 Kurdistan Journal of Applied Research (KJAR) Print-ISSN: 2411-7684 | Electronic-ISSN: 2411-7706 Special Issue: 2nd International Conference on the Health & Medical Sciences | DOI: 10.24017/science.2018.2.27 Received:19 May 2018 | Accepted: 20 June 2018 The Effect of Child Abuse on University Student’s Psychological Status: A Retrospective study Pary M. Azize Farida A. Kadir Lavin Luqman Othman Nursing Department Midwifery Department Information Technology Department Technical Institute of Sulaimani Technical Institute of Sulaimani Vise president of The Action Group (TAG) Sulaimani Polytechnic University Sulaimani Polytechnic University The American University of Iraq, Sulaimani Sulaimani, Iraq Sulaimani, Iraq Sulaimani, Iraq Pary.azize@spu.edu.iq farida_barwari3@yahoo.com ll14096@auis.edu.krd 161 Abstract: Child abuse commonly underpins adult depression. Child abuse is classified into four categories; physical, sexual, mental and neglect. This paper will study and discuss the rate of depression caused by child abuse at the time of the abuse, the data collected from the first section of the survey, which consisted of two categorical questions. There are two questions that this research will try to answer; have more females experienced one or multiple types of abuse during their childhood compared to male? And have the ones who have experienced abuse suffered from a degree of depression at the time of the abuse. The depression test that consisted of four questions that determined the participant’s depression percentage The result and tables have been duplicated from the Public Service Pension Plan (PSPP), 21 females and 36 males participated in the survey. In total 57 students answered the questions that were sent through email. 73% of the participants said that they were not abused as a child in any of the forms. 27% of the participants have been abused in one or more of the ways as a child., further, 71.4% of the abuse were physical followed by mental and neglect (28%. 28%, respectively). Likely there were zero records of sexual abuse. Most of the abuse was happening around age 1-5 years and less likely on age 1-5 and above. Females become more depressed than males. 57.2% of the abused children were suffering from anxiety followed by an interruption in their relationship and low self esteem It can be concluded that more female were abused as a child. We can see that the constant (Male) is 49.29 and the female participants are 26.34 more than the constant. This proves that females become more depressed than men. Therefore, much work will need to Protect the children from harm. Keywords: child abuse, depression, perception, physical abuse, sexual abuse. Mental abuse, neglect 1. INTRODUCTION The World Health Organization defines child abuse as “Intentional or unintentional behavior by adults, society, or a country with negative consequences for the health and physical development of the child” [1:71]. Globally, 40 million children have suffered annually from abuse [2]. Child abuse commonly underpins adult depression. Child abuse is classified into four categories; physical, sexual, mental and neglect [3]. The harm caused by child abuse as any detrimental effect of a significant nature on the child's physical, psychological or emotional wellbeing (Child Protection Act 1999). Recently, child abuse has accounted as one of the most complicated psychosocial issues around the world that is linked to depressive symptoms [4]. Physical abuse appears when the child is suffering from the risk of non accidental physical trauma, such as hitting, shaking, throwing, biting, burning and poisoning, which, sometimes can lead to injury and trauma and in some severe cases the child will be left with a permanent scar, Childhood sexual abuse (CSA) is a well-established risk factor for adult depression, that occur by involving the child in a sexual activity by an adult and adolescent [5]. Although, emotional abuse also appear when the child’s social, emotional, cognitive and intellectual ability has impaired mostly through family violence. When a child fails to meet the basic needs across their life by the lack of attachment or mistreated in terms of health care, adequate clothing, food and personal hygiene these might cause neglect, that related to the fail parental responsibility to seek help in order to provide a healthy environment for their children [6]. Thus, Bowlby in his theory reported that the range of attachment between caregiver and children play an important role in forming a Romantic- relationship, which, focus mostly on parent-child interaction [7] stated that maltreatment sometimes can lead to post traumatic stress disorder (PTSD) in life and also they found it difficult to make the relation between maltreatment and future stress [8]. Therefore, there is a direct relationship between child abuse and depression and parents are responsible for that. The higher the level of abuse the child has experienced, the more chance the child can get depression disorder in the future. The current study seeks to find out and discuss the rate of depression caused by children at the time of the abuse. 