Skip to main content
Top
Published in: Child and Adolescent Psychiatry and Mental Health 1/2018

Open Access 01-12-2018 | Research article

Lifetime and past-year prevalence of children’s exposure to violence in 9 Balkan countries: the BECAN study

Authors: George Nikolaidis, Kiki Petroulaki, Foteini Zarokosta, Antonia Tsirigoti, Altin Hazizaj, Enila Cenko, Jelena Brkic-Smigoc, Emir Vajzovic, Vaska Stancheva, Stefka Chincheva, Marina Ajdukovic, Miro Rajter, Marija Raleva, Liljana Trpcevska, Maria Roth, Imola Antal, Veronika Ispanovic, Natasha Hanak, Zeynep Olmezoglu-Sofuoglu, Ismail Umit-Bal, Donata Bianchi, Franziska Meinck, Kevin Browne

Published in: Child and Adolescent Psychiatry and Mental Health | Issue 1/2018

Login to get access

Abstract

Background

Children’s exposure to violence is a major public health issue. The Balkan epidemiological study on Child Abuse and Neglect project aimed to collect internationally comparable data on violence exposures in childhood.

Methods

A three stage stratified random sample of 42,194 school-attending children (response rate: 66.7%) in three grades (aged 11, 13 and 16 years) was drawn from schools in Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Former Yugoslavian Republic of Macedonia (FYROM), Greece, Romania, Serbia and Turkey. Children completed the ICAST-C questionnaire, which measures children’s exposure to violence by any perpetrator.

Results

Exposure rates for psychological violence were between 64.6% (FYROM) and 83.2% (Greece) for lifetime and 59.62% (Serbia) and 70.0% (Greece) for past-year prevalence. Physical violence exposure varied between 50.6% (FYROM) and 76.3% (Greece) for lifetime and 42.5% (FYROM) and 51.0% (Bosnia) for past-year prevalence. Sexual violence figures were highest for lifetime prevalence in Bosnia (18.6%) and lowest in FYROM (7.6%). Lifetime contact sexual violence was highest in Bosnia (9.8%) and lowest in Romania (3.6%). Past-year sexual violence and contact sexual violence prevalence was lowest in Romania (5.0 and 2.1%) and highest in Bosnia (13.6 and 7.7% respectively). Self-reported neglect was highest for both past-year and lifetime prevalence in Bosnia (48.0 and 20.3%) and lowest in Romania (22.6 and 16.7%). Experiences of positive parental practices were reported by most participating children in all countries.

