Prevalence of Family Violence/Child Abuse and its Relationship to Some Variables

Objective: The primary aims of the current study were to examine the prevalence of family violence/child abuse, and its relationships to some demographic variable such as family size, parents education and socioeconomic status. Additional aims were to review the risk and protective factors for family violence, and the impact of family violence on the child. Method: participants were (550) male and female children aged between 10-15 years. Participant completed well established psychological assessment tools to assess family environment characteristics, social and demographic


Introduction
Families have long been held responsible for the origin of violence, but it's only recently that it has been publicly recognized how often family members are the target of each other's violence. Even conservative estimates of the incidence of child abuse, spouse abuse, and child sex abuse are startling. Furthermore, the concern with family violence is not merely a reflection of a very broad Definition of abuse promulgated by an idealized view of family relationships. There has been thoughtful discussion about the appropriate definitions of family violence and child abuse [1]. But non consensus has been reached, and debates about definition continue. Different definitions have been based on a variety of factors including the nature of act itself-its form, intensity, and frequency; the physical or psychological impact on victim; the intent of the perpetrator; mitigating situational influences; and community standards regarding appropriate conduct. These problems, together with the fact that different definitions of abuse are more or less appropriate for deferent purposes, suggest that a consensual definition of violence or abuse is unlikely to be achieved [2]. In fact we suggest that calling an act "abusive" or " violent" isn't an objective decision but a social judgment, a judgment that it is outside the realm of responsibility of social scientists. The use of more explicit terms in family violence research would not only be more precise, but it would also help to eliminate misconceptions [3].
The risks of harm to children caused by domestic violence have been recognized. An amendments to the definition of harm in the Children Act 1989 now includes " impairment suffered from seeing or hearing the ill treatment of another" [4]. This reflects that children living with domestic violence are over-represented among children referred to statutory children and families teams with concerns about child abuse and neglect, and represent up to two thirds of cases seen at child protection conferences. There are many ways that children are exposed to family and domestic violencemany not including hearing or seeing the violence. For this reason, when it occurs in family with children, family and domestic violence is always child abuse or "child maltreatment". However, children's experiences of domestic violence are more than a child protection issue. Research with children suggests it has implications for education, health, welfare, civil and criminal justice.
Child abuse generically is human oriented commission or omission and Human created or tolerated conditions to inhibit or preclude the development of inherent potentials of children. Kaplan and Pelcovitz defined abuse as acts of commission that results in harm, and neglect as acts of omission that have negative effects [5]. Abuse is an exploitation of the rights of the parents to control, discipline and punish their children while neglect represents the failure to perform parental duties including those of supervision, nurturance and protection. It is further divided into four major categories Physical abuse, physical neglect, emotional abuse, and emotional neglect. Sexual abuse is often subsumed under physical abuse, but it has its unique characteristics that differentiate it from other kinds of maltreatment. Another definition of child abuse is any parental/caretaker act or failure to acts resulting in death, serious physical or emotional harm, sexual abuse or exploitation; or an act or failure to act which presents an imminent risk of serious harm to the child physical or emotional health and development [6]. Definitions of child abuse and neglect tend either to define aspects of the condition narrowly or to incorporate multiple characteristics. There is neither medical nor legal agreement on a unitary definition. The earliest definitions of child abuse were typically limited to physical assault as evidenced in the earlier term, "Battered child".
Definitions of child abuse and neglect may include one or a combination of five aspects of the condition: (1) physical assault, (2) emotional abuse, (3) emotional neglect, (4) physical neglect, and (5) sexual abuse. Child abuse or represent a serious social problem in our society today.
Clearly, this wide variability in incidence data relates in part, to whether the incidence of actual physical outcome such as reported physical injuries or the incidence of physical and violent acts toward children was considered. Five decades ego, Fontana [4] estimated 700 child deaths a year attributable to child abuse and family violence. These reports illustrate the differences in reporting approaches that yield disparate incidence data. From this survey, little information has been generated on age, gender, and other demographic characteristics of abused children. American Humane Association (1981) reported that 40% of the abused and neglected children in their sample were less than 6-year age and that there were no significant differences between the proportion of males and females. Gelles (1979) reported age data showing a slow decrease of physical punishment with respect to age. Eighty-four percent of 30to-4 year old children were reported to have been "slapped" by parent as compared to 23% of 15-to17-year-old adolescents .
Although child abuse has become a focus of concern for government and public sectors for last two decades in Arab countries, but still physical abuse harsh disciplinary and child rearing practices are common in this societies. Physical punishment at home or schools is a necessary part of our daily scenario referring to children [4]. Based on a summary of existing studies, WHO estimates that between 25 to 50 percent of children, are victims of physical abuse. Approximately 20 percent of girls and 5 to 10 percent of boys are victims of sexual abuse. Statistics on the prevalence of the problem indicate that domestic violence is a worldwide epidemic. A 2013 report of the World Health Organization (WHO) entitled [7], "Global and Regional Estimates of Violence Against Women: Prevalence and Health Effects of Intimate Partner Violence and Non-Partner Sexual Violence," found that intimate partner violence affects 30% of women worldwide and in the most prevalent type of violence against women. The WHO estimates that 38% of all women murdered are killed by their intimate partner, although recognizes this is likely an underestimation. It also reports that 42% of women who had been sexually or Abdullah  physically abused by their partner were injured: (1) 40 million children subjected to abuse each year, (2) Suicide is the third leading cause of death among adolescents worldwide,(3) 30% of severely disabled children in special homes in the Ukraine die before 18 years of age.(4) Approximately 20% of women and 5-10% of men report being sexually abused as children, while 25-50% of all children report being physically abused, (5) Statistics indicate that 3 million young girls are subjected to genital mutilation every year.
These estimates are very approximate since there are no prevalence studies for many countries in the world.
Recent high-quality studies conducted by UNICEF, the US Centers for Disease Control and Prevention [8], and national governments in a number of eastern and southern African countries found the following ranges of rates: Domestic violence is a serious problem around the world. It violates the fundamental human rights of women and often results in serious injury or death. While statistics vary slightly, women are victims of domestic violence in significantly greater proportion than men. In the U.S., the Department of Justice reports that from 1994-2010, 4 in 5 victims of domestic violence were women [9]. While women do use violence against intimate partners, women's use of violence is distinct from men's use of violence in historical, cultural, psychological, motivational and situational ways. Studies show that 3-4 million children between the ages of 3-17 are at risk of exposure to domestic violence each year. U.S. government statistics say that 95% of domestic violence cases involve women victims of male partners. The children of these women often witness the domestic violence [10]. It showed that there is a lot of data from certain countries, mainly high-income countries, but much less from others. In fact, for many countries in Africa, Latin America, and Asia there is simply no good data on child maltreatment or abuse. So, there is a need for more epidemiological data. On other hand, there are lots of differences in the prevalence estimates that we cannot at present explain. We don't know if they are due to, for instance, differences in the types of relationships between perpetrators and victims, to the age of onset of the abuse. The differences studies use different definitions of child maltreatment and different types of questionnaires.
Purposes of the study: The aims of the study are to investigate: 1) The prevalence of child abuse among families.
2) The influence of demographic variable on child abuse.
3) The risk and protective factors for family violence. 4) The effects of family violence on children.

