Impact of physical,psychological,and sexual violence on social adjustment of school children in India

Abstract

This study sought to understand the pervasiveness and impact of physical, psychological, and sexual violence on the social adjustment of Grade 8 and 9 school children in the state of Tripura, India. The study participants, 160 boys and 160 girls, were randomly selected from classes in eight English and Bengali medium schools in Agartala city, Tripura. Data were collected using a self-administered Semi-structured Questionnaire for Children/Students and a Social Adjustment Inventory which were custom-made for the study based on measures in the extant research adapted for the Indian context. Findings revealed that students experienced physical (21.9%), psychological (20.9%), and sexual (18.1%) violence at home, and 29.7% of the children had witnessed family violence. Boys were more often victims of physical and psychological violence while girls were more often victims of sexual violence. The social adjustment scores of school children who experienced violence, regardless of the nature of the violence, was significantly lower when compared with scores of those who had not experienced violence (p < 0.001). Social adjustment was poorer for girls than boys (p < 0.001). The study speaks in favour of early detection and intervention for all child maltreatment subtypes and for children exposed to interparental violence, and highlights the crucial role of schools and school psychology in addressing the problem.

Keywords

child maltreatment family violence India interparental violence school psychology social adjustment

Physical, psychological, and sexual violence against children are worldwide problems generating serious short- and long-term effects on children’s health, development, and learning, and severe consequences for the well-being of families, communities, and nations (Pinheiro, 2006; World Health Organisation [WHO], 2002). The extent of violence against children is difficult to measure because much occurs in the privacy of family homes and is never reported or investigated (UNICEF, 2009). Compounding this difficulty is the fact that in some nations data collection mechanisms do not exist (Pinheiro, 2006; UNICEF, 2009). At its worst, violence against children can result in child mortality. For example a decade ago, WHO (2002) estimated that annually worldwide 57,000 child deaths of children under 15 years of age were attributable to homicide at the hands of their parents. UNICEF (2003) estimates that in high-income countries, between 0.1 and 2.4 child deaths per 100,000 children are attributable specifically to child maltreatment and rates are estimated to be two to three times higher in low- and middle-income countries. Data from 37 low-income countries collected as part of the UNICEF (2009) Multiple Indicator Cluster Surveys which assist countries to monitor their progress towards the Millennium Development Goals (UNICEF, 2005), revealed that approximately 86% of children aged 2- to 14-years-old experienced both physical punishment and psychological aggression in the month preceding data collection. A global meta-analytic review of population-based studies of childhood sexual abuse has estimated cumulative prevalence rates for sexual abuse prior to age 18 as 18.0% for girls and 7.6% for boys (Stoltenborgh, Ijzendoorn, Euser, & Bakermans-Kranenburg, 2011).

A recent discussion article on child protection and child welfare in the Asia-Pacific region (Pouwels, Swales, Mccoy, & Peddle, 2010) summarized primary studies reporting the pervasiveness of physical, psychological, and sexual violence in the preceding 12 months for children in China (10%, 13%, and 2% respectively), Malaysia (19.0%, 20.4%, and 22.2% respectively), and Vietnam (47.5%, 39.5%, and 19.7% respectively). A study of childhood maltreatment in seven low- and middle-income countries (Dunne et al., 2009) revealed rates of physical, psychological, and sexual violence ever experienced during childhood for children in India were 33.1%, 46.8%, and 20.2% respectively. The results of these studies suggest that children in different countries experience different types of victimization at different rates. Even within countries there may be regional differences. These data are an important source of information for policy makers, children’s rights advocates, and professionals who work with children, including school psychologists. Differential patterns evident in the data highlight the considerable heterogeneity of risk and protective factors for children in different contexts. Hence, rates of physical, psychological, and sexual victimization must be considered in relation to multiple factors in the complex social ecology of children’s lives (Cicchetti & Lynch, 1993; Theron & Donald, 2012; Toland & Carrigan, 2011).

The purpose of this article is to draw attention to the impact of physical, psychological, and sexual violence on the social adjustment of school children in India: It is an effort to address the paucity of literature and research on child victimization in Indian societies (Deb, 2006). Indeed, very little empirical research has been conducted with adolescents in low and middle income countries on the association between children’s adjustment and physical, psychological, and sexual violence. This is important for school psychologists, internationally, who have the potential to play an important role in the detection of child physical, psychological, and sexual victimization, the provision of interventions to assist students to address the consequences of maltreatment, and to advocate for and with their counterparts in school systems and professional associations for better service-provision worldwide (Cook, Jimerson, & Begeny, 2010; Jimerson, Stewart, Skokut, Caredenas, & Malone, 2009). School psychologists, therefore, must be alert to the prevalence of different types of victimization within their school communities as child protection and preventive work are fundamental areas of work for all school psychologists (Woods, Bond, Tyldesley, Farrell, & Humphrey, 2011). Furthermore, with increasing globalization, school psychologists find themselves working interculturally, with a diverse array of students from different backgrounds requiring their focus on social adjustment and inclusion.

In this study we use the term social adjustment to mean children’s struggle to get along or survive in their social and physical environment (Lazarus, 1976). It is a functional term encapsulating both a state of being and signifying a process of change in response to circumstances (Miller, Yahne, & Rhodes, 1990). Research suggests that the consequences of violence against children depend on factors including the type of maltreatment, its severity and frequency, the age of the child, the child’s gender, and the presence or absence of risk and protective factors which increase or decrease child and family resilience (Macdonald, 2001; Peirson, Laurindeau, & Chamberland, 2001).

In the ensuing sections we also define and operationalize each of the violence subtypes as they are used in this study. This is important because, as Segal (1992) and others have pointed out (see Chen & Astor, 2009, and Rees & Seaton, 2011 in this journal, for example), most empirical knowledge about violence against children has been generated in the West and it is crucial that researchers assess this phenomenon within the constructs of their own socio-cultural contexts.

Physical violence and adjustment problems

Physical violence towards children is defined by the WHO (2002) as acts of commission by a caregiver that cause actual physical harm or have the potential for harm. The harm may or may not have been intended. Such acts can arise from the use of excessive discipline or corporal punishment. In this study, it specifically includes pushing, grabbing, kicking, hitting, choking, locking, burning, and punishing the child in painful ways. A large population-based self-report study of parents conducted in Chile, Egypt, India, and the Philippines, also known as the WorldSAFE study, revealed that mothers in India reported the highest rates of severe physical punishment including hitting children with objects (36%), kicking (10%), and choking (2%) at least once in the six months preceding data collection (Sadowski, Hunter, Bangdiwala, & Munoz, 2004).

The consequences of physical abuse and its relationship to adjustment have been documented in a number of studies. These studies have shown that physically abused school-aged children show greater overall adjustment difficulties, poorer social competence, lower cognitive capacity, and poorer overall school performance than their nonabused counterparts (see for example Kolko, 2002; Macdonald, 2001). For example, physically abused children may show aggressive and violent behaviours towards their peers (Beeghly & Cicchetti, 1994; Chen & Astor, 2009), have fewer positive interactions, and become disruptive and antisocial (Howes & Eldredge, 1985). They are over-represented in delinquent populations (Scudder, Blount, Heide, & Silverman, 1993) and juvenile offenders (Steele, 1976). Physically abused children are 2.5 times more likely to have repeated a year of school (Kurtz, Gaudin, Howing, & Wodarski, 1993). They complete fewer total years of school than other school students (Perez & Widom, 1994). Those in foster care are disproportionally represented in special education classes, grade retentions, and disciplinary actions resulting in suspensions and exclusions (Scherr, 2007). Research has also documented a concerning range of subsequent mental health conditions in adolescence and adulthood. For example, Silverman, Reinherz, and Giaconia’s (1996) longitudinal study found physically abused individuals experienced significantly more instances of depression, post-traumatic stress disorder, and anti-social behavior. Associations have also been found between a history of physical abuse and later health risk behaviours including heavy drinking, drug and inhalant use and abuse, smoking, HIV-risk behaviours, and use of dangerous weapons (Bensley, Van Eenwyk, & Simmons, 2000; Hussey, Chang, & Kotch, 2006; Malete, 2007). Retrospective studies of adults have shown that males are more likely than females to have experienced physical abuse as a child. Although negative consequences are evident for both genders, physical abuse seems more detrimental for girls (Thompson, Kingree, & Desai, 2004; Widom & White, 1997).

