Conocimientos sobre maltrato infantil en adolescentes maltratados y padres o tutores / Knowledge on child maltreatment in maltreated adolescents and in parents or tutors

Introducción: el maltrato infantil es un problema universal y multicausal que involucra factores biopsicosociales, en el que intervienen las características del agresor, el agredido, el medio ambiente y otras, no siempre bien reconocidas.Objetivo: evaluar los conocimientos sobre maltrato infantil en adolescentes ingresados por lesiones, o circunstancias que hicieron sospechar presencia de maltrato infantil, y que después se confirmó, así como en sus padres y/o tutores legales.Métodos: estudio descriptivo transversal, en 50 adolescentes ingresados por lesiones o circunstancias que hicieron sospechar presencia de maltrato infantil, y que después se confirmó durante su estancia en los servicios del Hospital Pediátrico Juan Manuel Márquez, durante el período comprendido de octubre de 2013 a octubre de 2014. Se les aplicó encuesta confeccionada al efecto. Los datos fueron incluidos en una base de datos automatizada con la hoja de cálculo electrónica Excel 2003, resumidos y representados en tablas estadísticas, y expresados textualmente. Se utilizó la estadística descriptiva. Resultados: el 90 y 92 por ciento de los adolescentes y padres respectivamente no tenían conocimientos sobre el maltrato infantil. Los tipos de maltratos infantiles identificados fueron: el psicológico en 36 por ciento, la negligencia en 22 por ciento y el físico en 20 por ciento. El 78 por ciento de los adolescentes y el 84 por ciento de los padres no tenían percepción del maltrato recibido o impartido.Conclusiones: existe insuficiente conocimiento del maltrato infantil en los adolescentes, y sus padres o tutores((AU)

Introduction: child maltreatment is a universal multi-cause problem involving biopsychosocial factors that comprise the agressor's and the victim's characteristics, the environment and others not well-accepted causes. Objective: to evaluate the knowledge on child maltreatment in adolescents admitted to hospital on account of injures or circumstances that may arouse suspicions of child maltreatment as well as in their fathers and/or legal tutors. Methods: descriptive and cross-sectional study of 50 adolescents who were hospitalized because of injuries or circumstances that aroused suspicions of maltreatment, which were later confirmed in their stay at Juan Manuel Marquez pediatric hospital from October 2013 to October 2014. They were surveyed and the collected data were entered into a database with Excel 2003, summarized and represented in statistical tables and expressed in the text. Summary statistics was used. Results: ninety percent of adolescents and 92 percent of parents did not have any knowledge about child maltreatment. The identified types of child maltreatment were psychological in 36 percent of cases, negligence in 22 percent and physical in 20 percent. Seventy and eight percent of adolescents and 84 percent of parents did not have any perception of the maltreatment given or received(AU)

The origin of maltreatment: An exploratory study on the intergenerational transmission of child abuse typologies

El objetivo del trabajo que se informa fue determinar si, en casos de transmisión inter-generacional de maltrato, se verificaba transmisión de tipologías de abuso y establecer el contexto del abuso. Se desarrolló un estudio exploratorio con 10 agresores de niños, quienes habían sido víctimas de abuso. Para la recolección de datos se utilizaron una entrevista semi-estructurada y un cuestionario socio-demográfico. Se realizó un análisis del contenido para estudiar los datos textuales, el test de Fisher para determinar la posible dependencia entre los tipos de abuso sufridos y practicados y análisis del componente principal para explorar asociaciones entre categorías. Se verificó la transmisión del abuso físico en siete casos, en dos casos de abuso psicológico y en dos de negligencia. No se encontró asociación estadísticamente significativa entre las tipologías de abuso sufrido y practicado. Las categorías Entorno Familiar (218 unidades de registro -u.r- unidad de codificación básica) y Relaciones Intrafamiliares (151u.r.) presentaron el mayor número de u.r., y las categorías Abuso Sexual (1u.r.) y Agresor como Figura de Identificación Reconocida (4u.r.), el más bajo. El contexto del abuso se explica mejor mediante un modelo bidimensional: Maltrato e Interacciones Sociales y Contexto del Abuso, Sentimientos y Percepciones. Se encontraron fuertes asociaciones entre Abuso Psicológico y Físico, Relaciones Interpersonales, Inclinación al Abuso y Hábitos Tóxicos, y entre ser la única víctima de agresiones, viendo al otro como figura de identificación y sentimientos negativos hacia el agresor. La transmisión de las tipologías de abuso no fue significativa, pero se encontraron asociaciones entre aspectos contextuales y son discutidos junto con sus limitaciones e implicaciones.

The way child maltreatment has been seen and dealt with has changed over time. Nowadays, it is a phenomenon of great importance and social recognition, being the target of many studies, and having led to the creation and implementation of several protection measures. The intergenerational transmission of maltreatment is one of the main causes for current child abuse and neglect. In this way, our objective was to assess whether a transmission of abuse typologies occurred, in the cases where an intergenerational transmission of maltreatment is observed. Thus, we developed an exploratory study using a convenience sample of 10 child aggressors, who had been victims of abuse during their own childhood, from the district. All participants fulfilled the inclusion criteria and had similar socio-economic background. The participants gave their informed consent to participate in this study. For data collection we used a semi-structured interview, developed specifically for this study, and a socio-demographic questionnaire that enabled a characterization of the sample. All the interviews were recorded and transcribed verbatim. The data produced was then analyzed using as used content analysis, to study the textual data collected with the interviews, and principal components analysis. Fisher’s test was used to determine the association between suffered and inflicted types of abuse (p < .005 was considered significant). Based on our data analysis we observed that in seven cases there was an intergenerational transmission of Physical Abuse, in two cases of Psychological Abuse and in another two cases of Neglect. In four cases different types of abuse, than those suffered, arose. In five cases, several types of abuse were inflicted concomitantly. However, there was no statistically significant relation between the types of abuse suffered and those inflicted. Furthermore, 813 recording units (r.u. - which are basic codification units) were obtained in the content analysis, throughout the seven pre-categories (21 categories, 10 sub-categories). The content analysis’ categories Family Environment and Intra-family Relationships, were the ones with the highest number of r.u., and also the most disparate, when compared with the remaining categories (Family Environment = 218 r.u., Intra-family Relationships = 151 r.u.); being followed by Physical Abuse (87 r.u.) and Feelings towards the Perpetrator (58 r.u.). In opposition, the categories with the lowest number of r.u. were Sexual Abuse (1 r.u.) and Aggressor as Recognized Identification Figure (4 r.u.). Moreover, we also found differences between the participants who inflict Physical Abuse and those who are negligent, as Physical Abuse is transmitted in most cases while negligence is not. Differences were also found in the quality of the family environment, outside-family relationships and self-recognition as aggressors. A relation between excusing / exonerating the aggressor and feeling self-guilt for the abuse was found. Also, a relation between naming the aggressor as the identification figure and self-recognition as an aggressor was found in this sample. A principal component analysis was performed and the results evidenced that the context where the abuse occurs is better explained by a two-dimension model, being the dimensions Maltreatment and Social Interactions and Abuse Context, Feelings and Perceptions. Strong associations were found between Psychological and Physical Abuse, Interpersonal Relationships, Feelings towards Abuse, and Toxic Habits / Consumptions, or no apparent reason as causes for abuse; and between being the only victim of aggressions, perceiving other (not the aggressor) as an identification figure and negative feelings towards the aggressor. The transmission of abuse typologies was not statistically significant in this sample; however associations between contextual aspects were found and are discussed along with the limitations and implications of this study. Furthermore, we believe this information could be applied in the development of primary prevention and intervention programs.