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 Table of Contents  
ORIGINAL ARTICLE
Year : 2021  |  Volume : 14  |  Issue : 1  |  Page : 66-71

Correlation between physical abuse and anxiety among school-going adolescents (10-16 years age) of Belagavi: A school-based study


1 Department of Child Health Nursing, KAHER Institute of Nursing Sciences, Belagavi, Karnataka, India
2 Department of OBG, KAHER Institute of Nursing Sciences, Belagavi, Karnataka, India

Date of Submission20-Apr-2020
Date of Acceptance26-Nov-2020
Date of Web Publication09-Feb-2021

Correspondence Address:
Prof. Gavishiddhayya B Salimath
Department of Child of Child Health Nursing, KAHER Institute of Nursing Sciences, Belagavi - 590 010, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/kleuhsj.kleuhsj_112_20

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  Abstract 

Introduction: The relationship between childhood maltreatment and bountiful range of mental divergence has been well assumed. Anxiety disorders are the usual mental health concern facing adolescents today, yet they are largely insufficiently treated. Physical abuse often does not occur in isolation, but as part of a constellation of behaviors including authoritarian control, anxiety-provoking behavior, and a lack of parental warmth.
Objectives: To find out the correlation between physical abuse and anxiety among school-going adolescents.
Materials and Methods: The present study was conducted among eight schools at Belagavi, using descriptive cross-sectional research design with stratified cluster sampling. It included primary and secondary schools of Belagavi. The study samples were consisted of 785 students. Self-structured physical abuse and anxiety scales were used to find out correlation between physical abuse and anxiety among the adolescents.
Results: The results of the study showed that out of total 785 study participants, 444 (56.56%) had exposed to moderate physical abuse, 196 (24.97%) had exposed to low physical abuse, and 145 (18.47%) had exposed to high level of physical abuse. The study findings showed that there is a significant positive relationship between physical abuse and anxiety among adolescents, with r = 0.1021.
Conclusions: The present study concluded that there is a significant positive relationship between physical abuse and anxiety among adolescents.

Keywords: Adolescents, anxiety, physical abuse


How to cite this article:
Salimath GB, Raddi SA. Correlation between physical abuse and anxiety among school-going adolescents (10-16 years age) of Belagavi: A school-based study. Indian J Health Sci Biomed Res 2021;14:66-71

How to cite this URL:
Salimath GB, Raddi SA. Correlation between physical abuse and anxiety among school-going adolescents (10-16 years age) of Belagavi: A school-based study. Indian J Health Sci Biomed Res [serial online] 2021 [cited 2021 Feb 25];14:66-71. Available from: https://www.ijournalhs.org/text.asp?2021/14/1/66/308943




  Introduction Top


The relationship between childhood maltreatment and bountiful range of mental divergence has been well assumed.[1] Every child has a right to a safe childhood and a life free from violence. The experience of child abuse and neglect infringe upon that right.[2] Anxiety disorders are the usual mental health concern facing adolescents today, yet they are largely insufficiently treated. If the anxiety problems were untreated, this will lead to severe consequences in adulthood.[3] Physical abuse often does not occur in isolation, but as part of a constellation of behaviors including authoritarian control, anxiety-provoking behavior, and a lack of parental warmth.[4]

The WHO defines physical abuse as intentional use of physical force against the child that results in – or has a high likelihood of resulting in – harm for the child's health, survival, development, or dignity. This includes hitting, beating, kicking, shaking, biting, strangling, scalding, burning, poisoning, and suffocating. Much physical violence against children in the home is inflicted with the object of punishing.[4] A pilot study has reported recently that approximately 84% of adolescents faced one or the other form physical abuse, common being among the age group of 11–12 years. The most persistent perpetrator of physical abuse was found as guardian/family member and followed by the friends and neighbors.[5] The Ministry of Women and Child Department, Government of India explored the study in 2007 across the 13 states in India, and the study stipulated that a critically high percentage of children in state run schools, i.e., 53.8% faced corporal punishment.[2] Daral et al. conducted a study among classes 7th–12th of government schools of Delhi, and a total of 1060 adolescents were included in the study. Majority were in mid-adolescence. Approximately 70% study participants' victims of at least one form of maltreatment. 42.6% of adolescents exposed to physical abuse.[6]