Psychological violence and adjustment problems

Psychological or emotional violence towards children is defined as non-physical forms of hostile treatment that have a detrimental effect on the child’s health and development (Gilbert et al., 2009; Pinheiro, 2006; WHO, 2002). In this study it includes verbally harassing, disparaging, criticizing, threatening, and ridiculing. These acts are intentional and convey to a child that he/she is worthless (Gilbert et al., 2009). Psychological violence may be the most prevalent form of child maltreatment, but it is also the most hidden, under-reported, and least studied of all the maltreatment subtypes (Barnett, Miller-Perrin, & Perrin, 2005). In a recent study of street children in Jaipur, India, Mathur, Rathore, and Mathur (2009) found high levels of what they defined as verbal and psychological abuse with boys being abused more than girls, and children who reported higher levels of psychological abuse also experiencing other forms of maltreatment.

Psychological or emotional abuse impacts children’s functioning in several ways. For example, research has shown that emotional abuse in early childhood increases the risk of aggression and social withdrawal in middle childhood and poor socioemotional competence in early adolescence (Shaffer, Yates, & Egeland, 2009). Clinical and research findings have revealed that psychologically or emotionally abused school-aged children can present with behaviours such as anger, noncompliance, high levels of negativity, poor impulse control, and lower social competence, as well as academic underachievement (see for example Erickson, Egeland, & Pianta, 1989; Yates, 2007). In particular, paternal psychological abuse has been associated with anxiety, depression, interpersonal sensitivity, and dissociation (Briere & Runtz, 1988). In retrospective research, psychological or emotional abuse has been associated with increased levels of psychopathology into adulthood including anxiety, depression, lowered self-esteem (Mullen, Martin, Anderson, Romans, & Herbison, 1996; Ney, Fung, & Wickett, 1994), interpersonal relationship problems (Berzenski & Yates, 2010), borderline personality traits (Allen, 2008), and eating disorders (Hund & Espelage, 2006; Mazzeo & Espelage, 2002). A history of psychological or emotional abuse has also been associated with an increased likelihood of dropping out of college (Duncan, 2000). Further, psychological or emotional abuse is thought to amplify the effects of other co-occurring maltreatment subtypes (Briere & Runtz, 1990).

Sexual violence and adjustment problems

Sexual violence towards children is defined as a crime involving a child in sexual activity with an adult or older person (generally five or more years older). It may involve contact or noncontact sexual acts. Contact acts include unwanted touching, masturbation, oral-genital contact, digital penetration, and vaginal and anal rape. Noncontact acts include voyeurism, exposure, making sexual comments, and showing children pornography (Gilbert et al., 2009; Putnam, 2003; WHO, 2002). In this study, sexual violence specifically includes touching of private body parts, fondling, penetration, and rape. In a recent study of high school students in Goa, India, Patel and Andrew (2001) found that one-third of the children surveyed had experienced some form of sexual abuse, and these individuals had significantly poorer academic performance, poorer mental and physical health, greater substance abuse, poorer parental relationships and higher rates of consensual sexual behaviours than their non-abused counterparts. Further, in a study conducted in Kolkata, India, Deb and Mukherjee (2009) found that 69.2% of sexually abused girls suffered from moderate or severe depression compared with 27.5% of non-sexually abused girls. The study also found that 20.8% and 60.1% of sexually abused girls had poor levels of social and emotional adjustment respectively, compared with 4.17% and 32.5% of non-sexually abused girls.

Child sexual abuse is the most researched of all the maltreatment subtypes. In addition to the physical consequences such as sexually transmitted infections, bedwetting, and soiling (Kendall-Tackett, Williams, & Finkelhor, 1993), children who have been sexually abused report higher rates of emotional and behavioural problems than their non-abused peers. In particular they may display inappropriate sexual behaviour (see for example Berliner & Elliot, 2002; Herrera & Carey, 1993; Putnam, 2003). In middle childhood, sexually abused children have problems with social withdrawal, isolation and dissociation (see for example, Macdonald, 2001). Sexually abused adolescents are at greater risk for deliberate self harm and attempted suicide (Kendall-Tackett et al., 1993). In the long-term, there are consequences for adult adjustment including risky sexual behaviours and sexual revictimization (Andrews, Corry, Slade, Issakids, & Swanston, 2004; Polusny & Follette, 1995; Van Roode, Dickson, Herbison, & Paul, 2009), and substance abuse (Kendall-Tackett, 2002). Research has identified debilitating mental health sequelae including higher risk for major depression (Briere & Runtz, 1993), suicidal behaviours, anxiety and phobias, post-traumatic stress disorder, dissociation, and problematic cognitions (see for example Berliner & Elliot, 2002). Studies have also uncovered association with health problems in adults including cardiac disease (Goodwin & Stein, 2004).

Multiple violence types

School-aged children can be exposed to more than one type of maltreatment occasionally or on a continuous basis (Finkelhor, Ormrod, & Turner, 2007). This has been termed multi-type maltreatment (Higgins & McCabe, 2001). Studies have disclosed that witnessing interparental violence and child maltreatment co-occur in the same families (Appel & Holden, 1998; Casanueva, Martin, & Runyan, 2009; Edleson, 1999). For example, Straus and Smith (1990) reported that child maltreatment is 18 times more likely to occur in homes where interparental violence exists. It is clearly established that experiencing dual violence not only has an immediate negative effect on children, but also a long-term detrimental impact on adult adjustment (Feerick & Haugaard, 1999; Grych, Jouriles, Swank, McDonald, & Norwood, 2000; O’Keefe, 1996; Shen, 2009a, 2009b). A study of married men conducted in the northern Indian state of Uttar Pradesh in the 1990s found high levels of domestic violence in the range of 18% to 45% across the different regions studied. Such violence included men shouting and yelling, slapping, pushing, punching, and kicking their wives. Only 1% to 2% of wives had sought medical treatment for their injuries (Martin, Tsui, Maitra, & Marinshaw, 1999).

There remains a paucity of empirical data on the pervasiveness and associated features of specific forms of violence against children in particular parts of India. The present study attempts to address this knowledge gap. The study is modest in that it attempts to determine the association between social adjustment and the experience of physical, psychological, and sexual violence. This is an essential precursor to more complex studies which may be able to isolate and consider multiple variables simultaneously. The following two hypotheses have been formulated for testing: (1) social adjustment of children who experienced physical, psychological, or sexual violence will differ significantly from social adjustment of children who did not experience physical, psychological, or sexual violence; (2) Social adjustment of boys and girls who experienced physical, psychological, and sexual violence will differ significantly.

Method

Site

The study was conducted in eight secondary schools in Agartala, Tripura, India. The state of Tripura is located in the far North-Eastern part of India to the west of Bangladesh. It is the third smallest state comprising approximately 3 million people, most identifying as Hindu. The literacy rate in Tripura (73.6%) is slightly higher than that for India overall (63.0%). Rates are higher for males (81.0%) than for females (64.9%) and higher in urban (89.2%) than rural areas (69.7%) (Census Commissioner, 2001). Workforce participation rates are 51% for males and 21% for females, and average monthly incomes in Tripura (Rs 1,600) (Government of Tripura, 2007) are below the Indian average (Rs 3,000) (Expressindia, 2009). In schools, the medium of instruction is predominantly Bengali or English and, to a lesser extent, Kokborok and the Tripuri tribal languages. Schools in Tripura are administered by the state government or private agencies including religious and philanthropic organizations. Approximately one-fifth (21.4%) of children drop out of school before completing the primary stage of education (which is up to Class 5 of elementary school). In Tripura, the middle stage of education (i.e. middle school) spans Classes 6 to 8, and the secondary stage (i.e. high school) caters for children in Classes 9 and 10. There has been substantial improvement in school attendance rates in Tripura between 1991 and 2001. The proportion of children aged 6- to 14-years-old not attending school has been reduced by half in the past decade from 43.4% in 1991 to 23.0% in 2001 (Government of Tripura, 2007).

Sample

Children (n = 320) aged 14- to 19-years-old were randomly selected from eight English and Bengali medium schools in the city of Agartala, Tripura. An equal number of boys (n = 160) and girls (n = 160) from Class VIII and Class IX participated in the study.

