Light and Hope in a Neglected Corner

The sun is out!

Eliot Spitzer is in the Governor’s office in Albany!  Cathy Widom has done it again! There’s a robin in the backyard!  

O frabjous day! Callooh! Callay!
                      Jabberwocky
, Lewis Carroll

Somehow, the combination of sun, the lovely blue sky as I drove to work, and scanning the blogs and a few psychiatric journals this morning, has filled me with a lightness of heart that I haven’t had for a while.  It all gives me reason to hope.
The real story here is Cathy Widom.

Skip this next paragraph if you don’t want to know why I think she’s important. Skip the entire diary if you find scientific work boring. Just go with the good feelings. It’s a new year, and a sunny morning.

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Who is Cathy Widom and why is she important? Widom is that rare bird who does longitudinal research on people. She follows kids and adults for years and years, and sees how they start and how they turn out. This is not popular work, nor is it easy. It takes money, which pretty much only the feds can fund. Some administrations – do I really need to say which ones? – tend to cut off that sort of research.  It is risky, because you have only a short while to prove your worth to your university, and a single, big longitudinal study that may not show results before your probationary time is up isn’t going to cut it.  But Widom, somehow, has done these studies over and over again.  And quite simply, her work is terrific. If you want to predict how early events in kids lives might lead to later problems or not, research that begins with people early and follows them over time is the Gold Standard. Widom’s work is golden.
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OK.  You are safely past the skipable paragraph, if you want to go to the heart of the matter. Note:  Here’s what Cathy Widom has done:  Widom followed about 1200 kids, beginning with some in 1967, up to being adults, average age about 29. That is a very big group to follow, and a very long time to follow them. About half were kids who had legally documented cases of abuse or neglect between 1967 and 1971 (before they were 11 years old), the others were very similar but without abuse or neglect.  

She looked to see what effect earlier abuse and neglect had on these children, now that they were all legally adults.  She found that neglect put these kids at great risk for depression as children and adults. For abused kids, risk was increased mostly for depression in adulthood. Sexual abuse alone did not increase risk for depression, (though other researchers have identified difficulties other than depression). Physical abuse and neglect predicted many later difficulties. For many of her participants, the depression started earlier than adulthood, particularly for neglected children.  

Why is this important? Isn’t this obvious?  Well, no. The overwhelming majority of research on abuse & neglect is really research on abuse.  There are very few studies of neglected kids. The general assumption is that neglect is not good, but that it doesn’t harm children as abuse does.  Neglected kids, once the dirt and grime are washed off, and the children are fed and their living quarters are cleaned up, are assumed to be ok.  Neglected kids look ok in most cases.  And if you can’t see the damage, most times there isn’t enough evidence to provide help or any kind of intervention.

There have been serious discussions about removing neglect from states’ mandatory reporting laws. Much less help is offered to children who are neglected, compared to children who are abused. Some agencies are very reluctant or slow to investigate neglect reports unless children show signs of neglect that has become abusive, e.g. a child whose neglect has resulted in physical harm, meaning it is now a clear-cut abuse case. Some policy makers believe that neglect cases clog up the system and deflect attention and funds away from the serious dangers that abused children face.  I sat on a state advisory board 8 years ago where this proposal was given serious discussion by a national child advocacy group.  (We strongly objected, I’m pleased to say.)

Widom’s work is very important in calling attention to neglect.  Let me emphasize that she is not saying that physical or sexual abuse has no long-term ill effects on children. It certainly does, but her work on those issues is a matter for another discussion. The piece I’m emphasizing here is that children who are neglected suffer ill effects that go beyond their immediate physical needs, and those ill effects extend into their adult lives.  The depression that many of them will have will also cause difficulties for their children, as is known from many other research studies.

It’s sick, isn’t it? I’m happy that there is hard evidence now that neglect in childhood leads to high risk for bad outcomes years later in adult life.  I’m smiling, because the social agency folks who don’t want to waste time on doing this kind of research because they don’t believe that it is worth doing have been proven wrong.   I’m laughing because we now have evidence of the sort that the bean counters among our legislators, politicians, and opinion makers have been demanding for years – but never expecting to get.  Thank you, Cathy Widom.

And I am happy that Eliot Spitzer is now Gov. of New York, though that’s not my state. It’s a new year, and one in which more children will get to shine, I hope.