Exposure to community VIOLENCE

EXPOSURE TO COMMUNITY VIOLENCEInga BregePSYC 1016 - Trauma and Development

Main Topics for Discussion

Overview of Exposure to Violence Forms and Prevalence

Consequences Psychological, Behavioral & Academic

Moderators Conclusion

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Exposure to Community Violence | Inga Brege

Forms & Prevalence

Overview

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Exposure to Violence

04/21/23Exposure to Community Violence | Inga Brege

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Exposure to interpersonal violence in one’s community

Mazza & Overstreet (2000) Direct and Indirect

Personal victimization Witnessing violent events

Shahinfar et al. (2000) Mazza & Overstreet (2000)

Levels of Violence Exposure Primary (victimized) Secondary (witnessed) Tertiary (heard about)

Buka et al. (2001)

Direct vs. Indirect


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Victimization “Intentional acts initiated by another

person to cause one harm (e.g., being chased, threatened, beaten up, robbed, mugged, raped, shot, stabbed, or killed)” Buka et al. (2001)

Witnessing Violence Observing an experience of physical threat,

harm, or even death of another individual Shakoor & Chalmers (1991)

Forms & Levels


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Environment of Exposure Domestic Violence (Familial and Home) Community Violence (Residential or School)

Zinzow et al. (2009)

Community Violence


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“The presence of violence and violence related events within an individual’s proximal environment, including home, school, and neighborhood; it may involve direct or threatened harm, be witnessed or experienced and involve known and unknown perpetrators”

Shahinfar et al. (2000) “The frequent and continual exposure

to the use of guns, knives, and drug and random violence.”

Mazza & Overstreet (2000)

Forms of Community Violence


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Severe Shootings Threats with a weapon Mugging/Robbery Stabbing Homicide

Mild Chasing Beating Shoving/Grabbing

Shahinfar et al. (2000)

Prevalence of Community Violence


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Increasing at epidemic proportions Stein et al. (2003)

Youths younger than 25 are twice as likely to be a victim of violence

Bureau of Justice Statistics (1991) Finkelhor & Dziuba-Leatherman (1994)

Regional & national surveys show 1/3 junior high and high school students have been threatened with physical harm

American School Health Association (1989) Centers for Disease Control (1993)

National study of adolescences showed 39.4% have witnessed violence

Kilpatrick, Saunders & Smith (2003)



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Homicide second leading cause of death in 15-24 year olds at 20.3:100,000 Inner-city youth at 143.9:100,000

Anderson et al. (1997) Fingerhut et al. (1992)

From 1970-1991, rate for teenage deaths due to homicide increased 220%

Bureau of Justice Statistics (1993)



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Rates increase within urban, low-income populations

Richters & Martinez (1993) 165 elementary school students in

Washington D.C. Exposure to violence (e.g. shooting,

stabbing, chases by gangs) 84% had witnessed violence 21% had been victims



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Dyson (1990) 530 Chicago elementary school children 33% witnessed shooting 31% witnessed stabbing 84% witnessed a beating



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Rates increase within minority populations

In 1994, the Children's Defense Fund reported: Males 15 - 24: African-Americans nearly 10

times more likely to be murdered than Whites Females 15 - 24: African-Americans nearly 5

times more likely to be murdered as Whites Slocumb (2001)



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Overstreet & Dempsey (1999) 75 African American youth age 10 - 15

years, living near housing projects in New Orleans

83% knew someone who died because of violence

43% have seen a dead body 85% witnessed drug dealing 10% threatened with murder



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Aisenberg (2001) 31 Latino children in Head Start classroom

exposed 80% exposed to 1+ community violence event

Bell & Jenkins (1993) 536 African American Chicago elementary

school children 26% witnessed someone getting shot 30% witnessed robbery 78% witnessed beating

Other Community Violence


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Electronic Aggression 50% increase in youth reporting

victimization through electronic media between 2000 and 2005. Wolak et al. (2007)

Teen Dating Violence 1 in 3 have experienced some kind of

relationship violence 1 in 4 have experienced physical abuse

Centers for Disease Control (2006)

Prevalence of School Violence


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220 school-associated violent deaths in U.S. between 1994 and 1999 172 were committed by students

Anderson et al. (2001) 36% of urban middle and high school

students reported gangs at their schools National Center for Education Statistics (2006)

1/3 of 5th to 12 graders had been exposed to school violence within the last month Shoving, grabbing, stealing, weapons

Goldstein & Conoley (1997)

Prevalence of School Violence


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65% of high school student have easy access to guns

80% know someone who has carried weapon to school

Sheley & Wright (1995) Many who are victims of bullying

Nansel et al. (2003) School bullying & guns

5391 students in grades 7, 9, and 11 in an urban public school

Bully victims are more likely to find it “not wrong” to bring a gun to school Glew et al. (2008)

Discussion


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What could be some limitations in assessing the prevalence of exposure to violence?

