Correction: Aleissa et al. The Association between Video Game Type and Aggressive Behaviors in Saudi Youth: A Pilot Study. Behav. Sci. 2022, 12, 289.

The authors would like to make the following correction to the published paper [...].

The Association between Video Game Type and Aggressive Behaviors in Saudi Youth: A Pilot Study.

Video gaming is a popular source of entertainment among children and adolescents. Although the Middle East is home to one of the fastest growing communities of video game users, most of the research established on this topic has been carried out through small scale studies. Our aim in this study is to assess the prevalence of video game use and its association with aggressive behaviors among adolescents in Saudi Arabia. This is a cross-sectional study involving boys and girls (aged 15−18 years) in both private and public secondary high schools in Riyadh, Saudi Arabia. Each participant completed a self-administered modified version of the aggression questionnaire, which consisted of 29 items scored on a 5-point Likert scale. This questionnaire assessed aggressive behaviors domains: physical aggression, anger, hostility, and verbal aggression and types of videogames and time of use. A total of 485 students were included in this study. The mean age of participants was 16.5 ± 0.9 years; 48% were boys. Adolescents who participated in action games had higher mean verbal (p < 0.01) and physical aggression (p < 0.01) scores. Adventure game players had significantly higher mean scores in all four types of aggressive behavior (p < 0.01). Participants who played simulation games had higher mean verbal aggressiveness (p < 0.01). Adolescents who participated in sports games had greater mean levels of anger (p = 0.01) and physical aggression (p = 0.01). Those who played strategy/puzzle games reported significantly higher mean scores of anger (p < 0.01), hostility (p = 0.01), and verbal aggression (p = 0.01). Females were more likely to show higher mean anger (p < 0.01) scores, whereas males were more likely to show higher mean physical aggression scores (p < 0.01). Conclusions: Our results do suggest that playing video games increases adolescent aggressive behaviors, which has been supported by other studies. We recommend educating parents on the pros and cons of playing video games and that parents schedule and limit the time their children spend playing video games.

Child maltreatment prevention readiness in Bahrain.

BACKGROUND AND OBJECTIVES: Child maltreatment (CM) is a major public health problem worldwide. Despite the well-documented cases of all forms of CM and the improvement of the national response to CM in Bahrain, efforts on the prevention of CM are still limited. The objective of this study was to assess the readiness to implement a national evidence-based CM prevention (CMP) program in Bahrain. METHODS: The cross-sectional study was conducted with 45 key informants who had influence and decision-making power over CMP. RESULTS: The overall score indicated low to moderate readiness. The key informants scored the highest on legislation, mandates, and policies (7.9), which was followed by the knowledge of CM prevention (7.2), institutional resources and links (5.2), and informal social resources (noninstitutional) (5.2). However, the lowest scores were the human and technical resources (1.2), attitudes toward CM prevention (3.3), will to address the problem, and material resources (3.8), current programs implementation and evaluation, and scientific data on CM prevention (4.5). CONCLUSION: This research has identified strengths and gaps in the country that needs to be addressed to develop programs that are responsive to the needs of the community. The development of a comprehensive well-resourced CMP program requires the collaborative efforts of legislators, political leaders, and professionals.

Readiness assessment for implementation of a large scale child maltreatment prevention program in Qatar.

BACKGROUND AND OBJECTIVES: Child maltreatment is a worldwide problem, with lifelong consequences for the survivors. The focus is shifting from Child Maltreatment Protection to Child Maltreatment Prevention. The objective of this descriptive study was to assess readiness for child maltreatment among stakeholders before implementation of large-scale prevention programs in Qatar. METHODS: The study involved structured interviews with 45 representatives of various stakeholders in sectors of national and local entities of Qatar. A survey was conducted among these stakeholders, to explore their perception and level of awareness of child maltreatment in Qatar. All of them responded, with a response rate of 100%. A multidimensional tool, developed by WHO and collaborators from several middle and low-income countries, was used to assess ten dimensions of readiness. RESULTS: Child maltreatment prevention readiness in Qatar is low with a total score of 37.8 on a scale of 0-100. The respondents scored high (≥ 5) in knowledge of child maltreatment (5.3), legislation, mandates and policies (6.8) and informal social resources (non-institutional) (5.6). Participants, however, scored low (≤ 5) in their knowledge about current program implementation and evaluation (1.1), human and technical resources (1.7), institutional resources and links (2.3), material resources (2.8), scientific data on child maltreatment prevention (3.1), attitude towards child maltreatment prevention (4.3) and will to address the problem (4.8). CONCLUSION: Child maltreatment prevention readiness in Qatar is low and requires improvement in some of the areas. It highlighted the need for capacity building among organizations across Qatar for a large scale CMP program to be successfully implemented.

