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Int J Child Adolesc Health 2013;6(3):00-00.

Running title: Case report

Child abuse and alcohol misuse in a victim: The role of ethnic


and societal factors
Sergei V Jargin, MD
Peoples Friendship University of Russia, Moscow, Russia
Abstract: The association of child abuse with alcohol misuse in adolescent
victims is known. A case report from the former Soviet Union (SU) is presented
in this short communication, illustrating an immediate cause-effect relationship.
An opportunity to stay away from the abusive atmosphere at home was
provided by a drinking company of schoolmates including some older boys
inspiring alcohol purchase and consumption. Ethnicity-related and other societal
factors contributing to alcohol misuse and antisocial behavior in adolescents are
discussed. Violence in families was a seldom theme in the professional
literature of the former SU. Public organizations sometimes did not react to
known cases of family violence. A part of the society appeared to be opposed to
a broad discussion of family violence because it is to some extent accepted.
There is no generally agreed policy with regard to child abuse; the matter being
complicated by shortage of adequately trained personnel and limited access to
foreign professional literature. The situation seems to be improving nonetheless:
the growing Russian economy enables further development of the social welfare
system, while broadening international cooperation must attract foreign
expertise into the country.
Keywords: Child abuse, adolescents, alcoholism, antisocial behavior
Correspondence: Sergei V Jargin, MD, Peoples Friendship University of
Russia, Clementovski per 6-82, 115184 Moscow, Russia. E-mail:
sjargin@mail.ru
Submitted: May 19, 2012. Revised: June 15, 2012. Accepted: June 21, 2012.

Introduction
Associations of child abuse (CA) with alcohol misuse (1-3), mental disorders
(4,5), poor social skills (6), antisocial behavior (7) and drug abuse (8) have been
reported. CA sometimes persists in families from one generation to another
(9,10); and there is a tendency of under-reporting (11). Detection and reporting
of CA, essential for its prevention and eradication, depend both on victims and
perpetrators. It is easy to expose a socially unprotected abuser, for example, an
alcoholic or mentally disordered individual. Otherwise, different tools can be
applied to prevent the disclosure: distortion of facts and counter-accusations of
libel; threats and intimidation of the former victim, acts against his financial or
personal interests. Here is presented a case report from the former Soviet Union
(SU), not associated with alcohol abuse in the perpetrators.

Case report
In the summer of 1959 Sergei (S) was three years old. His parents were
divorcing and he was sent together with a nanny to a suburb village. They spent