Methodology Population and Sample (Participants)
The target population for the study was all students in primary schools of Aleppo City (Syria) aged between 10-15 years. A random sample of (560) students was chosen, and a total (550) students completed the survey with response rate of (98.22%). The resulting sample included 270 (49.09 %) male and 280 (50.9%) female. They belonged to nuclear verses joint family systems and smaller, medium and large families in terms of number of children in the family. The analytic-descriptive method has been used in this research.

Instruments:
The Family Violence / Child Abuse Survey (Fv-Cas) Self instrument was used to reach the purposes of the study (Barakat, 2010, Malik & Shah, 2007. This survey included (40) items to get special data about the type of family violence and child abuse and its effects on the subjects. The four empirically determined subscale were physical abuse (10 item), Physical neglect (10 item), emotional abuse (10 items), and emotional neglect (10 items). The responses of the subjects were recorded on a 4-point rating scores with response categories of "never to always" with the scoring range of 1 to 4 VF-CAS score was determined as the sum of scores on each item that ranged from 40 to 160. The cut off points determined on the basis of percentile analysis for the (FV-CAS) were below to 54 as mild, 55-65 as moderate, and 66 and above as indicative of severe child abuse. Validity of the instrument was established through content and face validity, and the instrument was standardized on the responses of (45) subjects. It has been reported highly significant reliability coefficient (R=.89).and for its four subscales ranging from .65 to .90 [2,4]. Abdullah