Instruments

Two self-report study tools were custom-made for the study: A Semi-structured Questionnaire for Children/Students (Deb & Modak, 2007) and a Social Adjustment Inventory (Deb & Mukherjee, 2009). These were developed from reviews of the extant literature and from adaptation of existing measures. The first tool, the Semi-structured Questionnaire for Children/Students (Deb & Modak, 2007) is similar to what has since become known as the ISPCAN Child Abuse Screening Tool Children’s Version (ICAST-C) (Zolotor et al., 2009) to which the first author of this article was a contributor in the development and testing phases. The ICAST-C has been field tested in five middle and low income countries finding moderate to high internal consistency for item sub-scales and low rates of missing data (Zolotor et al., 2009). This screening tool is, in turn, based on elements of the Parent-Child Conflict Tactics Scale (Straus, Hanby, Finkelhor, Moore, & Runyan, 1998) and the Juvenile Victimisation Questionnaire (Finkelhor, Hamby, Ormrod, & Turner, 2005) both of which have been widely used in research worldwide. The Semi-structured Questionnaire has three sections. Section 1 covers background information about the respondent’s family and current circumstances including age, number of siblings, family type, academic performance, parents’ education and occupation, monthly family income, living environment, perceptions about the family environment, parenting style/approach, and parents’ drug and alcohol use. Section 2 consists of 15 items asking for information about the nature of violence experienced by the child (physical, psychological, and sexual), the frequency of violence, and the profile of the perpetrators of that violence. Section 3 comprised five items collecting data about reporting of violence to authorities such as law enforcement officials or local non-government organizations (NGOs) and the reasons for reporting or not reporting the incident to them.

The second study tool was the Social Adjustment Inventory. This instrument was originally based upon the Bell’s Adjustment Inventory (Bell, 1939, 1962) which has a long tradition of adaptation in psychological research in India. Bell’s original Adjustment Inventory measured a person’s degree of adjustment in four realms of life: health, social, emotional, and occupational. It has been widely used in therapeutic practice as it assists clinicians to identify relevant areas of adjustment and maladjustment. Several adaptations of this inventory can be found in the Indian literature (see for example Hussain, 1970; Jain, 1972; Mohan & Hussain, 1987; Pal, 1995; Singh, 1974. In this study, the Pal (1995) version of the Social Adjustment Inventory (1995) was used after local adaptation to the Bengali language (Deb & Mukherjee, 2009). It was employed as a means of determining the degree of social adjustment held by each child. The advantage of using this instrument lies in its wide use as it provides profiles of social adjustment in children with a range of comparative childhood issues, for example, chronic illness or disability. In this version, there were 60 items each with response categories of ‘yes’ or ‘no’. Example items included: ‘I don’t have any problem in mixing with people’; ‘It has become my habit to take an active part in social functions’; and ‘In my view, it is better to work in a group rather than individually’. Scoring was straightforward as recommended by Bell with ‘yes’ responses allocated a score of 2 and ‘no’ responses allocated a score of 1; generating a maximum score of 120 and a minimum score of 60. Low scores indicated poorer social adjustment while higher scores indicated better social adjustment. The socio-cultural admissibility of the test was ascertained by translating the items from English into the local Bengali language. This was undertaken independently by three experienced researchers. The Bengali version of the test was then back-translated into English to ensure stability of the test items (Mukherjee, 2006).

Procedure

To collect data in schools, permission was sought and obtained from the school authorities and then a tentative time schedule was developed for data collection. Data were collected from the children during school time. They gave informed, voluntary consent and all information provided by them was collected anonymously. The ethical issues which were of particular concern in this study included the need to ensure participants were fully informed about the nature of the study and measures taken to preserve their privacy, the voluntary nature of participation, and the importance of their consent for the data collection process. Additionally, in research with potential to cause distress, it was important to implement subtle actions for monitoring participant distress during the research process and for ensuring ongoing support for children who may need it (Cashmore, 2006; Simmel, Flanzer, & Webb, 2006).

Data analysis

The data collected from the school children were subjected to a thorough in-house review, before data were entered for analysis. Apart from descriptive statistics such as measures of central tendency and dispersions, t-tests were used for verification of hypotheses. Confidence Intervals for group comparisons were calculated at 95% and significance levels were set at 0.01 and 0.001. Calculations were performed using SPSS for Windows 17.0 (SPSS Inc., 2008).

Results

The sample comprised 320 children: 50% boys and 50% girls with 50% each from Classes 8 and Class 9. Their ages fell into three groupings: 14- to 15-years-old (92.5%), 16- to 17-years-old (5.9%) and 18-years-old and older (1.6%). Approximately 27.8% of respondents were the only child of their parents, 53.8% had one sibling, 12.8% had two siblings, and 5.6% had larger families with three or more siblings. Regarding the family type, slightly more children were growing up in single/nuclear families (53.8%) than joint/extended families (46.2%).

Children’s academic performance as measured by their average marks (academic grades) across all subject areas in their most recent examination revealed that well over half (60.3%) of the children were considered to be progressing in the good or very good range with a smaller proportion of the children performing in the moderate (24.4%) and not so good (14.4%) ranges. These data are presented in Table 1.
Table 1.
Participants’ background information (n = 320)

Parameters Characteristics Mode of response

n %

Age 14–15 years 296 92.5

16–17 years 19 5.9

18 years and above 05 1.6

Number of siblings None 89 27.8

One 172 53.8

Two 41 12.8

Three or more 18 5.6

Family type Joint/extended family 148 46.2

Single/nuclear family 172 53.8

Education Studying in class IX 160 50.0

Studying in class X 160 50.0

Academic performance in the last examination Very good (average marks 75% and above) 62 19.4

Good (average marks 60% and above) 134 41.9

Moderate (average marks 50% and above) 78 24.4

Not so good (below 50% marks) 46 14.4

The majority of the families lived in urban (51.1%) and semi-urban areas (21.1%). With regards to parents’ education, 50.0% of the fathers and 35.3% of the mothers were university graduates and 37.5% of the fathers and 27.9% of the mothers had post-graduate qualifications. Data indicate that 70.0% of the children’s fathers and 40.6% of the mothers were in the paid workforce. Of these parents, the most common type of occupation was in business with 25.3% of fathers and 10.3% of mothers engaged in business-related work. The remainder of parents were engaged in casual work and more than one-quarter of the mothers (28.8%) were stay-at-home mothers described as housewives in this study. The total monthly family income was spread with a small proportion of children (5.0%) reporting their parents’ incomes as more than Rs 20,001/per month. The majority of the families (69.0%) had incomes in the range Rs 10,000/to 20,000/per month and a smaller proportion (26.0%) reporting incomes of below Rs 10,000/per month.

Since family violence has a direct or indirect relationship with child abuse and neglect, the present study probed the issue with the children to understand the pervasiveness of the situation in Agartala, Tripura. About 29.7% of the children reported that they witnessed violence in the family mostly between their parents. In this regard, boys witnessed more violence (35.0%) as compared to girls (24.4%). About 8.4% of the children, irrespective of gender, witnessed violence regularly, defined as once or twice per week, while 34.7% witnessed the same occasionally, that is, once per month or once every six months. So far as manifestation of the violence is concerned, children mostly reported parents shouting or yelling at each other, followed by beating, kicking, or other forms of physical assault.

Nature of violence experienced by children

Findings revealed that 21.9% of children had experienced physical violence, 20.9% had experienced psychological violence, and 18.1% had experienced sexual violence. The notion that boys and girls might experience different types of violence was tested using a series of chi-squared tests (one-tailed). There was an important difference found in this exposure. Boys were more often victims of physical (24.4% compared with 19.4%) or psychological (21.0% compared with 20.0%) violence. Girls were more often victims of sexual violence (25.0% compared with 11.3%). A statistically significant difference, however, was found only between boys and girls in the case of sexual violence (p < 0.01). These data are presented in Table 2.
Table 2.
Nature of violence experienced by children

Nature of violence Sample group
Total (n = 320) % Chi-square (p-value) Level of significance

Boys (n = 160) % Girls (n = 160) %

Physical 24.4 19.4 21.9 1.17 NS

(39/160) (31/160) (70/320) (0.2793)

Psychological 21.9 20.0 20.9 0.17 NS

(35/160) (32/160) (67/320) (0.6802)

Sexual 11.3 25.0 18.1 10.19 0.01

(18/160) (40/160) (58/320) (0.0014)

Significant at 0.01 level: NS: Not significant.

