Complete Your CE Test Online - Click Here developed basic problem solving or “attack” skills and have considerable difficulty in academics. ● ● Social ○ ○ May be suspicious and mistrustful of adults; or, overly solicitous, agreeable, and manipulative, and may not turn to adults for comfort and help when in need. ○ ○ Talk in unrealistically glowing terms about her family; may exhibit “role reversal” and assume a “parenting” role. ○ ○ May not respond to positive praise and attention; or, may excessively seek adult approval and attention. ○ ○ Feel inferior, incapable, and unworthy around other children; may have difficulty making friends, feel overwhelmed by peer expectations for performance, and may withdraw from social contact; may be scapegoat by peers. ● ● Emotional ○ ○ May experience severe damage to self-esteem from the denigrating and punitive messages received from the abusive parent, or the lack of positive attention in a neglectful environment. ○ ○ Behave impulsively, may have frequent emotional outbursts, and may not be able to delay gratification. ○ ○ May not develop coping strategies to effectively manage stressful situations and master the environment. ○ ○ Exhibit generalized anxiety, depression, and behavioral signs of emotional distress; act out feelings of helplessness and lack of control by being bossy, aggressive, destructive, or by trying to control or manipulate other people. ○ ○ If punished for autonomous behavior may learn that self- assertion is dangerous and may assume a more dependent posture; may exhibit few opinions, show no strong likes or dislikes, not be engaged in productive, goal-directed activity; lack initiative, give up quickly, and withdraw from challenges. Adolescents The following are common outcomes of maltreatment in adolescents: ● ● Physical ○ ○ Sickly or have chronic illnesses. ○ ○ Sensory, motor, and perceptual motor skills may be delayed and coordination may be poor. ○ ○ The onset of puberty may be affected by malnutrition and other consequences of serious neglect. ● ● Cognitive ○ ○ May not develop formal operational thinking; may show deficiencies in the ability to think hypothetically or logically, and to systematically problem-solve. ○ ○ Thinking processes may be typical of much younger children; the youth may lack insight and the ability to understand other people’s perspectives. ○ ○ Academically delayed and may have significant problems keeping up with the demands of school. School performance may be poor. ● ● Social ○ ○ Difficulty maintaining relationships with peers; they may withdraw from social interactions, display a generalized dependence on peers, adopt group norms or behaviors to gain acceptance, or demonstrate ambivalence about relationships. ○ ○ Likely to mistrust adults and may avoid entering into relationships with adults. ○ ○ Maltreated youth, particularly those who have been sexually abused, often have considerable difficulty in sexual relationships. Intense guilt, shame, poor body image, lack of self-esteem, and a lack of trust can pose serious barriers to a youth’s ability to enter into mutually satisfying and intimate sexual relationships. ○ ○ Limited concern for other people, may not conform to socially acceptable norms, and may otherwise demonstrate delayed moral development. ○ ○ Unable to engage in appropriate social or vocational roles. They may have difficulty conforming to social rules. ● ● Emotional ○ ○ Emotional and behavioral problems, including anxiety, depression, withdrawal, aggression, impulsive behavior, antisocial behavior, and conduct disorders. ○ ○ Lack the internal coping abilities to deal with intense emotions, and may be excessively labile, with frequent and sometimes volatile mood swings. ○ ○ Considerable problems in formulating a positive identity. Identity confusion and poor self-image are common; may appear to be without direction and immobilized. ○ ○ No trust in the future and may fail to plan for the future; verbalize grandiose and unrealistic goals, but unable to identify steps necessary to achieve goals; often expect failure. Human trafficking Populations at risk: While human trafficking may occur at any age, young and older teens are at highest risk. Those at highest risk for human trafficking include: ● ● Youth in the foster care system. ● ● Youth who are identified as LGBTQ. ● ● Youth who are homeless or runaway. ● ● Youth with disabilities. ● ● Youth with mental health or substance abuse disorders. ● ● Youth with a history of sexual abuse. ● ● Youth with a history of being involved in the welfare system. ● ● Youth who identify as native or aboriginal. ● ● Youth with family dysfunction. Victim identification: Identifying victims of human trafficking are often a complex and difficult task. There is often fear for victim safety and/or loyalty to the perpetrator. This may result in little cooperation of the victim when trying to validate or verify clinical findings. Some victim identification and/or warning signs are but not limited to: ● ● A youth that has been verified to be under 18 years of age and is in any way involved in the commercial sex industry, or has a record of prior arrest for prostitution or related charges. ● ● Has an explicitly sexual online profile. ● ● Excessive frequenting of internet chat rooms or classified sites. ● ● Depicts elements of sexual exploitation in drawing, poetry, or other modes of creative expression. ● ● Frequent or multiple sexually transmitted diseases or pregnancies. ● ● Lying about or not being aware of their true age. ● ● Having no knowledge of personal data, such as but not limited to age, name, and/or date of birth. ● ● Having no identification. ● ● Wearing sexually provocative clothing. ● ● Wearing new clothes of any style, getting hair and/or nails done with no financial means. ● ● Secrecy about whereabouts. ● ● Having late night or unusual hours. ● ● Having a tattoo that he/she is reluctant to explain. ● ● Being in a controlling or dominating relationship. ● ● Hot having control of own finances. ● ● Exhibit hyper-vigilance or paranoid behaviors. ● ● Express interest in or in relationship with adults or much older men or women. nursing.elitecme.com Page 15