Research Results on Psychological Trauma of Adolescents Subjected to Parental Violence .... Distribution of Levels of Psychological Symptoms in Adolescents Subjected to Parental Violence
Rationale
Vietnam was one of the first signatories to the International Convention on the Rights of the Child (National Assembly, 2007), yet the issue of children being subjected to violence within families and schools persists at an alarming level (Quang Binh Department of Culture, Sports, and Tourism, 2012; Tran Thi Sau, 2015; Thuy T T., Yen B H., Tuyen H V., n.d.; Trang P T T., Vung N D., Hieu K T M., 2021) Forms of physical violence such as slapping, hitting, pinching, using objects to hit, ear- pulling, and hair-pulling, as well as emotional abuse including scolding, humiliation, abandonment, shaming, and verbal abuse, all leave profound physical and psychological consequences, resulting in PTSD symptoms in children Numerous studies have demonstrated that children exposed to violence or victimization during childhood exhibit significantly higher rates of violent behavior compared to those from non-violent environments (Buckley, H., Holt, S., & Whelan, S., 2007; Margolin, G., & Vickerman, K A., 2011; Higgins, D.J., & McCabe, M.P., 2013) Furthermore, research by Dauvergne and Johnson (2002) shows that children facing early adversities related to violence often experience emotional, social, self-perception, and behavioral issues These children tend to exhibit lower self-esteem, social skills, empathy, and are more prone to symptoms of depression, anxiety, and a sense of hopelessness compared to their peers in non-violent families According to Cleveland Clinic (2023), parental violence constitutes adverse childhood experiences for children aged 1 to 17
Research in Vietnam indicates that psychological trauma due to parental violence among adolescents is a major concern Comprehensive studies specifically addressing this issue are scarce, highlighting the need for further investigation.
“Psychological trauma in adolescents due to parental violence” was established, aiming to identify the psychological trauma symptoms in adolescents experiencing parental violence and propose measures to mitigate these damages.
Research objectives
Identify the psychological trauma symptoms in adolescents subjected to parental violence in Ho Chi Minh City and propose measures to reduce these traumas in adolescents.
Research subjects and objects
- Research subjects: Adolescents in several districts in Ho Chi Minh City
- Research objects: Psychological trauma symtoms in adolescents subjected to parental violence in Ho Chi Minh City.
Hypotheses
Hypothesis 1: Approximately 1/4 of adolescents in Ho Chi Minh City experience parental violence, with emotional violence being more prevalent than other forms
Hypothesis 2: Psychological trauma symptoms in adolescents subjected to parental violence in Ho Chi Minh City primarily include low self-esteem, dissatisfaction with life, sleep disturbances, symptoms related to re-experiencing trauma, avoidance behaviors, feelings of failure and distress, and aggressive behaviors
Hypothesis 3: There is a difference in psychological trauma symtoms based on the severity and duration of the violence
Hypothesis 4: Cognitive-behavioral therapy can reduce psychological trauma symptoms
- Review existing research and develop a theoretical framework related to the topic
- Identify the current state of parental violence and psychological trauma symptoms in adolescents in Ho Chi Minh City
- Propose measures to reduce psychological trauma symptoms in adolescents subjected to parental violence and experiment with cognitive-behavioral therapy to reduce these symptoms.
Scopes
- Research scope: The study is limited to adolescents in selected districts of Ho Chi Minh City
+ The study focuses only on parental violence, including emotional, physical, and economic abuse
+ PTSD symptoms are based solely on self-reported measures from adolescents, not expert psychological assessments
+ The study only examines PTSD symptoms related to stress, depression, anxiety, delinquent behaviors, and aggression in adolescents subjected to parental violence in
+ The study exclusively utilizes individual therapy to reduce PTSD in adolescents; other interventions are proposed as suggestions
- Time frame: The research is conducted between 2018 and 2023.
