Emotional and behavioral problems in adolescents exposure to community violence

U radu smo prikazali rezultate istraživanja o emocionalnim i bihejvioralnim problemima mladih koji su izloženi nasilju u zajednici i nasilju vršnjaka. Pod nasiljem u zajednici podrazumevali smo nasilna dela koja su se dešavala na ulici, u školi ili na putu do škole, kao i na bilo kom drugom mestu koje nije porodica. Brojna istraživanja ukazuju na to da iskustvo nasilja dovodi do promena u ponašanju, osećanjima, socijalnim odnosima, a i da je povezano sa antisocijalnim ponašanjem. Uzimajući u obzir značaj roditelja i njihov odnos prema deci, proučavali smo da li i koliko određene karakteristike roditeljstva (toplina, uključenost, nadzor i konzistentnost) utiču na tu vezu. Istraživanje smo sproveli u Beogradu, na uzorku od 505 učenika VIII razreda, školske 2007/2008. godine. Primenili smo upitnike napravljene za projekat SAHA (The Social And Health Assessment), koji je sproveden u više zemalja širom sveta. Koristili smo skale za procenu: izloženosti nasilju u zajednici, vršnjačkog nasilja, antisocijalnog ponašanja, Skalu snaga i teškoća i Skalu za procenu roditeljstva. Ispitanici su izveštavali o događajima koji su se desili u periodu od godinu dana pre istraživanja. U ispitivanom uzorku, 74,9% mladih je bilo izloženo nasilju vršnjaka. Najčešće je bila prisutna socijalna manipulacija, verbalno nasilje (vređanje, psovanje ili ismevanje), uzimanje ili uništavanje imovine, a najređe fizičko nasilje. Nešto manji broj ispitanika (72,1%) prisustvovao je nasilju nad drugom osobom. Mladi su obično videli da nekome prete ili da nekoga pljačkaju. Najređe je, kao i kod vršnjačkog nasilja, bilo prisutno fizičko nasilje. Svaki peti ispitanik (20,4%) i sâm je bio žrtva nasilja u zajednici (bili su izloženi pretnjama, jurili su ih sa ciljem da ih povrede), a samo malo ispitanika je bilo fizički povređeno. Među mladima koji su imali iskustvo sa nasiljem, 26,9% bilo je dvostruko traumatizovano (izloženost i svedočenje nasilju). Rezultati koje smo dobili odgovaraju rezultatima drugih istraživanja – dečaci su češće i žrtve i svedoci nasilja u zajednici. U pogledu izloženosti vršnjačkom nasilju nismo pronašli da postoji razlika po polu. Ispitanici su u 82,8% slučajeva saopštili da su u periodu od godinu dana pre istraživanja ispoljili antisocijalno ponašanje. Obično su činili manje prekršaje: - lagali roditelje i nastavnike ili povremeno bežali sa časova. Mladih koji su ozbiljno prekršili socijalne norme (napalo vršnjaka, posedovalo oružje) bilo je 36,8%, sa delinkventnim ponašanjem 9,5% ispitanika, a 1,2% je zbog svog ponašanja bilo i zakonski sankcionisano. Blaža antisocijalna ponašanja pokazuju i dečaci i devojčice, ali ozbiljne forme češće ispoljavaju dečaci. Rezultati našeg istraživanja potvrđuju da postoji povezanost između izloženosti i svedočenja nasilju u zajednici i vršnjačkog nasilja sa emocionalnim i bihejvioralnim problemima mladih. Adolescenti koji su bili izloženi nasilju u zajednici pokazuju više problema u svim sferama funkcionisanja (osim u emocionalnoj) i manje su spremni na prosocijalno ponašanje. Očigledni je da postoje problemi u ponašanju mladih koji su svedoci nasilja u zajednici: pažnja im je slabija i manje su zainteresovani za uključivanje u pozitivne interakcije sa drugima. Žrtve vršnjačkog nasilja imaju više problema u odnosima sa vršnjacima, češće pokazuju emocionalne i probleme u ponašanju i hiperaktivni su. Utvrdili smo da su izloženost i svedočenje nasilju u zajednici povezani sa antisocijalnim ponašanjem, a i mladi koji su bili žrtve vršnjačkog nasilja manifestuju blaže oblike takvog ponašanja. Opisane probleme u funkcionisanju ispoljavaju i dečaci i devojčice. Pol se izdvojio kao značajan faktor moderacije samo u slučaju vršnjačkog nasilja – devojčice sa takvim iskustvom pokazuju više problema u ponašanju i pažnja im je slabija nego kod dečaka. Mladi koji su bili izloženi nasilju ili su bili svedoci nasilja u zajednici svoje roditelje češće opisuju kao nekonzistentne, manje zainteresovane i hladnije u odnosu sa svojom decom. Adolescenti koji ispoljavaju antisocijalno ponašanje smatraju da su njihovi roditelji i manje spremni da ih kontrolišu. Rezultati našeg istraživanja su potvrdili da nasilje kojem su mladi izloženi na direktan ili indirektan način, kao i nasilje vršnjaka, ostavlja posledice u mnogim sferama života, a može se dovesti i u vezu sa antisocijalnim problemima. Pol je i ovde značajan faktor koji utiče na prirodu te povezanosti – dečaci su pod većim rizikom da dožive nasilje, a devojčice da ispolje probleme u ponašanju. Jedina karakteristika roditelja koja dobro predviđa verovatnoću pojave problema jeste nekonzistentnost. Kada smo u analizu uključili i izloženost vršnjačkom nasilju, konzistentnost roditelja je izgubila značaj, a kao jedini značajan prediktor emocionalnih i bihejvioralnih problema mladih pojavila se izloženost vršnjačkom nasilju. Opisani rezultati mogu biti od pomoći prilikom