MED-NERD

Violence, stress, and their relation to COVID-19.

Updated: August 25, 2022

Outline:

Overview
Key facts
Definition of violence
Psychological violence
Risk factors leading to violence
Types of violence
Violence in different categories
Recommendations for Prevention of violence
References

Overview:

Violence has increased massively over the recent decades despite the progression and the development that many countries have achieved in various fields. Violence takes different forms against different categories. COVID-19 pandemic showed increase in the levels of stress and violence especially in adolescence.

Key facts :

About 470,000 are victims of homicide yearly worldwide according to the World Health Organization (WHO).
In the United States, About 20 people per minute are abused physically by intimate partner, which is more than 10 million women and men yearly .
1 in 4 women and 1 in 9 men experience physical violence , contact sexual violence by intimate partner leading to injuries , transmission of sexually transmitted infections , post traumatic stress disorder, fearfulness , and the use of victim service.
Homicide is the third leading cause of death for people aging 10-24 years and the leading cause of death for African American youth with about 200,00 homicides yearly and this represents 42% of all homicides each year worldwide .
1 in 8 of young people reported being a victim of sexual abuse.

Definition of violence :

-According to the World report on violence and health (WRVH), violence is defined as:

"the intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community, that either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment, or deprivation."

Psychological violence :

-Researchers define psychological abuse as chronic verbal aggression and this in turn may lead

to physical violence.

-Psychological violence occurs when communication is difficult and the person is unable to tolerate the condition.

Risk Factors leading to violence:

The principles of public health consider violence as the outcome of the interaction between the following levels : the individual, the relationship, the community, and the social level.

1-The individual level:

Personal history: history of aggressive behaviour , psychological disorder, personality disorder, alcohol and substance abuse , being a victim of abuse ,being a victim of child maltreatment, biological factors and the environment surrounding individuals may lead to being a victim or an assailant.

2-The Relationships level :

Including family, friends, peers, and intimate partners that may affect the risks of being a victim or an assailant .

3-The Community level :

Meaning the context in which relationships occur and includes schools, neighbourhoods and workplaces ( e.g. the level of unemployment, mobility, and the local drug or gun trade.)

4-The Societal factors level:

These factors may encourage or inhibit violence including economic, cultural, and social policies that lead to inequalities between individuals and therefore increasing the risk of violence.( e.g. the access to weapons, male dominance over women, dominance of parents over children, cultures that already accept and encourage violence.)

See: Mania

Types of violence :

According to The World Health Organization (WHO), types of violence include : self-directed violence, interpersonal violence and collective violence.

1-Self-directed violence:

Means that the victim and the assailant are the same person. It includes two subtypes: self-abuse and suicide.

2-Interpersonal violence:

Means violence between individuals and it includes two subtypes: family and intimate partner violence and community violence.

Examples of interpersonal violence include: intimate partner violence, child maltreatment, and elder abuse which is subdivided into acquaintance and stranger violence for instance youth violence, violence in workplaces and other institutions, assault by strangers, and violence related to property crimes.

3-Collective violence :

Means violence committed by large group of individuals including the following subtypes: economic, social and political violence.

See: Adverse Childhood Experiences (ACEs)

Violence in different categories:

Violence against women:

- According to the WHO, By analysis of prevalence data of violence against women from 2000-2018 obtained from 161 countries , Nearly, 1 in 3 women experience physical or sexual violence 38% by intimate partner and 6% of women reported being sexually assaulted by someone else worldwide.

-According to the United Nations, Violence against women can be defined as: "any act of gender-based violence that results in, or is likely to result in, physical, sexual, or mental harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or in private life."

-Violence against women leads to numerous negative effects including: increasing risk of depression, anxiety disorders, injuries, illegal-pregnancies, and sexually transmitted infection such as HIV.

-Violence in families affects children negatively causing behavioural and emotional disturbances, mental and developmental problems increasing the risk of being an assailant or a victim of violence in the future .

-During COVID-19 pandemic and due to quarantine and the social and economic outcomes, Violence against women by abusive partners has increased .

Violence in elderly, Aggressive behaviour related to dementia :

Dementia affects behaviour and the ability to perform tasks. It may cause aggressive behaviour and this may be due to :

Memory loss, orientation problems, and other changes within the brain.
Physical or mental health problem causing frustration being not able to do things properly.
Improper Environment making elderly confused or stressed .
Connection and contact with others .
Aggression may be related to personality and the behaviour of the person before dementia.

