UNICEF has highlighted how children suffer violence throughout all stages of childhood and adolescence, in different contexts, and often at the hands of people they trust and interact with on a daily basis. Violent corporal punishment, 300 million children between 2 and 4 years old in the world regularly suffer violence from their family/guardians (about 3 out of 4), 250 million of these are punished physically (about 6 out of 10). Sexual violence, Sexual violence occurs against children of all ages: 15 million girls aged 15 to 19 have experienced incidents of sexual violence in their lives, and 2.5 million young women in 28 European countries report having suffered episodes of sexual violence before the age of 15.

1. Abuse and mistreatment
in the adolescent period.
by Dr. Bozzi Domenico
(Master's Degree in Psychology)

2. The statistic that alarms society and the
scientific world
UNICEF has highlighted how children suffer violence throughout
all stages of childhood and adolescence, in different contexts,
and often at the hands of people they trust and interact with on
a daily basis.
Violent corporal punishment, 300 million children between 2 and
4 years old in the world regularly suffer violence from their
family/guardians (about 3 out of 4), 250 million of these are
punished physically (about 6 out of 10).
Sexual violence, Sexual violence occurs against children of all
ages: 15 million girls aged 15 to 19 have experienced incidents
of sexual violence in their lives, and 2.5 million young women in
28 European countries report having suffered episodes of
sexual violence before the age of 15.

3. • Violence at school
• Half of students aged 13 to 15 – around 150 million – reported having experienced
violence from their peers at and outside school. In Italy, 37% of students of the same age
reported having been bullied at school at least once in the last two months and/or having
been involved in physical fights at least once in the last year.
• Violent deaths among adolescents
• a teenager is killed in an act of violence around the world , particularly in the 15-19 age
group. Although fatalities at sites of armed conflict are common, the majority of violent
deaths result from interpersonal violence.
In 2015, approximately 51,000 adolescent homicides occurred worldwide , accounting for
1 in 9 victims that year. Many factors – including gender, ethnicity and social exclusion –
increase the risk of violence and violent death.
• Gender Violence
• Gender-based violence remains a scourge, exacerbated and strengthened by gender
discrimination and harmful gender norms. Girls are particularly at risk of sexual
harassment and assault, especially in adolescence and during humanitarian crises.

4. Puberty and Adolescence
Adolescence is the period of time between the beginning of
sexual maturation (puberty) and adulthood;
The word adolescence derives from the Latin "adolescere", to
grow, develop, become big, and is a new phase of the
individual's development characterized by the physiological
phenomenon of puberty, adolescence is both a physical and
psychological phenomenon.
Therefore a beginning marked by puberty with its strictly
physical and biological phenomena, adolescence is configured
essentially as a psychological and social dimension and from
sexual maturity onwards corresponds to the need on the part of
the adolescent to become independent from his parents or to
prepare for to be so, and it is precisely the drive and behaviors
of autonomy that are initially partial and then progressive which
represent a characteristic and evident phenomenon of the
adolescent phase for its entire duration.

5. Puberty and Adolescence
• Delimiting the beginning of adolescence is quite easy, it is determined
with the first expressions of the so-called secondary sexual
characteristics, with puberty.
• The end of adolescence, however, does not have a characteristic
physiological correlate as it is a psychological, individual and social
phenomenon and therefore varies according to the various eras and
different cultures and if the various historical eras are analyzed to
document the constancy of puberty as opposed to the diversity of
adolescence proper, the second can be considered as the psychosocial
expression of the first (Jeammet P., 2005)

6. • Considering US data, almost one in five adolescents has a diagnosable mental
health disorder, 30% of high school students have developed symptoms of
depression and 18% have reported having seriously considered suicide
(Centers for Disease Control and Prevention, 2016; Substance Abuse and
Mental Health Services Administration, 2014, 2015).
• Furthermore, 70% of youth who have been exposed to the juvenile justice
system have a mental illness (Shufelt & Cocozza, 2006). Furthermore, high
school students with mental illnesses have a higher dropout rate than all other
disability groups (US Department of Education, 2014).
• Suicide is currently the third leading cause of death for individuals ages 10 to
14 and the second leading cause of death for those ages 15 to 24 (Centers for
Disease Control and Prevention, 2015).