Conclusions

Where significant differences in violence exposure by sex were observed, males reported higher exposure to past-year and lifetime sexual violence and females higher exposure to neglect. Children in Balkan countries experience a high burden of violence victimization and national-level programming and child protection policy making is urgently needed to address this.
Appendix
Available only for authorised users
Literature
1.
go back to reference Kempe CH, Silverman FN, Steele BF, Droegemueller W, Silver HK. The battered-child syndrome. JAMA J Am Med Assoc. 1962;181:17.CrossRef Kempe CH, Silverman FN, Steele BF, Droegemueller W, Silver HK. The battered-child syndrome. JAMA J Am Med Assoc. 1962;181:17.CrossRef
2.
go back to reference World Health Assembly. Prevention of violence. Geneva: WHO; 1997. World Health Assembly. Prevention of violence. Geneva: WHO; 1997.
3.
go back to reference World Health Organziation. Report of the consultation on child abuse prevention. Geneva: WHO; 1999. World Health Organziation. Report of the consultation on child abuse prevention. Geneva: WHO; 1999.
4.
go back to reference Norman RE, Byambaa M, De R, Butchart A, Scott J, Vos T. The long-term health consequences of child physical abuse, emotional abuse, and neglect: a systematic review and meta-analysis. PLoS Med. 2012;9:e1001349.CrossRefPubMedPubMedCentral Norman RE, Byambaa M, De R, Butchart A, Scott J, Vos T. The long-term health consequences of child physical abuse, emotional abuse, and neglect: a systematic review and meta-analysis. PLoS Med. 2012;9:e1001349.CrossRefPubMedPubMedCentral
5.
go back to reference Carr CP, Martins CMS, Stingel AM, Lemgruber VB, Juruena MF. The role of early life stress in adult psychiatric disorders. J Nerv Ment Dis. 2013;201:1007–20.CrossRefPubMed Carr CP, Martins CMS, Stingel AM, Lemgruber VB, Juruena MF. The role of early life stress in adult psychiatric disorders. J Nerv Ment Dis. 2013;201:1007–20.CrossRefPubMed
7.
go back to reference Lindert J, von Ehrenstein OS, Grashow R, Gal G, Braehler E, Weisskopf MG. Sexual and physical abuse in childhood is associated with depression and anxiety over the life course: systematic review and meta-analysis. Int J Public Health. 2014;59:359–72.CrossRefPubMed Lindert J, von Ehrenstein OS, Grashow R, Gal G, Braehler E, Weisskopf MG. Sexual and physical abuse in childhood is associated with depression and anxiety over the life course: systematic review and meta-analysis. Int J Public Health. 2014;59:359–72.CrossRefPubMed
8.
go back to reference Dube S, Anda R, Felittti D, Chapman D, Williamson W. Childhood abuse, household dysfunction, and the risk of attempted suicide throughout the lifespan. JAMA J Am Med Assoc. 2001;286:3089–96.CrossRef Dube S, Anda R, Felittti D, Chapman D, Williamson W. Childhood abuse, household dysfunction, and the risk of attempted suicide throughout the lifespan. JAMA J Am Med Assoc. 2001;286:3089–96.CrossRef
9.
go back to reference Harford TC, Yi H, Grant BF. Associations between childhood abuse and interpersonal aggression and suicide attempt among US adults in a national study. Child Abuse Negl. 2014;38:1389–98.CrossRefPubMedPubMedCentral Harford TC, Yi H, Grant BF. Associations between childhood abuse and interpersonal aggression and suicide attempt among US adults in a national study. Child Abuse Negl. 2014;38:1389–98.CrossRefPubMedPubMedCentral
10.
go back to reference Liu J, Fang Y, Gong J, Cui X, Meng T, Xiao B, et al. Associations between suicidal behavior and childhood abuse and neglect: a meta-analysis. J Affect Disord. 2017;220:147–55.CrossRefPubMed Liu J, Fang Y, Gong J, Cui X, Meng T, Xiao B, et al. Associations between suicidal behavior and childhood abuse and neglect: a meta-analysis. J Affect Disord. 2017;220:147–55.CrossRefPubMed
11.