Anxiety is mental health disorder characterized by feelings of worry, anxiety, or fear that are strong enough to interfere with one's daily activities. Anxiety disorders are the most prevalent mental health concern facing adolescents today, yet they are largely undertreated.[3] One in six adolescents has one or the other anxiety traits in 10–19 years' age. Mental health conditions account for 16% of the global burden of disease and injury in people aged 10–19 years. Half of all mental health conditions start by 14 years of age, but most cases are undetected and untreated. Anxiety is the ninth-leading cause for adolescents aged 15–19 years and sixth for those aged 10–14 years. Emotional disorders can profoundly affect areas such as schoolwork and school attendance. Social withdrawal can exacerbate isolation and loneliness. At its worse, depression can lead to suicide.[7]

Science revealed that early subjection to episodes that produce persistent fear and chronic anxiety can have life-long consequences by disrupting the developing architecture of the brain.[8] Unfortunately, many young adolescents are unprotected to such situations. An early situation of threats leads to exceptional fearful events alters the developing brain, particularly in those areas involved in emotions and learning. For young children who perceive the world as a threatening place, a wide range of conditions can trigger anxious behaviors that then impair their ability to learn and to interact socially with others.[9]

The present study is the first to examine physical abuse in primary and secondary school going adolescents and its relation with anxiety level in Belagavi and also in the Karnataka state. Therefore, the present study will attempt to understand the correlation between physical abuse and anxiety among school-going adolescents (10–16 years age) in Belagavi.

Objectives of the study

  • To estimate the prevalence of physical abuse among school-going adolescents (10–16 years age) in Belagavi
  • To estimate the prevalence of anxiety due to physical abuse among school-going adolescents (10–16 years age) in Belagavi
  • To find out the correlation between physical abuse and anxiety among school-going adolescents in Belagavi.



  Materials and Methods Top


Design and setting

The study was conducted in eight schools in Belagavi city using the descriptive research design. It included primary and secondary schools of Belagavi.

Sample

This comprised school children of primary and secondary grades selected by stratified cluster random sampling. Belagum city was divided into four strata North, East, South, and West, 2 schools were randomly selected from each of the four strata. Eight schools having the maximum enrollment in each zone were selected and adolescents from these schools in the age group of 10–16 years were included in the study. The sample size calculated to estimate a prevalence rate of physical abuse of 42.6% (Daral S et al.,2016), with the absolute precision, design effect 2, at 95% level of confidence. The required sample size was 785 students.

Tools for data collection

Tool I

Sociodemographic questionnaire was used to collect about sociodemographic characteristics of the study participants such as age, sex, type of family, mother and father education and occupation, and income.

Tool II

Physical abuse interview tool, to find out prevalence of physical abuse at home with the methods of physical abuse such as hitting beating, with the hand and also with objects, chocking, burning, locking in small place, etc. It contained 10 questions to be answered by with criteria 0 (never), 1 (sometimes), and 2 (most of the times).

Tool III

Anxiety assessment scale to find out the levels of anxiety, 9 questions were included with criteria 0 (never), 1 (sometimes), and 2 (most of the times). A score of 0–6 indicates mild anxiety.

The reliability of the tool

Was assessed by test-retest method the reliability value was 0.82. There was very high correlation coefficient, and it was a good tool for identifying the physical abuse and levels of anxiety among adolescents.

Pilot study

The pilot study was carried out on sample of adolescents from other schools to test the clarity and reliability of the tool and feasibility of the tool. The tool was tested and necessary changes were done in the form of re-phrasing of some items. The pilot study participants were not included in the main study sample frame.

Field work

Institutional ethical clearance was obtained from the Institutional Ethical Committee before the start of the study, also permission was obtained from office of the Directorate of Education (DDPI) of Belagavi District. Permission letter was also obtained by the all school headmasters, and consent from parents and assent from the study participants were obtained. The investigator met with students in the class room and explained the purpose of the study and distributed the questionnaire forms to be completed.

Inclusion criteria

  • Primary and secondary school-going adolescents of aged 10–16 years
  • Adolescent students who are willing to participate in the study
  • Adolescent students present at time of data collection.


Exclusion criteria

  • Those students whose parents decline to provide the informed consent
  • Students with cognitive, neurological, psychological, and endocrinal disorders.


