Teses e Dissertações

• Teses
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preocupação das organizações mundiais e um dos principais temas globais a ser resolvido, devido ao impacto que tem sobre o número de vítimas e a magnitude das sequelas orgânicas e emocionais que produz ao longo da vida de um individuo. Exposição à violência na infância tem sido associada com o desenvolvimento de problemas de saúde mental na adolescência e na vida adulta. No entanto, tem se pouca evidência disponível de estudos prospectivos em países de baixa ou média renda, assim mesmo, não são bem esclarecidas as diferenças por sexo na associação entre maus-tratos na infância e adolescência com o posterior desenvolvimento de depressão ou ansiedade. Os objetivos da presente tese foram: 1) estudar os diversos fatores associados com a exposição à violência na infância e adolescência dos membros do estudo de coorte de nascimentos de 1993 da cidade de Pelotas-RS, Brasil, 2) estudar a relação entre maus-tratos na infância e adolescência com o subsequente desenvolvimento de episódio depressivo maior aos 18-19 anos, neste mesmo estudo de coorte, e 3) sumarizar as evidências na literatura das diferenças por sexo na associação entre maus-tratos na infância com depressão ou ansiedade na idade adulta.


Abstract:
Violence is defined as the use of force or power as a form of threat against other persons, groups, or communities, with the likelihood of causing injury, death, psychological harm, alterations in development, or deprivation 1. The World Health Organization (WHO) 1 has declared violence a serious public health problem. According to the United Nations 2, 468,000 homicides were committed in the world in 2011. In 2010 3, 25.5 million years of healthy life were lost due to injuries resulting from interpersonal violence. A person that suffers mental, physical, or economic harm, or harm by omission, and which violates the criminal code, is considered a “victim�, individually or as a group 1. According to global data, 16% of the general population has been a victim of at least one crime in the previous year, while 40 million children under 15 years of age suffer abuse and neglect 4. Approximately 150 million girls and 73 million boys under 18 years were forced into sexual relations or suffered forms of victimization by sexual violence that involved physical contact 2. Between 133 and 275 million children witness domestic violence every year 4. The International Crime Victim Survey (ICVS) 5, using information on individuals over 16 years of age from 54 countries from 2000 to 2010, showed that countries of Africa had the highest incidence of victimization by theft (15.2%), aggression (19.8%), and sexual crime (14.5%), with 5-year recall; Latin American and Caribbean countries recorded the highest incidence of victimization by robbery (22.2%), and developed countries the highest victimization from domestic violence (12.4%) 5. The incidence of victimization in American adolescents 12 to 20 years of age decreased from 175 to 47.5 per 1,000 adolescents between 1993 and 2011 6. In Australia 5, the incidence remained stable from 2000 to 2011 (5.1 and 5.9 per 1,000 adolescents, respectively). In Canada 7, the childhood victimization rate was 9.7 victims per 1,000 children; victimization at 2 and 3 years of age was more common in boys, and after 5 years of age it was more common in girls. In Brazil, the National Household Sample Survey (PNAD) 8, conducted in 26 states in 2009, covering the population over 10 years of age and using a questionnaire with a one-year recall, showed that 7.4% of Brazilians self-reported victimization by robbery and 1.6% by physical aggression. According to the same survey, victimization by robbery was more common among individuals in the highest family income bracket, while victimization by physical aggression was more common in the lowest income bracket.

Keywords: Epidemiology; Adolescence; Violence; Chilhood; Mental health