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Nervenheilkunde 2017; 36(03): 161-167
DOI: 10.1055/s-0038-1635151
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Auswirkungen von Missbrauch, Misshandlung und Vernachlässigung im Kindesalter auf die psychische und physische Gesundheit im Erwachsenenalter

The consequences of child abuse, maltreatment and neglect on mental and somatic health in adulthood
P. L. Plener
1   Klinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Universitätsklinik Ulm
2   Zentrum für Transdiziplinäre Traumaforschung, Universität Ulm
,
A. Ignatius
2   Zentrum für Transdiziplinäre Traumaforschung, Universität Ulm
3   Institut für Unfallchirurgische Forschung und Biomechanik, Universität Ulm
,
M. Huber-Lang
2   Zentrum für Transdiziplinäre Traumaforschung, Universität Ulm
4   Klinik für Unfall-, Hand-, Plastische- und Wiederherstellungschirurgie, Universitätsklinik Ulm
,
J. M. Fegert
1   Klinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Universitätsklinik Ulm
2   Zentrum für Transdiziplinäre Traumaforschung, Universität Ulm
› Author Affiliations
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Publication History

eingegangen am: 16 November 2016

angenommen am: 19 December 2016

Publication Date:
03 February 2018 (online)

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Zusammenfassung

In der Gesamtbevölkerung stellen das Vorliegen einer Vorgeschichte von Vernachlässigung, Missbrauch oder Misshandlung im Kindes- und Jugendalter keineswegs seltene Phänomene dar. So werden schwere körperliche Misshandlungen von etwa 3%, sexueller Missbrauch von etwa 2%, schwere emotionale Vernachlässigung von knapp 7% und schwere körperliche Vernachlässigung von knapp 11% der Allgemeinbevölkerung in Deutschland berichtet. Wie die Forschungslage zeigt, werden durch das Erleben solcher Ereignisse in der Kindheit langdauernde Prozesse in Gang gesetzt, die im Erwachsenenalter zu psychischen oder physischen Folgeschäden führen können. Im Rahmen eines selektiven Reviews soll die aktuelle Literatur zu dieser Thematik aufgearbeitet werden. Studien, die vor allem innerhalb der letzten 10 Jahre publiziert wurden, zeigen sowohl funktionelle wie auch hirnmorphologische Veränderungen, die vor allem in Bereichen des emotionalen Erlebens und der emotionalen Regulation zu Veränderungen führen. Zusätzlich mehren sich die Hinweise für negative Konsequenzen auch auf somatischer Ebene. So konnten wiederholt Zusammenhänge mit chronischen Krankheiten gezeigt werden, wobei vor allem eine Einflussnahme über unser stressverarbeitendes System als mögliche Ursache diskutiert wurden. In Modellrechnungen wurde ein gesamtwirtschaftlicher Schaden von etwa 11 bis 30 Milliarden Euro pro Jahr als Folge von Vernachlässigung, Missbrauch und Misshandlung im Kindesalter errechnet. Der Prävention solcher Ereignisse sowie der frühzeitigen Erkennung und Behandlung kommt damit eine wesentliche gesellschaftliche Dimension zu.

Summary

A history of neglect, abuse and maltreatment in childhood and adolescence is not uncommon in the general population. Severe physical abuse has been reported from approximately 3%, sexual abuse from nearly 2%, severe emotional neglect from approximately 7% and severe physical neglect from around 11% of the German general population. Recent research findings have shown the pathways through which such traumatic experiences in childhood create an impact on mental or somatic sequelae in adulthood. This selective review aims at describing these mechanisms. Studies which have been published primarily within the last 10 years were able to show functional and morphological changes in the brain, especially in regions associated with emotion processing and emotion regulation. There is a growing number of studies reporting on somatic consequences, showing an association with diverse chronic disorders, with influences of our stress-regulating system being discussed as possible cause. Models have calculated the economic damage of childhood neglect, maltreatment and abuse to be as high as 11 to 30 billions Euro/year. Prevention as well as early identification and intervention of these traumatic events therefore is a societal imperative.

Schlüsselwörter

Kindesmisshandlung - Kindesmissbrauch - Vernachlässigung - Neurobiologie

Keywords

Child maltreatment - child abuse - neglect - neurobiology
 

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