conclusion of abuse essay

• Introduction
• Child Abuse in the Mainland
• Child Abuse in Oahu
• Results of Being Abused
• Why Neighbors Don't Report it (part 1)
• Why Neighbors Don't Report it (part 2)

Understanding Child Abuse and Neglect (1993)

Chapter: summary.

Child maltreatment is a devastating social problem in American society. In 1990, case reports involving over 2 million children were made to social service agencies. In the period 1979 through 1988, about 2,000 child deaths (ages 0-17) were recorded annually as a result of abuse and neglect (McClain et al., 1993), and an additional 160,000 cases resulted in serious injuries in 1990 alone (Daro and McCurdy, 1991). However tragic and sensational, the counts of deaths and serious injuries provide limited insight into the pervasive dimensions of child abuse and neglect. Reports of child maltreatment reveal little about the interactions among individuals, families, communities, and society that lead to such incidents. The services required for children who have been abused or neglected, including medical care, family counseling, foster care, and specialized education, cost more than $500 million annually, according to estimates by the General Accounting Office (1991).

No specific theories about the causes of child abuse and neglect have been substantially replicated across studies, yet significant progress has been gained in the past few decades in identifying the dimensions of complex phenomena that contribute to the origins of child maltreatment. Furthermore, research in the field of child maltreatment studies is relatively undeveloped when compared with related fields such as child development, social welfare, and criminal violence.

In part, this underdevelopment is influenced by a lack of funds as well as the methodological difficulties of research on topics with a complex

etiology. But in part it is underinvestment due to bias, prejudice, and the lack of a clear political constituency for children in general, and disadvantaged children in particular, in the competition for scarce research funds. Substantial efforts are now required to reach beyond the limitations of current knowledge and to gain new insights that can lead to the prevention of maltreatment and also improve the quality of social services and public policy decisions affecting the health and welfare of abused and neglected children and their families. Long-term research and collaborative ventures are necessary to develop knowledge that can improve understanding of, and response to, child maltreatment.

The panel has identified five key reasons why child maltreatment research should be viewed as a central focus of more comprehensive research activity.

Charge To The Panel

The commissioner of the Administration for Children, Youth, and Families (ACYF) in the U.S. Department of Health and Human Services requested that the National Academy of Sciences convene a study panel to undertake a comprehensive examination of the theoretical and pragmatic research needs in the area of child maltreatment. The Panel on Research on Child Abuse and Neglect was asked specifically to:

The report resulting from this study provides recommendations for allocating existing research funds and also suggests funding mechanisms and topic areas to which new resources could be allocated or enhanced resources could be redirected.

A Developmental And Ecological Perspective

Over the past several decades, a growing number of state and federal funding programs, government reports, specialized journals, and research centers, as well as national and international societies and conferences, have examined various dimensions of the problem of child maltreatment. The results of these efforts have been inconsistent and uneven. In addressing aspects of each new revelation of abuse or each promising new intervention, research efforts often have become diffuse, fragmented, specific, and narrow. What is lacking is a coordinated approach and a general conceptual

framework that can add new depth to our understanding of child maltreatment. A coordinated approach can accommodate diverse perspectives while providing direction and guidance in establishing research priorities and synthesizing research knowledge. Collaborative efforts are also needed to facilitate the integration and application of research on child maltreatment with related areas such as child development, spousal violence, substance abuse, and juvenile delinquency.

In contrast to conceptualizing this report in terms of categories of maltreatment or responses of the social system to child maltreatment, the panel presents a child-oriented research agenda that emphasizes the importance of knowing more about the backgrounds and experiences of developing children and their families, within a broader social context that includes their friends, neighborhoods, and communities. This framework stresses the importance of knowing more about the qualitative differences between children who suffer episodic experiences of abuse or neglect and those for whom maltreatment is a chronic part of their lives. And this approach highlights the need to know more about circumstances that affect the consequences, and therefore the treatment, of child maltreatment, especially circumstances that may be affected by family, cultural, or ethnic factors that often remain hidden in small, isolated studies.

The panel has adopted an ecological developmental perspective to examine factors in the child, family, and society that can exacerbate or mitigate the incidence and destructive consequences of child maltreatment. In the panel's view, this perspective reflects the understanding that development is a process involving transactions between the growing child and the social environment or ecology in which development takes place. Positive and negative factors in the cycle of child development merit attention in shaping a research agenda on child maltreatment. The panel's ecological perspective recognizes that dysfunctional families are often part of a dysfunctional environment. This report extends beyond what is—to what could be, if children and families were supported to attain healthy development. We cannot simply build a research agenda for the existing social system; we need to develop one that independently challenges the system to adapt to new perspectives, new insights, and new discoveries.

Identification And Definitions

Four categories of child maltreatment are now generally distinguished: (1) physical abuse, (2) sexual abuse, (3) neglect, and (4) emotional maltreatment. These four categories have become the focus of separate studies of incidence and prevalence, etiology, prevention, consequences, and treatment, with uneven development of research within each area and poor integration of knowledge across areas. Each category has developed its own

typology and framework of reference terms. As a result, we know very little about the extent to which different types of child abuse and neglect share common risk factors or the ways in which they respond to different types of interventions.

The co-occurrence of different forms of child maltreatment has been examined only to a limited extent and the specific causes, consequences, prevention, and treatment of selected types of child abuse and neglect is relatively unknown. Inconsistencies in definitions often preclude comparative analyses of clinical studies.

The complexity of studies on child maltreatment also reflects the fragmentation of services and responses by which our society addresses specific cases. Furthermore, the duration, source, intensity, timing, and situational context of incidents of child victimization are important. Yet information about these factors is rarely requested or recorded by social agencies or health professionals in the process of identifying or documenting reports of child maltreatment.

Despite vigorous debate over the last two decades, little progress has been made in constructing clear, reliable, valid, and useful definitions of child abuse and neglect. The difficulties in constructing definitions include such factors as lack of social consensus over what forms of parenting are dangerous or unacceptable; uncertainty about whether to define maltreatment based on adult characteristics, adult behavior, child outcome, environmental context, or some combination; conflict over whether standards of endangerment or harm should be used in constructing definitions; and confusion as to whether similar definitions should be used for scientific, legal, and clinical purposes.

Standardization of definitions is difficult and carries with it dangers of oversimplification. However, consistent definitions are necessary for better measurement and instrumentation in the field. Attempts to reach consensus on clear operational measures must be made to overcome existing limitations and to develop more refined measures. The formulation of research definitions of child maltreatment should be guided by four key principles: consideration of the specific objectives the definition must serve; division into homogeneous subtypes; conceptual clarity; and feasibility in practice.

Scope Of The Problem

From 1976, when the first national figures for child maltreatment were generated, to 1990, the most recent year covered by the National Child Abuse and Neglect Data System, reports of maltreatment have grown from 416,033 per year (affecting 669,000 children) to 1,700,000 per year (affecting 2,712,917 children). This alarming rise in the number of reported cases

of child maltreatment has promoted the view that there is an epidemic of child maltreatment in the United States.

The panel's review of national prevalence and incidence child maltreatment studies has revealed important methodological problems that greatly affect the usefulness of these data for drawing conclusions about both the scope and origins of the problem. These methodological problems include definitional issues, confusion of prevalence and incidence, the source of maltreatment data, sampling and design considerations, a paucity of reliable and valid measurement instruments, the problem of retrospective bias, the impact of mandatory reporting requirements on the reliability of survey respondents' reports, and scarce funding for methodological work (specifically instrument development). The paucity of rigorous epidemiological investigations has retarded progress in this field. However, the available evidence suggests that child abuse and neglect is an important, prevalent problem in the United States, with conservative estimates placing the annual number of children affected by this problem at more than 1 million, following an analysis of substantiated rates of reported cases. Child abuse and neglect are particularly important compared with other critical childhood problems because they are often directly associated with adverse physical and mental health consequences in children and families. Furthermore, given the prevalence of childhood maltreatment, the level of federal funds expended in this research area is extremely small when compared with the resources allocated for less prevalent childhood mental disorders, such as autism and childhood schizophrenia.

Specifically, the panel concludes:

Overview Of Etiological Models

Most forms of maltreatment are part of a pattern of maladaptive behavior that emerges over time, but research evidence regarding the origins and

maintenance of this pattern is not clear. Investigators disagree about whether child maltreatment is a continuum of behaviors (ranging from mild physical discipline to severe forms of physical or sexual abuse) or a set of unique behavioral problems with distinctive etiologies.

Since no single risk factor has been identified that provides a necessary or sufficient cause of child maltreatment, etiological models of child maltreatment have evolved from isolated cause-and-effect models to approaches that consider the combination of individual, familial, environmental, and social or cultural risk factors that may contribute to child maltreatment. The phenomenon of child abuse and neglect has thus been moved away from a theoretical framework of an individual disorder or psychological disturbance, toward a focus on extreme disturbances of childrearing, often part of a context of other serious family problems, such as substance abuse or mental illness.

Interactive models suggest that child maltreatment occurs when multiple risk factors outweigh protective, compensatory, and buffering factors. The role of particular risk or protective factors may increase or decrease during different developmental and historical periods, as individuals, their life circumstances, and the society in which they live change. These models show promise and suggest issues that need to be addressed in research on the etiology of child maltreatment.

Individual Ontogenic Factors

A parent's personality influences child development primarily through the interactive process of parenting. Disrupted parenting can occur in a variety of ways, especially when a parent's personality attributes (such as anger or anxiety) are compounded by additional stresses such as marital conflict, absence of the spouse, poverty, unemployment, and having a difficult child. Individual factors that have sometimes been associated with child maltreatment include adult attitudes, attributions, and cognitive factors; the intergenerational transmission of abusive parenting; the use of alcohol and drugs; characteristics of the child (such as temperament); and demographic factors such as maternal age, marital status, and household density. Research on the role of these individual factors in stimulating or maintaining neglectful or abusive behaviors has been contradictory and inconclusive, suggesting that no single factor, in isolation, can explain with satisfaction the origins of child maltreatment. For example, although alcohol often is cited as a principal risk factor in the etiology of child maltreatment, its relationship to child abuse and neglect remains uncertain. More needs to be known about the unique and immediate effects of alcohol, its co-occurrence with other problem behaviors such as antisocial personality disorder and substance abuse, the circumstances under which different types

of drinking situations lead to or sustain violence against children, and cultural factors that mitigate or exacerbate connections between substance use or abuse and aggression.

Family Factors

Dysfunctions in all aspects of family relations, not just parent-child interactions, are often present in the families of maltreated children, and research is needed to examine whether such dysfunctions contribute to or are consequences of child maltreatment. Anger, conflict, and social isolation are pervasive features of maltreating families. In many cases of maltreatment, there often is not a single maltreated child, but multiple victims. Thus, maltreated children may be exposed to considerable violence involving other family members as well as violence directed toward themselves.

A distinctive feature associated with chronically neglecting families is the chaotic and unpredictable character of the family system. The effect on children of repeated acts of violence or constant fluctuations in the makeup of their household, in addition to child neglect, has not been examined in the research literature, although such factors may contribute to unrelatedness and detachment.

An important gap in the literature on child maltreatment is the lack of comparative analysis of the effects of parenting styles and dysfunctional parenting patterns (including abuse and neglect) on children in different social, ethnic, and cultural groups. The relationships among physical discipline, stress, and parental and family dysfunctions that give rise to the emergence of child maltreatment also need to be clarified.

Although a parent's own history of victimization during childhood is thought to predict child maltreatment, this association is based on retrospective studies that are sometimes methodologically suspect. The relationship between physical discipline and child maltreatment is also largely unknown, particularly in the context of cultural differences and practices. Finally, stressful life events are thought to play an important role on parental abilities, but relations between stress and poor parenting are complex and poorly understood at this time.

Environmental and Community Factors

Family functioning occurs within the context of various social institutions and external forces that influence family and parent-child behaviors. Research on environmental factors has concentrated on neighborhood and community environments, but other factors may affect individual and family functioning as well, including the workplace, the media, the school, church, and peer groups.

Discussion of the relationship of poverty to child maltreatment has persisted since publications of the early professional papers on child abuse in the 1960s. Although child maltreatment is reported across the socioeconomic spectrum, it is disproportionately reported among poor families. Furthermore, child maltreatment—especially child neglect—is not simply concentrated among the poor, but among the poorest of the poor. Whether this association results from greater stress due to poverty-related conditions that precipitate abuse, or from greater scrutiny by public agencies that results in overreporting, or whether maltreatment is but one characteristic of the pattern of disruption among the poorest of the poor continues to be debated. The link between unemployment and maltreatment is significant in understanding the relationship between poverty and maltreatment. Families reported for abuse often have multiple problems, and the abuse may simply be a part—or a consequence—of a broader continuum of social dysfunctions.

Although it occurs in all social levels, violent behavior toward children, particularly severe violence, is more likely in poor families. Despite the fact that the evidence on maternal age as a risk factor for child maltreatment is mixed, mothers with young children living below the poverty line have the greatest risk of behaving violently toward children.

Although neighborhoods are recognized as important in the ecology of child maltreatment, more insight is needed into the processes by which neighborhood conditions and factors affect maltreatment. Poor neighborhoods differ in their social and physical conditions and in their ability to influence specific risks posed to children by poverty, unemployment, and community violence. Socioeconomic conditions have predictive value for explaining child maltreatment rates, yet some neighborhoods have higher or lower child abuse rates than would be expected based on socioeconomic conditions alone.

Social isolation has been identified as an important etiological risk factor in child maltreatment, but its role as a consequence or cause of maltreatment is uncertain. The influence of family ties and organizational affiliations (including employment and education) are poorly understood but increasingly recognized as powerful forces in shaping parenting styles and family functioning. Financial stability, employment, and neighborhoods can create a context that either supports a family during periods of stress or enhances the potential for abuse.

Social and Cultural Factors

Family practices and policies that reflect social and cultural values can foster or mitigate stress in family life. Although the relationship of cultural factors is not well understood, some American societal values may contribute to child maltreatment and they have achieved new importance in emerg-

ing theoretical models of child maltreatment. Racism, for example, can lead to an inequitable distribution of resources, education, and employment that undermine many ethnic minority families' abilities to support their children (financially and emotionally) and to provide parental care. The term societal neglect has been suggested to characterize American tolerance for a situation in which one-fifth of all preschool children live below the poverty line, with a substantially higher rate among ethnic minorities. Societal fascination with violence, including violence toward children, has been suggested as a risk factor for child maltreatment, as has the lack of coherent family leave and family support policies, particularly the absence of preventive health care for infants, children, and adolescents at risk for maltreatment.

Conclusions

Many factors have been identified as contributing to the occurrence of child maltreatment, but single-factor theories of child maltreatment have not been able to identify specific mechanisms that influence the etiology of child maltreatment. Such environmental factors as poverty and unemployment and such individual characteristics as a prior history of abuse, social isolation, and low self-esteem have been significantly associated with child maltreatment offenders, but the relationships among such factors are not well understood in determining the origins of child maltreatment. The panel believes that the etiology of maltreatment involves complex clusters of variables that interact along various dimensions of a child's ecological/transactional system. Factors that increase risk for maltreatment and factors that decrease the likelihood for maltreatment are found at all ecological levels and interact to produce child maltreatment. Although theoretical models that describe the etiological complexity of maltreatment have been developed, they have not been subjected to testing and adequate research. Our recommendations seek to address these limitations.

In the past, the risk factor literature for child maltreatment has been dominated by an orientation that emphasizes correction of perceived weaknesses or problem behaviors and ignores protective factors that may influence outcomes. In recent years, some researchers have begun to examine variables that foster healthy relationships and reduce risk for child maltreatment. The reduction of multiple vulnerabilities as well as the development of compensatory behaviors should be a goal for future prevention research.

Risk Factors and Pathways to Prevention

Until recently, the primary focus in designing preventive interventions was the identification and modification of problematic or damaging parental practices associated with child maltreatment, such as physical discipline, failure to provide children with basic necessities and care, and mismatches between a parent's expectations and a child's ability.

This singular focus on parental roles was altered with the recognition of the prevalence of sexual abuse in the late 1970s. Research on victims of child sexual abuse suggested that risk factors with respect to perpetrator characteristics, victim characteristics, and sociodemographic variables are far more heterogeneous than they are for physical abuse or neglect victims. As a result, prevention advocates focused on ways to strengthen potential victims of sexual abuse through classroom-based instruction for children of all ages.

