The Cycle of Violence: Examining Attitudes Toward and Experiences of Corporal Punishment in a Representative German Sample

Abusive head trauma: The body of the iceberg - A population-based survey on prevalence and perpetrators

BACKGROUND

Research on abusive head trauma (AHT) is usually research on clinically identified cases, while population-based studies, having the potential to identify cases of shaking that did not end with hospital admission, are missing to date.

OBJECTIVE

Thus, we aimed to assess the prevalence of AHT and associated risk factors in a representative sample of the German population.

PARTICIPANTS AND SETTING

We conducted a cross-sectional, observational study in Germany from July to October 2021. Using different sampling steps including a random route procedure, a probability sample of the German population was generated. The final sample consisted of 2503 persons (50.2 % female, mean age: 49.5 years).

METHODS

Participants were asked about sociodemographic information in a face-to-face interview and whether they had been ever responsible for the care of an infant and whether they had ever performed potential harmful methods including shaking to calm it, intimate partner violence (IPV) and adverse childhood experiences (ACEs) using a questionnaire.

RESULTS

In total, 1.4 % of women (N = 18) and 1.1 % of men (N = 13) reported to have at least once shaken an infant to calm it. Ever having used a potential harmful parenting method in calming an infant was reported by 4.9 % of women (N = 61) and 3.1 % (N = 39) of men. No gender differences were seen. A low income, living with someone under 16 in the household and victimization and perpetration of IPV and ACEs are associated with increased risks of shaking and other potential harmful methods to calm an infant.

CONCLUSIONS

Our data suggest that despite better knowledge on the dangers of shaking, the percentage of women that shake infants might be higher than previously thought. Also, intimate partner violence and ACEs are key risk factor for shaking and harmful parenting behaviors in general. This has important implications for future prevention programs.

Physically Violent Parental Practices: A Cross-Cultural Study in Cameroon, Switzerland, and Togo

Violence against children and adolescents is a widespread problem. However, most studies conducted in this field has been carried out in Western countries and studies are needed in non-Western countries, especially in Sub-Saharan Africa, where rates of child physical violence are high. The present study aimed firstly to document the different forms of physical violence and attitudes toward corporal punishment (CP) across Cameroon, Switzerland, and Togo. The second objective aimed, on the one hand, to understand the influence of cultural context, childhood physical abuse, and parental attitudes on physically violent parental practices in these three different cultural contexts. On the other, this study aimed to investigate the mediating role of childhood physical abuse and parental attitudes on the effect of cultural contexts on parental practices. Five hundred and forty-seven parents from Togo, Cameroon, and Switzerland filled out questionnaires concerning violent parental practices (ICAST-P), childhood physical abuse (CTQ-SF), and parental attitudes in favor of CP. Firstly, results highlighted some cultural differences regarding parental attitudes and practices. Secondly, the hierarchical regression showed that physical violence could be partially predicted by the cultural context, childhood abuse, and attitudes in favor of CP. Finally, childhood abuse and parental attitudes mediated the link between the cultural context and parental practices. This study underscores the importance of considering the cultural context when examining parental practices. Moreover, these results provide a better understanding of these types of parental practices in less studied contexts.

[Adverse Childhood Experiences in Mothers and Intergenerational Family Violence]

For children, own adverse experiences, as well as their exposure to intimate partner violence poses a severe risk for health and development. In order to answer the question of intergenerational transmission of family violence, adverse childhood experiences in mothers are considered to be a significant risk factor for the occurrence of child maltreatment and intimate partner violence in families, which, however, has been little studied in Germany. Therefore, this paper uses cross-sectional data of 5.646 mothers that was taken fromthe representative study "Kinder in Deutschland - KiD 0-3". Multiple binary-logical regression models were calculated in order to examine the influence ofmaternal adverse childhood experiences on various forms of family violence. As a result, 823 mothers (9,3 %) reported adverse childhood experiences; 157 (2,8 %) admitted that their child had already been exposed to physical harm or harsh punishment, and 168 (3,0%) reported intimate partner violence since the birth of their child, respectively 493 (8,7 %) since any past relationship. Taking demographic and socioeconomic factors into account, the occurrence of all three forms of violence becamemore likely inmothers with adverse childhood experiences: physical harm of the child (OR = 2,78, p ≤ 0,001), current intimate partner violence of themother (OR = 3,76, p ≤ 0,001), as well as her lifetime experiences in general (OR = 3,67, p ≤ 0,001). Therefore, the support and guidance of families (e.g., by early childhood interventions) should take into account the connection between negative maternal childhood experiences, as well as familial forms of violence, and, if applicable, make generous preventative offers. In case of signs for familial violence, additional protective steps should be applied.

