Explaining the accumulation of victimization in vulnerable children: Interpersonal violence among children traumatized by war and disaster in a children's home in Sri Lanka
Abstract:Research in postconflict settings indicated that children's exposure to war and natural disaster is a significant predictor of experiencing violence within their families. However, it is unclear if this effect is driven by characteristics of traumatized children or their parents. To disentangle these different factors we conducted a survey in a children's home in Sri Lanka. A total of 146 institutionalized children (aged 8 to 17) were interviewed using standardized questionnaires administered by local senior c… Show more
“…Within these fragile settings, studies have revealed that the burden of IPV against women and child maltreatment is staggering 10–13. War-related violence has long-lasting impacts on the mental health of both adults and children, leading to both higher use of violent discipline as well as maladjustment among children 6 14–17. Indirect experiences of conflict such as increased economic stress are also a shared risk factor for violence and can also lead to increased levels of IPV and child maltreatment within the same household 5…”
ObjectiveTo test the effectiveness of the Safe at Home programme which was developed to improve family well-being and prevent multiple forms of violence in the home.DesignWaitlisted pilot cluster randomised controlled trial.SettingNorth Kivu, Democratic Republic of Congo.Participants202 heterosexual couples.InterventionThe Safe at Home programme.Primary and secondary outcome measuresThe primary outcome was family functioning, with secondary outcomes of past-3 month co-occurring violence, intimate partner violence (IPV) and harsh discipline. Pathway mechanisms assessed included attitudes related to acceptance of harsh discipline, gender equitable attitudes, positive parenting skills and power sharing within the couple.ResultsNo significant improvements in family functioning were documented for women (β=1.49; 95% CI: −2.75 to 5.74; p=0.49) and men (β=1.09; 95% CI: −3.13 to 4.74; p=0.69). However, women in Safe at Home reported a OR=0.15 (p=0.000), OR=0.23 (p=0.001) and OR=0.29 (p=0.013) change in co-occurring IPV and harsh discipline; physical/sexual/emotional IPV by their partner and use of physical and/or emotional harsh discipline against their child, respectively, as compared with women in the waitlisted group. Men participating in Safe at Home reported a OR=0.23 (p=0.005) change in perpetration of co-occurring violence, OR=0.26 (p=0.003) change in any form of IPV perpetration and OR=0.56 (p=0.19) change in use of harsh discipline against their child as compared with the waitlist arm. Positive changes were also noted in pathway variables around attitudes, skills and behaviours within couples.ConclusionThis pilot trial demonstrated the Safe at Home programme to be highly effective in preventing multiple forms of violence in the home and improving equitable attitudes and skills in couples. Future research should assess longitudinal impact and implementation at scale.Trial registration numberNCT04163549.
“…Within these fragile settings, studies have revealed that the burden of IPV against women and child maltreatment is staggering 10–13. War-related violence has long-lasting impacts on the mental health of both adults and children, leading to both higher use of violent discipline as well as maladjustment among children 6 14–17. Indirect experiences of conflict such as increased economic stress are also a shared risk factor for violence and can also lead to increased levels of IPV and child maltreatment within the same household 5…”
ObjectiveTo test the effectiveness of the Safe at Home programme which was developed to improve family well-being and prevent multiple forms of violence in the home.DesignWaitlisted pilot cluster randomised controlled trial.SettingNorth Kivu, Democratic Republic of Congo.Participants202 heterosexual couples.InterventionThe Safe at Home programme.Primary and secondary outcome measuresThe primary outcome was family functioning, with secondary outcomes of past-3 month co-occurring violence, intimate partner violence (IPV) and harsh discipline. Pathway mechanisms assessed included attitudes related to acceptance of harsh discipline, gender equitable attitudes, positive parenting skills and power sharing within the couple.ResultsNo significant improvements in family functioning were documented for women (β=1.49; 95% CI: −2.75 to 5.74; p=0.49) and men (β=1.09; 95% CI: −3.13 to 4.74; p=0.69). However, women in Safe at Home reported a OR=0.15 (p=0.000), OR=0.23 (p=0.001) and OR=0.29 (p=0.013) change in co-occurring IPV and harsh discipline; physical/sexual/emotional IPV by their partner and use of physical and/or emotional harsh discipline against their child, respectively, as compared with women in the waitlisted group. Men participating in Safe at Home reported a OR=0.23 (p=0.005) change in perpetration of co-occurring violence, OR=0.26 (p=0.003) change in any form of IPV perpetration and OR=0.56 (p=0.19) change in use of harsh discipline against their child as compared with the waitlist arm. Positive changes were also noted in pathway variables around attitudes, skills and behaviours within couples.ConclusionThis pilot trial demonstrated the Safe at Home programme to be highly effective in preventing multiple forms of violence in the home and improving equitable attitudes and skills in couples. Future research should assess longitudinal impact and implementation at scale.Trial registration numberNCT04163549.
Studies show that war leads to an increase in harsh parenting and a decrease in parental warmth, which in turn has a devastating impact on children’s development. However, there is insufficient research on the factors that affect parenting in post-conflict regions. In addition, most previous studies on the role of parenting in the context of war rely on self-reports, which are subject to a number of limitations. To complement existing research, the present cross-sectional study used behavioral observations of 101 mothers and their 6–12 year old children to assess parenting in post-conflict northern Uganda. The aim of the current study was to explore associations between observed maternal warmth and coercion and self-reported socioeconomic status (e.g., mother’s educational level) as well as maternal (e.g., posttraumatic stress disorder), child (e.g., externalizing problems), and social contextual factors (e.g., family violence). Results show a link between observed parenting, child characteristics, and family violence. Higher levels of children’s externalizing problems were associated with more severe maternal coercion. In addition, a negative association was found between family violence and maternal warmth. Findings are discussed in terms of their implications for prevention and intervention programs and the use of behavioral observations in post-conflict environments.
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