Social adjustment

Comparison of the mean social adjustment scores for physically, psychologically, and sexually abused children and their non-abused counterparts was conducted using a series of unpaired t-tests (two-tailed) revealing significant differences for each violence sub-type at the p < 0.001 level. These data are displayed in Table 3. Recalling that lower mean scores indicate poorer social adjustment: Children who had experienced any form of violence at home recorded significantly poorer social adjustment than those children who had not experienced such violence. The first hypothesis, social adjustment of children who experienced physical, psychological, or sexual violence will differ significantly from social adjustment of children who did not experience physical, psychological, or sexual violence, was supported.
Table 3.
Comparison of the social adjustment scores of physically, psychologically, and sexually abused, and non-abused children

Sample group n Mean S.D. t* (test statistic) P- value Difference between means (95% CIs)

Physically abused 70 29.857 9.205 −15.562 (df = 318) <0.001 14.51 (12.68–16.35)

Not physically abused 250 44.368 6.103

Psychologically abused 67 35.269 11.481 −6.323 (df = 318) <0.001 7.49 (5.16–9.82)

Not psychologically abused 253 42.763 7.705

Sexually abused 58 31.621 11.509 −10.123 (df = 318) <0.001 11.69 (9.42–13.96)

Not sexually abused 262 43.313 6.947

Finally, to understand gender differences in the social adjustment of physically, psychologically, and sexually abused boys and girls, a further series of t-tests were conducted. Comparison of the mean social adjustment scores for boys and girls revealed significant differences for every violence sub-type at the p < 0.001 level. These data are displayed in Table 4. That is, girls showed significantly poorer social adjustment in response to their experiences of violence when compared with boys. The second hypothesis, social adjustment of boys and girls who experienced physical, psychological, and sexual violence will differ significantly, was accepted.
Table 4.
Comparison of the social adjustment scores of physically, psychologically, and sexually abused boys and girls

Sample group n Mean SD t* (test statistic) P- value Difference between means (95% CIs)

Physically abused boys 39 35.769 6.850 8.695 (df = 68) <0.001 13.35 (10.29–16.41)

Physically abused girls 31 22.419 5.732

Psychologically abused boys 35 42.457 9.224 7.078 (df = 65) <0.001 15.05 (10.80–19.29)

Psychologically abused girls 32 27.406 8.072

Sexually abused boys 18 41.667 8.852 5.478 (df = 56) <0.001 14.57 (9.24–19.89)

Sexually abused girls 40 27.100 9.586

Discussion

Before discussing the specific findings regarding physical, psychological, and sexual violence against children, it is important to be mindful of the social and cultural context within which it occurs. Tripura is a state with a diverse population attributable to the historical difficulties it has faced with successive waves of immigration and influxes of refugees, mainly from Bangladesh, at the time of partition (1947), during the Bangladesh war of independence (1971), and more recently because of the economic situation in that country. Tripura is not a particularly urbanized state with a lower proportion (17%) of the population living in urban centres compared with India’s national average (28%) (Government of Tripura, 2007). Many of the rural inhabitants are tribal people with ancestry in countries such as Tibet, Myanmar and Mongolia. Hence, in some ways, this state faces unique challenges.

This sample of children from schools, however, was from an urban area. Children were attending school beyond the elementary stage. They had parents who were more highly educated than the general population in India and had higher proportions of parents in the paid workforce with higher than average household incomes. Even so, a substantial proportion (29.7%) of the children in this study reported witnessing interparental violence involving their parents shouting, yelling, beating and kicking each other. Boys witnessed more violence (35.0%) than girls (24.4%). Available research confirms that this problem is not confined to India alone. For example, in a multi-country study conducted by Zolotor et al. (2009) found rates of exposure to violence at home in the past 12 months, reported by children (operationalized as adults shouting, hitting, kicking, slapping, or using weapons against each other) was 67% in Russia, 57% in Columbia, 49% in India, and 30% in Iceland. These comparisons are significant because the methodologies used to measure violence exposure in previous studies, and the present study, are similar. The findings support emerging theories suggesting that interparental violence is more likely in impoverished households and poorer countries, and where adults have little or no formal education (UNICEF, 2009).

The findings of the present study are congruent with the findings of Martin et al. (1999) who studied domestic violence in Northern India. Their study found that 30% of the men in their 6,000-strong sample had witnessed family violence as children. Moreover, men who had experienced family violence were more likely as adults to perpetrate physical and sexual assaults against their wives and to believe it was their right to do so. Furthermore, 54% of Indian women aged 15- to 49-years-old considered a husband to be justified in hitting or beating his wife in certain circumstances (UNICEF, 2011). This is cause for concern for the future families of children in our sample as it appears that that family violence levels have remained fairly stable over two generations.

For the children who have experienced family violence, research indicates that they will be at risk for a wide range of both internalizing and externalizing behaviour problems which may vary by developmental stage (Hughes, 1988; Moore & Pepler, 2006). Research also indicates that there is a risk of a wide range of adjustment problems for children exposed to family violence. However, the research is not unequivocal: some children exposed to family violence show extreme adjustment difficulties, while others score well within the normal range (Hughes & Luke, 1998). Much depends on the constellation of risk and protective factors surrounding the child, their family, and community. Protective factors would include sensitive and authoritative parenting, decent educational opportunities, good physical health, and psychological autonomy (Patel, Flisher, Nikapota, & Malhotra, 2008).

The pervasiveness of physical (21.9%), psychological (20.9%), and sexual violence (18.1%) experienced by the children, both reflect and contradict previous research. Almost one-fifth of the sample reported physical violence which seems comparable, or even lower, than findings from similar studies conducted in other countries. For example, in the United Kingdom, May-Chahal and Cawson (2005) studied over 2,800 young adults with 16% reporting some type of childhood violence and 7% reporting severe physical abuse at the hands of their parents. In the USA, Hussey, Chang, and Kotch (2006) found 28.4% of their 10,828 respondents had been slapped, hit or kicked by a parent or adult caregiver. Gilbert and colleagues’ (2009) review of the burden and consequences of violence against children in high-income countries reported on studies conducted in European countries which found rates of physical abuse of 12% in Macedonia and 29% in Moldava, and higher rates in rural than urban areas. In Segal’s (1995) study of discipline practices of professional middle class Indian parents, 42% of parents used harsh discipline including kicking, biting, punching, striking with an implement, or beating. Sadowski, Hunter, Bangdiwala, and Munoz (2004) found 36% of Indian mothers used the same. The data in the current study tend to show a decline from these figures and a slightly lower preponderance of physical abuse than that previously reported. Findings from the current study, however, indicating that boys experienced more physical violence than girls (24.4% versus 19.4%) were not supported by data from the WorldSAFE study of child discipline practices in India which found boys and girls were harshly disciplined rather equally (Hunter, Jain, Sadowski, & Sanhueza, 2000).

With respect to psychological violence, one-fifth (20.9%) of the sample reported exposure to psychological violence at home. This seems higher than some studies conducted in other countries. For example, May-Chahal and Cawson (2005) reported that 6% of young adults in the UK reported severe psychological abuse. In contrast, however, 22% of 14- to 17-year-olds in the USA reported recollections of emotional abuse during childhood (Finkelhor, Turner, Ormrod, & Hamby, 2009), a figure comparable to that found in the current study. Psychological or emotional abuse is the most common and intense form of violence reported by Indian street children (Mathur, Rathore, & Mathur, 2009). Regarding the impact of psychological violence against children, Shaffer et al. (2009) observed that both emotional neglect and emotional abuse were associated with increased aggression and social withdrawal in middle childhood, and lower ratings of socioemotional competence in early adolescence. Other studies have shown that children’s exposure to verbal aggression was the strongest predictor of adjustment difficulties (Moore & Pepler, 2006).

Findings that one-quarter of the girls experienced sexual abuse (25.0%) and that girls also experienced more sexual violence than boys (25.0% versus 11.3%) were not unexpected: These findings are comparable with studies throughout the world. For example, in a meta-analysis of 39 child sexual abuse prevalence studies in 21 countries, Pereda, Guilera, Forns, and Gomez-Benito (2009) reported rates of 10% to 20% for girls and approximately 10% for boys. However, the highest prevalence rates were found in South Africa with over 50% for both girls and boys. In an Indian sample of runaway, boys at an observation home in Delhi 38.1% reported exposure to sexual abuse (Pagare, Meena, Jiloha, & Singh, 2005). Importantly, Varia, Abidin, and Dass (1996) revealed that sexually abused children consistently had more psychological and social adjustment problems than their non-abused counterparts. Roberts, O’Connor, Dunn, Golding, and The ALSPAC Study Team (2004) investigated the links between child sexual abuse occurring before 13 years of age, and later mental health, family organization, parenting behaviors, and adjustment in offspring. The findings indicated that child sexual abuse had long-term repercussions for adult mental health, parenting relationships and child adjustment in the succeeding generation.