Data analysis

The data were analyzed by using Karl Pearson's correlation coefficient to find out the correlation between physical abuse and anxiety among school-going adolescents. The software used was the Statistical Package for the Social Sciences software version 20.

Duration of the study

The time duration of the present study was 2 years from December 2017 to December 2019.

Ethical clearance certificate was obtained from KLE University Ethics committee on Human subjects dated on 5th June 2017, Ref.No.KLEU/EC/17-18/D-102.


  Results Top


[Table 1] represents the sociodemographic characteristics of the study population. Maximum students 359 (45.73%) were in the age group of 15–16 years, followed by 273 (34.78%) in the 13–14 years age group and 153 (19.49%) students were 10–12 years old. The male-to-female ratio was 84.08:15.92 among the 785 study participants. In the present study, 653 (83.18%) were from the nuclear family and 132 (16.82%) were from the joint family. Out of 785 participants, most of them were 662 (84.33%) Hindu, 90 (11.20%) were belongs to other religion, and 33 (4.25%) were belongs Muslim religion. Out of 785 adolescents, 320 (40.76%) fathers were completed higher secondary education, 220 (28.03%) completed secondary education, 107 (13.63%) were completed primary education, and 78 of them completed degree and 60 of them were illiterates. Out of 785 adolescents, 378 (48.15%) mothers were completed secondary education, 213 (27.13%) completed higher secondary, 117 (14.90%) were completed primary education, and 29 of them completed degree and 48 of them were illiterates. Out of 785 adolescents, 316 (40.25%) fathers were self-employed, 258 (32.87%) private employees, 186 (23.69%) were farmers, and 13 (1.66%) government employees, 12 fathers were (1.53%) professionals. Out of 785 adolescents, 344 (43.82%) mothers were self-employed, 250 (31.85%) private employees, 143 (18.22%) were farmers, 27 (3.47%) were professionals, and 21 mothers were (1.53%) homemakers. Four hundred and ninety-two (62.68%) participants family had 6001–8000 rupees income per month, 144 (18.34%) participants had more than 8000 income 121 (15.41%) participants had 4000–6000 and 28 (3.57%) participants had 2000–4000 income none of them had above 8000 rupees income per month. Out of 785 adolescents, 546 (69.55%) of adolescents had two siblings, 228 (29.04%) has three and more than three siblings, and 11 (1.40%) had only one sibling.
Table 1: Distribution of the study participants according to sociodemographic variables (n=785)

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Out of total 785 study participants, 444 (56.56%) had exposed to moderate physical abuse, 196 (24.97%) had exposed to low physical abuse, and 145 (18.47%) had exposed high level of physical abuse at home [Table 2].
Table 2: Prevalence of physical abuse among school-going adolescents (n=785)

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Characteristics of physical abuse among school- going adolescents [Annexure 1]

Out of 785 study participants, 768 (97.83%) reported that they had been exposed to hitting, and being beaten and spanked with the hand by guardian/family member. Seven hundred and sixteen (91.21%) reported that they had been pushed and being grabbed and kicked by family member/guardian. Six hundred and twenty-six (79.75%) exposed to shouting and screaming by family members and 289 (36.82%) exposed to hitting and beating and spanking by object by guardian/family member. Two hundred and six (26.24%) reported that their ear been pulled and twisted/pinched by family member/guardian. Ninety-nine (12.61%) reported that their hair been pulled by family member/guardian. Seventy-six (9.68%) being locked in small place, 73 (9.30%) exposed to choking. Only 10 (1.27%) exposed to burn/scald by family member/guardian.

Characteristics of anxiety among school-going adolescents

Out of 785 study participants, 354 (45.10%) reported that sometimes they felt afraid of being alone at home only four of them they were expressed that they would feel always afraid of being alone at home. Three hundred and thirty-eight (43.06%) of adolescents reported that sometimes they worried about they will do badly at school work and 70 (8.92%) reported that they always worried about they will do badly at school work. Two hundred and eighty-nine (36.82%) of adolescents sometimes scared to take academic test, 59 (7.52%) of adolescents scared always to take academic test. Two hundred and eighty-two (35.92%) of adolescents sometimes felt low mood, with sadness and just cannot be bothered, only one adolescent reported it always. One hundred and eighty-two (23.18%) of adolescents reported sometimes bothered about silly thoughts and pictures in mind, 46 (5.86%) reported it always. One hundred and sixty-eight (21.40%) of adolescents reported sometimes felt sudden fear and terror or frightened. One hundred and fifty-four (19.62%) of adolescents reported that sometimes they worried about something bad will happen to me, 147 (18.73%) reported it for always. One hundred and twenty-seven (16.18%) of adolescents reported that sometimes they worried about what other people think of me, and only 6 of them felt it for always.

