Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Is there an association between poverty and child abuse?
While children of families in all income levels suffer
maltreatment, research suggests that family income is strongly
related to incidence rates. Children from families with annual
incomes below $15,000 per year are more than 25 times more likely
than children from families with annual income above $30,000 to be
harmed or endangered by abuse or neglect. Poverty clearly
predisposes to child abuse. Currently, social scientists are questioning the previous interpretation of such data. Recently new research is challenging this belief. Some argue that poor families have increased contact with reporting agencies -- social workers, police, etc. Some also argue that affluent families are more often given the "benefit of the doubt" by those who might be more suspicious of poorer means. In addition, wealthier families are felt to have a better access to legal counsel that, realistically or not, provide an "escape hatch" from investigation and prosecution.
Who abuses children?
According to the statistics, the majority of perpetrators of child
mistreatment (77%) are
parents and another 11% are other relatives of the victim. People
who are in other caretaking relationships to the victim (for example, child-care providers, foster parents, and facility staff) account for only
2% of the offenders. About 10% of all perpetrators are
classified as non-caretakers or unknown. In many states, child
abusers by definition must be in a caretaking role.
An estimated 81% of all offenders are under age 40. Overall,
approximately 61% of perpetrators are female, although the gender of
the abuser differs by the type of mistreatment. Neglect and medical
neglect
are most often attributed to female caretakers, while sexual abuse
is most often associated with male offenders.
Borderline personality disorder is a serious mental illness characterized by pervasive instability in moods, interpersonal relationships, self-image, and behavior. This instability often disrupts family and work life, long-term planning, and the individual's sense of self-identity. Originally thought to be at the "borderline" of psychosis, people with borderline personality disorder (BPD) suffer from a disorder of emotion regulation.
Dissociative identity disorder (formerly known as multiple personality disorder or split personality disorder) is a mental illness in which a person has at least two distinct personalities. Symptoms and signs include lapses in memory, feeling unreal, blackouts in time, hearing voices in their head that are not their own, not recognizing themselves in the mirror, and finding items in one's possession but not recalling how they were acquired. Treatment usually involves psychotherapy, medications, and sometimes hypnosis.
Rhabdomyolysis is a rapid deterioration and destruction of skeletal muscle. Some of the causes of rhabdomyolysis include severe burns, muscle trauma, coma, seizures, electrolyte imbalance, medications (statins), viruses, bacteria. Treatment of rhabdomyolysis depends on the cause.
Drug addiction is a chronic disease that causes drug-seeking behavior and drug use despite negative consequences to the user and those around him. Though the initial decision to use drugs is voluntary, changes in the brain caused by repeated drug abuse can affect a person's self-control and ability to make the right decisions and increase the urge to take drugs. Drug abuse and addiction are preventable.
Pubic lice (crabs) are parasitic insects found in the genital area, and are primarily spread through sexual contact. Symptoms of crabs include itching and visible nits (lice eggs) and crawling lice. Treatment includes using lice-killing shampoo and washing bedding and clothing in hot water.
Antisocial personality disorder (ASPD) has many symptoms, signs, and causes. Therapy is one treatment option for antisocial personality disorder. It is closely related to other personality disorders (PD), such as borderline personality disorder and narcissistic personality disorder.
Cerebral palsy (CP) is an abnormality of motor function and postural tone acquired at an early age (even before birth). Cerebral palsy is generally caused by brain trauma. Types of cerebral palsy include: spastic, choreoathetoid, and hypotonic. There is no cure for cerebral palsy, and treatment is generally managing the symptoms of the condition.
Learning disabilities can cause an individual to have trouble learning and using skills such as reading, listening, writing, reading, speaking, reasoning, and performing mathematics. There is no cure for learning disabilities. Parents and teachers working together to properly diagnose learning disabilities can properly plan a course of education. For some, medication may be appropriate as complimentary treatment.
Shaken baby syndrome is a form of child abuse in which violent shaking of an infant causes the brain to move inside the skull, causing bruising of the brain and tearing of blood vessels. The shaking results in bleeding around the brain, bleeding in the eyes, spinal cord and neck injuries, bruises, and rib fractures. Infants who survive may suffer brain damage and blindness.
Childhood depression can interfere with social activities, interests, schoolwork and family life. Symptoms and signs include anger, social withdrawal, vocal outbursts, fatigue, physical complaints, and thoughts of suicide. Treatment may involve psychotherapy and medication.
Compulsive gambling is a disorder that affects millions in the U.S. Symptoms and signs include a preoccupation with gambling, lying to family or loved ones to hide gambling, committing crimes to finance gambling, and risking importance relationships and employment due to gambling. Treatment may incorporate participation in Gamblers' Anonymous, psychotherapy, and medications like carbamazepine, topiramate, lithium, naltrexone, antidepressants, clomipramine, and fluvoxamine.
Domestic violence, or intimate partner abuse, is when one person in an intimate relationship uses any means to control the other person. It may take many forms, including emotional, psychological, physical, sexual, or economic abuse. Risk factors for domestic violence include drug and alcohol abuse, unemployment, and having a relationship with the victim. Part of treating domestic violence involves keeping the victim safe and developing a safety plan for home and the workplace.
Growth plate fractures and injuries occur in the area growing tissue near the end of the long bones of children and teens. Both boys and girls are susceptible to growth plate fracture and injury. Common causes include: a fall while playing sports or playing on furniture or playground equipment, overuse injury from sports, injuries from competitive sports, child abuse, frostbite, and juvenile arthritis. Growth plate fracture and injury are classified into five categories according to the Salter-Harris Classification.
There are many forms of sexual assault, including rape, attempted rape, child molestation, sexual intercourse that you say no to, inappropriate touching, and vaginal, anal, or oral penetration. Sexual assault can also be anything that forces someone to join in unwanted sexual contact or attention, such as voyeurism, exhibitionism, incest, and sexual harassment.
Munchausen syndrome by proxy (MSBP) is a mental illness (factitious disorder) in which a caregiver secretly abuses a child by faking symptoms in the child. Symptoms present in the child include suffocation, bleeding, poisoning, and induced seizures. Treatment involves maintaining the safety of the child and typically incorporates psychotherapy and psychiatric medications for both the perpetrator and victim.
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