Witnessing Domestic Violence: The Effect on Children

Primary care physicians can deal with domestic violence at multiple levels. Medical schools should educate physicians about possible adverse effects of children who have witnessed domestic violence. Efforts have been made recently to educate doctors about domestic violence, but the focus is on the main victims. Medical education should broaden the concept of domestic violence, including the impact on silent witnesses and encourage physicians to help prevent violence through sifting

The doctor can start anti-violence measures in the clinic. Since violent acts are mainly learning behaviors, doctors need to evaluate how their parents resolve conflict and anger response 15 This discussion is based on the assumption that a couple is considering giving birth or prenatal care You need to start when you are receiving. Education should also be given about the negative impacts of discussion and conflict on children. They should be encouraged to observe discipline and keep children away from the differences. Doctors can also discuss disciplines in non-violent disciplines such as timeouts and cancellation privileges.

Parents should be educated about the adverse effects of seeing violence on television and be encouraged to limit children's TV viewing time to within 2 hours a day. In addition, guns and other weapons in the house increase the risk of murder and suicide among families, so parents should be asked if we should keep weapons at home 18,19. . If a child sees a gun, it should not be touched, it should be said that he should immediately leave the place and talk to an adult.

Information on posters and domestic violence issues and resources can be displayed in waiting rooms, examination rooms, and workplace washrooms (Table 2). 15, 16, 20-22

During health checks for children and adults, physicians should periodically screen domestic violence by asking open and unreasonable questions. The discussion should start with a description of the importance of the topic, for example, "domestic violence such as" I am concerned about the health effects of domestic violence, so I ask all patients about domestic violence " You should follow specific questions about. 3) .1 According to experts, screening during a child's examination should be conducted personally with the mother23.

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If the child has emotional or behavioral problems, it is necessary to investigate domestic violence. Because these symptoms are not intended to witness domestic violence, the doctor may also ask about other causes such as child abuse, inconsistency between spouses, colleague relations, sexual violence and regional violence You should ask. The use of depression, alcohol and drugs should also be considered. Age-specific screening questions can be included in children's health checkups and exercises (Table 4). 1, 15 - 20, 24, 25

Witnessing domestic violence may adversely affect children's development. As with other toxic stress factors, exposure to domestic violence may interfere with your child's healthy brain development. This can lead to changes in stress reactions, carelessness, super panic reactions and other problems. The underlying symptoms of child exposure to domestic violence can be characterized as externalization or internalization symptoms. External symptoms are more pronounced and appear as behavioral problems. The endogenous symptoms are not so obvious and are likely to be characterized as mental health problems

The physical impact of witnessing domestic violence in older children is less pronounced than behavioral and emotional influences. The trauma that children experienced when witnessing domestic violence in the family plays an important role in their development and physical health. Older children sometimes can turn stress into behavior problems. Sometimes, children who have seen abuse will turn into drug abuse, hoping to get rid of the pain. However, children show physical symptoms related to behavioral or emotional problems, such as withdrawal from surrounding people, not being words, showing tension, embarrassment, and other regressions. Anxiety is often accompanied by physical symptoms of children who witness domestic violence at home. As their anxiety progresses to a more physical symptom, they may show signs of fatigue due to lack of sleep, lack of weight, poor diet and so on.