Research Methodology and Methods
Research Methods
The study utilizes a combination of methods, including document and literature review, practical research methods such as surveys, questionnaires, psychological testing, case studies, expert consultation, experiments, and mathematical statistics
THEORETICAL FOUNDATIONS OF PSYCHOLOGICAL
Overview of research on psychological trauma in adolescents due to
1.1.1 Overview of research on psychological trauma in adolescents abused by parents
Research on adolescents abused by parents focuses on three main aspects: first, studies on the prevalence and forms of abuse that adolescents experience, providing an overview of the frequency and types of violence adolescents face; second, research on the impact of parental abuse on adolescent development, analyzing the far-reaching effects of abuse on adolescents' psychology, behavior, and social life; and finally, studies on factors that influence the prevalence of parental abuse towards adolescents
1.1.1.1 Research on the prevalence of adolescents abused by parents
1.1.1.2 Research on the impact of parental abuse on adolescent development 1.1.1.3 Research on factors influencing the prevalence of parental abuse towards adolescents
1.1.2 Research on psychological trauma in adolescents abused by parents
Psychological trauma (PT) in adolescents abused by parents is an important area of study and has garnered significant attention from the scientific community Research in this field focuses on identifying and analyzing mental health symptoms and disorders that adolescents may experience as a result of family violence These studies not only help to better understand the psychological impact of parental abuse on adolescents but also provide a scientific basis for developing effective prevention and intervention measures Below are the two main branches of research on PT in adolescents abused by parents:
1.1.2.1 Research on mental health symptoms related to PT in adolescents abused by parents
An overview of studies on mental health symptoms related to PT in adolescents abused by parents reveals common findings about the serious symptoms caused by family violence The key findings from these studies include:
+ Sleep disturbances and bedwetting: Studies by Astbury et al (2000) and Hoeboer et al (2020) report physiological symptoms such as sleep disturbances and bedwetting in children subjected to family violence
+ Psychological arousal and stress: Research by Lloyd (2018) and others shows that family violence leads to stress and a sense of insecurity, negatively impacting children’s mental health
+ Symptoms of anxiety and depression: Studies by Grych and Fincham (1990), Astbury et al (2000), and Lloyd (2018) consistently report that children exposed to parental violence exhibit anxiety and depression, experiencing sadness, worry, and difficulty in maintaining a sense of safety
+ Feelings of guilt and shame: Research by Chester and Joscelyne (2018) notes that children often feel guilt and shame about their family’s violent situation, which exacerbates levels of depression and anxiety
Research indicates a strong correlation between family violence exposure and increased prevalence of aggressive behaviors in children Studies by Astbury et al (2000) and Bozzay et al (2017) demonstrate that exposure to domestic violence can lead to externalized negative behaviors, including vandalism and disruption.
+ Self-destructive and uncontrollable behavior: Some studies, including Astbury et al (2000), indicate that children may develop self-destructive behaviors, such as self- harm or running away from home
(3) Impact on academic performance and social relationships:
+ Poor academic performance: Research by Alsabawy and Qassim (2023) shows that parental abuse can negatively affect children’s ability to concentrate, focus, and achieve academically
+ Difficulty in social relationships: Gautam et al (2024) suggest that children experiencing family violence often struggle to form and maintain positive social relationships
Psychological symptoms vary significantly based on gender and nationality A study by Peltonen et al (2010) revealed that females tend to experience more severe internalizing symptoms, such as anxiety and depression, while males exhibit more pronounced externalizing symptoms, including aggression and substance abuse These findings suggest that cultural and societal factors contribute to the manifestation of psychological symptoms, influencing their intensity and presentation.
These studies highlight the broad and diverse impacts of parental abuse on children’s mental health and behavior, demonstrating that such abuse can manifest through various symptoms and requires timely intervention to mitigate its negative effects
1.1.2.2 Research on mental disorders related to PT in adolescents abused by parents
Common findings from studies on mental disorders related to PT in adolescents abused by parents include:
- All studies point to the profound effects of parental abuse on children’s mental health Children who experience physical or sexual abuse, or witness domestic violence, are at higher risk for mental disorders, particularly post-traumatic stress disorder (PTSD), depression, and anxiety disorders Additionally, children subjected to both physical and sexual abuse are at the greatest risk for mental disorders Sexual abuse, especially when combined with physical violence, tends to have more severe negative effects on children’s mental health than either physical or sexual abuse alone
- There are differences in how mental disorders manifest between boys and girls For example, boys are more likely to exhibit behavioral issues, while girls tend to experience anxiety and depression
- Research also shows that mental disorders stemming from parental abuse affect not only emotions and behavior but also cognitive and academic functioning Children subjected to sexual abuse, in particular, may struggle in areas such as language and memory
Diagnosing mental disorders in abused children presents unique challenges due to the intricate interplay of internal and external factors These factors include individual developmental characteristics and family dynamics Therefore, a comprehensive assessment is crucial, considering both the external stressors and internal psychological processes that influence the child's well-being This holistic approach is essential for accurate diagnosis and effective treatment planning.
