The first people to identify a problem often shape how others will perceive it.1 Nowhere is this truer than in the study of child abuse. The effort to understand, explain, predict, treat, and prevent the physical abuse of children has been strongly influenced by an individual level, medical/psychiatric perspective employed by those who first identified the problem of child abuse.
Although children have probably been the victims oí parental physical abuse for centuries,2"5 it was not until C. Henry Kempe and his colleagues0 wrote about the "clinical condition in young children who receive serious physical abuse, generally from a parent or foster parent," that the problem of child abuse received serious public and professional attention.
The faci that child abuse was "discovered" by the medical community has had profound implications for research and intervention. The first research articles on abuse characterized offenders as suffering from various lorms of psychopathology.7 4 Thus, for many years researchers applied a "kind of person" model to research and sought to identify the hypothesized personality and character disorders associated with abusers.
Although numerous articles attempted to present the psychological profiles of abusers, the research efforts were limited by methodological design problems, including small, non-representative samples and lack of appropriate comparison groups.10·11 "Kind of person" explanations failed to provide a consistent profile of abusers and failed to explain a significant amount of the variance in the abusive behavior of caretakers.
Current theoretical approaches to child abuse tend to recognize the multi-dimensional nature of abuse and locate the roots of physical abuse in the structure of the family and/or society. It is noteworthy that a sociologist and psychiatrist independently writing on family violence agree that social factors explain as much as 90% of the variance in family violence.12·1"
In this article, the major social and family factors related to the physical abuse of children arc reviewed. One of the great difficulties in the study of child abuse has been to develop precise definitions of abusive behavior. The term "abuse" has been applied toa wide range of acts of commission and omission including emotional abuse, medical neglect, willful vnalnourishment, and sexual victimization of children.14·'5 For purposes of clarity, we confine our examination only to acts of physical violence that injure children or have great potential of causing injury.
Five major social and family factors that have been consistently found to be related to the physical abuse of children are reviewed. The factors are:
* The cycle of violence - the intergenerational transmission of physical abuse;
* Low socioeconomic status:
* Social and structural stress;
* Social isolation and low community embedment;
* Family structure.
The article concludes with a brief review of some sociological theoretical frameworks that have been applied to the physical abuse of children.
THE CYCLE OF VIOLENCE
The single, most consistent finding reported in the child abuse literature is that experiencing abuse as a child increases the likelihood of becoming an abusive caretaker.6,10,11-16,18 However, this is not a perfect association. Potts and Herzberger point out that the relationship between being abused and becoming the abuser is probabaiistic, noi deterministic.'1,1 Kaufman and Ziglcr reviewed the major research studies on the cycle of physical abuse (Kaufman |. Ziglcr E, unpublished data). They note that data come from four primary sources - case study materials, social agency records, clinical interviews, and self-report questionnaire data. Kaufman and Zigler dismiss the evidence derived from case histories, agency data, and clinical interviews. Such studies are almost always limited by the use of small, non-representative samples. Few of the investigators include comparison groups in their studies. Data from self-report questionnaires and interviews find that between 17% and 70% of abused children grow up to become abusive caretakers.
Kaufman and Zigler reason that the best estimate is that some 30% of abused children grow up to be abusive (Kaufman J, Zigler E, unpublished data). They conclude that the link between being maltreated and becoming abusive is far from inevitable, and they advocate abandoning the notion that abused children grow up to be abuscrs. Yet, the 30% rate of abusive behavior is far greater than the rate of less than 4% of abusive behavior found among the general population. l8'20 Exposure to violence does appear to be a significant factor related to the likelihood of later abusive behavior, even if less than half of abused children grow up to become abusers.
Kaufman and Zigler suggest that (he most appropriate question to ask is not, "Do abused children grow up to be abusers?" (Kaufman |, Zigler E, unpublished data). Rather, they say researchers ought to ask, "Under what conditions do abused children grow up to be abusive?"
