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Gender differences in violence exposure and violence risk among adolescent inpatients.

Gender-specific rates of violence exposure and violence perpetration among psychiatrically ill adolescents has received little scientific attention. We examined 130 adolescent inpatients and found no difference between male and female subjects with respect to self-reported violence potential or actual violence perpetration. Female inpatients, however, were significantly more often victims of sexual assault, and male inpatients were significantly more often victims of physical assault. For male inpatients, a history of violence perpetration in one area was closely linked with a history of violence victimization in the same area. Alternatively, patterns of victimization and perpetration among female inpatients were less predictable and had crossover to victimization and perpetration experiences in other areas. Correlational analyses revealed that violence risk was associated with a broad range of internalizing and externalizing psychopathology. Significant associations with hopelessness, suicidality, and childhood trauma differentiated the violence risk of male and female inpatients. We propose a hypothesis for understanding these differences and conclude that although psychiatrically ill adolescent male and female patients may commonly fall victim to differing forms of violence, both genders are at equal risk for actual violence perpetration.

Adolescent↗

Violence exposure, trauma, and IQ and/or reading deficits among urban children.

BACKGROUND: Exposure to violence in childhood has been associated with lower school grades. However, the association between violence exposure and performance on standardized tests (such as IQ or academic achievement) in children is unknown. It is also not known whether violence exposure itself or subsequent symptoms of trauma are primarily responsible for negative outcomes. OBJECTIVE: To examine the relationship between violence exposure and trauma-related distress and standardized test performance among early school-aged urban children, controlling for important potential confounders. DESIGN: A total of 299 urban first-grade children and their caregivers were evaluated using self-report, interview, and standardized tests. MAIN OUTCOME MEASURES: The child's IQ (Wechsler Preschool and Primary Scale of Intelligence--Revised) and reading ability (Test of Early Reading Ability, second edition) were the outcomes of interest. RESULTS: After controlling for confounders (child's gender, caregiver's IQ, home environment, socioeconomic status, and prenatal exposure to substance abuse) violence exposure was related to the child's IQ (P =.01) and reading ability (P =.045). Trauma-related distress accounted for additional variance in reading ability (P =.01). Using the derived regression equation to estimate effect sizes, a child experiencing both violence exposure and trauma-related distress at or above the 90th percentile would be expected to have a 7.5-point (SD, 0.5) decrement in IQ and a 9.8-point (SD, 0.66) decrement in reading achievement. CONCLUSION: In this study, exposure to violence and trauma-related distress in young children were associated with substantial decrements in IQ and reading achievement.

Aptitude↗

Social support and the relationship between family and community violence exposure and psychopathology among high risk adolescents.

OBJECTIVE: The objective of this study was to examine the protective effect of social support in the relationship between exposure to violence and psychopathology. Exposure to violence in the family and exposure to violence in the community were examined separately. Exposure to violence was further divided according to whether violence was experienced as a victim or as a witness. Internalizing and externalizing forms of psychopathology, as well as post-traumatic stress symptomatology were examined. METHOD: Participants consisted of 65 high-risk adolescents admitted consecutively to psychiatric inpatient units. Data were collected by means of individual interviews, self-report questionnaires, and hospital charts. RESULTS: Social support emerged as a protective factor with respect to the maladaptive effects of family violence, experienced as either a victim or as a witness. In contrast, social support did not appear to buffer the maladaptive effects of community violence, regardless of whether violence was experienced as a victim or as a witness. In fact, the relationship between community violence and psychopathology was found to be generally nonsignificant regardless of social support status. CONCLUSIONS: These findings suggest that exposure to family violence may affect development differently than exposure to community violence, allowing social support to effectively buffer the effects of family, but not community violence. This finding highlights the importance of examining violence exposure that occurs within the family separately from violence exposure that occurs within the community.

Adolescent↗

At both ends of the gun: testing the relationship between community violence exposure and youth violent behavior.

Much psychological inquiry has focused on understanding the contribution that exposure to urban violence makes to violent behavior among youth. However, other ways in which these variables may be related have been largely overlooked. This study compared four alternative social-ecological models of the link between community violence exposure and violent behavior to determine the degree to which (1) community violence exposure contributes to violent behavior, (2) violent behavior contributes to community violence exposure, (3) both are consequences of common antecedents, and (4) both are manifestations of the same higher order construct. Two hundred and seventy-seven adolescent offenders were interviewed about family, neighborhood, cognitive, and peer characteristics, in addition to violent behavior and community violence exposure. Results suggest that a plausible way to understand the association between community violence exposure and youth violent behavior is to consider both as representations of a general involvement in violence.

