an isolated duty station in
the far southern part of the country. He currently lives with his wife, Claudia, and
a menagerie of “critters” at their cabin on property in rural western Washington.
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Why Do We Need a Text on Abuse in Society?
I don’t think anyone can deny that abuse, in one form or another, is now a major
social concern. Over the last 50 years or so, both the public and members of the
professional community have become increasingly concerned about the issues.
I happen to be a clinician as well as a sociologist. When I was preparing for
my clinical career, I didn’t have the advantage of formal training on handling
abuse issues. Most of what I learned had taken place when I was already in practice, usually through workshops, self-directed study, and professional supervision. Learning to handle abuse issues in the field is something like reading the
repair manual after your car has already broken down. As a result, I’ve become
convinced that we ought to start teaching prospective providers about abuse
before they embark on their careers.
When I began my college teaching career, I coordinated a clinically oriented
professional-technical program. With this assignment came the task of developing new curriculum for a program that was in transition at the time. One of the
first courses I developed was on the topic of abuse. It made sense to offer such a
course, since so much of what we encounter in social services has to deal with
abuse. However, I soon learned that formal courses on the topic were a rarity. I
also discovered that finding a textbook wasn’t so easy. While I found a number of
professional books dealing with specialized types and aspects of abuse, none of
the available books seemed geared to the classroom.
Who Is This Text For?
This book is written for students in a variety of academic disciplines (such as
sociology, psychology, and anthropology) and human service professions (such
as social work, family therapy, mental health counseling, psychiatry, and psychiatric nursing), who need an introduction to the topic of abuse. It is intended to
serve as a readable yet instructive introduction rather than an exhaustive examination of this evolving field. A number of other professional and technical volumes deal extensively with specialized topics in intervention and treatment
(some of which are included in the Recommended Reading section located at the
end of each chapter).
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I don’t assume the reader already has a background in the social sciences,
and I certainly don’t assume the reader has already been out in the field, although
some may already have been. I hope the text will appeal to a broad audience,
including those who want to pursue careers in social work, pastoral counseling,
mental health counseling, marriage and family therapy, psychology, psychiatry,
and nursing, although I it should serve as a useful resource for anyone who wants
to know more about the subject. I attempted to write it in a style I thought would
be appropriate for use in the field as well as in community-college, university,
and graduate-school courses.
Philosophy of the Book
For the most part, I have attempted to approach the topic from an ecological perspective. In essence, this means that we shouldn’t be interested in just single
explanations but, rather in the interacting explanations from a variety of perspectives and levels of analysis: societal and cultural, family, and, individual. My
sense is that when we approach the topic this way, a number of important questions emerge, reminding us about the complexity of the kind of issues we’re
dealing with are complex. What social and cultural influences are at play? How
do family relationships influence behavior? What personality and individual factors are at work?
The domain of abuse has not been a unified field of study. Until recently it
has been divided into a number of semi-autonomous research fields: child physical abuse, child neglect, child emotional or psychological maltreatment, child
sexual abuse, sexual offenders, domestic violence, and elder abuse. Members of
the research community usually focus their attention on one or more very specialized areas. Sometimes even within a particular specialty, such as child physical abuse, one might concentrate on just a small part of the issue. Clinicians,
however, have had to deal with whatever they encounter in the field, which
often forces them to engage in a more generalist form of practice. As a consequence, researchers and professionals have sometimes carried out their work
somewhat independently. By bringing each of the topic areas together in this
book, with an eye to practice, one of my hopes is that it will provide readers a
more unified view.
The first incarnation of this book, which addressed abuse in the family, had
eight chapters; Abuse in Society has fifteen. In addition to updating the original
material, this book has a significant amount of new content, including chapters
on bullying and sibling abuse, courtship violence and date rape, and abuse in the
relationships of sexual minorities. I’ve also included two chapters on emerging
issues: abuse by clergy and abuse in sports. Finally, I have included an epilogue
that attempts to integrate the topics of other chapters and take a look at what
may lie ahead.
The discussion is grounded in a review of the research as well as current practice. To make the material more approachable, I have included case examples and
media reports to add relevance and pique reader interest. Figures, charts, tables,
and other aids will also enhance readers’ understanding of complex material. Page xv Tuesday, October 11, 2016 2:44 PM
Although the chapters differ in content, each is structurally similar. A chapter Summary, a Review Guide, Suggested Activities, a Recommended Reading
list, and Internet Resources appear at the end of each chapter. Since critical thinking has become an increasingly important in higher education, you will also find
a section titled Critical Thinking Questions near the end of each chapter. Much
like the Socratic method of inquiry, these questions are designed to encourage
students to critically examine issues and ask ethical questions. Key terms and
concepts appear in bold type throughout the text. While descriptions and definitions accompany the terms and concepts in the discussion, I have included a glossary at the back of the book.
A Few Personal Observations
Those of us who teach and practice do not do our work in a vacuum. We live in
society too, and some of us may have been exposed to abuse in one form or
another. The kind of material presented here can be a painful reminder of personal issues related to prior maltreatment. One of the reviewers of the earlier
edition really brought this point home. She commented that over half of all students taking her courses are in various stages of recovery from maltreatment. I
have found this to be true in students taking my courses as well. If reading this
material brings up uncomfortable issues for you, it may be better to grapple with
them now, rather than unexpectedly encountering them when in the field.
Regardless of your personal experience, however, working with abuse issues can
be emotionally challenging for anyone, so you should probably be prepared to do
some personal introspection and be open to experiencing discomfort. If you find
yourself distressed, let your professor know. And don’t be shy about seeking professional assistance if you need it.
I hope you will take a close look at your feelings and attitudes about each of
the issues addressed in this book. I do want to challenge you to examine whatever feelings surface, and to use them as a way to learn more about yourself in
relation to others. Why do you think or feel as you do? How well do your old
beliefs fit with the new information you are being exposed to? What are the
implications of this new information? Does it change your preexisting attitudes?
If so, why? If not, why not?
How to Use This Text
While reading the book, you will naturally find some material that particularly
interests you. After completing a chapter, you may want to go back and take a
second, closer look. The chapter summaries may help you take in the “big picture.” As mentioned earlier, each chapter contains a series of legal and ethical
questions designed to spark discussion and critical thinking. The Review Guides
are designed to help you master the material. Initially, I suggest you use them to
assess how much of the material you’ve already learned. While terms are defined
within the context of the discussion, you might also want to use the glossary at
the back of the book to reinforce your understanding. Page xvi Tuesday, October 11, 2016 2:44 PM
Since a text of this nature cannot possibly deal with every issue, I have
appended a Suggested Readings section at the end of each chapter. Some are considered classics, while others represent cutting-edge work. Reading and discussing the material presented in this book is one thing, but fully integrating it may
require going deeper—doing something active or getting involved. To provide
some direction in this regard, I’ve included Suggested Activities at the back of
each chapter. While you probably don’t have the time to do them all, you may
find that doing at least some of them makes the material more meaningful.
One of the things I always like to share with my students is this: Any system
of education is also a system of ignorance. Any time an educator prepares a lecture, prepares a paper, or writes a chapter, we tell our intended readers what we
think is important. There are many other relevant and important things that we
don’t include. The danger in this situation is that other important insights and
ideas may be overlooked. While I’ve done my best to be as comprehensive as possible, because of time and space constraints there is much that isn’t included. I
encourage you to be a critical consumer of the concepts, positions, and information presented. By all means, go to the original sources and explore other issues
that spark your interest. If you have comments or questions, I’d be happy to hear
from you.
When I began to think about writing the acknowledgments, I came to realize just
how many people I needed to thank. Each has helped make this a better text and
helped make me a better person, and for this I am truly grateful. First and foremost among these is my wife, Claudia, who has had to live with me while I was
working on this and other projects. Second, a special thank-you goes to my friend
and former colleague Dennis Morton, who died a year ago. Not only did Dennis
give me a living example of how an educator can impact students, he also taught
me how important it is for a social scientist to have a big heart. Dennis read
drafts of the previous edition in its various stages of development and was there
to bounce some of the big-picture ideas back and forth. I miss him terribly.