Social adjustment is an important functional dimension of human life that is indicative of mental health. It is essential to well-being and to an individual’s ability to ‘perceive, comprehend and interpret our surroundings, to adapt to them or change them if necessary, and to communicate with each other and have successful social interactions’ (Lehtinen, Ozamiz, Underwood, & Weiss, 2005, p. 46). In this study, children who experienced physical, psychological, or sexual violence were found to have significantly poorer social adjustment when compared with non-abused children. These results are not surprising and are corroborated by numerous existing studies indicating negative outcomes for children experiencing maltreatment (for succinct reviews of this research see Asnes & Leventhal, 2009; Gilbert et al, 2009). The present study found that female children faced more social adjustment challenges than male children. This can be understood in terms of the structural inequalities in Indian society including gender inequality (Deb, 2006). Girls have less access to supports which are known to moderate the effects of family violence such as self determination, freedom of movement, and help seeking (Margolin & Gordis, 2000; Patel et al., 2008). As Kliewer, Lepore, Oskin, and Johnson (1998) note, opportunities to talk about violence exposure to supportive others is associated with less intrusive thinking and fewer internalizing symptoms. Despite the scope of domestic change brought about by globalization, underlying patriarchal structures persist in Indian societies (Da Costa, 2008; Kingdon, 2007). Culture may still determine the norms, values and beliefs surrounding the use of violence, and the way children understand and label their own experiences (Margolin & Gordis, 2000). More work is needed in this area to fully comprehend the ways in which culture affects violence towards children. Although we are cognizant of new perspectives urging for a paradigm shift in understanding child well-being with a focus on positive rather than negative indicators for children, activity rather than passivity, and survival rather than victimization (see for example Saith & Wazir, 2010; Theron & Donald, 2012), we also argue that illuminating the scope of the problem in previously unstudied areas is an important first step towards addressing the issue.

Limitations

This study has some limitations which must be considered. First, the sample comprised school children only from urban areas, limiting the diversity of the sample by ethnic background, socioeconomic and educational status. Thus, the findings may not be generalized to broader community samples. Second, the prevalence of physical, psychological and sexual violence, and rates of exposure to family violence were based on children’s self-reports. Although privacy, confidentiality, and anonymity was assured, it may be that some children did not reveal the true extent of the violence they experienced because of feelings of embarrassment, shame or guilt or, moreover, because of their emotional attachment to their parents and their desires for loyalty (Deb, 2006). In an article from a landmark longitudinal study, Fergusson and colleagues (2000) note substantial unreliability in the reporting of child maltreatment owing to individuals’ forgetting or blocking out memories of traumatic events, avoidance of recalling or describing their abusive experiences, and the influence of an individual’s level of adjustment at the time of completing a survey. These authors conclude that the main shortcoming of self-reports is the propensity to result in false negative reports (i.e. people who have experienced victimization reporting that they had not). Future studies may consider corroborating student self-report measures of adjustment with teacher reports. Teacher reports may be extended to also identify the specific educational effects of exposure to different types of violence. This information may assist schools to better address victimized students’ specific psychological needs.

Conclusion and implications

Overall, about one-fifth of the children experienced psychological, physical, and sexual violence in this sample of school children from Tripura, India. This is the first study to document pervasiveness of different violence subtypes against children in this small north-eastern Indian state. The study found that boys were more often victims of physical and psychological violence while girls were more often victims of sexual violence. The social adjustment scores of school children who experienced violence, regardless of the nature of the violence, was significantly lower when compared with scores of those who had not experienced violence. Social adjustment was poorer for girls than boys.

For school psychology worldwide, the findings of this study recapitulate the need for early detection and intervention for all maltreatment subtypes and for children exposed to interparental violence. However, for awareness about the prevalence of adolescents’ physical, psychological, and sexual violence to be useful to schools, it must be embedded in broader understandings about the key features of the complex and dynamic social ecologies in which children live (Cicchetti & Lynch, 1993; Toland & Carrigan, 2011). Victimization does not occur in a social and/or political vacuum. Demonstrating links between the presence of victimization and children’s social adjustment problems is the first step in articulating the problem. Future research, however, must undertake more complex analyses to understand the process by which adjustment problems arise in some children and not others living in similar contexts and, moreover, to identify culturally-meaningful resiliency-enhancement strategies (Theron & Donald, 2012). This takes on particular salience in developing countries where children’s vulnerability is compounded by influences in the wider macro-system such as community poverty, poor literacy, unemployment, and deeply-rooted cultural beliefs and practices (Deb, 2006).

The study’s findings have implications for schools generally. Within schools, teachers can be guided to take their role as ‘sentinels’ for children very seriously (Sedlak, 1993). Teachers, as well as school psychologists, have the potential to play a key role in identifying children who have experienced victimization, providing support in the classroom on a day-to-day basis, modelling and building trusting relationships, ensuring children’s safety and security at school, and referring them to appropriate treatment programs where necessary (Phasha, 2008; Watts, 1997). To champion this role, teachers will do better with the support of school psychologists; their involvement is crucial to creating deeper understandings about physical, psychological, and sexual violence and its consequences for children’s adjustment. Within an eco-systemic view there is hope: A sense that children’s school experiences and relationships have the potential to generate protective effects enabling vulnerable children to thrive in the face of adversity (Theron & Donald, 2012).

The availability of school psychologists within schools in India, however, is likely to present some serious challenges. A study conducted approximately 15 years ago found that counselling services were available in only 9% of schools in India (Bhatnagar, 1997), and a more recent study of school psychology provision in 83 member states of the United Nations found the number of school psychologists in India was unknown (Jimerson et al., 2009). It is estimated that in the world’s most child-populous countries (China, India, and Indonesia), at least 379 million children have no access to school psychology services (Jimerson et al., 2009; Ying, Wu, & Lin, 2012). In India, psychologists, including counselling psychologists, tend to work in clinics and provide support to schools and services for children rather than being located within school environments where they can deliver key services such as individual assessments, specific interventions for individuals and groups, training for other school staff, and promoting mental health and wellness overall. Hence, the profession of school psychology in India is in its relative infancy despite advocacy for the same at least two decades (see for example Paliwal, 1984; Arulmani, 2007). To this end, the Indian School Psychology Association (InSPA) is setting an aspirational goal of appointing at least one trained school psychologist in each school (InSPA, 2010). To meet this goal will require enormous professional effort and political will. Should it be achieved, school psychologists in India will be well on the way to creating supportive contexts with capacity to build resilience for and with children in the face of adversity.

Parameters	Characteristics	Mode of response
Age	14–15 years	296	92.5
16–17 years	19	5.9
18 years and above	05	1.6
Number of siblings	None	89	27.8
One	172	53.8
Two	41	12.8
Three or more	18	5.6
Family type	Joint/extended family	148	46.2
Single/nuclear family	172	53.8
Education	Studying in class IX	160	50.0
Studying in class X	160	50.0
Academic performance in the last examination	Very good (average marks 75% and above)	62	19.4
Good (average marks 60% and above)	134	41.9
Moderate (average marks 50% and above)	78	24.4
Not so good (below 50% marks)	46	14.4

Nature of violence	Sample group	Total (n = 320) %	Chi-square (p-value)	Level of significance
Physical	24.4	19.4	21.9	1.17	NS
(39/160)	(31/160)	(70/320)	(0.2793)
Psychological	21.9	20.0	20.9	0.17	NS
(35/160)	(32/160)	(67/320)	(0.6802)
Sexual	11.3	25.0	18.1	10.19	0.01
(18/160)	(40/160)	(58/320)	(0.0014)

Sample group	n	Mean	S.D.	t* (test statistic)	P- value	Difference between means (95% CIs)
Physically abused	70	29.857	9.205	−15.562 (df = 318)	<0.001	14.51 (12.68–16.35)
Not physically abused	250	44.368	6.103
Psychologically abused	67	35.269	11.481	−6.323 (df = 318)	<0.001	7.49 (5.16–9.82)
Not psychologically abused	253	42.763	7.705
Sexually abused	58	31.621	11.509	−10.123 (df = 318)	<0.001	11.69 (9.42–13.96)
Not sexually abused	262	43.313	6.947

Sample group	n	Mean	SD	t* (test statistic)	P- value	Difference between means (95% CIs)
Physically abused boys	39	35.769	6.850	8.695 (df = 68)	<0.001	13.35 (10.29–16.41)
Physically abused girls	31	22.419	5.732
Psychologically abused boys	35	42.457	9.224	7.078 (df = 65)	<0.001	15.05 (10.80–19.29)
Psychologically abused girls	32	27.406	8.072
Sexually abused boys	18	41.667	8.852	5.478 (df = 56)	<0.001	14.57 (9.24–19.89)
Sexually abused girls	40	27.100	9.586

Footnotes

Acknowledgements

Sibnath Deb acknowledges the work of Dr Subhasis Modak in data collection for this study. Sincere gratitude is extended to the school authorities for giving permission for data collection, and to the students who volunteered to be part of the study; they merit special appreciation. The collaboration between India and Australia to facilitate dissemination of these research findings was made possible by an Endeavour Executive Award awarded to Sibnath Deb when he was a Visiting Research Fellow in the Faculty of Health, Queensland University of Technology.

