MUNCHAUSEN BY PROXY SYNDROME

In this study, the main aim is to shed light onto the Munchausen by Proxy Syndrome news case articles from Turkey and the USA as well as to increase awareness related to the topic. Munchausen Syndrome by Proxy is a form of child abuse and as the perpetrator of the abuse mostly a parent of the victim, it is not easy to prove the abuse by the medical staff. Most of the time, the perpetrator is ‘mother’ of the child, who fabricates a story about the child’s sickness and seeks for medical attention for the child.

HIDDEN AND MULTIPLE VICTIMIZATION: FORCED MARRIAGE IN TURKEY

Aim: Forced marriages are the marriages in which one or both spouses do not give consent to the marriage. Violence, threats, or any other form of coercion is involved to actualize the marriages and cause multiple victimization. Victims of forced marriages may be women, men, girls and boys. The subject of the victimization may be all types of violence. This study aims to evaluate and to raise the awareness of the professionals who work in the field, and to suggest solutions to prevent the forced marriages. Materials and Methods: In the study, a total of 296 people (66% women and 34% men), who work in the fields in Mersin, Diyarbakır, Şanlıurfa and Istanbul provinces where the risk factor is high, were surveyed; and workshops were organised with them. The survey results were analysed by using the SPSS 20 statistical program. Results: The survey was applied to the professionals working in the field. Only 46% of participants correctly answered the question about the age of marriage with parental consent. 10% of the participants stated that they look positively to the marriage of those under the age of 18. 9 out of 100 people working in the field do not see child marriage as a type of forced marriage. 32% of the employees in the field specified that they do not know where to apply in case of the danger of forced marriage. Conclusion: The main factors lead to forced marriage may be specified as lack of education, customs and traditions, family honour, economic reasons, migration, social and family pressure on parents, and domestic violence. Forced marriages have significant negative impacts especially for young women. Trainings of the professionals will be the first step of solving the problem. The next step will be defining forced marriage as a criminal offence in Turkey.

THE LEVEL OF RECOGNITION OF PHYSICAL AND SEXUAL CHILD ABUSE OF DOCTORS AND NURSES WORKING IN SULTANBEYLİ STATE HOSPITAL

Physical and sexual acts of violence against children seriously harm the life and mental health of the child. These actions that harm the child often tend to hide by the child or his family. The termination of the actions that harm the child and being noticed due to the damage caused by the child depends on the level of recognition of the physical and sexual violence of the physicians and nurses faced during the provision of health services. In this study, it is aimed to measure the physical and sexual violence recognition levels of physicians and nurses, which are most likely to encounter cases of child victims of physical and sexual violence. With the questionnaire study, it was aimed that physicians and nurses would try to question their awareness of abuse and develop sensitivity. With the developing sensitivity, it will be ensured that each phenomenon is taken with a different perspective and the violent action that is carried out or planned to be carried out as a result. In this way, every child awaiting help can be intervened before the violent act becomes chronic and reaches a level that threatens the child's life. It is aimed to approach the patients with a multidisciplinary approach and to adapt the child to normal life with social support.

THE RELATIONSHIP BETWEEN MANIPULATION AND DATING VIOLENCE

Manipulation which is a type of social influence occurs when a person influences and operates another person by changing their thoughts or behaviors. Manipulation differs from its purpose. Harmful manipulation has features such as suppressing the person by manipulating the person, restricting free will and showing implicit aggression. At the same time, the manipulator’s motives are hidden and the goal is to benefit the manipulator. Dating violence is defined as being subjected to abuse by husband/ wife, date, girlfriend/boyfriend or ex-partner. The aim of this study is to investigate the relationship between being affected by the manipulation in students’ close relationships and exposure to dating violence in their emotional relationships. This research is descriptive. 200 students between the ages of 18-28 at Yeditepe University participated in the study. Three different questionnaire forms were used to collect data. They are respectively demographic form, being affected by the manipulation questionnaire which consists of 20 questions and the exposure to dating violence questionnaire which consists of 42 questions. The answer to each question has an equal coefficient effect. At the end of the exposure to dating violence questionnaire, there is a description of a forensic case and questions about whether the case was resolved or not. Exposure to dating violence questionnaire consists of 7 sub-categories; emotional, verbal, social, physical, economic, sexual and digital. The mean age of the participants is 22,08±2,03. Participants consist of students who 48% (N=96) are men and 52% (N=204) are women. According to Pearson Correlation analysis; there is a moderately significant positive correlation between exposure to dating violence and being affected by manipulation (r= .319, p <0.001). The findings suggest that when the rate of being affected by the manipulation in the close relationships of participants increases, dating violence increases.

