Child abuse in Hong Kong revisited after 15 years: characteristics of victims and abusers

The selective child welfare funnel. Children's exposure to violence and CWS investigations in Sweden

BACKGROUND

Research indicates that child welfare services reach out to children exposed to violence unequally depending on the child's social background, living conditions and violence type.

OBJECTIVE

Based on the notion of selective recognition of vulnerability and risk, this study explores which children CWS pursue to a complete child welfare investigation.

PARTICIPANTS AND SETTING

A register was set up including all children (n = 1764) between 7 and 12 years that were investigated for suspected exposure to violence by CWS in the municipality of the City of Stockholm, Sweden, in 2019.

METHODS

This cohort was systematically compared to demographic data and national self-report prevalence studies to explore possible biases regarding which children CWS investigates. Descriptive analysis, cluster analysis and logistic regressions were used.

RESULTS

The results confirm previous research that children exposed to violence have reduced access to material resources and inferior living conditions compared to non-exposed children. Physical abuse is more prevalent among boys of foreign backgrounds in stable, two-parent families residing in higher-status suburbs. Conversely, neglect is more common among children of Swedish backgrounds in low-income, single-parent households living in low-status suburbs. In comparison with self-reported prevalence studies, sexual and psychological abuse seem underrepresented in the study group, while neglect and violence in the family are relatively more frequently investigated compared to self-reported prevalence studies.

CONCLUSIONS

The results indicate that CWS should develop its methods to reach certain vulnerable groups that are underrepresented for safeguarding and support, for example, girls exposed to sexual abuse.

Childhood maltreatment and impulsivity in offenders: Examining the mediating roles of self-compassion and cognitive reappraisal

BACKGROUND

The higher impulsivity of offenders in prison is a challenge for prison intervention. Childhood maltreatment, one of the factors closely related to the generation and development of impulsivity, is also prevalent in offenders. Therefore, it is critical to investigate the underlying paths that generate impulsivity in offenders who have experienced childhood abuse.

OBJECTIVE

Targeting positive protective factors, this study aimed to probe the mediating roles of self-compassion and cognitive reappraisal in the relationship between childhood maltreatment and impulsivity in offenders.

METHODS

The participants included 2643 offenders, 1534 males and 1109 females. Each participant completed the appropriate questionnaires to measure childhood maltreatment, impulsivity, self-compassion, and cognitive reappraisal. The PROCESS macro was used to perform the mediation analysis and hypothesis testing.

RESULTS

The findings showed that childhood maltreatment indirectly affected offenders' impulsivity through self-compassion and cognitive reappraisal, and the mediating effect of self-compassion was stronger than that of cognitive reappraisal. Further analyses found that sexual abuse indirectly affected impulsivity through self-compassion, and the remaining types of childhood maltreatment were associated with impulsivity in indirect pathways through self-compassion and cognitive reappraisal.

CONCLUSIONS

The results suggest that reinforcing practical training in self-compassion and cognitive reappraisal, especially the former, might facilitate the reduction of impulsive symptoms among offenders with backgrounds of childhood maltreatment.

Understanding factors associated with barefoot social workers' decision making in assessing and reporting child physical abuse in China

BACKGROUND

Mandatory reporting is new in China, and barefoot social workers are responsible for detecting and reporting child maltreatment.

OBJECTIVE

Guided by the decision-making ecology, this study examined factors associated with barefoot social workers' decision making in assessing and reporting child physical abuse in China.

PARTICIPANTS AND SETTINGS

Cross-sectional data were collected from barefoot social workers (N = 1489) in a metropolitan city in Southern China.

METHODS

Descriptive, bivariate, and binary logistic regression analyses were conducted. Dependent variables were barefoot social workers' assessments of and intention to report child physical abuse in two cases.