Many other friends, colleagues, and students have helped me in important
ways. They were tolerant when I was caught up with the writing. They were forgiving when I got stretched too thin and even got a little cranky. My students are
always a source of inspiration, especially those who share their own stories of
hope and recovery. A special thank-you also goes to my colleague Denise Arnold,
who used manuscript versions of this text in her abuse classes, allowing me to
use her students as guinea pigs to field-test the material. The people in my own
department also deserve thanks, especially Leon Khalsa-Maulen and Daniel Suh,
who looked at and provided feedback on various pieces.
I want to thank Neil Rowe, my publisher at Waveland Press. Neil became
more like a partner. He was ever patient and ever diligent, putting up with delays
but demanding a book that fully lived up to the original proposal. His interest in
and enthusiasm for this project meant a lot to me, and I can’t say enough about
what a nice experience it was to have this kind of relationship. I am especially Page xvii Tuesday, October 11, 2016 2:44 PM
grateful to Gayle Zawilla, my editor at Waveland Press, for whom I have enormous respect. I am thankful for her good sense, candor, and attention to detail. I
cannot say enough about the hard work she put into making this the best possible text. She is a consummate professional who epitomizes my idea of what an
editor should be.
Finally, dear reader, I want to thank you. Were it not for you, this book would
not exist. I hope you find it useful in your studies, your practice, and your life.
Alan R. Kemp
Key Peninsula, Washington Page xviii Tuesday, October 11, 2016 2:44 PM Page xix Tuesday, October 11, 2016 2:44 PM
The abuse of power and people is likely more pervasive than any of us want to
realize. It includes child abuse (physical abuse, neglect, psychological maltreatment, child sexual abuse, bullying, and sibling abuse), intimate partner violence
(courtship violence, date rape, domestic violence, and abuse in the lives of sexual
minorities), and the maltreatment of elderly and disabled people. Its existence in
the family, religion, and sports is now becoming better understood, but its presence in other social institutions is still less well known. For example, up until
now we have paid scant attention to its manifestation in the film industry, education, health care, business, the criminal justice system, and government—in
short, the rest of society. Attending to the problem may well be among the most
important challenges facing us today. For this reason it may be in our best interests to learn about it, manage its impact, and change how we administer our
social institutions—and ultimately how we relate to one another.
Part I, The Nature of Abuse and Neglect, contains only a single chapter—but
it is an important one, for it introduces the topic of abuse in society and provides
a context for studying it. Chapter 1, The Abuse Landscape, explores abuse in its
various forms: physical, psychological, emotional, and sexual. Abuse is perpetrated against different target populations—children, adults, and the elderly—
and we touch on each of these here, with expanded discussion in later chapters.
This section includes an overview of the various forms of maltreatment and presents the systemic or ecological perspective adopted in the rest of the text—the
macro, meso, and micro levels of analysis. In this regard, we examine social, cultural, relationship, and individual influences on abuse. We also provide some
basic grounding in the social sciences and the theory-research cycle. We survey the
various approaches and techniques social scientists use for conducting research
on abuse in its different forms and perpetrated against several population groups.
The two distinctive research approaches—deductive and inductive—are introduced. Also discussed are a variety of specific quantitative and qualitative
research methods: the experiment, survey research, secondary analysis of existing data, and field studies that employ participant-observation, ethnography, and
case studies conducted with general and clinical populations.
Part II, Child Maltreatment, examines child abuse, one of the most heartwrenching issues of our times. Chapters 2 through 5 deal with child physical abuse,
child neglect, child psychological maltreatment, and child sexual abuse, respecxix Page xx Tuesday, October 11, 2016 2:44 PM
tively. These chapters attempt to define the topics, report incidence and prevalence
estimates, address the theories used to explain the phenomena, and explore ways
to intervene and combat abuse and maltreatment. Chapter 6 focuses on sex offenders, including an analysis of sexual predators and the legal issues involved. Chapter
7 explores bullying and sibling abuse. Chapter 8 reviews child maltreatment surveys and addresses the legal and ethical issues in child maltreatment including
investigation, risk assessment, court involvement, treatment, and intervention.
Part III, Intimate Partner Violence, examines abuse against adults occurring
within the context of one’s adult relationships, Chapter 9 discusses courtship violence and date rape, including a discussion of stalking. Chapter 10 covers the problem of domestic violence—its definitions, possible causes (including society’s
attitudes about women), and some new (and, I think, exciting) research. We discuss steps that are being taken to help victims and things we can do to deal with
perpetrators. Chapter 11 focuses on abuse in the relationships of sexual minorities.
Part IV, Maltreatment of Elderly and Disabled People, includes but a single
chapter. It addresses the abuse and neglect of individuals who are vulnerable
because of declining or impaired physical, mental, or emotional functioning.
Chapter 12 describes the often-neglected issue of this type of abuse. This is a
timely topic, since the so-called “Baby Boom” generation, among the largest in
recent history, is in or approaching old age. We investigate the explanations for
this type of abuse, including society’s attitudes about elderly and disabled people.
Part V, Emerging Issues, contains two chapters, each of which addresses
issues of abuse that have only recently emerged in the public consciousness and
have not gotten much scholarly attention. Abuse by clergy (Chapter 13) has
come to light because of revelations about abuse by Roman Catholic priests and
the cover-ups by their bishops. We discuss clergy sexual misconduct, the exploitation of adult congregants by religious leaders, and clergy-perpetrated sexual abuse,
which has been the focus of the priest abuse scandal within the Roman Catholic
Church. Chapter 14 addresses abuse in sports (both youth and adult). Abuse in
sports varies from abuse that occurs elsewhere primarily in the context in which
it takes place and the dynamics that are unique to sports. Abuse in sports has
emerged largely because of media reports of hazing in youth sports, the sexual
abuse of athletes by coaches, violence perpetrated by NFL players, and the effects
of repetitive head injuries experienced by NFL players, as well as the sexual
abuse scandal at Pennsylvania State University involving former football Defensive Coordinator Jerry Sandusky and the boys he sexually exploited.
It is a rare thing when we can “take in” a territory as vast as abuse in society,
re-examine this social problem in the light of emerging insights, and speculate
about what might be different in the future. We endeavor to do so in Part VI, the
final chapter of this book. Included is a brief historical overview, a discussion of
trauma theory (which can be applied to survivors of various forms of abuse), a
summary of key social policy responses to abuse, and a survey of both clinical and
social interventions. In conclusion, we review the insights that emerge in the preceding chapters and briefly speculate upon what lies ahead regarding abuse in
society, exploring trends and topics that seem likely to emerge at some future
point in time. Page 1 Tuesday, October 11, 2016 2:44 PM
The Nature of
Abuse and Neglect
People who are abused are taught to keep quiet about what has happened to them, yet exposing
abuse is a first step in effectively dealing with it. Page 2 Tuesday, October 11, 2016 2:44 PM Page 3 Tuesday, October 11, 2016 2:44 PM
The Abuse Landscape
Professional Attention
Defining Maltreatment
Basic Human Needs
Ambiguous Boundaries
Continuums of Abuse
Family Abuse Spillover
Theory, Research and Practice
The Theory-Research Cycle
Research Methods
Theory and Practice
The Macro Level: The “Big Picture”
The Meso Level: Family and Small-Group Influences
The Micro Level: Individualist Explanations
The Complex Nature of Abuse
3 Page 4 Tuesday, October 11, 2016 2:44 PM
Chapter One
We ask professionals to respond to a whole range of social problems, including trauma,
abuse, and neglect.
The field of abuse encompasses maltreatment in its many forms, such child
physical abuse, child neglect, child sexual abuse, child psychological maltreatment, bullying and sibling abuse, courtship violence and date rape, domestic violence, and the maltreatment of elderly and disabled people—indeed, the abuse of
anyone by someone in a position of trust. Terms like family maltreatment, family
abuse, and family violence have all been used more or less synonymously in the
field. Former US Attorney General Janet Reno once described abuse as the leading contributor of most other social problems. The problem of abuse has caught
on with the general public—for good when it increases awareness and inspires
the desire for remedial action, and for ill when shock leads to knee-jerk reactions
that, in the end, don’t contribute to either a thoughtful understanding or to finding solutions.