7. Although these numbers are worrying, there is evidence
that mental disorders can be treated, mitigated and
managed, but early identification and support from the
people around the adolescent is needed (National
Research Council and Institute of Medicine, 2009).
While risk factors for depression, anxiety, and suicide in
adolescents have been the focus of much research, less
is known about the protective factors surrounding these
conditions ( Beesdo , Knappe , & Pine, 2009

8. Protective and Risk Factors
• A key protective factor is a healthy network of peers even though they
may sometimes have a negative influence on each other (Prinstein,
Boergers, & Spirito, 2001; Smith, Chein, & Steinberg, 2014), the
importance of these studies is to focus on the positive impact of peer
relationships. Beginning in the adolescent years, children rely less on
their parents for support and begin to turn to their peer group for
support (American Psychological Association, 2002; Furman &
Buhrmester, 1992). This is a normal part of the developmental process
and often means that teenagers feel more comfortable confiding in
friends rather than parents or other adults.

9. Protective and Risk Factors
• Peers and friends are at the forefront of interactions with peers with mental
disorders; therefore, it is important to understand the role of peers in this
period of development, especially in relation to mental health. Because of
the variety of peer relationships among adolescents and different cultures
(French, 2015; Rude & Herda, 2010), studies have been limited to those
conducted in the United States and to those representing multiple racial and
ethnic groups, to understand the nature general peer influence in the United
States. The studies selected were those that focused on the supportive role
of peer relationships, rather than the negative role of peer relationships.
University students were excluded. At study entry, the ages of study
participants ranged from 12 to 18 years.

10. • The researchers used several variables to measure peer-related concepts:
type of relationship with peers, social support, close friendship, friendship
network, friendships, peer support, social status, social interactions, social
relationships, friendship support and competence in close friendships.
• Many researchers have examined peer support and depression in the
adolescent population. Czyz et al. (2012) found that peer bonding improved
adolescents' depressive symptoms 3, 6, and 12 months after psychiatric
hospitalization. Jacobson and Newman's (2016) analysis found perceptions
of group and close friendships in adolescents provided a mediating effect on
levels of depression in adults, using Add Health data, which consisted of a
nationally representative sample of middle and high school students.
• Results from Kornienko and Santos' (2014) study indicated that in males
with high levels of social anxiety, an increase in friendship popularity was
associated with a decrease in depressive symptoms. However, the opposite
occurred for females, where friendship popularity was associated with
increased depressive symptoms in girls with high levels of social anxiety.

11. • The data were collected after 8 months and the sample was made up of first
and second grade students. The work of Miller et al. (2014) demonstrated
that strong friendships predicted depression in adolescents at risk or who
reported maltreatment. This result is inconsistent with the researcher's
hypothesis. Although the data in this study were collected at ages 4, 6, 8, 12,
14, 16, and 18, for the purposes of this study the data were analyzed at ages
16 and 18.
• Newman et al. (2007) specifically assessed eighth-grade students' transition
to high school and found that changes in peer support were associated with
increases in depressive symptoms during this period. Pachucki et al. (2015)
found that girls with more depressive symptoms were more likely to exhibit
social inhibition and that girls with higher self-esteem were more likely to
have more social interactions and higher social status. This study was
limited to participants from a small private school in an urban California
setting. In the context of non-continuity in romantic relationships.

12. • In addition to examining peer support and depression,
researchers have also studied the correlation between peer
support and suicide. Czyz et al. (2012) found that adolescents
were half as likely to attempt suicide during a 12-month
period after hospitalization for suicidal intent or ideation or a
suicide attempt if they reported improvements in bonds with
peers during the same period of time.
• Assessing social connectedness, Rew et al. (2013) determined
that social connectedness was a predictor for all types of
health-promoting behaviors, including stress management.