go back to reference Proctor LJ, Lewis T, Roesch S, Thompson R, Litrownik AJ, English D, et al. Child maltreatment and age of alcohol and marijuana initiation in high-risk youth. Addict Behav. 2017;75:64–9.CrossRefPubMed Proctor LJ, Lewis T, Roesch S, Thompson R, Litrownik AJ, English D, et al. Child maltreatment and age of alcohol and marijuana initiation in high-risk youth. Addict Behav. 2017;75:64–9.CrossRefPubMed
12.
go back to reference Nemeroff CB. Paradise lost: the neurobiological and clinical consequences of child abuse and neglect. Neuron. 2016;89:892–909.CrossRefPubMed Nemeroff CB. Paradise lost: the neurobiological and clinical consequences of child abuse and neglect. Neuron. 2016;89:892–909.CrossRefPubMed
13.
go back to reference Fergusson DM, McLeod GFH, Horwood LJ. Childhood sexual abuse and adult developmental outcomes: findings from a 30-year longitudinal study in New Zealand. Child Abuse Negl. 2013;37:664–74.CrossRefPubMed Fergusson DM, McLeod GFH, Horwood LJ. Childhood sexual abuse and adult developmental outcomes: findings from a 30-year longitudinal study in New Zealand. Child Abuse Negl. 2013;37:664–74.CrossRefPubMed
14.
go back to reference Boden JM, Horwood LJ, Fergusson DM. Exposure to childhood sexual and physical abuse and subsequent educational achievement outcomes. Child Abuse Negl. 2007;31:1101–14.CrossRefPubMed Boden JM, Horwood LJ, Fergusson DM. Exposure to childhood sexual and physical abuse and subsequent educational achievement outcomes. Child Abuse Negl. 2007;31:1101–14.CrossRefPubMed
15.
go back to reference Debowska A, Boduszek D. Child abuse and neglect profiles and their psychosocial consequences in a large sample of incarcerated males. Child Abuse Negl. 2017;65:266–77.CrossRefPubMed Debowska A, Boduszek D. Child abuse and neglect profiles and their psychosocial consequences in a large sample of incarcerated males. Child Abuse Negl. 2017;65:266–77.CrossRefPubMed
16.
go back to reference Bartlett J, Kotake C, Fauth R, Easterbrooks A. Intergenerational transmission of child abuse and neglect: do maltreatment type, perpetrator, and substantiation status matter? Child Abuse Negl. 2017;63:84–94.CrossRefPubMed Bartlett J, Kotake C, Fauth R, Easterbrooks A. Intergenerational transmission of child abuse and neglect: do maltreatment type, perpetrator, and substantiation status matter? Child Abuse Negl. 2017;63:84–94.CrossRefPubMed
17.
go back to reference UNICEF. Hidden in plain sight: a statistical analysis of violence against children. Report. New York; 2014. UNICEF. Hidden in plain sight: a statistical analysis of violence against children. Report. New York; 2014.
20.
go back to reference Zolotor AJ, Puzia ME. Bans against corporal punishment: a systematic review of the laws, changes in attitudes and behaviours. Child Abuse Rev. 2010;19:229–47.CrossRef Zolotor AJ, Puzia ME. Bans against corporal punishment: a systematic review of the laws, changes in attitudes and behaviours. Child Abuse Rev. 2010;19:229–47.CrossRef
21.
go back to reference Putnam FW. Ten-year research update review: child sexual abuse. J Am Acad Child Adolesc Psychiatry. 2003;42:269–78.CrossRefPubMed Putnam FW. Ten-year research update review: child sexual abuse. J Am Acad Child Adolesc Psychiatry. 2003;42:269–78.CrossRefPubMed
22.
go back to reference Amaya-Jackson L, Socolar R, Hunter W, Runyan D, Colindres R. Directly questioning children and adolescents about maltreatment: a review of survey measures used. J Interpers Violence. 2000;15:725–59.CrossRef Amaya-Jackson L, Socolar R, Hunter W, Runyan D, Colindres R. Directly questioning children and adolescents about maltreatment: a review of survey measures used. J Interpers Violence. 2000;15:725–59.CrossRef
23.
go back to reference Butchart A, Phinney Harvey A, Kahane T, Mian M, Fuerniss T. Preventing child maltreatment: a guide to taking action and generating evidence. Geneva: World Health Organization; 2006. Butchart A, Phinney Harvey A, Kahane T, Mian M, Fuerniss T. Preventing child maltreatment: a guide to taking action and generating evidence. Geneva: World Health Organization; 2006.
