Food Restriction as a Form of Child Abuse in Ten Cases of Psychosocial Deprivation Dwarfism

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Abstract
Ten children with a psychosocial deprivation syndrome had linear growth failure, retarded bone age, a voracious and bizarre appetite, and behavior abnormalities which were a consequence of maternal rejection. Direct and indirect evidence suggests that their food had been persistently restricted by mothers who abused the children physically and had personality traits characteristic of such mothers. Most of the children had a low IQ. Weight recovery occurred regularly in the hospital and in three cases in the home, providing food was not restricted. Diagnosis was difficult because ravenous appetites and abnormal stools suggested malabsorption in seven cases; however, histories, absorption tests, and weight recovery which occurred despite temporary persistence of abnormal stools indicated that malabsorption was not the primary cause of malnutrition. Deviant be havior and abnormal stools were used to rationalize frustration and food restriction. Intensive psychotherapy of the mother is necessary.