RESULTS

For a less severe physical abuse case, case severity (OR = 2.78, p < .001), receiving a social worker license (OR = 1.64, p = .03), and having a reporting history (OR = 23.55, p = .03) were associated with higher odds of assessments, whereas being younger (OR = 0.97, p = .04) was associated with lower odds. For a more severe physical abuse case, case severity (OR = 3.64, p < .001) and child welfare training (OR = 2.27, p = .03) were associated with higher odds of assessments. Across two cases, case severity (Case 1: OR = 1.44, p < .001; Case 2: OR = 1.34, p < .001), assessment of whether it is abuse (Case 1: OR = 11.48, p < .001; Case 2: OR = 15.98, p < .001), impacts of reporting on the family (Case 1: OR = 1.21, p < .001; Case 2: OR = 1.25, p < .001), and perceived behavior control (Case 1: OR = 1.06, p = .01; Case 2: OR = 1.10, p = .01) were associated with higher odds of reporting. Impacts of reporting on the child (OR = 1.27, p < .001) were associated with higher odds of reporting the less severe case. Attitudes regarding punishment of offenders or victims of child abuse (OR = 1.09, p = .01) and subjective norms of reporting (OR = 1.09, p = .01) were associated with higher odds of reporting the more severe case.

CONCLUSIONS

This study identified factors associated with barefoot social workers' decision making in assessing and reporting child physical abuse in China. Results of this study indicate the importance of providing training to barefoot social workers on recognizing, detecting, and reporting child physical abuse. It is also important to encourage them to receive continued social work training and obtain a social work license, which may increase their confidence in decision making. Furthermore, increasing the effectiveness of mandatory reporting is needed.

Family Risk Factors Associated With Oppositional Defiant Disorder Symptoms, Depressive Symptoms, and Aggressive Behaviors Among Chinese Children With Oppositional Defiant Disorder

Family factors including parental emotion dysregulation and harsh parenting practices place children at high risk for malfunctioning in emotion regulation, depressive symptoms, and aggressive behaviors. This study investigated the associations among parental emotion dysregulation, harsh parenting practices (i.e., emotional abuse and corporal punishment), and child emotion regulation and child oppositional defiant disorder (ODD) symptoms and co-occurring depressive symptoms and aggressive behaviors. Participants included 239 parent-child dyads from 14 primary schools in Mainland China. All children were diagnosed with ODD. Parental emotion dysregulation, harsh parenting practices, and child emotion regulation were reported by parents; child ODD symptoms were reported by parents and teachers; child depressive symptoms were reported by children; and child aggressive behaviors were reported by teachers. Data indicated that parental emotion dysregulation was related to child ODD symptoms in the home and depressive symptoms indirectly through harsh parenting practices and child emotion regulation. Harsh parenting practices were related to child ODD symptoms in the home directly and indirectly through child emotion regulation. Moreover, emotional abuse was associated with child depressive symptoms directly and indirectly through child emotion regulation. Our findings highlighted the need for prevention and intervention targeting parent emotion dysregulation and harsh parenting practices among children with ODD.

Attitudes mediate the intergenerational transmission of corporal punishment in China

This research aimed to examine the intergenerational transmission of corporal punishment and the role of parents' attitudes toward corporal punishment in the transmission processes in Chinese societies. Based on social-cognitive theory, it was hypothesized that parents' attitudes toward corporal punishment would mediate the transmission of corporal punishment. Seven hundred and eighty-five fathers and eight hundred and eleven mothers with elementary school-age children (data collected in winter 2009) were recruited through convenience sampling techniques. The Chinese version of Parent-Child Conflict Tactics Scale (CTSPC) and Attitude toward Physical Punishment Scale (ATPP) were used as the main assessment tools to measure parents' corporal punishment experiences in childhood, current use of corporal punishment and attitudes toward corporal punishment. Findings revealed that the strength of intergenerational transmission of corporal punishment was strong and parents' attitudes toward corporal punishment played a mediating role in the continuity of corporal punishment for both fathers and mothers in China. The findings highlighted the role of attitudes in the intergenerational transmission of corporal punishment within the Chinese cultural context and also suggested the need for intervention programs to focus on modification of maladaptive attitudes toward what is appropriate and effective discipline.

