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Domestic violence may occur between any of a family’s constituent elements.

In the United States, despite methodological difficulties in reporting and surveying, it is estimated to be most common between husbands and wives, and parents and children (Gelles 49). Most often, victims are women or children (Straus 17). An enormous number of individuals are affected as aggressors, victims, or witnesses. In 1985 a nationwide random sample survey indicated that 10.7 percent of children during the previous year “had been the victim of a severe violent act” (Biglan, Lewin, ; Hops 107). A 2003 national survey found that 34 percent of “adults in the United States .

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. . witnessed a man beating his wife or girlfriend and .

. . 14 percent of women report that a husband or boyfriend has been violent with them . . . [and] as many as 30 percent of women treated in emergency departments (EDs) have injuries or symptoms related to physical abuse” ( McLoughlin, Lee, Letellier, ; Salber 617-619).

In the family setting, incidents of violence often reoccur, escalate, spread to include other family members, and have transgenerational effects. A recent study undertaken by Mullender highlights an emerging concern about young people’s attitudes to violence. The study was of 1,300 young persons between the ages eight to sixteen from Bristol, North London and Durham: • Most knew that domestic violence is common and considered fighting between parents to be wrong.

• The majority felt it was worse for men to hit women as men are stronger.• Most, especially teenagers, considered threats to be as bad as actual violence. • Out of those questioned 75 per cent thought children living with domestic violence could do something practical, i. e. calling the police or telling someone.

Perhaps more importantly, the study showed that: • Over 75 per cent of 11-12-year-old boys thought that women get hit if they make men angry, and more boys than girls, of all ages, believed that some women deserve to be hit. • Boys aged 13-14 were even less clear that men should take responsibility for their violence.• Boys of all ages, particularly teenagers, appeared to have less understanding than girls did, of who is at fault, and more commonly excused the perpetrator.

Undoubtedly, healthcare professionals should never lose sight of the fact that whilst there may be no evidence of direct abuse, young adults from abusive and violent homes do experience various negative consequences. The seriousness of these may not be manifested for many months or even years, but must never be underestimated.The healthcare professional has a responsibility to respond to the child’s actual and potential needs within established frameworks of child protection and confidentiality. For this to succeed, health organizations have to take due care by ensuring that appropriate policies, or protocols, informed by national guidelines, are in place, and that staff are both aware of and able to operate within them. “Adolescents’ responses vary enormously with some teens being affected far more than others, and teenagers within the same family can be affected differently.

Each child’s experience and reactions are unique…it will be hard to discern the impacts of living with domestic violence on adolescents, especially as some of the resulting behaviors also occur in children experiencing other forms of abuse and neglect. ” (Hester et al. 44) The list of possible negative effects can appear endless and includes: • Being secretive, silent and afraid to tell. • Being protective of their mother and/or siblings, which may lead to them having a maturity beyond their years, whilst other adolescents exhibit regression.• Attitudes to their father or stepfather may be ambivalent, often due to a feeling of confusion.

• Being fearful, hyper-vigilant, mistrustful, anxious and sometimes excessively agitated. • Experiencing feelings of guilt and helplessness and even thinking that the violence is their fault. This is particularly so if the violent episode follows an argument between the adults that is related to the child. • Experiencing nightmares, bedwetting, sleep disturbances, eating difficulties leading to weight loss or obesity. • In some children, long periods of sadness, which may progress to depression.• In younger children, delay in developmental milestones. • In contrast in some older children, a very adult way of acting in order to minimize the violence or protect the mother.

In addition Hester et al. (44) found that whilst some teenagers show poor social skills others attain a high level of social skills development with an ability to negotiate difficult situations. A teens’ ability to acquire sophisticated coping strategies to deal with the on-going abuse should never be underestimated; neither should the child’s attachment to the abusive parent which, for some, may continue to be strong.It ought to be noted that whilst there is a wide spectrum of possible negative health and social outcomes for teenagers who have lived in an abusive home, not all of them manifest adverse characteristics in their later life. We should never underestimate the power of recovery and the resilience of many young people or adults, who are able to move forward from the situation.

“It is important to remember that some adolescent remain perfectly well adjusted despite living with abuse and that a majority survive within non clinical or ‘normal’ levels of functioning” (Mullender and Morley 4).Nevertheless there are those like Brandon and Lewis who believe that “The evidence points to the possibility that the cumulative harm from witnessing violence will affect the child’s emotional and mental health in future relationships…. [U]ntil professionals recognize that when the child sees violence at home there is a likelihood of significant harm, it will not be possible to prevent long-term damage. ” (Brandon and Lewis 41). Youth psychologists often hold competing views with regards to the medium- and longterm effects of family violence in later life.Kashani and Wesley, summarizing contemporary research, acknowledge that children who have grown up in an abusive home whilst remaining a heterogeneous group, nevertheless have similarities in their responses at the time, and in the future (Kashani and Wesley 37).