Examining the Relationship Between Witnessing Intimate Partner Violence and Victimization Among Children in Saudi Arabia.

Childhood exposure to violence can lead to physical, mental, and emotional harm, whether a child is a direct victim or a witness to violent events. The aim of this study is to examine the relationship between witnessing intimate partner violence (IPV) and victimization among children. A cross-sectional, national study was conducted in secondary high schools in the five main provinces of Saudi Arabia (SA) using International Society for Prevention of Child Abuse and Neglect (ISPCAN) ISPCAN Child Abuse and Neglect Screening Tool-Child: Home version. Boys and girls, public and private schools were selected to participate. Students (N = 16,939) aged 15 to 18 years completed the survey instrument which included demographics, different types of abuse (physical, psychological, and sexual), neglect, and witnessing IPV. Mean age of the participants was 16.8 ± 0.9 years, and 51% were boys. Eighty-one percent lived with both parents, 6% with single parent, and 2% with step-parent. Fifty-two percent of the participants witnessed IPV. Those who witnessed IPV were more likely to be abused compared with those who did not (p < .01). Among those who witnessed physical IPV, girls had a significantly greater likelihood of experiencing psychological abuse (odds ratio [OR] = 3.7, confidence interval [CI] = [1.9, 6.8]), physical abuse (OR = 1.3, CI = [1.0, 1.6]), and neglect (OR = 1.6, CI = [1.4, 1.9]) but less likelihood of experiencing sexual abuse (OR = 0.6, CI = [0.5, 0.7]) than boys. Among those who witnessed psychological IPV, girls had a significantly greater likelihood of experiencing neglect (OR = 1.3, CI = [1.2, 1.5]) but less likelihood of experiencing sexual abuse (OR = 0.5, CI = [0.5, 0.6]) than boys. Boys who witnessed physical IPV and psychological IPV had a significantly greater likelihood of experiencing sexual abuse compared with girls. Witnessing IPV increases the chances of child and adolescent victimization. Multidisciplinary approaches involving social workers, law enforcement personnel, and domestic violence and child protection workers could effectively respond to this problem.

Child maltreatment prevention readiness in Gulf Cooperation Council (GCC) countries.

BACKGROUND AND OBJECTIVES: Child maltreatment (CM) is a global public health problem that has received growing attention over the past five decades. There have been many recent advances in child maltreatment prevention (CMP). The objective of this study is to assess CMP readiness to implement large-scale evidence-based CMP programs in Gulf Cooperation Council (GCC) countries. METHODS: This cross-sectional study (n = 244) was conducted in the GCC countries. Participants were key decision makers and senior managers in the field of CM. The Readiness Assessment for the Prevention of Child Maltreatment (RAP-CM) was used to assess 10 dimensions of CMP readiness. RESULTS: The key informants gave CMP readiness scores of 47.8 out of 100. Four of the dimensions (knowledge of CMP; legislation, mandates, and policies; institutional resources and links; and informal social resources) had high readiness scores (≥5), while six dimensions (attitudes towards CMP; scientific data on CMP; current program implementation and evaluation; will to address the problem; material resources; and human and technical resources) had low readiness scores (<5). CONCLUSION: GCC countries have moderate-to-fair readiness to implement large-scale evidence-based CMP programs. Strengthening their material, human, and technical resources, and improving the quality of scientific data, collaboration, and attitudes towards CMP are required to improve each country's readiness.

Understanding the needs of the Kingdom of Saudi Arabia: Child maltreatment prevention program development.