A Demographic Form
It was also developed to seek personal information of the respondents like age, gender, socioeconomic status, family size, parental education.
The theoretical rationale of the scale: The instrument has been designed depending on the hypothesis of the "relationship between violence and family system" according to the context theory in family counseling. It is clear that violence affects family members other than the victims themselves. In term of children adaptation, this is seen most clearly in a relatively new line of research of the children of battered women. Children's reactions to parental conflict can be conceptualized as the three component process wherein (a) the conflict serves as aversive event that creates distress in the child, (b) the child reacts emotionally or instrumentally in an attempt to alleviate the distress, and (c) the child's actions that reduce the conflict are likely to be maintained because of function they serve for the child and for the family as a whole.

Data Collection and Analysis
The (FV-CAS) administered by researcher and hand scored following the administration and scoring guidelines set tow by each part of the survey. Data were analyzed using SPSS for Windows, version 10. Descriptive statistic frequencies and percentages were used to summarize the data for question one. The statistical procedures like between-within ANOVA were employed to determine the relationship of child abuse with different variables under consideration and differences across group of children with mild, moderate and severe abuse.

Results
Purpose one "The prevalence of family violence /child maltreatment among the sample of children ". Questionnaire data for the percentage of the types of child abuse are presented in Table 1.

Type of Child abuse Males (n=270) Females (n=280)
Physical abuse 62% 69% Emotional abuse 87% 80% Physical neglect 54% 47% Emotional neglect 68% 57% The results indicated that emotional abuse (male 87%, female 80%) was the first maltreatment of our families, and the second was physical abuse (male 62%, female 69%). Emotional neglect and physical neglect were the later frequently.  To determine the differences regarding different demographic variables across three child abuse. One-way ANOVA was computed which indicated moderately significant effect of family size on the child abuse scores. F (2.65) = 4.66, P< .01. With highest mean scores of children from larger families Child Abuse Scale than other two groups Similarly data showed a significant effect of mother's education on child abuse score, F=4.72 ,P <.01.
Mean FV-CAS score of children from low mothers education group (below to 10Th grade) was the highest (M=45.46, SD=15.89) compared to other two groups. However, a non-significant effect was depicted for socioeconomic status for children's FV-CAS, F (2,199) =1.52, P=ns. Understanding who is likely to experience family violence and who is likely to perpetrate it allows practitioners, researchers and policy-makers to better understand how to develop and implement prevention strategies and activities. Risk factors for family violence and defined as an attribute that increases the probability of domestic violence. These can exist for those at risk perpetrating violence as well as those at risk of being a victim of violence. The following table is based on the research and findings outlined in the World Health Organization's Preventing Intimate Partners and Sexual Violence Against Women Report (2013) [11]. Risk factors with the strongest reported effect are indicated with an asterisk. Family violence knows no boundaries, it cuts across every segment of society and accurse in all ages, racial, ethnic, socioeconomic, and religion. Neighborhood characteristics: * High Proportion of poverty * High proportion of unemployment * High proportion of female illiteracy * Low proportion of women with high Level of autonomy. * Low proportion of women with higher education Neighborhood characteristics * High Proportion of poverty * High proportion of unemployment * High proportion of male illiteracy * High proportion of households that use Corporal punishment

Societal level Societal level
Divorce laws, and protective marriage laws None provided (WHO, 2013) It has been showed that there are characteristics of perpetration and socialization on one hand, and characteristics of victimization regarding the child on the other hand. In addition, these characteristics related to demographic, psychological and social variables, all impact on the behavior of maltreatment of the child in the family.