Egeland, !acobvitz, and Papatola have followed 267 high risk mothers from the last three months of their pregnancies to the time when their children were in kindergarten.21 Seventy percent of the mothers who were seriously abused were abusive to their children. Those mothers who were seriously abused but who did not become abusive shared a number of characteristics, including having at least one parent or foster parent who provided love and support when they were children. As adults, these molhers had husbands who provided a supportive home environment and a stable source of income. Hunter and Kilstrom report that parents who broke the cycle of abuse had more extensive social supports, fewer ambivalent feelings about their pregnancies, and healthier babies.22 The non-abusive, abused parents displayed more open anger about their abusive experiences and were able to describe these experiences freely. They were typically abused by only one parent while the other parent provided support.
Both studies that have examined the condition under which violence and abuse is repealed point to the fact that the link can be broken if present support - both psychological and social - is available.
LOW SOCIOECONOMIC STATUS
The first researchers who studied child abuse thought that social, economic, and demographic factors were irrelevant to the actual act of abuse.9 Indeed, child abuse may be found among all socîoeconomic groups. Yet, a disproportionate number of cases of abuse come from low income families. 10.10-18,2-5-25
There is a need for caution in interpreting data on the relationship between child abuse and social class. The caution stems from the fact that lower class families are much more vulnerable to being publically recorded for abusive behavior. A variety of investigators and experiments have demonstrated that, given the same injury or condition, children from lower class homes are much more likely to be reported as being abused than children from middle or upper class families.20"28
Data collected directly by questionnaire or interview arc loss subject to the biases of official report data, and these data do confirm the higher rales of abuse among the lower class. The difference between social classes, however, is not nearly as great as it would seem from the data collected from official agency or case study sources.
Researchers agree that the mechanism through which low socioeconomic status works to bring about child abuse is social stress. Abusive and neglectful families are reported as experiencing more stressful life events than non-maltreating families.16,1,23-26
One of the more significant social Stressors that is related to abuse and neglect is uncmp/oyment. Among families in which (he father is unemployed or employed part-time, the risk of abuse is higher than in other households where the father has fulltime work.8,1,8
Poor housing conditions and larger than average family size are also risk factors for maltreatment.16-29 Other stressful life conditions found related to abuse include a new baby present in the home, presence of a handicapped person in the home, illness, death of a family member, and child care problems.
Stress produced by child-related factors can also lead to abuse. Low birth weight babies, premature children, and handicapped, retarded, or developmentalty disabled children are at higher risk for abuse than children without these conditions. 16,17,23,27,30
SOCIAL ISOLATION AND LOW COMMUNITY EMBEDMENT
Parents who abuse their children tend to be socially isolated from both formal and informal social networks.23,11 Smith found thai abusive mothers have fewer contacts with their parents, relatives, neighbors, or friends, and engaged in fewer social or recreational activities.12
The lack of formal or informal social networks deprives abusive parents of support systems that would aid them in dealing wilh social or family stress. Moreover, the lack of community contacts makes these families less likely to change their behavior to conform with community values and standards/'3 Thus, they are particularly vulnerable to violent responses to stress while not perceiving their behavior as deviant.
Certain family structures are common among abusive and neglectful families. There is a general belief that single parents are at higher risk to abuse their children. Unfortunately, it is difficult to partial out the effects of youth and poverty from the impact of the single parent family structure - many single parent homes are those of young mothers who live in poverty.
Within intact homes, a major structural feature found related to the use of abusive violence toward children is inequality. Straus and colleagues found that the rate of severe violence toward children was highest in homes where there was little shared decision making.18 Those homes in which either the husband or wife dominated the decision making and where little family equality existed were among the most violent.
EXPLAINING THE ABUSE OF CHILDREN
The study of child abuse abounds with simplistic models. The earliest research advanced a psychopathological model - mental illness caused people to abuse their children. Other intra-individual models proposed thai abuse was caused by alcohol and/or drugs.