Relationship between Harsh Parenting and Aggressive Behaviors in Male Juvenile Delinquents: Potential Mediating Roles of Peer Victimization and Hostile Attribution Bias

Harsh parenting can be regarded as a harsh behaviors, feelings, and attitudes toward children in the process of parenting. According to the theory of intergenerational transmission of violence, harsh parenting is an important factor affecting children's aggressive behavior, but the theory does not clarify the specific action path between harsh parenting and aggressive behavior. In order to reveal the relationship between harsh parenting and the aggressive behavior of juvenile delinquents, 604 male juvenile delinquents (N = 604; M_age = 16.57 years; SD = 0.612 years) were investigated using the Harsh Parenting Questionnaire, the Buss-Perry Aggression Questionnaire, the Multidimensional Peer Victimization Scale, and the Word Sentence Association Paradigm for Hostility in Chinese. Analysis using structural equation modeling procedures showed that (a) all variables were positively associated with each other; (b) the partial indirect effect of harsh parenting on aggressive behaviors was determined through the mediators of peer victimization and hostile attribution bias independently; and (c) the partial indirect effect was determined through the mediators of peer victimization and hostile attribution bias sequentially. The results suggest that harsh parenting can explain the highly aggressive behavior of male juvenile delinquents. Moreover, harsh parenting may also predict the risk of peer victimization and hostile attribution bias, thereby predicting the development of highly aggressive behaviors.

Parental stress and physical violence against children during the second year of the COVID-19 pandemic: results of a population-based survey in Germany

BACKGROUND

Parents and caregivers belonged to those with the highest burdens during the COVID-pandemic. Considering the close link between parental stress and child maltreatment, identifying families with high parental stress is of utmost importance to prevent violence against children. Within this study, we thus aimed to investigate the interplay of parental stress, changes in parental stress, and physical violence against children during the second year of the COVID-pandemic on an exploratory level.

METHODS

We conducted a cross-sectional, observational study in Germany from July to October 2021. By using different sampling steps, a representative probability sample of the German population was generated. A subsample of these participants with children under the age of 18 was included for analysis within this study (N = 453, 60.3% females, M_age = 40.08; SD = 8.53).

RESULTS

Higher parental stress levels were associated with more physical violence against children, higher levels of own experiences of child maltreatment, and mental health symptoms. An increase in parental stress during the pandemic was associated with female sex, the use of physical violence against children, and parental experience of child maltreatment. Parents who have ever used physical violence against their children have been characterized by higher parental stress levels, a stronger increase in parental stress during the pandemic, own experience of child maltreatment, mental health symptoms and sociodemographic characteristics. Higher parental stress levels, a stronger increase of parental stress during the pandemic, having pre-existing psychiatric disorders, and parental experience of child maltreatment predicted an increased use of physical violence against children during the pandemic.

CONCLUSIONS

Our results underscore the importance of parental stress for the risk of physical violence against children, more so in times of overall increased stress due to the pandemic and underline the need for low threshold support for families at risk in times of crises.

Adverse childhood experiences growing up in East or West Germany or abroad

Background

Adverse childhood experiences (ACEs) are potentially traumatic events that occur before the age of 18. The term encompasses various adverse childhood experiences, e.g., physical, psychological, and sexual abuse, physical and psychological neglect, and family dysfunction. Prevalence estimates for a broad spectrum of ACEs against the background of where childhood and adolescence were spent are scarcely available in Germany. This study examines the frequencies of adverse childhood experiences, considering growing up in East or West Germany or abroad and interacting with different age cohorts and gender.

Methods

A total of 5,018 individuals (51.4% female) aged 14 years and older were retrospectively assessed on adverse childhood experiences using questionnaires "adverse childhood experiences" (ACE). Logistic regression models were used to analyze the association between birth cohort, gender, and where a person grew up. Descriptive statistics and univariate analyses were used to calculate frequencies, proportions, and unadjusted associations for each variable.