Adolescent↗

The association between caregiver substance abuse and self-reported violence exposure among young urban children.

This study examined the relative importance of caregiver substance abuse as a correlate of child-reported exposure to violence. A total of 407 female African-American primary caregivers and their children age 6 to 7 were evaluated. The association between child report of violence and exposure to substance abuse by others (both within and outside the home) was considered after controlling for variance accounted for by child characteristics, caregiver characteristics, home environment, and neighborhood environment (including neighborhood crime). Caregiver alcohol abuse, children's witnessing of drug use in the home, and children's witnessing of drug deals all explained significant additional variance in violence exposure. These findings suggest that for early elementary-age children, meaningful prevention of violence exposure may be possible via addressing their exposure to substance abuse in their home and community.

Caregivers↗

Predictors of violence exposure among inner-city youth.

Examined the ability of demographic variables and risk factors (parental substance use, number of people in the home, out-of-home placements, grades repeated, arrest history, and total life stress) to predict exposure to community violence among 342 high school students from inner-city Baltimore referred for mental health care in community centers or in the schools. Over 90% of the sample knew at least 1 victim of a violent act, 77% reported witnessing a violent act, and 47% reported past victimization by violence. Risk variables were more powerful regression predictors of violence exposure than demographic characteristics such as race, sex, or clinical setting. Even after controlling for demographic differences in violence exposure, risk factors as a group accounted for another 10% to 15% of variance. Life stress was the most consistent predictor of violence exposure for this sample, and life stress was the only variable to make a significant unique contribution to the prediction of all 4 violence criteria.

Adolescent↗

Risk factors for community violence exposure in adolescence.

Community violence is recognized a significant public health problem. However, only a paucity of research has examined risk factors for community violence exposure across domains relevant to adolescents or using longitudinal data. This study examined youth aggressive behavior in relation to community violence exposure among a community epidemiologically defined sample of 582 (45% female) urban adolescents. Internalizing behaviors, deviant peer affiliation, and parental monitoring were examined as moderators of the association between aggressive behavior and exposure to community violence. For males with aggressive behavior problems and deviant peer affiliation or low parental monitoring, co-occurring anxiety symptoms protected against subsequent witnessing community violence. In contrast, males with aggressive behavior problems and co-occurring depressive symptoms were at increased risk for witnessing community violence. Implications of the findings for preventive interventions and future research are discussed.

Adolescent↗

Sense of coherence: a mediator between violence exposure and psychopathology in Russian juvenile delinquents.

Previous research has demonstrated that exposure to community violence tends to have a hazardous impact on the health and well being of youth. In this context, sense of coherence is related to indicators of well being and mental health and is considered crucial for human information processing in resolving conflicts and coping with enduring stress. The aim of the present study was to explore the role of sense of coherence as a potential mediator in the relationships between community violence exposure and psychopathology, controlling for involvement in severe problem behavior. The study was conducted with a group of Russian juvenile delinquents (N = 159; a highly traumatized population with a history of frequent exposure to violence), who completed a set of questionnaires assessing their exposure to community violence, psychopathology, involvement in severe problem behaviors, and sense of coherence. The relationships among the variables of interest were explored using a structural equation modeling approach. Sense of coherence partially mediated the link between victimization and psychopathology. The direct relationships between victimization and psychopathology decreased in size, suggesting that higher levels of sense of coherence can potentially reduce the levels of psychopathology. These results have an important theoretical value and are meaningful for clinical work, suggesting that preventive and therapeutic interventions should aim at increasing sense of coherence, which might be especially valuable in populations at risk.

Adolescent↗

Parent-youth concordance regarding violence exposure: relationship to youth psychosocial functioning.

PURPOSE: To examine the relationship between parent-youth concordance with regard to youth exposures to violence and youth psychosocial functioning, including perpetration of violence, distress symptomatology, and social skillfulness. METHODS: A battery of self-report questionnaires were completed by 333 parent-youth dyads residing in urban public housing developments. Concordance status (<50%, 50-80%, and >80%) was based on dyad agreement regarding youth's violence exposures. The relationship between concordance and psychosocial factors was assessed by a series of analyses of covariance tests. RESULTS: Parents underestimated the extent to which their children were victims of or witnesses to violence and suffered from distress symptoms. Low concordance status was associated with youth perpetration of violence and distress symptomatology, as well as lower self-esteem and problem-solving skillfulness. Youth in the low concordance group characterized their families as exhibiting less involvement, open communication, and parental monitoring. CONCLUSIONS: Concordance between parents and youth is associated with youth psychosocial competence and strong family functioning. Findings underscore the need to incorporate a parent component in primary and secondary violence-prevention programs. Further examination of the processes which contribute to concordance may enhance our ability to prevent youth engagement in violence and its untoward psychosocial sequelae.