We have been inundated with reports of abuse of all kinds in recent years,
including cases like that of Josh Powell, who killed his two boys and himself
before setting their house on fire in Washington state (Alcindor, 2012; Smolowe
et al., 2012) or Los Angeles-area teacher Mark Berndt, who was charged with 23
counts of lewd conduct with his third-grade students (Audi et al., 2012; Lovett &
Nagourney, 2012); and a spate of allegations about abuse by priests (Farrell,
2009); as well as the conviction of former Penn State defensive coordinator Jerry
Sandusky of 45 counts of sexually abusing ten young boys he befriended though
his charity, Second Mile (Amber, 2012; Chan & Takagi, 2011; Drape, 2012) (see Page 5 Tuesday, October 11, 2016 2:44 PM
The Abuse Landscape
Box 1.1). Add to these examples the abuse that takes place behind closed doors
and we have a troubling situation.
Box 1.1
A Few Selected High-Profile Cases Involving Allegations of Abuse
Josh Powell
On Superbowl Sunday, 2012, a social worker brought Charlie and Braden Powell, ages 7 and 5,
respectively, to their dad’s newly rented home near Graham, Washington. The boys were in the
custody of their maternal grandparents but the judge had ordered supervised visits. When the
social worker and the boys arrived, Josh Powell, their father, grabbed the boys and pulled them
into the house. The social worker used her cell phone to call 9-1-1, but it was already too late.
Josh had struck each of the boys with a hatchet and set the house on fire. Within minutes the
house was engulfed in flames and everyone inside was dead (Breuer, 2010; Paulson, 2012).
Josh Powell had lost custody of the boys after his own father, Steven Powell, with whom he
and the boys were living, was arrested for voyeurism and possessing child pornography. While
Josh was not implicated in his father’s case, he did live in the same home and was named as a
“person of interest” in the disappearance of his wife, Susan Cox-Powell, less than two years
before. Only days before the murder-suicide, the judge in the custody case ordered Josh to
undergo a psychosexual evaluation.
Mark Berndt
Mark Berndt, 61, who had taught at Miramonte Elementary School in Los Angeles for over 30
years, was arrested in 2012 and charged with 23 counts of committing lewd acts with children,
his third-grade students. The case came to light when a photo developer called the police about
pornographic photos of the students, presumably taken by Mr. Berndt. The photos included
images of the naked children bound and gagged.
Jerry Sandusky
After a three-year investigation, former Penn State defensive coordinator Jerry Sandusky was
arrested in 2011 on 40 counts of child rape and sexual abuse. The cases involve at least 8 young
boys he met through his charity, the Second Mile Foundation. Earlier in 2001, graduate assistant
Mike McQueary had reported the rape of a boy in the shower to Sandusky’s boss, legendary
coach Joe Paterno. In 2011, as a result of the charges Paterno and the president of the university
were fired. One June 22, 2012, Sandusky was found guilty of 45 counts of sexually abusing 10
young boys (Drape, 2012). While the jury was deliberating, Sandusky’s own adopted son, Matt,
disclosed that he too had been sexually abused by his dad.
Professional Attention
We can think of professional attention as a reflection or extension of community
needs and demands, but really it’s a back-and-forth proposition. The professional
community both informs the public about problems it uncovers and responds to
public concern. Once the public becomes aware and concerned, it wants something done. Then, it is only appropriate for professionals to respond.
To get a sense of professional involvement, you don’t have to go any further
than the person credited with launching the whole business of psychotherapy, Page 6 Tuesday, October 11, 2016 2:44 PM
Chapter One
Sigmund Freud. Based on reports of his patients, Freud first attributed early
trauma, often in the form of sexual abuse, as the cause of a psychiatric disorder
he named hysterical neurosis (Eissler, 2001). If we have a difficult time dealing
with family maltreatment issues today, it was certainly no easier in the late 1800s
and early 1900s, when Freud was doing his pioneering work. In Victorian Viennese society, sex was a touchy subject, and Freud’s patients were making allegations of sexual abuse by parents and other caretakers, most of whom were highstatus members of their society. Indications are that when Freud asserted that
the recollections of his patients represented real events, his ideas were rejected.
Recent explorations about the development of Freud’s ideas suggest that it was
only when he modified his theory to suggest that these disclosures were really
tied in to guilt-ridden fantasies rather than real events that Freud gained professional acceptance (Masson, 1984). This modification of theory purported that the
patients, when children, had secret sexual fantasies involving their opposite-sex
parent. Some scholars (Masson, 1984) believe that this marked the beginning of
a long period of professional neglect regarding child sexual abuse that lasted
from the beginning of the 20th century to the early 1980s (a topic that we discuss
in more detail in Chapter 5).
Back in Freud’s day it was quite normal for people to feel it was a parent’s
right to treat their children almost any way they wanted. It wasn’t until 1962,
when pediatrician C. Henry Kempe and his colleagues wrote a startling article
about what they called “battered child syndrome” that appeared in the Journal of
the American Medical Association (Carter, 2015; Kempe et al., 1962) that we began
paying attention to the problem of abuse. Building on reports from other physicians as well as his own experience, Kempe and his associates began to use x-ray
technology to reveal a troubling phenomenon. X-rays revealed numerous broken
bones in some children, each in differing stages of healing, which suggested a
pattern of severe physical abuse. The article by Kempe et al. (1962) is rightly
credited with jolting the professional community into awareness about the seriousness of child physical abuse.
According to one source, child sexual abuse became a semiautonomous specialty in the late seventies (Finkelhor, 1992), and by the mid-1980s it caught on
as a public and professional issue. Some suggest that 1984 marked the beginning
of intense attention to the issue of child sexual abuse, with the breaking of the
McMartin day care case (Haugaard & Repucci, 1988) and several other cases
involving multiple allegations of sexual abuse by child care providers. Public
interest intensified in the wake of publicity surrounding these cases (Haugaard &
Repucci, 1988) (see Box 1.1). Now, we know that many of the techniques used
by the investigators were highly suggestive, discrediting the original allegations
(Schreiber et al., 2006).
The early 1970s marked the beginning of public and professional concern
about the problem of domestic violence. It was in 1972 that the term spouse abuse
first appeared in the social science indexes (Gondolf, 1985), and battered
women’s shelters began to appear. In 1975, the National Organization for Women
launched an effort to study the problem of battering (Gelles, 1993a). Some
sources say that our more enlightened contemporary awareness of family violence Page 7 Tuesday, October 11, 2016 2:44 PM
The Abuse Landscape
began in earnest as a result of the women’s movement. When women began
speaking out about their abuse, others began to listen (see Gelles, 1980). It was
also in the 1970s that the media picked up on the issue. A book and TV movie, The
Burning Bed, appeared and stirred public sentiment (McNulty, 1980). According to
one source, there was very little professional literature on domestic violence until
the early 1970s (Gondolf, 1985). This source also suggests that the scant professional literature found prior to that time tended to characterize victims as provokers of their own abuse, something we now call “blaming the victim.” Even now,
people raise questions about why women stay in abusive relationships—the implication being that they are somehow to blame for their own misfortune. One pioneering researcher in the area, Lenore Walker, wrote a groundbreaking book in the
late 1970s, applying Seligman’s theory of learned helplessness to explain that
severely battered women are often caught up in a cycle of violence over which they
have no control (Walker, 1979). In addition to Walker’s book, other works
appeared in the mid-to-late 1970s that are now regarded as classics (Gondolf,
1985). It is also likely that the 1970s marked the beginning of public and professional attention to the issue of elder abuse, which came about at the instigation of
advocates for the elderly (Gelles, 1993a). However, interest in this area was
largely neglected until the mid-1990s (see Chapter 12).
Since public intervention and research funding are limited, there is also competition for dollars. If there is a disadvantage to giving attention to any specific
type of abuse, it would be that it takes away from other areas that also need
attention. For example, David Finkelhor (1992) has suggested that when there
was a great deal of publicity about child sexual abuse, research dollars shifted
away from child physical abuse. Finkelhor (1992) also observed that both physical abuse (Chapter 2) and sexual abuse (Chapter 5) pale in comparison to neglect
cases (Chapter 3), which represent the largest part of many child protective service caseloads but which have been largely overlooked. Psychological or emotional maltreatment is now regarded by many in the field as an overarching form
of maltreatment (Chapter 4). However, it has gotten only scant attention.
What Is Maltreatment?