Advocacy Journey Promoting Child Sexual Abuse Prevention in Hong Kong

In a country without a mandatory child abuse reporting system, advocacy for child welfare law can be a tedious and difficult process. This article documents a 10-year advocacy journey based on the capacity-building concept in social sustainability theory which aims to: raise public awareness of child sexual abuse, provide an idea for branding an inquiry column, and connect advocacy efforts to law reforms. Over the past decade in Hong Kong, a total of 336 public inquiries were anonymously sent to Wu Miu Column and published in three local major newspapers. Among these inquiries, 131 inquiries involved child sexual abuse that the "affected individuals" were molested in school or at home and knew the abusers but did not report their cases to child protection services. Inquirers reported more male than female abusers. Proportionally and significantly, female abusers tended to abuse younger children, compared to male abusers who tended to abuse older children. Many abusers were minors who abused younger children, which explains people's reluctance to report the abuse to child protection services. The discovery of this underage phenomenon motivated child advocates to challenge the common law presumption that a boy under the age of 14 is incapable of sexual intercourse. Social workers in this advocacy journey must sustain continuous efforts to prevent youth from becoming future perpetrators.

Family Polyvictimization and Elevated Levels of Addiction and Psychopathology Among Parents in a Chinese Household Sample

When studying the co-occurring victimization within a family, current literature often focuses on individual violence and fails to cover more than two forms of violence. This study fills the research gap by using families, instead of individuals, as units and investigating the prevalence of family polyvictimization. Family polyvictimization is defined as the co-occurrence of child victimization, intimate partner violence (IPV) between parents, and elder abuse within a family. This study analyzed a set of data from 7,466 households, with at least a child under 18 years of age, in six regions in China collected during 2009 and 2010. Descriptive analyses and ordinal logistic regressions were performed to explore the prevalence of family polyvictimization, as well as its associations with parents' addictive behaviors and negative health factors. The lifetime prevalence and the past-year prevalence of family polyvictimization was 2.53% and 1.09%, respectively. Parents from a polyvictimized family were more likely to report addictive behaviors, and to show poorer mental health and more posttraumatic stress disorder (PTSD) and depressive symptoms than those who were less exposed to violence. Findings show the importance of the whole-family approach to screening multiple types of violence within a family when one type is detected, as well as the potential usefulness of identifying at-risk families among parents with addictive behaviors and poor mental health.

Child maltreatment and interpersonal relationship among Chinese children with oppositional defiant disorder

Child maltreatment negatively affects children's development and wellbeing. This study investigated the associations between child maltreatment (i.e., emotional neglect, emotional abuse, and physical abuse) and interpersonal functioning, including parent-child relationship, teacher-student relationship, and peer relationships among children with oppositional defiant disorder (ODD). A total of 256 children with ODD and their parents and class master teachers from Mainland China completed questionnaires. Results showed a negative correlation between emotional abuse (parent-reported) and children's interpersonal relationships with parents, teachers, and peers. Emotional neglect and physical abuse were related to poor parent-child relationships. Latent profile analysis revealed three profiles of child maltreatment among children with ODD. ODD children with more severe levels of one type of maltreatment were also more likely to have experienced severe levels of other types of maltreatment. Children with ODD who were in the group of high maltreatment had the poorest quality of interpersonal relationships. Our findings highlight the urgent need to prevent child maltreatment and promote more positive parenting in families with ODD children.

Predictors of re-entry into the child protection system in Singapore: a cumulative ecological-transactional risk model

This study examines the risk factors of re-entry for 1,750 child protection cases in Singapore using a cumulative ecological-transactional risk model. Using administrative data, the present study found that the overall percentage of Child Protection Service (CPS) re-entry in Singapore is 10.5% based on 1,750 cases, with a range from 3.9% (within 1 year) to 16.5% (within 8 years after case closure). One quarter of the re-entry cases were observed to occur within 9 months from case closure. Seventeen risk factors, as identified from the extant literature, were tested for their utility to predict CPS re-entry in this study using a series of Cox regression analyses. A final list of seven risk factors (i.e., children's age at entry, case type, case closure result, duration of case, household income, family size, and mother's employment status) was used to create a cumulative risk score. The results supported the cumulative risk model in that higher risk score is related to higher risk of CPS re-entry. Understanding the prevalence of CPS re-entry and the risk factors associated with re-entry is the key to informing practice and policy in a culturally relevant way. The results from this study could then be used to facilitate critical case management decisions in order to enhance positive outcomes of families and children in Singapore's care system.