kreiranja programa prevencije nasilja među mladima.In this paper we presented research findings on emotional and behavioral problems in youth who were exposed to community violence and peer victimization. Numerous researches indicate that experience of violence leads to changes in behavior, emotions, social relationships, but that it is also connected to antisocial behavior. Taking into account the importance of parents and their attitude towards children, we studied weather certain characteristics of parenting (warmth, involvement, supervision, and consistency) influence this relationship. Research was conducted in Belgrade, on a sample of 505 eighth grade students, during school year 2007/2008. We applied the questionnaires developed for the project SAHA (The Social and Health Assessment), which was conducted in several countries throughout the world. We used following assessment scales: Exposure to Community Violence Scales, Peer Victimization Scale, Antisocial behavior, The Strength and Difficulties Questionnaire (SDQ), Parenting Scales. Subjects reported on the events that took place over a period of one year before the survey. In the survey sample, 74.9% of adolescents have been exposed to peer victimization. The most frequent occurring was social manipulation, verbal abuse (insults, swearing or ridiculing), taking or destruction of property, and the least common physical violence. Slightly smaller number of subjects (72.1%) attended the violence against another person. Young people often saw someone being threatened or robbed. The least common was, as it was with peer victimization, a physical violence. One in five subjects (20.4%) was victim of community violence himself (they were subjected to threats, were chased after with intent to inflict injuries), but a very small number of subjects were physically injured. Among youth who had experience with violence, 26.9% of them were twice as traumatized (both through exposure and through witnessing). Our findings correspond to those from other studies – boys are more often both victims and witnesses of community violence. We did not find a difference in gender, regarding exposure to peer victimization. Total of 82.8% subjects reported that they expressed antisocial behavior during previous year. These usually consisted of minor infractions – lying to parents and teachers or occasional class skipping, but 36.8% of subjects seriously violated social norms (attacked peer, weapon possession). Delinquent behavior was manifested in 9.5% of subjects, and 1.2% of them were legally sanctioned due to their conduct. Both boys and girls exhibit milder antisocial behaviors, but severe forms are more frequently displayed by boys. Results of our study show connection between exposure, witnessing community violence, and peer victimization, with emotional and behavioral problems in youth. Young people who were exposed to community violence show more problems in all aspects of functioning (except in emotional one) and they are less willing to display prosocial conduct. Witnesses of community violence display more problems in behavior, poorer attention and they are less interested in participating in positive interactions with others. Subjects of peer victimization have more problems in peer relations, express more often emotional and behavioral problems, and are more hyperactive. We determined that exposure to and witnessing community violence are related to antisocial behavior, and that youth, who were subjects to peer victimizations, exhibit milder forms of these behaviors. Both boys and girls exhibit described problems in functioning. Gender appeared significant factor of moderation only in case of peer victimization – girls who were exposed, show more problems in behavior and have poorer attention than boys. Youth who were exposed to or witnessed community violence, describe their parents more often as inconsistent, less interested in their children and more reserved, and those who exhibit antisocial behavior consider their parents less willing to control them. Results of our study confirmed that violence young people were directly or indirectly exposed to, as well as peer victimization, has consequences in many aspects of life, and it can be brought in connection with antisocial problems. Gender is an important factor which influences the nature of this connection – boys have greater risk to experience violence and girls to manifest behavioral problems. The only parental characteristic that predicts well the probability of problem occurring is inconsistency. Once we included exposure to peer victimization into analysis, parental consistency lost its significance, and exposure to peer victimization appeared as the only significant predictor of emotional and behavioral problems in youth. These results may help us in designing programs for prevention of violence among youth

Inside out – do adverse childhood experiences predict nonsuicidal self-injury?