2. METHODS AND MATERIALS A retrospective - quantitative study was chosen in order to seek and discuss the rate of depression caused by children at the time of the abuse. The current study examined abuse perceptions, among 57 university mailto:farida_barwari3@yahoo.com https://www.psychologytoday.com/us/conditions/child-abuse https://www.google.iq/url?sa=t&rct=j&q=&esrc=s&source=web&cd=22&ved=2ahUKEwjLq_XdnMHcAhVGBiwKHahuC_IQFjAVegQIBxAB&url=https%3A%2F%2Fwww.pspp.ca%2F&usg=AOvVaw0oQZ1zP5ejmhU4UpMBcHhO https://www.google.iq/url?sa=t&rct=j&q=&esrc=s&source=web&cd=22&ved=2ahUKEwjLq_XdnMHcAhVGBiwKHahuC_IQFjAVegQIBxAB&url=https%3A%2F%2Fwww.pspp.ca%2F&usg=AOvVaw0oQZ1zP5ejmhU4UpMBcHhO https://www.psychologytoday.com/us/conditions/child-abuse 162 students through a google form/ email. The forms were sent to 60 students, 57 of which sent their responses anonymously (email addresses were not collected). There are two sections that this research attempted to find; some demographic data such as having more females experienced one or multiple types of abuse during their childhood compared to male? And have the ones who have experienced abuse suffered from a degree of depression at the time of the abuse. Description of data Section A This section demonstrates the data collected from the first section of the survey, which consisted of five categorical questions. The first question asked the participant if they have been abused during their childhood, second, to specify their gender; then question about types of abuse, age of being abused and finally asked about the effect of Abuse on the psychological and behavioral status. Section B This section will demonstrate results acquired from the depression test that consisted of four questions that determined the participant’s depression percentage. Data Analysis (Model Applications) I had trouble finding the right model to explain all of the data. Since the regression model is unable to explain 100% of my data it was hard to make decisions. Another challenge was cleaning up the data and representing it in a format that was obtainable by PSPP. 3. RESULTS Section A Table 1 illustrates that (21, 36.8%) females and (36, 63.2%) males were participated in the survey . In total 57 out of 60 subjects answered the questions that were sent through email. Table 1. Gender Ration (table has been duplicated from PSPP). Figure 1 represents that 27% of the participants have been abused in one or more of the ways (sexual, neglect, mental and physical) as a child. The participants that have not been abused were stated 73% of the participant Figure 1: Abused status (Graph taken from PSPP). Figure 2: It shows the types of abuse. In (Figure 2), shows that a physical abuse addressed as the most type (70%), followed by mental and neglect abuse. Figure 3: It shows the age of the participates that faceed abuse. Figure 3 shows that 1-5 years old addressed as a highly Age of being abused, followed by 5-10 years. Gender and Abused Figure 4: Gender and Abuse (Graph taken from PSPP). Figure 4 illustrates the number of and males that were abused. The x-axis represents the two genders and the y-axis shows the number of participants that were abused. From the bar chart, it can be concluded that more female were abused as a child. 73% 27% Abuse Status not abused abused 0 50 100 physical abuse sexual abuse mental abuse neglect types of abuse 0 100 1year- 5 years 5years-10 years 15 and above age age and abuse Value Table Value Frequency % Valid % Cum % Female 1 21 36.8 36.8 36.8 Male 2 36 63.2 63.2 100.0 Total 57 100.0 100.0 1= female 2=male Abused 163 Section B This section will demonstrate results acquired from the depression test that consisted of four questions that determined the participant’s depression percentage. Figure 5: It shows the percentages of depression and abuse. A histogram shows the percentage of depression of the participants. The mean of the graph is 63.3%. This shows that there is a normal distribution. Figure 6: It shows some psychological and mental effects of child abuse. This figure shows that 57.2% of the abused children were suffering from anxiety followed by an interruption in their relationship and low self esteem, which showed to be on the same percentage. Figure 7: child abuse and some behavioral status This figure shows that most of the abuse was effected sleeping and eating habits, self harm and constant absence from school were also effected of abuse. Model In this research Regression model has been used to analyze the data. Regression model: Dependent=Depression, Independent=Female, Constant=Male. Table 2: Gender and Abuse (Table taken from PSPP). Table 2 is a regression model that was run at Female and depression rate, making the male the constant. The model explains 42% of the data. From the Anova model we can see that the model is scientifically significant since the significance 0.009. We can see that the constant (Male) is 49.29 and the female participants are 26.34 more than the constant. This proves that females become more depressed than men. 4. DISCUSSION It is hard for a person to speak about abuse since the act is difficult to indicate. Therefore, a retrospective - quantitative study was chosen in order to seek and discuss the rate of depression caused by children at the time of the abuse. This study reported that, 73% of the participants said that they were not abused as a child in any of the forms. While, 27% of the participants have been abused in one or more of the ways as a child, we