In recent years, schools have placed a new emphasis on violence prevention programs, designed to equip students to develop nonviolent methods of conflict resolution. Although the generalizability of these programs to the field of child maltreatment has not been systematically assessed, such programs represent a promising direction for future research.

Parental Enhancement Programs

Parental practices in families with young children are a major focus of research on prevention strategies for child maltreatment. Prevention strategies have built on individual, familial, and community-level risk and protective factors that contribute directly to both parental practices and to child well-being. This research foundation has provided the basis for identifying vulnerable families that are at high risk for maladaptive parental practices. Increasingly, at-risk communities are becoming the target of early intervention programs.

Four major types of prevention strategies have been developed for families with young children (defined as the prenatal period through age 8): (1) comprehensive programs, often including home visitor services that vary widely in both scope and content, (2) center-based programs that include a family support component, parent information services, and early childhood education services, (3) community-based interventions that offer a range of family support services, and (4) hospital-based interventions.

Although some well-designed, randomized control, clinical trials exist (such as the Olds study [1986a,b] in upstate New York), many early intervention services lack a theoretical framework and their mission is not always well defined. Some interventions demonstrate that knowledge about child development can be transferred to parents in a relatively brief period of time (i.e., 6-12 weeks), but a time commitment of six months or more is

needed to change attitudes and strengthen parenting and interpersonal skills. Prevention programs need to focus directly on families at most risk for maltreatment, to accommodate families with differing needs and experiences, and to adapt to changing family situations.

Community-Based Prevention Programs

The large majority of existing community-based programs focus on prevention of physical and sexual abuse. Child maltreatment prevention programs that are found in the schools are primarily child sexual abuse prevention programs designed for children in elementary and high schools. In addition to major efforts in child sexual abuse prevention, the panel reviewed two other efforts that may have implications for the prevention of child abuse and neglect. These are community-based antipoverty programs, some of which involve vocational or educational assistance, and the violence prevention programs in the schools designed to educate children, primarily adolescents, about conflict resolution skills. Such programs may be important in helping improve the welfare of many families and peer relations, but they have not been systematically evaluated in terms of their outcomes for child abuse and neglect.

Although sexual abuse prevention education programs have generally achieved the goals of teaching prevention knowledge and skill acquisition, it is not clear that these gains are retained over time or are useful to a child under assault, especially if the offender is a relative or trusted adult. Less is known about the efficacy of child sexual abuse prevention programs compared with prevention efforts directed primarily at the physical abuse and neglect of children. There is disagreement in the child safety field about the theories that should guide child sexual abuse prevention programs. At this juncture, it seems critical for child sexual assault prevention programs to evaluate the contributions of extensive parent and teacher training components. Research efforts should be expanded to include extended after-school programs and in-depth discussion programs for certain high-risk groups (e.g., former victims, teen-age parents).

Since poverty has consistently been associated with child maltreatment, particularly child neglect, programs designed to improve the income of poor families could become a major source of prevention of child neglect. At a time when education has become an important requirement for better-paying jobs, programs designed to increase the career options of young parents through educational and vocational training efforts are commonly viewed as part of the preventive spectrum for child maltreatment.

Day care providers, teachers, principals, and others who have ongoing and long-term contact with children are in a position to identify suspected victims of maltreatment and report them to child protective services. Such

interventions can be a source of reduced incidence for the recurrence or the prevention of child maltreatment. However, the low percentage of suspected cases identified by educators and other personnel in the school system that are eventually reported to child protection agencies may be a cause for concern. Day care providers, educators, and other youth service personnel require training in the identification of child abuse and neglect, guidance in reporting suspected cases, and methods for supporting maltreatment victims and their families, including referrals to relevant treatment services and peer support groups for victims.

Since many families who are reported for child maltreatment are characterized by other forms of violence (including spouse abuse and involvement in criminal assaults), interrupting the cycle of violence in one area of life may have spillover effects on others, but this assumption needs to be tested empirically. School-based interventions have several advantages, including accessibility to a broad youth population, mandated attendance, ease in scheduling, and cost effectiveness. Although school-based violence prevention programs are a promising development, no firm conclusions can be drawn at this time regarding their effectiveness or generalizability for the prevention of child abuse, and it is not known if participants will be less likely to be perpetrators of family violence.

Media representatives can become important participants in public education about prevention in child abuse and neglect. Media efforts to prevent child maltreatment may benefit from lessons derived from the role of the media in addressing public health issues. Similarly, media programs could be developed to promote community support for appropriate parental practices, especially in the use of physical discipline, and to improve the response of bystanders who witness acts of child maltreatment in public places.

Community-based prevention efforts show promise, especially in the design of multisystem approaches that can build on family-school-media-community approaches. Many avenues can be considered in designing prevention programs, but well-designed program evaluations are critical for developing a knowledge base to guide future efforts. The community mental health approach and community-based interventions designed to reduce smoking and heart disease represent much promise, but such efforts have not yet been developed or tested in the area of child maltreatment.

The Role of Cultural and Social Values in Prevention

Prevention programs increasingly focus on ways to foster cultural changes that could lead to regulatory and voluntary approaches to reinforce health messages at other system levels. Several areas that have relevance for prevention research on child maltreatment include attitudes toward the use

of corporal punishment, the effects of criminal sanctions on the maltreatment of children, and the use of violence as a means of resolving conflict. Reliance on corporal punishment by parents has been identified by some researchers as an important risk factor for physical abuse, but corporal punishment is usually not dealt with in programs to prevent physical abuse. Research is needed on whether the inclusion of alternatives to spanking in such programs reduces physical abuse.

In considering the effectiveness of criminal sanctions in the area of child maltreatment, associated problems of abusive and neglectful families need to be recognized. Many of these families are already involved with the legal system because of other behaviors, including substance abuse, juvenile delinquency, and other crimes. Assessment of the impact of criminal sanctions solely in the area of child maltreatment is challenging, since the perpetrators may be removed from the home in a variety of other ways involving the court system.

Evaluations of home visitation programs, school-based programs for the prevention of sexual abuse and violence, and other community-based child maltreatment prevention programs are quite limited. Many evaluations are compromised by serious methodological problems, and many promising preventive interventions do not systematically include child maltreatment as a program outcome. Children and families who are most at risk for child maltreatment may not participate in the interventions, and those that do may not be sufficiently motivated to change or will have difficulty in implementing skills in their social context, especially if they live in violent neighborhoods.

The panel's primary conclusion is that comprehensive and intensive prevention programs that incorporate a theoretical framework, identifying critical pathways to child maltreatment, offer the greatest potential for future programmatic efforts. New theoretical models that incorporate ecological and developmental perspectives have complicated the development of prevention research, but these models hold much promise, for they suggest multiple opportunities for prevention. Prevention research needs to be guided by rigorous evaluation that can provide knowledge about the importance of different combinations of risk and protective factors, the developmental course of various forms of maltreatment, and the importance of replacing or supplementing risk behaviors with compensatory skills. In the face of uncertainty as to whether etiologies of the various forms of child maltreatment are similar or different, a diverse range of approaches to prevention research should be encouraged.

Consequences

For over 30 years, clinicians have described the effects of child abuse and neglect on the physical, psychological, cognitive, and behavioral development of children. Physical consequences range from minor injuries to severe brain damage and even death. Psychological consequences range from chronic low self-esteem to severe dissociative states. The cognitive effects of abuse range from attention problems and learning disorders to severe organic brain syndromes. Behaviorally, the consequences of abuse range from poor peer relations to extraordinarily violent behaviors. Thus, the victims of abusive treatment and the society in which they live pay an enormous price for the results of child maltreatment.

Yet empirical studies of child maltreatment have identified important complexities that challenge our understanding of factors and relationships that exacerbate or modify the consequences of abusive experiences. The majority of children who are abused do not show signs of extreme disturbance. Research has suggested a relationship between child maltreatment and a variety of short- and long-term consequences, but considerable uncertainty and debate remain about the effects of child victimization on children, adolescents, and adults.

The scientific study of child maltreatment and its consequences is in its infancy. Until recently, research on the consequences of physical and sexual child abuse and neglect has been limited by delays between the child's experience and official identification of maltreatment. Maltreatment often occurs in the presence of multiple problems within a family or social environment, including poverty, violence, substance abuse, and unemployment. Distinguishing consequences that are associated directly with the experience of child maltreatment itself rather than other social problems is a daunting task for the research investigator.

As a result, we do not yet understand the consequences on children of particular types or multiple forms of abuse. Nor do we yet know the importance of the particular timing, intensity, and context of abuse on the outcome. Factors such as age, gender, developmental status, family relationships, and placement experiences of the child may influence the outcomes of maltreatment experiences. Disordered patterns of adaptation may lie dormant, only to appear during times of stress or in conjunction with particular circumstances. Furthermore, certain intrinsic strengths and vulnerabilities within a child and the child's environment may affect the extent to which abuse will have adverse consequences.

Victims of child abuse and neglect are at increased risk for delinquency and running away, but the majority of childhood victims do not manifest these problem behaviors. Significantly less is known about connections between childhood victimization and other problem behaviors, such as teen-

age pregnancy, use of alcohol and illicit drugs, and self-destructive behavior. Alcohol and illicit drug use are both illegal for teenagers, creating a natural confounding of alcohol and substance use with delinquency. Diagnoses of alcoholism are complicated by the presence of antisocial personality disorder, which in turn may include components of criminal behavior and sexual promiscuity. Engaging in any one of these behaviors, then, might increase the likelihood of involvement in other high-risk behaviors.

Issues of Stigma, Bias, and Discrimination

Problem behaviors may result from the chain of events occurring subsequent to the victimization rather then the victimization experience per se. For example, being separated from one's biological parents, subsequent to the abuse and neglect incident(s), and placed in foster care can be associated with deleterious effects. Furthermore, children can encounter discrimination against their race, color, language, life and family styles, and religious and cultural beliefs that affect their self-esteem and magnify the initial and lasting effects of both types of victimization. The observed relationship between early childhood victimization and later problem behaviors may also be affected by practices of the juvenile justice system that disproportionately label and treat maltreatment victims as juvenile offenders.

Protective Factors

Not all abused and neglected children grow up to become dysfunctional adults. A broad range of protective factors, such as temperamental attributes, environmental conditions, and positive events, can mitigate the effects of early negative experiences. The consequences of childhood maltreatment vary by demographic, background, and clinical variables—such as the child's gender, the family's socioeconomic status, and the level of marital and family violence.

Individual characteristics, such as high intelligence, certain kinds of temperament, the cognitive appraisal of victimization experiences, a relationship with a significant person, and out-of-home placement experiences protect some childhood victims. But conflicting or indirect evidence about most of these characteristics and experiences results in a major gap in knowledge about what factors make a difference in the lives of abused and neglected children. Research is needed to determine the role of protective factors and mediating individual characteristics, particularly how they operate to increase or decrease vulnerability for problem behaviors.

Placement outside the home may act to protect abused and neglected children from serious long-term consequences, but such an action is controversial. Foster care placements may pose additional risks for the abused or

neglected child, and the trauma of separation from one's biological family can also be damaging. Although some out-of-home placements may exacerbate stress in children from abusive and neglectful households, such placements may not always be deterimental. However, abused and neglected children in foster care and other out-of-home placement experiences, who typically come from multi-problem families, are a particularly vulnerable group because they have experienced both a disturbed family situation and separation from their natural parents.

Knowledge of the long-term consequences of childhood maltreatment into adulthood is extremely limited, with sparse information on intellectual and academic outcomes and medical and physiological consequences. Some research has addressed parenting behaviors (particularly the intergenerational effects of abuse), but the vast majority of existing research has focused on psychosocial outcomes and, in particular, psychopathology.

Childhood victimization often occurs in the context of multiproblem homes. Other family variables, such as poverty, unemployment, parental alcoholism or drug problems, and other factors that affect social and family functioning, need to be disentangled from the specific effects of childhood abuse and neglect. Few studies have assessed the long-term consequences on the development of abused and neglected children, beyond adolescence and into adulthood. Control groups matched on socioeconomic status and other relevant variables become necessary and vital components of this research, in order to determine the effect of childhood victimization on later behavior, in the context of family and demographic characteristics.

Interventions And Treatment

Research on interventions in child maltreatment is complicated by ethical, legal, and logistical problems, as well as difficulties in isolating factors specifically associated with child abuse and neglect in programs that often include families with multiple problems. Interventions include the assessment and investigation of child abuse reports by state child protection agencies, clinical treatment of physical injuries, legal action against the perpetrator, family and individual counseling, self-help services, and informal provision of goods and services (e.g., homemaker and respite care). Multiple agencies determine policies that guide interventions in child abuse and neglect and coordinate human and financial resources to fulfill these objectives. Researchers in this area have limited resources to collect compatible data, the results of project evaluations are rarely published in the profes-

sional literature, and issues of service delivery and accessibility are difficult to document.

The fragmentary nature of research in this area inhibited the panel's ability to evaluate the strengths and limitations of the intervention process. Furthermore, we did not have sufficient time to evaluate the full spectrum of administrative and legal procedures associated with reports of child maltreatment. The panel has thus focused its attention on those areas in which significant theory and empirical evidence exist.

Treatment of Child Victims

Despite the large literature on the detrimental effects of child maltreatment, the majority of treatment programs do not provide services directed at the psychosocial problems of the abused child. Children's involvement in treatment programs has generally occurred in the context of family-based services in which some children have received direct programmatic attention but others have not. Treatment interventions for child victims of abuse and neglect draw extensively from approaches for treating other childhood and adolescent problems with similar symptom profiles, but the psychological effects of abuse have not been well formulated in terms of theoretical constructs that can provide a basis for intervention.

Treatment of Adult Survivors

The treatment of adult survivors of childhood sexual victimization is a newly emerging field; the first programs appeared in the late 1970s. Many adult survivors of child abuse do not identify themselves as such, and most treatment programs or studies for adult survivors focus on child sexual abuse rather than other forms of child maltreatment. Research on the treatment of adult survivors is submerged in the literature on adult psychological disorders such as addiction, eating disorders, borderline personality disorders, and sexual dysfunction.

Treatment for Adult and Adolescent Sex Offenders

The treatment of child molesters is a controversial issue. Treatment programs are frequently offered to adult and adolescent offenders as part of plea bargaining negotiations in criminal prosecutions. The traditional assumption has been that children and society are better protected by offender treatment than by traditional prosecution and incarceration if the treatment service is effective. However, there is currently considerable debate about whether child molesters can be effectively treated. Until recently, adolescent sexual offenders have been neglected in clinical and research literature.

Empirically tested models to explain why adolescents commit sexual crimes or develop deviant sexual interest patterns are lacking.

The most common approaches to treating child molesters are comprehensive treatment programs aimed at simultaneously treating multiple aspects of deviant sexual behavior. Although many different approaches to the treatment of sexual offenders have been tried (including group therapy, family systems treatment, chemical interventions, and relapse prevention), scientific data indicating sustained reductions in recidivism are not available. Most studies follow offenders for only one year after treatment, and the effectiveness of the treatments in eliminating molestation behavior beyond that period is not known. Preliminary outcome data on the treatment of juvenile sex offenders show positive outcomes, although there is a lack of substantive research in the field and a lack of consensus regarding basic principles of treatment.

Family-Oriented Interventions

Most treatment interventions for physical abuse, child neglect, and emotional abuse seek to change parenting practices or the home environment. Only recently have treatment services incorporated empirical findings that examine the interactions of family members, abusive parents' perceptions of their children, behavioral characteristics that may restrict parenting abilities, and emotional reactions to stressful childrearing situations.

A lack of consensus exists regarding the effectiveness of a wide range of treatment services for maltreating families, including parental enhancement programs, family systems treatment, home-based services, and family support programs. Outcome studies have indicated positive behavioral and attitudinal changes as a result of family or parent treatment, but few studies have examined the effects of such interventions on subsequent reports of child abuse and neglect beyond one year. Definitive conclusions about the generalizability of the findings from studies of family-oriented programs in reducing subsequent child maltreatment are difficult to develop because the participants in these programs often present varied types of parental dysfunction.