Non-suicidal self-injury (NSSI) is defined as behavior that is self-directed and deliberate, resulting in injury or potential injury to oneself without suicidal intent, although it consistently correlates with suicidality. Common forms of NSSI include cutting, burning, scratching, banging, hitting, biting etc. Meta-analysis showed that overall childhood maltreatment is associated with NSSI, especially in the case of childhood emotional neglect or emotional abuse. Highly lethal self-harm was associated with childhood physical peer victimization, sexual abuse, emotional abuse, and emotional neglect. The NSSI questionnaire designed for this study was based on several questionnaires such as Deliberate Self-Harm Inventory (DSHI), Inventory of Statements About Self-Injury (ISAS), Ottawa Self-Injury Inventory (OSI) and Self-Harm Behaviour Questionnaire (SHBQ). The NSSI used in this survey contains 12 items with joint binary (yes or no) and numeric (how many times) scales. On all items, respondents provided answers with respect to two time periods: before and after the age of 18 (laws in Serbia restrict rights of persons under the age of 18 and some of those are related to potentially risky behaviors such as rights regarding alcohol purchase). Overall, approximately 4% of respondents reported NSSI at least once in lifetime, out of which 3.6% reported NSSI at least once before the age of 18 and 1.8% at least once after the age of 18. Since this is a form of behaviour is typical for younger adolescents, as expected, the NSSI is more prevalent before the age of 18 (2 = 17.225, p < .01). The correlation between the frequency of NSSI before and after the age of 18 is r = 0.73 (p < .01), while the correlation between suicide attempts and NSSI was Φ = 0.25 (p < .01). When it comes to the prediction of NSSI that occurred after the age of 18, ACE scores were not significant predictors. However, regression analysis showed about 9% of the variance of the NSSI before the age of 18 can be related to ACEs. Specifically, three types of ACEs were significant predictors of NSSI: sexual abuse (β = 0.16, p < .01), incarceration of a family member (β = 0.11, p = 0.051) and abuse of father by the partner (β = 0.15, p = 0.012). Available data suggest that at least one part of the variance can be ascribed to the ACEs. Therefore, emphasis should be put on fostering coping strategies in adolescents that would lead to diminishing negative consequences of ACEs.Knjiga rezimea / XXV naučni skup Empirijska istraživanja u psihologiji 29–31. mart 2019

Depressive symptoms, exposure to aggression and delinquency proneness in adolescence: Impact of two decades of war and political violence on adolescent mental health

Traumatic experiences in Serbia in the last two decades have caused significant psychological consequences in children and adolescents. The aim of this study was to investigate the relationship between depressive symptoms, exposure to aggression and delinquency proneness among high school and elementary school students in Belgrade, Serbia. The participants were 899 students (51.8% were female) with no prior treatment for psychological problems, with a mean age of 16.70±1.95. All used instruments were taken from the modified Social and Health Assessment (SAHA). Our findings show that delinquent behavior or exposure to delinquency was significantly related to depressive symptoms. The strongest predictors of depression were variables concerning legal consequences, affiliation with delinquent peers, victimization by community violence and peer victimization. This study confirmed a strong correlation between depression and exposure to violence. Identifying adolescents with depressive symptoms is important for prevention of serious mental health consequences

Psychopathology and resilience in relation to abuse in childhood among youth first referred to the psychiatrist