The major theoretical approaches to child abuse have been reviewed extensively elsewhere.14,34 This section reviews some of the more complex theories that have been applied to examining the family and its role in the abuse of children. These theories include an economic model, a sociocultural explanation, an ecological model, and an exchange theory approach.
AN ECONOMIC MODEL
The economic or social-structural model explains that violence and abuse arise out of socially structured stress. Stress, such as low income, unemployment, and illness, is unevenly distributed in the social structure. When violence is the accepted response or adaptation to stress, stress leads to violence and abuse.35
A SOCIOCULTURAL EXPLANATION
Students of violence have explained the occurrence of family violence, including child abuse, by drawing on sociocultural attitudes and norms concerning violent behavior. Societies, cultures, and subcultures that approve the use of violence arc thought to have the highest rates of domestic violence and abuse of children.13
AH ECOLOGICAL WODEL
Garbarino has proposed an ecological model of child maltreatment.36 The model rests on three levels of analysis: the relationship between organism and environment, the interacting and overlapping system in which human development occurs, and environmental quality. Garbarino proposes that maltreatment arises out of a mismatch between parent, children, and family to neighborhood and community.
Exchange theory proposes thai family violence and child abuse are governed by the principle of costs and rewards.37 Abuse is used when the rewards are higher than the costs. The private nature of lhe family, the reluctance of social institutions and agencies to intervene - in spite of mandatory child abuse reporting laws - and lhe low risk of other interventions reduce the costs of abuse and violence. The cultural approval of violence as both expressive behavior and, in the case of disciplining children, instrumental behavior, raises the potential rewards for violence.
The comparative recency of child abuse as an area of study and the fact that the first decade of research was dominated by the psychopathology model has resulted in the limited level of theoretical development of the field. Yet, despite the rather primitive level of theory building and theory testing, one conclusion is inescapable. Researchers have found that no one factor can explain the presence or absence of child abuse. Characteristics of the child, parent, family, social situation, and community are related to which children are abused and under what conditions. Individual states of caretakers and community factors are moderated and influenced by family structurc and family situations. Although there are indeed multiple factors related to abuse of children, all operate through the structure and function of the family group.
1. Nelson BJ: Making an Issue of Child Abuse: Political Agenda Setting for Social Problems. Chicago. University of Chicago Press, 1984.
2. Dc Mause; L (ed): The History of Chlidhood. New York, Psyehohistorv Press. 1974.
3. De Mause L: Ourforebearers madcchildhoüd a nightmare. Psychology Today 1975; 8:85-87.
4. Radbill S: A history of child abuse and infanticide, in Heller R, Kempe C (eds): The Haltered Child, ed 2. Chicago. University of Chicago Press. 1974, pp 5-21.
5. Robin M: Historical introduction; Sheltering arms: The roots of" child protection, in Newbcrger F.H (ed): Ch i Ul Abuse. Boston. Linie Brown. 1985. pp 1-14.
6. Kempe CH. Silverrmin KN. Sleek' Br. et al: The battered-child syndrome. UMA 12: 181:17-24.
7. Bennie E, Sciare A: The haltered child syndrome. Am J Psychintrv 1969; 125:975-979.
8. Galdslon R: Observations of children who have been physically abused by their parents. Am I Psychiatry 19b5 ; 122:440-44?.
9. Steele B, Pollock C: A psychiatric study of parents who abuse inlants and small children, in Heifer R. Kempe C teds); The Battered Child, ed 2. Chicago. University of Chicago Press. 1974.
10. Gelles R: Child abuse as psychopathokigy: A sociological critique and reformulation. Am J Orthopsvchiatry 1973: 45:b11-b21.
11. Spinetta J. Rigler D: The child abusing parent: A psychological review. Psychol Bull 1972; 77:296-504.
12. Sleelc B: The child abuser, in Kutash IL, Kutash SB. Schlcsinger LB. et al (eds): Violence: Perspectives on Murder and Aggression. San Francisco. (ossey-fiass. 1978. pp 285-500.