Levels of physical abuse and anxiety among school-going adolescents

Among 10–12 years age group school-going adolescents, 24.18% were experienced mild physical abuse and 58.82% of them were experienced moderate physical abuse. 16.99% were reported severe physical abuse. Among the 13–14 years' age group of school-going adolescents, 26.01% were experienced mild physical abuse, 54.21% reported moderate physical abuse, and 19.78% reported severe physical abuse. Among the 15–16 years' age group of school-going adolescents, 24.51% were experienced mild physical abuse and 56.56% reported moderate physical abuse and 18.18% reported severe physical abuse. The level of anxiety was also assessed in the study participants, Among the 10–12 years' age group of school--going adolescents, 23.5% were in mild anxiety levels, 54.2% were in moderate level of anxiety, and 22.2% were experienced severe level of anxiety. Among the 13–14 years' age group of school-going adolescents, 19.8% were in mild anxiety levels, 59.3% were in moderate level of anxiety, and 20.9% were experienced severe level of anxiety. Among the 15–16 years' age group of school-going adolescents, 21.4% were in mild anxiety levels, 53.2% were in moderate level of anxiety, and 25.3% were experienced severe level of anxiety.

[Table 3] reveals that there is a significant positive relationship between physical abuse and anxiety among adolescents, with r = 0.1021, P = 0.0042. This indicates that as the level of physical abuse increases among adolescents, the level of anxiety will also increase. Therefore, this hypothesis was accepted.
Table 3: Correlation between physical abuse scores and anxiety scores in adolescents by Karl Pearson's correlation coefficient method

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  Discussion Top


The current findings of our study improve our knowledge of the relationship between physical abuse and levels of anxiety among school-going adolescents. In this study, we found that 10–16 years aged school-going adolescents were the victims of physical abuse, and study participants have also expressed their different levels of anxiety due to physical abuse which was perpetrated by the family member/guardian. Similar study has reported that victims of physical abuse were observed to have high levels of anxiety traits; the study also reported that anxiety among adolescents will effect brain functions-related psychology ability of reasoning and alter in the behavior among the adolescents and this will lead to maladjustment to their present environment will have more negative behaviors in their day today life. In our study, among adolescents, hitting, being beaten and spanked with the hand was being most common form of physical abuse. This is supported by the similar study which has been carried out by Ministry of Women and Child Welfare (MWCD) Government of India had reported a higher prevalence of child maltreatment. In the present study, we found a significant positive correlation with physical abuse and anxiety among school-going adolescents. Similar study has conducted Bruce, L. C, et al. to assess the relationship between child maltreatment and anxiety disorders and the study results are found that there is a significant relationship between child maltreatment and the anxiety among the study participants (r = 0.599, physical abuse). In the present study, we found a significant relationship (r = 0.1021, P < 0.05) between physical abuse and anxiety among school-going adolescents. Hence, the study proved that if the level of physical abuse increases the level of anxiety also increases.

Strengths of the study

The present study is the first to examine physical abuse in primary and secondary school-going adolescents and its relation with anxiety level in Belagavi and also in the Karnataka state. We included a variety of primary and secondary schools in Belagavi. Other strengths of the study are the use of a descriptive design and the fact that our measure of anxiety level and physical abuse were based on self-report rather than parental or teacher reports.

Limitations of the study

In regard to sample characteristics, generalization from primary and secondary school students to other adolescents in the different schools may be limited. The other fact that concerns is, anxiety levels may be influenced by the genetic and environmental factors.


  Conclusion Top


Based on the findings of the study, following conclusions were drawn.

Out of total 785 study participants, 444 (56.56%) had exposed to moderate physical abuse, 196 (24.97%) had exposed to mild physical abuse, and 145 (18.47%) were the victims of severe physical abuse. Seven hundred and sixty-eight (97.83%) reported that they experienced hitting, and being beaten, and spanked with hand by guardian/family member. The present study also found a significant positive relationship between physical abuse and anxiety among adolescents, with r = 0.1021, P = 0.0042. This indicates that as the level of physical abuse increases among adolescents, the anxiety will also increase.