Family Income and Supplemental Benefits

Government programs designed to alleviate or mitigate the effects of poverty on children are often part of a comprehensive set of services for low-income, maltreating families. Such programs include Social Security supplemental income programs, Aid to Families with Dependent Children, Women with Infants and Children food supplement program, Head Start, rent-subsidy programs, and school lunch programs, among others. While

national and local child welfare programs designed to improve the well-being of all poor families may provide food, shelter, and other necessary resources for children in households characterized by neglect or abuse, the relationship between income support, material assistance, and the subsequent reduction of maltreatment has not been systematically addressed.

Community-Based Interventions

Family-oriented interventions often exist within a context of a broad range of diverse services provided by community agencies. Understanding these responses to child maltreatment is important in understanding the experiences of children and families following reports of maltreatment. Yet little is known about the efficacy of these community-based interventions.

A few treatment programs have been developed at the community level to provide services to families, such as counseling and educational services for the parents, supervised day care, and specialized referrals for community services, including mental health care, housing, and substance addiction treatment. Although such neighborhood-focused programs may assist children who are victims of abuse or neglect, program evaluations usually do not consider outcomes in terms of maltreatment subpopulations.

Medical Treatment of Child Abuse

Health professionals in private practice, community health clinics, and hospitals are often the first point of contact for abused children and their families when physical injuries are sustained. Little is known about treatments recommended for abused children in medical settings, and even less is known about specific treatment outcomes. Studies suggest, however, that many health professionals may not be sufficiently trained to detect or validate signs of abuse or to deal with the emotional, technical, and legal aspects of evaluating maltreated children, particularly sexually abused children.

Child Protective Services

Child protection agencies receive and screen initial reports of child abuse and neglect from educators, health personnel, police, members of the public (e.g., neighbors, family friends), relatives (including siblings and parents), and others to determine whether investigation is required. The processes that determine their responses to children and families have not attracted much research attention, although a few studies have attempted to document and characterize various stages of the process and their effects on children and families. Evaluations of operations of child protective services

are complicated by the emergency situation in which most investigations occur, the confidential nature of the process, limited budgets, staff turnover, variations in definitions of child maltreatment and the absence of clear objectives, procedures, and standards of evaluation. The lack of systematic record-keeping and compatible data, and political sensitivity also inhibit the observation and analysis of decisions made by child protective services workers.

Research on the nature and effectiveness of risk assessment and referral decisions involving maltreating families is difficult, and we know little about factors that influence the assessment, investigation, and substantiation of specific cases; the operation of the referral system and follow-up services; the character of cases that are likely to receive services; the nature, intensity, and length of the services provided; and outcomes resulting from intervention services for different types of child maltreatment. Many factors can affect referral decisions, including availability of services, costs to clients and sponsors, ease of access, client attitudes, perceived need, and organizational relations. Recent clinical reports of child abuse cases suggest that many cases are closed immediately after services have been initiated and, in some instances, even prior to actual service delivery.

Child Welfare Services

The decision to allow a maltreated child to remain with family members or relatives during treatment is a critical and controversial aspect of the case management process. In some cases, temporary or permanent foster care is provided to children on the premise that protection of the child from physical harm is paramount.

Research on services provided to children in foster or kinship care is difficult. Information about children in foster care is often dispersed among biological parents, foster parents, relatives, and caseworkers, and cooperation among agencies providing services is frequently hampered by issues of confidentiality, funding and eligibility requirements, budgetary restrictions, and the specialized nature of professional services, that tend to focus on isolated problems.

Legal Intervention in Child Maltreatment

A small proportion of child maltreatment cases that are reported to child protection agencies become involved with juvenile courts, family courts, and criminal courts. Areas of convergence and conflict between the goals of service providers and the legal system in the treatment of child abuse and neglect have been documented, but much uncertainty remains in this area. Legal interventions in child maltreatment are complicated by many factors,

such as the absence of physical evidence, difficulties in obtaining consistent and reliable testimony from children, emotional trauma that might be incurred in forcing a child victim to testify against a parent or other adult who may have harmed him or her, and inconclusive scientific evidence regarding the effectiveness of treatment in halting abusive and neglectful behavior. Even though relatively low numbers of sexually abused children are involved in court proceedings, the legal treatment of child sexual abuse cases has attracted significant research attention. Almost nothing is known about the quality of court experiences for children or adults who are affected by physical abuse, neglect, and emotional maltreatment.

Social and Cultural Interventions

National policies, professional services, and institutional programs sometimes reveal inconsistent policies and fundamental value conflicts. Values that strongly influence the current American social context for responding to reported or suspected child maltreatment include respect for child safety and family preservation. The rights of individual privacy, confidentiality, and other liberties that are often constitutionally guaranteed also influence both the provision of social and professional interventions as well as evaluations of their effectiveness.

The conditions under which child, parental, or community rights should supersede all other rights and obligations, and the criteria that should be considered in balancing long-term dangers against immediate threats, are unclear. Research defining the ''best interests of the child" is becoming a significant issue in determining the outcomes of assignment of visitation and custodial rights in court decisions.

Medical, psychological, social, and legal interventions in child maltreatment cases seek to reduce the negative physical, behavioral, and emotional consequences of child abuse and neglect, foster attitudes and behaviors that improve the quality of parent-child interactions, and limit or eradicate recurrences of maltreatment. Interventions have been developed in response to public, professional, legal, and budgetary pressures that often have competing and sometimes contradictory policies and objectives. Some interventions focus on protecting the child or protecting the community; others focus on providing individual treatment for the child or the offender; others emphasize developing family coping strategies and improving skills in parent-child interactions. Assumptions about the severity of selected risk factors, the adequacy of caretaking behaviors, the impact of abuse, and the steps necessary to prevent abuse or neglect from recurring may vary.

Little is known about the quality of existing interventions in treating different forms of child maltreatment. No comprehensive inventory of treatment interventions currently exists, and we lack basic descriptive and evaluative information regarding key factors that influence the delivery and results of treatment for victims and offenders at different developmental stages and in different environmental contexts. A coherent base of research information on the nature and the effectiveness of treatment is not available at this time to guide the decisions of case workers, probation officers, health professionals, family counselors, and judges.

Investigations of child maltreatment reports often influence the development and availability of other professional services, including medical examinations, counseling, evaluation of risk factors, and substantiation of complaints. Research on various federal, state, and private agency involvement and interactions in treatment interventions has not been systematically organized. Although the panel acknowledges the challenges of performing research in this area, future study designs require adequate sample sizes, well-characterized and well-designed samples, and validated and comparable measures.

Human Resources, Instrumentation, And Research Infrastructure

Child maltreatment research in the 1990s will require a diverse mix of professional skills and collaborative efforts. The development of human resources, measurement tools, and research infrastructure in this field is complicated by the absence of support for problem-oriented research efforts in academic centers; the legal and ethical complexities associated with this kind of research; the lack of a shared research paradigm that can integrate interdisciplinary efforts across types of maltreatment; problems in gaining access to relevant data and study populations; the absence of data and report archives; and funding inconsistencies associated with shifting research priorities.

The Research Community

A variety of disciplines and subject areas contributes to studies of child maltreatment, including medicine (especially pediatrics and psychiatry), psychology, social work, criminal justice, law, sociology, public health, nursing, anthropology, demography, statistics, and education. Few systematic efforts have been made to integrate research on child maltreatment with the knowledge that has evolved from recent studies of normal child development, family systems, adult and child sexual behavior, family violence, community violence, substance abuse, poverty, and injuries.

Academic training for professionals who must work in the area of child maltreatment has not kept pace with the demands for expertise. About a dozen child maltreatment research programs exist at various universities, medical centers, and child advocacy organizations, but the depth and quality of these centers as well as the skills and affiliations of their research staff are generally unknown. Consequently, considerable effort is needed to deepen and broaden the human resources, instrumentation, and research infrastructure available for addressing the key research questions.

The number of doctorates and other advanced degrees that involve dissertations on child maltreatment studies has been increasing over the past decade, reflecting a growing interest in research in this field. Although many universities offer graduate courses in child abuse and neglect, less than half a dozen universities now sponsor graduate or postgraduate training programs in this field. Graduate training programs have achieved consensus regarding the general body of information necessary in the field of child maltreatment, but considerable variability exists in the length of the programs, student eligibility requirements, time requirements for classroom instruction and practical experience, and the availability of financial support.

Methodological Issues

The absence of support for methodological research has impeded scientific progress in child maltreatment studies. The development of adequate research tools is essential to move a research field beyond theoretical or design problems toward the collection and analysis of empirical data.

Methodology and instrumentation issues present one of the most significant barriers to the development of child maltreatment research. A number of issues deserve particular attention:

In many cases research instruments may simply be unavailable. Measures have been developed to assess "normal" child behavior or other problems in samples of unabused children, but they may not be adequate to assess child maltreatment issues and they may not be standardized on diverse cultural or ethnic populations. Furthermore, available research instruments adapted from other fields may not provide significant information for the practitioner. Difficulties in the use of instruments may result from training—researchers have often come from disciplines that give inadequate

attention to the importance of valid and reliable measures and empirical results. Overall, the use of standard measures of family characteristics and social environmental characteristics seems to be less frequent in child maltreatment research than in child development and family research in general.

The development and use of standardized measures in child maltreatment research is complicated by an additional set of pragmatic and professional factors, including the lack of budgetary support for instrumentation research projects, publication policies that discourage discussions of psychometric work in reporting research results, and research sponsors' preference for substantive rather than methodological topics.

Although some useful resources can be identified, the field of child maltreatment studies has not successfully developed a comprehensive information service designed to integrate research publications from diverse professional and private sources in an easily accessible format. In contrast to effective dissemination programs focused on criminal justice research, limited efforts exist to summarize and disseminate maltreatment research findings from the fields of psychology, social work, medicine, and other relevant disciplines.

Federal Funding for Research

Federal support for child maltreatment research is currently divided among 28 separate offices in 5 federal departments—the departments of Health and Human Services, Justice, Education, Defense, and Transportation. The forms of federal research support are diverse, including large research center program awards, individual research awards, data collection efforts, individual training grants, and evaluations of demonstration projects. With the exception of the National Center for Child Abuse and Neglect, which has a research program focused explicitly on studies of child maltreatment, most federal agencies support child maltreatment research in the context of other scientific objectives and program responsibilities, such as research on violence, maternal and child health care, family support, mental health, and criminal justice. As a result, federally supported research activities that may advance scientific knowledge of the identification, causes, consequences, treatment, and prevention of child abuse and neglect are often embedded within other research studies that have multiple objectives. No central repository exists to maintain an ongoing index of federally supported research on child maltreatment.

A 1992 forum sponsored by the Federal Interagency Task Force on Child Abuse and Neglect indicated that the total federal research budget for studies directly related to child maltreatment research is in the $15-20 million range. It is important to note that these figures reflect only research that is "primarily relevant" to child abuse and neglect studies. Additional

research efforts related to child maltreatment are also sponsored by federal agencies, although the level of investment in these secondary research efforts depends on the perceived significance of studies about parent-child interactions, substance abuse, family violence, and juvenile delinquency to child maltreatment.

The relevance of child maltreatment research to the central mission of each federal department appears to be idiosyncratic and uneven. Adopting a comprehensive view of research on child maltreatment presents certain difficulties of identification, organization, and taxonomy. Efforts to prevent child abuse and neglect and improve child welfare are dispersed among a wide range of federal programs within the U.S. Department of Health and Human Services alone. However, most of these efforts are not "child abuse" in name, and no systematic effort has been made to evaluate the lessons for child maltreatment learned from them. Various direct services for abused children and their families, demonstration projects, and educational and information dissemination activities are scattered throughout other federal program efforts as well.

Clearly, not all research on children, families, poverty, and violence is relevant to studies of child maltreatment. However, the fragmented and specialized character of the current federal research portfolio in these issues can hamper systematic efforts to organize and build on advances in research. The specialized roles of federal programs that have relevance for studies of child maltreatment continue to inhibit the development of this field. Research investigators and program officers in separate agencies are often unaware of previous studies or active projects related to their research interests. Researchers funded by separate agencies to conduct studies on aspects of child maltreatment often work with separate theoretical paradigms, use different sample populations, develop project-specific methodologies, draw on separate research databases, and present their results in a wide variety of journals and professional meetings. The absence of a central tracking and documentation resource center and the diffuse organization of the federal research portfolio, as well as the fragmented bureaucratic and legislative requirements that are associated with child maltreatment, inhibit the development of a dynamic and interdisciplinary research field.

State Roles in Research on Child Maltreatment

No comprehensive inventory of state research programs exists for studies on child maltreatment issues, but it is unlikely that the total amount of research funds available from individual state agencies is significant (i.e., greater than $1 million per year). However, individual scientists reported to the panel that they have received occasional research support from various state agencies, including the maternal and child health departments and

family services offices in the states of Hawaii, Illinois, and Minnesota, the children's trust funds administered by the states, and other offices. The decentralized and sporadic nature of state-funded research efforts discourages efforts to build collaborative interdisciplinary research teams or long-term studies focused on complex research topics.

States are a potential source of future support for specific training and data collection programs in areas such as the criminal justice, education, and public health systems that need to be integrated into comprehensive studies of outcomes and consequences of child abuse and neglect. It is useful to think of the state agencies as important partners in building an expanded research base for studies of child maltreatment.

State science programs are expected to assume a larger role in sponsoring and using research related to domestic health, social, and environmental issues in the decades ahead. The 1992 report of the Carnegie Commission on Science, Technology and Government, for example, concluded that new scientific and technological advisory organizations will be needed to foster better communication between and within the states. These organizations will need to improve the gathering of scientific knowledge, of identifying best practices, and of suggesting research priorities in national science and technology forums. Studies on child maltreatment should be viewed as an important opportunity for building collaborative state and federal research organizations directed toward long-term improvements in social service programs in areas such as child protection, child welfare, family counseling, and foster care.

Private Foundations

In addition to research funding from governmental agencies, at least eight private foundations have selected child abuse and neglect as a priority funding area. Despite this interest, the amount of funds provided by private foundations for studies on child maltreatment is quite limited.

The nongovernmental sector may be an important source of potential funding for dissertation and graduate student support in funding studies on the relationships among child maltreatment, child development, family welfare, poverty, and others. It is most important, therefore, to see the private sector as a collaborator in strengthening the research foundation for studies on child maltreatment.

Support for child maltreatment research has developed in a haphazard, piecemeal fashion, reflecting the absence of a national plan for providing research, educational, and professional support for studies of child abuse and neglect. Governmental roles in this area have been complicated by

poor leadership, the absence of sufficient funds to support a robust research program, uncertainties about the most promising research directions to pursue, tensions between the role of the federal and state governments in sponsoring projects in such areas as child maltreatment and child and family welfare, and conflicting social values about the proper interventions to develop in response to child maltreatment incidents. Tensions also exist in the allocation of funds between professional and social services for maltreated children and their families and research projects that seem to provide no immediate benefits for these groups.

Given the current status and evolution of child maltreatment studies, a broad diversity of parallel efforts should be maintained. Top-down or centralized approaches should be avoided that may discourage or fail to recognize the significance of emerging theoretical paradigms, instrumentation research, and other approaches that seek to extend the boundaries of current knowledge about the origins, scope, and consequences of child abuse and neglect. In particular, attention to cultural and ethnic issues that affect our understanding of childhood needs, child development, and family life require a breadth of effort that currently does not exist in the research community.

While diversity of effort is important to maintain, the panel concludes that better national leadership is needed to organize the research base. Such leadership requires more informed documentation of research efforts so that scientific findings, instrumentation, theory, and data can be better recorded, integrated, and disseminated to researchers and practitioners. There is also a pressing need to connect education, research, and practice so that individuals who become caseworkers, family counselors, administrators, legal officials, and future scientists have a richer understanding of the complexities of child maltreatment. Finally, the development of both young and mature scientists needs attention to build a foundation for future explorations of the intricate scientific questions that lie ahead.

Ethical And Legal Issues

Ethical and legal issues for studies of child maltreatment will gain increasing prominence with the growth of research activities on child maltreatment, especially as researchers acquire the ability and resources to conduct long-term prospective studies of nonclinical samples involving large numbers of children and families.

Human Subjects Research Issues

Many ethical issues arise in the course of human subjects research, some of which have special relevance for studies of child maltreatment.

Five issues that deserve special attention are: (1) the recruitment of research subjects; (2) informed consent and deception; (3) assignment of subjects to experimental or control programs; (4) issues of privacy, confidentiality, and autonomy; and (5) debriefing or desensitizing of research subjects following research on matters that may involve deception or significant stress.

