Browsing by Author "Chandraratne, N.K."

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Association of attachment with parents and abusive experiences during childhood
(Sri Lanka Medical Association, 2016) Chandraratne, N.K.; Fernando, A.D.; Gunawardena, N.S.
INTRODUCTION: Improving parent-child attachment is considered to be an effective intervention in preventing child abuse. OBJECTIVES: This study is aimed at determining the association between parent-child attachment and experience of abuse during childhood. METHOD: A cross sectional analytical study was conducted among a representative sample of 1479 schooling young adults aged 18-20 years in Gampaha District, selected using a multi-stage cluster sampling method. Experience of abuse during childhood were determined using the self-administered locally validated tool SICAST-R. Parent-child attachment was determined using Inventory of Parent and Peer Attachment (IPPA), a self-administered tool, which measures the attachment to parents during childhood in the dimensions of communication, trust and alienation. RESULTS: The prevalence rates for abusive experience during childhood were 45.4% (95% CI=42.9–47.9), 9.1% (95% CI=7.6-10.5) and 27.9% (95% CI=25.7–30.2) for physical, sexual and emotional abuse respectively. All three dimensions that describe the attachment with the mother were significantly associated with being physically (poor trust:OR=3.71, 95% CI=1.52-9.05; poor communication: OR=1.72, 95%CI=0.89-3.35; presence of alienation: OR=2.63, 95%CI=1.72-4.00), sexually (poor trust: OR=3.62, 95%CI=1.07-12.25; poor communication :OR=2.44, 95% CI=1.01-5.92; presence of alienation: OR=3.89, 95% CI=2.22-6.81) and emotionally (poor trust: OR=6.56, 95% CI=2.88-14.91; poor communication: OR=3.19, 95% CI=1.78-5.71; presence of alienation: OR=3.32, 95% CI=2.21-4.98) abused during childhood. Similarly, aall three dimensions that describe the attachment with the father were significantly associated with being physically (poor trust: OR =3.16, 95%CI = 1.92-5.19; poor communication: OR=2.72, 95%CI=1.57-4.72; presence of alienation: OR=2.53, 95%CI=1.80-3.56), sexually (poor trust: OR=2.49, 95%CI = 1.18-5.29; poor communication: OR = 3.28, 95%CI = 2.27-4.74; presence of alienation: OR = 2.55, 95%CI = 1.54-4.22) and emotionally (poor trust: OR = 3.29, 95%C I= 2.00-5.39; poor communication:OR = 4.47, 95%CI = 2.05-9.73; presence of alienation: OR=3.21, 95%CI = 2.30-4.48) abused during childhood. CONCLUSIONS: Poor attachment with parents is associated with abusive experience during childhood. Public Health Programmes should focus on improving parent-child attachment.
Cultural adaptation, translation and validation of the ISPCAN Child Abuse Screening Tool - Retrospective Version (ICAST-R) for young adults in Sri Lanka
(Elsevier Science Inc, 2018) Chandraratne, N.K.; Fernando, A.D.; Gunawardena, N.
The aim of the present study was to adapt and validate the ISPCAN child abuse screening tool-retrospective version (ICAST-R) in Sri Lanka with a view to investigating the experiences of physical, sexual and emotional abuse during childhood. The adaptation was performed using qualitative research methods with young adults, parents, teachers, and a multidisciplinary group of experts. The translation to Sinhala (the local Sri Lankan dialect) was carried out by a nominal group technique. A multidisciplinary team of experts assessed the Sinhala ICAST-R (SICAST-R) for its content validity. Moreover, acceptability, reliability and construct validity were determined by conducting a validation study among 200 schooling young adults. The principal component analysis (PCA) technique was used to assess the construct validity. Response rates for each item were taken as evidence of acceptability. The internal consistency was assessed by Cronbach's alpha, and test-retest reliability after two weeks was assessed using Cohen's kappa coefficient. The adaptation of ICAST-R included the introduction of an objective manner by which to measure severity of abuse and the inclusion of a set of questions regarding help-seeking behavior following physical and emotional abusive experiences. The SICAST-R showed adequate content validity and high acceptability, with response rates ranging from 90.3% to 99.5%. The minimum Cohen's kappa coefficient was 0.76, indicating good test-retest reliability. The internal consistency (Cronbach's alpha) for the total tool was 0.708, with the three constructs being 0.398, 0.844 and 0.637 for physical, sexual and emotional abuse, respectively. The PCA demonstrated good reproducibility for sexual and emotional abuse with the hypothesized structure. Overall, the SICAST-R showed adequate validity for the assessment of experiences of physical, sexual and emotional abuse during childhood among Sri Lankan young adults.
