طول عمر و شیوع خشونت در کودکان در سال گذشته در 9 شهرستان بالکان: مطالعه BECAN Lifetime and past-year prevalence of children’s exposure to violence in 9 Balkan countries: the BECAN study

Background Violence against children has attracted gradually increasing clinical attention over recent decades. From its frst reporting by the American pediatrician Henry Kempe in the 1960s [1] up to its recognition by the World Health Organization as a major public health issue in the late 1990s [2, 3], perspectives on the subject matter have changed drastically. During the last decades, violence against children has experienced increasingly interdisciplinary attention, frst predominantly in social policy, social work, psychology and clinical practice and more recently also in public health. Reasons and causes of the phenomenon’s increased visibility over the years should be attributed to the literature on the severe implications of early exposure of children to violence or deprivation. Violence exposure in childhood is associated with negative physical and emotional health outcomes [4] which include anxiety and depression [5–7], suicidal ideation [8–10], substance use [11], dissociation and personality disorders, neurobiological implications [12] as well as with wider psychosocial consequences such as adolescent delinquency, educational shortcomings [13, 14], difculties in relationships and family roles in adulthood, criminal activity [15] and reproduction of the “circle of violence” [16]. Tis paper follows the UNICEF defnitions of violence against children and uses this interchangeably with the term children’s exposure to violence. Physical violence against children includes “all corporal punishment and all other forms of torture, cruel, inhuman or degrading treatment or punishment as well as physical bullying and hazing by adults or other children”. Psychological violence includes all “psychological maltreatment, mental abuse, verbal abuse and emotional abuse or neglect”. Sexual violence includes “any sexual activities imposed by an adult or child against which the child is entitled to protection by criminal law. […] Sexual activities are also considered as abuse when committed against a child by any other child if the ofender is signifcantly older than the victim or uses power, threat or other means of pressure”. Neglect includes the “failure to meet children’s physical and psychological needs, protect them from danger or obtain medical, birth registration or other services when those responsible for their care have the means, knowledge and access to services to do so [17]”. Violence against children is thus more broadly defned than child abuse and neglect or child maltreatment. Violence against children has over the past decade attracted international attention and its prevention and reduction has now been included into the Sustainable Development Goals [18]. Tere is currently a global interest to multiply eforts and join forces to eradicate children’s exposure to all forms of violence and increase awareness of the problem at global and local levels. An increasing number of countries across the globe have prohibited all forms of violence against children [19]. Of the nine countries participating in this study, Greece, Romania, Bulgaria and Croatia had enacted laws prohibiting violence against children in the home and school. Albania and Former Yugoslav Republic Of Macedonia (FYROM) joined them in 2010 and 2013, while Bosnia and Herzegovina, Serbia and Turkey have expressed commitment to law reforms banishing violence against children in all settings [19]. A recent systematic review found that attitudes condoning corporal punishment and other forms of violence against children decrease drastically in countries with legislation that bans all forms of violence against children, as do prevalence rates [20].