Devlet Koruması Altında Büyüyen Bireylerin Kurum Yaşantılarından Önceki Olumsuz Çocukluk Çağı Deneyimlerinin İncelenmesi

Öz

Olumsuz çocukluk çağı deneyimleri; fizyolojik, sosyolojik ve psikolojik sağlığın temel sosyal belirleyicilerinden biri olmakla birlikte, yaşamın ilerleyen yıllarında sağlık açısından tehlikeli davranışlarda bulunma risklerine temel oluşturmaktadır. Bu araştırmada çocukluğunun bir dönemini devlet koruması altındaki kurumda deneyimlemiş bireylerin kurum bakımından önceki yaşantılarının, olumsuz çocukluk çağı deneyimleri boyutunda incelenmesi amaçlanmıştır. Nitel araştırma yöntemi kapsamında gerçekleştirilen çalışmada fenomenoloji deseni kullanılmıştır. Kartopu örnekleme ile oluşturulan araştırmanın çalışma grubunu, çocukluğunun bir dönemini devlet koruması altındaki kurumda geçiren 10 yetişkin oluşturmaktadır. Veri toplama aracı olarak araştırmacılar tarafından geliştirilen yapılandırılmış ve yarı yapılandırılmış görüşme formları kullanılmıştır. Bireylerin kurum bakımı öncesi yaşantılarına ilişkin görüşleri ve hikâyeleri kendi deneyimleri üzerinden derinlemesine görüşmelerde ifade edilmiştir. Veriler, Maxqda Analytics Pro 2020 programı kullanılarak içerik analizine tabi tutulmuş ve “hane içi işlev bozukluğu, ihmal ve istismar” temaları altında gruplandırılmıştır. Araştırmaya katılan bireylerin kurum bakımında ve kurum bakımından sonraki yaşantılarından bağımsız olarak, kendisine bakım verenlerle birlikte geçirdiği zamanlarda en az bir olumsuz çocukluk çağı deneyimine sahip olduğu bulunmuştur. En az bir olumsuz çocukluk çağı deneyimi bulunan bireylerin daha farklı temalarda da olumsuz çocukluk çağı deneyimlerinin bulunması çalışmanın diğer önemli bir sonucudur.

Anahtar Kelimeler

• Olumsuz çocukluk çağı deneyimleri
• korunma ihtiyacı olan çocuk
• kurum bakımı öncesi yaşantılar

Examining the Adverse Childhood Experiences of Individuals Who Grew up Under the Protection of the State Before Their Institutional Life

Öz

Adverse childhood experiences; although it is one of the main social determinants of physiological, sociological and psychological health, it forms the basis for the risks of engaging in health-hazardous behaviors in the later years of life. In this study, it is aimed to examine the previous experiences of individuals who have experienced a period of their childhood in an institution under the protection of the state, in the dimension of adverse childhood experiences. The phenomenology design was used in the study carried out within the scope of the qualitative research method. The study group of the research, which was formed by snowball sampling, consists of 10 adults who spent a period of their childhood in an institution under state protection. Structured and semi-structured interview forms developed by the researchers were used as data collection tools. The opinions and stories of the individuals regarding their pre-institutional care experiences were expressed in in-depth interviews based on their own experiences. The data were subjected to content analysis using the Maxqda Analytics Pro 2020 program and grouped under the themes of "domestic dysfunction, neglect and abuse". It was found that the individuals participating in the research had at least one adverse childhood experience during the time they spent with their caregivers, regardless of their experiences in institutional care and later in institutional care. Another important result of the study is that individuals with at least one adverse childhood experience also have adverse childhood experiences in different themes.

Anahtar Kelimeler

• Adverse childhood experiences
• child in need of protection
• experiences before institutional care