THE EFFECTS OF INDIVIDUAL AND SOCIAL RISK FACTORS ON VIOLENT CRIMES OF JUVENILES

Introduction: The involvement of children in violent crimes as a perpetrator gets the attention of both researchers and society. The purpose of the study is to identify the risk factors that distinguish juveniles in terms of violent crime. The criminal behavior children were examined in two categories in this study. The first category is composed of non-violent crimes against individuals such as larcency, drug use, opposition to the law of meetings and demonstrations. The second category consists of crimes involving intensive violence against individuals such as armed robbery, felonious injury, murder, and sexual assault. Method: Within the scope of the study 940 court files of the juveniles, which are adjudicated between 2015 and 2019 in the Istanbul Courthouse Jurisdiction, were selected randomly. Available information about children in the court file recorded retrospectively. Individual (gender, age at the date of crime, substance use, working in a job, self-harming behavior, run away from home and previous crime history) and social risk factors (duration of education, risky peer, parental education level, working parent, parental crime history, family type, number of siblings, sibling crime history, sibling substance abuse, domestic violence, sharing problems with the family, total monthly income of the family, domestic migration) was compiled using binary coding system. The factors affecting violent crime were determined by logistic regression analysis. Findings: It was found that individual risk factors consist of being male gender, age at the date of crime, substance use, working in a job and run away from home. Whereas the context of social risk factors, it was found that the father's job, father's history of crime and not sharing personal troubles with the family predicted violent crimes. When the researchers put both groups into analysis at the same time, they found that being male gender, age at the date of crime, working in a job, a runaway from home, domestic violence, sharing personal problems with the family have predicted violence. Result: As a result, both individual and social risk factors have been found effective in dragging children to violent crimes.

DETERMINATION OF SECONDARY SCHOOL STUDENTS' AWARENESS REGARDING CYBER VIOLENCE

During the survey conducted with secondary school students, it was observed that there was a connection between children's internet usage habits and their views on cyber violence. On the other hand, many children do not have full awareness of cyber violence due to their inability to make a clear distinction between cyber violence and daily behaviors (jokes, discussions). Furthermore, in line with the results of the survey analysis, it should be noted that the data obtained also varies according to the age and gender characteristics of the study group. The conducted field work is beyond our intended has been useful in determining the detection of cyber violence awareness, as it provides information about their reactions to cyber violence, except that whether children have information about what cyber violence is.

RETROSPECTIVE EVALUATION OF SEXUAL ABUSE CASES APPLIED TO DİCLE UNIVERSITY FORENSIC MEDICINE DEPARTMENT

Sexual abuse is a global public health problem that causes many medical, legal, social and economic problems in the short and long term. In this study, it was aimed to evaluate the sociodemographic characteristics and variables of our sexual abuse cases with the literature data. We retrospectively analyzed 175 cases who applied to our department for sexual abuse between January 1, 2013 and December 31, 2018. It was determined that 143 of 175 cases were found under the age of 18. 91,4% of the cases in our study were female and 8,6% were male. It has been observed that victims are frequently abused by people they know. It was found that 17 of the cases were abused by their family members. It was observed that most of those who denied the incident were victims of incest. When the education status of the victims during the incident is examined; 60 (34.3%) cases were found to be at primary school level, 19 (10.9%) cases were found to be at secondary school level, 11 (6.3%) cases were found to be at high school level; It was determined that 78 of all cases (44.6%) still continue their education and 22 cases (12.6%) quit their education. Lesions were detected in the sexual examination of 45(25,7%) of 175 cases; 39 (22,3%) of these cases had acute lesions and 6 (3,4%) of these cases had chronic lesions. Pregnancy occurred in 4 of the victims. Suicide attempts of 8 (4,6%) cases were determined. As a result, sexual abuse is a problem that requires a multi-faceted approach. Common centers should be established to raise the awareness of the society, to prevent sexual abuse, and to support the victims psychologically and socially. Procedural challenges should be reduced, media support should be obtained, and primary protection activities should be organized.

