Child maltreatment has physical, psychological, cognitive, and behavioral consequences. Physical consequences range from minor injuries to brain damage and even death. Psychological consequences range from chronic low self-esteem, anxiety, and depression to substance abuse and other self-destructive behavior and suicide attempts. Cognitive effects include attention problems, learning disorders, and poor school performance. Behavioral consequences range from poor peer relations to physical aggression and antisocial behavior to violent behavior. These consequences are influenced by gender differences and environmental factors such as multi-problem families characterized by parental alcoholism, drug problems and other inadequate social and family functioning. Some early adverse experiences may be indirect, creating by-products. They may change the environment or family situation, which in turn may predispose a person to problem behavior, or may expose the child to further harmful experiences. In this way, the consequences may be due not so much to the abuse or neglect, but to the chain of events it triggers. Tables, figures, notes
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