Patterns of family violence change during the pandemic

Among teens treated for injuries caused by domestic violence, the proportion of incidents involving drugs or illegal weapons more than doubled during the pandemic, and incidents involving alcohol nearly doubled, according to data presented on October 10 at the American Academy of Pediatrics 2021. National Conference.

“The COVID-19 pandemic has amplified risk factors known to increase family interpersonal violence, such as the increased need for parental supervision, parental stress, financial difficulties, poor mental health and isolation,” said Johns Hopkins medical candidate investigator Mattea Miller. Baltimore University School of Medicine.

To examine the issue, she and her colleagues “sought to characterize the prevalence and circumstances of adolescent injuries resulting from family interpersonal violence,” Miller said. Medscape Medical News.

Their retrospective analysis focused on children aged 10 to 15 seen before or during the pandemic in the emergency department of the Johns Hopkins Children’s Center for injuries resulting from a violent incident with a family member.

Of the 819 incidents of violence-related injuries observed during the study period – the pre-pandemic occurred from January 1, 2019 to March 29, 2020, and the pandemic period occurred from March 30, 2020, date first issued in Maryland, as of Dec.31, 2020 – 448 (54.7%) involved a family member. The proportion of these injuries was similar before and during the pandemic (54.6% vs. 54.9%; P = .99).

Most (83.9%) of these incidents occurred at home, 76.6% involved a parent or guardian and 66.7% involved the youth taken to hospital by the police.

Seeing so much teen violence was unexpected.

It is surprising that families represent such a high level of violence involving adolescents, said Christopher S. Greeley, MD, MS, head of the pediatric public health division at Texas Children’s Hospital and professor of pediatrics at Baylor College of Medicine in Houston, who was not involved in the research.

“The most common source of physical abuse in young children – infants and toddlers – are parents,” who account for about 75% of cases, “but seeing so much violence among adolescents was unexpected,” a- he declared. Medscape Medical News.

Patients in the study cohort were more likely to be black than the general hospital emergency department population (84.4% vs. 60.0%) and more likely to be covered by public insurance (71.2% against 60.0%).

In the study cohort, 54.0% of patients were women.

“We were surprised to see that 8% of visits were not referred to a social worker” – 92% of patients in the study cohort received a social work consultation during their emergency room visit – and this number “has not changed. during the COVID-19 pandemic, ”Miller said. The pandemic has exacerbated the types of stress that social workers can help address, so “this potentially represents a gap in care that is important to fill,” she added.

Increased consumption of alcohol, drugs and weapons

The largest increases between the pre-pandemic period and the pandemic period were observed in incidents involving alcohol (10.0% vs. 18.8%; P ≤ 0.001), illegal drugs (6.5% vs. 14.9%; P ≤ 0.001) and weapons, most often a knife (10.7% vs. 23.8%; P .001).

“An obvious potential explanation for the increase in alcohol, drugs and guns [involvement] would be the impact of the pandemic on mental health in conjunction with the economic stressors that some families may experience, ”said Greeley. Teachers are the most common to report child abuse, so it is possible that reports of violence decreased when schools switched to distance learning. But with most schools returning to in-person learning, the data has yet to show an increase in reporting, he noted.

“The epidemiology of family violence can be affected by the increase in time spent at home, disruptions in school and family routines, exacerbations of mental health problems and the financial strains common during the pandemic,” said the study’s principal investigator, Leticia Ryan, MD, MPH, director of pediatric research at Johns Hopkins Medicine.

And research has shown an increase in alcohol and illegal drug use during the pandemic, she noted.

“As we move into post-pandemic life, it will be important to identify teens and families at risk and provide support,” Ryan said. Medscape Medical News. “The emergency department is an appropriate environment to intervene with young people who have experienced family violence and initiate prevention strategies to avoid future violence.

Identification and intervention strategies for at-risk patients include: ARTS AND CRAFTS substance use screening tool. And “case management, involvement of child protection services, and linkage to relevant support services may all be appropriate, depending on the circumstances,” Miller added.

“Exposure to domestic violence at a young age increases the likelihood that a child will be exposed to further violence or become a perpetrator in the future, thus continuing a cycle of violence,” Miller explained. “Since studies of adolescent violence often focus on peer-to-peer violence, a better understanding of the epidemiology of violence-related injuries resulting from family violence is needed to better inform the development of coping strategies. more comprehensive prevention. “

This study did not find any external funding. Miller, Greeley and Ryan did not disclose any relevant financial relationship .

American Academy of Pediatrics (AAP) National Conference 2021. Presented October 10, 2021.

Tara Haelle is a Dallas-based science and medical journalist.

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