Issues Derived from Research on Children and Families

The validity of scientific research takes on special relevance in studies of children and other vulnerable populations, when research results are likely to influence social policy and public perceptions of the problem under study. Information that scientists disseminate about child victimization is often socially and politically sensitive and can affect both parental and professional behavior as well as public policy. Scientific information, communicated through the popular media, can influence the manner in which abusive parents view abuse, and the ways in which victims view themselves. High-quality research is needed to provide information that has a factual, scientific basis, rather than information based on conjecture or opinion.

Because validity is so important but hard to achieve in research on children and families, factors that affect validity are receiving increased attention. These factors include the definitions of child maltreatment, instrumentation and research methods, selection of subject samples, collection of data, interpretation of findings, and safeguards for ensuring privacy, confidentiality, and reliability in the research study.

Research on Socially Sensitive Topics

Scientific studies of child maltreatment require extraordinary care and confidentiality in eliciting, safeguarding, and disclosing information from respondents because of the socially sensitive nature of the research subject. Family disciplinary practices, the use of violence between family members, and expressions of anger or rage are difficult to detect, observe, and record. Research on children's sexual development is one of the most unexamined areas in all of social science, impeded by a variety of social taboos, political sensitivities, and ethical ambiguities in general and discussions of sexual behavior with children in particular.

Researchers who seek to foster valid and creative research projects must address fundamental ethical issues in the recruitment of research subjects; the process of obtaining informed consent; the assignment of subjects; debriefing, dehoaxing, and desensitizing subjects when deception or stress-

ful research is involved; and in providing referrals for children and family members in distress.

Research Priorities

Despite the clear significance of child maltreatment, the panel concludes that research in this area is in an early stage of development. Although much insight has been gained over the past three decades, the field has not yet developed an integrated and organized base of knowledge or ongoing data collection efforts that can inform practice, guide the development of programs and policies relevant to child maltreatment, and shape the formation and testing of major hypotheses in this field. As a result, research is needed in diverse areas to explore promising directions. At the same time, research on child maltreatment requires guidance, coordination, and leadership to organize the research base and cultivate future generations of researchers who are well trained and informed about the complex research questions in this field.

The panel concludes that a research agenda for child maltreatment studies should address four separate objectives. We need knowledge that can:

Each chapter in this report includes key research recommendations within the topic under review. In the final chapter of the report (Chapter 10) the panel uses the four headings listed above as a framework for organizing the research priorities that it selected as the most important to address in the decade ahead. Details regarding each priority area appear in the individual chapters of the report.

Under each general heading below, the panel has organized the research priorities in order of their importance, with the most important recommendation listed first within each section.

The Nature and Scope of Child Maltreatment

Research definitions of child maltreatment are inconsistent, and the breadth and quality of instrumentation for child maltreatment studies are seriously incomplete. The variation in existing definitions and inadequate instrumentation impedes high-quality research, inhibits the comparison of studies of related phenomena, and restrains the development of good evaluations of intervention efforts. Improved definitions and instrumentation will facilitate the development of small- and large-scale epidemiologic investigations. These investigations would provide solid information on the occurrence of these important problems as well as on key etiologic agents.

Research Priority 1. A consensus on research definitions needs to be established for each form of child abuse and neglect. The development of consensus requires a major federal and professional commitment to a dynamic, evolutionary process, guided by a series of expert multidisciplinary panels and developed in conjunction with existing agencies, that could review existing work on research definitions.

Research Priority 2: Reliable and valid clinical-diagnostic and research instruments for the measurement of child maltreatment are needed to operationalize the definitions discussed under Research Priority 1. The absence of appropriate instrumentation and methodology is a second serious barrier to the development of good child maltreatment research. The reliability and validity of these instruments must be established by sound methodology, including testing their relevance and usefulness for economically and culturally diverse populations.

Research Priority 3: Epidemiologic studies on the incidence and prevalence of child abuse and neglect should be encouraged, as well as the inclusion of research questions about child maltreatment in other national surveys. After considerable work on instrumentation, including investigations into effective questioning strategies, the panel recommends funding several epidemiologic studies of different size and scope (including different age groups and ethnic groups) to address several different questions relating to child maltreatment (for example, the extent of the hidden nature of abuse).

Understanding the Origins and Consequences of Child Maltreatment

Research Priority 4: Research that examines the processes by which individual, family, community, and social factors interact will improve understanding of the causes of child maltreatment and should be supported. Theoretical models that integrate a variety of risk and protective factors are a promising development in research on the origins of child maltreatment and deserve further research attention. Rather than endorsing

a single approach, the panel recommends that diverse models be tested using a variety of research strategies so that researchers can test theory and generate hypotheses about mechanisms that activate or protect against individual child maltreatment.

Research Priority 5: Research that clarifies the common and divergent pathways in the etiologies of different forms of child maltreatment for diverse populations is essential to improve the quality of future prevention and intervention efforts. Studies that compare the etiologies of different types of maltreatment, and the patterns of risk and protective factors among populations that vary by ethnicity, cultural, and economic status, should be supported. It is particularly important at this time to uncover key pathways for child victimization that may be amenable to prevention or other forms of intervention.

Research Priority 6: Research that assesses the outcomes of specific and combined types of maltreatment should be supported. Research is needed that assesses direct and indirect consequences of child maltreatment across different domains of life, such as health, cognitive and intellectual skills, and social behavior in a variety of cultural contexts.

Research Priority 7: Research is needed to clarify the effects of multiple forms of child victimization that often occur in the social context of child maltreatment. The consequences of child maltreatment may be significantly influenced by a combination of risk factors that have not been well described or understood. The presence or absence of certain characteristics and other adverse events may influence a child's response to childhood victimization, and in some cases the combined effects of two stresses (such as family environment and poor caretaking) may be greater than the sum of the two considered separately. The social context is particularly important, since the effects of abuse or neglect often cannot be separated from other problems confronting families experiencing a variety of problems. It is not yet known whether a syndrome of problem behaviors or combined risks have common origins or whether discrete behaviors have different etiologies. These contrasting pathways have different implications for intervention strategies.

Research Priority 8: Studies of similarities and differences in the etiologies and consequences of various forms of maltreatment across various cultural and ethnic groups are necessary. The effects of risk potentiating and protective factors on child maltreatment in diverse cultural and ethnic groups have not been adequately explored.

Improving Treatment and Preventive Interventions

At present, we have limited knowledge about the range or nature of treatment and preventive services for child maltreatment or the context in

which these services are available to children and their families. Research evaluations in this area therefore must seek to broaden understanding of what currently exists as well as documenting what services appear to work for which individuals or groups, under what circumstances. Research on service interventions must also seek to identify factors and mechanisms that facilitate, or impede, the transfer of knowledge between researchers who study the origins, nature, scope, and outcomes of child maltreatment and those who develop and implement policies and programs for child and family services in the public sector.

Research Priority 9: High-quality evaluation studies of existing program and service interventions are needed to develop criteria and instrumentation that can help identify promising developments in the delivery of treatment and prevention services. Independent scientific evaluations are needed to clarify the outcomes to be assessed for service delivery programs in the area of child maltreatment. Such evaluations should identify the outcomes to be assessed, clarify the instrumentation and measures that can provide effective indicators of child and family well-being or dysfunction, and develop the criteria that should be considered in evaluating the effectiveness of a specific program or service. Evaluation studies currently rely heavily on reported incidents of child maltreatment as a measure of program effectiveness. Given the uncertainties associated with official detection of child maltreatment, such outcomes may have limited value in measuring the achievements or limitations of a selected program intervention.

Rigorous evaluation studies should be an essential part of all major demonstration projects in the area of child maltreatment, and funds should also be available for investigator-initiated evaluation studies of smaller program efforts. Smaller programs should be encouraged to use similar assessment instruments, so that results can be compared across studies. Scientific program evaluations, published in the professional literature, are an important means of transferring the knowledge and experience gained in the service sector into the research community. Such information exchange can improve the quality of studies on the origins, consequences, and other aspects of child maltreatment, ultimately leading to improved services and programs.

Evaluation research is particularly important in the following areas:

Research Priority 10: Research on the operation of the existing child protection and child welfare systems is urgently needed. Factors that influence different aspects of case handling decisions and the delivery and use of individual and family services require attention. The strengths and limitations of alternatives to existing institutional arrangements need to be described and evaluated. We have very poor information about the methods and mechanisms used to identify and confirm cases of child maltreatment, to evaluate the severity of child and family dysfunction, to assess personal and social resources, family strengths, and extrafamilial influences, and to match clients to appropriate treatments based on these formulations. An analysis is needed of interactions among different agencies involved in intervention and treatment and the degree to which decisions made by one agency affect outcomes in others. A research framework that provides standardized classifications and descriptions of child maltreatment investigations, adjudications, and treatment services should be developed. Comparative studies are needed to describe the agencies involved in the system, the types of interventions available for selected forms of maltreatment, the costs of investigating and responding to reports of child maltreatment, and the outcomes of case reports. Such studies should also consider the development of alternatives to existing institutional arrangements to improve the quality of service delivery systems.

Research Priority 11: Service system research on existing state data systems should be conducted to improve the quality of child maltreatment research information as well as to foster improved service interventions. Variations in state definitions of child abuse and neglect as well as differences in verification procedures result in significant unevenness in the quality of research data on child maltreatment reports.

Research Priority 12: The role of the media in reinforcing or questioning social norms relevant to child maltreatment needs further study. Important lessons can be learned from the role of the media in fostering healthy or unhealthy behaviors in areas such as the use of alcohol, smoking, drug use, and condom use. Research is needed that can identify the significant pathways by which key factors and behaviors affect child maltreatment, such as parenting styles, the use of corporal punishment, the use of violence and time-out periods in stress management and conflict resolution, and young children's relationships with strangers and abusive caretakers.

A Science Policy for Research on Child Maltreatment

The complexity of the problem of child maltreatment requires a sustained commitment to high-quality research, national leadership, human resources, and adequate funds. Scientific knowledge can contribute to our understanding of the nature, scope, origins, and consequences of child maltreatment, but such knowledge cannot be developed in a haphazard manner. Thus the panel has formulated priorities for science policy and the research infrastructure that supports child maltreatment studies in order to highlight key strengths and existing deficiencies in the research system.

Research Priority 13: Federal agencies concerned with child maltreatment research need to formulate a national research plan and provide leadership for child maltreatment research. Existing fragmentation in the federal research effort focused on child maltreatment requires immediate attention. National leadership is necessary to develop a long-term plan that would implement the child maltreatment research priorities identified by the panel, help coordinate the field, and focus it on key research questions. The panel believes that Congress, federal agency directors, and the research community should weigh the strengths and limitations of alternative federal research management approaches presented in this report in considering how to implement a national research plan for child maltreatment. Once a course of action has been formulated, current and proposed agency research activities need to be examined so that areas of strength, duplication of effort, and gaps in current efforts can be identified.

Research Priority 14: Governmental leadership is needed to sustain and improve the capabilities of the available pool of researchers who can contribute to studies of child maltreatment. National leadership is also required to foster the integration of research from related fields that offer significant insights into the causes, consequences, treatment, and prevention of child maltreatment.

Research Priority 15: Recognizing that fiscal pressures and budgetary deficits diminish prospects for significant increases in research budgets generally, special efforts are required to find new funds for

research on child abuse and neglect and to encourage research collaboration and data collection in related fields. The federal government spent about $15 million in fiscal year 1992 on research directly related to child maltreatment. As a first step in strengthening the research portfolio, the panel recommends that the research budgets of the National Center on Child Abuse and Neglect, the National Institute of Mental Health, the National Institute of Child Health and Human Development, the Centers for Disease Control and Prevention, and the Department of Justice that are relevant to child maltreatment studies be doubled over the next three years. Second, the panel recommends that the National Center on Child Abuse and Neglect convene a consortium of government agencies, private foundations, and research scientists to develop a task force to identify ways in which research on programs relevant to child maltreatment (such as substance abuse, spousal violence and child abuse, child homicides, juvenile delinquency, and so forth) can be more systematically integrated into the research infrastructure for child abuse and neglect.

Research Priority 16: Research is needed to identify organizational innovations that can improve the process by which child maltreatment findings are disseminated to practitioners and policy makers. The role of state agencies in supporting, disseminating, and utilizing empirical research deserves particular attention. Research on the information dissemination process can strengthen the ways in which science is used to inform and advise legislative and judicial decision makers. Such research can also contribute to the effective partnerships among scientists, practitioners, clinicians, and governmental officials to encourage the use of sound research results in formulating policies, programs, and services that affect the lives of thousands of children and their families.

State agencies have an important role in developing and disseminating knowledge about factors that affect the identification, treatment, and prevention of child maltreatment. The National Center on Child Abuse and Neglect should encourage the development of a state consortium that can serve as a documentation and research support center, allowing the states to collaborate in sponsoring child maltreatment studies and facilitating the dissemination of significant research findings to state officials.

Research Priority 17: Researchers should design methods, procedures, and resources that can resolve ethical problems associated with recruitment of research subjects; informed consent; privacy, confidentiality, and autonomy; assignment of experimental and control research participants; and debriefings. Research is needed to clarify the nature of individual and group interests in the course of research, to develop clinical advice and experience that can resolve such conflicts among such interests, and to identify methods by which such guidance could be communicated to researchers, institutional review boards, research administrators, research subjects, and others.

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Daro, D., and K. McCurdy 1991 Current Trends in Child Abuse Reporting and Fatalities: The Results of the 1990 Annual Fifty State Survey . Chicago: National Committee for Prevention of Child Abuse.

General Accounting Office 1991 Child Abuse Prevention: Status of the Challenge Grant Program . May. GAO:HRD91-95. Washington, DC.

McClain, P.W., J.J. Sacks, R.G. Froehlke, and B.G. Ewigman 1993 Estimates of fatal child abuse and neglect, United States, 1979 through 1988. Pediatrics 91(2):338-343.

Olds, D.L., C.R. Henderson, R. Chamberlin, and R. Tatelbaum 1986a Preventing child abuse and neglect: A randomized trial of nurse home visitation. Pediatrics 78:65-78.

Olds, D.L., C.R. Henderson, R. Tatelbaum, and R. Chamberlin 1986b Improving the delivery of prenatal care and outcomes of pregnancy: A randomized trial of nurse home visitation. Pediatrics 77:16-28.

The tragedy of child abuse and neglect is in the forefront of public attention. Yet, without a conceptual framework, research in this area has been highly fragmented. Understanding the broad dimensions of this crisis has suffered as a result.

This new volume provides a comprehensive, integrated, child-oriented research agenda for the nation. The committee presents an overview of three major areas:

• Definitions and scope —exploring standardized classifications, analysis of incidence and prevalence trends, and more.
• Etiology, consequences, treatment, and prevention —analyzing relationships between cause and effect, reviewing prevention research with a unique systems approach, looking at short- and long-term consequences of abuse, and evaluating interventions.
• Infrastructure and ethics —including a review of current research efforts, ways to strengthen human resources and research tools, and guidance on sensitive ethical and legal issues.

This volume will be useful to organizations involved in research, social service agencies, child advocacy groups, and researchers.

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Abuse Essays (Examples)

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Abuse effects of abuse in children abuse.

buse: Effects of abuse in children buse: Effects and Impacts on Children The purpose of this paper is to research the subject of childhood abuse in view of what is suffered both immediately and on the long-term basis in relation to the child's psychological, biological and social development. Child abuse is all too common in today's world and is a subject that is almost daily splashed across the news. Physical abuse is by Merck Manual as being "battery'. Battery has the same meaning as physical violence to the body. Further the manual reveals that it is an element in every race and throughout every layer of societal structure leaving no one race, sex, group, or religion unscathed by its' effects. Two million children are abused in the United States each year; the numbers are likely much higher with 2000 to 5000 children dying each year as a result of abuse or neglect. Indeed, child abuse….

American Psychiatric Assocation, 1994. Diagnostic and Statistical Manual of Mental Disorders, Fourth Ed. Washington D.C.