Child victims and poly-victims in China: are they more at-risk of family violence?

Multiple forms of violence may co-occur on a child. These may include various forms of child victimization and different types of family violence. However, evidence that child victims are more likely to witness other types of family violence has been lacking in China. Using data of a large and diverse sample of children recruited from 6 regions in China during 2009 and 2010 (N=18,341; 47% girls; mean age=15.9 years), the associations between child victimization and family violence witnessed were examined. Descriptive statistics and the associations between child victimization, demographic characteristics, and family violence witnessed were analyzed. Lifetime and preceding-year rates were 71.7% and 60.0% for any form of child victimization and 14.0% and 9.2% for poly-victimization (having four or more types of victimization), respectively. Family disadvantages (i.e., lower socio-economic status, single parents, and having more than one child in the family) were associated with child victimization and poly-victimization. Witnessing of parental intimate partner violence, elder abuse, and in-law conflict also increased the likelihood of child victimization and poly-victimization, even after the adjustment of demographic factors. Possible mechanisms for the links between family violence and child victimization are discussed. The current findings indicated the need for focusing on the whole family rather than the victim only. For example, screening for different types of family violence when child victims are identified may help early detection of other victims within the family.

The Evolving Evidence Base for Child Protection in Chinese Societies

Child maltreatment is a substantial public health problem worldwide. Although extensively studied in Western countries, until recently little systematic research had been published about the situation in the world's most populous nation and ethnic diaspora. In this review, we examine trends from community-based research with Chinese young people and parents in mainland China, Hong Kong SAR, Taiwan, Singapore, and Malaysia. It is clear that many Chinese adolescents experience a substantial burden from various forms of maltreatment and the psychological and behavioral correlates are similar to those found in other cultures. However, the research reveals a large gap between this reality and Chinese adults' perceptions about emotional, physical, and sexual abuse. Comprehensive awareness programs are needed to close this information gap and thereby mobilize support for prevention and care initiatives.

Childhood physical and sexual abuse: prevalence and correlates among adolescents living in rural Taiwan

OBJECTIVE

The aims of this cross-sectional survey study were to examine the prevalence and correlates of childhood physical and sexual abuse in adolescents living in the rural areas of Taiwan.

METHOD

A sample of indigenous (n=756) and non-indigenous (n=928) adolescents was randomly selected from junior high schools in the rural areas of southern Taiwan. Structured questionnaires were used to collect data anonymously. The prevalence of childhood physical and sexual abuse was examined and their correlates were examined using univariate and multivariate logistic regression.

RESULTS

A total of 374 (22.2%) adolescents reported experience of physical abuse and 42 (2.5%) reported sexual abuse in their childhood. Multivariate logistic regression analyses revealed that the adolescents who perceived poor family function, frequent family conflicts and whose parents drank habitually were more likely to experience physical abuse. The adolescents who were indigenous and perceived frequent family conflicts were more likely to experience childhood sexual abuse. Further analyses indicated that indigenous boys had a higher risk of being the victims of sexual abuse than non-indigenous boys, while no difference was found between indigenous and non-indigenous girls.

CONCLUSION

The results remind clinical workers of the importance of taking abuse histories from adolescents on a routine basis, and this is especially important in the case of dysfunctional families.

PRACTICE IMPLICATIONS

Adolescents who live in rural areas have less social and medical resources for early detection and intervention of physical and sexual abuse. Correlates of physical and sexual abuse identified in this study may be helpful for the design and implementation of preventive intervention.

Corporal punishment and physical maltreatment against children: a community study on Chinese parents in Hong Kong

OBJECTIVE

This study aimed to examine rates and associated factors of parent-to-child corporal punishment and physical maltreatment in Hong Kong Chinese families.