24.
go back to reference Bianchi D, Ruggiero R. Guidelines on data collection and monitoring systems on child abuse. Florence: ChildOnEurope; 2009. Bianchi D, Ruggiero R. Guidelines on data collection and monitoring systems on child abuse. Florence: ChildOnEurope; 2009.
25.
go back to reference Meinck F, Steinert JI, Sethi D, Gilbert R, Bellis M, Mikton C, et al. Measuring and monitoring national prevalence of child maltreatment: a practical handbook. Copenhagen: World Health Organization Regional Office for Europe; 2016. Meinck F, Steinert JI, Sethi D, Gilbert R, Bellis M, Mikton C, et al. Measuring and monitoring national prevalence of child maltreatment: a practical handbook. Copenhagen: World Health Organization Regional Office for Europe; 2016.
26.
go back to reference Zolotor AJ, Runyan DK, Dunne MP, Jain D, Péturs HR, Ramirez C, et al. ISPCAN Child Abuse Screening Tool Children’s Version (ICAST-C): instrument development and multi-national pilot testing. Child Abuse Negl. 2009;33:833–41.CrossRefPubMed Zolotor AJ, Runyan DK, Dunne MP, Jain D, Péturs HR, Ramirez C, et al. ISPCAN Child Abuse Screening Tool Children’s Version (ICAST-C): instrument development and multi-national pilot testing. Child Abuse Negl. 2009;33:833–41.CrossRefPubMed
27.
go back to reference Runyan DK, Dunne MP, Zolotor AJ, Madrid B, Jain D, Gerbaka B, et al. The development and piloting of the ISPCAN Child Abuse Screening Tool—Parent version (ICAST-P). Child Abuse Negl. 2009;33:826–32.CrossRefPubMed Runyan DK, Dunne MP, Zolotor AJ, Madrid B, Jain D, Gerbaka B, et al. The development and piloting of the ISPCAN Child Abuse Screening Tool—Parent version (ICAST-P). Child Abuse Negl. 2009;33:826–32.CrossRefPubMed
28.
go back to reference Radford L, Corral S, Bradley C, Fisher HL. The prevalence and impact of child maltreatment and other types of victimization in the UK: findings from a population survey of caregivers, children and young people and young adults. Child Abuse Negl. 2013;37:801–13.CrossRefPubMed Radford L, Corral S, Bradley C, Fisher HL. The prevalence and impact of child maltreatment and other types of victimization in the UK: findings from a population survey of caregivers, children and young people and young adults. Child Abuse Negl. 2013;37:801–13.CrossRefPubMed
29.
go back to reference Iovu M. The potential of ISPCAN Child Abuse Screening Tool Children’s Version (ICAST-CH) for mapping child maltreatment experiences. In: Dulama E, Valcan T, Ciocian M, editors. Perspect. asupra Probl. din Domen. Educ. - Cercet. si Apl. Cluj-Napoca: Presa Universitara Clujeana; 2012. p. 7–22. Iovu M. The potential of ISPCAN Child Abuse Screening Tool Children’s Version (ICAST-CH) for mapping child maltreatment experiences. In: Dulama E, Valcan T, Ciocian M, editors. Perspect. asupra Probl. din Domen. Educ. - Cercet. si Apl. Cluj-Napoca: Presa Universitara Clujeana; 2012. p. 7–22.
30.
go back to reference Chang H-Y, Lin C-L, Chang Y-T, Tsai M-C, Feng J-Y. Psychometric testing of the Chinese version of ISPCAN Child Abuse Screening Tools Children’s Home Version (ICAST-CH-C). Child Youth Serv Rev. 2013;35:2135–9.CrossRef Chang H-Y, Lin C-L, Chang Y-T, Tsai M-C, Feng J-Y. Psychometric testing of the Chinese version of ISPCAN Child Abuse Screening Tools Children’s Home Version (ICAST-CH-C). Child Youth Serv Rev. 2013;35:2135–9.CrossRef
31.
go back to reference Runyan D, Brandspigel S, Zolotor A, Dunne M. Manual for Administration: The ISPCAN Child Aubse Screening Tool (ICAST). Aurora: International Society for the Prevention of Child Abuse and Neglect; 2015. Runyan D, Brandspigel S, Zolotor A, Dunne M. Manual for Administration: The ISPCAN Child Aubse Screening Tool (ICAST). Aurora: International Society for the Prevention of Child Abuse and Neglect; 2015.