Kaynakça

1. Altshuler, S. J., & Gleeson, J. P. (1999). Completing the evaluation triangle for the next century: Measuring child “well-being” in family foster care. Child Welfare, 78(1), 125-147.
2. Anda, R. F., Felitti, V. J., Bremner, J. D., Walker, J. D., Whitfield, C., Perry, B. D., Dube, S. R., & Giles, W. H. (2006). The enduring effects of abuse and related adverse experiences in childhood: A convergence of evidence from neurobiology and epidemiology. European Archives of Psychiatry and Clinical Neuroscience, 256(3), 174–186. doi: 10.1007/s00406-005-0624-4.
3. Bellis, M. A., Hughes, K., Leckenby, N., Hardcastle, K. A., Perkins, C., & Lowey, H. (2015). Measuring mortality and the burden of adult disease associated with adverse childhood experiences in England: A national survey. Journal of Public Health (United Kingdom), 37(3), 445–454. doi: 10.1093/pubmed/fdu065.
4. Bogdan, R., & Biklen, S. K. (1997). Qualitative research for education. Boston, MA: Allyn & Bacon.
5. Brown, J., Cohen, P., Johnson, J. G., & Salzinger, S. (1998). A longitudinal analysis of risk factors for child maltreatment: Findings of a 17-year prospective study of officially recorded and self-reported child abuse and neglect. Child Abuse and Neglect, 22(11), 1065–1078. doi: 10.1016/S0145-2134(98)00087-8.
6. Chapman, D. P., Whitfield, C. L., Felitti, V. J., Dube, S. R., Edwards, V. J., & Anda, R. F. (2004). Adverse childhood experiences and the risk of depressive disorders in adulthood. Journal of Affective Disorders, 82(2), 217–225. doi: 10.1016/j.jad.2003.12.013.
7. Clemens, V., Bürgin, D., Eckert, A., Kind, N., Dölitzsch, C., Fegert, J. M., & Schmid, M. (2020). Hypothalamic-pituitary-adrenal axis activation in a high-risk sample of children, adolescents and young adults in residential youth care – Associations with adverse childhood experiences and mental health problems. Psychiatry Research, 284 (112778), 1-7. doi: 10.1016/j.psychres.2020.112778.
8. Courtney, M. E., & Dworsky, A. (2006). Early outcomes for young adults transitioning from out‐of‐home care in the USA. Child & Family Social Work, 11(3), 209-219.