These studies emphasize the need for early and comprehensive interventions to support abused children and reduce the long-term negative effects on their mental health and cognitive functioning
1.1.3 Research on models of prevention and intervention for psychological trauma in adolescents abused by parents
1.1.3.1 Research on prevention models for psychological trauma in adolescents abused by parents
Research on prevention models for PT in adolescents abused by parents reveals common themes, including:
- Raising awareness: Emphasis is placed on raising awareness about violence and child trauma, as well as developing educational programs and training for professionals, support staff, and volunteers to recognize and prevent violence early on
- Training and skill development: Improving parenting skills and addressing ineffective parenting behaviors are key focus areas
- Community relationships and support: Highlighting the importance of a holistic and multi-disciplinary approach involving experts and the community, with proposals to build support infrastructure and integrated community networks to provide resources for at-risk families
- Early intervention and support: Advocating for early intervention in high-risk families and providing support programs for adolescents
All studies aim to improve the psychological well-being of children by integrating education, early intervention, community support, and skill development, creating an effective prevention system for PT resulting from family violence
1.1.3.2 Research on intervention models for PT in adolescents abused by parents
Theoretical basis on psychological trauma in adolescents subjected
1.2.1 Theories on parental Violent Behavior
1.2.2.1 Theories on Violent Behavior a Definition
From synthesizing various viewpoints on violence, this research views violent behavior as reactions or conduct by an individual, using power or force through words or actions to coerce, oppress, threaten, assault, etc., causing harm to the physical or mental well-being of others Violent behavior can occur in all environments When it occurs within the family, it is called domestic violence b Theories on Violent Behavior
1.2.2.2 Theories on Parental Violent Behavior toward children a Definition
This research identifies parental violent behavior toward children as a form of domestic violence, where the reactions or conduct of parents use power or force through words or actions to coerce, oppress, threaten, or assault, causing harm to the physical or mental well-being of their children The perpetrators of such behavior can be either the father, mother, or both, whether they are biological or adoptive parents The victims are children in the family, whether they are biological or adopted b Types of Parental Violent Behavior toward children:
Based on the nature of violence, the World Health Organization (WHO, 1996) divides it into four types: physical, sexual, emotional, and economic violence
This research focuses on three types of parental violent behavior toward children: physical violence, emotional violence, and economic violence, excluding sexual violence
The common theme among the definitions discussed is the emphasis that psychological trauma stems from extremely distressing and stressful events or experiences that surpass an individual’s ability to endure and cope Psychological trauma triggers strong negative emotional reactions such as fear, anxiety, and feelings of helplessness These emotions are often long-lasting and profoundly affect the mental well-being of the traumatized individual, manifesting in various symptoms Based on the aforementioned viewpoints, the research defines psychological trauma as follows:
Psychological trauma describes a state where an individual experiences an event or series of events that cause severe stress or distress, surpassing their ability to cope, affecting their thoughts, emotions, behavior, and ability to interact socially Psychological trauma can manifest through many symptoms, including anxiety, depression, post-traumatic stress disorder (PTSD) symptoms, guilt, and difficulties in establishing or maintaining healthy relationships Treatment and support for such psychological trauma often include individual psychotherapy, group support, and sometimes medication
1.2.2.2 Physiological Basis of Psychological Trauma
It is evident that psychological trauma is a complex mental phenomenon The symptoms of psychological trauma often take many forms, with symptoms that overlap and mirror one another to such an extent that they present significant challenges in diagnosis and treatment (Judith Armstrong et al., 2014) In fact, the symptoms of psychological trauma vary greatly between individuals, depending on the severity of the trauma
Adolescents aged 12-18 exhibit symptoms of psychological trauma similar to adults: symptoms related to PTSD, depression, anxiety, guilt, and withdrawal from relationships The most distinct difference in the symptoms of psychological trauma at this age compared to younger children and adults is impulsive and aggressive behavior (National Center for PTSD, 2018) Studies show a connection between psychological trauma and the following symptoms: (1) stress symptoms; (2) depression symptoms;
(3) anxiety symptoms; (4) aggressive behavior; (5) delinquent behavior a Psychological Trauma and Stress Symptoms
Stress related to psychological trauma is often described as an acute or chronic process Acute stress responses are characterized by short-term sympathetic responses to real or perceived threats, usually resulting in a "fight or flight" reaction Like acute stress responses, chronic stress responses can occur in response to a single traumatic event or following multiple stressors Chronic trauma often manifests through abnormal physiological and behavioral processes, outlined in DSM-5 (Diagnostic and
Statistical Manual of Mental Disorders, Fifth Edition) as the following symptom clusters (Bisson, J I., Cosgrove, S., Lewis, C., Robert, N P., 2015):
(3) Negative changes in beliefs and emotions
Among the scales used to identify stress-related symptoms, the PCL-5 scale is commonly used (Weathers, F W., Litz, B T., Herman, D S., Huska, J A., & Keane,
T M., 1993) b Psychological Trauma and Depression Symptoms
In general, the symptoms of depression related to psychological trauma can be described as: sadness, pessimism about the future, feeling like a failure, dissatisfaction with oneself, guilt, feeling punished, dissatisfaction with oneself, loss of interest in activities, some physical changes such as difficulty sleeping, fatigue, loss of appetite, social changes, feeling lonely, and feeling that no one cares
A study by Aparicio Castro concluded that the BDI is an effective screening tool for identifying depression symptoms (Aparicio Castro, E., Candeliere Merlicco, A., María Santa, C., & Villaverde González, R., 2024) c Psychological Trauma and Anxiety Symptoms
In general, the symptoms of anxiety related to psychological trauma can include: anxiety, fear without clear cause, easily confused or worried, easily irritable, worrying about small things, panic, loss of control, difficulty breathing, trembling or loss of control, easily sweating, rapid or strong heartbeat, chest pain or discomfort, itching or numbness, nausea or indigestion, weakness or easy fatigue, restlessness or inability to sit still, dizziness or loss of balance, difficulty concentrating, difficulty sleeping, lightheadedness or feeling out of control…
Numerous studies have demonstrated the high reliability of the SAS scale, making it a valuable tool for evaluating anxiety symptoms in individuals suffering from physical and psychological trauma (Ruan, Y., Lin, H., Lu, X., Lin, Y., Sun, J., Xu, C., Zhou, L., Cai, Z., & Chen, X., 2024) This scale has been found to be particularly effective in assessing anxiety levels in populations that have experienced traumatic events, providing healthcare professionals with reliable data for diagnosis and treatment planning.
