Children’s Responses to Maltreatment: Key Conclusions From a Systematic Literature Review

Abstract

Child maltreatment (CM) has received much research attention in recent years, leading to the enormous development of services provided to children worldwide. However, although the literature in the field of trauma studies recognizes that responses to trauma are of central importance, for a variety of reasons, the research on this subject is sparse. The current systematic literature review was therefore designed to characterize and analyze the existing knowledge on children’s responses to CM, while putting in focus all possible responses that will appear in the identified manuscripts. Key databases were explored using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and only six studies were identified as relevant to the focus of the current study. Utilizing thematic analysis, the results addressed four main themes: the studies’ methodologies, the terminology and responses that were explored in these studies, the abuse-related factors and contexts that were taken into account, and the consequences for the children (of their responses to the maltreatment). A key conclusion from this review is that concepts in this area, as well as theory, are considerably lacking. Promoting the development of theory regarding children’s responses to CM is urgently needed, as it will greatly impact clinical intervention, legal investigation, and the development of prevention programs.

“If Only I Could Have Stopped It”: Reflections of Adult Child Sexual Abuse Survivors on Their Responses During the Abuse

“…First, in prevention programs, children are still instructed to fight or flee when they find themselves in situations of CSA (Daigneault et al, 2012; Finkelhor, 2009; Morris et al, 2017). Second, in the forensic context, the credibility of CSA survivors is still assessed based on fight-or-flight responses: They are assumed to be more credible if they used such responses (e.g., Katz et al, 2020; Suarez & Gallup, 1979). The current findings add to the previous findings demonstrating that there is an urgent need to revise our understanding of what actually happens in these situations so as to improve our approaches in their aftermath.…”

“…In the specific area of child maltreatment (CM), a recent systematic literature review pointed to the lack of any conceptual framework of child responses, highlighting the urgent need to advance the development of the relevant theory (Katz et al, 2020). Finkelhor et al (1995) examined children’s behavior in situations of victimization using telephone interviews with a nationally representative sample of 2,000 American youths aged 10–16 and their caretakers.…”

Peritraumatic Pain in Child Sexual Abuse: Children’s Descriptions of Pain as Conveyed in Their Testimonies Following Child Sexual Abuse

“…CSA and other forms of child maltreatment leave their traces on the subjective experience of self and body. Particularly, it has been postulated that “the body keeps the score” (van der Kolk, 2015), and that trauma may result in post-traumatic orientation to bodily signals (Tsur, 2020; Tsur et al, 2018). Experiences of pain related to CSA may correspond with the essential experience of uncontrollable, invasive, interpersonal manifestations of abuse (Tsur et al, 2017).…”

“…In the case of CSA, however, the source of this pain, i.e., the injurious factor is a person, often a caregiver, who may have continual opportunities to victimize the child. As such, responses to CSA are suggested to differ from the conservative “fight-flight-freeze” responses, and are intertwined in a complex dynamic with the perpetrator (Katz et al, 2020). Indeed, the children’s narratives uncover a unique function of pain experiences within that dynamic.…”

“…As such, pain may serve as a defensive mechanism, which signals to the child that something very wrong is taking place. Consequently, pain sensations during CSA may activate defensive strategies, involving various sorts of peritraumatic responses (Katz et al, 2020). Additionally, peritraumatic pain may promote expressions of suffering by the child (either verbal or nonverbal), thus communicating to the perpetrator that his or her actions are harmful.…”