DETERMINANTS OF AGE DISCRIMINATION EXPERIENCED BY INDIVIDUALS AGED 65 AND OLDER LIVING IN 2 PRIVATE NURSING HOMES IN ISTANBUL

The increase in the age of individuals causes their mental and physical structures to be perceived differently. Elderly individuals are thought to be unable to do the activities they can do due to social stereotypes, in addition to their reduced physical functions. The main focus of the research is to evaluate age discrimination from the perspective of the participants. We aim to examine the types of age discrimination experienced by individuals living in nursing homes and their effects. In this context, themes and sub-themes were determined after the literature on the subject was reviewed. Then, the questions were created to identify the problems that cause age discrimination. The qualitative research method was used as it was aimed to understand the subject studied more deeply and to look at the cases through the eyes of the participants. The inter-case analysis method and semi-structured interview technique were used in the study. Since the interviews are conducted individually and through the eyes of the victim, it is aimed to be analyzed at the micro and meso levels. Our interview schedule was made in a private nursing home in Istanbul, depending on the institutions. Case report was evaluated in terms of socio-cultural, psychosocial, and social norms. Within the framework of a certain age (65 years and above), different results may emerge from the individuals interviewed because we examine age discrimination. Considering the data obtained as a result of the research, it is seen that there is not enough awareness about discrimination against the elderly, and sufficient supervisory and preventive measures are not implemented. It is thought that there may be physical and social changes caused by age-related changes, as well as political and socio-cultural factors. This research aims to identify the problems that cause age discrimination and to produce additional alternative actions to be taken.

STALKER HARASSMENT; CASE REPORT

Stalking is defined as the act of determining the person as a target and following and communicating with the person repeatedly without his/her consent, creating concern for her safety. Compared to forensic medicine applications, it’s a group that is relatively common in the field of psychiatry, and reporting the results of forensic medical evaluation is rarely done in this respect. The case applied to the clinic with the allegation of mobbing, and besides it’s a rare case in forensic medicine practice due to the characteristics of the event she experienced, it was aimed to discuss the evaluation to be made in such cases in terms of stalking. The 33-year-old female case, working in a company as senior manager, stated that she didn’t accept the proposal of a male employee in another city and in the same position as her, to be her girlfriend and she was verbally threatened by this person afterwards, wandered around her workplace and home and followed her for a long time. In her mental evaluation; It was found that the person was subjected to psychological violence and stalking harassment; the verbal threats and behaviors of the aggressor had a traumatic effect on her mental health for a long time and the action she was exposed to permanently deteriorated the mental health of the person. Stalking is addressed in different areas within the framework of mobbing or violence against women. Considering that in cases of stalking harassment, which doesn’t have a specific legal provision, it may result in the most severe form of violence against women due to its consequences, besides studies on prevention and legal regulation, as highlighted in the case presented, the identification of trauma and forensic medical documentation and also the need for psychiatric follow-up and support in terms of treatment should be considered.

EVALUATION OF THE INCEST CASES WHO APPLIED TO MERSİN UNIVERSITY MEDICAL FACULTY DEPARTMENT OF FORENSIC MEDICINE IN 2019

Incest relationship, which has many different definitions, is a form of sexual abuse that is more difficult to manifest and its effects on the victim are much more severe. In our study, it was aimed to develop solutions by evaluating the sociodemographic and forensic medical characteristics of the incest victims who were sent to Mersin University Forensic Medicine Department. Method: The forensic investigation documents and medical reports of 34 incest cases that were sent to us for forensic reports with the allegation of sexual assault between January 2019 and January 2020 were analyzed retrospectively. Findings: It was found that most of the cases (85.3%, n: 29) were women, average age being 15.41, with the majority (41.2%, n: 14) between the ages of 6-12. It was observed that in 44.1% of the cases (n: 15) the defendant was the victim's biological father, in 47.1% (n: 16) of the cases the incident took place in the shared house where the victim and the defendant lived. In 32.4% of the cases (n: 11), the incident was reported by school counselors, the person to whom the victim told the event first was most frequently their mother (35.3%, n: 12). In 70.6% of the cases (n: 24), the first person to whom the victim told the incident supported the forensic reporting process. Biological evidence was detected in 8.8% (n: 3) of the cases, the victim's mental health deteriorated in 61.8% (n: 21) of the cases, most common psychopathology being Post Traumatic Stress Disorder (41.2%, n: 14). Conclusion: Our study reveals the importance of schools, where children can communicate with others, in the emergence of incest. On that account, it should be ensured that children continue their education and benefit from guidance services. All teachers, especially counselors, should be made aware on the matter of sexual abuse of children. In addition, "systematic sexual education" for children should be included in the curriculum. Since incest cases are mostly reported late, more often than not biological evidence cannot be obtained. The occurrence of psychopathology in most of the victims shows the importance of mental evaluation. In addition, it should be ensured that all procedures, including clinical treatment, are carried out in centers where multidisciplinary approach can be provided, to prevent secondary suffering due to reinterrogations and examinations of the victim in the judicial process.