Distinguishing Between Poor/Dysfunctional Parenting and Child Emotional Maltreatment - Appendix 3

Appendix 3

Criteria for More Than Inconsequential Fear Reaction

Victim's significant fear reaction, as evidenced by both of the following

1. Fear (verbalized or displayed) of bodily injury to self or others
2. At least one of the following signs of fear or anxiety lasting at least 48 hours:
   1. Persistent intrusive recollections of the incident
   2. Marked negative reactions to cues related to incident, as evidenced by any of the following
      1. avoidance of cues
      2. subjective or overt distress to cues (Note: perpetrator can be a cue)
      3. physiological hyperarousal to cues (Note: perpetrator can be a cue)
   3. Acting or feeling as if incident is recurring
   4. Persistent symptoms of increased arousal, as evidenced by any of the following:
      1. Difficulty falling or staying asleep
      2. Irritability or outbursts of anger
      3. Difficulty concentrating
      4. Hypervigilance (i.e., acting overly sensitive to sounds and sights in the environment; scanning the environment expecting danger; feeling keyed up and on edge)
      5. Exaggerated startle response

Criteria for More Than Inconsequential Physical Injury

An injury involving any of the following:

1. Any injury to the face or head
2. Any injury to a child under 2 years of age
3. More than superficial bruise(s) (i.e., bruise that is other than very light red in color [for example, violet, blue, black] OR bruises with total area exceeding that of the victim's hand OR are tender to light touch)
4. More than superficial cut(s)/scratch(es) (i.e., would require pressure to stop bleeding)
5. Bleeding internally or from mouth or ears
6. Welt (bump or ridge raised on the skin)
7. Burns
8. Loss of consciousness
9. Loss of functioning (including, but not limited to, sprains, broken bones, detached retina, loose or chipped teeth)
10. Heat exhaustion or heat stroke
11. Damage to internal organs
12. Disfigurement (including, but not limited to, scarring)
13. Swelling lasting at least 24 hours
14. Pain felt (a) in the course of normal activities and (b) at least 24 hours after the physical injury was suffered.

Source: Richard E. Heyman and Amy Slep, Family Translational Research Group, Department of Psychology, State University of New York at Stony Brook, Stony Brook, NY 11794-2500. Used with permission.