Purpose 4:
The Effects of Domestic Violence on Children a. What are the feelings of children who are exposed to battering? Children who are exposed to battering become fearful and anxious. They are always on guard, watching and waiting for the next event to occur. They never know what will trigger the abuse, and therefore, they never feel safe. They are always worried for themselves, their Abdullah  mother, and their siblings. They may feel worthless and powerless.
Children who grow up with abuse are expected to keep the family secret, sometimes not even talking to each other about the abuse. Children from abusive homes can look fine to the outside world, but inside they are in terrible pain. Their families are chaotic and crazy. They may blame themselves for the abuse thinking if they had not done or said a particular thing, the abuse would not have occurred. They may also become angry at their siblings or their mother for triggering the abuse. They may feel rage, embarrassment, and humiliation [12].
Children of abuse feel isolated and vulnerable. They are starved for attention, affection and approval. Because mom is struggling to survive, she is often not present for her children. Because dad is so consumed with controlling everyone, he also is not present for his children. These children become physically, emotionally and psychologically abandoned.
b. What behaviors do children who witness domestic violence exhibit? The research evidence highlights the serious consequences for many children who exposed to domestic violence. The emotional responses of children who witness domestic violence may include fear, guilt, shame, sleep disturbances, sadness, depression, and anger (at both the abuser for the violence and at the mother for being unable to prevent the violence). Studies of children's emotional and behavioral responses show increased likelihood of risk of disturbance among children living with domestic violence. Children tend to speak in terms of fear, anger, sadness, and loss. Researchers and clinicians using standardized tools focus on externalizing behaviors (aggressive and anti-social behavior) or internalizing behaviors (anxiety and depression).
Physical responses may include stomachaches and/or headaches, bedwetting, and loss of ability to concentrate. Some children may also experience physical or sexual abuse or neglect. Others may be injured while trying to intervene on behalf of their mother or a sibling [13]. The behavioral responses of children who witness domestic violence may include acting out, withdrawal, or anxiousness to please. The children may exhibit signs of anxiety and have a short attention span which may result in poor school performance and attendance. They may experience developmental delays in speech, motor or cognitive skills. They may also use violence to express themselves displaying increased aggression with peers or mother. They can become self-injuring. Generally, children witnessing domestic violence have significantly more behavioral and emotional problems then children who are not in this abusive environment. Problems for children can relate to their particular child development issues and will be mediated by other factors such as the extent of the abuse, their level of support, size of the family, parents education [14].
c. What are the long-term effects on children who witness domestic violence? Whether or not children are physically abused, they often suffer emotional and psychological trauma from living in homes where their fathers abuse their mothers. Children whose mothers are abused are denied the kind of home life that fosters healthy development [13]. Children who grow up observing their mothers being abused, especially by their fathers, grow up with a role model of intimate relationships in which one person uses intimidation and violence over the other person to get their way. Because children have a natural tendency to identify with strength, they may ally themselves with the abuser and lose respect for their seemingly helpless mother. Abusers typically play into this by putting the mother down in front of her children and telling them that their mother is "crazy" or "stupid" and that they do not have to listen to her. Seeing their mothers treated with enormous disrespect, teaches children that they can disrespect women the way their fathers do [15].
Most experts believe that children who are raised in abusive homes learn that violence is an effective way to resolve conflicts and problems. They may replicate the violence they witnessed as children in their teen and adult relationships and parenting experiences. Boys who witness their mothers' abuse are more likely to batter their female partners as adults than boys raised in nonviolent homes. For girls, adolescence may result in the belief that threats and violence are the norm in relationships. Children from violent homes have higher risks of alcohol/drug abuse, post traumatic stress disorder, andjuvenile delinquency. Witnessing domestic violence is the single best predictor of juvenile delinquency and adult criminality. It is also the number one reason children run away [12].