To support the completion of this research Dr Walsh was supported by a Queensland University of Technology Vice-Chancellor’s Research Fellowship (2010–2012).

Sibnath Deb, PhD, Professor and Head of Applied Psychology, Pondicherry University (A Central University), India. His research interests include students’ mental health, child abuse and neglect, and adolescent reproductive health. At the time of the study, Sibnath Deb was affiliated with the Department of Applied Psychology, Calcutta University, Kolkata, India. Address: Department of Applied Psychology, Pondicherry University, RV Nagar, Kalapet, Puducherry, 605014, India. Email: sibnath23@gmail.com

Kerryann Walsh, PhD, is a Senior Research Fellow in the Centre for Learning Innovation, Queensland University of Technology. Her research interests include educational consequences of child abuse and neglect, mandatory reporting of child abuse and neglect, child sexual abuse prevention programs, and teacher training for child protection. Address: Centre for Learning Innovation, Faculty of Education, Queensland University of Technology, Victoria Park Road, Kelvin Grove 4059, Queensland, Australia. Email: k.walsh@qut.edu.au

References

Allen

(2008). An analysis of the impact of diverse forms of childhood psychological maltreatment on emotional adjustment in early adulthood. Child Maltreatment, 13(3), 307–312.

Andrews

Corry

Slade

Issakids

Swanston

(2004). Child sexual abuse. In Ezzati

Lopez

A. D.

Rodgers

Murray

C. J. L.

(Eds.), Comparative quantification of health risks: Global and regional burdens of disease attributable to selected major factors, (Vol. 2, pp. 1851–1940). Geneva: World Health Organisation.

Appel

A. E.

Holden

G. W.

(1998). The co-occurrence of spouse and physical child abuse: A review and appraisal. Journal of Family Psychology, 12(4), 578–599.

Arulmani

(2007). Counselling psychology in India: A the confluence of two traditions. Applied Psychology: An International Review, 56(1), 69–82.

Asnes

A. G.

Leventhal

J. M.

(2009). The global burden of child maltreatment. In Ehri

(Ed.), Maternal and child health: Global challenges, programs, and policies (pp. 463–477). New York, NY: Springer.

Bhatnagar

(1997). Guidance and counselling. In: Buch

M. B.

(Ed.), Fifth survey of educational research 1988–1992, (Vol 1, pp. 216–234). New Delhi: National Council of Educational Research and Training.

Barnett

Miller-Perrin

C. L.

Perrin

R. D.

(2005). Child psychological maltreatment. In Barnett

Miller-Perrin

C. L.

Perrin

R. D.

(Eds.), Family violence across the lifespan: An introduction, 2nd edn. (pp. 151–178). Thousand Oaks, CA: Sage Publications.

Beeghly

Cicchetti

(1994). Child maltreatment, attachment, and the self system: Emergence of an internal state lexicon in toddlers at high social risk. Development and Psychopathology, 6(1), 5–30.

Bell

H. M.

(1939). The theory and practice of personal counseling: With special reference to the adjustment inventory. Stanford, CA: Stanford University Press.

10.

Bell

H. M.

(1962). Manual: Bell adjustment inventory (revised student form). Palo Alto, CA: Stanford University Press.

11.

Bensley

L. S.

Van Eenwyk

Simmons

K. W.

(2000). Self-reported childhood sexual and physical abuse and adult HIV-risk behaviors and heavy drinking. American Journal of Preventive Medicine, 18(2), 151–158.

12.

Berliner

Elliott

(2002). Sexual abuse of children. In Myers

Berliner

Briere

Hendrix

Jenny

Reid

(Eds.), The APSAC handbook on child maltreatment, 2nd edn. (pp. 55–78). Thousand Oaks, CA: Sage Publications.

13.

Berzenski

S. R.

Yates

T. M.

(2010). A developmental process analysis of the contribution of childhood emotional abuse to relationship violence. Journal of Aggression, Maltreatment and Trauma, 19(2), 180–203.

14.

Briere

Runtz

(1988). Multivariate correlates of childhood psychological and physical maltreatment among university women. Child Abuse and Neglect, 12(3), 331–341.

15.

Briere

Runtz

(1990). Differential adult symptomatology associated with three types of child abuse histories. Child Abuse and Neglect, 14(3), 357–364.

16.

Briere

Runtz

(1993). Childhood sexual abuse: Long-term sequelae and implications for psychological assessment. Journal of Interpersonal Violence, 8(3), 312–330.

17.

Casanueva

Martin

S. L.

Runyan

D. K.

(2009). Repeated reports for child maltreatment among intimate partner violence victims: Findings from the national survey of child and adolescent well-being. Child Abuse and Neglect, 33(2), 84–93.

18.

Cashmore

(2006). Ethical issues concerning consent in obtaining children’s reports on their experience of violence. Child Abuse and Neglect, 30(9), 969–977.

19.

Census Commissioner. (2001). Census of India. Retrieved October 4, 2010, from http://www.censusindia.net/.

20.

Chen

J.-K.

Astor

R. A.

(2009). The perpetration of school violence in Taiwan: An analysis of gender, grade level and school type. School Psychology International, 30(6), 568–584.

21.

Cicchetti

Lynch

(1993). Toward and ecological/transactional model of community violence and child maltreatment: Consequences for children’s development. Psychiatry, 56(1), 96–118.

22.

Cook

C. R.

Jimerson

S. R.

Begeny

J. C.

(2010). A model for predicting the presence of school psychology: An international examination of sociocultural, sociopolitical, and socioeconomic influences. School Psychology International, 31(4), 438–461.

23.

Da Costa

(2008). ‘Spoiled sons’ ‘sincere daughters’: Schooling, security, and empowerment in rural West Bengal, India. Journal of Women in Culture and Society, 33(2), 283–308.

24.

Deb

(2006). Children in agony: A sourcebook. New Delhi: Concept Publishing Company.

25.

Deb

Modak

(2007). Semi-structured Questionnaire for Children/Students. Kolkata: University of Calcutta.

26.

Deb

Mukherjee

(2009). Impact of sexual abuse on mental health of children. New Delhi: Concept Publishing Company.

27.

Duncan

R. D.

(2000). Childhood maltreatment and college drop-out rates: Implications for child abuse researchers. Journal of Interpersonal Violence, 15(9), 987–995.

28.

Dunne

M. P.

Zolotor

A. J.

Runyan

D. K.

Andreva-Miller

Choo

Y. W.

Gerbaka

Isaeva

Jain

Kasim

M. S.

McFarlane

Mamyrova

Ramirez

Volkova

Youssef

(2009). ISPCAN Child Abuse Screening Tools Retrospective version (ICAST-R): Delphi study and field testing in seven countries. Child Abuse and Neglect, 33(11), 815–825.

29.

Edleson

J. L.

(1999). The overlap between child maltreatment and woman battering. Violence Against Women, 5(2), 134–154.

30.

Erickson

M. F.

Egeland

Pianta

(1989). The effects of maltreatment on the development of young children. In Cicchetti

Carlson

(Eds.), Child maltreatment: Theory and research on the causes and consequences of child abuse and neglect (pp. 647–684). New York, NY: Cambridge University Press.

31.

Expressindia. (2009). Average Indian’s income crosses Rs 3000. Retrieved October 4, 2010, from http://www.expressindia.com/latest-news/Average-Indians-income-crosses-Rs-3000/468084/.

32.

Feerick

M. M.

Haugaard

J. J.

(1999). Long-term effects of witnessing marital violence for women: The contribution of childhood physical and sexual abuse. Journal of Family Violence, 14(4), 377–398.

33.

Fergusson

D. M.

Horwood

L. J.

Woodward

L. J.

(2000). The stability of child abuse reports: A longitudinal study of reporting behaviour of young adults. Psychological Medicine, 30(3), 529–544.

34.

Finkelhor

Hamby

S. L.

Ormrod

Turner

(2005). The Juvenile Victimisation Questionnaire: Reliability, validity, and national norms. Child Abuse and Neglect, 29(4), 383–412.

35.

Finkelhor

Ormrod

Turner

(2007). Poly-victimisation: A neglected component in child victimization. Child Abuse and Neglect, 31(1), 7–26.

36.

Finkelhor

Turner

Ormrod

Hamby

S. L.

(2009). Violence, abuse, and crime exposure in a national sample of children and youth. Pediatrics, 124(5), 1411–1423.

37.

Gilbert

Widom

C. S.

Browne

Fergusson

Webb

Janson

(2009). Child maltreatment 1: Burden and consequences of child maltreatment in high-income countries. The Lancet, 373, 68–81.

38.

