Adult survivors of unresolved abuse frequently report tolerating abusive adult relationships as a consequence of childhood experiences and as a result of very low self-esteem and feeling worthless of hopeless (Courtois, 1988). Mental health counselors may fail to inquire about the presence of abuse in the older adult's existing relationships or may not thoroughly investigate potential incidents of abuse (i.e., accidents). Therefore, those working with older adults should assess possible patterns of abuse in the client's life so that education regarding self-protection and evaluating the trustworthiness of others is provided. In addition, the client's low self-esteem and negative feelings about himself or herself resulting from early childhood sexual trauma must be examined to minimize the possibility of continued abuse in future relationships.
A comprehensive review of collective empirical findings confirms the common notion that the experience of sexual abuse in childhood may be associated with a wide range of problematic symptoms in adulthood for primary survivors. Among the most well documented adult sequelae of childhood sexual trauma are depression, self-destructive behavior, anxiety, feelings of isolation and stigma, poor self-esteem, and substance abuse (Beitchman et al., 1992; Browne and Finkelhor, 1986; Cahill et al., 1991; Green, 1993; Kilpatrick, 1987; Sheldrick, 1991).
When a parent or caregiver makes negative comparisons between children, or rejects a child as a form of punishment, these too are forms of emotional abuse. Emotional abuse often has long-lasting effects. It can harm a child's ability to feel, share, and understand feelings, and can destroy their sense of self-worth or self-esteem. Self-esteem is a person's belief in their importance and abilities. People with low self-esteem have a hard time accepting that they have skills and abilities and are worthy of love and affection.
Childhood victimization may alter the child's self-concept, attitudes, or attributional styles; this change may then influence the person's response to later situations. For example, the clinical literature has identified low self-esteem as one of the major characteristics of childhood victims. Lowered self-esteem may result from childhood victimization directly, caused by the child's feelings of low self-worth, derived from the idea that he or she was somehow responsible for the abuse or neglect. Low self-esteem may also be indirectly related to abuse and neglect as a by-product of lowered cognitive functioning and poor social and interpersonal skills.
Victims are children who are frequently aggressed on by peers (Perry, Kusel, & Perry, 1988), and prolonged peer victimization may increase children's introspection regarding attributed or actual flaws (see Graham & Juvonen, 2001). Such rumination may lead to low self-esteem and negative self-beliefs (Kochenderfer-Ladd & Ladd, 2001; Mechanic, 1983). Chronic victimization may also cause children to develop the generalized belief that peers are hostile (see Kochenderfer-Ladd & Ladd, 2001).
Maltreating mothers offered more negative feedback, particularly to their daughters, than nonmaltreating mothers. Maltreated girls showed more shame when they failed and less pride when they succeeded than nonmaltreated girls. The relation between differential socialization practices and the self-conscious emotions is explored as it relates to observed gender differences in emotionality and self-concept.
On average, self-esteem and self-agency increased and depressive symptoms decreased over time. Multivariate growth modeling indicated that, regardless of gender, physical abuse was negatively related to initial levels of self-esteem, and physical abuse and physical neglect were positively associated with initial levels of depressive symptoms. Emotional maltreatment was predictive of changes in self-esteem and changes in depressive symptoms. Initial levels of self-esteem were negatively associated with initial levels of depressive symptoms. The findings contribute to enhancing our understanding of the developmental processes whereby early maltreatment experiences are linked to later maladjustment.
Type of maltreatment was also related to specific aspects of children's adjustment. For instance, sexual abuse predicted low self-esteem, but not problems in peer relationships. Emotional maltreatment, on the other hand, was related to difficulties in peer relationships, but not to low self-esteem. Thus, the best predictions of specific aspects of children's adjustment were provided by considering timing, type, and severity of maltreatment. For some groups of maltreated children, having a good friend was associated with improvement over time in self-esteem.
However, three out of the four exception group caregivers who underwent therapy were also among the most severely abused. Furthermore, the therapy experienced was required at the foster institution where they were placed. A relationship with a supportive and nonabusive adult during early childhood or with a therapist at any time may have enhanced the abused parent's self-esteem and helped them realize that others can be emotionally available in time of need.
Most studies assessing children of battered women report serious childhood problems including increased anxieties (Christopoulos et al., 1987), poor school performance and conduct disorders (Carlson, 1984; Hilberman & Munson, 1978), increased aggression (Christopoulos et al., 1987; Jaffe, Wilson & Zak, 1986; Wolfe, Jaffe, Wilson & Zak, 1985), lower self-esteem (Hughes & Barad, 1983), impaired social problem-solving skill (Rosenberg, 1987), and generally high levels of behavior problems and psychopathology (Fantuzzo et al., 1991; Holden & Ritchie, 1991).