Aggressive behavior related to psychological trauma may include many symptoms, such as frequently starting fights, fighting with friends or siblings, losing control when angry, displaying disrespectful attitudes, being hostile, threatening or intimidating others, swearing or insulting others, causing trouble, not following rules, being violent toward animals, breaking things, causing disturbances at home and in public…
Delinquent behavior related to psychological trauma includes a range of misbehavior, violating social and legal rules, manifested through specific behaviors such as: frequently lying, cheating, stealing, running away from home, skipping school, smoking or using stimulants and prohibited substances like alcohol or drugs, engaging in criminal activities, displaying violent and dangerous behavior toward oneself or others, causing trouble at school or in public places, destroying public property, participating in gang activities, and engaging in prostitution…
In several studies using the CBCL scale, many authors have shown that the CBCL scale has the necessary psychological attributes to assess children's behavioral issues, and it also aligns with other child behavior assessment tools, such as the Strengths and Difficulties Questionnaire (SDQ) (Uğurlu, M., Sửzer Boz, E., & Turgut, S., 2024); (Baumann, N., Anderson, P J., Johnson, S., Marlow, N., Wolke, D., & Jaekel, J.,
1.2.3 Theories on Psychological Trauma in Adolescents Subjected to Parental Violence
1.2.3.2 Theories on Psychological Trauma in Adolescents Subjected to Parental Violence a Definition
Based on the established definition of psychological trauma and the viewpoints of several authors presented, the research defines: Psychological trauma in adolescents subjected to parental violence is the condition where an adolescent experiences violent behavior from parents or guardians, affecting their emotions, thoughts, behavior, and ability to interact socially This significantly impacts the adolescent's psychological and social development b Symptoms
RESEARCH ORGANIZATION AND METHODS
Research locations and subjects
The research was conducted in Ho Chi Minh City, one of the largest and most developed cities in southern Vietnam Due to the complex developments of the Covid-
19 pandemic, the study focused on surveys in several representative districts of Ho Chi Minh City instead of across the entire city The selected districts include District 1, District 3, Binh Thanh District, Binh Tan District, and Tan Phu District
- Age criteria: The research includes adolescents aged 12 to 15 years The age distribution is as follows:
12 years old: 297/849 individuals, accounting for 35.0%;
13 years old: 264/849 individuals, accounting for 31.1%;
14 years old: 168/849 individuals, accounting for 19.8%;
15 years old: 120/849 individuals, accounting for 14.1%
- Gender criteria: The survey includes both male and female participants Specifically, there are 417/849 males, accounting for 49.1%, and 432/849 females, accounting for 50.9%
- Care/education organization criteria: A total of 784/849 adolescents were surveyed at 5 randomly selected secondary schools, including 2 suburban and 3 urban schools, accounting for 92.34% In addition, the sample includes 48/849 adolescents from the HCMC Social Work, Education, and Vocational Training Center for Adolescents, accounting for 5.7%, and 17/849 adolescents from shelters, accounting for 2.0%
Among the total study participants (849), the majority (761 or 89.63%) resided with their biological parents A small proportion (11 individuals, or 1.3%) were living with adoptive parents, while a significant number (77 or 9.1%) did not reside with their parents.
The supporting research subjects are 120 individuals, including those working in psychology and related fields The aim of the survey is to assess the necessity and feasibility of measures to mitigate psychological trauma in adolescents subjected to parental violence in Ho Chi Minh City, using a convenience sampling technique.
Research organization
Specific Research Methods
2.3.1 Document and literature research method
PSYCHOLOGICAL TRAUMA OF ADOLESCENTS
Results of screening adolescents subjected to parental violence in
3.1.1 Negative events experienced by adolescents
- Out of a total of 849 adolescents, 277 (accounting for 32.6%) had experienced violence or similar events This is the highest rate compared to other negative events such as serious accidents, fires, or natural disasters This proportion indicates that violence is a more prevalent issue in the surveyed group
3.1.2 Experiences of violence faced by adolescents
Data from the study shows that among the 277 adolescents who experienced violence or similar events, there is a clear distinction between those who only witnessed violence and those who became direct victims Specifically:
- Witnessing violence (56.3%): Witnessing physical violence, with 46 children (16.6%) having witnessed parents physically harming each other, such as hitting or slapping; witnessing psychological violence includes 110 children (39.7%) who heard their parents emotionally hurt each other by cursing or speaking disrespectfully
- Becoming direct victims (71.1%): Physical violence includes 50 children (18.0%) who only experienced physical violence; psychological violence includes 103 children (37.2%) who only experienced psychological violence; combined violence: 44 children (15.9%) experienced both physical and psychological violence along with other forms of violence The high rate of psychological violence (37.2%) compared to physical violence (18.0%) reflects a serious issue in family relationships Psychological violence, being easily perpetuated and continuous, often receives less attention than physical violence but still has far-reaching impacts on children's mental health Specifically, psychological violence can cause long-term damage, affecting self- esteem, feelings of safety, and the ability to develop social relationships
3.1.3 Timing of violent behavior toward adolescents
- Violence occurring within one year (42.6%), involving 82 adolescents
- Violence occurring over five years (31%), involving 61 adolescents
- Violence occurring 2-3 years ago (18.8%), involving 37 adolescents
- Violence occurring 4-5 years ago (8.6%), involving 17 adolescents
Based on these groups, the thesis selected 197 subjects to further explore the current state of parental violence toward adolescents and the psychological trauma of adolescents subjected to parental violence.