Facts of Life: Issue Briefings for Health Reporters

Abuse There Are Many Factors That Must

Abuse There are many factors that must be considered when evaluating a possible abuse situation. The first thing that must be done is that all parties involved must be committed to taking the situation seriously, but also committed to acting without prejudice. Instances of abuse should neither be ignored nor falsely identified. "ecause childhood molestation has been hidden for decades, our quick suspicions are well founded. ut there can be backlash: innocent acts by parents are often falsely misconstrued as sexual abuse." (Heller) When approached by the teachers, I would ensure her that coming to speak to me was a good action to take. In this situation, the family in question is not culturally American. It must be considered, first, that there are many cultural differences between a Chinese family and an American family. Communication and social interaction is definitely affected by this cultural difference. For example, this child is very quiet….

Bibliography

Gambil, L. (1989) Can more touching lead to less violence in our society? The truth seeker, Mar./Apr. Retrieved May 5, 2005, from  http://www.ttfuture.org/services/bonding/articles/gambil.htm .

Heller, S. (1999) Touch taboos (Healthy touching between parents and children). Mothering, Sept. Retrieved May 5, 2005, from  http://www.findarticles.com/cf_0/m0838/1999_Sept/60947819/p1/article.jhtml .

Calvert, R. (2003) Editor's message: introducing Skinship Journal. Skinship Journal, i, 1. Retrieved May 5, 2005, from http://www.skinshipjournal.com/editormessage.html.

Abuse of Older Adults Abuse

Even with under reporting, approximately 5% of elder women are likely abused to the point where they seek medical attention at least annually. These women are often well-known in their communities, so when they come into the emergency room with some story of malady, they know everyone will want to about what happened. In some cases, the trend is becoming more supportive, though. As educational programs transend economic barriers; more rural women are believed to have access to community services that are less than judgemental. They may have to travel to the next community, but there are still services that will, at the very least, intercede and find them a safer environment. This research concludes, based on qualitative and literature analysis, that it is even more difficult for rural women to get into the system. The women who go to their local clinics or egional Medical Centers are seriously….

(1986). Introduction. In K. Pillemar, & R. Wolf (Eds.), Elder Abuse: Conflict in the Family (pp. 1-3). Boston, MA: Auburn House.

What is Elder Abuse? (2006, March). Retrieved from Action on Elder Abuse:  http://www.elderabuse.org.uk/About%20Abuse/What_is_abuse%20define.htm 

Bergeron, L., & Gray, B. (2003). Ethical Dilemmas of Reporting Suspected Elder Abuse. Social Work, 48(1), 96+.

Cooper, C., Selwood, a., & Livingston, G. (207). The prevelence of elder abuse and neglect: a systemematic review. Age and Ageing, 37(2), 151-60.

Abuse at Home and Domestic

This can also be done to enable one attain a restraining order against their spouse while in the course of getting a divorce. In conclusion, victims of domestic violence should be treated fairly and not discriminated against because of their gender. The system needs to make adjustment so as to be able to accommodate cases of domestic violence and abuse against men. The reason why these cases are rising is due to the cases of male victims not being taken seriously and is a form of discrimination. I believe that for domestic violence cases to be reduced there needs to be cooperation between various social institutions that will ease the processing of cases of domestic violence. The police need to be able to contact between the police and shelters for victims of domestic violence in order to make sure victims receive adequate help. eferences Dewar esearch. (2008). Plight of male victims of….

Dewar Research. (2008). Plight of male victims of domestic abuse. Retrieved April 16,

2010, from  http://www.dewar4research.org/DOCS/PlightOfMaleVictimsSummaryMay08.pdf 

Domestic Violence definition. (2002). Retrieved April 16, 2010, from  http://www.crimereduction.homeoffice.gov.uk/violentcrime/dv03a.htm 

Hanna, C. (1998). The paradox of hope: the crime and punishment of domestic violence.

Abuse and Neglect in Nursing

GAO report showed that one in every five nursing homes across the country was found deficient in terms of its care practices. It was also discovered that some of the abuse incidents had been serious enough to put the resident's life in jeopardy. In many cases, abuse was not even reported though it should have been "classified as actual harm or worse. These included such problems as serious avoidable pressure sores, severe weight loss, and multiple falls resulting in broken bones and other injuries" (p. 31). The report also explained what is meant by sufficient staff. According to CMS guidelines, "determination of sufficient staff is to be made based on the staff's ability to provide needed care to residents. The staff must be able to provide residents with sufficient care so they may reach their highest practicable physical, mental, and . . . well being." (Corzine, p. 32) Hawes (2002)….

1. Catherine Hawes, (2002) Elder Abuse In Residential Long-Term Care Facilities: What Is Known About Prevalence, Causes, And Prevention. Available Online:  http://finance.senate.gov/hearings/testimony/061802chtest.pdf 

2. Valerie L. Corzine. Advocating for Quality Nursing Home Care and Sufficient Staffing in Colorado. The Colorado Lawyer 31 (October 2005) Available Online:  http://www.9news.com/advertorial/seniorsource/docs/05OctAdvocatingQuality.pdf 

3. Abuse of Residents Is a Major Problem in U.S. Nursing Homes. Prepared for Rep. Henry A. Waxman by Minority Staff Special Investigations, U.S. House of Representatives July 30, 2001: Available Online: http://74.125.47.132/search?q=cache%3AgMqL-bd94GoJ%3Aoversight.house.gov%2Fdocuments%2F20040830113750-34049.pdf+Abuse+of+Residents+Is+a+Major+Problem+in+U.S.+Nursing+Homes.+Prepared+for+Rep&hl=en&gl=us

Abuse and Harassment in Sports

Abuses of Power elative to Elite Athletes It is often the case that elite athletes are subjected to rigors and standards that are far beyond what is expected of the majority of the general public. There are many issues that are common among elite athletes that are known to affect either their bodies or their minds. For instance, some athletes are subjected to such high levels of discipline from either coaches or parents that the experience can be considered emotional harassment or even abuse. Coaches and parents can also use and abuse an elite athletes' bodies in many different ways. There is often a fine line between an eating disorder and attempts to maintain a body in a state of being able to achieve peak performance. Females athletes often attempt to suppress weight gain while it is more common for males to attempt to gain weight by increasing muscle weight and….

Bonci, C., Bonci, L., Granger, L., Johnson, C., Malina, R., Milne, L., . . . Vanerbunt, E. (2008). National Athletic Trainers' Association Position Statement: Preventing, Detecting, and Managing Disordered Eating in Athletes. Journal of Athletic Training, 80-108.

Fasting, K., Brackenridge, C., & Knorre, N. (2010). Performance Level and Sexual Harassment Prevalence Among Female Athletes in the Czech Republic. Women in Sport & Physical Activity Journal, 26-32.

Fasting, K., Brackenridge, C., & Sundgot, B. (2003). Experiences of sexual harassment and abuse among Norwegian elite female athletes and nonathletes. Research Quarterly for Excercise and Sport, 84-97.

Gervis, M., & Dunn, N. (2004). The emotional abuse of elite child athletes by their coaches. Child Abuse Review, 215-223.

Abuse and Fraud Medicare Agreement

The safe harbors do not cover every area of permissible behavior, and an arrangement may not qualify as a safe harbor, but still not subject someone to the risk of prosecution. In fact, the courts have interpreted the Federal Anti-Kickback Law relatively narrowly. The court in Feldstein v. Nash Community Health Servs., 51 F. Supp.2d 673 (E.D.N.C. 1999), implied that the government has to show that a defendant knowingly intended to violate the anti-kickback law. However, the court did not go so far as to permit ignorance of the law to form a defense to the charge; on the contrary, the court expected the health-care providers to know the content of fraud alerts issued by the regulatory agency. The Feldstein court was building on earlier similar decisions in Hanlester Network v. Shalala, 51 F.3d 1390 (9th Cir. 1995) and United States v. Bay State Ambulance & Hosp. ental Serv. Inc.,….

42 C.F.R. 1001.952.

42 U.S.C.S. 1320a-7.

Ambulance & Hosp. Rental Serv. Inc., 874 F.2d 20 (1st Cir. 1989).

Feldstein v. Nash Community Health Servs., Inc., 51 F. Supp. 2d 673 (E.D.N.C. 1999)

Abuse and Fraud a Joint

Furthermore, we cannot forge a safe harbor under 42 C.F.R. §1001.952(p), because Sundown Community Hospital is not a physician's group (Altshuler, Creekpaum, & Fang, 2008). Finally, the proposed arrangement does not fall within the safe harbor provided for investments in group practice because the hospital would not meet the criteria of: equity interests held by licensed professionals; equity interests being in the entire practice; unified business with unified decision making and pooling of financial interests; and revenues from ancillary services coming only from in-office ancillary services (Altshuler, Creekpaum, & Fang, 2008). Consequently, the proposed arrangement would fall outside of the safe harbor provisions of the Medicaid Anti-Kickback Statutes; however, the proposed arrangement may fall within the exceptions to the Stark Statute. Reviewing the Stark Statute, no physician may refer Medicare or Medicaid patients to an entity (here, the hospital) to which he/she has a financial relationship unless the transaction falls….

Abuse of the Elderly by Family Members

Physical Abuse of Older People by Their Families hen grandpa and grandma are getting on in years and they are living with their children, the data from reliable sources shows that in far too many cases, physical abuse is visited upon the elderly family members by their own children or grandchildren. This is a travesty but moreover it is a felony to physically abuse older people, and family members guilty of those attacks need to be advised that no matter how angry or un-happy they may be by an elderly family member's behaviors, violence is unacceptable. The fact that Americans are growing older and that many of them are being physically abused -- in numerous cases by their own families -- is a great cause for concern. This paper references scholarly sources that point out the frequency of physical abuses that the elderly are subjected to, and the reasons why they are….

Works Cited

Brogden, Michael, and Nijhar, Preeti. (2000). Crime, Abuse, and The elderly. Philadelphia, PA: Taylor & Francis U.S..

Hickey, Eric W. (2003). Encyclopedia of Murder and Violent Crime

Thousand Oaks, CA: Sage Publications.

National Association of Adult Protective Services Administrators

Abuse and Pregnant Women

Violence against pregnant women is a commonplace phenomenon and this research paper will explain the background of violence against pregnant women. Women undergo different forms of violence for instance, beating, threats, raping and unwilling prostitution. Some years back, it wasn't a big issue as approach towards women was a tad bit different back then. Men were treated as the dominant sex due to their physical strength. So is the case with education and men. It is common for men to get educated while women remain undereducated. With the passage of time, this created a genuine gap for women in the society as they were being undermined. Now violence against women, in general, is red flagged especially in Asia where women are treated very poorly. Now the circumstances for women are improving slowly and gradually in Asia but not completely (Jasinsk, 2004). Violence against pregnant women isn't just limited to developing countries;….

Altman, D.G. (2000). Statistics in medical journals: some recent trends. Statistics in Medicine, 19, 3275 -- 3289. (1)

Asling-Monemi, K.R.T. Naved, L.A. Persson. (2009). Violence against women and the risk of fetal and early childhood growth impairment: a cohort study in rural Bangladesh. Archives of Disease in Childhood, 94, pp. 775 -- 779

Audi, .A.C., Correa, S.A.M. Santiago, S.M. Perez-Escamilla, R. (2008). Violence against pregnant women: prevalence and associated factors. Revista de Saude Publica, 42, pp. 877 -- 885

Center for Cognitive Ageing and Cognitive Epidemiology. (2013). Systematic reviews and meta-analyses: a step-by-step guide. Retrieved from:  http://www.ccace.ed.ac.uk/research/software-resources/systematic-reviews-and-meta-analyses

Abuse Domestic Violence Case Study

Angela's case study illuminates several aspects of domestic violence. The case shows how domestic violence progresses from what was originally a normal relationship, through stages of escalating violence. Each section shows how persons outside the family might have the opportunity to intervene or offer support. What was most interesting about this case was the different legal obligations of health care workers, educators, and colleagues. Not all people are obliged to report suspected domestic violence. It is important to understand one's role and whether or not reporting is appropriate. eporting is appropriate and warranted when there are obvious gunshot wounds or gunpowder burns, and also when an early childhood educator suspects domestic violence being perpetrated on a child (Minnesota Statutes, 2015). Each segment of the case study shows how complex the issue is, and how each person has a different role to play and different levels of responsibility. The main things to….

MINCAVA (2015). Global violence prevention. Retrieved online:  http://www.globalvp.umn.edu/cgi-bin/index.pl 

Minnesota Statutes (2015). Retrieved online:  https://www.revisor.mn.gov/statutes/?id=626.52

Abuse of the Under-Privileged by

In fact, one study suggested tat if a fruit or vegetable could not be arvested mecanically, it would not be grown in te United States after 1975 (Braceros: History, Compensation). Workers in te Bracero Program faced a great amount of worker exploitation in te form of low pay and lost wages, bot from te United States government as well as teir own ome government in Mexico. Currently, te governments of bot participating countries are working to compensate te families of te bracero workers for te lost wages garnised during tat time. However, despite te U.S. government's efforts to rigt its wrongs in past situations, te fact remains tat exploitation of immigrant and undocumented workers in te United States is still a problem tat is faced today. Today, undocumented and immigrant workers face a new set of callenges. For example, in a survey, 25% of workers wose employers found out tat….

http://www.nilc.org/immsemplymnt/SSA_no-match_survey_final_report_11-20-03.pdf 

Millner, Caille. "The long-lost promises to the braceros." SFGate, 2008. Web. 10 Dec. 2010.

 http://articles.sfgate.com/2008-12-01/opinion/17130878_1_braceros-first-years-legal-settlement

Satanic Abuse Representations in the Media and

Satanic Abuse epresentations in the Media and Social Science Literature Throughout history, few things have been able to literally scare the bejabbers out of people as much as reports of satanic abuse in general and in their own communities in particular. Indeed, based on various reports from Europe and North American over the past four centuries, it would seem that when Satan fell from Heaven, he fell directly into many peoples' lives. Even today, isolated but sensationalized reports of satanic abuse can still create the widespread perception that these practices are commonplace and are increasing in prevalence. The hysterical reaction that can sweep through entire communities is proof positive of the continuing relevance of this phenomenon today. Irrespective of the actual reality of the satanic entity, the implications of these reactions for some people are profound and severe and may even cause some people to experience potentially life-threatening mental health….

Almond, P. (2008). The Witches of Warboys: An Extraordinary Story of Sorcery, Sadism and Satanic Possession. New York I.B. Tauris & Co. Ltd.

Brion, D.J. (1993, September). 'The hidden persistence of witchcraft.' Law and Critique, vol. 4,

no. 2, pp. 227-252.

Cockburn, A. (1993, March 19). 'Legal Abuse in Dade County.' New Statesman & Society, vol. 6,

Special Population & Substance Abuse Special Population

SPECIAL POPULATION & SUBSTANCE ABUSE Special Population and Substance Abuse Prison inmates and substance abuse Drug courses or rehabilitation programs for drug offenders The reoffender issue Drawbacks of not providing rehab treatments and facilities Cost vs. benefit analysis if rehabilitation programs and imprisonment Drug abuse or substance abuse is a major issue in the U.S. It is the addictive and patterned use of drugs in quantities that are not approved by the health and medication regulating bodies, neither administered under the supervision of any clinician. Substance abuse covers wide categories of drugs used without the prescription of health administrators with excessive and often dangerous consumption levels. Substance abuse includes the use of performance enhancing and psychoactive drugs. The leading organizations that issue the standards and symptoms of drug and substance abuse are World Health Organization's International Statistical Classification of Diseases, American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM), and ICIS Medical organization elated Health….

CASAColumbia (2010). Behind Bars II: Substance Abuse and America's Prison Population. The National Center on Addiction and Substance Abuse at Colombia University. Retrieved from:  http://www.casacolumbia.org/templates/PressReleases.aspx?articleid=592&zoneid=79 

CDCR. (2013). Streamlined Substance Abuse Treatment Models. Office of Substance Abuse Treatment Services, California Department of Corrections and Rehabilitation. Retrieved from:  http://www.cdcr.ca.gov/DARS/ 

Clear, T.R. (2007). Imprisoning Communities: How Mass Incarceration Makes Disadvantaged Neighborhoods Worse: How Mass Incarceration Makes Disadvantaged Neighborhoods Worse. Oxford University Press, USA.

Fazel, S., Bains, P., & Doll, H. (2006). Substance abuse and dependence in prisoners: a systematic review. Addiction, 101(2), 181-191.