METHOD

Cross-sectional and randomized household interviews were conducted with 1,662 Chinese parents to collect information on demographic characteristics of parents and children, marital satisfaction, perceived social support, evaluation of child problem behaviors, and reactions to conflicts with children. Descriptive statistics, analyses of variances, and logistic regression analyses were conducted.

RESULTS

The rates of parent-to-child physical aggression were 57.5% for corporal punishment and 4.5% for physical maltreatment. Mothers as compared to fathers reported higher rates and more frequent use of corporal punishment on their children, but this parental gender effect was insignificant among older parents and those with adolescent children. Boys as compared to girls were more likely to experience higher rates and more frequent parental corporal punishment, especially in middle childhood at aged 5-12. Furthermore, parents perpetrated more frequent physical maltreatment on younger as compared to older children. Results from logistic regression analyses indicated that significant correlates of parental corporal punishment were: children's young age, male gender, and externalizing behaviors as well as parents' young age, non-employment, and marital dissatisfaction. For parent-to-child physical maltreatment, significant correlates were externalizing behaviors of children and parental marital dissatisfaction.

CONCLUSIONS

Hong Kong Chinese parents commonly used corporal punishment on their children, which was associated with characteristics of children, parents, and family.

Nurses' intention to report child abuse in Taiwan: a test of the theory of planned behavior

The purposes of this study were to identify factors associated with nurses' intention to report suspected child abuse in Taiwan, and to determine the empirical adequacy of the extended theory of planned behavior (TPB) to explain nurses' intention to report child abuse. A stratified quota sampling technique was used to select registered nurses in emergency rooms, psychiatric units, and pediatric units in Taiwan. A total of 1,362 questionnaires from 1,617 nurses were used for the analyses. Structural equation modeling demonstrated that nurses' attitudes toward reporting child abuse, perceived behavioral control, subjective norms, and knowledge of the child abuse and reporting law explained 85% to 91% of the variance in nurses' intention to report child abuse for the less severe and severe child abuse cases in vignettes, respectively. The findings support the use of the extended TPB in identifying factors associated with nurses' intention to report child abuse in Taiwan.

Factors associated with nurses' intention to report child abuse: a national survey of Taiwanese nurses

OBJECTIVE

The objectives were to determine the experiences of Taiwanese nurses with a new child abuse reporting law and to assess attitudinal correlates of nurses' intention to report.

METHOD

A stratified quota sampling technique was used to select registered nurses working in pediatric, psychiatric and emergency care units in Taiwan. A total of 1400 (return rate 88%) questionnaires from 1617 nurses were used. The questionnaire includes demographic information, attitudes toward and knowledge of child abuse and reporting laws, and eight vignettes of child abuse.

RESULTS

Most nurses (86%) said they had never reported a child abuse case; 21% said they had failed to report a suspected case of child abuse. Most (80%) had never had any child abuse education. About 75% felt their nursing education and in-service training was inadequate or absent. Most had an inadequate knowledge of the reporting law (mean score: 60% correct). Nurses only answered 17-43% of the law-related questions correctly. The majority accepted the professional responsibility to report. There were some differences among pediatric, psychiatric and emergency care nurses. In general, these Taiwanese nurses had negative attitudes toward corporal punishment and toward parents who abuse their children. The study also identified a variety of attitudes related to intention to report relevant to the Theory of Planned Behavior.

CONCLUSIONS

Nurses accept responsibility for reporting but they believe their professional preparation for reporting is inadequate. There is a strong need for in-service and pre-service education about child abuse among nurses in Taiwan.

The meaning of child abuse for nurses in Taiwan

The purpose of this study was to explore nurses' experiences and perspectives regarding child abuse in Taiwan. Semistructured interviews with Taiwanese nurses were audiotaped and transcribed verbatim for this descriptive study. The method of category development proposed by the grounded theory method was used to develop categorical themes that reflected the nurses' experiences and perspectives. From the 18 registered nurses interviewed, four major categorical themes emerged that were integral to nurses' experiences working with abused children: the meaning of child abuse, conflict, feeling frustrated, and nurses' roles. Findings provide a base for understanding child abuse from the perspectives of nurses and a beginning understanding of interventions needed to improve identification and reporting of child abuse in Taiwan. Although nurses have considerable awareness and concern about child abuse, additional education related to this issue is needed.