Research results on parental violence toward adolescents
3.2.1 General research results on parental violence toward adolescents
General assessments of the extent of parental violence toward adolescents show that 163/197 cases reported that parental violence "rarely" occurred, accounting for 82.7% Meanwhile, 17.3% of the remaining adolescents reported experiencing violence at levels of "occasionally," "frequently," and "very frequently."
Statistical results show that psychological violence has the highest average score (AS) at 2.22, followed by economic violence (AS = 1.93), and finally physical violence (AS = 1.88) This indicates that psychological violence by parents toward adolescents is more prevalent than other forms of violence
3.2.2 Specific research results on parental violence toward 197 adolescents
3.3 Research Results on Psychological Trauma of Adolescents
3.3.1 Research results on symptoms of psychological trauma in general
Table 1 Symptoms of psychological trauma of adolescents subjected to parental violence in Ho Chi Minh City in general
Group Item Symtoms Theoretical Framework
4.18 I experience feelings of panic and heightened startle response
Group of Symptoms Related to Overreactive Responses
5.2 I feel fear without any identifiable cause
5.3 I am easily confused and experience a sense of terror
5.5 I perceive everything as unfavorable and anticipate negative outcomes
5.10 I notice an increased heart rate
4.17 I have become excessively vigilant, defensive, and perfectionistic
4.19 I find it difficult to concentrate
4.14 I struggle to experience positive emotions (finding it challenging to feel happiness or love towards close ones)
4.11 I often experience very negative emotions such as fear, horror, anger, guilt, or shame
5.12 I experience fainting spells and feel almost as if I am about to faint
4.7 I attempt to avoid objects, locations, individuals, or situations that may remind me of a past traumatic event
Group of Symptoms Related to Re- experiencing and Avoidance Behavior 4.8 I have difficulty recalling significant aspects of the previous traumatic event
4.6 I strive to avoid memories, thoughts, or feelings related to the past traumatic event
4.5 When something triggers a memory of the past traumatic event, I may have a strong reaction (such as rapid heartbeat, shortness of breath, sweating, etc.)
4.1 Memories of the traumatic event cause me distress, and I wish to avoid recalling them, as they instill fear
5.19 I find it challenging to fall asleep easily and have trouble achieving restful sleep
Group of Symptoms Related to Restlessness and Insomnia
5.9 I struggle to remain calm and sit still
4.20 I have difficulty initiating sleep or staying asleep
7.8 I do not obey teachers Group of Symptoms
Related to Disobedient Behavior and Fighting
7.9 I do not comply with my parents’ instructions
7.14 I tend to engage in physical aggression towards others
7.17 I often yell excessively Group of Symptoms
Related to Yelling and Interest in Fire
7.18 I have a tendency to play with fire
6C I feel that I have completely failed in my personal life, particularly in my relationship with my parents
Group of Symptoms Related to Feelings of Failure and Distress 6A I am sad and distressed to an extent that is unbearable
6D I feel resentment and dissatisfaction with everything
Group of Symptoms Related to Low Self-
6J I perceive myself as ugly and repulsive
3.3.2 Results of Ranking the Groups of Psychological Symptoms in Adolescents Subjected to Parental Violence
- Group of Symptoms with Moderate Severity: This includes Group 3 (restlessness and insomnia), Group 7 (low self-esteem and dissatisfaction with life), Group 6 (feelings of failure and distress), and Group 2 (re-experiencing and avoidance behavior related to trauma)
- Group of Symptoms with Mild Severity: This encompasses Group 1 (overreactive responses, fear, and panic), Group 5 (yelling behavior and fascination with fire), and Group 4 (disobedient behavior and fighting)
The data indicates that adolescents subjected to parental violence in Ho Chi Minh City experience psychological symptoms ranging from moderate to mild severity
3.3.3 Distribution of Levels of Psychological Symptoms in Adolescents Subjected to Parental Violence in Ho Chi Minh City
The research findings on the distribution of levels of psychological symptoms in adolescents subjected to parental violence in Ho Chi Minh City present a clear picture of the psychological state of this group:
- 20.29% of adolescents exhibited no symptoms or only insignificant symptoms, indicating that a small proportion may not be severely affected or only experience mild symptoms
- 33.5% displayed mild symptoms, suggesting that the majority are affected at a light level, though some symptoms warrant attention without significantly disrupting their daily lives
- 26.4% encountered symptoms of moderate severity, indicating a substantial portion of the study group experiences more pronounced symptoms, which significantly affect their psychological state and behavior
- 12.2% reported a considerable number of symptoms, indicating that some adolescents are experiencing more severe symptoms that may have a profound impact on their quality of life and adaptability
- 7.61% exhibited a high number of symptoms, highlighting a small but notable proportion facing very severe symptoms that may necessitate deeper professional intervention for effective support