So far, we’ve done a brief review of the major forms of maltreatment: child physical abuse, child sexual abuse, child psychological maltreatment, child neglect,
domestic violence, and elder maltreatment. Though most of us have a pretty
good idea about what these various forms of maltreatment are, we’ve yet to
define our terms.
Maltreatment can be loosely defined as an act, failure to act, or pattern of
behavior by someone in a position of trust that results (or can result) in serious
physical injury or emotional harm (Doak, 2011). An assault, which may or may
not in and of itself constitute abuse, can be defined as a threat or any single abusive
act, psychological or physical. A pattern of active physical, sexual, or emotional
assaults that results in injury or harm constitutes abuse. The failure to attend to
the basic human needs of a dependent person for whom one has responsibility
constitutes neglect. Physical abuse represents a physical assault or pattern of Page 8 Tuesday, October 11, 2016 2:44 PM
Chapter One
behavior that attacks the victim’s physical integrity. While there is controversy
over where to draw the line between acceptable parental punishment and abuse,
any act of punishment that results in injury is generally defined as abuse. Any
physical assault that represents part of a pattern of harmful behavior or is sufficiently severe also can be considered physical abuse. Emotional or psychological
maltreatment can be understood as a pattern of verbal attacks, or the neglect of
genuine psychological or emotional needs. Sexual abuse can be thought of as the
inappropriate use of another, which includes sexual contact for the purpose of sexual gratification, domination, or both. Sexual abuse by its very nature may also be
an assault on an authentic sense of self, including one’s sexuality.
Not only is abuse usually defined according to its type but it is also classified
according to the status of the victim (child, spouse, or elder) and the relationship
between victim and offender. Domestic violence, for instance, is a pattern of
abusive behavior in which one person establishes power and control over one’s
intimate partner. Sexual contact with children by an adult or significantly older
person is child sexual abuse, even if the victim participates, because children
lack an understanding of the long-range consequences of their involvement and
therefore can’t consent. Because children are known to engage in sexual exploration with each other, a five-year age difference, while arbitrary, has been used to
differentiate between abuse and exploration (Finkelhor, 1986b). Child sexual
abuse can be either incest (if it is perpetrated by a close relative) or non-incestuous abuse (if it is perpetrated by someone other than a close relative). It is interesting that, while cultures vary in what they consider to be incestuous (e.g., what
the relationship is between the parties), all cultures have an incest taboo—that
is, all cultures define certain kinds of intimate sexual contact between family
members as forbidden.
In the past, when people thought of sexual abuse, they usually thought of
unnatural acts of non-incestuous abuse as being perpetrated by sexual deviants
with a sexual preference for children. These individuals exist and are professionally classified as pedophiles. While predatory pedophiles do exist, most child
sexual abuse is perpetrated by family members or close personal friends, some of
whom may or may not be pedophiles.
Basic Human Needs
The matrix sketched in Table 1.1 below suggests that we can differentiate
between abuse and neglect on the basis of whether the person is physically, sexually, or psychologically maltreated or whether their basic needs are neglected.
This assumes that basic human needs are critically important. The work of a
founding father of humanistic psychology, Abraham Maslow, suggests that each
of us comes into the world with certain basic human needs. These needs exist at
different levels from the most basic to the more abstract (Maslow, 1954). They
include essential physical necessities such as food and water, a certain degree of
safety and security, love and belonging, and self-esteem, as well as self-actualization or psychic/spiritual completion or wholeness. According to Maslow’s
scheme, we do not work to achieve fulfillment at higher levels unless lower-level
needs are at least somewhat satisfactorily achieved. In the area of abuse, the sig- Page 9 Tuesday, October 11, 2016 2:44 PM
The Abuse Landscape
Table 1.1
Family Maltreatment Matrix
Abuse/Neglect Can Be Physical or Nonphysical
assault or
physical abuse
Child sexual
assault or child
psychological abuse
Spouse/ Domestic
Spousal rape
assault or abuse
Elder physical
Rape or elder
sexual abuse
Elder psychological
assault or abuse
Failure to
Attend to
Basic Needs
Child neglect
Elder neglect
nificance of this model is that victims of abuse cannot be expected to be whole if
the achievement of basic needs is interrupted by abuse or neglect.
These ideas can assist us to think about ways abuse and neglect can impact
the ability of their victims to experience life in a positive, creative, and fulfilling
way. Maslow’s simple but classic hierarchy of needs can also help us to establish
such nonphysical human needs as affection, belonging, and self-esteem as essential to human existence. Studies have shown that nontangible needs such as love
and self-esteem are essential to normal growth and development. This, as well
as the role of human development, will be covered more extensively when we
address the problems of neglect and psychological maltreatment (Chapters 3
and 4).
Ambiguous Boundaries
When dealing with abuse in the family, there aren’t always clear lines between
the types of abuse; it’s common for more than one type to occur simultaneously.
Psychological or emotional abuse, for instance, comes into play when any of the
other forms of abuse are present. Some experts in the field believe that psychological maltreatment is the form of abuse that underlies all other types of maltreatment (see Chapter 4). We can use what happens in domestic violence as one
example. As our definition states, domestic violence can be seen as a pattern of
behavior in which a person is abusive as a way to establish power and control
over a person with whom he has or has had a close personal relationship. In contrast to popular belief, the actual battering may be a relatively infrequent activity.
It doesn’t have to be used continually in order for the abuser to maintain power
and control. The implied threat it causes is often powerful enough. At other
times, the abuser uses various forms of manipulative, coercive, and otherwise
psychologically abusive behavior as additional tools to establish and maintain
dominance. All the physical, emotional, and sexual forms of domestic violence
can thus be thought of as expressions of a more central process—that of maintaining domination and control. Page 10 Tuesday, October 11, 2016 2:44 PM
Chapter One
Continuums of Abuse
Models called continuums of abuse are representations of abusive behaviors
arranged on a line from least to most severe. They are often employed in the
domestic violence field to help educate victims and professionals about abusive
patterns. Three common continuums are the physical abuse continuum, sexual
abuse continuum, and psychological abuse continuum. These seem so simple
and obvious that one can miss their significance. As a clinician I’ve found that
abusers are often so practiced at rationalizing their behavior that they develop a
distorted view of what they are doing. Most batterers will justify and explain
away their behavior as being anything but abuse. The continuums, which contain
very practical and concrete examples, serve as a way to do a “reality check.” If the
suspected perpetrator is engaging in a range of specific behaviors depicted on a
continuum, the abuse pattern materializes easily enough—that is, if the human
service professional is willing to ask questions about the behaviors on the continuum and if people are willing to disclose. The range of physically, sexually, and
emotionally abusive behaviors, which serve to establish and maintain domination and control, can be graphically depicted as shown in Figure 1.1.
Continuums such as these have been commonly used in domestic violence
education. They are not intended to be precise but to graphically show the kinds
of behaviors commonly associated with various types of abuse. Some of these
may also apply to cases of child emotional and physical abuse when the motivation revolves around dominance and control.
Though some noted child abuse pioneers (Groth & Burgess, 1977, as cited in
Sgroi, 1982; Sgroi, 1982) argue that sexual abuse is an “acting out” of power and
Figure 1.1
Continuums of Abuse in Domestic Violence
Throwing things
Breaking bones
Internal injuries
Denying medical care
Source: Based on Kemp (1998)
Emotional or
Withholding affection
Minimizing feelings
Destroying valued things
Questioning sanity
Threatening pets
Threatening to abandon
Threatening violence
Treating as sex object
Minimizing sexual needs
Criticizing sexually
Obsessive jealousy
Sexual name calling
Demanding sex
Forcing to strip
Forcing to observe sex
Forcing unwanted acts
Forcing unwanted sex
Forced sex after beatings
Using weapons to force sex
Injuring during sex Page 11 Tuesday, October 11, 2016 2:44 PM
The Abuse Landscape
control needs, there also seem to be qualitaFigure 1.2 A Continuum of
tively significant differences in how these
Grooming Behavior in Child
needs are expressed in child sexual abuse
Sexual Abuse
and other types family violence cases. These
differences center on motivation. In child
Nonsexual game playing
sexual abuse cases, the purpose of the gradaGames involving touching
tion of behaviors seems to focus on graduInnocent kissing
ally enticing the child into more intimate
Mouth-to-mouth kissing
sexual activity, a process called grooming. In
Exposing or undressing
Observing while toileting
the case of the sexually abusive behaviors
Touching when undressed
acted out in other types of family violence
Fondling private parts
cases, the behaviors seem to be an expresHas child touch private parts
sion of a sense of entitlement and part of a
Penetration with objects
more general pattern of domination and conSexual penetration
trol. Behaviors that could be more useful on
Taking sexual photos
a child sexual abuse continuum would inThreatening to injure
clude qualitatively different examples from
Injuring during sex
those in the domestic violence, such as the
range of behaviors that child sexual abusers
Source: Based on Kemp (1998)
engage in as part of grooming their victims.
