Neonatal and infantile abuse in a family settings

Abstract

General profi les Neonatal mistreatment consists of one or more inadequate behaviors, possibly repeated over time, with or without a precise criminal design, towards an infant under the age of two months and involves a substantial risk of causing physical injury and/or emotional. What the victim of abuse is older will talk about child maltreatment, although the substance of deviant or clinically relevant behaviors remains practically unchanged [1]. In general, four types of "abuse" are recognized [2]. "physical abuse", consisting of infl icting physical damage or engaging in actions that create a high risk of body trauma. Specifi c forms include shaking, falls, blows, stings, and burns. Especially in the fi rst months of life, during clinical monitoring, the most frequent relevant data are head injuries, bone fractures, and burns (some even serious). In detail, however, frequent skin lesions such as handprints or oval fi ngermark caused by slaps, grips and shaking, long band bruises (caused by whipping with a belt), subtly arched bruises (caused by whipping with elastic), burns caused by cigarettes or hot bodies, symmetrical burns of the upper or lower limbs, bite marks, thickened skin or scars at the corners of the mouth caused by gagging, patchy alopecia, with variable hair length, caused by hair-tearing, up to bruises and more or less marked petechial signs, single or multiple fractures, simple or displaced, of the cranial bones, ribs, vertebrae, limbs, and long bones, ending with internal traumas and focal neurological alterations as a consequence of the reported traumas. "sexual abuse", consisting of physical abuse characterized by a sexual impulse. Forms of sexual abuse include intercourse, i.e. oral, anal or vaginal penetration, but also simple harassment, i.e. genital contact in the absence of complete intercourse and forms that do not involve physical contact with the perpetrator of abuse, such as exposure of the genitals by the abuser, to show sexual material to a child, and to force a child to participate in a sexual act with another child or to participate in the recording of pornographic material. The hypotheses of sexual violence, however, do not include the "exploratory sexual game between children", which is characterized by the following elements: a) the children must not have a difference in their age greater than three years; b) children must both be under the pre-pubertal age; c) the children must not have previously manifested sexual drives or desires contextualized in contacts of a sexual nature or any case inappropriate concerning the reference context; d) the physical contact of the genital areas or the simple earning must take place without violence or external coercion and must not manifest itself in a framework of pleasure with an erotic and / or sexual background. Otherwise, any action against a child that is carried out for the sexual gratifi cation of an adult or a signifi cantly older child constitutes sexual

Perrotta Integrative Clinical Interviews‐3 (PICI‐3): Development, regulation, updation, and validation of the psychometric instrument for the identification of functional and dysfunctional personality traits and diagnosis of psychopathological disorders, for children (8–10 years), preadolescents (11–13 years), adolescents (14–18 years), adults (19–69 years), and elders (70–90 years)

“…The PICI‐C‐3 consists of 128 items and can detect based on symptomatology suffered dysfunctional traits based on 19 different disorders (not personality, as before the age of 14 years it is not possible); the test chosen for validation comparison, which comes closest to the results of the test, is Child Behavior Checklist (CBCL), 94 although it is possible to compare in the former case the diagnostic outcome of the specific disorders based on the activations of individual dysfunctional personality traits (0–9 traits per disorder), while in the latter case, it is possible to derive from the lists of dysfunctional behaviors the symptomatology that is incorporated and counted among the symptoms of the disorders identified by the PICI‐C‐3, also because of studies on attachment and childhood trauma. 96 , 97 The CBCL consists of 128 items between the first and second parts (social skills with behavior and emotional problems). Comparing the symptom outcomes with the outcomes from the administration, and normalized the results to obtain the direct comparison of data, statistical analysis confirmed 94.1% data compatibility, Pearson's coefficient ( R ) of 0.969 and p < 0.001.…”

Affective Dependence: From Pathological Affectivity to Personality Disorders: Definitions, Clinical Contexts, Neurobiological Profiles and Clinical Treatments

“…And if up to now, too many therapies focused on the dependent symptom have failed, it is precisely for this reason. The treatment of emotional dependence is primarily structured on the achievement of short and long-term goals, such as dealing with and resolving the patient's current suffering in terms of symptoms and behavioral dysfunctions and dealing with early experiences of abandonment, physical and emotional neglect, maltreatment or abuse [36], which generally underlie the belief that they are worth nothing and not worthy of being loved that characterize patients suffering from emotional dependence (understood as behavioral dependence); the general treatment instead of personality disorders, including addiction, focuses on the structure and functional mode of action. In the latter case, an integrated approach to solve or at least better manage the pathological consequences appears evident: cognitive-behavioral psychotherapy, strategic or psychodynamic, which focus on the exploration of the fear of independence and the difficulties of self-assertion (the strategic model appears particularly useful precisely because of its natural ability to adapt to the patient, reasoning on the most suitable functions and strategies) [37] and the use of an integrative psychopharmacological therapy only if strictly necessary.…”