also the summers of 1960 and 1961, having little contact with other children;
and the boy sat on a sofa or a bench days on end, which did not contribute to his
physical development and social skills. In 1963 his mother remarried, the
stepfather being 15 years older than S. The following risk factors of CA were
present in this case: weak social support, a second younger child in the family,
young age of the perpetrator and maltreatment history in his past (12). An
ethnic factor obviously played a role: the stepfather was of Jewish descent,
while S used to point out his Russian ethnicity. S was in a sense an ethnic
misconception: his father and maternal grandfather were Russians, but maternal
grandmother was at least partly of Jewish descent. Having a Jewish stepfather,
who even worked for a short period at his school, S was, without understanding
it, often treated by the social environment as a Jew, which was expressed by
bullying. The bullying was sometimes visibly inspired by older persons
including some teachers. The author does not intend to say that Jewish children
were generally bullied in Soviet schools: it was different at various places; and
especially at schools with diversified ethnic composition there were no visible
signs of it. Many Jewish children were not bullied, because they behaved
adequately: somewhat distanced, friendly, not denying their difference. On
the contrary, S stressed his Russian ethnicity and behaved ambitiously,
involuntarily provoking his social environment. S himself participated in
bullying Jewish children, which cannot be morally justified, but is
psychologically explicable in this particular case. Today Sergei regrets it and
would like to ask all persons independently of ethnicity, towards whom he
behaved inappropriately directly or indirectly as a result of his childhood
trauma, to accept his sincere apologies. Fortunately, S managed to dispose of all
ethnic prejudice in his later life. There is no other way in our age of
globalization; and corresponding new ethics needs to be developed (13); which
is however outside the scope of this paper. Probably, for the similar reason, the
social environment was quite indifferent to the violence in their family. For
example, S asked for help some of his companions, "hooligans" 2-4 years older
than he; they discussed it but did not do anything. The maternal grandmother,
who lived separately, wrote letters to the authorities about CA in the family, it
had no effect either. Moreover, the ethnic factor obviously contributed to
Sergeis alcohol consumption: consciously and subconsciously he tried to
appear as Russian as possible. This psychological mechanism, predisposing to
alcohol consumption and antisocial behavior, seems to be active in some people
of mixed descent; just to name the famous poet, actor and singer Vladimir
Vysotsky, whose father was of Jewish origin. Vysotsky was immensely
popular; he had an enduring effect on Russian mass culture
(http://en.wikipedia.org/wiki/Vladimir_Vysotsky), avoided Jewish traits in his
works and image, being at the same time prone to alcohol consumption.
The physical abuse was administered predominantly by slapping in the
face and whipping with a belt. The first episode complicated by nasal bleeding
happened when S was approximately 8 years old. Episodes of violence went
along with intimidation and verbal abuse, in connection with physical abuse and
out of it. There are statements in the literature that CA is heavily laden with
emotions (14). In this case, it could have been so in the beginning, but later the
scenes of abuse became more theatrical and less laden by true emotion on the
part of the abuser. Battery and verbal abuse sometimes occurred before
spectators: the mother, relatives and friends. Sometimes, the mother took part in
battering, which has been described in the literature as a pattern where mothers
participate in abuse of their children more often if their partners were
stepfathers of victims rather than genetic fathers (15). A motive could have been

subconscious revenge to the disloyal ex-spouse in the person of his son,


probably on the background of dissociation, because maternal affection was
visibly present, especially during early childhood, and spontaneously returned.
As usual in such cases, everything associated with the physical abuse was laden
with shame; and S rarely told anybody about it. Once he positively answered a
question of a schoolteacher whether he had been physically punished; it had no
consequences. Another teacher, puzzled by the nationalistic remarks made by S
at school, came for a home visit. It was followed by a remission in violence of
several months duration, accompanied by success in his school studies; in
agreement with reports that maltreated children are at risk of insufficient school
functioning (16).
Apart from occasional participation in parties at home, where alcohol
was not consumed in excess, and drinking up to a bottle of beer with a
schoolmate, S had not consumed alcohol till the age of 13 years, when he drank
a 750 ml bottle of fortified wine with an older boy. During the 1969-70 school
year, his alcohol consumption increased up to 250 ml of vodka with beer or a
750 ml bottle of fortified wine at one session. An opportunity to stay away from
the abusive atmosphere at home was provided by a drinking company of
schoolmates including some older boys inspiring alcohol purchase and
consumption. During the last two school years, S was repeatedly arrested by the
militia (police) and spent several nights at a sobering-up station. Shortly after
the start of his study at a university in 1973, a separate room was rented for S by
his mother. One year later he was dismissed from the university due to
drunkenness and truancy, served two years with the army and resumed
university education after a 4-years interruption. In 1979, on his mothers
initiative, an intramuscular implantation of a disulphiram preparation Esperal
had been performed, which was followed by abstinence of about 8 months
duration. After a challenge from the environment, he resumed alcohol
consumption; there were no signs of the disulphiram-ethanol reaction. S
discontinued alcohol misuse at the age of approximately 35 years, working
abroad in a non-challenging environment.