13. • The findings were consistent in finding peer support as a
protective factor against suicide, depression, anxiety and
stress, and was positively correlated with mental well-being,
self-esteem and optimism. The exceptions are represented by
the studies by Miller et al. (2014) and Kornienko and Santos
(2014).
• Participants in these studies were adolescents who had
confounding circumstances such as risk or history of
maltreatment or social anxiety. Miller et al. (2014)
hypothesized that for some adolescents, maintaining close
friendships over time could increase stress and lead to
increased depression and suicidal ideation.

14. • There are individuals who are more likely to develop a psychological illness than
the average population, to experience a condition of discomfort and to develop a
psychopathology.
• Protective factors are made up of resources or conditions that concern the
individual, the family, the school, community and social context, capable of
counteracting or reducing the impact of risk factors or said in another way, they
are able to help support and promote the compatibility of the individual with the
social environment.
• Among the protective factors we can include the individual abilities of the subject
such as self-efficacy, resilience, coping strategies which are made up of the mental
and behavioral solutions that a person implements to manage and deal with
problematic situations.
• Coping skills therefore characterize adaptation to a stressful situation and are a
dynamic process aimed at managing the balance between the individual and the
environment. Unfortunately, adaptation does not always have a positive outcome.
Sometimes the skills used in some stressful situations are not suitable for
managing them, so they tend to amplify the stressful event. In this case we talk
about dysfunctional coping as it leads to an increase in stress.

15. • Even the possibility of counting on at least one reference person (system of
relationships and social support), the possibility of counting on a social
network of help are factors that protect the child or adolescent in adapting to
a stressful situation.
• As regards risk factors, however, we must take into account that various
research has suggested that abandonment is the type of abuse associated
with the highest risk of future maltreatment (DePanfilis D, Zuravin S J.,
2002; Fluke JD, Yuan YYT, Edwards M., 1999; Fryer GE, Miyoshi T J.,
1994). Another risk factor is family conditions, families that have family
members in prison or families that are isolated and not connected to other
people (extended family, friends, neighbors), families that suffer other types
of violence, including relational violence, families with high conflict and
negative communication styles.

16. • Then there are the emotional difficulties of the child and adolescent,
the difficulty or inability to control and regulate their emotions and
impulses, school problems, the ecological context, constitutional
handicaps, interpersonal problems, developmental delays/difficulties
in development.
• Among the family conditions, low social class, family conflicts,
parental problems (mental illness, depression, substance abuse), large
family, poor bond with parents, emotional deficiencies, disorganized
family, distorted communication emerge.

17. • Among the emotional difficulties, childhood abuse, emotional apathy or insensitivity,
stressful life events, low self-esteem, difficulty in controlling emotions emerge. Among
the school problems, school failures and demotivation emerge.
• Among the factors linked to the community context, the very poor disorganized
neighborhood with few services, with malfunctioning services, with scattered and non-
integrated networks, an unsupportive environment, lack of formal and informal control,
racial injustice, unemployment and extreme poverty emerge.
• Among the constitutional handicaps, perinatal complications, sensory disabilities, organic
handicaps and neurochemical disorders emerge.
• Interpersonal problems include peer rejection, isolation and alienation.
• Among the developmental delays/difficulties in development we have intellectual deficit,
social incompetence, attention deficit, learning disorder, poor working skills.
Mistreatment and abuse can be expressed in different ways such as physical mistreatment,
psychological mistreatment, assisted violence, sexual abuse, online abuse, pathology of
care (serious neglect/neglect, lack of care, overcare) and also to touch on very current
bullying and cyberbullying

18. • With the term "risk" we are talking about activities that can cause damage to the
development of children and adolescents characterized by unfavorable situations
that induce an imbalance between the resources available to the child and the
factors of disadvantage, also considering the family and social context in which he
moves.
• Different risk factors can in combination determine situations capable of favoring
mistreatment and abuse (Sullivan PM, Knutson D., 2000). Some characteristics of
the child, parents and environment can put a child at risk of maltreatment (Cirillo
G., 2011).