The grooming behavior involves the offender
beginning his preparation of a child victim with relatively innocent forms of interaction and gradually increasing the level of activity until the perpetrator seduces
the child into participating in sexual activity (see Figure 1.2).
Family Abuse Spillover
Family violence inflicted on one family member impacts other family members.
Others in the family very often witness it or become aware of it later. In the case
of spouse abuse, for example, even if the children are not actually present in the
room where it occurs, they are usually well aware of what’s going on. Sometimes
in these situations children try to intervene and end up being hurt themselves.
Even when children stay clear and are not victims of the physical abuse, simply
being aware of one parent abusing the other is distressing. It is probably sufficiently traumatic to constitute emotional or psychological abuse in its own right,
and there are now jurisdictions in which exposing a child to spousal abuse is
defined as a form of child abuse.
Theory, Research, and Practice
Since this text is designed for those wishing to better understand abuse, and
since there are so many theories, models, and statistics, it seems only appropriate
to put the topic into the context of science and social science.
The Theory-Research Cycle
One way to begin this discussion is to introduce the theory-research cycle (Wallace, 1971). We can think of a theory as a tentative explanation for some phe- Page 12 Tuesday, October 11, 2016 2:44 PM
Chapter One
nomenon, a set of logically interrelated statements that attempts to describe,
explain, and sometimes predict how the phenomenon will behave. While a theory may provide a way of looking at phenomena and may guide research, a theory doesn’t in and of itself constitute evidence, or provide proof, of its own
claims. This is where research comes into play—as a systematic process that provides evidence supporting theory. In what is sometimes referred to as the classic
or empirical research method, the experiment, the researcher tests theory in a
controlled environment to see if it holds up. When engaging in this type of
research, the investigator typically reviews the literature, conducts the experiment, gathers the data; and analyzes it in the search for new knowledge.
Theory and research are also interdependent. They rely on each other.
Although theory often guides research, research is the accepted process for testing existing theory, confirming it, or disconfirming it, which in turn leads to
modifications in theory or to the development of new theory. Walter Wallace
(1971) describes the relationship between theory and research as being that of a
continuous cycle (see Figure 1.3 below) (Kemp, 2014).
Figure 1.3
Theory-Research Cycle
The researcher begins with a
theory, which assumes a
cause-and-effect relationship
between two or more variables.
The researcher attempts to make sense
of the results or observations—
describing, explaining, and perhaps even
attempting to predict what will occur in
particular situations.
The research design is developed.
The variables are “operationalized.”
The variable believed to cause change is
the independent variable.
The variable it is believed to influence is
the dependent variable.
The researcher begins with
observations, often in the
natural environment.
Source: Based on Wallace (1971) and further adapted from Kemp (2014) and Kendall (2016) Page 13 Tuesday, October 11, 2016 2:44 PM
The Abuse Landscape
According to the research-theory cycle the investigator can begin with a theory or direct observations (Wallace, 1971). If one begins with a theory, the investigator designs a research project to test it, makes observations, gathers and
analyzes the data, and then tries to come to some up with conclusions or generalizations (a hypothesis) about what it all means. This is called the deductive
approach (sometimes called the “top-down” approach). The investigator starts
with a general idea and tries to deduce a conclusion based on theory. An investigator can also start on the opposite side of the theory-research cycle. The
observer sees something in the natural environment that causes him or her to
ask questions about what it means. The researcher looks for patterns, or broader
generalizations, that might lead to conclusions about what the phenomenon
means, which could then lead to new theory. This is called the inductive
approach (or “bottom-up” approach). With the inductive approach the investigator begins with specific observations which forms the basis of new theory (Trochim, 2006).
Research Methods
There are also many specific methods of research: the experiment (classical or
empirical research), survey research, case study, field study, participant-observation, historical analysis, and even the secondary analysis of existing data, in
which the investigator interprets in new ways the data gathered by others. Examples of each type of research are integrated throughout this book, or in any good
text on abuse. Why? Because it is important to understand and because abuse
researchers come from such diverse backgrounds. Some methods are better than
others depending on what it is the investigator is trying to learn. In the experiment (a form of classical or empirical research), the investigator tries to establish
a cause-and-effect relationship between two or more variables using the principles of scientific method. Social scientists often regard this type of research as the
benchmark of academia—the standard by which all other methods are judged.
However, in the abuse field it is generally considered unethical to conduct direct
experimental research, necessitating the use of other methods. This means we
must often look for alternatives. For a summary of key elements of scientific
method, please refer to Table 1.2 on the following page.
Qualitative, “softer” methods of research are also used. The researches uses
these nonnumeric approaches in an attempt to “get at” and describe an experience. Rather than being done in a controlled environment, where the investigators attempt to control the variables, qualitative research tends to be done in the
natural environment, often relying upon naturalistic observations. Generally
speaking, quantitative methods are associated with the deductive approach and
qualitative research is usually associated with the inductive approach. Table 1.3
(on p. 15) attempts to visually summarize the key features of each type of
research: deductive and inductive, quantitative and qualitative, and the general
placement of various research methods on a continuum from deductive, quantitative and explanatory to inductive, qualitative and exploratory.
Science is the process of systematically testing ideas in order to differentiate
between myth and certainty. Science is usually divided into the natural sciences, Page 14 Tuesday, October 11, 2016 2:44 PM
Chapter One
Table 1.2
Basic Elements of the Scientific Method
Information about the phenomena being studied must be both valid (accurately related to the focus of inquiry) and reliable (repeatable—i.e. consistently yielding similar results when following the same procedures).
The results of experimentation should be predictable based on the theory
used and the hypothesis tested.
The researcher should be able to control at least one variable (the independent variable) in order to test the effect on at least one other variable (the
dependent variable). This helps determine if a cause-and-effect relationship
exists between the two.
Specific criteria must be met before the phenomena under study are said to
be understood:
Covariation of events—the predicted variation of one variable (the dependent variable) in response to the manipulation of the other (the independent variable) must occur as predicted.
Sequence—the hypothesized cause (the independent variable) must in
fact precede in time the observed effect (the dependent variable).
Elimination of alternative explanations—steps must be taken to insure
that some other intervening variable did not cause the observed effect.
Source: Based on Kemp (2014), p. 14
or “hard sciences” like chemistry and physics, and what is referred to as the
“soft” sciences, or social sciences. The goal of the social sciences is to uncover
and explain human behavior. As in the natural sciences, scientific method is the
generally accepted process, though there is also now a greater acceptance of
qualitative research as another way of knowing. The scientific method essentially
involves identifying a question or problem to be solved, developing some tentative ideas or guesses about what causes it (the hypothesis), and then testing
this hypothesis to see whether or not it can be supported. This is done by operationalizing the key concepts to be tested in the hypothesis, following accepted
methods in doing the hypothesis testing, and then describing and explaining
the results. When social scientists believe the results apply to what we’re really
trying to study, we say the results are valid. When different researchers apply the
same research methods and get the same results, we say the results are reliable.