BACKGROUND: Global efforts are being made to combat child maltreatment (CM); however, in 2011 the Kingdom of Saudi Arabia's (KSA) response to this issue was found to be mediocre. Several developments have been implemented in KSA since then, and reevaluation is now necessary. OBJECTIVE: To assess the CM-prevention readiness (CMPR) of KSA in regard to implementing large-scale, evidence-based CM-prevention programs. PARTICIPANTS AND SETTING: Key informants based in KSA who were decision makers and senior managers in the CM field; face-to-face interviews were conducted in the participants' offices. METHODS: This was a cross-sectional study. We used the multi-dimensional tool "Readiness Assessment for the Prevention of Child Maltreatment - short version," which examines 10 dimensions concerning this topic. Comparison between the results of this study and those of the 2011 examination was performed to determine how the situation in KSA has changed. RESULTS: Sixty informants were interviewed; the majority being females (57%) and from governmental institutions (56%). The average total score for the 10 dimensions was 47.4%, an increase from the 43.7% reported in 2011. The strongest dimensions were legislations and mandates (8.3/10), followed by knowledge (7.1/10) and institutional links and resources (5.8/10). The lowest scores concerned human and technical resources (1.7/10) and attitude towards CM (2.8/10). Compared to the 2011 results, some dimensions showed significant improvements, but the majority had remained consistent. CONCLUSIONS: Time and commitment are necessary to secure CMPR improvement. Periodic assessment of CMPR is required to provide proper recommendations to the government regarding the progress of CM-prevention strategies.

Prevalence of Sexual Abuse Among Secondary School Students in Saudi Arabia.

Child sexual abuse (CSA) is a public health problem that has been found to be linked to negative health outcomes. Data on CSA in Saudi Arabia are limited, and there are many gaps in research in this field. The aim of this study is to examine the prevalence of sexual abuse among children in Saudi Arabia. A cross-sectional, national survey (N = 16,010) utilizing International Society for Prevention of Child Abuse and Neglect Child Abuse Screening Tool Children's Version was conducted at secondary high schools in Saudi Arabia. Participant's mean age was 16.8 ± 0.9 years, and 50.8% were boys. Sixteen percent of the participants reported exposure to any type of CSA during their lives. Boys and those who lived with step-parent were more likely to be sexually abused compared to those who didn't (p < .05). Ordinary least squares regression analysis revealed that gender was the predictor significantly associated with CSA. Evidence-based prevention programs targeting mainly the high-risk groups should be implemented.

Child maltreatment prevention strategies: Saudi youth perspectives.

BACKGROUND AND OBJECTIVES: Child maltreatment (CM) is a global problem that has long-term negative outcomes. The objective of this study is to explore the knowledge and perceptions of youth regarding CM prevention. METHODS: The study was conducted in Saudi Arabia using International Child Abuse Screening Tool (ICAST). Answers to open-ended questions were analyzed and a list of CM prevention strategies was generated. RESULTS: Participants identified a range of preventive strategies that were grouped into three main themes: 1) collective preventive efforts; 2) recognizing and responding to CM; 3) gaining closure. For each overarching theme, a list of subthemes were derived. Subthemes included raising awareness through the mass media; school professionals' capacity building and curriculum advancement; strengthening family relationships; enact CM preventive legislations and policies; monitoring media content and video games and limiting access to firearms for the first theme. The second theme comprised the subthemes reporting services and protective services. As for the third theme it included rehabilitation; punishment for CM crimes and connection to spirituality. CONCLUSION: Gathering youth perspectives on CM prevention will help us in designing future prevention strategies.

Relationship between childhood bullying and addictive and anti-social behaviors among adults in Saudi Arabia: a cross-sectional national study.