Teenagers’ responses to living in a violent and abusive home can include: • They may express anger and distress in ways viewed by others as inappropriate. • Carlson (1990) found that adolescent boys from abusive homes were more prone to running away, possibly as a means of avoiding violence against themselves.Similarly, he found adolescent male witnesses to family violence were more apt to use physical violence against their mothers. • Carlson also found that young males from violent homes had often experienced suicidal thoughts. In a study undertaken by Kashani et al. (1998) they found that juveniles who had committed interfamilial homicide had frequently experienced a significant history of family violence. Moreover, the homicide commonly followed an unsuccessful suicide attempt.

According to the American Medical Association, children of all ages from violent homes: “may exhibit somatic concerns, including headaches, school avoidance, and abdominal complaints. School age children frequently develop impaired concentration and difficulty staying focused on schoolwork. Older children often manifest aggressive behaviour, with boys being more likely to have such aggressive behavioural problems, while girls are more likely to have somatic concerns. Both sexes often express guilt at not being able to stop domestic violence” (AMA 16).Studies suggest that routinely the mother does not discuss the violence with her child or children making it harder for them to articulate their thoughts and feelings. Equally, as adolescents, they often avoid talking about their experiences with outsiders for fear of being taken into care, and many retain a degree of loyalty to the abusing father as they have good memories as well as the bad ones. Corrigan (1998) argues that teenager’s responses to witnessing their mother being assaulted by their father vary according to the sex, age, and stage of development of the child and their role in the family.

Other factors that may influence outcomes are the extent and frequency of the violence, repeated separations and moves, economic and social disadvantage and special needs that a child may have independent of the violence (Jaffe et al. ). In a recent study that interviewed teenagers from a range of different backgrounds, Mullender (2000) identified that black and Asian adolescent’s ability to seek help was significantly influenced by their fears of receiving bad advice and unsympathetic treatment from white organizations.Overall, studies suggest that the child’s stress levels are often associated with the actual and potential threat to their mother and that once she has received support and protection the child may begin to feel safer itself. To date, the role of school-based prevention represents the most farreaching attempt to influence youth attitudes about relationships and violence.

Jaffe (2000) have conceptualized some primary and secondary prevention efforts, that is, targeting adolescents before domestic violence occurs and also during the early signs of its occurrence. Works CitedAmerican Medical Association, Diagnostic and Treatment Guidelines on Mental Health Effects of Family Violence. 515 N. State Street Chicago, IL 60610. Chicago 1995. http://www. ama-assn.

org/ Biglan A. , Lewin L. , ; Hops H. ‘A contextual approach to the problem of aversive practices in families’. In G.

R. Patterson (Ed. ), Depression and aggression in family interaction (pp. 103-130). Hillsdale, NJ: Lawrence Erlbaum, 1990. Brandon, M. and Lewis, A.

, ‘Significant Harm and Children’s Experiences of Domestic Violence’, Child and Family Social Work, 1, pp. 33-42, 1996.Carlson, B. E. , ‘Adolescent Observers of Marital Violence’, Journal of Family Violence, 7, pp. 249-59, 1990. Corrigan, S.

, ‘Caught in the Middle’. Exploring Children and Young People s Experience of Domestic Violence. Northern Ireland Women’s Aid Federation, Belfast, 1998. Gelles R.

J. “Methodological issues in the study of family violence”. In G. R. Patterson (Ed.

), Depression and aggression in family interaction (pp. 49-74). Hillside, NJ: Lawrence Erlbaum, 1990. Hester, M.

, Pearson, C. and Harwin, N. , Making an Impact. Children and Domestic Violence: a Reader.Jessica Kingsley Publishers, London and Philadelphia, 2000.

Jaffe, P. , Wolfe, D. W. and Wilson, S. Children of Battered Women: Issues in Child Development and Intervention Planning.

Newbury Park, CA: Sage, 2000. Kashani, J. and Wesley, A. D.

, ‘The Impact of Family Violence on Children and Adolescents’, Developmental Clinical Psychology and Psychiatry, 37, Sage, London, 1998. McLoughlin E. , Lee D. , Letellier P. , ; Salber P.

(2003). Emergency department response to domestic violence — California, 1992. Morbidity and Mortality Weekly Report, 42 (32), 617-619. Morley, R.and Mullender, A. , Preventing Domestic Violence to Women. Police Research Group Crime Prevention Unit Series: Paper No.

48. Home Office Police Department, London 1994. Mullender, A.

, Reducing Domestic Violence…What Works? Meeting the Needs of Children. Crime Reduction Series. Policing and Reducing Crime Unit, Home Office, London January 2000.

Straus M. A. (2001). “Physical violence in American families: Incidence rates, causes and trends”. In D.

D. Knudsen ; J. L. Miller (Eds. ), Abused and battered: Social and legal responses to family violence (pp. 17-34). New York: Aldine de Gruyter.

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