Psychological concomitants, more than the severity of the acts themselves, constitute the real trauma in child abuse and are responsible for the damaging consequences of physical and sexual abuse. Five distinct subtypes of psychological maltreatment can be identified: (1) spurning, a type of verbal battering that combines rejection and hostile degradation; (2) terrorizing, threatening to physically hurt, kill, or abandon the child if he or she does not behave; (3) isolating, the active isolation of a child by an adult in a closet or room for an extended period of time; (4) exploiting or corrupting, modeling antisocial acts and unrealistic roles or encouraging and condoning deviant standards and beliefs; and (5) denying emotional responsiveness, ignoring a child's attempts to interact and reacting to a child in a mechanistic way. Research strongly associates psychological maltreatment with a wide range of emotional and behavioral problems. A case study demonstrates the significance of medical, legal, social, and family issues associated with psychological abuse of children as well as assessment procedures and treatment options. The case study shows that psychological maltreatment affects the victim's sense of self, interpersonal relationships, and world view. 44 references