Prevalence, Correlates and Subjective Experience of Emotional Abuse in Adolescents Presenting to Child and Adolescent Psychiatry Services: A Mixed Methods Study

Abstract

Introduction: The burden and impact of childhood emotional abuse (CEA) among children and adolescents utilizing psychiatry services is a less studied area, especially in the Indian context. This study aims to study the prevalence and correlates of CEA in adolescents attending psychiatry services and to understand the subjective experience of emotional abuse (EA) in this population. Methods: Adolescents aged between 12 and 18 years attending child and adolescent psychiatry (CAP) services were recruited for the study. The prevalence of CEA was assessed using ICAST-C (ISPCAN Child Abuse Screening Tool), temperament was assessed using the Malhotra Temperament Scale, and psychosocial adversities were assessed with the Parent Interview Schedule (PIS). From those reporting CEA, a few of them were interviewed to get narratives of subjective experiences of CEA, and this was analyzed using thematic analysis. Results: In total, 81 adolescents were recruited for the study, and among them, 82.7% (n = 67) reported at least 1 form of EA in the last year, and 93.8% (n = 76) of them reported a lifetime history of at least 1 form of EA. The frequency of other psychosocial adversities like abnormal intrafamilial relationships (n = 33; 40.7%) and inadequate or distorted intrafamilial communications (n = 49; 60.5%) was high in this sample. There was a significant association between the presence of EA in the last year and physical abuse (p =.00) and neglect (p =.01) in the last year. Narratives for qualitative analysis were collected from 21 adolescents. The most common themes in the context of CEA were related to academics (n = 10) and emotional and behavioral problems in the child (n = 7). Conclusions: There is a high prevalence of EA among adolescents attending CAP services. There is a high co-occurrence of other forms of abuse and other psychosocial adversities with EA. As adverse childhood experiences (ACEs) pose a high risk for future physical and mental health sequelae, this needs to be identified early and intervened with.