Crystal Meth Addiction and Abuse Problems in Los Angeles County

Meth Addiction and Abuse Problems Meth Crystal Addiction and Abuse Problems in Los Angeles County Meth addiction and abuse problems are on a rise in Los Angeles County and many other places in other countries. Its use and abuse has become so common that some people have started referring to it as the new heroin. Just like any other drug, the use of this drug above its therapeutic dose has produced toxicities that have been proven to be hazardous to human health. When people find themselves in addiction and abuse problems of Meth crystals, they then turn to the health care institutions and other rehab centers, which increase the responsibility of nurses as well as counselors. In this paper we shall look at some of the complications of addiction and abuse problems in Los Angeles County. We shall also see its impacts on the human health and health care systems. Furthermore, we shall….

"Amphetamines: Drug Use and Dependence | Merck Manual Professional." Merck.com. Retrieved 2011-01-09.

"Are there any effective treatments for methamphetamine abusers?" (2009)The Methamphetamine Problem: Question-and-Answer Guide. Tallahassee: Institute for Intergovernmental Research.

"Desoxyn (Methamphetamine Hydrochloride) Drug Information: User Reviews, Side Effects, Drug Interactions and Dosage at." Rxlist.com. Retrieved 2011-01-09.

"Erowid Methamphetamine Vault: Effects." Erowid.org. Retrieved 2011-01-0

buse: Effects of abuse in children buse: Effects and Impacts on Children The purpose of this paper is to research the subject of childhood abuse in view of what is suffered both…

Abuse There are many factors that must be considered when evaluating a possible abuse situation. The first thing that must be done is that all parties involved must be committed…

Literature Review

Family and Marriage

Even with under reporting, approximately 5% of elder women are likely abused to the point where they seek medical attention at least annually. These women are often well-known…

Research Paper

Sports - Drugs

This can also be done to enable one attain a restraining order against their spouse while in the course of getting a divorce. In conclusion, victims of domestic violence…

Death and Dying  (general)

GAO report showed that one in every five nursing homes across the country was found deficient in terms of its care practices. It was also discovered that some…

Abuses of Power elative to Elite Athletes It is often the case that elite athletes are subjected to rigors and standards that are far beyond what is expected of the…

The safe harbors do not cover every area of permissible behavior, and an arrangement may not qualify as a safe harbor, but still not subject someone to the…

A-Level Coursework

Furthermore, we cannot forge a safe harbor under 42 C.F.R. §1001.952(p), because Sundown Community Hospital is not a physician's group (Altshuler, Creekpaum, & Fang, 2008). Finally, the proposed…

Physical Abuse of Older People by Their Families hen grandpa and grandma are getting on in years and they are living with their children, the data from reliable sources shows…

Capstone Project

Sports - Women

Violence against pregnant women is a commonplace phenomenon and this research paper will explain the background of violence against pregnant women. Women undergo different forms of violence for instance,…

Sociology - Counseling

Angela's case study illuminates several aspects of domestic violence. The case shows how domestic violence progresses from what was originally a normal relationship, through stages of escalating violence. Each…

American History

In fact, one study suggested tat if a fruit or vegetable could not be arvested mecanically, it would not be grown in te United States after 1975 (Braceros:…

Mythology - Religion

Satanic Abuse epresentations in the Media and Social Science Literature Throughout history, few things have been able to literally scare the bejabbers out of people as much as reports…

SPECIAL POPULATION & SUBSTANCE ABUSE Special Population and Substance Abuse Prison inmates and substance abuse Drug courses or rehabilitation programs for drug offenders The reoffender issue Drawbacks of not providing rehab treatments and facilities Cost…

Meth Addiction and Abuse Problems Meth Crystal Addiction and Abuse Problems in Los Angeles County Meth addiction and abuse problems are on a rise in Los Angeles County and many other…

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• Knowledge Base
• How to conclude an essay | Interactive example

How to Conclude an Essay | Interactive Example

Published on January 24, 2019 by Shona McCombes . Revised on July 23, 2023.

The conclusion is the final paragraph of your essay . A strong conclusion aims to:

• Tie together the essay’s main points
• Show why your argument matters
• Leave the reader with a strong impression

Your conclusion should give a sense of closure and completion to your argument, but also show what new questions or possibilities it has opened up.

This conclusion is taken from our annotated essay example , which discusses the history of the Braille system. Hover over each part to see why it’s effective.

Braille paved the way for dramatic cultural changes in the way blind people were treated and the opportunities available to them. Louis Braille’s innovation was to reimagine existing reading systems from a blind perspective, and the success of this invention required sighted teachers to adapt to their students’ reality instead of the other way around. In this sense, Braille helped drive broader social changes in the status of blindness. New accessibility tools provide practical advantages to those who need them, but they can also change the perspectives and attitudes of those who do not.

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Table of contents

Step 1: return to your thesis, step 2: review your main points, step 3: show why it matters, what shouldn’t go in the conclusion, more examples of essay conclusions, other interesting articles, frequently asked questions about writing an essay conclusion.

To begin your conclusion, signal that the essay is coming to an end by returning to your overall argument.

Don’t just repeat your thesis statement —instead, try to rephrase your argument in a way that shows how it has been developed since the introduction.

Prevent plagiarism. Run a free check.

Next, remind the reader of the main points that you used to support your argument.

Avoid simply summarizing each paragraph or repeating each point in order; try to bring your points together in a way that makes the connections between them clear. The conclusion is your final chance to show how all the paragraphs of your essay add up to a coherent whole.

To wrap up your conclusion, zoom out to a broader view of the topic and consider the implications of your argument. For example:

• Does it contribute a new understanding of your topic?
• Does it raise new questions for future study?
• Does it lead to practical suggestions or predictions?
• Can it be applied to different contexts?
• Can it be connected to a broader debate or theme?

Whatever your essay is about, the conclusion should aim to emphasize the significance of your argument, whether that’s within your academic subject or in the wider world.

Try to end with a strong, decisive sentence, leaving the reader with a lingering sense of interest in your topic.

The easiest way to improve your conclusion is to eliminate these common mistakes.

Don’t include new evidence

Any evidence or analysis that is essential to supporting your thesis statement should appear in the main body of the essay.

The conclusion might include minor pieces of new information—for example, a sentence or two discussing broader implications, or a quotation that nicely summarizes your central point. But it shouldn’t introduce any major new sources or ideas that need further explanation to understand.

Don’t use “concluding phrases”

Avoid using obvious stock phrases to tell the reader what you’re doing:

• “In conclusion…”
• “To sum up…”

These phrases aren’t forbidden, but they can make your writing sound weak. By returning to your main argument, it will quickly become clear that you are concluding the essay—you shouldn’t have to spell it out.

Don’t undermine your argument

Avoid using apologetic phrases that sound uncertain or confused:

• “This is just one approach among many.”
• “There are good arguments on both sides of this issue.”
• “There is no clear answer to this problem.”

Even if your essay has explored different points of view, your own position should be clear. There may be many possible approaches to the topic, but you want to leave the reader convinced that yours is the best one!

• Argumentative
• Literary analysis

This conclusion is taken from an argumentative essay about the internet’s impact on education. It acknowledges the opposing arguments while taking a clear, decisive position.

The internet has had a major positive impact on the world of education; occasional pitfalls aside, its value is evident in numerous applications. The future of teaching lies in the possibilities the internet opens up for communication, research, and interactivity. As the popularity of distance learning shows, students value the flexibility and accessibility offered by digital education, and educators should fully embrace these advantages. The internet’s dangers, real and imaginary, have been documented exhaustively by skeptics, but the internet is here to stay; it is time to focus seriously on its potential for good.

This conclusion is taken from a short expository essay that explains the invention of the printing press and its effects on European society. It focuses on giving a clear, concise overview of what was covered in the essay.

The invention of the printing press was important not only in terms of its immediate cultural and economic effects, but also in terms of its major impact on politics and religion across Europe. In the century following the invention of the printing press, the relatively stationary intellectual atmosphere of the Middle Ages gave way to the social upheavals of the Reformation and the Renaissance. A single technological innovation had contributed to the total reshaping of the continent.

This conclusion is taken from a literary analysis essay about Mary Shelley’s Frankenstein . It summarizes what the essay’s analysis achieved and emphasizes its originality.

By tracing the depiction of Frankenstein through the novel’s three volumes, I have demonstrated how the narrative structure shifts our perception of the character. While the Frankenstein of the first volume is depicted as having innocent intentions, the second and third volumes—first in the creature’s accusatory voice, and then in his own voice—increasingly undermine him, causing him to appear alternately ridiculous and vindictive. Far from the one-dimensional villain he is often taken to be, the character of Frankenstein is compelling because of the dynamic narrative frame in which he is placed. In this frame, Frankenstein’s narrative self-presentation responds to the images of him we see from others’ perspectives. This conclusion sheds new light on the novel, foregrounding Shelley’s unique layering of narrative perspectives and its importance for the depiction of character.

If you want to know more about AI tools , college essays , or fallacies make sure to check out some of our other articles with explanations and examples or go directly to our tools!

• Ad hominem fallacy
• Post hoc fallacy
• Appeal to authority fallacy
• False cause fallacy
• Sunk cost fallacy

College essays

• Choosing Essay Topic
• Write a College Essay
• Write a Diversity Essay
• College Essay Format & Structure
• Comparing and Contrasting in an Essay

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Your essay’s conclusion should contain:

• A rephrased version of your overall thesis
• A brief review of the key points you made in the main body
• An indication of why your argument matters

The conclusion may also reflect on the broader implications of your argument, showing how your ideas could applied to other contexts or debates.

For a stronger conclusion paragraph, avoid including:

• Important evidence or analysis that wasn’t mentioned in the main body
• Generic concluding phrases (e.g. “In conclusion…”)
• Weak statements that undermine your argument (e.g. “There are good points on both sides of this issue.”)

Your conclusion should leave the reader with a strong, decisive impression of your work.

The conclusion paragraph of an essay is usually shorter than the introduction . As a rule, it shouldn’t take up more than 10–15% of the text.

Cite this Scribbr article

If you want to cite this source, you can copy and paste the citation or click the “Cite this Scribbr article” button to automatically add the citation to our free Citation Generator.

McCombes, S. (2023, July 23). How to Conclude an Essay | Interactive Example. Scribbr. Retrieved March 22, 2024, from https://www.scribbr.com/academic-essay/conclusion/

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• Child Abuse

Essays on Child Abuse

Child abuse essay covers a topic that is brutal but needs to be written about. Criminal behavior poses a threat to society, and it's especially devastating when directed towards children. This painful subject is getting a lot of public attention in the past years, and writing child abuse essays are a way of shining light on this issue. While researching for your essay you will discover heartbreaking statistics – about 1 billion children were abused within the past year. The numbers and facts you will come across are unsettling. child abuse essay samples below will help you gather information for your essays and offer some guidelines when exploring this topic. Writing essays on child abuse is challenging in many ways, so it’s understandable if you need assistance, which we can provide you with.

This project aims to assess whether the primary schools in the UK implemented Eileen Munro’s Recommendations. It critically analyses the effectiveness of child protection in UK’s primary schools. The report advocates for review on child protection targets which enable both children and social workers a freedom to apply judgment as...

The discussion section elaborates the argument on whether any of Eileen Munro’s recommendations were implemented. To begin with, let us briefly review some of the endorsements. The Munro report changes the current child protection approach that is extremely rigid and incomprehensible because of the bureaucratic procedures that leave professionals glued...

Words: 1932

Putting up child protection ensures the safeguard of children from varying harmful activities that they are exposed to from their parents or the environment they live in. It is important to address issues that affect the children as a can severely impact the young ones both psychologically and also physically....

Words: 1200

Child Protection is a fundamental issue that has been addressed at various levels of governance. The United Kingdom is one of the many countries that are still grappling with how best to protect a child from any dangerous exposure. Prof Eileen Munro was tasked to come up with a report...

Words: 1648

Sexual assault is defined as an infringement of a person's sexual space by sexual touch without consent by coercion or physical force to engage in a sexual act against the person's will. It ranges from verbal sexual insults to the physical acts such as groping, rape, and sodomy and child...

Words: 1622

An Assessment of the Brothers` ACE Score and ACE that Might Indicate Future-Offending Behaviour ACE, also known as Adverse Childhood Experiences denotes to the stressful situations that young children encounter as they grow. The child can be either directly hurt through abuse or indirectly regarding the environment, which they are situated...

Words: 3789

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In today’s world, cases of child abuse are on the raising trend globally. It’s a matter of great concern when people close to the children; physically, emotionally or sexually abuse them. In most occasions, guardians who are mentally stable and highly conscious of their actions continually and methodically abuse their...

Words: 1410

Child abuse has become a severe social and public health problem and many studies have revealed the alarming number of child abuse cases all over the world. The diverging parenting norms and standards of different cultures has made it difficult to arrive at an agreement on the definition of child...

Words: 1081

The article Preventing Child Sexual Abuse, What Parents Know? analyzes the out parental information with regards to the prevention of child abuse in Saudi Arabia. The study begins with a definition of a sexual offense which is regarded as the engagement of a child in sexual activities without...

Words: 1113

Child Abuse and Neglect Child abuse is any action performed by a parent, guardian, or caregiver that cause serious physical, sexual or emotional harm to a child. On the other hand, child neglect refers to maltreatment of a child due to failure by parent, guardian or caregiver to provide needed care....

Words: 1643

It is universally agreed among scientist, sociologist, physiologist, criminologist and other interested scholars that youths in the adolescence stage are more likely to engage in antisocial behaviors.  However, numerous studies are concerned with activities that teens are more apt to participate in the adolescent stage such as substance abuse and...

Words: 1363

Over the years elderly mistreatment has been recognized as a social problem that has affected the society at large. The magnitude of the problem is uncertain but it is increasing in the United States and other countries in the world. Elderly abuse can be referred to as an intentional act...

Words: 1001

Related topic to Child Abuse

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Essay On Abuse Of Abuse

Introduction: Understanding abuse is quite hard, most of the people that are abused have no clue about what is being done to them hence, to study abuse it is very important that we understand what abuse is and the ways in which someone can abuse another individual. People who are being abused first of all do not know if they are a victim of abuse , also the ones who are being abusive do not understand what they are doing is wrong and effects the victim’s life in several ways. People think that violence or domestic violence is only when someone physically hits someone else, but there are other ways of abuse as well. Abuse can be physical, psychological, emotional or even sexual. There are different ways to define abuse, it also has different contexts and different types. Abuse can be defined as …show more content…

People usually misuse their power over a certain person to abuse them when the victim is vulnerable and dependent upon the abuser. Abuse of authority is mostly considered to be political, when the government is corrupt, and they use the funds for their personal gain instead of helping the people of a specific country. Abuse of corpse is also a context of abuse, this is mostly relevant when an abuser has necrophilia or if they intend on physically harming or a dead body. Abuse of discretion is when proper facts and findings in a judiciary matter are not considered which misleads the outcome of an entire case. Abuse of confidence is mostly related to plagiarism or spreading information to people who are not authorised to know it, in other words exposing someone. Ad hominem abuse is abuse that mostly involves insulting, it can also be known as personal abuse, in this the abuser may point out irrelevant character flaws and use them to make the victim’s argument less important. Bullying is the most commonly form of abuse that we witness these days, bullying is common among high school or college students and

Examples Of Abuse Of Power In The Crucible

When power goes unchecked and unchallenged, it becomes a breeding ground for exploitation and oppression. In a Business.com article, Petrina Coventry states that “Victims of abuse are often stressed and confused about their situation. This confusion can block the person’s confidence to report the issue, or they ignore it, thinking it will go away in time” (Coventry). Victims of abuse are often intimidated and overwhelmed, making it difficult for them to speak out against their abusers. If the abuse of power is not recognized and addressed, it can continue to perpetuate and cause harm to vulnerable individuals.

Lavallee Abuse Essay

It all started off in an abusive common law relationship between Angelique Lyn Lavallee and Kevin Rust. The couple had been together for a few years and the abuse Ms. Lavallee endured was physical, sexual, emotional and verbal. (Morris & Pilon, 1992) As a result of this abuse, Lavallee had made consecutive visits to the hospital. (Morris & Pilon, 1992) One summer night on August 31, 1986 the couple had hosted a party.