understand that this confession must have been hard for this number of participants as it is always counted as taboo for a child to talk about the abuse they are receiving. In fact, this study expects parents to abuse their child in order to discipline their child be “behaving”. In contrast to Bowlby theory [7] ‘attachment theory’ in (1982) who reported that the range of attachment between caregiver and children plays an important role in forming a significant relationship, which focus mostly on parent-child interaction [9]. Stated that Attachment is one specific aspect of the relationship between a child and a parent with its purpose being to make a child safe, secure and protected. Regarding the types of abuse, this study was found that our participants were suffering most from physical abused with fortunately no sexual abuse. There is a a study [10] reported that ‘Child maltreatment" are most likely cover as an umbrella of the physical abuse (affecting 8.0 percent of the children globally) followed by sexual abuse (1.6 percent), emotional abuse (36.3 percent), and neglect (4.4 percent). Therefore, depending on this finding, emotional abuse is a leading type of abuse among the other, In terms of the age and child abuse, this study found that 1-5 years old were more likely abused followed by 5-10 years old. This proved by the fact that 70% of the abuse were taking action below the age of 3[11]. Regarding gender and child abuse, This study was expecting to see an almost equal amount of females and males saying yes to being abused. However the finding of the study [9] revealed that, and stated that more female were abused as a child than male, In the analysis showed 0 20 40 60 80 anxiety low selfe steem maintaining relationships p e rc e n a g e o f su b je ct s a ff e ct e d psychological and mental effect What are some psychological and mental effects of child abuse? 0 20 40 self harm eating disorder trouble sleeping Absent from school oftenbehavioral effect What are some behavioral effects of child abuse? Depression rate 164 that there is a significant association between gender and child abuse. Keeping in mind that male participants were more than female participants, this means that the percentage of abuse among female participants and male participants is significantly high. This finding was surprising, since it was unexpected that there would be inequality between female and male from such a young age, knowing that males have a more badly behaved nature than females. Male children are often more outgoing, taking more risks and trying to push boundaries more than female children. Female children are usually quiet and are able to take directions easier than males. The participants who had been abused have suffered from a high degree of depression at the time. Further, the findings show that the constant (Male) is 49.29 and the female participants are 26.34 more than the constant. This proves that females become more depressed than male. As It is well known that female were depressed twice as male because of normal hormonal change [10,11,12]. Regarding the impact of being abused on the mental, Psychological and behavioral health. This study found that a majority of the people that have been abused having a significantly higher rate of depression. Since the topic of mental health and depression is almost a taboo, therefore, children feel ashamed and are not allowed to show signs of sadness [13]. This makes the child feel even more depressed and lost, and in the long run this will impact the mental, social and behavioral state of the child. As humans, we are socializing species, speaking and sharing our feelings with other human beings makes us feel safer and releases out stress, when the person forbidden or too frightened to share their thoughts and feelings, as a consequence, this might start to develop anxiety as a consequence of abuse [14]. This study represents that anxiety has the highest influenced followed by low self esteem and communication. In terms of the impact of abuse on the behavior of the victim, most of the participants reported that, they were suffering from eating disorder and sleeping disturbance. This result being supported by the WHO report, which said that eating disorder, sleeping disturbance, poor relationship and PTSD are all counted as another consequence of being abused [15]. As human nature stress and fear affects sleeping patterns and eating habits. Some people might be eating too much during difficult times and start developing numerous of diseases, while others take the opposite approach and stop eating food, which also leads to numerous diseases respectively. [16] Supported this finding and states biological, physiological and social processes of a victim are the cause of eating disorders and a few factors that have an impact on one’s relationships and social life, trust, self worth, and communication. As mentioned before abuse in childhood is usually carried out by a close person to the victim, this would lead to the breakage of that trust bridge between the victim and other people around them, which, makes them find it hard to keep a healthy relationship with others, Once the anxiety and the depression make their way into a human brain, that person will start to believe that they have lost their self worth, and will lose the knowledge of their place in the relationship. [17] Browne Angella in his study about child sexual abuse states that there are long term and short term effects of abuse. Based on his study, long term effects of child sexual abuse and child abuse in general include low self-esteem, difficulty in trusting others. 