Background Bullying is a widespread public health problem among youth with potentially far reaching negative implications. Objective To determine the prevalence of childhood bullying and its association with addictive and anti-social behaviors among adults. Subjects Adults (n = 10,156) aged ≥18 years were invited to participate. Methods A cross-sectional, national study utilizing Adverse Childhood Experiences International Questionnaire (ACE-IQ) was conducted in Saudi Arabia (SA). Odds ratios (OR) and 95% confidence intervals (CIs) were calculated for bullying in relation to the outcome. Results Participant's mean age was 34.3 ± 11.3 years and 52% were male. Thirty-nine percent of the participants reported being bullied. Significant gender differences were found in terms of prevalence of different types of bullying. Men reported higher prevalence of physical (40% vs. 33%, p < 0.01) and sexual (19% vs. 10%, p < 0.01) types of bullying. In contrast, women tend to report higher prevalence of psychological (16% vs. 9%, p < 0.01) and social (14% vs. 10%, p < 0.01) types of bullying. Bullying victims were 1.8 (95% CI 1.6-2.1) times more likely to smoke, 2.3 (95% CI 1.9-2.7) times more likely to drink alcohol, 2.9 (95% CI 2.4-3.4) times more likely to use drugs, 2.1 (95% CI 1.8-2.4) times more likely to have ever had out of wedlock sexual relations, and 2.5 (95% CI 2.1-3.0) times more likely to have suicidal thoughts compared to those who were not bullied. Conclusion Childhood bullying increases the chances of risky behaviors among adults in SA. Prevention of bullying should be in the national agenda of the Ministry of Education.

Gender-based disparities in the impact of adverse childhood experiences on adult health: findings from a national study in the Kingdom of Saudi Arabia.

BACKGROUND: Adverse Childhood Experiences (ACEs) have been linked to an increased risk of health and social problems throughout life. Studies on gender differences from developing countries are scarce. In this paper, we will examine gender variations in the types of reported ACEs and gender-specific relationships between cumulative ACEs and physical and mental health, and Risky Health Behaviors (RHB) in adulthood in the Kingdom of Saudi Arabia (KSA). METHODS: A cross sectional national study was conducted in all of the 13 regions in KSA in 2013 using the ACE- International Questionnaire (ACE-IQ). We used multivariate logistic regression to examine the relationship between 4 + ACEs and physical, mental health and RHBs for both men and women separately after adjusting for age, education, marital status and current employment. RESULTS: The total number of participants was 10,156 and women comprised 48% of the sample. The majority of respondents (80%) reported at least one ACE. Women had higher percentages of < =2 ACEs (65% vs 55%; p <0.05) while men were more likely to have 4+ ACEs (33% vs 25%; p < 0.05). When compared to participants with 0 ACE, men who reported 4+ ACEs were associated with the highest likelihood of using drugs (OR = 9.7; 95% CI: 6.4-14.5) and drinking alcohol (OR = 9.2; 95% CI: 6.3-13.6). On the other hand, women who experienced 4+ ACEs were associated with the highest likelihood of depression (OR = 7.0; 95% CI: 5.2-9.4), anxiety (OR = 6.4; 95% CI: 5.0-8.2) and other mental illnesses (OR = 7.4; 95% CI: 5.2-10.6). As for chronic diseases, abused men and women in childhood showed similarly a twofold increased risk of developing diabetes, hypertension, coronary heart disease and obesity when compared to non-abused participants. CONCLUSION: Findings highlight the need to consider gender specific differences in the development of preventive strategies to address ACEs in KSA.

Family profile of victims of child abuse and neglect in the Kingdom of Saudi Arabia.

OBJECTIVES: To describe the family profile of child abuse and neglect (CAN) subjects in Saudi Arabia. METHODS: Data were collected retrospectively between July 2009 and December 2013 from patients' files, which were obtained from the Child Protection Centre (CPC) based in King Abdulaziz Medical City, Riyadh, Saudi Arabia. Four main sets of variables were examined: demographics of victim, family profile, parental information, and information on perpetrator and forms of abuse.  RESULTS: The charts of 220 CAN cases were retrospectively reviewed. Physical abuse was the most common form of abuse (42%), followed by neglect (39%), sexual abuse (14%), and emotional abuse (4%). Children with unemployed fathers were 2.8 times as likely to experience physical abuse. Children living in single/step-parent households were 4 times as likely to experience physical abuse. Regarding neglect children living in larger households (≥6) were 1.5 times as likely to be neglected by their parents as were children living in smaller households (less than 6). Regarding sexual abuse, male children were 2.9 times as likely to be abused as were female children.  CONCLUSIONS: The recent acknowledgment of CAN as a public health problem in Saudi Arabia suggests that time will be needed to employ effective and culturally sensitive prevention strategies based on family risk factors.