Discussion
The case should be classified as intimate partner violence (IPV), a common
problem, affecting many children (17); it illustrates a cause-effect relationship
between CA and early-onset alcohol consumption with antisocial behavior in an
adolescent, facilitated by societal and ethnicity-related factors. Exogenous
nature of the early-onset alcohol misuse is demonstrated by the fact that, in spite
of considerable experience of alcohol consumption, S did not develop any
physical dependence and discontinued alcohol misuse because of professional
and familial reasons. He did not resume excessive alcohol consumption also
later, having come back to Russia, in spite of the challenges from old buddies
etc. It appears probable that, although family violence is associated with alcohol
misuse during adolescence, a mentally healthy adult can overcome a
psychological dependence on alcohol, developed as a consequence of CA. It is
in agreement with the data showing no significant association between CA and
alcohol abuse in male victims becoming adults (18,19) in contrast to
adolescents (2,3). To finish the case report on an optimistic note, it should be
mentioned that S made conscious efforts to achieve forgiveness of the
perpetrators, and was obviously successful in it. It was reported that forgiveness
is associated with improved alcohol-related outcomes (20). Moreover, his
mother and the stepfather cooperated with the author of this paper in elucidation

of the motives, of psychological, ethnic and social factors of CA. In particular,


according to his mothers memory partly confirmed by those of S, behavioral
and communication abnormalities noticed during his early childhood had
probably been caused by partial isolation from other children and bullying by
older boys, which was apparently in some cases inspired by adults and tolerated
by his nanny. Later S overcame his communication difficulties, admittedly, not
without help of alcohol. This is, in fact, another factor contributing to
alcoholism, which can be ethnicity-related: to become "insider" through alcohol
consumption. This mechanism was exploited: in workers, students and
intelligentsia companies, the ringleaders called zavodila could be observed, who
manipulated others towards regular alcohol consumption, while non-drinkers
were sometimes stigmatized (21).
Violence in families was seldom discussed in professional literature of
the former SU (22). Existence of CA was sometimes plainly denied (23); many
cases of CA remained therefore undisclosed (24). Public organizations
sometimes did not react to known cases of family violence. The todays
Russian-language professional literature on CA is still scarce and partly
represented by compilations from foreign publications. A part of the society
seems to be opposed to public discussion of family violence because it is to
some extent accepted (22). There is no generally agreed policy with regard to
the CA (25,26); the matter being complicated by shortage of adequately trained
personnel and limited access to foreign professional literature (27). The
situation seems to be improving nonetheless: a considerable part of CA has
occurred in connection with excessive alcohol consumption and heavy binge
drinking, which appears to be in decline in todays Russia (21,28,29). A
conclusion is therefore optimistic: the growing Russian economy enables
further development the social welfare system, while broadening international
cooperation must attract foreign expertise into the country.

References
1. Makhija N, Sher L. Childhood abuse, adult alcohol use disorders and suicidal
behaviour. QJM 2007;100(5):305-9.
2. Caballero MA, Ramos L, Gonzlez C, Saltijeral MT. Family violence and
risk of substance use among Mexican adolescents. Child Abuse Negl
2010;34(8):576-84.
3. Rothman EF, Bernstein J, Strunin L. Why might adverse childhood
experiences lead to underage drinking among US youth? Findings from an
emergency department-based qualitative pilot study. Subst Use Misuse
2010;45(13):2281-90.
4. Larkin W, Read J. Childhood trauma and psychosis: evidence, pathways, and
implications. J Postgrad Med 2008;54(4):287-93.
5. Lown EA, Nayak MB, Korcha RA, Greenfield TK. Child physical and sexual
abuse: a comprehensive look at alcohol consumption patterns, consequences,
and dependence from the National Alcohol Survey. Alcohol Clin Exp Res
2011;35(2):317-25.
6. Garbarino J. The consequences of child maltreatment: biosocial and
ecological issues. In Gelles RJ, Lancaster JB (Editors). Child Abuse and
Neglect. Biosocial Dimensions. New York: Aldine de Gruyter, 1987: 299316.
7. Jonson-Reid M, Presnall N, Drake B, Fox L, Bierut L, Reich W, Kane P,
Todd RD, Constantino JN. Effects of child maltreatment and inherited liability
on antisocial development: an official records study. J Am Acad Child Adolesc
Psychiatry 2010;49(4):321-32.

