Violence prevention in adolescence

THE WORLD Health Organization (WHO) defines violence as the intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community, which either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelop-ment, or deprivation.

The protection of children from all forms of violence was recognised as a right of children in the 1989 United Nations Convention on the Rights of the Child, ratified by Jamaica in 1991. Prevention of violence against children (VAC) has been identified as important to national and human development because of its long-term impact on children’s development and the economy.

Children can be exposed to violence at every developmental stage and in all locations: home, school and community. However, both the nature of VAC and its potential impacts differ according to children’s level of development, as well as the family context and community in which they live. In early adolescence (10-14 years), children become more independent and interact with wider groups of people. Boys are more likely to be physically attacked or suffer intentional and unintentional injuries. There is also an increase in fighting between children, and exposure to cyberbullying, with its risks for sexual exploitation. Both sexes experience corporal punishment, and our current information suggests that girls disproportionately experience sexual abuse. However, there is limited information on sexual abuse of boys.

In late adolescence (15-19 years), girls continue to experience sexual abuse by family members and caregivers, but are also increasingly vulnerable to the kind of aggression directed towards older women, including intimate partner violence. Boys, on the other hand, are more vulnerable to physical attacks by family members and others, and are at greater risk of dying from homicide. Gender disparities widen in adolescence; boys gain autonomy, mobility, opportunity and power, (including power over girls’ sexual and reproductive lives), while girls are correspondingly deprived.

During adolescence, girls are increasingly socialised into gender roles and are under pressure to conform to conventional notions of masculinity and femininity.

EXPOSURE TO VIOLENCE DATA

International estimates indicate (see Figure below) that 1.3 billion boys and girls experienced corporal punishment or violent disciplining at home in the previous year; 261 million schoolchildren 13-15 years experienced peer violence, including bullying and physical fights. Some 18 million adolescent girls aged 15-19 years have experienced sexual abuse at some point in their childhood, and 55 million adolescent girls in the same age group had experienced physical violence since age 15. Most concerning is that 100,000 children were victims of homicide in the past year.

In Jamaica, more than 90 per cent of 11-12-year-olds had experienced corporal punishment at home and at school, 35 per cent had witnessed community violence, and more than 90 per cent had been victims of peer or community violence, while 34 per cent had witnessed physical intimate partner violence.

POLYVICTIMISATION

Polyvictimisation, or the exposure to multiple forms of

violence, is particularly high in Jamaica, with no exposure to violence or exposure to a single form only occurring in 2.2 per cent. Most children had experienced two (37.9 per cent), three (45.1 per cent) or four and five forms (14.8 per cent) of violence. Polyvictimisation is more detrimental than exposure to repeated forms of a single type of violence.

Jamaican children of both sexes who had experienced polyvictimisation were at greater risk for impaired intellectual functioning or reasoning and poor school performance as a result. Additionally, boys had more disruptive and aggressive behaviours. The interventions required to address these effects, including one-on-one psychological support and remedial/special education for large numbers of children are not affordable. Consequently, prevention of exposure to violence in all its forms is the recommended approach to reduce violencerelated morbidity.

Three main successful evidence-based approaches to prevention have been identified: enhancing individual capacities of persons, embedding violence prevention strategies into existing services, and institutions and eliminating the root cause of violence.

Enhancing individual capacities of parents, caregivers and community members through parenting and child development programmes that include violence prevention, as well as social protection programmes for those who require it, can both prevent violence and create a nurturing environment free from fear for children to realise their full potential.

Children themselves can also be equipped with skills that build resilience and capabilities to act in their own interests, to cope with stress and adversity, and to reject harmful social norms, including rigid attitudes to masculinity.

VIOLENCE PREVENTION

Violence prevention should be embedded in services that children and families normally access, including health and education services. This aims to strengthen families and communities so they can provide the care and protection children need and identify those who require additional services early. This requires new forms of training for healthcare, education and social service providers. High-quality earlychildhood development is particularly important to violence prevention in adulthood.

Eliminating root causes of violence include supporting community development to reduce gang infiltration; community policing to build trust; design of public spaces to reduce physical factors (e.g., poor lighting) that promote violence; targeting high-risk communities for social intervention; and changing social norms that promote violence, including banning corporal punishment and providing education on non-physical forms of discipline.

REFERENCES

Know Violence in Childhood, 2017. Ending Violence in Childhood. Global Report 2017. Know Violence in Childhood. New Delhi, India.

The impact of polyvictimisation on children in LMICs: the case of Jamaica. Samms-Vaughan M., Lambert M. Psychol Health Med. 2017 Mar;22(sup1):67-80. MAUREEN SAMMSVAUGHAN, Professor of Child Health, Child Development & Behaviour, Department of Child & Adolescent Health, UWI