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Tsunga L, Heron J, Lake MT, Halligan SL, Malcolm-Smith S, Hoffman N, Zar HJ, Fraser A, Stein DJ, Donald KA. Exposure to Violence and Mental Health Outcomes Among Pre-schoolers in a South African Birth Cohort. Res Child Adolesc Psychopathol 2024:10.1007/s10802-024-01211-y. [PMID: 38861248 DOI: 10.1007/s10802-024-01211-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2024] [Indexed: 06/12/2024]
Abstract
Little is known about the relationship between violence exposure and mental health in preschoolers living in low- and middle-income countries (LMICs). Multiple regression analyses investigated associations between violence exposure and mental health in the Drakenstein Child Health Study (N = 978), a South African birth cohort. Lifetime violence exposure was assessed at age 4.5 years using the parent-report Child Exposure to Community Violence Checklist (CECV). Mental health was assessed at age 5 years using the Child Behaviour Checklist (CBCL 1.5-5). Eighty-three percent of the children were exposed to some form of violence. Internalising and externalising behaviours were positively associated with overall violence exposure (β per one unit change in the overall score = 0.55 [0.16, 0.94] and β = 0.53 [0.23, 0.84], respectively), domestic victimisation (β per one unit change in the subscore = 1.28 [0.28, 2.27]; β = 1.14 [0.37, 1.90]) and witnessing community violence (β = 0.77 [0.15, 1.39]; β = 0.68 [0.19, 1.18]). There was a positive association between polyvictimisation and externalising (β = 1.02 [0.30, 1.73]) but not internalising (β = 0.87 [-0.06, 1.80]) behaviour problems. Evidence for an association of witnessing domestic violence with internalising (β = 0.63 [-0.97, 2.24]) or externalising (β = 1.23 [-0.04, 2.50]) behaviours was less robust. There was no association between community victimisation and internalising or externalising behaviours (β = 0.72 [-1.52, 2.97; β = 0.68 [ -1.06, 2.41]). Observations highlight the risk for mental health problems among preschoolers living in high-violence contexts and emphasize the need for early interventions.
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Affiliation(s)
- Lucinda Tsunga
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa.
- Department of Population Health Sciences, University of Bristol, Bristol, United Kingdom.
| | - Jon Heron
- Department of Population Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Marilyn T Lake
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
| | - Sarah L Halligan
- Department of Psychology, University of Bath, Bath, United Kingdom.
- Department of Psychiatry, University of Stellenbosch, Stellenbosch, South Africa.
| | - Susan Malcolm-Smith
- ACSENT Laboratory, Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Nadia Hoffman
- Department of Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Heather J Zar
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
- The SA-MRC Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Abigail Fraser
- Department of Population Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Dan J Stein
- Department of Psychiatry, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- South African Medical Research Council Unit on Risk & Resilience in Mental Disorders, Stellenbosch, South Africa
| | - Kirsten A Donald
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
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Do HP, Dunne MP, Vo TV, Nguyen LH, Luong-Thanh BY, Valdebenito S, Baker PRA, Tran BX, Hoang TD, Eisner M. Applying the WHO INSPIRE Framework to Ending Violence Against Pregnant Women and Unborn Children: A Case Study in Vietnam. Violence Against Women 2024:10778012241230324. [PMID: 38380997 DOI: 10.1177/10778012241230324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
This article adapted the INSPIRE framework, developed by the World Health Organization to prevent violence against children, to the systematic analysis of city-level healthcare services for pregnant women who experienced intimate partner violence. A mixed-methods study conducted in-depth interviews with 22 health and social care professionals and 140 pregnant women in Vietnam. The women were more likely to report limited system-level support for partners regarding violence and mental health, while the professionals perceived more weaknesses in policies and management of services. Traditional values tend to isolate abused women from receiving social services. The INSPIRE framework is innovative and could be applied in other contexts.
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Affiliation(s)
- Huyen Phuc Do
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- Institute of Health Economics and Technology, Hanoi, Vietnam
| | - Michael P Dunne
- Australian Centre for Health Law Research, Faculty of Business and Law, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Thang Van Vo
- Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
- Faculty of Public Health, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Lan Hoang Nguyen
- Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
- Faculty of Public Health, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Bao-Yen Luong-Thanh
- Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
- Faculty of Public Health, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Sara Valdebenito
- Institute of Criminology, University of Cambridge, Cambridge, UK
| | - Philip R A Baker
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, Australia
| | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
- Department of Health, Behaviours and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Tuyen Dinh Hoang
- Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
- Faculty of Public Health, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Manuel Eisner
- Institute of Criminology, University of Cambridge, Cambridge, UK
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Tsunga L, Lake M, Halligan SL, Malcolm-Smith S, Hoffman N, Heron J, Zar H, Fraser A, Donald K, Stein DJ. Early Childhood Violence Exposure Patterns in The Drakenstein Child Health Study (DCHS). Wellcome Open Res 2023; 8:36. [PMID: 37781446 PMCID: PMC10534083 DOI: 10.12688/wellcomeopenres.18598.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2023] [Indexed: 10/03/2023] Open
Abstract
Background: Research has highlighted high rates of exposure to violence among South African youth. However, work to date has been largely cross-sectional, focused on violence exposure during the adolescence period, and has been limited to specific types of violence exposure. We examined violence exposure in South African preschool children between 3 and 6 years of age, capturing both direct and indirect forms of violence, and tested for potential sex differences across the several types of exposures. Methods: Lifetime direct and indirect exposure to domestic and community violence was measured by parental report when children were 3.5 years (N = 530), 4.5 years (N = 749) and 6 years of age (N= 417) in a South African birth cohort located in a peri-urban community. Results: There are three main findings. First, a large proportion of children (72%-75%) were reported as having been exposed to some form of direct or indirect violent experience in their homes or communities from a young age. Second, there was significant polyvictimization, with 49% of the children being exposed to more than one type of violence by age 6. Third, by 4.5 years of age, there was evidence that boys were more likely than girls to be exposed to domestic victimisation (28% vs. 17%) and polyvictimization (38% vs. 28%). Conclusions: These findings highlight the high levels of violence exposure in young South African children, particularly among boys, and the need for prevention at both the community and individual levels.
