Global Prevalence of Childhood Exposure to Physical Violence within Domestic and Family Relationships in the General Population: A Systematic Review and Proportional Meta-Analysis

Do the norms of tolerance for child physical abuse modify the intergenerational transmission of physical abuse?

BACKGROUND

Intergenerational transmission of physical abuse is well-known; however, the potential for contextual effect modification remains unknown.

OBJECTIVE

We investigated whether the norms of tolerance for child physical abuse modify the intergenerational transmission of physical abuse.

PARTICIPANTS AND SETTING

Data from the Child Living Standard Survey (grades five and eight) conducted between 2016 and 2018 in three prefectures in Japan was analyzed.

METHODS

The norms of tolerance for child physical abuse were calculated based on the proportion of caregivers who physically abuse their offspring in each of the 33 districts (n = 43,534). The caregivers' childhood physical abuse victimization and perpetration of child physical abuse were assessed via questionnaire. A multilevel analysis was performed to evaluate the cross-level interaction of the norms of tolerance for child physical abuse at the neighborhood level on the association between the caregiver's childhood physical abuse victimization and perpetration of child physical abuse, stratified by fathers (n = 4334) and mothers (n = 38,290).

RESULTS

By district, the average percentage of caregivers who physically abuse their offspring was 14.4 %. Intergenerational transmission was confirmed for both fathers and mothers. Fathers who are living with highly tolerant norms for child physical abuse showed higher odds of intergenerational transmission of physical abuse, while mothers showed no effect modification.

CONCLUSION

The norms of tolerance for child physical abuse showed a more prominent intergenerational transmission of physical abuse for fathers but not for mothers. To modify the cycle of physical abuse, interventions to reduce norms of tolerance for child physical abuse may be useful.

Radiographers' emotional reactions to suspected child abuse

INTRODUCTION

In cases of suspected physical abuse (SPA) in children, a full skeletal survey is performed. Radiographers performing the survey may experience emotional challenges during the examination. The purpose of the study was to explore the emotional aspects of SPA imaging among radiographers and how they respond to potential challenges.

METHODS

Data were collected from 8 paediatric radiographers with responsibility for SPA imaging working in three Danish university hospitals using semi-structured in-depth interviews. Interviews were carried out by an experienced radiographer and a social anthropologist. Recordings were transcribed verbatim and thematic analysis applied.

RESULTS

Most radiographers described skeletal surveys as a potential emotional challenge. Four over-arching themes were identified; Interactions with caregivers and child, Fear of making errors, Dealing with the dead, and Coping with challenges. Except 'Dealing with the dead', each theme had several sub-themes.

CONCLUSION

Emotional challenges in SPA imaging among radiographers form a complex pattern with interactions with caregivers and the child unfolding in an intense atmosphere where staff are required to regulate feelings. In the highly demanding context of SPA, potential emotionally challenging experiences require both organisational and individual attention.

IMPLICATIONS FOR PRACTICE

The results of this study should inspire department managers and paediatric radiographers to establish or maintain space in working patterns for informal collegial debriefing, or more systematic formal debriefing, thereby promoting a culture where emotional impact is recognised and supported.

Theoretical Analysis of the Cycle of Intimate Partner Violence: A Systematic Review

Research on the intergenerational transmission of intimate partner violence (IPV), or the "cycle of violence," from childhood exposure (G1) to the perpetration of IPV in adulthood relationships (G2), has increased over the past decades. The link between childhood exposure to interparental violence and future IPV perpetration is largely explained by postulations from social and psychological theories, such as social learning theory. These theories provide claims regarding IPV transmission pathways and the mechanisms underpinning the transmission. However, evidence from extant theory-informed studies on the cycle of violence has generated several null and counter-predictive findings, which raises questions about the nature of the theory-informed research, as well as methodological questions. This systematic review sought to analyze how existing studies applied specific theories to research IPV transmission, and the mechanisms underpinning these transmissions. Following the PRISMA procedure for systematic reviews, we reviewed empirical articles from five databases (Scopus, Web of Science, CINAHL, Informit, and PubMed) published between 1990 and 2024. Results from the 30 included studies were synthesized under three theoretical categories, namely: social, psychological, and cultural theories. Under each theoretical category, we found inconsistent evidence, lack of empirical examination of theory-driven variables, and reductionist approaches, in terms of how claims from the theories are applied in research on IPV transmission. Research guided by a singular theoretical framework presented inconsistencies compared to those applying a multi-theory approach. As a result, we recommend an integrated theoretical model that considers the comprehensive and transactional process/factors that underpin IPV transmission.

Childhood trauma distribution and behavioural problems among Pakistani adolescents

BACKGROUND

Childhood trauma adversely impacts adolescents, and consequently, they develop behavioural problems. Understanding the distribution of childhood traumas and their association with behavioural problems among adolescents is paramount for the preventive efforts.