Unit 7 P4 Health And Social Care Study

Financial abuse, such as being robbed,also sexual abuse for example being sexual abused or raped. There is a common mistaken in what people believe that only abuse happens within a care setting, however this isn 't true. service users can be vulnerable in their community, if they look different or behave differently to the acceptance norms in society, they are easily targeted by groups. Because they believe they will not resist or they believe the vulnerable person is not considered reliable witness if a crime is committed against them due to their vulnerability. Abuse mostly happens in residential care homes, because they provide the potential for abuse to happen to an

Strengths And Weaknesses In Current National And Local Legislations

LO2 UNDERSTAND CURRENT LEGISLATIONS, POLICES AND PROFESSIONAL INVOLEMENT REGARDING ABUSE IN HEALTH AND SOCIAL CARE CONTEXTS. 2.1 Analyse the strength and weakness in current national and local legislations and policies relating to those vulnerable to abuse. There are government organisations who are in charge of many legislations and polices. These are created to prevent abuses and also create a healthy society and environments. They also safeguard vulnerable children from abuses.

A Long Way Gone Annotated Bibliography

The research focuses on the leading and most frequent types of child abuse. This research is of great value as it makes it easy for the reader to understand the different types of child abuse. It is not easy to understand child abuse and its different kinds without consulting researches like this one. This researches, under different subheadings, discusses several kinds of child abuse and explains them in detail.

Unit 11 Safeguarding

There are several types of abuse, I will discuss, physical, emotional, neglect, sexual. I will also analyse the factors that are implemented to assist the health and social care setting. I will define seven forms of abuse Physical abuse can be

Theme Of Abuse In Laurie Halse Anderson's Speak

(Hook) Abuse is a overly toxic action that causes many pushbacks in ones life. (Bridge) In Laurie Halse Andersons’s novel Speak, Melinda, the protagonist, experiences abuse and readers see just how much it is displayed in her everyday life. (FS) From as early as the beginning of the novel, readers see Melinda is an outcast.

The Wounded Heart Book Report

For instance, for this student, before reading this book, I would categorize this different types of abuse differently, from more severe to less severe, and perhaps giving less importance to those I viewed as less severe. But it is important to understand that for each of these victims, each abuse was very serious, very severe, and they should be treated equally. This book is also a great source of understanding for those who were perpetrators of abuse, especially against children, it will help them to understand the consequences of their actions, and how perhaps once act, have completely changed the life of a child. This book is also important to parents and those who work with children, when we, as adults understands the risks that children, adolescents and any person who is not able to protect themselves are facing, we hopefully can be more vigilant of children, women and any possible

Minimise Abuse In Health And Social Care Essay

3.1. Explain existing working practice and strategies designed to minimise abuse in health and social care contexts Adult Protection Tactics Many working practices are applied minimising abuse in Health and Social Care Sectors- Adams (2007) states that "in England, multiagency codes of practice aiming to tackle and prevent abuse of vulnerable adults developed in the light of the publication of the official guidance No Secrets (DOH and Home Office, 2000)". Protection of Vulnerable Adults (POVA) Adams (2007) states that "The protection of vulnerable adults (POVA) scheme was introduced in England and Wales in a phased programme from 2004, as required in the Care Standard Act 2000".

Augusten Burroughs 'How To Identify Love Knowing What It's Not'

Know What Relationship Your In In “How to identify Love Knowing What it’s Not” Augusten Burroughs provides a definition of abuse that is more nuanced than physical harm. The formal definition of abuse is the improper usage or treatment of an entity, often to unfairly or improperly gain benefit. There are many different types of abuse and the essay touches base on four different types. Abuse is a spectrum that ranges from controlling, to emotional abuse, to physical abuse.

Developmental Issues In Foster Care

Abuse is another thing that has been linked, to problems in a child 's development. The earlier abuse and neglect occur in a child 's life the more severe the impact. Furthermore, the stage of development, while the abuse occurs will influence the type and severity of the consequences. Additionally, the more chronic and long lasting the abuse and neglect, the more harmful it is. When the abuse and neglect are caused, by parents or another significant figure a child, becomes confused because their supposed source of safety is the source of their harm.(Frederico 343).

Examples Of Direct Abuse

Mrs. P’s son was using his mother’s money and her belongings as if they were his own without the permission of his mother. Her bills were not paid and some of her assets were old or thrown away, this is a gross abuse of financial and material abuse by her son. MENTAL HEALTH ABUSE. Many service users are likely to be abused by those who are supposed to protect them from harm and abuses.

Abuse In Relationships Essay

Domestic abuse is used for one purpose that purpose is to gain total control

Essay On Elder Abuse

Elder abuse can be referred to as a single or repeated act or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person. Elderly people often get abuse by people who should be their protector and carer, in most circumstances many elderly adults are abused in their own homes, in relatives’ homes, and even in facilities responsible for their care. If you suspect that an elderly person is at risk from a neglectful or overwhelmed caregiver, or being preyed upon financially, it’s important to speak up. Learning about the warning signs of elder abuse, what the risk factors are, and how you can prevent and report the problem it’s very vital in protecting the elderly from abuse, some of these abuse are; • Not caring for someone property (neglect) • Pressuring

Informative Speech On Child Abuse

Central idea Child abuse can be committed in several ways and the impact it has on the victim is extremely serious and does not only affect them in childhood but also adulthood. Preview The main points I am going to be covering are; what child abuse is, the three most common types of child abuse and the impact that child abuse has on the victim. And finally I am going to be sharing information about the perpetrator’s characteristics Body 1.

More about Essay On Abuse Of Abuse

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Substance addiction is a chronic relapsing disorder. Individuals abuse substances for different reasons. There may be personal and mitigating circumstances that lead people to substance abuse (e.g. stress or unhappiness). People may also be at increased risk of initiating substance abuse due to their age. The commencement of adolescence, for example, is a unique period of neurobiological development. Compared to children and adults, adolescents exhibit a number of psychological traits, such as risky and reward-seeking behaviour. The emergence of these traits may reflect the relatively early functional development of brain limbic affective and reward systems compared to the prefrontal cortex. As such, the period of adolescence may confer a vulnerability to the onset of drug misuse and addiction due to developmental changes in neurobiology, which seem to encourage reward-centred and risky decision-making behaviour.

Additionally, there are genetic risks for substance abuse. Twin registry and adoption studies, for example, have shown that the heritability of alcoholism may be as high as 50–60%. Whatever the cause, substance abuse and dependence confers significant social, mental, and medical impairment in those individuals afflicted, together with huge economic costs to society.

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Essay on Drug Abuse

Here we have shared the Essay on Drug Abuse in detail so you can use it in your exam or assignment of 150, 250, 400, 500, or 1000 words.

You can use this Essay on Drug Abuse in any assignment or project whether you are in school (class 10th or 12th), college, or preparing for answer writing in competitive exams. 

Topics covered in this article.

Essay on Drug Abuse in 150 words

Essay on drug abuse in 250-300 words, essay on drug abuse in 500-1000 words.

Drug abuse is a global issue that poses serious risks to individuals and society. It involves the harmful and excessive use of drugs, leading to physical and mental health problems. Drug abuse can result in addiction, organ damage, cognitive impairment, and social and economic difficulties. Prevention efforts should focus on education, raising awareness about the dangers of drug abuse, and promoting healthy lifestyles. Access to quality healthcare and addiction treatment services is crucial for recovery. Strengthening law enforcement measures against drug trafficking is necessary to address the supply side of the problem. Creating supportive environments and opportunities for positive engagement can help prevent drug abuse. By taking collective action, we can combat drug abuse and build healthier communities.

Drug abuse is a growing global concern that poses significant risks to individuals, families, and communities. It refers to the excessive and harmful use of drugs, both legal and illegal, that have negative effects on physical and mental health.

Drug abuse has severe consequences for individuals and society. Physically, drug abuse can lead to addiction, damage vital organs, and increase the risk of overdose. Mentally, it can cause cognitive impairment, and psychological disorders, and deteriorate overall well-being. Additionally, drug abuse often leads to social and economic problems, such as strained relationships, loss of employment, and criminal activities.

Preventing drug abuse requires a multi-faceted approach. Education and awareness programs play a crucial role in informing individuals about the dangers of drug abuse and promoting healthy lifestyle choices. Access to quality healthcare and addiction treatment services is vital to help individuals recover from substance abuse. Strengthening law enforcement efforts to curb drug trafficking and promoting international cooperation is also essential to address the supply side of the issue.

Community support and a nurturing environment are critical in preventing drug abuse. Creating opportunities for individuals, especially young people, to engage in positive activities and providing social support systems can serve as protective factors against drug abuse.

In conclusion, drug abuse is a significant societal problem with detrimental effects on individuals and communities. It requires a comprehensive approach involving education, prevention, treatment, and enforcement. By addressing the root causes, raising awareness, and providing support to those affected, we can combat drug abuse and create a healthier and safer society for all.

Title: Drug Abuse – A Global Crisis Demanding Urgent Action

Introduction :

Drug abuse is a pressing global issue that poses significant risks to individuals, families, and communities. It refers to the excessive and harmful use of drugs, both legal and illegal, that have detrimental effects on physical and mental health. This essay explores the causes and consequences of drug abuse, the social and economic impact, prevention and treatment strategies, and the importance of raising awareness and fostering supportive communities in addressing this crisis.

Causes and Factors Contributing to Drug Abuse

Several factors contribute to drug abuse. Genetic predisposition, peer pressure, stress, trauma, and environmental influences play a role in initiating substance use. The availability and accessibility of drugs, as well as societal norms and cultural acceptance, also influence drug abuse patterns. Additionally, underlying mental health issues and co-occurring disorders can drive individuals to self-medicate with drugs.

Consequences of Drug Abuse

Drug abuse has devastating consequences on individuals and society. Physically, drug abuse can lead to addiction, tolerance, and withdrawal symptoms. Substance abuse affects vital organs, impairs cognitive function, and increases the risk of accidents and injuries. Mental health disorders, such as depression, anxiety, and psychosis, are often associated with drug abuse. Substance abuse also takes a toll on relationships, leading to strained family dynamics, social isolation, and financial instability. The social and economic costs of drug abuse include increased healthcare expenses, decreased productivity, and the burden on criminal justice systems.

Prevention and Education

Preventing drug abuse requires a comprehensive and multi-faceted approach. Education and awareness programs are essential in schools, communities, and the media to inform individuals about the risks and consequences of drug abuse. Promoting healthy coping mechanisms, stress management skills, and decision-making abilities can empower individuals to resist peer pressure and make informed choices. Early intervention programs that identify at-risk individuals and provide support and resources are crucial in preventing substance abuse.

Treatment and Recovery

Access to quality healthcare and evidence-based addiction treatment is vital in addressing drug abuse. Treatment options include detoxification, counseling, behavioral therapies, and medication-assisted treatments. Rehabilitation centers, support groups, and outpatient programs provide a continuum of care for individuals seeking recovery. Holistic approaches, such as addressing co-occurring mental health disorders and promoting healthy lifestyles, contribute to successful long-term recovery. Support from family, friends, and communities plays a significant role in sustaining recovery and preventing relapse.

Law Enforcement and Drug Policies

Effective law enforcement efforts are necessary to disrupt drug trafficking and dismantle illicit drug networks. International cooperation and collaboration are crucial in combating the global drug trade. Additionally, drug policies should focus on a balanced approach that combines law enforcement with prevention, treatment, and harm reduction strategies. Shifting the emphasis from punitive measures toward prevention and rehabilitation can lead to more effective outcomes.

Creating Supportive Communities:

Fostering supportive communities is vital in addressing drug abuse. Communities should provide resources, social support networks, and opportunities for positive engagement. This includes promoting healthy recreational activities, providing vocational training, and creating safe spaces for individuals in recovery. Reducing the stigma associated with drug abuse and encouraging empathy and understanding are crucial to building a compassionate and supportive environment.

Conclusion :

Drug abuse remains a complex and multifaceted issue with far-reaching consequences. By addressing the causes, raising awareness, implementing preventive measures, providing quality treatment and support services, and fostering supportive communities, we can combat drug abuse and alleviate its impact. It requires collaboration and a collective effort from individuals, communities, governments, and organizations to build a society that is resilient against the scourge of drug abuse. Through education, prevention, treatment, and compassion, we can pave the way toward a healthier and drug-free future.

Essay On Domestic Violence

500 words essay on domestic violence.

Domestic violence refers to the violence and abuse which happens in a domestic setting like cohabitation or marriage. It is important to remember that domestic violence is not just physical but any kind of behaviour that tries to gain power and control over the victim. It can affect people from all walks of life and it basically subjects towards a partner, spouse or intimate family member. Through an essay on domestic violence, we will go through its causes and effects.

Causes of Domestic Violence

Often women and children are the soft targets of domestic violence. Domestic violence is a gruesome crime that also causes a number of deaths. Some of the most common causes of domestic violence are illiteracy and economical dependency on the menfolk.

The male-dominated society plays an important role in this problem. Further, dowry is also one of the leading causes which have the consequence of violence against newly-wed brides. In many parts of the world, physically assaulting women and passing horrendous remarks is common.

Moreover, children also become victims of this inhuman behaviour more than often. It is important to recognize the double standards and hypocrisy of society. A lot of the times, the abuser is either psychotic or requires psychological counselling.

However, in a more general term, domestic violence is the outcome of cumulative irresponsible behaviour which a section of society demonstrates. It is also important to note that solely the abuser is not just responsible but also those who allow this to happen and act as mere mute spectators.

Types of Domestic Violence

Domestic violence has many ill-effects which depend on the kind of domestic violence happening. It ranges from being physical to emotional and sexual to economic. A physical abuser uses physical force which injures the victim or endangers their life.

It includes hitting, punching, choking, slapping, and other kinds of violence. Moreover, the abuser also denies the victim medical care. Further, there is emotional abuse in which the person threatens and intimidates the victim. It also includes undermining their self-worth.

It includes threatening them with harm or public humiliation. Similarly, constant name-calling and criticism also count as emotional abuse. After that, we have sexual abuse in which the perpetrator uses force for unwanted sexual activity.

If your partner does not consent to it, it is forced which makes it sexual abuse. Finally, we have economic abuse where the abuser controls the victim’s money and their economic resources.

They do this to exert control on them and make them dependent solely on them. If your partner has to beg you for money, then it counts as economic abuse. This damages the self-esteem of the victim.

Get the huge list of more than 500 Essay Topics and Ideas

Conclusion of the Essay on Domestic Violence

To conclude, domestic violence has many forms which include physical aggression like kicking and biting and it can also be sexual or emotional. It is essential to recognize the signs of domestic violence and report the abuser if it is happening around you or to you.

FAQ of Essay on Domestic Violence

Question 1: Why is domestic violence an issue?

Answer 1: Domestic violence has a major impact on the general health and wellbeing of individuals. It is because it causes physical injury, anxiety, depression. Moreover, it also impairs social skills and increases the likelihood that they will participate in practices harmful to their health, like self-harm or substance abuse.

Question 2: How does domestic violence affect a woman?

Answer 2: Domestic violence affects women in terms of ill health. It causes serious consequences on their mental and physical health which includes reproductive and sexual health. It also includes injuries, gynaecological problems, depression, suicide and more.

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Sexual Abuse, Essay Example

Pages: 3

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Introduction

• Vulnerability of children predisposes many to sexual abuse
• Abuse can be physical or psychological
• Effects of physical abuse include isolation and depression
• It can also lead to inability to engage in normal sexual behavior
• Post traumatic stress disorder is a common psychological disorder among the victims
• Sexually abused children more likely to develop deviant and promiscuous behavior
• Some engage in promiscuous behavior leading to sexually leading to sexually transmitted disease
• Others are unable to form lasting relationships
• Preventive measures should be put in place to prevent abuse
• Treatment is not a guaranteed remedy for the victims
• Prevention is the best remedy

The vulnerability of children makes them the most common targets of sexual abusers. In the US, it has become a significant issue regarding public health. Child sex abuse is categorized as abuse of an individual below the age of 18. The effects can be classified as physical and psychological and occur immediately and also later in life. Changes in personality character in children are the main recognition features of abuse. Having an appreciation of the long term effects of sexual abuse is very important when ones to understand personality characters of the victims who go through the experience. For effective management of victims of sexual abuse, it is imperative that we recognize the cause of the observed disorder and determine the Adversity to the child.

Post-traumatic stress disorder (PTSD) is common among children who have been victims of sexual abuse as outlined by Kinnear (p 18). This results due the nature of the abuse. The violence that is involved during the act in addition to the pain causes is bound to have delayed reaction on the child. If the abuser is known to the child, the extent of stress is more due to frequent exposure. The signs are normally related with association of the circumstances preceding and during the abuse with any other circumstance the child is presented with. As a result, the child will avoid such situation and may appear withdrawn. Reports have shown that sexually abused children develop anxiety and deviant sexual behaviors including promiscuity.