5. CONCLUSION In conclusion, this study confirms that, physical child abuse is a significant type of abuse, which most common among female victims and cause depression. Abuse mostly takes place from the age 1-5. This problem needs to be solved and we need to provide help for these children. This study will recommend to develop an application or a software that would provide 24/7 service of professional counselors that are online to help children who are suffering from any of the four types of abuse. Since most children in Kurdistan have access to device, the software can be installed on all the devices that are imported into the country and children should be trained and informed on the use of the software through schools and child supporting groups. We also recommend another approach that would guarantee that information will be passed on to all of the children in the country and that is through hiring dedicated people who would go and talk to all children in all of the schools and kindergartens. Informing children and training children on what needs to be done when abuse takes place will be very effective, it will help the child build a trust bridge with the school or the kindergarten (the place that they have received the information from). REFERENCE [1] Z. Cetin, M. A. Ozozen-Danaci. “multivariate examination of the child-abuse potential of parents with children aged 0-6,” Eurasian Journal of Educational Research, 66, 71-86, 2016. http://dx.doi.org/10.14689/ejer.2016.66.4 [2] Department of Communities, Child Safety and Disability Services:, What is child abuse? International, C. C. (July 6, 2017) Retrieved December 13, 2017, from Queensland Government; https://www.communities.qld.gov.au/childsafety/protecting- children/what-child-abuse [3] M. Rostami, M. Abdi, H. Heidari. “Study of Various Types of Abuse during Childhood and Mental Health,” Social and Behavioral Sciences 159; 671 – 676. 2014. [4] M. C. Cutajar, P. E Mullen, J. R. Ogloff, S. D. Thomas, D. L. Wells. “Psychopathology in a large cohort of sexually abused children followed up to 43 years,” Child Abuse Negl; 34(11):813- 22, 2010. [5] A. R. Jasmer, “Medical News: Physical Child Abuse Sends Thousands to Hospitals - in Pediatrics, Domestic Violence from MedPage Today,” Medical News and Free CME from MedPage Today. Paediatr Child Health; 9(8): 541–545, 2014. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC272416/ [6] K. Rodd, “Childhood Psychological Maltreatment and Neglect, Intimate Relationships,” Adult. B. A., Queen’s University, 2015. [7] J. Bowlby, “Attachment and loss,” Tavistock Institute of Human Relations. 2nd edition. New York. 1982 https://www.abebe.org.br/files/John-Bowlby-Attachment- Second-Edition-Attachment-and-Loss-Series-Vol-1-1983.pdf. [8] A. Dias, L. Sales L, R. Mota-Cardoso; T. Mooren, R. Kleber, “Child maltreatment, revictimization and Post-Traumatic Stress Disorder among adults in a community sample,” International Journal of Clinical and Health Psychology 17, 97-106, 2017. [9] D. Benoit, “Infant-parent attachment: Definition, types, antecedents, measurement and outcome of sexually abused children followed up to 43 years,” Child Abuse Negl.; 34(11): 813- 22, 2010. [10] Safe Horizon. “Child Abuse Facts,” Accessed March 3, 2015. [11] D. D. Vachon, R. F. Krueger, F. A. Ragosch, D. Cicchetti, “Comparable consequences across different forms of child maltreatment,” JAMA Psychiatry, 2015. http://dx.doi.org/10.14689/ejer.2016.66.4 https://www.communities.qld.gov.au/childsafety/protecting-children/what-child-abuse https://www.communities.qld.gov.au/childsafety/protecting-children/what-child-abuse https://www.ncbi.nlm.nih.gov/pubmed/20888636 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2724160/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC272416/ https://www.abebe.org.br/files/John-Bowlby-Attachment-Second-Edition-Attachment-and-Loss-Series-Vol-1-1983.pdf https://www.abebe.org.br/files/John-Bowlby-Attachment-Second-Edition-Attachment-and-Loss-Series-Vol-1-1983.pdf https://www.ncbi.nlm.nih.gov/pubmed/?term=Benoit%20D%5BAuthor%5D&cauthor=true&cauthor_uid=19680481 165 [12] World Health Organization. “Gender disparities in mental health,” Geneva: World Health Organization, 2013. [13] C. May-Chahal. “Gender and Child Maltreatment: The Evidence Base,” Social Work & Society.4(1), 2006. [14] J. Klevens, K. Ports, “Gender inequity associated with increased child physical abuse and neglect: A cross-country analysis of population-based surveys and country-level statistics,” Journal of Family Violence DOI 10.1007/s10896-017-9925-4, 2017. [15] World Health Organization, “Child abuse and neglect,” Geneva: World Health Organization, 2002. [16] M. Manja, A. Keizer, “Body representation disturbances in visual perception and affordance perception persist in eating disorder patients after completing treatment,” Scientific Reports, 7, 1, 2017. [17] B. Angela, F. David, “Impact of child sexual abuse: A review of the research,” Psychological Bulletin, 99(1), 66-77, 1986.