The scientific method implies that the universe, including human behavior, operates according to predictable rules that can be identified and observed. In order
to test hypotheses and generate new knowledge social scientists usually simplify
the process as much as possible. Social scientists are looking for causation—in
other words, a cause-and-effect relationship is presumed to operate. In order to
find causation they want to exclude extraneous or intervening variables as
much as possible, so they can be confident that whatever conclusions they arrive
at are solid. This is important if future research is to build on the results. Based
on the challenges in carrying out systematic research on family abuse, it’s not
hard to see why the study of the various forms of abuse seems so segmented. In Page 15 Tuesday, October 11, 2016 2:44 PM
The Abuse Landscape
Table 1.3
Comparing Approaches to Research
begins with theory
forms hypothesis
makes observations, tests hypothesis
generalizes results
modifies theory
begins with observations
makes generalizations
results may help give shape to new theory
Quantitative Research
emphasis on determining cause and effect
attempts to control variables
natural science worldview
examines behavior of individual variables
goal: to determine cause and effect
focus on objective reality
outcome oriented
reality can be observed and measured
Qualitative Research
emphasis on an exploration of phenomena
naturalistic (no attempt to control variables)
anthropological worldview
goal: to understand actor’s view
focus on actors’ subjective reality
process oriented
reality is subjective
General Placement of Selected Research Methods
field research
survey research
participant observation
secondary analysis of existing data
case studies
historical analysis
Source: Based on Kemp (2014), p. 15
addition to the investigators having different interests, it is absolutely necessary
to try to reduce the scope of study to manageable proportions so that the search
for causative explanations can go forward.
In the area of family abuse, numerous social scientists have studied an array
of suspected factors. One of the most consistent findings that emerges is that
single-cause explanations do not seem to work; and multiple, interrelated factors are suspected to interact, contributing to the problem. Causative explanations (i.e., explanations that try to establish cause-and-effect relationships) are
often hard to come by. The type of studies that can help us arrive at causative
explanation are called controlled studies or experimental studies. An important cautionary note is appropriate here. Researchers strive to be very careful
about the kind of generalizations, or assumptions, they make about how the
world really works, even when doing controlled or experimental studies. Only
when the data seem valid and reliable and the samples being studied seem to
represent the population as a whole should researchers conducting experimental
studies be willing to go out on a limb and make claims about how human behavior operates. Page 16 Tuesday, October 11, 2016 2:44 PM
Chapter One
When causative explanations can’t be found, social scientists generally look
for the existence of factors that seem to be related to each other in some way.
When we can establish that two factors are related, but can’t establish cause and
effect, we call this kind of information correlational data. The two variables are
correlated but do not necessarily have a cause-and-effect relationship. If one variable increases when the other variable increases, they are said to be positively correlated. In other words, the variables move in the same direction. For example,
when the unemployment rate goes up, so do reports of domestic violence and
child abuse. When one variable increases as the other variable decreases, they are
said to be negatively correlated. For example, when treatment services are provided
to victims of abuse, their symptoms of disturbance decline. We can measure correlation mathematically, and when we do so it is typically called r. The value of
correlation is reported on a continuous scale or continuum (from –1 to +1), as
illustrated below in Figure 1.4. Correlational data is less compelling than causative data. Where cause-and-effect relationships can be established, the factors
associated with abuse can be called predictors. Where the relationships are only
correlational they are called markers.
Figure 1.4
Correlation Continuum
When information simply defines or describes some observation, it is called
descriptive data. Statistics that merely describe incidence but don’t establish a
relationship between variables are called descriptive statistics. Descriptive statistics are like snapshots with numbers. They describe a phenomenon at a certain
place and time and have less explanatory power than even correlational data.
With inferential statistics we make generalizations, or inferences, about the
whole population on the basis of studying a sample. Inferential statistics are used
in formal, controlled research.
As we discussed earlier, abuse in the family has reemerged relatively recently
as a focus of professional attention. While we have been accumulating a large
body of information, we still have a very long way to go in the understanding of
family abuse. Studying something as personal and sensitive as abuse poses special challenges. Much of the knowledge we have been able to gather is either
descriptive or correlational, with some exceptions. The two most common Page 17 Tuesday, October 11, 2016 2:44 PM
The Abuse Landscape
sources of information are clinical samples from victims or offenders who have
already been identified; and population samples drawn from the general population. There are difficulties associated with each.
One of the chief problems is that abuse, by its very nature, is something generally carried out in secret—it is the rare perpetrator who wants to disclose his or
her abusive behavior. As for victims, they often are unable to identify their mistreatment as abuse, or they may fear the consequences of disclosing abuse. Since
asking people about prior abuse may be safer, this is the approach that is often
taken. Research such as this tends to be done by sampling the general population.
Retrospective studies draw population samples by asking adults about their
childhood experiences. While it may feel safer to disclose childhood abuse from
the distant past as opposed to abuse that is currently occurring in adulthood, retrospective studies have another problem—the reliability (or lack thereof) of memory. In addition to the general problems associated with reliability, memory was at
the heart of a major controversy in the field of family maltreatment: the false
memory/repressed memory debate. Those on the “false memory” side of the
debate asserted that so-called repressed memories are often artifacts of subtle
suggestion on the part of therapists or victim advocates. Those on the “repressed
memory” side of the debate asserted that memories that surfaced later in life were
real. They counter arguments from the other side with the contention that abuse
is so traumatic that memories are repressed unless triggered later in life. We discuss the false memory/repressed memory debate at greater length in Chapter 8.
In contrast to population samples, clinical samples are not representative of
the population as a whole since they are drawn from groups of people who are
receiving counseling or mental health services. As a result, we need to be careful
about the kinds of generalizations we make from data gathered from them. Certain questions arise: Because a large number of people in clinical samples have
been maltreated, can we assume that maltreatment causes the psychological or
behavior problems? Do people in clinical samples report abuse partly as a way to
explain their current problems, when other factors could be at play? While the
results of research done with clinical samples can be interesting and informative
about these specific populations, it is hard to generalize from them about the
population as a whole.
The kinds of statistics the layperson is most likely to come in contact with
are those from official reports or large surveys. In order to understand how best
to use information from these sources, we can think of family maltreatment as
being like an iceberg. The part we can see would be like the tip of the iceberg,
while much of it remains unseen and submerged. The official reports of abuse
would be like the tip of the iceberg, leaving much information beneath the surface. While research that uses the scientific method attempts to explain maltreatment, official reports tell us how much abuse is reported; large surveys try to
inform us about abuse that has occurred but has not necessarily been reported.
There are several widely used reports: the FBI Uniform Crime Reports, the
National Crime Victimization Survey, the National Family Violence Surveys, the Page 18 Tuesday, October 11, 2016 2:44 PM
Chapter One
National Incidence Study of Child Abuse (NIS), and the National Elder Abuse
Incidence Study. The Uniform Crime Reports can help us track fatalities but are
not helpful in other areas of family maltreatment. Two well-known self-report
surveys are the National Crime Victimization Survey and the National Family
Violence Surveys. The National Crime Victimization Survey, prepared by the
Bureau of the Census for the Department of Justice, provides details about various acts of abuse based on a representative sampling of 60,000 households. The
National Family Violence Surveys, conducted by a team of researchers headed by
Murray Straus, are really two surveys that used large representative samples
taken ten years apart—in 1975 and 1985. In the United States today, the National
Center on Child Abuse and Neglect conducts a periodic study of child abuse and
neglect, the National Incidence Study of Child Abuse and Neglect (usually abbreviated as NIS) (Doak, 2011). The most recent version is NIS-4 (Sedlak et al.,
2010). It is regarded as the single most comprehensive source of information on
child abuse and neglect. Reporting child abuse and neglect is mandatory in all 50
states but is virtually nonexistent for domestic violence. The National Elder
Abuse Incidence Study was last done in 1998 and is now becoming dated. However, it still serves as a starting point for information on elder abuse.
So far we’ve outlined three different types of research information: experimental, correlational, and descriptive data. Sometimes even professionals can get
confused about what each kind of information can tell us, especially when the
issue is as emotionally charged (and sometimes polarized) as this field can be.
One team of early maltreatment researchers undertook a critical examination of
the explosion of research published on the subject and expressed some significant reservations about the value of much of it (Hotaling & Sugarman, 1986).
Most of the studies they surveyed performed only correlational comparisons yet
attempted to make assertions about causality. Another criticism of some of the
early research is that it was done without using comparison groups. Hotaling and
Sugarman (1986) pointed out that we should be extremely careful about accepting conclusions based on correlational data, especially when these studies do not
use comparison groups. (For more detailed discussion of how Hotaling and Sugarman applied social science methods to the literature on domestic violence, see
Chapter 10). If we need to be careful about the conclusions we draw from correlational data, we need to be all the more careful with the kinds of conclusions we
arrive at on the basis of descriptive information.