13. Straus M: A sociological perspective on family violence, in oreen M (ed): Violence and the Family. Boulder. Colorado. Westview Press. 1980.
14. Gelles R, Straus M: Determinants of violence in the family: Toward a theoretical integration, in Burr W. et al (eds): Contemporary Theorien About the Family. New York. Free Press. 1979. vol 1. pp 549-581.
15. Gelles R: Family violence, in Turner RH. Short IF, Jr (eds): Annual Review of Sociology. Palo Alto. California. Annual Reviews, Inc.. 1985. vol 11. pp 347-567.
16. Gil D: Violence Against Children: Physical Child Abuse in the United States. Cambridge. Massachusetts. Harvard University Press. 1970.
17. Parke RD. CollmerCW: Child abuse: An interdisciplinary analysis, in Hetherington M (ed): Review of Child Development Research. Chicago. University of Chicago Press, 1975. vol 5. pp 1-102.
18. Siraus M. Gelles R. Steinmetz S: Behind Closed Doors: Violence in the American Family. New York. Doubleday/'Anchor, 1480.
19. Potts D. Herzberger S: Child Ahuse: A Cross Cenerational Pattera of Child Retiring'.' Presented at the Annual Meeting of the Midwest Psychological Association. Chicago. 1979.
20. Burgdorf K: Recognition und Reporting oj Child Maltreatment. Rockville. Maryland. Westat. 1980.
21. Egdand B. Jacobvitz D. PapatolaK: Intergenerational continuity of abuse, in Gelles R, Lancaster J (eds): Child Abuse and Neglect: Hiosocial Dimensions. Hawthorne. New jersey. Aldine de Gruytcr. 1987. to be published.
22. Hunter R. Kilstcom N: Breaking the cycle in abusive families. Am J Psychiatry 1979: 156:1520-1522.
23. Elmer E: Children in Jeopardy: A Study of Abused Minors and Their Families. Pittsburgh, University of Pittsburgh Press, 1907.
24. Maden MF. Wrench DF: Significant findings in child abuse research. Victimology 1977; 2:196-224.
25. Pelton L: Child abuse and neglect: The myth of classlessness. Am J Orthopsychiairy 1978; 48:608-617.
26. Gelles R: On the association of sex and violence in the fantasy production of college students. Suicide 1975; 5:78-85.
27. Newherger EH. Reed RB. Daniel IH, el al: Pediatrie social illness: Toward an eliologic clnssifiealion. Pediatrics 1977: 60:178-185.
28. Turben JP. O Toole R: Physician's Recognition of Child Abuse. Presented at Annual Meeting of American Sociological Association. New York, 1980.
29. Johnson B. Morse H: I injured children and their parents. Children 1968: 15:147-152.
30. Friedrich W, Boriskin J: The role of the child in abuse: A review of literature. Am J Orthopsychialry 197b; 46:580-590.
31. Garbarino J. Gilliam G: Understanding Abusive Familien,. Lexirigton. Massachusetts, D.C. Heath, 1980.
32. Smith S: The Battered Child Syndrome. London, Butters worth, 1975.
33. Steinmetz S: Violence between family members. Marriage Fant Rev 1978: 151:1-10.
34. Gelles R: Violence in the family; A review of research in the seventies. J Marriage Finn 1980; 42:873-885.
35. Coser LA: Continuities in the Study of Social Conflict. New York, Free Press, 1967.
36. Garbarino J: The human ecology of child maltreatment. J Marriage Fain 1977; 39:721-735.
37. Gelles R: An exchange/social control theory, in Kinkelhor D. Gelles R. Straus M. et al: The Dark Side of Families: Current Family Violence Research. Beverly Hills. California, Sage, 1983. pp 151-165.