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Affiliation(s)
- Lucinda Tsunga
- Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Marilyn Lake
- Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
| | | | - Susan Malcolm-Smith
- ACSENT Laboratory Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Nadia Hoffman
- Department of Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Jon Heron
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Heather Zar
- Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
- The SA-MRC Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Abigail Fraser
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Kirsten Donald
- Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Dan J. Stein
- Department of Psychiatry, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
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Walsh C, Cunningham T. THE PAINS OF PARAMILITARISM: The Latent Criminogenic Effects of Exposure to Paramilitary Violence Among Young Men in a Post-Conflict Society. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:547-558. [PMID: 37593052 PMCID: PMC10427590 DOI: 10.1007/s40653-023-00516-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/05/2023] [Indexed: 08/19/2023]
Abstract
Purpose: Whilst most people who experience adversity recover, there is a cumulative body of evidence that illustrates that the effects can be long lasting, and can even become debilitating over time. Links have been made between traumatic distress, mental health disorders and disturbances in behavioural and emotional regulatory systems that may in context elevate the risk of offending. Despite the burgeoning evidence around the criminogenic effects of adversity, few studies have examined the traumatic effects of paramilitary related adversity in the context of post-conflict Northern Ireland. Methods: With reference to DSM-V PTSD diagnostic clusters, the aim of this study was to explore the latent impact of adversity and latent trauma among justice involved young men and identify potential criminogenic effects of exposure to paramilitary related adversity. Results and conclusions: This study found that across the sample, young men had self-reported to have experienced significant adversity, including violent victimisation. Exposure to paramilitary adversity often began during early adolescence. The participants described symptoms that were consistent with clinically diagnosable disorders such as Post-Traumatic Stress Disorder. Despite this, there appears to be a paucity of trauma screening and assessment, and few supports that victim could benefit from. In the absence of appropriate and evidence-based supports, many young men appear to find other (and more maladaptive) ways to cope. This exacerbates the risk of interfacing with the justice system and may even contribute towards a deterioration in wider psycho-social outcomes. Implications for practice are discussed.
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Affiliation(s)
- Colm Walsh
- Queen’s University Belfast, Belfast, United Kingdom
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Tsunga L, Lake M, Halligan S, Malcolm-Smith S, Hoffman N, Heron J, Zar H, Fraser A, Donald K, Stein D. Early Childhood Violence Exposure Patterns in The Drakenstein Child Health Study (DCHS). Wellcome Open Res 2023. [DOI: 10.12688/wellcomeopenres.18598.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Background: Research has highlighted high rates of exposure to violence among South African youth. However, work to date has been largely cross-sectional, focused on violence exposure during the adolescence period, and has been limited to specific types of violence exposure. We examined violence exposure in South African preschool children between 3 and 6 years of age, capturing both direct and indirect forms of violence, and tested for potential sex differences across the several types of exposures. Methods: Lifetime direct and indirect exposure to domestic and community violence was measured by parental report when children were 3.5 years (N = 530), 4.5 years (N = 749) and 6 years of age (N= 417) in a South African birth cohort located in a peri-urban community. Results: There are three main findings. First, a large proportion of children (72%-75%) were reported as having been exposed to some form of direct or indirect violent experience in their homes or communities from a young age. Second, there was significant polyvictimization, with 49% of the children being exposed to more than one type of violence by age 6. Third, by 4.5 years of age, there was evidence that boys were more likely than girls to be exposed to domestic victimisation (28% vs. 17%) and polyvictimization (38% vs. 28%). Conclusions: These findings highlight the high levels of violence exposure in young South African children, particularly among boys, and the need for prevention at both the community and individual levels.
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Grzejszczak J, Gabryelska A, Gmitrowicz A, Kotlicka-Antczak M, Strzelecki D. Are Children Harmed by Being Locked up at Home? The Impact of Isolation during the COVID-19 Pandemic on the Phenomenon of Domestic Violence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13958. [PMID: 36360840 PMCID: PMC9657348 DOI: 10.3390/ijerph192113958] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 10/09/2022] [Accepted: 10/24/2022] [Indexed: 06/16/2023]
Abstract
The phenomenon of violence against children is a very complex one. There are many types of child abuse, and they are culturally dependent to a significant degree. Although studies show that children generally only suffer from mild COVID-19 infection, some social restrictions introduced during the pandemic, such as home isolation, may have many severe consequences on the population's mental health. Studies on this topic suggest that violence against children increased during lockdown due to the COVID-10 pandemic. This narrative review summarizes this available literature on the subject and discusses the different forms of violence against children, their cultural aspects, the impact of the COVID-19 pandemic on the phenomenon of violence, the long-term consequences of the above, and forms of assistance for abused minors.
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Affiliation(s)
- Jagoda Grzejszczak
- Department of Child and Adolescent Psychiatry, Medical University of Lodz, 90-151 Lodz, Poland
| | - Agata Gabryelska
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 90-151 Lodz, Poland
| | - Agnieszka Gmitrowicz
- Department of Child and Adolescent Psychiatry, Medical University of Lodz, 90-151 Lodz, Poland
| | | | - Dominik Strzelecki
- Department of Affective and Psychotic Disorders, Medical University of Lodz, 90-151 Lodz, Poland
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