Uvod/Cilj. Zlostavljanje u detinjstvu može biti uzrok različitih psiholoških problema kod odraslih osoba. Malo se, međutim, zna o specifičnim kliničkim i porodičnim profilima, kao i karakteristikama rezilijentnosti adolescenata koji su doživeli zlostavljanje u detinjstvu. Cilj našeg rada bio je ispitivanje simptoma, porodičnog funkcionisanja i rezilijentnosti adolescenata sa iskustvom zlostavljanja u detinjstvu upućenih na psihijatrijski pregled. Metode. Uzorak se sastojao od 84 konsekutivno regrutovana mlada ispitanika (prosečne starosti 14,90 ± 3,10, u rasponu od 11 do 18 godina) upućena na prvi pregled u Kliniku za decu i omladinu Instituta za mentalno zdravlje u Beogradu, koji su na osnovu Matrice rizika za zlostavljanje i zanemarivanje dece bili podeljeni u dve grupe. Prvu grupu činili su adolescenti sa iskustvom zlostavljanja u detinjstvu (n = 38, 13 dečaka, 25 devojčica), a drugu, kontrolnu grupu, adolescenti bez iskustva zlostavljanja u detinjstvu (n = 47, 20 dečaka, 27 devojčica). U istraživanju su korišćeni sledeći upitnici: Upitnik za samoprocenu adolescenata (Youth Self-Report - YSR), Skala adolescentnih rezilijentnih stavova (Adolescent Resilience Attitudes Scale - ARAS) i Upitnik za porodicu, (Self-Report Family Inventory - SFI). Rezultati. Značajne razlike pronađene su kod adolescentkinja. Na upitniku YSR, zlostavljane adolescentkinje imale su značajno više skorove delinkventnog ponašanja i marginalno veće skorove anksioznosti/depresivnosti i socijalnih problema. Analize upitnika SFI pokazale su značajno lošije funkcionisanje kod zlostavljanih adolescentkinja u svim podskalama osim na podskali direktivnog vođstva. Na upitniku ARAS, zlostavljane adolescentkinje imale su značajno niže skorove na podskali uvida i marginalno niže skorove na podskali za inicijativu. Zaključak. Navedeni rezultati mogli bi imati praktičnu primenu pri planiranju specifičnih preventivnih strategija i tretmana koji se posebno fokusiraju na delinkventne tendencije kao i na jačanje rezilijentnosti obezbeđivanjem pozitivnog okruženja u okviru porodice, škole i zajednice.Background/Aim. Child abuse may be related to adverse psychological outcomes in adult life. However, little is known about specific clinical, family and resilience profiles of adolescents that have experienced child abuse. The aim of this study was to investigate clinical symptoms, family functioning and resilience characteristics of adolescents with the experience of abuse, first referred to psychiatrists. Methods. The study included 84 young participants (mean age 14.90 ± 3.10, ranging from 11 to 18 years) as consecutive first referrals to the Clinic for Children and Youth of the Institute of Mental Health, Belgrade, Serbia. The sample consisted of two groups, based on the Child Abuse Matrices of Risks. The first group included adolescents with the experience of abuse in childhood (n = 38, 13 males, 25 females), whereas the second, control group, comprised of non-abused adolescents (n = 47, 20 males, 27 females). The presence of abuse was evaluated by the Child Abuse Matrices of Risks. The study used the following questionnaires: Youth Self-Report (YSR), Adolescent Resilience Attitudes Scale (ARAS), and Self-Report Family Inventory (SFI). Results. Significant differences were found only among females. According to YSR, the abused girls had significantly higher scores on the Delinquent Behavior scale and marginally higher scores on Anxious/ Depressed and Social Problems scales. Analyses of the SFI showed significantly lower family functioning among the girls with the child abuse history for all scales except for the Directive Leadership. The abused girls also showed significantly lower scores on the Insight scale, and marginally lower Initiative scores at the ARAS. Conclusions. These findings may have practical application in the creation of specific preventive and treatment strategies, particularly focused on delinquent tendencies, as well as on enhancing resilience through providing positive environments within families, schools and communities

Nonsuicidal Self-Injury (NSSI) in Serbia: Nationally representative sample study

Although NSSI has been drawing the attention of researchers intensely for the last 30 years, to date there is no published study about rates of NSSI behaviors in countries of south-eastern Europe. The study aimed to explore NSSI in the Republic of Serbia. Data were collected using multistage random sampling. The final sample consisted of 2792 participants (57.4% female) while the NSSI subsample consisted of 405 participants (54.3% males). Results showed the NSSI rate in Serbia is 4.3% based on a percentage of people who answered affirmatively to lifetime NSSI engagement. However, when the percentage of people who reported at least one positive answer through the NSSI behaviors checklist, the rate rises to 14.5%. The most frequent NSSI behavior is wound picking. NSSI rate drops to 8.8% when wound picking is excluded. Those engaged in NSSI were more likely to report suicide attempts and seek professional help than those who did not report NSSI. Gender differences in NSSI frequency are found only in cases of headbanging and burning oneself. This study showed the scope of NSSI-related problems is similar in Serbia compared to other countries. It also raised questions about the lack of preventive programs and treatment strategies for dealing with NSSI in Serbia.[https://www.sciencedirect.com/science/article/pii/S2772598722000320]Corresponding author. Institute for Educational Research, Dobrinjska 11/3, 11 000, Belgrade, Serbia. E-mail addresses: [email protected], [email protected] (A. Radanović)

Analysis of trauma severity and the impact of abuse and neglect on personality traits in adolescents