Violence in children and the effect of COVID-19 pandemic :

Effect of Covid-19 pandemic on children and adolescents:

-Covid-19 pandemic affected the mental health of the most vulnerable populations including children and adolescents .

-Quarantine greatly affected children and adolescents as they were isolated from social life and outdoor activities and some of them experienced domestic violence .

-The stress of that period of pandemic also affected the mental health of children and adolescents increasing the levels of fear and anxiety.

-Children with parents having psychiatric disturbances are more likely to develop psychic disorders and the risk increased with the pandemic of covid-19.

-The overload of working from home and taking care of children during the pandemic increased the risk of children facing emotional and behavioural troubles.

-A study in China has shown that among 1036 quarantined children, aging from 6 to 15 years old, 112 presented with depression, 196 presented with anxiety , and 68 presented both depression and anxiety.

-Moreover, it was reported in China that children and adolescents aging from 13 to 18 years presented with symptoms of worry, inattention and clinging during the pandemic.

-The stress can increase the risk of neuroinflammation as a result of exaggerated signalling in the brain leading to a wide range of disorders including: depression, anxiety disorders, aggression and psychosis.

Violence in Youth :

- It is defined as : the intentional use of power or physical force to harm others physically or psychologically by people aged from 10-24 years such as fighting , bullying , threatening with weapons and gang-related violence .

-It is an adverse childhood experience ( ACE) that affects mental health and wellbeing on the long term.

-Violence against youth harms their development and causes : troubles in coping with stress, learning challenges, impaired decision making abilities, academic difficulties, school dropout, decrease connection to peers, increasing health-care costs, decreasing property value, being an assailant or a victim of violence in the future, drug and substance abuse, smoking, obesity, depression, high-risk sexual behaviour, and suicide .

-It is necessary to specify the root causes of violence especially violence against African Americans.

-A study showing data collected from 40 developing countries declares that about 42% of boys and 37% of girls experienced bullying .

Risk factors increasing violent behaviour in youth include :

-Behavioural disorders such as conduct disorder and attention deficit hyperactivity disorder.

- Substance abuse , tobacco and alcohol abuse .

-School failure, unemployment .

-Being involved in crimes and gangs .

-Violence in families .

-Poor monitoring of children.

-Poor connection between parents and their children .

-Parental substance abuse and depression.

-low family income and unemployment in family.

-Access to alcohol, illicit drugs , and firearms .

-Inequality and poverty .

- Laws and Policies for education and social protection.

See: Bulimia nervosa

Recommendations for Prevention of violence :

It is always recommended to seek a doctor or psychiatrist in case of violence.
Social programs to help children and adolescents deal with anger and stress and manage their lives.
Programs targeting parents increasing their awareness and their knowledge about violence.
Strict restrictions to limit the access to alcohol, drugs and firearms.
Provide suitable environment and eliminate sources of stress.
Involve elderly in exercises physically and mentally.
Empowerment of women and implantation of interventions that ensure safety of women.
Developing strict policies that limit Racism and ensure gender and race equality.

See: Mania

See: Bulimia nervosa

See: Adverse Childhood Experiences (ACEs)

See: Anxiety Disorders

References :

(1) James Calleja, in Encyclopedia of Violence, Peace, & Conflict (Second Edition), 2008

https://www.sciencedirect.com/topics/psychology/psychological-violence

(2) de Figueiredo CS, Sandre PC, Portugal LCL, Mázala-de-Oliveira T, da Silva Chagas L, Raony Í, Ferreira ES, Giestal-de-Araujo E, Dos Santos AA, Bomfim PO. COVID-19 pandemic impact on children and adolescents' mental health: Biological, environmental, and social factors. Prog Neuropsychopharmacol Biol Psychiatry. 2021 Mar 2.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7657035/

(3) Violence Prevention Alliance Approach. (2022).From

https://www.who.int/groups/violence-prevention-alliance/approach

(4) https://apps.who.int/violence-info/elder-abuse

(5) Violence against women. (2022). From

https://www.who.int/health-topics/violence-against-women#tab=tab_1

(6) Violence against women. (2022). From

https://www.who.int/news-room/fact-sheets/detail/violence-against-women

(7) NCADV | National Coalition Against Domestic Violence. (2022).From

https://ncadv.org/STATISTICS

(8) https://www.cdc.gov/violenceprevention/youthviolence/fastfact.html

(9) WHO, Youth violence. https://www.who.int/news-room/fact-sheets/detail/youth-violence