Health Impacts and Medical Interventions on Physical Violence Among Adolescents: A Review And Strategies in Indonesia

Introduction: Violence against adolescents is a global public health issue with significant impacts on physical and psychological health. Data shows that many children around the world experience physical, sexual, or emotional violence, with a high prevalence in Indonesia. Based on data from the 2013 Child Violence Survey, violence against adolescents in Indonesia remains very high, with significant impacts on their physical and psychological health, as well as their academic performance.

Objective: This study aims to identify the causes of violence, including family dynamics, social media, and mental health, as well as its impacts, such as health disorders and decreased academic performance.

Review: Various factors causing physical violence among adolescents in Indonesia include family influence, social media, and peers. The impact is very detrimental, both in the short and long term, both in terms of physical and mental health. The findings indicate the need for early intervention and additional education in schools to effectively address adolescent violence. The synergy between various disciplines at the Faculty of Medicine is key to creating evidence-based prevention strategies. To mitigate the negative impact, additional education in schools and early interventions involving various disciplines are greatly needed. The synergy between educational programs, government policies, and social support is key to preventing violence. With the strengthening of legal protection, as well as increased attention from parents and the social environment, it is hoped that a safer environment for teenagers can be created.

Summary: Overall, this review emphasizes the importance of holistic interventions involving families, schools, and communities to address violence among adolescents and improve their quality of life. There is a need for preventive efforts that involve education in schools, family interventions, and stricter government policies. The success of preventing and addressing physical violence among adolescents heavily relies on the collaboration of all parties involved.

INTRODUCTION

Violence is a behavior that is intentionally carried out, causing physical injury or psychological distress. Campbell and Humphrey define child violence as any action that harms or potentially endangers the health and well-being of a child, carried out by individuals who have responsibility for that child. This responsibility can be held by family, friends, or the surrounding community (¹). It is estimated that around 50% or more of the 1 billion children worldwide aged 2 to 17 years experienced physical, sexual, and emotional violence or neglect in one year in 2018, particularly in the regions of Africa, Asia, and North America. A 2002 report by the World Health Organization (WHO) showed a decline in the quality of life for women due to acts of violence, with mortality rates reaching 40-70% as a result of violence perpetrated by partners. In the United States, every 9 minutes a woman becomes a victim of physical violence, and 25% of women are killed by their male partners (²).

Based on the results of the Child Violence Survey in 2013, it was found that violence against adolescents in Indonesia is still very high. This survey involved respondents aged 13-17 who were asked to report their experiences of violence in the past 12 months. The results indicates that 1 of 4 boys have experienced physical violence, 1 of 8 have experienced emotional violence, and 1 of 12 have been victims of sexual violence. Meanwhile, among girls, 1 of 7 were reported to have experienced physical violence, 1 of 9 experienced emotional violence, and 1 of 19 became victims of sexual violence (³). This data illustrates the urgency of addressing violence against adolescents in Indonesia.

The purpose of this literature review is to identify the causes of violence, its impacts, and what interventions can be implemented to reduce violence among adolescents in Indonesia.

REVIEW

Types of Violence

Violence among teenagers is generally divided into three categories: direct violence (such as physical aggression, threats, and mockery), indirect violence (such as spreading false news and ostracism), and intimidation. According to the Integrated Service Center for the Protection of Women and Children, violence against children includes physical violence (hitting, kicking), emotional violence (threats, insults), sexual violence (pornography, harassment), neglect (failing to meet the child's basic needs), and economic violence (employing children for economic purposes or involving them in prostitution) (⁴) (⁵).

Impact of Violence

Peer violence has a significant negative impact on physical and psychological health. Physically, it can trigger psychosomatic symptoms such as headaches, fatigue, stomachaches, and dizziness. The psychological impacts include low self-esteem, depression, anxiety, sleep disturbances, feelings of loneliness, despair, and even suicidal thoughts. In addition, this violence also impacts academic performance, with several studies showing a decline in achievement and attendance issues at school (⁶).

Factors that Trigger Violence in Teenagers

Several factors that trigger violence in adolescents include a less active family role, exposure to violence in the media, pressure from aggressive peers, mental health disorders such as attention deficit hyperactivity disorder (ADHD) or bipolar disorder, and experiences of violence during childhood (¹).

Peers of the same age have a significant influence on adolescent violence. The presence of peers often triggers violence, as teenagers seek attention that they might not receive from their parents. Peers play an important role as sources of knowledge and information, as well as in the problem-solving process. Research shows that peer involvement in adolescent relationship violence often occurs due to a lack of affection and attention from parents. Therefore, parents need to pay special attention to their child's social environment, as most of their life is spent with peers. Guidance and attention from parents are essential, as they should have the closest relationship with their child (⁷).

A study discusses the influence of social media on violence in teenage relationships. The study shows that 57.6% of respondents experienced relationship violence due to social media use, while 10.1% were unaffected by social media. Statistical analysis shows a significant relationship between social media use and youth violence (p-value = 0.012), as well as exposure to online violence (59.8%), which is also closely related to relationship violence (p-value = 0.048). In conclusion, social media and the internet play a role in increasing the risk of dating violence among teenagers (⁸).

Knowledge does not have a significant impact on violence in teenage relationships. Although teenagers have a solid understanding of violence, this is not always reflected in their behavior. Exposure to violence in the surrounding environment often makes violence seem normal, so they do not realize that such actions are considered violence. Therefore, schools need to improve education on the definition, forms, and prevention of relationship violence by implementing additional programs outside of regular class hours or through non-formal education provided by teachers (⁹).

The role of the family significantly influences violence in teenage relationships. Permissive parenting, with high freedom and low control, can make teenagers feel that their desires must always be fulfilled. If their desires are not fulfilled, teenagers might express their frustration through violence towards their partner. Many teenagers feel neglected by their parents and rarely share their problems with them. To prevent violence, parents need to improve communication, become friends with their children, and spend more time together, thereby strengthening family bonds and reducing the risk of violent behavior

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