8. Gonzalez A, MacMillan HL. Preventing child maltreatment: an evidencebased update. J Postgrad Med 2008;54(4):280-6.
9. Lancaster JB, Gelles RJ. Introduction. In: Gelles RJ, Lancaster JB (Editors).
Child Abuse and Neglect. Biosocial Dimensions. New York: Aldine de Gruyter,
1987:314.
10. Ney PG. Child mistreatment: possible reasons for its transgenerational
transmission. Can J Psychiatry 1989;34(6):594-601.
11. Rodriguez E, Lasch KE, Chandra P, Lee J. Family violence, employment
status, welfare benefits, and alcohol drinking in the United States: what is the
relation? J Epidemiol Community Health 2001;55(3):172-8.
12. Hindley N, Ramchandani PG, Jones DP. Risk factors for recurrence of
maltreatment: a systematic review. Arch Dis Child 2006;91(9):744-52.
13. Jargin SV. Overpopulation and modern ethics. S Afr Med J 2009;99(8):5723 continued in 2010;100(11):694 and 2011;101(8):494.
14. Herbruck CC. Breaking the cycle of child abuse. Minneapolis: Winston
Press, 1979.
15. Alexandre GC, Nadanovsky P, Moraes CL, Reichenheim M. The presence
of a stepfather and child physical abuse, as reported by a sample of Brazilian
mothers in Rio de Janeiro. Child Abuse Negl 2010;34(12):959-66.
16. Cicchetti D, Toth SL, Hennessy K. Child maltreatment and school
adaptation: Problems and promises. In: Sigel IE, Cicchetti D, Toth SL (Editors).
Advances in applied developmental psychology. Vol. 8. Child abuse, child
development, and social policy. Norwood, NJ: Ablex, 1995:30130.
17. Zolotor AJ, Denham AC, Weil A. Intimate partner violence. Prim Care
2009;36(1):167-79
18. Widom CS, Hiller-Sturmhfel S. Alcohol abuse as a risk factor for and
consequence of child abuse. Alcohol Res Health 2001;25(1):52-7.
19. Langeland W, Hartgers C. Child sexual and physical abuse and alcoholism:
a review. J Stud Alcohol 1998;59(3):336-48.
20. Webb JR, Robinson EA, Brower KJ. Mental health, not social support,
mediates the forgiveness-alcohol outcome relationship. Psychol Addict Behav
2011;25(3):462-73.
21. Jargin SV. On the causes of alcoholism in the former Soviet Union. Alcohol
Alcohol 2010;45(1):104-5.
22. Nikulina EA. Organizational and pedagogical prevention system of child
abuse in families. Candidate Dissertation. Saratov: Saratov State University,
2006. [Russian]
23. Kovac C. Paediatricians meet to tackle child abuse in former Soviet bloc.
BMJ 2002;30;324(7340):756.
24. Semenova IV. The problem of child abuse and the ways of its solution. In:
Social pediatrics - problems, research, solutions. Proceedings of the Prof. N.G.
Veselov 60 Years Anniversary Scientific and Practical Conference. Saint
Petersburg, 28 November 2000:3942. [Russian]
25. Besschetnova OV. Social work with children - victims of abuse in families
(analysis of domestic and foreign experience). Balashov: Niklolaev, 2003.
[Russian]
26. Smagina MV. Child abuse in family as a socio-cultural phenomenon in
todays Russia. Candidate Dissertation. Stavropol: North Caucasus Social
Institute, 2006. [Russian]
27. Murphy J, Jargin S. International perspectives and initiatives: The state of
medical libraries in the former Soviet Union. Health Info Libr J
2010;27(3):244-8.

28. Jargin SV. Letter from Russia: child abuse and alcohol misuse in a victim.
Alcohol Alcohol 2011;46(6):734-6.
29. Jargin SV. Letter from Russia: minimal price for vodka established in
Russia from 1 January 2010. Alcohol Alcohol 2010;45(6):586-8.