The statistics on physical child abuse are alarming. It is estimated hundreds of thousands of children are physically abused each year by a parent or close relative. Thousands die. For those who survive, the emotional trauma remains long after the external bruises have healed. Communities and the courts recognize that these emotional "hidden bruises" can be treated. Early recognition and treatment is important to minimize the long term effect of physical abuse.

Children who have been abused may display:

• a poor self image
• sexual acting out
• inability to trust or love others
• aggressive, disruptive, and sometimes illegal behavior
• anger and rage
• self destructive or self abusive behavior, suicidal thoughts
• passive or withdrawn behavior
• fear of entering into new relationships or activities
• anxiety and fears
• school problems or failure
• feelings of sadness or other symptoms of depression
• flashbacks, nightmares
• drug and alcohol abuse

Often the severe emotional damage to abused children does not surface until adolescence or later, when many abused children become abusing parents. An adult who was abused as a child often has trouble establishing intimate personal relationships. These men and women may have trouble with physical closeness, touching, intimacy, and trust as adults. They are also at higher risk for anxiety, depression, substance abuse, medical illness, and problems at school or work. Without proper treatment, physically abused children can be damaged for life. Early identification and treatment is important to minimize the long-term consequences of abuse. Child and adolescent psychiatrists provide comprehensive evaluation and care for children who have been abused. The family can be helped to learn new ways of support and communicating with one another. Through treatment, the abused child begins to regain a sense of self-confidence and trust.

Physical abuse is not the only kind of child abuse. Many children are victims of neglect, or sexual abuse, or emotional abuse. In all kinds of child abuse, the child and the family can benefit from the comprehensive evaluation and care of a child and adolescent psychiatrist.