Goodwin

R. D.

Stein

M. B.

(2004). Association between childhood trauma and physical disorders among adults in the United States. Psychological Medicine, 34(3), 509– 520.

39.

Government of Tripura, 2007. Tripura human development report. Retrieved September 20, 2010, from http://tripura.nic.in/hdr/welcome.html.

40.

Grych

J. N.

Jouriles

E. N.

Swank

P. R.

McDonald

Norwood

W. D.

(2000). Patterns of adjustment among children of battered women. Journal of Consulting and Clinical Psychology, 68(1), 84–94.

41.

Herrera

Carey

K. T.

(1993). Child sexual abuse: Issues and strategies for school psychologists. School Psychology International, 14(1), 69–81.

42.

Higgins

D. J.

McCabe

M. P.

(2001). Multiple forms of child abuse and neglect: adult retrospective reports. Aggression and Violent Behavior, 6(6), 547–578.

43.

Howes

Eldredge

(1985). Responses of abused, neglected and non-maltreated children to the behaviors of their peers. Journal of Applied Developmental Psychology, 6(2–3), 261–270.

44.

Hughes

H. M.

(1988). Psychological and behavioral correlates of family violence in child witnesses and victims. American Journal of Orthopsychiatry, 58(1), 77–90.

45.

Hughes

H. M.

Luke

D. A.

(1998). Heterogeneity in adjustment among children of battered women. In Holden

G. W.

Geffner

Jouriles

E. N.

(Eds.), Children exposed to marital violence (pp. 185–221). Washington, DC: American Psychological Association.

46.

Hund

A. R.

Espelage

D. L.

(2006). Childhood emotional abuse and disordered eating among undergraduate females: Mediating influence of alexithymia and distress. Child Abuse and Neglect, 30(4), 393–407.

47.

Hunter

W. M.

Jain

Sadowski

L. S.

Sanhueza

A. I.

(2000). Risk factors for severe child discipline practices in rural India. Journal of Pediatric Psychology, 25(6), 435–447.

48.

Hussain

(1970). Mohsin-Shamhad adaptation of the Bell adjustment inventory. Patna: Psychological Scientific Works.

49.

Hussey

J. M.

Chang

J. J.

Kotch

J. B.

(2006). Child maltreatment in the United States: Prevalence, risk factors, and adolescent health consequences. Pediatrics, 118(3), 933–942.

50.

Indian School Psychology Association. (2010). Profile. Retrieved July 20, 2011, from http://inspa.info/about.html.

51.

Jain

(1972). Adjustment scale questionnaire. New Delhi: Agra Psychological Association Cell.

52.

Jimerson

S. R.

Stewart

Skokut

Caredenas

Malone

(2009). How many school psychologists are there in each country of the world? International estimates of school psychologists and psychologist-to-student ratios. School Psychology International, 30(6), 555–567.

53.

Kendall-Tackett

(2002). The health effects of childhood abuse: Four pathways by which abuse can influence health. Child Abuse and Neglect, 26(6–7), 715–730.

54.

Kendall-Tackett

K. A.

Williams

L. M.

Finkelhor

(1993). Impact of sexual abuse on children: A review and synthesis of recent empirical studies. Psychological Bulletin, 113, 164–180.

55.

Kingdon

G. G.

(2007). The progress of school education in India. Oxford Review of Economic Policy, 23(2), 168–105.

56.

Kliewer

Lepore

S. J.

Oskin

Johnson

P. D.

(1998). The role of social and cognitive processes in children’s adjustment to community violence. Journal of Consulting and Clinical Psychology, 66, 199–209.

57.

Kolko

D. J.

(2002). Child physical abuse. In Myers

Berliner

Briere

Hendrix

Jenny

Reid

(Eds.), The APSAC handbook on child maltreatment, (2nd edn. (pp. 21–54). Thousand Oaks, CA: Sage Publications.

58.

Kurtz

P. D.

Gaudin

J. M.

Howing

P. T.

Wodarski

J. S.

(1993). The consequences of physical abuse and neglect on the school age child: Mediating factors. Children and Youth Services Review, 15(2), 85–104.

59.

Lazarus

R. S.

(1976). Patterns of adjustment. New York, NY: McGraw-Hill Book Company.

60.

Lehtinen

Ozamiz

Underwood

Weiss

(2005). The intrinsic value of mental health. In Herrman

Saxena

Moodie

(Eds.), Promoting mental health: Concepts, emerging evidence, practice (pp. 46–57). Geneva: World Health Organisation, Department of Mental Health and Substance Abuse.

61.

Macdonald

(2001). Effective interventions for child abuse and neglect: An evidence-based approach to planning and evaluating interventions. Chichester: John Wiley & Sons.

62.

Malete

(2007). Aggressive and antisocial behaviours among secondary school students in Botswana: The influence of family and school based factors. School Psychology International, 28(1), 90–109.

63.

Margolin

Gordis

E. B.

(2000). The effects of family and community violence on children. Annual Review of Psychology, 51, 445–479.

64.

Martin

S. L.

Tsui

A. O.

Maitra

Marinshaw

(1999). Domestic violence in northern India. American Journal of Epidemiology, 150(4), 417–426.

65.

Mathur

Rathore

Mathur

(2009). Incidence, type and intensity of abuse in street children in India. Child Abuse and Neglect, 33(12), 907–913.

66.

May-Chahal

Cawson

(2005). Measuring child maltreatment in the United Kingdom: A study of the prevalence of child abuse and neglect. Child Abuse and Neglect, 29(9), 969–984.

67.

Mazzeo

S. E.

Espelage

D. L.

(2002). Association between childhood physical and emotional abuse and disordered eating behaviors in female undergraduates: An investigation of the mediating role of alexithymia and depression. Journal of Counseling Psychology, 49(1), 86–100.

68.

Miller

W. R.

Yahne

C. E.

Rhodes

J. M.

(1990). Adjustment: The psychology of change. Englewood Cliffs, NJ: Prentice Hall.

69.

Mohan

S. M.

Hussain

(1987). Mohsin-Shamhad adaptation of the Bell adjustment inventory (modified version). Patna: Psychological Scientific Works.

70.

Moore

T. E.

Pepler

D. J.

(2006). Wounding words: Maternal verbal aggression and children’s adjustment. Journal of Family Violence, 21(1), 89–93.

71.

Mukherjee

(2006). A Study on the Impact of Sexual Abuse on Mental Disposition of Girl Children. Unpublished Doctoral Thesis. Kolkata, India: University of Calcutta.

72.

Mullen

P. E.

Martin

J. L.

Anderson

J. C.

Romans

S. E.

Herbison

G. P.

(1996). The long-term impact of the physical, emotional, and sexual abuse of children: A community study. Child Abuse and Neglect, 20(1), 7–21.

73.

Ney

P. G.

Fung

Wickett

A. R.

(1994). The worst combination of child abuse and neglect. Child Abuse and Neglect, 18(9), 705–714.

74.

O’Keefe

(1996). The differential effects of family violence on adolescent adjustment. Child and Adolescent Social Work Journal, 13(1), 143–166.

75.

Pagare

Meena

G. S.

Jiloha

R. C.

Singh

M. M.

(2005). Sexual abuse of street children brought to an observation home. Indian Pediatrics, 42(1), 134–139.

76.

Pal

(1995). Social Adjustment Inventory. Agra: Agra Psychological Research Cell.

77.

Paliwal

T. R.

(1984). The prospects for school psychology in Indian schools. School Psychology International, 5(1), 27–30.

78.

Patel

Andrew

(2001). Gender, sexual abuse and risk behaviours in adolescents: A cross-sectional survey in schools in Goa. National Medical Journal of India, 14, 263–267.

79.

Patel

Flisher

A. J.

Nikapota

Malhotra

(2008). Promoting child and adolescent health in low and middle income countries. Journal of Child Psychology and Psychiatry, 49(3), 313–334.

80.

Peirson

Laurendeau

M.-C.

Chamberland

(2001). Context, contributing factors, and consequences. In Prilleltensky

Nelson

Peirson

(Eds.), Promoting family wellness and preventing child maltreatment: Fundamentals for thinking and action (pp. 41–123). Toronto: University of Toronto Press.

81.

Pereda

Guilera

Forns

Gomez-Benito

(2009). The prevalence of child sexual abuse in community and student samples: A meta-analysis. Clinical Psychology Review, 29(4), 328–338.

82.

Perez

C. M.

Widom

C. S.

(1994). Childhood victimization and long-term intellectual and academic outcomes. Child Abuse and Neglect, 18(8), 617–633.

83.

Phasha

T. N.

(2008). The role of the teacher in helping learners overcome the negative impact of child sexual abuse: A South African perspective. School Psychology International, 29(3), 303–327.