9. Creswell, J. W. (2013). Qualitative inquiry & research design: Choosing among five approaches. Los Angeles, USA: Sage Publications.
10. Danese, A., & McEwen, B. S. (2012). Adverse childhood experiences, allostasis, allostatic load, and age-related disease. Physiology and Behavior, 106(1), 29–39. doi: 10.1016/j.physbeh.2011.08.019.
11. Dong, M., Giles, W. H., Felitti, V. J., Dube, S. R., Williams, J. E., Chapman, D. P., & Anda, R. F. (2004). Insights into causal pathways for ischemic heart disease: adverse childhood experiences study. Circulation, 110(13), 1761-1766.
12. Dube, S. R., Felitti, V. J., Dong, M., Giles, W. H., & Anda, R. F. (2003). The impact of adverse childhood experiences on health problems: evidence from four birth cohorts dating back to 1900. Preventive Medicine, 37(3), 268–277. doi: 10.1016/S0091-7435(03)00123-3.
13. Edwards, V. J., Holden, G. W., Felitti, V. J., & Anda, R. F. (2003). Relationship between multiple forms of childhood maltreatment and adult mental health in community respondents: results from the adverse childhood experiences study. American Journal of Psychiatry, 160(8), 1453-1460.
14. Elmacı, D. (2010). Günümüzün yetim kalan kuruluşları: Yetiştirme yurtları. Türk Eğitim Bilimleri Dergisi, 8(4), 949-970.
15. Fantuzzo, J. W., & Fusco, R. A. (2007). Children’s direct exposure to types of domestic violence crime: A population-based investigation. Journal of Family Violence, 22(7), 543–552. doi: 10.1007/s10896-007-9105-z.
16. Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The adverse childhood experiences (ACE) study. American Journal of Preventive Medicine, 14(4), 245–258. doi: 10.1016/S0749-3797(98)00017-8.
17. Fowler, P. J., Toro, P. A., & Miles, B. W. (2009). Pathways to and from homelessness and associated psychosocial outcomes among adolescents leaving the foster care system. American Journal of Public Health, 99(8), 1453–1458.
18. Gorman–Smith, D., & Tolan, P. (1998). The role of exposure to community violence and developmental problems among inner-city youth. Development and psychopathology, 10(1), 101-116.
19. Gökçe, O. (2019). Klasik ve nitel içerik analizi; felsefe, yöntem, uygulama. Konya: Çizgi Kitabevi.
20. Greenfield, E. A., Lee, C., Friedman, E. L., & Springer, K. W. (2011). Childhood abuse as a risk factor for sleep problems in adulthood: Evidence from a U.S. National Study. Annals of Behavioral Medicine, 42(2), 245–256. doi: 10.1007/s12160-011-9285-x.
21. Harris, N. B. (2018). The Deepest Well: Healing the Long-Term Effects of Childhood Adversity. New York, NY: Houghton Mifflin Harcourt. Hart, R. A. (1992). Children’s participation: From tokenism to citizenship. London: Earthscan–UNICEF.
22. Herrenkohl, T. I., Klika, J. B., Herrenkohl, R. C., Russo, M. J., & Dee, T. (2012). A prospective investigation of the relationship between child maltreatment and indicators of adult psychological well-being. Violence and Victims, 27(5), 764-776.
23. Hughes, K., Bellis, M. A., Hardcastle, K. A., Sethi, D., Butchart, A., Mikton, C., Jones, L., & Dunne, M. P. (2017). The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis. The Lancet Public Health, 2(8), 356-366. doi: 10.1016/S2468-2667(17)30118-4.
24. Jamora, M. S., Brylske, P. D., Martens, P., Braxton, D., Colantuoni, E., & Belcher, H. M. (2009). Children in foster care: Adverse childhood experiences and psychiatric diagnoses. Journal of Child & Adolescent Trauma, 2(3), 198–208.
25. Karakuş, Ö., Kırlıoğlu, M., Başer, D., & Burcu, B. (2013). Yetiştirme yurdunda kalmakta olan ergenlerin anne-baba algıları: nitel bir çalışma. Toplum Ve Sosyal Hizmet Dergisi, 24(2), 123-144.
26. Keiley, M. K., Howe, T. R., Dodge, K. A., Bates, J. E., & Pettit, G. S. (2001). The timing of child physical maltreatment: A cross-domain growth analysis of impact on adolescent externalizing and internalizing problems. Development and Psychopathology, 13(4), 891-912.
27. Kesen,F., Karakuş, Ö., Deniz, E. (2012). Yetiştirme yurtlarında kalan çocukların kuruluşa geliş nedenlerinin incelenmesi. Toplum ve Sosyal Hizmet Dergisi, 23(1), 139-150.
28. Kunitz, S. J., Levy, J. E., McCloskey, J., & Gabriel, K. R. (1998). Alcohol dependence and domestic violence as sequelae of abuse and conduct disorder in childhood. Child Abuse and Neglect, 22(11), 1079–1091. doi: 10.1016/S0145-2134(98)00089-1. Langeland, W., & Hartgers, C. (1998). Child sexual and physical abuse and alcoholism : A review. Journal on the Studies of Alcohol, 59, 336-348.
29. Margolin, G., & Gordis, E. B. (2000). The effects of family and community violence on children. Violence On Children, 51, 445–479.
30. McLaughlin, K. A., Conron, K. J., Koenen, K. C., & Gilman, S. E. (2010). Childhood adversity, adult stressful life events, and risk of past-year psychiatric disorder: a test of the stress sensitization hypothesis in a population-based sample of adults. Psychological Medicine, 40(10), 1647-1658.
31. Miles, M. B., & Huberman, A. M. (1994). Qualitative data analysis: An expanded sourcebook. sage.Moustakas, C. (1994). Phenomenological research methods. CA: Sage.
32. Nurius, P. S., Green, S., Logan-Greene, P., & Borja, S. (2015). Life course pathways of adverse childhood experiences toward adult psychological well-being: A stress process analysis. Child Abuse and Neglect, 45, 143–153. doi: 10.1016/j.chiabu.2015.03.008.
33. Rose, J., & Johnson, C. W. (2020). Contextualizing reliability and validity in qualitative research: toward more rigorous and trustworthy qualitative social science in leisure research. Journal of Leisure Research, 51(4), 432–451. doi: 10.1080/00222216.2020.1722042.
34. Salazar, A., Keller, T., Gowen, L., & Courtney, M. (2013). Trauma exposure and PTSD among older adolescents in foster care. Social Psychiatry and Psychiatric Epidemiology, 48(4), 545–551.
35. Saldana, J. (2011). Fundamentals of qualitative research. New York: Oxford University Press.
36. Shonkoff, J. P., Garner, A. S., Siegel, B. S., Dobbins, M. I., Earls, M. F., McGuinn, L., ... & Committee on Early Childhood, Adoption, and Dependent Care. (2012). The lifelong effects of early childhood adversity and toxic stress. Pediatrics, 129(1), 232-246.
37. Slack, K. S., Berger, L. M., & Noyes, J. L. (2017). Introduction to the special issue on the economic causes and consequences of child maltreatment. Children and Youth Services Review, 72, 1–4.
38. Stake, R. E. (1995). The art of case study research. Thousand Oaks, CA: SAGE.
39. Suglia, S. F., Koenen, K. C., Boynton-Jarrett, R., Chan, P. S., Clark, C. J., Danese, A., ... & Zachariah, J. P. (2018). Childhood and adolescent adversity and cardiometabolic outcomes: a scientific statement from the American Heart Association. Circulation, 137(5), 15-28.
40. Thomas, J. (1993). Doing critical ethnography. Newbury Park, CA: SAGE.
41. Wade, R., Cronholm, P. F., Fein, J. A., Forke, C. M., Davis, M. B., Harkins-Schwarz, M., Pachter, L. M., & Bair-Merritt, M. H. (2016). Household and community-level Adverse Childhood Experiences and adult health outcomes in a diverse urban population. Child Abuse and Neglect, 52, 135–145. doi: 10.1016/j.chiabu.2015.11.021.
42. Yıldırım, A. ve Şimşek, H. (2018). Sosyal bilimlerde nitel araştırma yöntemleri. (11. Baskı). Ankara: Seçkin Yayıncılık.