32.
go back to reference Petroulaki K, Tsirigoti A, Nikolaidis G. Training manual and guidelines for researchers for the modified ICAST-CH and ICAST-P Questionnaires. Athens: BECAN Consortium; 2010. Petroulaki K, Tsirigoti A, Nikolaidis G. Training manual and guidelines for researchers for the modified ICAST-CH and ICAST-P Questionnaires. Athens: BECAN Consortium; 2010.
33.
go back to reference Borgers N, de Leeuw E, Hoax J. Children as responders to survey research: cognitive development and response quality. Bull Methodol Sociol. 2000;66:60–6.CrossRef Borgers N, de Leeuw E, Hoax J. Children as responders to survey research: cognitive development and response quality. Bull Methodol Sociol. 2000;66:60–6.CrossRef
34.
go back to reference Petroulaki K, Tsirigoti A, Zarokosta F, Nikolaidis G. Epidemiological survey on child abuse and neglect in 9 Balkan Countries. Athens: BECAN Consortium; 2013. Petroulaki K, Tsirigoti A, Zarokosta F, Nikolaidis G. Epidemiological survey on child abuse and neglect in 9 Balkan Countries. Athens: BECAN Consortium; 2013.
35.
go back to reference Petroulaki K, Tsirigoti A, Zarokosta F, Nikolaidis G. Epidemiological characteristics of minors’ exposure to experiences of violence in Greece: the BECAN study. Psychiatriki. 2013;24:262–71.PubMed Petroulaki K, Tsirigoti A, Zarokosta F, Nikolaidis G. Epidemiological characteristics of minors’ exposure to experiences of violence in Greece: the BECAN study. Psychiatriki. 2013;24:262–71.PubMed
36.
go back to reference Ajdukovic M, Susac N, Rajter M. Gender and age differences in prevalence and incidence of child sexual abuse in Croatia. Croat Med J. 2013;54:469–79.CrossRefPubMedPubMedCentral Ajdukovic M, Susac N, Rajter M. Gender and age differences in prevalence and incidence of child sexual abuse in Croatia. Croat Med J. 2013;54:469–79.CrossRefPubMedPubMedCentral
37.
go back to reference Sofuoğlu Z, Oral R, Aydın F, Cankardeş S, Kandemirci B, Koç F, et al. Epidemiological study of negative childhood experiences in three provinces of Turkey. Turk Pediatr Ars Turk Pediatr Assoc. 2014;49:47–56.CrossRef Sofuoğlu Z, Oral R, Aydın F, Cankardeş S, Kandemirci B, Koç F, et al. Epidemiological study of negative childhood experiences in three provinces of Turkey. Turk Pediatr Ars Turk Pediatr Assoc. 2014;49:47–56.CrossRef
38.
go back to reference Stoltenborgh M, Bakermans-Kranenburg MJ, Alink LRA, van IJzendoorn MH. The universality of childhood emotional abuse: a meta-analysis of worldwide prevalence. J Aggress Maltreat Trauma. 2012;21:870–90.CrossRef Stoltenborgh M, Bakermans-Kranenburg MJ, Alink LRA, van IJzendoorn MH. The universality of childhood emotional abuse: a meta-analysis of worldwide prevalence. J Aggress Maltreat Trauma. 2012;21:870–90.CrossRef
39.
go back to reference Meinck F, Cosma AP, Mikton C, Baban A. Psychometric properties of the Adverse Childhood Experiences Abuse Short Form (ACE-ASF) among Romanian high school students. Child Abuse Negl. 2017;72:326–37.CrossRefPubMed Meinck F, Cosma AP, Mikton C, Baban A. Psychometric properties of the Adverse Childhood Experiences Abuse Short Form (ACE-ASF) among Romanian high school students. Child Abuse Negl. 2017;72:326–37.CrossRefPubMed
40.
go back to reference Stoltenborgh M, Bakermans-Kranenburg MJ, van Ijzendoorn MH, Alink LRA. Cultural-geographical differences in the occurrence of child physical abuse? A meta-analysis of global prevalence. Int J Psychol TF. 2013;48:81–94.CrossRef Stoltenborgh M, Bakermans-Kranenburg MJ, van Ijzendoorn MH, Alink LRA. Cultural-geographical differences in the occurrence of child physical abuse? A meta-analysis of global prevalence. Int J Psychol TF. 2013;48:81–94.CrossRef
41.
