Defining Psychological Maltreatment: Seven Recognized Forms
Part Two of a Four-Part Deep Dive - Reading time: 5 to 7 minutes
In Part 1 of this series, we traced the history of psychological maltreatment (PM), the damage it causes, and why professionals often overlook it. In this second installment, we turn to definitions. What exactly counts as PM? How do experts categorize it? And where is the line between poor parenting and maltreatment?
PM is not a vague concept. Decades of research have provided definitions and classification systems that are detailed and reliable. The challenge lies in applying these consistently in practice.
A Language for Psychological Maltreatment
One of the most powerful tools in protecting children is language. The American Professional Society on the Abuse of Children (APSAC) defines psychological maltreatment as: “A repeated pattern of caregiver behavior, or extreme incidents, that convey to a child that they are worthless, flawed, unloved, unwanted, endangered, or only of value in meeting another’s needs” (APSAC, 2019).
This definition has become a reference point for child protection professionals. It highlights both repeated patterns and severe single incidents that can undermine children’s well-being.
The problem is not that PM lacks a definition—it has one. The problem is that definitions vary widely by jurisdiction. Amy J. L. Baker (2009) found that statutory language differs so much between states that reporting rates can vary by a factor of 500. These gaps mean that one child may be protected while another, in a different state but experiencing the same harm, is not.
Seven Interlocking Forms of Psychological Maltreatment
Spurning: Active rejection, ridicule, or humiliation. A caregiver may mock a child’s intelligence or appearance. Over time, the message of worthlessness is internalized, often leading to low self-esteem and depressive symptoms.
Terrorizing: Placing a child in constant fear through threats or unsafe situations. Examples include threats of harm or exposing a child to violence. Children often respond with heightened stress and anxiety, and may show symptoms of post-traumatic stress (Spinazzola et al., 2014).
Isolating: Restricting a child’s contact with peers or normal developmental experiences. This may involve preventing school attendance or interfering with friendships. The result is loss of peer support and slower social development.
Exploiting/Corrupting: Involving children in harmful or illegal behavior, such as substance use or excessive labor. This can distort moral reasoning and increase risk of later criminal involvement.
Denying emotional responsiveness: Withholding affection or ignoring a child’s emotional needs. When caregivers fail to respond consistently, children may feel invisible and struggle to form secure attachments (Baker & Brassard, 2014).
Neglect of mental, medical, or educational needs: Failing to provide necessary services or interventions, such as ignoring a diagnosed learning disability or refusing medical care. Such neglect can worsen existing conditions or create new challenges.
Overpressuring: Placing excessive or developmentally inappropriate demands on a child, such as expecting advanced academic performance at a very young age. This can foster anxiety, perfectionism, and fragile self-worth.
The Harm Standard
Central to APSAC’s guidance is the harm standard. This standard asks whether caregiver behavior has caused—or is likely to cause—significant emotional, cognitive, or social impairment.
The harm standard serves two purposes:
It ensures protection by clarifying when intervention is warranted.
It sets limits, preventing overreach into cultural or parenting practices that may not be harmful. Inconsistent application, however, creates disparities.
What qualifies as harm in one state may be dismissed as discipline in another (Baker, 2009). This inconsistency leaves some children unprotected.
Cultural Considerations
Culture shapes how caregiver behaviors are perceived. Practices such as strict discipline may be normative in some communities, but cultural acceptance does not mean a child is unharmed. Training in cultural competence, combined with evidence-based assessment, helps professionals balance respect for diversity with recognition of maltreatment (APSAC, 2019).
Why Definitions Matter
Clear and consistent definitions are not just theoretical—they have direct consequences for practice, policy, and children’s lives.
Professional confidence and action: When definitions are vague, professionals may hesitate to report or intervene, worrying about whether their concerns meet the threshold for maltreatment. Research shows that mandated reporters often cite definitional uncertainty as a barrier to taking action (Kenny, 2001). By contrast, precise definitions improve accuracy and timeliness of reports.
Consistency across jurisdictions: Children should not have different levels of protection depending on where they live. Yet Baker (2009) found that variation in state statutes can lead to reporting differences of several hundredfold. Uniform definitions aligned with APSAC’s categories help ensure similar responses to similar harms.
Data collection and research: Without clear definitions, prevalence studies underestimate how widespread PM is, and comparisons across states or countries become unreliable. As Brassard, Hart, Baker, and Chiel (2019) argue, consistent terminology is essential for building an evidence base that can guide prevention and intervention.
Policy development: Policymakers rely on accurate data and definitions to allocate resources and evaluate outcomes. Vague statutory language makes it difficult to measure progress or to demonstrate the cost-effectiveness of prevention and intervention programs (Fang et al., 2012).
Training and education: For teachers, healthcare providers, and social workers, definitions shape the content of training programs. Clear categories allow for case examples, decision-making tools, and practice scenarios that build recognition skills. Without this, many professionals remain uncertain about what qualifies as PM (APSAC, 2019).
The issue, then, is not that PM is difficult to define—it is definable, and leading researchers have reached broad consensus on its categories. The issue is that definitions are applied inconsistently, which contributes to under-identification, inconsistent substantiation, and delayed intervention.
Scholar’s Corner
“Precise definitions are essential not just for research, but for protecting children from ongoing psychological harm.”
Why This Series Matters
Defining PM is an important step. Once we know what to look for, the task becomes learning to recognize it in real time. PM may not leave physical marks, but its signs can be clear when professionals are trained to see them.
In Part 3 of this series—“Seeing the Signs: Identification and Assessment of Psychological Maltreatment”—we will examine how PM is identified in practice, the risk and protective factors that shape its course, and the role of multidisciplinary collaboration in ensuring children are not overlooked.
Something to Think About
Learning about the seven forms of psychological maltreatment can change how we view everyday interactions with children. What once seemed like “strict” or “normal” parenting may look different when seen through this lens. How is your knowledge helping you notice children who might be struggling—or support families in healthier ways? And what skills or resources would make you more confident in using this knowledge?