AIM/OBJECTIVE

The present research aimed to investigate this association among adolescents.

METHODS

This association was investigated among adolescents (N = 200) between 12 and 18 years. Childhood Trauma Questionnaire and Strength and Difficulty Questionnaire was used to assess the distribution of trauma and internalizing and externalizing behavioural problems among adolescents through purposive and convenience sampling technique.

RESULTS

The findings across trauma distribution indicated higher distribution of childhood abuse and neglect across males as compared to females. Males further significantly scored higher on sexual abuse and emotional neglect. Apparently, a large number of adolescents experienced all five sub types of childhood traumas (sexual abuse, emotional abuse, physical abuse, emotional and physical neglect). Additionally, across the severity continuum of childhood traumas, male scored higher on the severe to extreme continuum for all subtypes except physical abuse, where females scored higher. Lastly, logistic regression analysis indicated higher peer problems among those adolescents who have experienced all types of childhood traumas.

CONCLUSION

These findings could be beneficial for intervention-based programs and policies to help trauma-exposed adolescents cope with their lives.

Reducing family and school-based violence at scale: a large-scale pre-post study of a parenting programme delivered to families with adolescent girls in Tanzania

BACKGROUND

Parenting programmes, including those delivered in the Global South, are effective strategies to reduce violence against children (VAC). However, there is limited evidence of their impact when implemented at scale within routine delivery systems. This study aimed to address this gap by evaluating the real-world delivery of Parenting for Lifelong Health for Teens in Tanzania.

METHODS

Participating parents/caregivers and their adolescent girls were recruited by local implementing partners in 2020-2021 as part of a community-based HIV prevention initiative focused on addressing drivers of female adolescent HIV-vulnerability such as VAC, caregiver-adolescent relationships and sexual reproductive health communication. The 14-session, group-based parenting programme was delivered by trained teachers and community facilitators. Quantitative surveys administered by providers measured a variety of outcomes including child maltreatment (primary outcome) and multiple secondary outcomes linked to increased risk of VAC. Multilevel models examined pre-post effects as well as variation by attendance and baseline demographic variables.

RESULTS

Pre-post data from 27 319 parent/caregiver-child dyads were analysed, of which 34.4% of parents/caregivers were male. Analyses showed large reductions in child maltreatment (parents/caregivers: IRR=0.55, (95% CI 0.54, 0.56); adolescents: IRR=0.57, (95% CI 0.56, 0.58)), reduced intimate partner violence experience, reduced school-based violence, increased communication about sexual health, reduced poor supervision, reduced financial insecurity, reduced parenting stress, reduced parent and adolescent depression, and reduced adolescent conduct problems. In contrast to these positive outcomes, parents/caregivers and adolescents also reported reduced parental positive involvement and support of education, with those experiencing greater adversity reporting less change than those with less adversity.

CONCLUSIONS

This study is the first to examine the large-scale implementation of an evidence-based parenting programme in the Global South. Although additional research is necessary to examine potential negative effects on positive parenting and parent support of education, findings suggest that Furaha Teens can sustain its impact on key outcomes associated with VAC when delivered at scale.

Causal and common risk pathways linking childhood maltreatment to later intimate partner violence victimization

Childhood maltreatment and intimate partner violence (IPV) victimization are major psychiatric risk factors. Maltreatment substantially increases the likelihood of subsequent IPV victimization, but what drives this association is poorly understood. We analyzed retrospective self-reports of maltreatment and IPV victimization in 12,794 participants (58% women, 42% men) from the Twins Early Development Study at ages 21 and 26 using quantitative genetic methods. We estimated the etiological influences common to maltreatment and IPV, and the effect of maltreatment on IPV beyond such common influences. Participants who reported childhood maltreatment ( ~ 7% of the sample) were 3 times more likely than their peers to also report IPV victimization at age 21, 4 times more likely at 26. The association between maltreatment and IPV was mostly due to environmental influences shared by co-twins (42-43%) and genetic influences (30-33%), as well as nonshared environmental influences (25-27%). The association between maltreatment and IPV was similar for women and men, but its etiology partly differed by sex. Maltreatment had a moderate effect on IPV in phenotypic models (β = 0.25-0.30), decreasing to a small-to-moderate range in causally informative models accounting for their common etiology (β = 0.15-0.21). Risk factors common to maltreatment and IPV victimization are largely familial in origin, environmental and genetic. Even considering common risk factors, experiencing maltreatment may be causally related to subsequent IPV victimization. Interventions promoting safe intimate relationships among young adults exposed to maltreatment are warranted and should address family-level environmental risk and individual-level risk shaped by genetics.

