Childhood verbal abuse shows similar impact to physical abuse

• While often not immediately obvious, its effects may be no less damaging or protracted
• Prevalence of verbal abuse has risen substantially while that of physical abuse has halved 

Being verbally abused as a child can have a very similar impact on mental health in later life as being physically abused, according to a large intergenerational study led by Liverpool John Moores University and reported widely in the media.

While often not immediately obvious, the effects of verbal abuse may be no less damaging or protracted, the findings indicate.

This large retrospective study of more than 20,000 participants examining birth cohorts from the 1950s onwards showed reductions in childhood physical abuse but increases in childhood verbal abuse. It is published today (August 6, 2025) in the open access journal BMJ Open.

Abuse can exert lifelong effects on mental and physical health and wellbeing, which can manifest as elevated anxiety and depression, problematic alcohol and drug use, risky behaviours, violence towards others and serious health issues, such as cardiovascular disease and diabetes, they explain.

Like physical abuse, verbal abuse is a source of toxic stress, which may affect the neurobiological development of children.

While estimated 1 in 6 children endures physical abuse, often from family and caregivers, around one in three children is subjected to verbal abuse.

Policy focus on physical not verbal abuse

But despite its high prevalence, policies and initiatives to prevent violence against children have tended to focus on physical abuse, often overlooking the potential impact of verbal abuse, the researchers point out. 

The team from LJMU's Public Health Research Institute, Bangor University and Public Health Wales pooled data from 7 relevant studies, involving 20,687 adults from England and Wales, and published between 2012 and 2024.  The studies had all involved questions on childhood physical and verbal abuse using the validated Adverse Childhood Experiences tool, and the short Warwick-Edinburgh Mental Wellbeing Scale to measure adult mental wellbeing. 

The survey asked participants how often they had been: feeling optimistic about the future; feeling useful; feeling relaxed; dealing with problems well; thinking clearly; feeling close to other people; and able to make up their own mind about things. 

Responses were scored from 1 (none of the time) to 5 (all of the time) and added up. Low mental wellbeing was considered as being more than one standard deviation below average scores (equivalent to around 1 in 6 of the sample). Analysis of all the data showed that experience of either physical or verbal abuse as a child was independently associated with a similar significant increase (52% and 64%, respectively) in the likelihood of low mental wellbeing as an adult.

And experience of both abuse types more than doubled this likelihood compared with no exposure to either type.  

With no support measures to combat physical abuse risk swapping one form of abuse for another (verbal).

Professor Mark Bellis, LJMU

Even when physical abuse was part of a person’s childhood experiences, those who had also experienced verbal abuse as a child faced an additional risk, with the prevalence of low mental wellbeing rising from 16% with no abuse to 22.5% (physical abuse only), 24% (verbal abuse only) and 29% (both physical and verbal abuse). 

Individual components of mental wellbeing also showed similar associations, with the prevalence of never or rarely having felt close to people in the preceding fortnight rising from 8% for neither abuse type, to 10% for physical abuse alone, to just over 13.5% for verbal abuse alone, and to just over 18%  for both types, after adjusting for potentially influential factors. 

Those born in or after 2000 had higher likelihoods of all individual poor mental wellbeing components as well as overall low mental wellbeing. And men were more likely to report never or rarely feeling optimistic, useful, or close to other people, while women were more likely to report never or rarely feeling relaxed.

The prevalence of child physical abuse halved from around 20% among those born between 1950 and 1979 to 10% among those born in 2000 or later. But the reverse was true of the prevalence of verbal abuse, which rose from 12% among those born before 1950 to around 20% among those born in 2000 or later. Reported physical and verbal abuse were both highest among those who lived in areas of the greatest deprivation. 

Mark Bellis, Professor of Public Health and Behavioural Sciences at LJMU, said: “Verbal abuse may not immediately manifest in ways that catch the attention of bystanders, clinicians, or others with a responsibility for safeguarding children. However, some impacts may be no less harmful or protracted.

“As a society, and indeed in many countries, legislation now prevents the physical abuse of children, which is a positive but it also leaves a potential void which should be filled with instructional advice and support on appropriate parenting.

“Without such support, measures to reduce the physical punishment of children risk simply swapping one type of harmful abuse for another, with equally long-term consequences.”

Notes for editors

For further information, please contact Professor Mark Bellis m.a.bellis@ljmu.ac.uk or the LJMU press office on 07725 192767 g.b.hollyman@ljmu.ac.uk

Research: Comparative relationships between physical and verbal abuse of children, life course mental well-being and trends in exposure: a multi-study secondary analysis of cross-sectional surveys in England and Wales is authored by Professor Mark Bellis, Professor Zara Quigg, Dr Nadia Butler, Dr Charley Wilson and others Doi: 10.1136/bmjopen-2024-098412

Journal: BMJ Open