Results

37.4% (N = 1,878) of respondents reported experiencing at least one form of ACE. Individuals who grew up abroad report significantly more adverse childhood experiences than individuals in East or West Germany. Men and women who grew up in East Germany reported a lower rate of ACEs. We found significant effects for all predictors: Where childhood and adolescence were predominantly spent, year of birth, and gender. Significant differences in the prevalence of adverse childhood experiences within the gender groups were only found for sexual and physical abuse and substance dependence in the household.

Conclusion

The results suggest that the socio-political context plays an essential role in the experience of adverse childhood experiences, both in frequency and risk. Thus, child abuse and neglect studies should increasingly focus on societal risk and protection mechanisms.

Predictors of Parental Coping During the Covid-19 Pandemic: A Survey in Germany

The Covid-19 pandemic has been profoundly affecting nearly everybody, but families with minors have been hit particularly. Closure of schools and kindergartens, home schooling, and working from home have led to a profound upheaval in family life. Parental adverse childhood experiences (ACEs) are an important determinant for parenting behavior. Importantly, ACEs can increase the vulnerability to stress and impair coping strategies. The current pandemic leads to increased parental stress, a risk factor for harsh parenting behavior, Therefore, we aimed to assess the role of ACEs and sociodemographic factors associated to parental coping during the current pandemic. In a cross-sectional online survey, 687 parents of minors in Germany were included. Demographic and psychosocial factors associated to parental coping during the first lockdown due to the Covid-19 pandemic were assessed. Results show that younger age of the respective child, income loss, dissatisfaction with the sharing of childcare duties, and ACEs were significantly associated with an increase of potential harmful parenting behavior during the Covid-19 pandemic. An increase of dissatisfaction with the sharing of childcare duties during the pandemic was predicted by working from home and taking care of the children mainly by oneself, while sharing childcare duties with the partner equally resulted even in an increase of satisfaction with sharing of childcare duties during the pandemic. These findings demonstrate that a history of childhood adversity in a parent is a risk factor for harmful parenting during the pandemic. Parental satisfaction with sharing of caregiving is an important factor for parental coping during the pandemic. Sharing of caregiving between partners should be encouraged.

Child maltreatment by nursing staff and caregivers in German institutions: A population-representative analysis

BACKGROUND

Child maltreatment by caregivers seem to make a significant contribution to general maltreatment rates. Interestingly, research assessing prevalence rates of maltreatment mainly focuses on individual components either in relation to different types of maltreatment or in relation to different types of institutions.

OBJECTIVE

The current study assesses prevalence rates for child maltreatment by caregivers in hospitals, rehabilitation centers, facilities for the disabled, schools, Kindergartens, and after-school care or residential care.

PARTICIPANTS AND SETTING

In a cross-sectional survey, a representative sample of the German population above the age of 14 (N = 2,516) was selected in a random route approach. Participants were questioned retrospectively for the experience of physical, emotional and sexual abuse and neglect by caregivers in institutions.

RESULTS

The results demonstrate a relatively high rate of child maltreatment in German institutions. In detail, during inpatient stays in medical institutions, 19.0% of the participants reported to have experienced at least one type of maltreatment by nursing staff. Furthermore, 30.3% reported to have experienced at least one type of maltreatment by teachers during school life and 11.6% reported maltreatment by caregivers in care facilities. A significant number of participants reported multiple forms of maltreatment in all assessed institutions. Younger age of the respondents was associated with lower prevalence rates, which could be attributed to higher awareness for maltreatment in institutions nowadays.

CONCLUSIONS

Our results demonstrate that child maltreatment by caregivers in institutions is a prevalent problem. A higher awareness for caregivers as potential perpetrators of maltreatment in institutions, including schools, medical institutions and care facilities, is needed in order to improve this alarming situation.

[Children of mentally ill parents : Also a topic in the context of child protection]

BACKGROUND

Severe mental illness in parents increases the risk of neglect, physical and sexual abuse (adverse childhood experiences, ACE) of children.

OBJECTIVE

Presentation of the current situation of child protection issues in psychiatric care in Germany and the derivation of needs and potential solution strategies.

MATERIAL AND METHODS

Based on a selective literature search, the needs and the current situation in Germany are presented and potential solution strategies are pointed out. The analysis is supplemented by a descriptive evaluation of specific consultation requests to the medical child protection hotline, which were descriptively evaluated and served as a starting point for the selective literature search.

RESULTS

Despite the well-known comprehensive influence of mental illnesses of parents on their children, psychiatric patients have not yet been systematically registered regarding whether they have to care for underage children. There is a lack of systematic and comprehensive support for families at risk. Of all calls to the project medical child protection hotline, calls from the field of adult psychiatry and psychosomatics make up by far the highest proportion from the field of adult medicine.