Mental health of an abused child is also affected adversely. Owing to the heinous nature of the offense, the child is bound to become isolated and depressed. Over time, the child becomes withdrawn from society. Kinnear (19) postulated that the stigma attached to abuse of child also fosters the guilty feeling. As a result, the child enters adulthood without having experienced the challenges which normally stimulate response behavior for survival as an adult.

Physically, some victims are rendered unable to engage in normal sexual practices owing to the physical trauma to the affected organs. The abuser is obviously in a hurry to avoid being caught. The element of struggle implies that injury is bound to occur. As result, the ability to function as normal adult and fulfill their reproductive duties is greatly hampered even in the absence of psychological tendencies. The fear involved in correlating sexual activity wit abuse becomes a hindering factor hence making the individuals unable to form lasting relationships.

Sexual abuse is bound to lead to sexually transmitted diseases to the child. Most abusers are adults who have previously engaged in sexual activities and could thus be carriers of such diseases. Transmission rates are also higher owing to the injury sustained. As observed from most instances, such treatment for such disease is hampered by the diagnostic challenges since the victim may hide the fact they were abused Finkelman (p 41). The shame and trauma involved may prevent the child from opening up to responsible adults.

According to Kinnear (18), inclination to crime has been observed to occur in children who have been sexually abused. Their appreciation of danger is compromised due to loss of self-esteem thus propagating tendencies of disruptive behavior and conduct. Besides, the abused child is bound to feel dejected. This feeling propels most abused children to risk taking behavior. The withdrawal period also takes away valuable time for personal development and the individual may lack a source of income. Substance abuse is also rife among individuals who have been abused. This originates from the search of a coping mechanism.

In conclusion therefore, it is imperative that society protects children from abuse of any form. Sexual abuse has adverse effects running into adult life. Treatment and care of victims is not a guaranteed remedy for the victims. As a result, it is better prevention than care.

Works Cited

Finkelman, Byrgen “Child Abuse: Short- And Long-Term Effects” USA: Taylor & Francis, 1995p

Kinnear, Karen L. ‘Childhood Sexual Abuse: A Reference Handbook”, California: ABC-  CLIO, 2007

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Tips for Writing an Effective Application Essay

How to Write an Effective Essay

Writing an essay for college admission gives you a chance to use your authentic voice and show your personality. It's an excellent opportunity to personalize your application beyond your academic credentials, and a well-written essay can have a positive influence come decision time.

Want to know how to draft an essay for your college application ? Here are some tips to keep in mind when writing.

Tips for Essay Writing

A typical college application essay, also known as a personal statement, is 400-600 words. Although that may seem short, writing about yourself can be challenging. It's not something you want to rush or put off at the last moment. Think of it as a critical piece of the application process. Follow these tips to write an impactful essay that can work in your favor.

1. Start Early.

Few people write well under pressure. Try to complete your first draft a few weeks before you have to turn it in. Many advisers recommend starting as early as the summer before your senior year in high school. That way, you have ample time to think about the prompt and craft the best personal statement possible.

You don't have to work on your essay every day, but you'll want to give yourself time to revise and edit. You may discover that you want to change your topic or think of a better way to frame it. Either way, the sooner you start, the better.

2. Understand the Prompt and Instructions.

Before you begin the writing process, take time to understand what the college wants from you. The worst thing you can do is skim through the instructions and submit a piece that doesn't even fit the bare minimum requirements or address the essay topic. Look at the prompt, consider the required word count, and note any unique details each school wants.

3. Create a Strong Opener.

Students seeking help for their application essays often have trouble getting things started. It's a challenging writing process. Finding the right words to start can be the hardest part.

Spending more time working on your opener is always a good idea. The opening sentence sets the stage for the rest of your piece. The introductory paragraph is what piques the interest of the reader, and it can immediately set your essay apart from the others.

4. Stay on Topic.

One of the most important things to remember is to keep to the essay topic. If you're applying to 10 or more colleges, it's easy to veer off course with so many application essays.

A common mistake many students make is trying to fit previously written essays into the mold of another college's requirements. This seems like a time-saving way to avoid writing new pieces entirely, but it often backfires. The result is usually a final piece that's generic, unfocused, or confusing. Always write a new essay for every application, no matter how long it takes.

5. Think About Your Response.

Don't try to guess what the admissions officials want to read. Your essay will be easier to write─and more exciting to read─if you’re genuinely enthusiastic about your subject. Here’s an example: If all your friends are writing application essays about covid-19, it may be a good idea to avoid that topic, unless during the pandemic you had a vivid, life-changing experience you're burning to share. Whatever topic you choose, avoid canned responses. Be creative.

6. Focus on You.

Essay prompts typically give you plenty of latitude, but panel members expect you to focus on a subject that is personal (although not overly intimate) and particular to you. Admissions counselors say the best essays help them learn something about the candidate that they would never know from reading the rest of the application.

7. Stay True to Your Voice.

Use your usual vocabulary. Avoid fancy language you wouldn't use in real life. Imagine yourself reading this essay aloud to a classroom full of people who have never met you. Keep a confident tone. Be wary of words and phrases that undercut that tone.

8. Be Specific and Factual.

Capitalize on real-life experiences. Your essay may give you the time and space to explain why a particular achievement meant so much to you. But resist the urge to exaggerate and embellish. Admissions counselors read thousands of essays each year. They can easily spot a fake.

9. Edit and Proofread.

When you finish the final draft, run it through the spell checker on your computer. Then don’t read your essay for a few days. You'll be more apt to spot typos and awkward grammar when you reread it. After that, ask a teacher, parent, or college student (preferably an English or communications major) to give it a quick read. While you're at it, double-check your word count.

Writing essays for college admission can be daunting, but it doesn't have to be. A well-crafted essay could be the deciding factor─in your favor. Keep these tips in mind, and you'll have no problem creating memorable pieces for every application.

What is the format of a college application essay?

Generally, essays for college admission follow a simple format that includes an opening paragraph, a lengthier body section, and a closing paragraph. You don't need to include a title, which will only take up extra space. Keep in mind that the exact format can vary from one college application to the next. Read the instructions and prompt for more guidance.

Most online applications will include a text box for your essay. If you're attaching it as a document, however, be sure to use a standard, 12-point font and use 1.5-spaced or double-spaced lines, unless the application specifies different font and spacing.

How do you start an essay?

The goal here is to use an attention grabber. Think of it as a way to reel the reader in and interest an admissions officer in what you have to say. There's no trick on how to start a college application essay. The best way you can approach this task is to flex your creative muscles and think outside the box.

You can start with openers such as relevant quotes, exciting anecdotes, or questions. Either way, the first sentence should be unique and intrigue the reader.

What should an essay include?

Every application essay you write should include details about yourself and past experiences. It's another opportunity to make yourself look like a fantastic applicant. Leverage your experiences. Tell a riveting story that fulfills the prompt.

What shouldn’t be included in an essay?

When writing a college application essay, it's usually best to avoid overly personal details and controversial topics. Although these topics might make for an intriguing essay, they can be tricky to express well. If you’re unsure if a topic is appropriate for your essay, check with your school counselor. An essay for college admission shouldn't include a list of achievements or academic accolades either. Your essay isn’t meant to be a rehashing of information the admissions panel can find elsewhere in your application.

How can you make your essay personal and interesting?

The best way to make your essay interesting is to write about something genuinely important to you. That could be an experience that changed your life or a valuable lesson that had an enormous impact on you. Whatever the case, speak from the heart, and be honest.

Is it OK to discuss mental health in an essay?

Mental health struggles can create challenges you must overcome during your education and could be an opportunity for you to show how you’ve handled challenges and overcome obstacles. If you’re considering writing your essay for college admission on this topic, consider talking to your school counselor or with an English teacher on how to frame the essay.

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NO JUDGMENTS: Essays, by Lauren Oyler

Why do people like to watch boxing? We admire the fighters: their guts, their footwork. It is elegant yet brutal. It entertains. It is a form of proxy violence — someone else being hit and doing the hitting — that taps into our primal urges.

Lauren Oyler made her name as a pugilist. Her breakout essay on the website BookSlut famously begins, “I have always hated Roxane Gay’s writing.” Her reviews get attention partly because she voices the criticism that one may be too politic to express. Typically, that criticism is harsh. Typically, it is funny. Even her 2021 debut novel, “Fake Accounts,” contains a 40-page parody of the fragmentary novel form that was dominant in that moment, especially among women writers. It goes on for so long that the reader has time to love it, hate it, become exasperated with it, resign herself to it and, finally, admire its diabolical commitment.

Now Oyler has returned with “No Judgment,” a collection of eight essays written specifically for the book. Her sense of humor is present, as is her agile thinking. But fans of blood sport won’t find much here to satisfy their baser appetites. Far from incendiary, the book is cleareyed and grounded. Several essays here provoked the surprising thought, “This is the sanest thing I have ever read on this topic.”

The book begins with an introduction explaining that some of the essays were inspired by “a growing agitation about what I perceived to be misunderstandings and fallacies spreading in cultural criticism and commentary.” Others center on personal experiences. Topics include: the evolution of internet gossip, the flawed social network Goodreads and the creep of the word “vulnerable” into arts criticism. The uniting idea, if there is one, seems to be about how people are using or absorbing media wrong, and how this is annoying.

The essays are long and unhurried, and the fare will be familiar to anyone who spends a lot of time online. Many of them involve Twitter discourses of the past few years. Martin Scorsese’s views on Marvel movies make an appearance, as do the online sagas of the writers Lauren Hough, Kathleen Hale and Elizabeth Gilbert, each of whom raised the hackles of the online reviewing community with a variety of consequences.

The first essay, “Embarrassment, Panic, Opprobrium, Job Loss, Etc.,” traces gossip through the 21st century, from the rise and fall of the website Gawker to #MeToo and whisper networks, and the notorious anonymously sourced list of “bad media men” that shook up the magazine world in 2017. These episodes are fluidly stitched together with added context from history and literature, which is the structure of most of the essays in the book. At its best, it feels like your smart friend explaining to you something you missed on the internet, why it’s important and what it means. Occasionally, it feels like your friend overexplaining these things.

Oyler is a sharp and confident critic, and some interpretations in the book are outstanding. For instance, her reading of the film “Tár,” in an essay called “The Power of Vulnerability,” suggests it is not about cancel culture, as many critics wrote when it first came out, but about what would happen if a woman acted like a man. She writes: “We see Tár from rise to downfall, playing the man the entire time. We see her being called maestro. … Most important, we see her in this astounding, unrealistic career, which, in reality, a woman like her would never achieve. Not only because she is a woman, but because she is a woman who acts like a man: cocky, selfish, self-important, rude, on closer inspection a total fraud.” This is an invigorating way to think about the film, and one that sidesteps trite notions of cancellation.

Likewise, in an essay about the forever war of irony versus sincerity, sparked by David Foster Wallace’s 1993 essay “E. Unibus Pluram” and rehashed every few years online, she proposes that the binary itself is fake. “These oppositions are, have always been, reductive, false: A complex work will almost always have both irony and sincerity, and it is possible to express sincere — or authentic, or true — feelings through irony, a rhetorical device that is useful when you want to represent the tension between two conflicting ideas at the same time.”

The collection’s most ambitious essay is an assessment of autofiction as a form rather than a genre. There are many interesting reflections here on Oyler’s own work (“Fake Accounts” is autofiction) and on the work of others — Vladimir Nabokov, Sheila Heti, Sally Rooney and more.

I had never considered, for example, the space between the reader’s projection of an author of autofiction, and who the author really is. That the author can play with this — either defying or reifying the reader’s preconceived notions — is a tool, and a very cool one.

Still, the book’s measuredness cuts both ways. While it likely demonstrates Oyler’s growth as a writer (you can’t be an edgelord all your life), it lacks the boldness of her novel and magazine writing. It is oddly safe. “TED Talks are stupid,” she writes. Well, yeah; The Onion launched a series making fun of them in 2012.

That these essays were written specifically for the book, meaning they did not run as magazine stories or pegged to news events, made me wonder, sometimes, at the why of them. Why these particular topics? Why this set of minor irritations? Is there anything new or definitive about them? Is there a sense of risk, aesthetically or otherwise?

Luckily, the execution is fresh enough to keep one reading. And the barbs, when they do come, are good — in the final essay, a cheap dentist is described as “a tan man in a linoleum hole.” Maybe it’s best to follow the book’s lead and approach it with equanimity: We can appreciate and mourn its maturity both at once.

NO JUDGMENT : Essays | By Lauren Oyler | HarperOne | 288 pp. | $28.99

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Drug and Alcohol Abuse Analytical Essay

Introduction, works cited.

For along time now, drug and alcohol abuse in the society has been a problem that affects the youth and the society at large. The youth in the society get engaged in abusing substances that they feel all help them forget their problems. This paper highlights the problems of drug abuse and alcohol drinking among the youth in the society.

Alcohol is a substance that contains some elements that are bring about physical and psychological changes to an individual. Being a depressant, alcohol affects the nervous system altering the emotions and perceptions of individuals. Many teenager abuse alcohol and other drug substances due to curiosity, the need to feel good and to fit in their different groups. Drinking alcohol should not be encouraged because it usually affects the health of the youth.

It puts their health at a risk. Drinking youth are more likely to engage in irresponsible sexual activities that may result in unexpected pregnancies and sexually transmitted diseases. Additionally, teenagers who drink are more likely to get fat while complicating further their health conditions. Moreover, the youth drinking are at a risk of engaging in criminal activities hence being arrested (Cartwright 133).

According to the Australian Psychological Society, a drug can be a substance that brings about physical or psychological changes to an individual (2). Youngsters in the in the community take stuffs to increase enjoyment or decrease the sensational or physical pain. Some of the abused drugs by the youth in the society include marijuana, alcohol, heroine and cocaine.

The dangers of drug abuse are the chronic intoxication of the youth that is detrimental to their societies. Much intake of drugs leads to addiction that is indicated by the desire to take the drugs that cannot be resisted.

The effect of alcohol and other hard drugs are direct on the central nervous system. Alcohol and drug abuse is linked to societal practices like, partying, societal events, entertainment, and spirituality. The Australian Psychological Society argues that the choice of a substance is influenced by the particular needs of the substance user (3).

However, the effects of drug abuse differ from one individual to another. The abuse of drugs becomes a social problem whenever the users fail to meet some social responsibilities at home, work, or school. This is usually the effect when the substances are used more than they are normally taken. Additionally, when the use of substances is addictive, it leads to social problems (Cartwright 135).

Drug and alcohol abuse among the youth in the society should be discouraged and voided at all costs. The youth are affected and the society is affected. The productive young men and women cannot perform their social duties. One way in which the abuse of drugs and alcohol can be avoided in the society is through engaging the youth in various productive activities. This will reduce their idle time while keeping them busy (Cartwright 134).

They will not have enough time for drinking. Additionally, they will have fewer problems to worry about. They should also be educated and warned about the dangers of drug and alcohol abuse both to their health and to the society. Since alcohol and substance abuse is related to increased crime in the society, its reduction will lead to reduced crime rates and economic growth.

The Australian Psychological Society. Alcohol, and Other Drugs . Australian Psychological society. Web.

Cartwright, William. Costs of Drug Abuse to the Society. The Journal of Mental Health Policy and Economics , 1999. 2, 133-134.

• Chicago (A-D)
• Chicago (N-B)

IvyPanda. (2023, December 18). Drug and Alcohol Abuse. https://ivypanda.com/essays/drug-and-alcohol-abuse/

"Drug and Alcohol Abuse." IvyPanda , 18 Dec. 2023, ivypanda.com/essays/drug-and-alcohol-abuse/.

IvyPanda . (2023) 'Drug and Alcohol Abuse'. 18 December.

IvyPanda . 2023. "Drug and Alcohol Abuse." December 18, 2023. https://ivypanda.com/essays/drug-and-alcohol-abuse/.

1. IvyPanda . "Drug and Alcohol Abuse." December 18, 2023. https://ivypanda.com/essays/drug-and-alcohol-abuse/.

Bibliography

IvyPanda . "Drug and Alcohol Abuse." December 18, 2023. https://ivypanda.com/essays/drug-and-alcohol-abuse/.

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