Intention to participate in child sexual abuse prevention programs: a study of Chinese adults in Hong Kong

OBJECTIVES

This study aimed to explore factors relating to intention to participate in community child sexual abuse (CSA) prevention programs among Chinese adults in Hong Kong.

METHOD

A total of 1,606 Chinese adults (497 men and 1,109 women) were individually interviewed about their intention to participate in community CSA prevention programs, endorsement of myths about CSA, their acquaintance with CSA victims, worry about CSA, and perceived prevalence of CSA.

RESULTS

Among participants, nearly two-thirds believed CSA involved physical injuries of victims, 40% perceived boys as unlikely victims of CSA, and one-third were skeptical about children reports of CSA. About 24% of participants reported that they would definitely take part in CSA prevention programs. Participants who showed definite intention to participate in these programs endorsed fewer myths in relation to CSA, showed more worry about children being at risk of sexual abuse, perceived CSA as more prevalent and involving more physical injuries of victims, and were more likely to be women.

CONCLUSIONS

Attention should be addressed to predisposing factors of adult participation in CSA prevention programs.

Characteristics of child sexual abuse cases referred for psychological services in Hong Kong:a comparison between multiple incident versus single incident cases

This study examined 58 sexually abused children referred for clinical psychological services in 1999 in Hong Kong and compared the characteristics and disclosure patterns between those with multiple incidents of abuse and those with single incident. The former group was more likely to have been abused by a family member, took a longer time to disclose, and was more often abused in contexts where the abusers had control and power. Over 40% of subjects also reported presence of other persons during abuse. Myths and misconceptions among professionals are highlighted. Implications on future service development and training needs in child protection are discussed.

Childhood experience of sexual abuse among Hong Kong Chinese college students

OBJECTIVES

This study aimed to explore the prevalence rate and profiles of abusers and victims of child sexual abuse in a Chinese society.

METHOD

A convenience sample of 2,147 Hong Kong Chinese college students completed questionnaires which included items on definitions of child sexual abuse, recall of sexual abuse experience before age 17, information about the sexual abuse incidents, and personal demographics.

RESULTS

The overall prevalence rate for various forms of child sexual abuse was 6%, with the rates being higher for females than for males. The average age of the victims at the time of the sexual abuse was 11 years old, with a majority of them experiencing sexual abuse during their teenage years. The average age of the abusers as estimated by the victims was 24 years old, and only 28% of the abusers were strangers to the victims. Males were about three times more likely than females to be sexually abused by their friends, whereas females were about twice more likely than males to be sexually abused by strangers. Only 39% of the victims reported their sexual victimization to others, and 56% of the reported incidents were not followed up.

CONCLUSIONS

As compared to Western studies, the present study showed lower rates for more intimate or severe forms of child sexual abuse. The Chinese victims were more reluctant to disclose their sexual victimization than their Western counterparts. Limitations and practical implications of the study are also discussed.

Incest and women of color: a study of experiences and disclosure

Clinical literature on incest trauma assumes a homogeneity of experience of all incest survivors including women of color. Experiences relating to community, culture, and family need to be acknowledged as salient aspects of the experiences of women of color who are also incest survivors. Twelve participants were interviewed regarding their experiences related to disclosure and coping. Participants described value systems, community mindedness, social attitudes, negative consequences amongst other social and cultural issues as factors affecting incest disclosure. Participants described cognitive reframing, determination and separation from the perpetrator as ways of coping with incest.

Conceptualization, reporting and underreporting of child abuse in Hong Kong

OBJECTIVE

To understand the conceptualization of child abuse and attitudes on reporting behaviors of Hong Kong adults.

METHODS

Cross-sectional telephone survey of 1,001 randomly selected subjects.