Theory and Practice
The pioneers in the field of abuse came from a range of professions and academic
disciplines—sociology and social work, criminology and law enforcement, psychology and counseling, medicine and nursing, theology and chaplaincy, and
many others. From its beginnings the field has been multidisciplinary, embracing
diverse perspectives and experience.
I like to use an often-quoted Hindu parable about a group of blind men when
considering the interdisciplinary nature of fields like abuse in society. In the para- Page 19 Tuesday, October 11, 2016 2:44 PM
The Abuse Landscape
ble, the blind men are asked to describe an elephant. The first approaches the elephant and grabs its tail. He says the elephant is like a rope. The second puts his
arms around a leg and says an elephant is like the trunk of a tree. Then, a third
grabs the snout at exactly the same moment the elephant shoots a stream of
water, so he says the elephant is like a water hose. The fourth grasps an ear and
says an elephant is like a fan that circulates the air. The moral is that each description is both correct and incorrect—correct because the account, as far as it goes,
is accurate; and incorrect, because none of the men was able to understand the
totality of the elephant. A solution to the paradox only becomes apparent when
one recognizes that the descriptions are really complementary, not contradictory.
The field of abuse and neglect is multidisciplinary because people from
diverse fields and professions have joined its ranks. It is multidimensional
because its practitioners recognize that dealing with sensitive problems like
abuse requires them to work with whole persons—body, mind, and spirit—as
well as networks of friends and colleagues, communities, and even society at
large. Since graduate programs that train abuse professionals are a rarity, most
people in the field have completed graduate education in other disciplines, each
with its own body of literature and preferred research methods.
To get a sense of how diverse these perspectives are, lets briefly look at just
two academic disciplines: psychology and sociology. The field of psychology is
concerned with understanding thinking, feeling, and behavior. Its focus tends to
be on the individual and it has three main branches, or schools: behavioral, psychodynamic, and humanistic. At the risk of oversimplifying, the behavioral
approach looks at how rewards, reinforcement, and punishment influence learning and shape behavior. The psychodynamic school, influenced by Sigmund Freud
and Carl Jung, tends to look at complex internal processes, including the unconscious. The humanistic branch, sometimes called the “third wave” in psychology,
is interested in the uniquely human dimensions of subjective experience. In contrast, sociology is more broadly concerned with society and human relationships.
It too has several branches, often referred to as “perspectives” or “paradigms.”
The key ones are functionalism, conflict theory, and symbolic interactionism.
Again, at the risk of oversimplifying, functionalism is interested in social structure, practices, and the role of social institutions such as the family, religion, and
education. Conflict theory looks at inherent conflicts between classes of people
(e.g., rich–poor; men–women; black–white; straight–gay), usually over such
things as the control of resources and social influence. Symbolic interactionism is
concerned with the social interpretation of experience and the effects of labeling.
Like the blind men and the elephant, diverse disciplines and professions
approach human experience differently. Each have their own strengths and limitations. In relation to the topic of abuse, some investigators attempt to explain it
on the basis of the characteristics of individual perpetrators; others attempt on
the basis of family dynamics; while still others look at broad social and economic
conditions that seem to breed problems. Some of the research attempts to use
controlled data; other research makes use of correlations; still other research tries
to ferret out answers from large-scale survey data; while many other forms of
research analyze and interpret official statistics. Since the issues are so complex, Page 20 Tuesday, October 11, 2016 2:44 PM
Chapter One
a conceptual framework seems in order. So, we will explore as much of the available research we can, and in doing so we will make use of a systems or ecological
model, as discussed below.
A number of abuse investigators have become interested in the various interrelationships and in understanding abuse in a more unified way. In these efforts,
some have proposed ecological models (Bronfenbrenner, 1994, 1997a, 1997b),
while others call for the adoption of systems approaches (for detailed discussions see Blau et al., 1993; Edelson & Tolman, 1992; Gondolf, 1993; Lewis, 2000;
Milner & Crouch, 1993). Ecological and systems approaches emphasize the idea
that complex interrelationships between individuals, families, communities, and
the society at large interact and play a role in abuse. These approaches stress that
human behavior takes place within a social environment or ecology: family,
neighborhood, school, community, society, and so on.
The terms “ecological” and “systems” are sometimes used almost interchangeably; however, “systems” is often used as a description for the dominant
theoretical orientation in the field of marriage and family therapy. I should probably briefly mention that, when simultaneously discussing the area of domestic
violence and the field of marriage and family therapy, there is some conflict
related to key philosophical positions. I limit discussion here, since these issues
are addressed in greater depth later (Chapter 10). However, following is the crux
of the conflict.
Basically, the family systems approach assumes that problems arise as the
result of how the family system is organized and functions. The assumption is
that there is dysfunction in significant relationships and that the best approach to
therapy is to work on relationships. In the domestic violence field, on the other
hand, the dominant view suggests that domestic violence occurs because of an
imbalance of power. From this point of view, it is not appropriate to assume we
are dealing with equals, since one member of the dyad has more power than the
other. Therefore, the prevailing view is that we should not work with couples
together because we may endanger victims if we require them to interact with
their abusing partners. (In fact, advocates and therapists report that victims are
often battered or endangered as the result of something they’ve said during a
therapy session.)
It is important to distinguish between the study of family maltreatment and
the methods we employ when we try to intervene. The systems or ecological
approach introduced here does not necessarily mean that we want to put victims
and perpetrators together in therapy; however, it does attempt to provide a
framework in which to study abuse. Keeping this in mind, let’s continue the discussion of the systemic or ecological approach.
General Systems Theory. Systems theory has its roots in efforts to extend
the principles long valued in the natural sciences to the social sciences. Ludwig
von Bertalanffy (1934, 1968), a pioneer “systems thinker,” is credited with originating a broad theoretical framework called general systems theory. Bertalanffy
also advocated for moving beyond examining simple, linear, cause-and-effect Page 21 Tuesday, October 11, 2016 2:44 PM
The Abuse Landscape
relationships to looking at the more complex interrelationships that exist in
dynamic, living systems. He was himself a biologist and suggested that many of
the principles of biology could be extended to all living systems, including human
beings, and even to human social systems (von Bertalanffy & Sutherland, 1974).
One of the most interesting concepts associated with systems theory is the
notion that the whole is greater than the sum of its parts. Systems theorists have
coined the term emergent characteristics to apply to the unique characteristics
that result from the interaction of people in certain special relationships. When
people marry, the marriage—with all its new obligations and possibilities—is an
example of how the whole (in this case, the marriage) is more than just the combined lives of two individuals. It has great social meaning, as do families,
extended families, communities, and society as a whole. Systems theorists are
interested in exploring the social realities that result when individuals, families,
groups, and whole societies act and interact.
According to systems theory, all systems are goal directed (i.e., they strive to
accomplish specific tasks). Human beings and human social systems are no
exception. Individual human beings strive to fulfill all their basic needs, but in
order to accomplish many of them, especially when young, they need the support
and help of other people. Viewed in this model, families are systems and are
essential to providing for the needs of the young and the old. The family is the
one social institution where members should be able to fulfill their need for love,
belonging, acceptance, and self-esteem, and ultimately where they can get the
support and encouragement they need to seek higher meaning and truth. Communities and societies, by extension, serve similar functions on a grander scale.
States and nations provide for economy, the internal security of citizens, and
defense against outside aggression. In addition to trying to accomplish the fulfillment of basic goals, systems theory proposes that we strive to maintain homeostasis, or stability, within a certain range of functioning. If there is too little or
too much of something, the system’s feedback mechanism will give an alert so
that the system can take appropriate steps to return to its desired balance.
Systems theory offers an explanation both for why systems change and why
they stay the same. They change when they get feedback information that says
they either need less of something they have or more of something they do not.
According to the model, systems resist change if that change is perceived as a
threat to stability or homeostasis. We can use this part of the model to help us
understand and explore both the pain of living with family abuse and the resistance to change.
That systems strive to accomplish basic life goals is an integral part of systems theory. The goal directedness of systems is sometimes referred to as cybernetics. Using an archer’s target rings as a model, we can imagine that we aim our
arrow and attempt to hit the bull’s-eye in the center of the target. Becoming a
good archer requires skill and experience, so we learn to modify what we do. If
we hit too far up we then lower our aim; if we hit too far to the right we must aim
left on our next shot, and so on. The cybernetic or goal-directed nature of systems can help us understand the role of goals and the use of feedback in trying
to accomplish them. Much behavior, even incomprehensible behavior, is moti- Page 22 Tuesday, October 11, 2016 2:44 PM
Chapter One
vated by goals of one kind or another. When the feedback is ignored, the system
is described as relatively closed. When communication is good, boundaries appropriate, and structural integrity in place, the system is said to be relatively open.