Introduction: Abuse and neglect might cause multiple and long-term consequences on physical and mental health, development and future life of children. The consequences that abuse and neglect cause on a child’s personality and functioning in adult life have particular importance. The aim: Determining the level of trauma, as well as differences in personality traits of adolescents who are on psychiatric treatment and has been registered in Department for the protection of children against abuse and neglect, comparing with children who are on psychiatric treatment but not abused, and control group of adolescents. Materials and methods: The study analysed three groups: abused group on psychiatric treatment, group on psychiatric treatment and not abused, and control healthy population. All subjects filled out General questionnaire with basic socio-demographical data, Childhood Trauma Questionnaire (CTQ), and Temperament and Character Adolescent Inventory (ATCI – 46). Results: There is statistically significant difference between groups in all types of abuse: physical, emotional, sexual, as well as emotional and physical neglect (p<0.001). Psychiatric group has significantly lower scores on Persistence (P) (p<0.01), while abused group has lower scores on Harm avoidance (HA) (p<0.05). Negative correlation between abuse and Self-transcendence (ST), and negative correlation between physical abuse and Self-directedness (SD) has been shown. Conclusion: Abuse and neglect in children and adolescents are a significant cause of trauma and can cause different psychopathology, as well as changes on character and temperament traits

Epilepsy and interictal epileptiform activity in patients with autism spectrum disorders

Purpose: The purpose of this study was to determine the prevalence of epilepsy and subclinical epileptiform abnormalities in children with autism spectrum disorder (ASD), and to investigate its effects on core autistic symptoms and adaptive behavior skills. Methods: Patients with diagnosis of ASD who met full criteria on Autism Diagnostic Interview-Revised (ADI-R) were included in the study. Adaptive behavior skills were assessed by Vineland Adaptive Behavior Scale-II (VABS-II). Clinical assessment for epilepsy and video electroencephalography (EEG) (v-EEG) examinations during wakefulness and/or sleep were prospectively performed in all patients. Results: A total of 112 patients with diagnosis of ASD of mean age 6.58 +/- 3.72 were included in the study. Based on clinical and v-EEG assessments, three groups of patients were defined: 1) patients with epilepsy (n = 17; 15.2%); 2) patients with epileptiform discharges in absence of clinical seizures (n = 14; 12.5%); 3) patients without epilepsy and without epileptiform discharges ( n = 81; 72.3%). There were no significant differences between three groups of patients on ADI-R subscores. Speech development was also not significantly related to epilepsy. There was a slight tendency of the VABS-II motor skills score to be higher in the group of patients with autism without clinical diagnosis of epilepsy and without subclinical epileptiform discharges (p lt 0.05) in comparison with the two other groups. According to this tendency, we might claim that patients with higher scores on motor skills could have 0.88 times lower odds for having epileptiform EEG activity. Conclusions: According to our results, we were not able to detect differences in the ADI-R between the three populations with ASD, all with unknown etiology. Epilepsy, as well as subdinical epileptic discharges, showed small effects on Motor Skills in patients with autism, and had no effect on adaptive behavior Communication/Socialization/Daily Living Skills

Adjustment disorders in hospital treated adolescents: A follow-up study

Introduction. Adjustment disorders represent a frequent diagnostic entity especially among adolescents. They involve a wide spectrum of various emotional and behaviour problems. Objective. The aim was to investigate characteristics of diagnostic category known as adjustment disorders among hospital treated adolescents for the first time at the Clinical Department for Children and Adolescents of the Institute of Mental Health in Belgrade, during five consecutive years, as well as to investigate the outcome of the disorder in follow-up period. Methods. We conducted a retrospective investigation of the first time hospital treated adolescents from Belgrade with discharge diagnosis of adjustment disorders during 2000-2004. The follow up was conducted 5-10 years after a first discharge from the hospital. Results. During the investigated period 75 adolescents from Belgrade were hospitalized for the first time with diagnosis adjustment disorder. From the studied patients the main sample was formed that included 24 (32%) males and 51 (68%) females. After 5-10 years a follow-up of 52 patients was conducted (sample at follow-up) which included 16 (30.77%) males and 36 (69.23%) females. Of the main sample, 70% of the patients were under follow-up. After the first hospitalization 58% of adolescents continued with further psychiatric treatment, either as rehospitalized or out-of-hospital patients. Conclusion. Our findings showed that 38% of adolescents under follow-up for 5-10 years after the first discharge from hospital with the diagnosis adjustment disorders had multiple hospitalizations. The outcome of the disorder among these patients was the worst, because three-quarters of the patients were rediagnosed in the follow-up period with a new psychiatric disorder, often from psychotic spectrum