MAIN RESULTS

There is a discrepancy between perceived prevalence and the ability to name different child abuse types without prompting: 79.9% named physical abuse, while 41.2% felt it was common: 21.0% named child neglect, while 76.9% felt it was common; 13.4% named psychological abuse, while 47.4% felt it was common; 6.8% named sexual abuse, while 23.5% felt it was common. Most respondents classified severe physical abuse situations as abusive (e.g., "severely injuring a child"). Other scenarios such as "mildly injuring a child" and neglect and psychological abuse scenarios (e.g., "leaving a young child alone at home" and "shouting at a child often") were often not classified as abusive. As regards case-reporting behavior, only about 40% would report abuse cases to authorities. Those who would not report abuse were less likely to classify abuse situations as abusive and more likely to think that seeking help is difficult, troublesome and unhelpful.

CONCLUSIONS

The official reported prevalence figures for child abuse in Hong Kong should be interpreted with care, because underreporting is likely to be serious. Hong Kong people's conceptualization and awareness of what comprises child abuse is found to differ from official definitions. They are reluctant to report abuse cases, due to their perceived low efficacy of case reporting. Both the difference in conceptualization and the reluctance to report might partly be attributable to Chinese culture.

Prevalence and correlates of physical abuse in Hong Kong Chinese adolescents: a population-based approach

OBJECTIVE

The objectives were to estimate the prevalence and correlates of physical abuse-related outcomes in the family setting in Hong Kong's adolescent population.

METHOD

A cross-sectional study design was used. A randomly selected sample of 3,355 secondary school students in Kwai Tsing District of Hong Kong was surveyed. The response rate was 98%.

RESULTS

The prevalence rates of corporal punishment, being beaten by parents for no apparent reason, being beaten to injury by family members in the past 3 months and any one of the above three were 4.9% (95% CI, 4.2% to 5.6%), 2.0% (95% CI, 1.5% to 2.5%), 1.1% (95% CI, .98% to 1.2%) and 6.6% (95% CI, 5.7% to 7.5%), respectively. Students who had experienced the above physical abuse-related outcomes were at a significant disadvantage for a wide range of morbidity indicators, including self-perceived bad health, anxiety and stress, somatic illnesses (such as asthma and epigastric pain), injuries and accidents, and hospitalization. They were more likely to have poor familial relations and coping skills, and to take up habits which potentially put their health at risk, such as smoking, alcohol consumption, and fighting with others.

CONCLUSIONS

Our prevalence estimates of physical abuse in the family setting for a student population in Hong Kong is an improvement over previous local estimates of physical abuse occurrence, which were mainly based on case notifications and clinical samples. The results also show that the abused adolescents are growing up in an environment filled with physical, psychological, and familial adversities.

The rate of physical child abuse in Chinese families: a community survey in Hong Kong

OBJECTIVE

This study aimed to describe the extent and pattern of parental child battering in Chinese families in Hong Kong. It was hypothesized that the unique feature of filial piety in Chinese culture will create a different pattern of child abuse in Hong Kong when compared to Western societies.

METHOD

A telephone survey of 1,019 households randomly selected from the local residential telephone directory was completed. Three hundred and fifty-nine fathers and 660 mothers of a child at or under the age of 16 participated in the study. The occurrence of child abuse was assessed by the Chinese version of the Conflict Tactics Scale (Straus, 1979).

RESULTS

The base rate of physical child abuse was 526 per 1,000 children for minor violence and 461 per 1,000 children for severe violence. Minor violence was most likely directed at children aged 3-6 years or children without siblings in the family; and committed by mothers, parents aged 19-37 years, or housewives/unemployed fathers. The highest rate of severe violence occurred among boys or children aged 3-6 years; and was committed by mothers, parents aged 19-37 years, or housewives/unemployed fathers. Common risk factors of child abuse were identified for Chinese and US families.

CONCLUSIONS

When compared to US families, Chinese families showed slightly lower rates of minor violence but higher rates of severe violence toward children. Children aged 3-6 years were the most vulnerable victims and female caregivers the most likely abusers in both US and Chinese families. Our findings also suggested that it cannot be assumed that results based on local official statistics and clinical samples regarding the extent of child abuse and characteristics of the victims and abusers can be accurately extended to community samples.