Adolescent↗

A clinically useful screening interview to assess violence exposure in youth.

The Exposure to Violence Screening Measure (EVSM) was evaluated as a structured interview for assessing violence exposure among inner-city youth. Psychometric analysis of the measure on a sample of 352 inner-city teenagers indicated adequate internal consistency. The validity of the EVSM was supported by significant correlations between the total score and measures of life stress and behavioral problems.

Adaptation, Psychological↗

Adolescent violence exposure, gender issues and impact.

Youth violence is a growing problem worldwide. Research on adolescent violence in India is limited. Fifteen hundred high school students were investigated to study the prevalence and demographic characteristics of witnesses, victims and perpetrators of violence and to see the impact of violence exposure on their psychosocial adjustments. Sixty nine percent of students had witnessed violence in real life and 28% were of serious nature. Media violence exposure was universal. The prevalence of victims and perpetrators was 27% and 13% respectively. Bullying was prevalent. Male sex was the most important predictive risk factor for witnessing and perpetrating violence (P < or = 0.001). Victims were predominantly females. Those having exposure to violence had poorer school performance and adjustment scores (P < or = 0.05). Thus violence exposure is prevalent even in the lives of Indian adolescents and gender differences exist. Its impact on their psychosocial adjustments is detrimental. Early identification and corrective interventions of these adolescents is vital.

Adaptation, Psychological↗

No safe haven. II: The effects of violence exposure on urban youth.

OBJECTIVES: To examine the moderating effects of gender, grade level, and ethnicity on the associations between violence exposure and adolescents' internalizing symptoms and externalizing behavior and to explore whether such relationships persist over time. METHOD: A survey of adolescents' exposure to violence, internalizing symptoms, and externalizing behavior was administered to 2 cross-sectional samples of 6th, 8th, and 10th graders (N = 2,748 in 1994 and 2,600 in 1996) in an urban school system. Approximately 1,100 adolescents participated in both surveys and served as the longitudinal sample. RESULTS: Structural equation models indicated that violence exposure was closely associated with both externalizing behavior (r = 0.74-0.79) and internalizing symptoms (r = 0.36-0.38). The strength of association was similar across gender and ethnic groups. However, violence exposure was more closely related with internalizing symptoms for younger adolescents than their older counterparts. The longitudinal analysis suggested that exposure to violence reported at time 1 was related to adolescents' internalizing symptoms and externalizing behavior 2 years later. CONCLUSIONS: These results document high levels of violence exposure for urban youths and indicate links to a range of psychiatric symptoms and indicators of poor adjustment. Such findings carry implications for direct clinical work with young people, as well as for program development and public policy.

Adolescent↗

Urban adolescent mothers exposed to community, family, and partner violence: is cumulative violence exposure a barrier to school performance and participation?

Using a risk and resilience perspective, the authors assessed urban adolescent mothers' exposure to community, family, and partner violence and analyzed the relationships between cumulative violence exposure and multiple school outcomes, within the context of welfare reforms. Positive attitude toward school and social support were examined as moderators of violence exposure on school outcomes. The authors pilot tested the questionnaire with 10 participants, then surveyed 120 adolescent mothers regarding their violence exposure, school performance and participation, positive attitude toward school, and social support. Results indicate very high rates of lifetime exposure to violence; intercorrelations and regression analyses indicate that as violence exposure increases, school outcomes tend to worsen, with positive attitude toward school found to be a significant moderator of the effects of exposure to community violence on behavior problems in school. Implications for researchers, practitioners, school policies and programs, and welfare policies and programs conclude the article.

Achievement↗

Violence exposure and substance use in adolescents: findings from three countries.

OBJECTIVE: To investigate relationships between exposure to community violence (witnessing and victimization) and reported substance use (cigarettes, alcohol, marijuana, and hard drugs) in a cross-national sample of adolescents, after controlling for the level of the adolescents' own violent behavior. METHOD: A self-report survey was conducted in 3380 14- to 17-year-old adolescents in urban communities of 3 different countries: Antwerp, Belgium (N = 958); Arkangelsk, Russia (N = 1036); and New Haven, Connecticut (N = 1386). RESULTS: In all 3 countries, levels of reported smoking, alcohol use, marijuana use, and hard drug use showed increases with adolescent exposure to violence. Although positively related, substance use was increased less markedly in US adolescents who witnessed violence. CONCLUSION: Current findings further emphasize the association between violence exposure and potential severe physical and psychosocial health problems in adolescents. In addition, the findings suggest that violence exposure and its consequences are a worldwide urban phenomenon. Cross-national differences were found, however, that warrant additional research, and prospective studies are needed to investigate the pathways from violence exposure to substance abuse.