3.3.4 Comparison of Psychological Symptoms based on Violence Factors 3.3.4.1 Comparison of Psychological Symptoms by Level of Violence a Comparison of Psychological Symptoms Based on Physical Violence b Comparison of Psychological Symptoms Based on Emotional Violence c Comparison of Psychological Symptoms Based on Economic Violence
The comparison of psychological symptom groups by levels of violence indicates that symptoms related to overreactive responses, particularly fear and panic, are most strongly impacted by all three forms of violence: physical, emotional, and economic Data analysis reveals that symptoms in this group significantly increase in frequency of violence, with marked increases observed in adolescents experiencing violence regularly and continuously This underscores that overreactive symptoms may be crucial indicators of negative impacts from violence, necessitating targeted interventions to alleviate these symptoms and provide more effective support for adolescents facing violence
3.3.4.2 Comparison of Psychological Symptoms Based on Duration of Violence
ANOVA findings indicate a significant association between the duration of violence exposure and the severity of psychological symptoms in adolescents These symptoms include sensitivity, panic, re-experiencing, avoidance, restlessness, and insomnia The most pronounced symptoms were observed when violence occurred 4-5 years prior to the assessment, highlighting the lasting impact of traumatic experiences on adolescent mental health.
3.3.5 Comparison of Psychological Symptoms Based on Demographic Information
3.3.5.1 Comparison of Psychological Symptoms by Gender
Analysis reveals a significant difference in the levels of psychological symptoms between male and female adolescents
3.3.5.2 Comparison of Psychological Symptoms by Age
Analysis of psychological symptom levels by age shows a clear trend of increasing symptoms as adolescents grow older
3.3.5.3 Comparison of Psychological Symptoms by Care/Education Organization
Psychological symptom levels vary significantly across care and educational organizations School environments exhibit the lowest symptom levels (1.50), followed by shelters (1.59) Centers have the highest symptom levels at 3.00.
3.3.5.4 Comparison of Psychological Symptoms by Caregiver
ANOVA analysis shows no statistically significant difference in the levels of psychological symptoms among different caregiver groups (F = 0.841, p = 0.433) This suggests that although there are differences in average psychological symptom scores among caregiver groups, these differences are not substantial enough to achieve statistical significance.
Correlation Between the Levels of Various Forms of Violence and
3.4.1 Correlation Between the Levels of Various Forms of Violence and the
Emotional violence exhibits a significant correlation with psychological symptoms, as demonstrated by the Pearson correlation coefficient of 0.552 and the corresponding significance level of 0.000 This suggests a robust relationship between these variables, indicating that emotional violence may be a substantial contributor to the presence of psychological symptoms.
Figure 3.1 Regression Model of Various Forms of Violence on
3.4.2 Role of Coping Strategies (Moderating Variable) in the Correlation
Between the Levels of Various Forms of Violence and Psychological Symptoms
3.5 Case Study Results on Psychological Trauma in Adolescents Subjected to Parental Violence
SOLUTIONS TO REDUCE PSYCHOLOGICAL
Basis for proposing measures to reduce psychological trauma for
4.2 Principles for proposing solutions to reduce psychological trauma for adolescents abused by parents in Ho Chi Minh City
Measures to reduce psychological trauma for adolescents abused by
4.3.1 Measure 1: Raising awareness among parents about the consequences of child abuse
4.3.2 Measure 2: Raising awareness among adolescents about the Child Law and child protection services via telephone
4.3.3 Measure 3: Guiding the development of self-awareness skills to promote positive thinking based on the personal circumstances of the individuals
4.3.4 Measure 4: Utilizing certain life values to influence the perception of adolescents, helping them find dreams and believe in a better future
4.3.5 Measure 5: Developing emotional management skills to prevent and reduce aggressive behavior for adolescents abused by parents
4.3.6 Measure 6: Counseling and therapy to reduce symptoms of psychological trauma
Surveying the necessity and feasibility of measures to reduce
4.4 The relationship between measures to reduce psychological trauma for adolescents abused by parents
4.5 Surveying the necessity and feasibility of measures to reduce psychological trauma for adolescents abused by parents
4.5.2 Surveying the necessity of some measures to reduce psychological traua for adolescents abused by parents
The average score is 4.40, indicating that all measures are highly rated in terms of reducing psychological trauma However, prioritizing measures such as individual therapy and developing emotional management skills emphasizes the importance of direct and effective interventions in treating and reducing the symptoms of psychological trauma
4.5.2 Surveying the feasibility of some measures to reduce psychological damage for adolescents abused by parents
Despite the moderate feasibility of various measures (average score: 3.99), there are substantial variations in their implementation Measures like counseling and emotional management skill development are considered more achievable, while awareness-raising and perception shifts encounter greater obstacles in their execution and effectiveness.