19. • It seems that the age of the child is very important in the sense that the younger the child,
the higher the risk of severe and fatal maltreatment, then the child may have health
problems such as chronic diseases, physical and developmental disabilities, preterm birth ,
being unwanted or unplanned, emotional and behavioral difficulties (Wu SS, Ma CX,
Carter RL, et al., 2004); for parents, low self-esteem, poor impulse control (aggression,
hostility...), substance/alcohol abuse, the young age of the mother or father, depression or
other mental illnesses (including reactive paternal depression (Takehara K. et al., 2016),
poor interactions of mothers or fathers with their children, poor knowledge of their
development or unrealistic expectations towards them, negative conception of children's
behavior of their children, the negative perception of their normal development
(Brofenbrenner U., 1986).
• These parental factors can make children more vulnerable to being abused. Furthermore,
they generate the risk of physical abuse which continues in the first years following if
present at birth (Kotch JB et al., 1999).

20. • The young age of the mother or father as a risk factor must prompt
support and support interventions, taking care of the adult in difficulty,
to alleviate any major difficulties that these parents may experience in
raising their children/ and (Sidebotham P., Golding J., 2001).
• Other risk factors should also be considered such as environmental
factors, social isolation, unsupportive family and social environment,
unsatisfactory marital relationships or couple conflicts (physical or
verbal aggression between parents) and stressful life events, poverty
and unemployment. , poor educational level, presence of more than
one child to look after, a house with a single parent, cohabiting men
not biologically linked to the child, family violence. Often many
factors coexist and are interrelated, thus increasing the risk of
mistreatment.

21. • The importance of family relationships has also emerged in studies in which,
regardless of the type of violence, the same family dynamics are considered at risk
if characterized, for example, by a lack of clarity in the definition and management
of roles and by difficulties in communication (Paavilainen E et al.2001).
• With the term "risk" we are talking about activities that can cause damage to the
development of children and adolescents characterized by unfavorable situations
that induce an imbalance between the resources available to the child and the
factors of disadvantage, also considering the family and social context in which he
moves. Different risk factors can in combination determine situations capable of
favoring mistreatment and abuse (Sullivan PM, Knutson D., 2000).

22. • Some characteristics of the child, parents and environment can put a child at
risk of maltreatment (Cirillo G., 2011). It seems that the age of the child is very
important in the sense that the younger the child, the higher the risk of severe
and fatal maltreatment, then the child may have health problems such as chronic
diseases, physical and developmental disabilities, preterm birth , being
unwanted or unplanned, emotional and behavioral difficulties (Wu SS, Ma CX,
Carter RL, et al., 2004);
• for parents, low self-esteem, poor impulse control (aggression, hostility...),
substance/alcohol abuse, the young age of the mother or father, depression or
other mental illnesses (including reactive paternal depression (Takehara K. et
al., 2016), poor interactions of mothers or fathers with their children, poor
knowledge of their development or unrealistic expectations towards them,
negative conception of children's behavior of their children, the negative
perception of their normal development (Brofenbrenner U., 1986).These
parental factors can make children more vulnerable to being maltreated.

23. • Furthermore, they generate the risk of physical abuse which continues
in the first years following if present at birth (Kotch JB et al., 1999).
The young age of the mother or father as a risk factor must prompt
support and support interventions, taking care of the adult in difficulty,
to alleviate any major difficulties that these parents may experience in
raising their children/ and (Sidebotham P., Golding J., 2001).
• Other risk factors should also be considered such as environmental
factors, social isolation, unsupportive family and social environment,
unsatisfactory marital relationships or couple conflicts (physical or
verbal aggression between parents) and stressful life events, poverty
and unemployment. , poor educational level, presence of more than
one child to look after, a house with a single parent, cohabiting men
not biologically linked to the child, family violence. Often many
factors coexist and are interrelated, thus increasing the risk of
mistreatment.

24. • The importance of family relationships has also emerged in studies in
which, regardless of the type of violence, the same family dynamics
are considered at risk if characterized, for example, by a lack of clarity
in the definition and management of roles and by difficulties in
communication (Paavilainen E et al.2001).
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• By Dr. Bozzi Domenico (Master's Degree in Psychology)