CONCLUSION

An increased awareness of child protection issues is necessary in the field of adult psychiatric treatment. Systematic counselling services for acute cases and also networking and structured cooperation with other medical fields, such as child and youth psychiatry, pediatrics and child and youth welfare should be addressed.

[Authoritarianism becomes respectable in Germany: A risk factor for condoning physical violence toward children?]

Authoritarianism becomes respectable in Germany: A risk factor for condoning physical violence toward children? Abstract. Objective: Authoritarianism denotes aggressive behavior toward subordinates, submission to authorities, and conventionalism. Authoritarianism is assumed to be a central factor in the emergence of right-wing extremist ideology. Horkheimer described a close relationship between authoritarianism and the use of physical violence as a disciplinary method. Against the background of the current increase in right-wing extremist ideologies in Germany, which manifests itself in both social and political realms, this study examines the association between authoritarian and right-wing extremist ideology and the affirmation of corporal punishment as a disciplinary method. Method: We performed a cross-sectional study on a representative sample of the German population (N = 2,524). Results: 44.5 % of the participants supported corporal punishment. When respondents reported authoritarian and right-wing extremist attitudes, we discovered an increased affirmation of physical violence as a disciplinary method. Regarding party preference, participants who stated that they preferred the right-wing Alternative for Germany Party (AfD) showed the highest rate of supporting corporal punishment. Conclusions: The results presented indicate that the condoning of corporal punishment is still very widespread in Germany, and that the children of parents with authoritarian and right-wing extremist attitudes comprise a risk group for physical violence. Increased social awareness of these risks is necessary in light of the current increase of right-wing ideologies.

Trends in child maltreatment in Germany: comparison of two representative population-based studies

BACKGROUND

Child maltreatment of all types is a serious concern for society, and it is important to monitor trends in incidence in order to inform child welfare agencies and policy-makers about emerging issues. In Germany, however, information on such trends is limited: apart from official sources, the only published study is a comparison of surveys conducted in 1992 and 2011 that had focused primarily on sexual abuse. The present study is the first to look at more recent trends and to examine other types of maltreatment as well.

METHODS

We compared the datasets of two population-based nationwide surveys, one conducted in 2010 (N = 2504) and the other in 2016 (N = 2510). Both had used identical methodology. Participants aged 14 years and older had been selected randomly using the Kish selection grid method, and information about childhood experiences of abuse had been solicited using the Childhood Trauma Questionnaire.

RESULTS

The overall percentage of respondents who reported having experienced at least one type of child maltreatment decreased over the 6 years, from 35.3% in 2010 to 31.0% in 2016; however, the percentages who reported multiple types of maltreatment remained stable. The decrease in any type of maltreatment was mainly driven by fewer reports of physical neglect, which was likelier to be reported by older respondents who had experienced privation during the (post-) war years and whose representation was lower in the later survey. There was a significant increase over time in the prevalence of emotional abuse, with respondents aged 26-45 years reporting higher rates of this type of maltreatment. The prevalence rates of other types of maltreatment remained unchanged. All effect sizes were very small.

CONCLUSIONS

At present, the systems in place in Germany for monitoring the occurrence of child maltreatment are insufficient. While this study contributes to a better understanding, more information is needed, particularly on populations that have been excluded or underrepresented in previous research efforts. As has been done elsewhere, large databases should be set up, using identical methodologies and definitions, in order to accurately assess trends over time in different types of abuse and neglect.

Psychosocial problems in traumatized refugee families: overview of risks and some recommendations for support services

This article is an abridged version of a report by an advisory council to the German government on the psychosocial problems facing refugee families from war zones who have settled in Germany. It omits the detailed information contained in the report about matters that are specific to the German health system and asylum laws, and includes just those insights and strategies that may be applicable to assisting refugees in other host countries as well. The focus is on understanding the developmental risks faced by refugee children when they or family members are suffering from trauma-related psychological disorders, and on identifying measures that can be taken to address these risks. The following recommendations are made: recognizing the high level of psychosocial problems present in these families, providing family-friendly living accommodations, teaching positive parenting skills, initiating culture-sensitive interventions, establishing training programs to support those who work with refugees, expanding the availability of trained interpreters, facilitating access to education and health care, and identifying intervention requirements through screening and other measures.