Causal and common risk pathways linking childhood maltreatment to later intimate partner violence victimization

Childhood maltreatment and intimate partner violence (IPV) victimization are major psychiatric risk factors. Maltreatment substantially increases the likelihood of subsequent IPV victimization, but what drives this association is poorly understood. We analyzed retrospective self-reports of maltreatment and IPV in 12794 participants (58% women, 42% men) from the Twins Early Development Study at ages 21 and 26 using quantitative genetic methods. We estimated the etiological influences common to maltreatment and IPV, and the direct causal effect of maltreatment on IPV beyond such common influences. Participants exposed to maltreatment (~7% of the sample) were 3 times more likely to experience IPV victimization than their peers at age 21, 4 times more likely at 26. The association between maltreatment and IPV was mostly due to environmental influences shared by co-twins (42-43%) and genetic influences (30-33%). The association between maltreatment and IPV was similar for women and men, but its etiology partly differed by sex. Maltreatment had a moderate-to-large effect on IPV in phenotypic models (β = 0.23-0.34), decreasing to a small-to-moderate range in causal models accounting for their common etiology (β = 0.15-0.21). Risk factors common to maltreatment and IPV victimization are largely familial in origin, environmental and genetic. Even considering common risk factors, experiencing maltreatment is causally related to subsequent IPV victimization. Interventions promoting safe intimate relationships among young adults exposed to maltreatment are warranted and should address family-level environmental risk and individual-level risk shaped by genetics.

Association between witnessing domestic violence against the mother in childhood and intimate partner violence in adulthood: A population-based analysis of Peru

Objective

To assess the association between witnessing domestic violence against the mother in childhood and intimate partner violence (IPV) in adulthood.

Study design

An analytical cross-sectional study was conducted using data from the 2019 Peruvian Demographic and Family Health Survey (ENDES). The independent variable was the condition of witnessing physical violence by the father against the mother during childhood. The dependent variable was IPV, defined by the presence of some subtype of violence (physical, psychological, and sexual) against the respondent in the last year by her husband or partner. To assess this association, generalized linear models of the Poisson Family with a logarithmic link function were performed to estimate crude and adjusted prevalence ratios (aPR) with their respective 95% confidence intervals (95% CI).

Results

Data from 17,911 Peruvian women between 15 and 59 years of age were analyzed. Most women were between 30 and 49 years old (71.4%), were cohabiting (65.0%), and had secondary education (43.2%). The prevalence of IPV in the last year was 16.0%, and the history of witnessing domestic violence against the mother during childhood was 42.0%. In the regression models, those with the studied exposure showed a higher prevalence of experiencing an episode of IPV in the last year (any IPV [aPR: 1.69; 95% CI: 1.50-1.91]; physical IPV [aPR: 1.70; 95% CI: 1.43-2.02], psychological IPV [aPR: 1.64; 95% CI:1.42-1.88], and sexual IPV [aPR: 1.68; 95% CI: 1.22-2.32]).

Conclusions

Women with a history of domestic violence towards their mothers were likelier to have had IPV in the last year than women who did not report violence towards their mothers during childhood. Approximately two in ten Peruvian women reported having had IPV in the past year, and nearly half reported witnessing domestic violence against their mother as a child.

Child abuse and neglect and mental health outcomes in adulthood by ethnicity: Findings from a 40-year longitudinal study in New Zealand/Aotearoa

BACKGROUND

Longitudinal studies consistently report adverse long-term outcomes of childhood maltreatment. Little is known about the impact of childhood maltreatment on mental health among a marginalized population (New Zealand Māori); therefore, we cannot assume the effects of maltreatment are the same across the population.

OBJECTIVE

Associations were examined between childhood sexual abuse (CSA), childhood physical punishment (CPP) and childhood neglect (CN) (<16 years) and mental health outcomes 18-40 years, by ethnicity (Māori/non-Māori).

PARTICIPANTS AND SETTING

Data from the Christchurch Health and Development Study, a study of a birth cohort of 1265 children born in Christchurch in 1977. By age 40, 17.8 % (n = 191) reported New Zealand Māori ethnic identity; 82.2 % (n = 883) were non-Māori.

METHODS

CSA, CPP (<16 years) were measured at 18, 21 years; CN was measured at 40 years. Major depression, anxiety disorder, suicidal ideation, alcohol abuse/dependence and cannabis abuse/dependence were measured at ages 21, 25, 30, 35 and 40 years. Childhood confounding variables controlled. Analyses were extended to include Māori ethnicity.

RESULTS

After statistical adjustment, experience of severe childhood maltreatment increased odds of mental health problems 1.8-2.6×, compared to no maltreatment; the effects of maltreatment were similar for males and females. For Māori, some higher rates of mental health problems were seen among those maltreated, no statistically significant associations were detected after Bonferroni correction (among severe maltreatment vs. no maltreatment). Limitations should be considered when interpreting results.

CONCLUSIONS

Exposure to childhood maltreatment has long-term effects into middle-age. Further research employing culturally-sensitive approaches may help clarify Māori childhood maltreatment outcomes.