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.
Sexual abuse is the third most frequently reported form of child mistreatment (10% of all cases). Experts believe that sexual abuse may be the most underreported type of abuse because of the secrecy or "conspiracy of silence" that so often characterizes these cases. A generally accepted definition of sexual abuse is that of a child involved in sexual activity for which consent cannot be given, is outside of the victim's developmental age, is unable to comprehend, and/or "violates the law or social taboos of society." Examples include fondling and any form of genital, anal, or oral-genital contact with a child that are unwarranted. These acts may occur whether the child is clothed or unclothed. Non-touching child sexual abuse would include exhibitionism, voyeurism,
and the involvement of a child in prostitution or pornography.
What causes child abuse deaths?
The most lethal form of child abuse is neglect. Deaths from
neglect can, for example, be caused by accidents due to lack of
supervision or abandonment or from the failure to seek medical
attention for an injury, illness, or condition.
Fatal injuries from mistreatment can and do result from many
different acts. Children may die from severe head trauma (injury),
shaken baby syndrome, trauma to the abdomen or chest, scalding,
burns, drowning, suffocation, poisoning,
starvation, etc.
What factors predispose a person to child abuse?
Specialists evaluating an abused child's environment and family
background have noted several risk factors for potential abuse:
The abuser's childhood: Approximately 20% of offenders were
themselves abused as children.
The abuser's substance abuse: Children in alcohol-abusing
families are nearly four times more likely to be mistreated, almost five
times more likely to be physically neglected, and 10 times more
likely to be emotionally neglected than children in non-alcohol-abusing families. Of all child-abuse cases, 50%-80% involve some
degree of substance abuse by the child's parents.
Family stress: The disintegration of the nuclear family and its
inherent support systems have been held to be associated with child
abuse.
Social forces: Experts debate whether a presumed reduction in
religious/moral values coupled with an increase in the depiction of
violence by the entertainment and informational media may increase
child abuse.
The child: Children at higher risk for abuse include infants who
are felt to be "overly fussy," handicapped children, and children
with chronic diseases.
Specific "trigger" events that occur just before many fatal
parental assaults on infants and young children include an infant's
inconsolable crying, feeding difficulties, a toddler's failed toilet
training, and exaggerated parental perceptions of acts of
"disobedience" by the child.
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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