Results of using individual therapy to reduce symptoms of
4.6.1 Ethics in clinical practice and related issues of confidentiality and legality
4.6.2.1 Introduction and reasons for case selection
This case study focuses on P.D.T., a 15-year-old adolescent living in Ho Chi Minh City, selected because it is a typical example of the impact of domestic violence on the psychological development of children P.D.T has experienced a series of stressful events and crises in life, from living in a financially unstable family with relationship issues to facing violence from a stepfather, feeling abandoned when his mother gave birth to a younger brother, and experiencing difficulties during the COVID-19 pandemic
The case of P.D.T is a typical example of domestic violence and its profound impact on children's mental health Studying this case helps to better understand the effects of domestic violence and provides insights into the symptoms of psychological trauma that children may experience This case represents many other adolescents undergoing similar situations, especially in the context of domestic violence Researching P.D.T underscores the necessity of appropriate intervention measures to support children affected by domestic violence and raises awareness of psychological issues in this demographic
4.6.2.2 Basic information of the subject
4.6.2.5 Listing issues and approaches for the problems
4.6.2.6 Form of intervention and therapeutic results a Assessment of psychological trauma symptoms through tools
The client’s self-assessment results regarding psychological trauma symptoms show important information about the level and nature of the symptoms they are experiencing The overall average score of the symptoms is 1.55, indicating a
“moderate level of symptoms.” b Therapy plan b1 Setting therapy goals
Based on the analysis and assessment of the current state of PTSD symptoms, the therapist and the client and their guardian identified four output goals:
(1) Reduce symptoms related to restlessness and difficulty sleeping, excessive sensitivity, symptoms related to re-experiencing, and avoidance behavior
(2) Reduce symptoms related to low self-esteem and dissatisfaction with life
(3) Improve relationships with those around them
(4) Improve and prevent future aggressive behavior b2 Therapy techniques and duration b.2.1 Therapeutic techniques
Based on the analysis of T's issues, the therapist plans to use several methods and techniques as follows:
- Cognitive restructuring technique: Helps the client identify and change negative or unrealistic thoughts This technique focuses on helping the client change how they think about situations, thereby reducing feelings of stress and improving overall mood
Through breathing meditation and mindfulness techniques, clients learn to connect mind and body, centering themselves in the present moment These techniques foster a sense of inner peace by reducing anxiety and stress By focusing on mindful breathing, clients cultivate a heightened awareness of their physical and mental states, fostering a deep sense of relaxation and serenity.
- Techniques to enhance self-confidence and self-esteem: Utilizes techniques to boost the client’s self-confidence and self-esteem, such as identifying and developing personal strengths This technique helps the client feel better about themselves, thus alleviating symptoms and improving quality of life
- Relaxation techniques: Applies relaxation techniques such as progressive muscle relaxation, relaxing music, or deep breathing exercises to help the client reduce stress and improve psychological status
Exposure techniques, a cornerstone of anxiety therapy, involve gradually exposing clients to anxiety-provoking stimuli By confronting triggers, clients learn to tolerate and reduce avoidance, ultimately desensitizing themselves to once-feared situations This process aids in the habituation of anxiety responses, fostering a more manageable relationship with anxiety-inducing stimuli.
- Behavioral techniques: Applies other behavioral techniques such as establishing positive habits, time management, and building conflict resolution skills to assist the client in improving their behavior and social relationships b.2.2 Duration of therapy c Implementation of therapy plan
The therapist conducted 10 direct working sessions d Therapy results d.1 Qualitative assessment
After 10 therapy sessions, significant progress was made on the objectives T's symptoms decreased markedly, and their quality of life improved significantly T was less haunted by intrusive memories, no longer held negative self-assessments, and T's actions were less influenced by others' judgments T also established positive relationships with the therapist and, initially, with their mother, facilitating T’s continued efforts to address personal difficulties
However, some goals have yet to be fully completed d.2 Quantitative assessment
With an overall average score of 1.00, T's overall symptom level has decreased to the level of “completely absent or with negligible symptoms.” This indicates that therapy has successfully reduced T's PTSD symptoms, with many symptoms significantly diminished and an overall positive effect e Termination of the case and follow-up plan after therapy
1 The research has indicated that domestic violence is a serious and common issue that profoundly affects the psychological development and behavior of adolescents Forms of violence such as physical, psychological, and economic abuse cause many severe psychological trauma symptoms, including anxiety, depression, and self-harm behavior
2 The theoretical study of psychological trauma in adolescents affected by parental violence shows a clear correlation between domestic violence and psychological trauma Parental violence is considered a form of domestic violence, where parents use power and strength to harm their children's mental and physical well-being Psychological trauma describes a state in which an individual experiences events or a series of events that cause significant stress or distress, exceeding the individual's coping ability, affecting their thoughts, emotions, behaviors, and social interaction abilities Psychological trauma can manifest through various symptoms, including anxiety symptoms, depression symptoms, post-traumatic stress disorder (PTSD) symptoms, feelings of guilt, and difficulties in establishing or maintaining healthy relationships Psychological therapy and support for these psychological trauma cases often include individual psychological therapy, group support, and sometimes medication Psychological trauma in adolescents due to parental violence refers to the condition of an adolescent who experiences violence from their parents or guardians, affecting their emotions, thoughts, behaviors, and social interaction abilities This significantly impacts the psychological and social development of adolescents