go back to reference UNICEF. The state of the world’s children 2008: women and children—child survival. New York: UNICEF; 2008. p. 2007.CrossRef UNICEF. The state of the world’s children 2008: women and children—child survival. New York: UNICEF; 2008. p. 2007.CrossRef
42.
go back to reference Stoltenborgh M, van IJzendoorn MH, Euser EM, Bakermans-Kranenburg MJ. A global perspective on child sexual abuse: meta-analysis of prevalence around the world. Child Maltreat. 2011;16:79–101.CrossRefPubMed Stoltenborgh M, van IJzendoorn MH, Euser EM, Bakermans-Kranenburg MJ. A global perspective on child sexual abuse: meta-analysis of prevalence around the world. Child Maltreat. 2011;16:79–101.CrossRefPubMed
43.
go back to reference Al-Eissa MA, AlBuhairan FS, Qayad M, Saleheen H, Runyan D, Almuneef M. Determining child maltreatment incidence in Saudi Arabia using the ICAST-CH: a pilot study. Child Abuse Negl. 2015;42:174–82.CrossRefPubMed Al-Eissa MA, AlBuhairan FS, Qayad M, Saleheen H, Runyan D, Almuneef M. Determining child maltreatment incidence in Saudi Arabia using the ICAST-CH: a pilot study. Child Abuse Negl. 2015;42:174–82.CrossRefPubMed
44.
go back to reference Artz L, Burton P, Ward CL, Leoschut L, Phyfer J, Loyd S, et al. Optimus study South Africa: technical report sexual victimisation of children in South Africa. Zurich: UBS Optimus Foundation; 2016. Artz L, Burton P, Ward CL, Leoschut L, Phyfer J, Loyd S, et al. Optimus study South Africa: technical report sexual victimisation of children in South Africa. Zurich: UBS Optimus Foundation; 2016.
45.
go back to reference Stoltenborgh M, Bakermans-Kranenburg MJ, van Ijzendoorn MH. The neglect of child neglect: a meta-analytic review of the prevalence of neglect. Soc Psychiatry Psychiatr Epidemiol. 2013;48:345–55.CrossRefPubMed Stoltenborgh M, Bakermans-Kranenburg MJ, van Ijzendoorn MH. The neglect of child neglect: a meta-analytic review of the prevalence of neglect. Soc Psychiatry Psychiatr Epidemiol. 2013;48:345–55.CrossRefPubMed
46.
go back to reference Finkelhor D, Turner H, Ormrod R, Hamby SL. Violence, abuse, and crime exposure in a national sample of children and youth. Pediatrics. 2009;124:1411–23.CrossRefPubMed Finkelhor D, Turner H, Ormrod R, Hamby SL. Violence, abuse, and crime exposure in a national sample of children and youth. Pediatrics. 2009;124:1411–23.CrossRefPubMed
47.
go back to reference Johnsona R, Kotch J, Catellier D, Winsor J, Dufort V, Hunter W, et al. Adverse behavioural and emotional outcomes from child abuse and witnessed violence. Child Maltreat. 2002;7:179–86.CrossRef Johnsona R, Kotch J, Catellier D, Winsor J, Dufort V, Hunter W, et al. Adverse behavioural and emotional outcomes from child abuse and witnessed violence. Child Maltreat. 2002;7:179–86.CrossRef
48.
go back to reference Hardt J, Rutter M. Validity of adult retrospective reports of adverse childhood experiences: review of the evidence. J Child Psychol Psychiatry. 2004;45:260–73.CrossRefPubMed Hardt J, Rutter M. Validity of adult retrospective reports of adverse childhood experiences: review of the evidence. J Child Psychol Psychiatry. 2004;45:260–73.CrossRefPubMed
49.
Metadata
Title
Lifetime and past-year prevalence of children’s exposure to violence in 9 Balkan countries: the BECAN study
Authors
George Nikolaidis
Kiki Petroulaki
Foteini Zarokosta
Antonia Tsirigoti
Altin Hazizaj
Enila Cenko
Jelena Brkic-Smigoc
Emir Vajzovic
Vaska Stancheva
Stefka Chincheva
Marina Ajdukovic
Miro Rajter
Marija Raleva
Liljana Trpcevska
Maria Roth
Imola Antal
Veronika Ispanovic
Natasha Hanak
Zeynep Olmezoglu-Sofuoglu
Ismail Umit-Bal
Donata Bianchi
Franziska Meinck
Kevin Browne
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Child and Adolescent Psychiatry and Mental Health / Issue 1/2018
Electronic ISSN: 1753-2000
DOI
https://doi.org/10.1186/s13034-017-0208-x

Other articles of this Issue 1/2018

Child and Adolescent Psychiatry and Mental Health 1/2018 Go to the issue