Dissertation committee:
Χ. Σπηλιοπούλου, Καθηγήτρια, Ιατρική Σχολή, Ε.Κ.Π.Α.
Σ. Παπαδόδημα, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, Ε.Κ.Π.Α.
Α. Τσίτσικα, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, Ε.Κ.Π.Α.
Δ. Βλαχοδημητρόπουλος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, Ε.Κ.Π.Α.
Κ. Μωραΐτης, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, Ε.Κ.Π.Α.
Σ. Μιχαλά, Επίκουρος Καθηγήτρια, Ιατρική Σχολή, Ε.Κ.Π.Α.
Α. Σολδάτου, Επίκουρος Καθηγήτρια, Ιατρική Σχολή, Ε.Κ.Π.Α.
Summary:
According to World Health Organization violence is defined as "the intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community that either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment or deprivation." This definition associates intentionality with the committing of the act itself, irrespective of the outcome it produces. Interpersonal violence is divided into two subcategories; violence at the domestic context and community violence.
For each allegation about intimate partner violence (IPV), there are at least two others that are not reported to the Police. The global lifetime prevalence of intimate partner violence among ever-partnered women is 30%, while the global lifetime prevalence of non-partner sexual violence is 7.2%
In the late 1980s, the first research articles were published, using the records of patient-victims of interpersonal violence that had attended a hospital, as long as forensic clinical examinations' records of victims of interpersonal violence, which had reported the incident to the Authorities. According to the literature head and neck injuries appear to be related to adult women IPV victimization.
In 2005, Law N 3500 about domestic violence was passed in Greece, which provided stricter penalties for causing bodily harm within the family context, comparing with the Penal Code, while rape within marriage was criminalized for the first time.
Despite the existence literature, research articles in Greece are scarce, appearing sporadically. The purpose of this PhD thesis was to perform a first systematic recording and analysis of the phenomenon of violence in Greece, using the archives of the forensic clinical examinations that were conducted at the Department of Forensic Medicine and Toxicology of the Medical School of the NKUA, during a five-year period (2012-2016).
2466 victims of interpersonal violence were examined, two third of which concerned cases of community violence and one third cases of domestic violence. 31.1% of the allegations concerned victims that knew the perpetrator(s) and 35.1% allegations against strangers, while 26.9% concerned IPV, 4.9% violence between parents and children and 1.7% violence between siblings.
The results of our study are consistent with the literature, as female victimization is mainly related IPV cases, while men are mostly victims and perpetrators in cases of community violence. In the majority of IPV cases, the victim has been abused several times in the past until the victim reached the critical point to make the allegation and the perpetrators mainly used their limbs as a means of exercising physical violence. One out of four women and one out of seven men who had reported the incident had been examined by another physician before the forensic clinical examination. The most frequently encountered injuries to victims of IPV were identified, regardless of gender, primarily in the upper limbs and secondarily in the head, while in the rest of the body they are differentiated according to the sex of the persons involved. IPV incidents occur mostly in private places, mainly in the home where the victim lives, as opposed to incidents of community violence, which occur mainly in public places. The most common reason to report physical community violence was robbery, with conflicts between neighbors and relatives following and road rage being the fourth most frequent cause. In male victims of community violence, injuries were primarily detected in the head and secondarily in the upper limbs, while in females victims were more common in the upper limbs and were located secondarily in the head, with the trunk, lower limbs and neck following in that frequency range, regardless of the victim's sex.
One third of the incidents of community violence concerned youth violence, between males, who were known to each other. Allegations for sexual violence, kidnapping and athletic violence were much more frequent in cases of youth violence, than in the rest of allegations about community violence.
Comparison of incidents of domestic violence with those of community violence emerged some remarkable findings, such as the fact that the involvement of female as perpetrators is more common in cases of community violence. In addition, differences at the 24-hour breakdown were observed, as well as the complete lack of use of firearms in the domestic context.
In contrast to existing literature, which has shown that head and neck injuries are related to cases of IPV, the present study has shown that localization of injuries only to the neck and the feet are more common in female victims of IPV, while injuries to the hands and the legs, as long as chest injuries could indicate victimization in the community context.
With regard to child victimization, the most important finding was that in seven out of ten allegations the victims knew the perpetrators, and that in six of them the perpetrators were relatives of the victim, mainly the parents. Regarding sexual violence, contrary to existing literature, allegations for spousal sexual violence were few (only five complaints out of a total of 576) and the fact that all these female victims refused to give consent to a genital examination.
One in four victims aged under 18 years-old, who had made allegations for interpersonal violence and had been examined by another physician prior to the forensic clinical examination is a victim of domestic violence, which highlights the importance of the vigilance/watchfulness of physicians, and in particular pediatricians, in early identification of children who have been abused in order to deal with them appropriately.
The phenomenon of violence in Greece, both in general as in its particular forms, such as IPV and child abuse, should be prevented both by educating citizens to respect for the laws and by building a society based on values and principles that recognize the respect for the rights and equality of citizens.
As in the past, so in the future, violence will still probably be an integral part of human nature. The assumption that it cannot be dealt with as a whole, but could be eliminated to a significant extent, should be the basis of all forms of prevention and treatment, either at the social/societal level or at the individual level.
