There are many interacting causes of child abuse and neglect. Characteristics or circumstances of the abuser, the child, and the family may all contribute. In many cases the abuser was abused as a child. Substance abuse (see drug addiction and drug abuse) has been identified as a key factor in a growing number of cases. In some cases abusers do not have the education and skills needed to raise a child, thus increasing the likelihood of abuse, and providing inadequate parental role models for future generations. Children who are ill, disabled, or otherwise perceived as different are more likely to be the targets of abuse. In the family, marital discord, domestic violence, unemployment and poverty, and social isolation are all factors that can precipitate abuse.
Patterns of abusive behavior may result in the physical or mental impairment of the child or even death. Small children are especially vulnerable to physical injury such as whiplash or shaken infant syndrome resulting from battery. Abused children are more likely to experience generalized anxiety, depression, truancy, shame and guilt, or suicidal and homicidal thoughts or to engage in criminal activity, promiscuity, and substance abuse.