The Equality Institute, Melbourne, VIC, Australia.
Department of Sociology, Emory University, Atlanta, GA, USA.
Lancet Glob Health. 2017 May;5(5):e512-e522. doi: 10.1016/S2214-109X(17)30103-1.
BACKGROUND: Although childhood trauma and violence against women are global public health issues, few population-based data from low-income and middle-income countries exist about the links between them. We present data from the UN Multi-country Study on Men and Violence in Asia and the Pacific, exploring the pathways between different forms of childhood trauma and violence against women. METHODS: In this multicountry study, we interviewed multistage representative samples of men and women, aged 18-49 years, in Asia and the Pacific, using standardised population-based household surveys. Men were interviewed in six countries, and women in four. Respondents were asked questions about their perpetration or experience of intimate partner violence or non-partner sexual violence, childhood trauma, and harsh parenting (smacking their children as a form of discipline). We used maximum likelihood multivariate logit models to explore associations between childhood trauma and violence against women, and fitted path models to explore associations between experience and perpetration of child maltreatment. FINDINGS: Between Jan 1, 2011, and Dec 1, 2012, 10 178 men and 3106 women completed interviews in this study, with between 815 and 1812 men per site and 477 and 1103 women per site. The proportion of men who experienced any childhood trauma varied between 59% (n=478, 95% CI 54·0-63·3; Indonesia rural site) and 92% (n=791, 89·4-93·8; Bougainville, Papua New Guinea). For women, the results ranged from 44% (n=272, 37·7-50·8; Sri Lanka) to 84% (n=725, 80·7-86·8; Bougainville, Papua New Guinea). For men, all forms of childhood trauma were associated with all forms of intimate partner violence perpetration. For women, all forms of childhood trauma were associated with physical intimate partner violence, and both physical and sexual intimate partner violence. There were significant, often gendered, pathways between men's and women's perpetration and experiences of childhood trauma, physical intimate partner violence, harsh parenting, and other factors. INTERPRETATION: The data point to both a co-occurrence and a cycle of abuse, with childhood trauma leading to violence against women and further child maltreatment, which in turn increases the risk of experience or perpetration of violence during adulthood. Efforts to prevent both forms of violence would benefit from a meaningful integrated approach. Interventions should promote positive parenting, address inequality and the normalisation of violence across the life course, and transform men's power over women and children. FUNDING: Partners for Prevention. National studies were funded by the UN Population Fund in Bangladesh and China, UN Women in Cambodia and Indonesia, UN Develoment Programme in Papua New Guinea, and CARE in Sri Lanka.
背景:尽管童年创伤和针对妇女的暴力是全球公共卫生问题,但来自低收入和中等收入国家的此类问题相关人群数据却很少。我们呈现了来自联合国亚洲及太平洋地区男性和暴力问题多国家研究的数据,该研究旨在探索不同形式的童年创伤与针对妇女的暴力之间的关联。
方法:在这项多国家研究中,我们在亚洲及太平洋地区使用标准化的基于人群的入户调查,对年龄在 18-49 岁的男性和女性进行了多阶段的代表性抽样调查。在六个国家对男性进行了访谈,在四个国家对女性进行了访谈。受访者被问及关于其实施或经历亲密伴侣暴力或非伴侣性暴力、童年创伤和严厉育儿(打孩子作为一种管教方式)的问题。我们使用最大似然多元逻辑回归模型来探索童年创伤与针对妇女的暴力之间的关联,并拟合路径模型来探索儿童虐待的实施和经历之间的关联。
结果:在 2011 年 1 月 1 日至 2012 年 12 月 1 日期间,本研究中共有 10178 名男性和 3106 名女性完成了访谈,每个地点的男性受访者人数在 815 至 1812 人之间,女性受访者人数在 477 至 1103 人之间。经历任何形式童年创伤的男性比例在 59%(n=478,95%CI 54·0-63·3;印度尼西亚农村地区)至 92%(n=791,89·4-93·8;巴布亚新几内亚的布干维尔岛)之间不等。对于女性,结果范围从 44%(n=272,37·7-50·8;斯里兰卡)到 84%(n=725,80·7-86·8;巴布亚新几内亚的布干维尔岛)不等。对于男性,所有形式的童年创伤都与所有形式的亲密伴侣暴力实施有关。对于女性,所有形式的童年创伤都与身体亲密伴侣暴力有关,同时也与身体和性亲密伴侣暴力有关。男性和女性的实施和经历童年创伤、身体亲密伴侣暴力、严厉育儿以及其他因素之间存在显著的、通常是性别差异的关联。
解释:这些数据表明存在虐待的同时发生和循环,即童年创伤导致针对妇女的暴力,并进一步导致儿童虐待,而这反过来又增加了成年期间经历或实施暴力的风险。预防这两种形式的暴力都将受益于一种有意义的综合方法。干预措施应促进积极育儿,解决整个生命周期中不平等和暴力行为的常态化问题,并改变男性对妇女和儿童的权力。
资金:预防伙伴关系。国家研究由联合国人口基金在孟加拉国和中国、联合国妇女署在柬埔寨和印度尼西亚、联合国开发计划署在巴布亚新几内亚以及 CARE 在斯里兰卡提供资金支持。
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