Adolescent↗

Violence exposure in real-life, video games, television, movies, and the internet: is there desensitization?

It is believed that repeated exposure to real-life and to entertainment violence may alter cognitive, affective, and behavioral processes, possibly leading to desensitization. The goal of the present study was to determine if there are relationships between real-life and media violence exposure and desensitization as reflected in related characteristics. One hundred fifty fourth and fifth graders completed measures of real-life violence exposure, media violence exposure, empathy, and attitudes towards violence. Regression analyses indicated that only exposure to video game violence was associated with (lower) empathy. Both video game and movie violence exposure were associated with stronger proviolence attitudes. The active nature of playing video games, intense engagement, and the tendency to be translated into fantasy play may explain negative impact, though causality was not investigated in the present design. The samples' relatively low exposure to real-life violence may have limited the identification of relationships. Although difficult to quantify, desensitization to violence should be further studied using related characteristics as in the present study. Individual differences and causal relationships should also be examined.

Attitude↗

Violence exposure, posttraumatic stress disorder, and depressive symptoms among recent immigrant schoolchildren.

OBJECTIVE: Many recent immigrant children are at risk for violence exposure and related psychological distress resulting from experiences before, during, and after immigration. This study examines the rates of violence exposure and associated symptoms among recent immigrant children in Los Angeles. METHOD: 1,004 recent immigrant schoolchildren (aged 8-15 years) were surveyed about their prior exposure to violence and symptoms of posttraumatic stress disorder (PTSD) and depression. Participants included children whose native language was Spanish, Korean, Russian, or Western Armenian. RESULTS: Participants reported high levels of violence exposure, both personal victimization and witnessing violence, in the previous year and in their lifetimes. Thirty-two percent of children reported PTSD symptoms in the clinical range, and 16% reported depressive symptoms in the clinical range. Although boys and older children were more likely to have experienced violence, girls reported more PTSD and depressive symptoms. Linear multiple regressions revealed that PTSD symptoms were predicted by both recent and lifetime violence exposure (p values < .001 and p < .05, respectively), when depressive symptoms and gender were controlled. On the other hand, depressive symptoms were predicted by recent victimization only (p < .001) when PTSD and gender were controlled. CONCLUSION: These findings document the need for interventions addressing the psychological sequelae of violence exposure in immigrant children.

Adolescent↗

Violence exposure among school-age children in foster care: relationship to distress symptoms.

OBJECTIVE: To describe the amount and nature of violence exposure and examine the relationship between violence exposure and distress symptoms among children in foster care. METHOD: Violence exposure and distress symptoms were evaluated in interviews, conducted between July 1996 and March 1998, of 300 children from Los Angeles County living in out-of-home placement. RESULTS: Interviews were successfully completed in 91% of eligible children. The majority of children (85%) reported having been a witness to violence, and 51% had been a victim of violence during their lifetime. Of these youths, 54% and 41%, respectively, reported having been exposed to such violence in the past 6 months. Girls, victims of assaultive violence and weapon related violence, and those reporting exposure to mild violence were more likely (p < .05) to have higher levels of distress symptoms than those without such characteristics, after age was controlled for. CONCLUSIONS: Children in foster care continue to have high levels of violence exposure, even after removal from their biological parents' home. The relationship between violence exposure and distress symptoms underscores the need for clinicians to inquire about multiple forms of violence exposure among children living in out-of-home placement.

Adolescent↗

The relations between family environment and violence exposure among youth: findings from the national survey of adolescents.

A national household probability sample of 4,023 adolescents (ages 12 to 17) completed telephone interviews assessing demographics, adverse family environment, and violence exposure. Logistic regressions examined relations among family environment and each violence exposure type, controlling for demographics and other violence exposures. Relationships between family environment and violence exposure varied, depending on type of violence reported, most notably between intrafamilial versus extrafamilial violence. After controlling for family environment, exposure to one violence type significantly increased the likelihood of other violence exposures. Family substance use and not always living with a natural parent were significantly associated with all three types of violence exposure. Findings indicate that clinical assessments should include a thorough evaluation of family environment and violence exposure and also highlight the need for treatment to focus on the adolescent and broader family unit. Future research is needed to further examine these complex interrelationships and their associations with adolescent outcomes.

Adolescent↗