Acknowledgments

The authors are grateful for the administration, parents, and students of primary and secondary schools of Belagavi, for their support and participation.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.


  Annexure Top


Annexure 1: Self-structured tools used for data collection

Section I: Questionnaire on determinants and consequences of physical abuse among adolescent students

Name: __

School Name: __

Class: ___

Code no: __

Section I: Sociodemographic variables

  1. Age


    1. 10–11 years
    2. 12–14 years
    3. 15–16 years


  2. Gender


    1. Male
    2. Female


  3. Class


    1. 5th Class
    2. 6th Class
    3. 7th Class
    4. 8th Class
    5. 9th Class10th Class


  4. Type of family


    1. Nuclear
    2. Joint
    3. Extended


  5. Religion


    1. Hindu
    2. Christian
    3. Muslim
    4. Other (Specify)


  6. Residence


    1. Urban
    2. Rural


  7. Fathers education


    1. Illiterate
    2. Primary
    3. Secondary
    4. Higher Secondary
    5. Degree
    6. Post Graduate


  8. Mothers education


    1. Illiterate
    2. Primary
    3. Secondary
    4. Higher Secondary
    5. Degree
    6. Post Graduate


  9. Fathers occupation


    1. Farmer
    2. Government employee
    3. Self Employed
    4. Private Employee
    5. Professional
    6. Unemployed


  10. Mothers occupation


    1. Farmer
    2. Government employee
    3. Self-employed
    4. Private employee
    5. Professional
    6. Homemaker


  11. Monthly family income


    1. <Rs. 2000
    2. Rs. 2001–4000
    3. Rs. 4001–6000
    4. Rs. 6001–8000
    5. More than Rs. 8000


  12. No of Siblings


    1. One
    2. Two
    3. Three
    4. More than three
    5. None


  13. Physically challenged


    1. Yes
    2. No


Section II: Questionnaire on the prevalence of physical abuse among adolescent students

Please respond to each item by marking (✓)



Section II: Structured questionnaire to assess the anxiety among school-going adolescents (Kutcher Generalized Social Anxiety Scale)

Please respond to each item by marking (✓)





 
  References Top

1.
Elkazaz RH, Berma AE, Ebied IA. Physical punishment in secondary schools students and its relation with anxiety level. J Nurs Health Sci 2017;6:63-9.  Back to cited text no. 1
    
2.
Ministry of Women and Child Development, Government of India 2007. Study on Child Abuse India; 2007. Available from: http://wcd.nic.in/childabuse. [Last accessed on 2020 Apr 06].  Back to cited text no. 2
    
3.
Siegel RS, Dickstein DP. Anxiety in adolescents: Update on its diagnosis and treatment for primary care providers. Adolesc Health Med Ther 2012;3:1.  Back to cited text no. 3
    
4.
Child Abuse or Child Maltreatment. Available from: https://en.wikipedia.org/wiki/Child_abuse. [Last accessed on 2020 Apr 06].  Back to cited text no. 4
    
5.
Gavishiddhayya BS, Raddi SA. Prevalence of physical abuse among school going adolescents. Int J Sci Res Rev 2018;7:4.  Back to cited text no. 5
    
6.
Daral S, Khokhar A, Pradhan S. Prevalence and determinants of child maltreatment among school-going adolescent girls in a semi-urban area of Delhi, India. J Trop Pediatr 2016;62:227-40.  Back to cited text no. 6
    
7.
Adolescent Mental Health, Available from: https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health. [Last accessed on 2020 Apr 06].  Back to cited text no. 7
    
8.
National Scientific Council on the Developing Child. Persistent Fear and Anxiety Can Affect Young Children's Learning and Development: Working Paper No. 9; 2010. Available from: http://www.evelopingchildharvard.edu. [Last accessed on 2020 Apr 06].  Back to cited text no. 8
    
9.
Violence Against Children. Available from: https://www.who.int/news-room/fact-sheets/detail/violence-against-childr?en. [Last accessed on 2020 Apr 06].  Back to cited text no. 9
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

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