3 The study was conducted in Ho Chi Minh City, selecting representative districts to ensure the diversity and representativeness of the research sample The research subjects are adolescents aged 12 to 15 years, including students and children living in shelters and social work centers The research methods include surveys with questionnaires and tests using specific measurement tools to assess psychological trauma symptoms and the status of parental violence
4 The research results show that psychological trauma symptoms in adolescents affected by domestic violence are very diverse Symptoms such as restlessness, difficulty sleeping, feelings of failure, and re-experiencing violent events are identified as prominent The research results indicate that the status of psychological trauma among adolescents affected by parental violence in Ho Chi Minh City is very diverse Specifically, 20.29% of adolescents show no symptoms or only mild symptoms, 33.5% have mild symptoms, 26.4% experience moderate symptoms, 12.2% have quite a few symptoms, and 7.61% undergo very severe symptoms Analysis also shows that the rate of severe symptoms and the level of impact from violence vary depending on gender, age, and the duration of violence All forms of violence have a positive correlation with the level of psychological trauma symptoms The linear regression model emphasizes that psychological violence has the most substantial impact on the psychological trauma symptoms of adolescents, highlighting the need for intervention and psychological support focused on this factor
5 To minimize psychological trauma, the research recommends implementing synchronized intervention measures Educating parents about the harms of violence, developing life skills for children, and using cognitive-behavioral therapy (CBT) are essential methods CBT has been proven effective in reducing psychological trauma symptoms and improving the quality of life for adolescents These measures need to be implemented flexibly and appropriately for each individual to achieve the best results in supporting the reduction of psychological trauma
For Adolescents
- Adolescents need to recognize that parental violence against children is behavior that is inappropriate from both moral and legal perspectives If they are not aware of this, it may lead to a state of silent acceptance and resignation, lacking the awareness to resist and protect themselves, making it difficult for the community to intervene effectively, and even harder to intervene through legal means
- Adolescents affected by domestic violence should proactively participate in therapy programs, especially cognitive-behavioral therapy (CBT) These programs can help reduce psychological trauma symptoms such as restlessness, difficulty sleeping, feelings of failure, disobedient behavior, fighting, as well as heightened sensitivity and re-experiencing violent events Engaging in these activities will support the improvement of self-awareness, reduce anxiety and depression, and enhance coping abilities with difficult experiences
Engaging adolescents in activities fostering emotional management, communication, and conflict resolution skills is crucial for their development By participating in such activities, they enhance their confidence and resilience in navigating challenging situations Moreover, these skills contribute significantly to their mental well-being, empowering them with the necessary tools to cope with the complexities of adolescence.
- Adolescents should seek support from trusted individuals, including teachers, social workers, or support organizations This helps alleviate feelings of loneliness and find necessary assistance in dealing with psychological issues.
For Families
- Participate in psychological education workshops to better understand the psychological characteristics of their children, the consequences of parental violence, and appropriate parenting methods, especially positive discipline instead of violence
Recognizing signs of psychological trauma in adolescents, such as restlessness, feelings of inadequacy, and self-destructive tendencies, is crucial for families To effectively address these issues, parents should actively engage in counseling and training programs that enhance their behavior management and family dynamics Such programs provide support and guidance, enabling parents to delve into internal factors and provide more effective support for their children's well-being.
- Parents need to manage their own emotions well to avoid causing psychological and physical violence against their children This includes staying calm in all situations, avoiding punishment, physical discipline, or using abusive language against their children Instead, they should be patient and take the time to talk with their children, understand the reasons, and help them adjust their behavior It is also necessary to establish clear rules so that children understand expectations and requirements, and to implement and adhere to those rules
- Support adolescents in seeking help: Families should encourage and support adolescents in seeking help from psychological support organizations and intervention programs Family support plays a crucial role in encouraging adolescents to participate in these programs.
For Schools
- Schools need to implement educational programs about child rights and support services for children within the curriculum This not only helps students understand their rights but also provides information about available support services to assist them in difficult situations
- Schools should introduce programs focused on life skills, emotional management, and social skills development in the curriculum These programs help students improve self-esteem, reduce feelings of failure and distress, and equip them with necessary skills to cope with challenging situations Additionally, schools need to provide psychological support services, creating a safe and friendly environment for students to share and receive timely assistance
- Teachers need training on how to identify symptoms of psychological trauma and how to support students affected by domestic violence Teachers should be capable of early detection and timely intervention to assist students
- Schools should establish and maintain counseling services to support students facing psychological difficulties This service needs to provide both individual and group counseling, as well as assistance with issues related to domestic violence.