84.

Pinheiro

P. S.

(2006). World report on violence against children. Geneva, Switzerland: United Nations Secretary-General’s Study on Violence against Children.

85.

Polusny

M. A.

Follette

V. M.

(1995). Long-term correlates of child sexual abuse: Theory and review of the empirical literature. Applied and Preventive Psychology, 4(3), 143–166.

86.

Pouwels

Swales

Mccoy

Peddle

(2010). Child protection and child welfare in the Asia Pacific region: Discussion paper. High-Level meeting on Cooperation for Child Rights in the Asia-Pacific Region. Beijing, China, 4–6 November.

87.

Putnam

F. W.

(2003). Ten-year research update review: Child sexual abuse. Journal of the American Academy of Child and Adolescent Psychiatry, 42(3), 269–278.

88.

Rees

Seaton

(2011). Psychologists’ response to crises: International perspectives. School Psychology International, 32(1), 73–94.

89.

Roberts

O’Connor

Dunn

Golding

the ALSPAC Study Team. (2004). The effects of child sexual abuse in later family life; mental health, parenting and adjustment of offspring, Child Abuse and Neglect, 28(5), 525–545.

90.

Sadowski

L. S.

Hunter

W. M.

Bangdiwala

S. I.

Munoz

S. R.

(2004). The world studies of abuse in the family environment (WorldSAFE): A model of a multi-national study of family violence. International Journal of Injury Control and Safety Promotion, 11(2), 81 90–81 90.

91.

Saith

Wazir

(2010). Towards conceptualizing child wellbeing in India: The need for a paradigm shift. Child Indicators Research, 3(3), 385–408.

92.

Scherr

T. G.

(2007). Educational experiences of children in foster care: Meta-analyses of special education, retention and discipline rates. School Psychology International, 29(4), 419–438.

93.

Scudder

R. G.

Blount

W. R.

Heide

K. M.

Silverman

I. J.

(1993). Important links between child abuse, neglect, and delinquency. International Journal of Offender Therapy and Comparative Criminology, 37(4), 315–323.

94.

Sedlak

A. J.

(1993). Estimating the national prevalence of child abuse from sentinel data. Alexandria, VA: American Statistical Association.

95.

Segal

(1992). Child abuse in India: An empirical report on perceptions. Child Abuse and Neglect, 16(6), 887–908.

96.

Segal

U. A.

(1995). Child abuse by the middle class? A study of professionals in India. Child Abuse and Neglect, 19(2), 217–231.

97.

Shaffer

Yates

T. M.

Egeland

B. R.

(2009). The relation of emotional maltreatment to early adolescent competence: Developmental processes in a prospective study. Child Abuse and Neglect, 33(1), 36–44.

98.

Shen

A. C.

(2009a). Long-term effects of interparental violence and child physical maltreatment experiences on PTSD and behavior problems: A national survey of Taiwanese college students. Child Abuse and Neglect, 33(3), 148–160.

99.

Shen

A. C.

(2009b). Self-esteem of young adults experiencing interparental violence and child physical maltreatment: Parental and peer relationships as mediators. Journal of Interpersonal Violence, 24(5), 770–794.

100.

Silverman

A. B.

Reinherz

H. Z.

Giaconia

R. M.

(1996). The long-term sequelae of child and adolescent abuse: A longitudinal community study. Child Abuse and Neglect, 20(8), 709–723.

101.

Simmel

Flanzer

S. M.

Webb

M. B.

(2006). A new look at ethical issues in child maltreatment research. In Feerick

M. M.

Knutson

J. F.

Trickett

P. K.

Flanzer

S. M.

(Eds.), Child abuse and neglect: Definitions, classifications, and a framework for research (pp. 359–384). London: Paul H Brookes Publishing Co.

102.

Singh

H. M.

(1974). The adjustment inventory. New Delhi: Agra Psychological Research Cell.

103.

Steele

(1976). Violence within the family. In Helfer

R. E.

Kempe

C. H.

(Eds.), Child abuse and neglect: The family and the community (pp. 3–24). Cambridge, MA: Ballinger.

104.

Stoltenborgh

van Ijzendoorn

M. H.

Euser

E. M.

Bakermans-Kranenburg

M. J.

(2011). Global perspective on child sexual abuse: Meta-analysis of prevalence around the world. Child Maltreatment, 16(2), 70–101.

105.

Straus

M. A.

Hamby

S. L.

Finkelhor

Moore

D. W.

Runyan

(1998). Identification of child maltreatment with the Parent-Child Conflict Tactics Scales: Development and psychometric data for a national sample of American parents. Child Abuse and Neglect, 22(4), 249–270.

106.

Straus

M. A.

Smith

(1990). Family patterns and child abuse. In Straus

M. A.

Gelles

R. J.

(Eds.), Physical violence in American families: Risk factors and adaptations to violence in 8,145 families (pp. 507–525). New Brunswick, NJ: Transaction Publishing.

107.

Theron

L. C.

Donald

D. R.

(2012). Educational psychology and resilience in developing contexts: A rejoinder to Toland and Carrigan (2011). School Psychology International, DOI:10.1177/0143034311425579–DOI:10.1177/0143034311425579.

108.

Thompson

M. P.

Kingree

J. B.

Desai

(2004). Gender differences in long-term health consequences of physical abuse of children: Data from a nationally representative survey. American Journal of Public Health, 94(4), 599–604.

109.

Toland

Carrigan

(2011). Educational psychology and resilience: New concept, new opportunities. School Psychology International, 32(1), 95–106.

110.

UNICEF. (2003). A league table of child maltreatment deaths in rich nations: Innocenti report card number 5. New York, NY: UNICEF Division of Communication.

111.

UNICEF. (2005). Multiple indicator cluster surveys (MICS). New York, NY: Strategic Information Section, Division of Policy and Planning.

112.

UNICEF. (2009). Progress for children: A report card on child protection: Innocenti report card number 8. New York, NY: UNICEF Division of Communication.

113.

UNICEF. (2011). State of the world’s children: Adolescence an age of opportunity. New York, NY: UNICEF Division of Communication.

114.

Van Roode

Dickson

Herbison

Paul

(2009). Child sexual abuse and persistence of risky sexual behaviors and negative sexual outcomes over adulthood: Findings from a birth cohort. Child Abuse and Neglect, 33(3), 161–172.

115.

Varia

Abidin

R. R.

Dass

(1996). Perceptions of abuse: Effects on adult psychological and social adjustment. Child Abuse and Neglect, 20(6), 511–526.

116.

Watts

(1997). Responding to child abuse: A handbook for teachers. Rockhampton, QLD: Central Queensland University Press.

117.

Widom

C. S.

White

H. R.

(1997). Problem behaviours in abused and neglected children grown up: prevalence and co-occurrence of substance abuse, crime and violence. Criminal Behaviour and Mental Health, 7(4), 287–310.

118.

Woods

Bond

Tyldesley

Farrell

Humphrey

(2011). The role of school psychologists in child protection and safeguarding. School Psychology International, 32(4), 361–376.

119.

World Health Organisation. (2002). World report on violence and health. Geneva: World Health Organisation, Office of Publications.

120.

Yates

T. M.

(2007). The developmental consequences of child emotional abuse: A neurodevelopmental perspective. Journal of Emotional Abuse, 7(2), 9–34.

121.

Ying

Lin

(2012). Longitudinal linkages between depressive and posttraumatic stress symptoms in adolescent survivors following the Wenchuan earthquake in China: A three-wave, cross-lagged study. School Psychology International, 33(4), 416–432. published online as doi: 10.1177/0143034311421271.

122.

Zolotor

A. J.

Runyan

D. K.

Dunne

M. P.

Jain

Peturs

Ramireze

Volkovaf

Deb

Lidchih

Muhammadi

Isaevaf

(2009). ISPCAN Child abuse screening tool children’s version (ICAST-C): Instrument development and multi-national pilot testing. Child Abuse and Neglect, 33(11), 833–841.

Nature of violence	Sample group		Total (n = 320) %	Chi-square (p-value)	Level of significance
Nature of violence	Boys (n = 160) %	Girls (n = 160) %	Total (n = 320) %	Chi-square (p-value)	Level of significance
Physical	24.4	19.4	21.9	1.17	NS
Physical	(39/160)	(31/160)	(70/320)	(0.2793)
Psychological	21.9	20.0	20.9	0.17	NS
Psychological	(35/160)	(32/160)	(67/320)	(0.6802)
Sexual	11.3	25.0	18.1	10.19	0.01
Sexual	(18/160)	(40/160)	(58/320)	(0.0014)