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Table 4 Violence against children results

From: Mental health of women and children experiencing family violence in conflict settings: a mixed methods systematic review

Author Prevalence of family violence Prevalence of a mental health problem Evidence of association between family violence and mental health problem
Catani (2008) [12]
Sri Lanka
95.6% reported at least one family violence event type ever. 64.2% in the last month
Children experienced or witnessed 5.3 (SD = 3.2) violent event types. 68.8% of children reported being beaten with an object. 18% of children had suffered at least one injury because of the violent treatment, and 10% of them needed medical treatment. 55.4% reported having witnessed other family members being hit
4.3% reported having experienced or witnessed at least one incident of sexual abuse or sexual violence at home
PTSD: 30.4% (28.5% boys; 32.6% girls); Major Depressive Disorder: 19.6%;
Past suicidality: 22.6%; Current suicidal ideation: 17.2%
Exposure to war predicted family violence (p < 0.001)
Exposure to family violence predicted PTSD symptoms (p < 0.001)
Catani (2009) [40]
Afghanistan
77% (71.3% girls, 81.3% boys) reported at least one type of family violence event ever. 35.2% in the last month
Children witnessed on average 4.3 violent event types within family (mean boys = 5.0, girls: 3.5)
23.2% had ever witnessed other family members being hit. 31.5% had witnessed their mother being beaten by the father
41.6% children reported being beaten by their father. 59.9% children reported being beaten by mother. 11% children suffered at least one injury (bruises, bleeding and broken bones)
14.1% and 26.1% of the boys fulfilled all DSM- IV criteria for probable PTSD Exposure to war predicted family violence in girls (p < 0.001) but not boys
Correlation between family violence and PTSD (p < 0.01)
Fayyad (2017) [47]
Lebanon
Prevalence of violence in the overall group not given 38% of the students had post-war mental health problems as measured by the SDQ plus impact variable
36% had a CRIES score above 30 (PTSD)
Degree of war exposure was a significant predictor of both SDQ (OR 1.42; 95% CI 1.12–1.80) and CRIES (OR 1.41; 95% CI 1.11–1.80)
Stratified by SDQ score (Low SDQ score group = no problem; High or borderline SDQ score = postwar problem)
Parents hit: Low SDQ score group = 2% parents hit; high SDQ score = 13.7% (p =  < 0.001)
Parents hit each other: Low SDQ score group = 2% parents hit; high SDQ score = 11.6% (p = 0.001)
Faced family violence: Low SDQ score group = 17.5% parents hit; high SDQ score = 37.4% (p = 0.001)
Stratified by CRIES score (CRIES < 30 = not indicating PTSD; ≥ 30 indicating PTSD)
Family violence: CRIES < 30 = 19.8%; CRIES ≥ 30 = 35.2% (p value = 0.013)
O'Leary (2018) [27]
Afghanistan
71% of reported some level of physical violence
At home: 36.2% were hit or hurt, 86.1% screamed at aggressively, 70% called names, 70.7% were pushed, grabbed or kicked; no child reported sexual abuse
  
Panter-Brick (2011) [43]
Afghanistan
Family violence was reported in 47% by at least one informant over the previous year
11.5% family-level violence (severe physical beatings)
  Family violence (severe beating) was associated with an increase in SDQ (p =  < 0.01) and CRIES (p =  < 0.05) scores but not depression (DSRS)
For SDQ, scores increased by 1.85 points (CI 0.03, 3.66) with traumatic beatings and 1.26 points (CI 0.50, 2.03) with a family member who is violent at home
Panter-Brick (2015) [42]
Afghanistan
27% report domestic violence in the last year Mental health was measured at two timepoints T1 and T2. Mean scores at each time point were:
CRIES: T1 = 8.0; T2 = 5.9
DSRS: T1 = 9.5; T2 = 7.3
SDQ:T1 = 9.0; T2 = 9.4
Adjusted OR: 4.84 (p < 0.01) stressor of domestic violence causing sustained distress
Saile
(2016) [28] Uganda
88.9% were exposed to at least one event from the family violence spectrum. Mean number of family violence adverse events = 3.85 (SD = 3.33)
77% experienced being hit with an object
53% experienced acts of verbal abuse
42% were threatened
38% reported to have witnessed other family members being beaten, punched, or kicked
Severe physical maltreatment:
15% were punched or kicked on the body 3% were burnt with hot water or a cigarette on purpose
4% of children were threatened to be killed
PTSD = 3.3–7.2%
Depression = 26.3–38.2%
Adjusted model for the association between family violence and mental health outcomes:
SDQ = beta coefficient 0.24 (p < 0.001)
CDI score (depression symptoms) = beta coefficient 0.17 (p < 0.001)
UPID score (PTSD) = beta coefficient 0.11 (p < 0.05)
Mediation pathways
Model assessing the effect size of traumatic exposure leading to family violence to child psychopathology:
SDQ = 0.17 (95% CI 0.10, 0.27)
CDI score (depression symptoms) = 0.07 (95% CI 0.02, 0.12)
UPID score (PTSD) = 0.06 (95% CI -0.01, 0.15)
Model assessing the effect size of traumatic exposure leading to family violence to child psychopathology, mediated by perceived maternal care:
SDQ = 0.07 (95% CI 0.03, 0.11)
CDI score (depression symptoms) = 0.04 (95% CI 0.02, 0.07)
UPID score (PTSD) = 0.04 (95% CI 0.01, 0.08)
Sriskandarajah (2015) [41]
Sri Lanka
83.8% reported at least one event of victimisation at home and 71.6% that the violence was in the last month,
76.9% were slapped on body, arms or legs, 44.8% hit with hard objects, 37.3% threatened verbally, 12.8% had at least one injury, 5% needed medical treatment
Mean number of intimate partner violence events for the mother is 3.4 in the past year
Exposure to mass trauma events was associated with victimisation of the child by both the mother and the father
  
  1. CDI, Child Depression Inventory; CI, confidence interval; CRIES, Child Revised Impact of Events Scale. Score of 30 or more indicates PTSD; DSRS, Depression Self Rating Scale; OR, Odds ratio; SDQ, Strengths and Difficulties Questionnaire; UPID, UPID, University of California at Los Angeles PTSD Reaction Index for DSM-IV