Physical, sexual and emotional abuse during childhood: Experiences of a sample of Sri Lankan young adults
(Elsevier Science Inc, 2018) Chandraratne, N.K.; Fernando, A.D.; Gunawardena, N.
Abuse during childhood is a human tragedy leading to lifelong adverse health, social, and economic consequences for survivors. This descriptive, cross-sectional study aimed to determine the prevalence of childhood physical, sexual and emotional abusive experiences among students (aged 18-19 years) in a Sri Lankan district. Multistage cluster sampling was used to select a sample of 1500 students. Experiences of physical, sexual and emotional abuse and age at abuse, perpetrators, consequences and severity were assessed using a version of ISPCAN Child Abuse Screening Tool-Retrospective Version (ICAST-R) which was culturally adapted and validated by the authors for use amongst Sinhalese students. The prevalence of the various forms of abuse during childhood was as follows: physical: 45.4% (95% CI: 42.9-7.9); sexual: 9.1% (95% CI: 7.6-10.5); emotional: 27.9% (95% CI: 25.7-30.2). The corresponding percentages of individuals categorized as having experienced severe or very severe abuse were as follows, physical: 0.3% (2/672); sexual: 4.05% (3/135); emotional: 8.8% (36/412). Experience of physical abuse was more prevalent amongst male students (54.8% vs. 38.3%) as was emotional abuse (33.9% vs. 23.2%), whereas experience of sexual abuse was more prevalent amongst female students (11.5% vs. 6.4%). Parents and teachers were the commonest perpetrators of physical and emotional abuse. Most of the sexually abusive acts were committed by neighbors or strangers. Some physically abusive acts were more frequent at earlier ages than emotional and sexual abusive acts, which were more common in late adolescence. The results indicate the necessity of targeted interventions to address this public health issue.
Prevalence and severity of abusive experiences during childhood among a group of young adults from Gampaha District
(Sri Lanka Medical Association, 2016) Chandraratne, N.K.; Fernando, A.D.; Gunawardena, N.S.
INTRODUCTION: Abuse during childhood is a public health problem leading to adverse health, social and economic consequences. OBJECTIVES: The study aims to determine the prevalence and severity of physical, sexual and emotional abuse during childhood among young adults aged 18-20 years schooling in the Gampaha District. METHOD: A descriptive cross-sectional study was conducted among 1500 schooling young adults selected by multistage cluster sampling. The prevalence of physical, sexual and emotional abuse was ascertained using the validated version of ICAST-R (ISPCAN Child Abuse Screening Tool-Retrospective Version). The severity of abusive experiences was assessed using a tool developed by the researchers based on modified Delphi technique. RESULTS: Prevalence of physical abusive experiences during childhood was 45.4% (95%CI = 42.9–47.9) (males- 54.8%, 95%CI = 51.1–58.8, females- 38.3%, 95%CI = 35.0–41.3), prevalence of severe physical abuse was 0.1%.. Being 'beaten by an object' was the commonest experience among both males (45.9%, 95% CI = 42.8–49.8) and females (32.0%, 95% CI = 28.7-35.6). Prevalence of sexual abuse during childhood was 9.1% (95% CI=7.6-10.5) (males: 6.4%, 95%CI=4.6–8.3, females: 11.5%,95%CI = 9.4–13.7), prevalence of severe sexual abuse was 0.2%. ‘Someone exposing their genitals’ was the commonest act (9.1%, 95%CI = 7.1-11.1) experienced by females and ‘Someone touching the genitals’ was the commonest act (4.0%, 95%CI = 2.5-5.7) experienced by males. Prevalence of emotional abuse during childhood was 27.9% (95%CI = 25.7–30.2) (males: 33.9%, 95%CI = 30.4–37.3, females: 23.2%,95% CI = 20.3–26.1) severe emotional abuse was seen among 2.4%. Insulting or criticizing was the most common abusive act among both males (29.5%, 95%CI = 26.2-33.1) and females (20.1%, 95%CI = 17.2-22.9). CONCLUSIONS: Prevalence of physical, sexual and emotional abusive experiences during childhood were high among schooling young adults in the Gampaha District. This calls for targeted interventions.