According to the model, all systems have boundaries that separate systems
from their environments and from each other. In order for a system to have internal integrity, its boundaries must also keep harmful elements out and allow for
the inclusion of those things that are needed for the system to accomplish its
goals and maintain itself. When boundaries perform the function of allowing in
what is needed and keeping out what is harmful, they are called selectively permeable boundaries.
In systems theory, living systems have a complex organization that includes
many subsystems. Human beings, for instance, have a number of biological subsystems, including nervous, respiratory, digestive, and so on. Each subsystem has
its own functions and plays its role in the maintenance and survival of the primary system. Within a human being we could also posit physical and psychological subsystems, each working in conjunction with the other. Not only do living
systems have subsystems but they are also themselves parts (or subsystems) of
other larger systems. On the social level, each of us exists within groups of other
human beings that form families, friendship groups, classes, neighborhoods,
communities, and societies. It is here, in discussing different levels of interaction, that we can apply ideas drawn from a systems or ecological perspective to
help us organize our exploration of abuse.
A Pioneering Ecological Model. A classic ecological model for describing
abuse is the one adopted by Belsky (1980), based upon the earlier work of Bronfenbrenner (1977a, 1977b; 1997) and Tinbergen (1951). It is organized into a
multilevel system. Belsky’s system (1980) has four factors or levels believed to
be involved with abuse: an ontogenic level, a microsystem level, an exosystem
level, and a macrosystem level. In Belsky’s framework (1980), the individual factors of the abuser make up the ontogenic level. The microsystems level is Belsky’s term for those factors in the child’s immediate environment, such as the
home, the parents’ work, school, friends, and so on. The exosystem consists of
relationships that indirectly affect people (e.g., community efforts to change
laws, or the launching of a child abuse prevention campaign). Belsky characterizes the macrosystem as being all encompassing, taking in all the other levels and
including broad and sweeping factors such as culture, attitudes, norms, values,
sex roles, and the like. Many abuse authors have discussed the usefulness of
using an ecological framework for understanding maltreatment (e.g., Cicchetti &
Lynch, 1995; Garbarino & Eckenrode, 1997; Stockhammer et al., 2001).
The Ecological Model Adopted in This Text. Belsky’s framework may be a bit
more complex than is necessary for our purposes. In keeping with the principle of
parsimony, or the idea that we should prefer the simpler models that explain as
much or more, we will be using a three-level system to organize our discussion:
macro, meso, and micro, meaning large, middle, and small (Kemp, 1998). We can
use the macro level for explanations of phenomena that occur at the level of communities and the society. The exploration of the contribution of the culture Page 23 Tuesday, October 11, 2016 2:44 PM
The Abuse Landscape
occurs at this level and can include norms, economics, and political organization.
Family systems would be at the meso level. Explanations about how family systems functioning contributes to or protects families from abuse occur at this
level. We can use the micro level to apply to everything at the individual level.
This includes all explanations about individual behavior, personality, personal
motivation, and psychopathology. We will be looking at individual perpetrator
factors, including personality and psychopathology, at the micro level; functional
and dysfunctional family systems at the meso level; and factors in our culture and
society that contribute to family abuse at the macro level.
There are two measures of family maltreatment that can give us an estimate
of the big picture, or macro level: incidence and prevalence estimates. Incidence
estimates refer to the number of people who are abused during a given year.
Prevalence estimates tell how many people living within a particular society
have been abused. In addition to discussing some proposed explanations for
abuse, we briefly survey some of the most frequently used statistics. The purpose
is to start “framing in” the field. Since we will be discussing incidence and prevalence estimates in greater detail in the chapters that follow, we will only briefly
discuss a few examples here.
With issues as emotionally charged as abuse, people want to know how big
the problem is. To look for answers we turn to statistics—although most of us
also appreciate that statistics can be misleading if improperly used. There is an
often-heard concern about the misuse of statistics that goes something like this:
“There are liars, damn liars, and statistics.” Another concern is that statistics
seem so complex, technical, and analytical that we can get bogged down in them
and lose sight of what we really hope to understand. We do, however, need to
examine statistics if we want to have any chance of determining the scope and
size of the problem. As discussed earlier, statistics can be descriptive, correlational, or inferential. When trying to describe the incidence and prevalence of
abuse we must turn to descriptive statistics, which, as the name implies,
describes whatever part of the landscape we are able to sample.
A number of abuse investigators have become interested in the various
interrelationships and in understanding abuse in a more unified way. In these
efforts, some have proposed ecological models (Bronfenbrenner, 1994, 1997),
while others call for the adoption of systems approaches (for detailed discussions see Lewis, 2000; Our best estimates of child maltreatment probably come
from the most recent National Incidence Study of Child Abuse, NIS-4). The NIS-4
data derive from a nationally representative sample of 122 counties (Sedlak,
2010). It uses information from sentinels, i.e. professionals who are in a position to know about abuse and neglect that may not be reported to the authorities. This report estimates that approximately 1.25 million children in the
United States experience maltreatment, a number that includes both neglect and
abuse (Sedlak et al., 2010). Of the maltreatment cases, the majority (61% or
about 771,700) involve neglect, while the other 44% (about 533,300 cases)
involve abuse. Of the neglect cases, approximately 47%, (about 360,500) are Page 24 Tuesday, October 11, 2016 2:44 PM
Chapter One
educational neglect; 38%, (295,300), physical neglect; and, 25% (193,400), emotional neglect. Of abuse cases, approximately 58%, (323,000) are physical abuse;
27%, (148,500), emotional maltreatment; and slightly less than 24%, (about
135,300 cases), sexual abuse.
In addition to the National Incidence Studies (Sedlak, 2010), The U.S. Department of Health and Human Services annually collects data from the states on
actual referrals and reports of child maltreatment. The most recent of these is Child
Maltreatment 2014 (U.S. Department of Health and Human Services, 2016). Referrals come from any source and are either screened in or screened out. Those that
are screened in are called reports. Most reports are investigated to determine if
they are substantiated or indicated. To be counted as substantiated CPS must have
enough evidence to conclude that the allegations of maltreatment or risk of maltreatment were supported or founded by state law or policy. The term indicated is
used when the suspected maltreatment could not be substantiated under state
law or policy but there was reason to suspect that at least one child may have
been maltreated or was at-risk of maltreatment. The total number of substantiated and indicated reports is somewhat lower than estimates from the National
Incidence Studies. In 2014, there were substantiated or indicated cases involving
702,208 children. 75% of these involved neglect; 17% physical abuse; and about
8% sexual abuse (U.S. Department of Health and Human Services, 2016).
One incidence estimate of spousal maltreatment is drawn from the 2014
National Crime Victimization Survey, which samples 60,000 homes. It suggests that
2.4 per 1000 persons were victims of nonfatal intimate partner violence in 2014
(U.S. Department of Justice, 2015). It suggests that in 2014 approximately
635,000 violent crimes were perpetrated on victims by a spouse, ex-spouse, boyfriend, or girlfriend. Chapter 10 looks at this problem in some depth.
According to the National Center on Elder Abuse (2016), approximately 1 in 10
Americans aged 60+ have experienced some form of elder abuse. Some estimates
range as high as 5 million elders who are abused each year. One study (Lachs &
Pillemer, 2015) estimated that only 1 in 14 cases of abuse are reported to authorities. Data on reported cases substantiate about 192,000 cases of elder maltreatment (Teaster et al., 2006). As with child abuse and domestic violence, there are
a number of different types of elder maltreatment, including physical, sexual, and
psychological maltreatment as well as financial exploitation, neglect, and even
“self-neglect” (see Chapter 12).
Fatalities. In recent years, fatalities from child maltreatment have ranged
from approximately 1,000 to about 1,500 per year (NCPCA, 1992; NCCAN,
1988; Gelles & Straus, 1988; U.S. Department of Health and Human Services,
2010; U.S. D…
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