Discussion
Several important findings are evident from this study. First, results of this study showed high rate prevalence of domestic-child abuse among the sample of the study. Abdullah  Second, findings further suggest, however that there are important gender differences in child abuse. Third, findings point to important differences in the family functioning regarding demographic variables such as family size and mother education. Forth, not only does abuse history appear related to the level of family problems, but these family environment characteristics including parent-child relations such as characteristics of both abusive parents and vulnerable child in addition to abusive situation that play an important role in family violence that are evident from literatures.
It appears that emotional abuse is more prevalent our families as parents believe in using emotional punishment as an essential instrument because they had learned it from their own parents. It depicted that parents in Syrian households don't take care of the psychological and emotional needs of their children that is more problematic for their children [4]. The descriptive statistics showed that the type of abuse most frequently observed: emotional abuse and physical violence as, therefore forms of active maltreatment, as opposed to neglect. The greater of the child and of the abuser were considered in the analysis. The gender variable had a relativity predictable performance, compared to the known literature, [16].
The nature of the marital relationship between the child's parents was an important variable that determine the couple relationship and the question of the presence of violence. Thus the parent's education -especially mother's education -and family size were important variables in determining family violence. The first scenario is associated with parents who have education, and the second scenario is associated with parents who have more children. Being unaware of the impacts, parents use abusive language that is hurting for the children, parental negative attitude might produce lower self-esteem and inferiority complex in children, and effects of emotional abuse might be manifested in the form of helplessness and worthlessness [17].
In discussing child abuse prevention must be held as a primary goal. Unfortunately, professionals typically become involved after the fact. Understanding the common characteristics both parent and child contribute to these situations, as well as environmental factors, is key to this process. The personal, psychological, and physical traits both parent and child bring into their relationship determine whether it will become an abusive one. This section will discuss characteristics of abusive parents and of vulnerable children, and the abusive situation.

Characteristics of Abusive Parents
The parents past history, present life situation, life stressors, psychological characteristics, circumstances at pregnancy and expectations of the child al are pertinent in evaluating the potential for abuse in home. In examining the child-rearing histories of abusive parents, researchers propose that abusive children become abusive parents [12] and that the element most common to abusive parents was the history of having been significantly deprived or neglected, with or without physical cause, in their own earliest years. In term of life situations, father's employment is significant. When father are unemployed there is a higher rate of child maltreatment in home, and parental violence to be related to the father's occupation. The higher incidence of child abuse among blue-collar than among white-collar workers. Families who are socially isolated also appear to be at greater risk for child abuse, and we can determine abusing parents from other parents on some life situation characteristics: (1) recent moves, (2) mother-child separation, (3) serious childhood trouble for the mother, (4) few children, (5) older father and (6) low job status for the father [18]. On the other hand, only a small percentage of abusing parents evidence psychopathology. In attempting to identify personality characteristics that relate to child mal treatment, researchers found three significant personality factors: unhappiness, rigidity, and distress to have an effect on child abuse [19].

Characteristic of the Vulnerable Child
The nature and physical characteristics of the child play an important role. Some children appear to be more vulnerable to abuse than others are. Researchers have been shown that children perceived as different by their parents are at greater risk for abuse. Kennell, Voos & Klaus [20] listed nine important steps to the bonding or attachment process development on childhood: (1) planning the pregnancy, (2) confirming the pregnancy, (3) accepting the pregnancy , (4) fetal movement, (5) accepting the fetus as an individual, (6) birth, (7) seeing the baby, (8) touching the baby, and (9) caretaking .

The Abusive Situation
The abusive situations include several known precipitating circumstances: crying, marital conflict, specific acts of the child, escalating sequences of negative interactions and lack of empathy. High risk signals in the behavior of the mother can be observed in the delivery room including: (1) lack of interest in baby, (2) unwillingness or refusal to touch and hold, (3) lack of eye contact with baby, (4) hostile verbalizations or expression toward the child,(5) hostility toward father, (6) negative remarks or disappointment over sex [21]. On the other hand, the stress factors in abusing parents include change in job, recent moves, change in financial status, major illness in family, marital discord [22]. Better awareness of the importance of social and family variable, as well as of the school context on the multiple facets of abuse, will inevitably be useful to healthcare professionals, trained mainly for the assessment of emotional and physical risk factors. This study intends to contribute in this sense.

Conclusion
Findings of this study showed high rate prevalence of domestic-child abuse among the sample of the study. In addition, further suggest, however that there are important gender differences in child abuse. Findings point to important differences in the family functioning regarding demographic variables such as family size and mother education [23,24]. Not only does abuse history appear related to the level of family problems, but these family environment characteristics including parent-child relations such as characteristics of both abusive parents and vulnerable child in addition to abusive situation that play an important role in family violence that are evident from literatures. Characteristics of abusive parents, vulnerable child, and the abusive situation represent important psychosocial variables that play role in the family violence.

Recommendations
Future research is encouraged to further investigate the impotence of some variables such as victim's gender, marital age, maternal employment, divorced/separated parents, and abuser's gender. Based on this finding we can plan for the significant family counseling programs on the three levels: productive m preventive and remedial strategies. Theses finding also have significant treatment implications.