Discussion


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Failure to distinguish between direct and indirect exposure as well as severe and mild exposure

Relationship between the witnessed victim or perpetrator

Richters & Martinez (1993) Parental versus child report discrepancies Parental coping or simply underestimate child's

exposure Child confuses experiences of witnessing versus

victimization Richters & Martinez (1993)

Child's failure to distinguish fantasy from experience

Allen et al. (1999) Shahinifar et al. (2000)

Psychological, Behavioral and Academic

Consequences

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Consequences


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Psychological 50% of children exposed to violence with develop a

psychiatric disorder Martinez & Richters (1993)

Behavioral Anti-social & Aggressive Exposure predicted violent behavior among urban

African American and White 3rd and 8th graders Singer et al. (1999)

Exposure predicted externalizing symptoms 2 years later Schwab-Stone et al. (1999)

Higher levels of exposure associated with violent adolescents Flannery, Singer & Wester (2001)

Academic

Psychological Consequences


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Posttraumatic Stress Disorder (PTSD) Re-experiencing/intrusive thoughts Avoidance Arousal

Posttraumatic Stress (PTS) symptoms Anxiety Depressive symptoms Somatization

Major Depressive Disorder Generalized Anxiety Disorder


Psychological Consequences


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Exposure results in distinct psychological effects Even after controlling for external stressors

such as poverty, poor housing, single parent households

Many co-occurring symptoms suggest distinct reactions Mazza & Overstreet (2000)

Posttraumatic Stress Symptoms


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Child and adolescent exposure to community violence frequently results in PTSD/PTS symptoms

Mazza & Overstreet (2000) Fitzpatrick and Boldizar (1993)

221 African Americans age 7 - 14 years, in 8 urban housing communities

Only 11.9% showed no PTSD symptoms Overstreet et al. (1999)

75 African American age 10 - 15 years, living near public housing in New Orleans

Average 6.2 PTSD symptoms 33% reported symptoms similar to PTSD criteria Exposure predicted PTSD, independent of age, gender

and other nonviolent stressors

PTSD/PTS Comorbidty


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Fletcher (1996) High rates of generalized anxiety disorder, depression,

and dissociation Elementary school children also displayed adjustment

disorder, separation anxiety, and low self-esteem Preschoolers showed similar patterns of co-occurence

Mazza & Reynolds (1999) Depression, suicidal ideation, and PTSD symptoms all had

significant correlation with exposure (p<.001) Found PTSD mediated depressive and suicidal symptoms Suggests violence exposure results initially in PTSD/PTS

symptoms and later manifest into comorbid symptoms Kliewer et al. (1998)

Found intrusive thoughts about violence mediated symptoms of depression and anxiety

Depression


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Martinez & Ritchers (1993) Inner-city elementary students exposed to

violence displayed significantly more depression symptoms

Singer et al. (1995) 3,735 high school students Community violence accounted for significant

portion of variance in depressive symptoms Independent of family and age factors

Gorman-Smith & Tolan (1998) 245 Latino and African American students Exposure significantly correlated to present and

subsequent anxiety and depression symptoms

Suicidal Ideation


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Freeman et al. (1993) 223 elementary students, 6 - 12 years old Found suicide ideation rates for children exposed to

community violence was similar to those without previous exposure

Vermeiren et al. (2002) 1509 adolescents in Antwerp, ranged from 12 - 18

years Suicidal ideation and deliberate self-harm were both

related to violence exposure Why discrepancy? Suicide may be

dependent on age

Anxiety


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Hill & Madhere (1996) 150 African American children in inner-city areas Violence exposure, including anticipation of retaliation,

predictor for anxiety levels Fletcher (1996)

Anxiety in preschoolers and elementary students after experiencing trauma

Cooley-Quille (1995) Found no association between exposure and anxiety in

37 school children White et al. (1998)

385 children between 11 and 14 Dramatic reduction in anxiety symptoms compared to

national norm (>1 standard deviation less)

External Consequences


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Aggressive/Antisocial Behavior DuRant et al. (1994)

225 African American youth, age 11 -19, living in or around nine housing complexes

44.4% males and 52.4% females have attacked someone out of anger

64.6% males and 55.5% females involved in physical fight in past year

19.2% males and 13.5% females attacked someone with weapon and intent to seriously injure or kill

Found previous violence exposure strong predictor to current violent behavior

Schwab-Stone et al. (1999)


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2 cross-sectional samples of 6th, 8th, and 10th graders in Eastern urban schools

1,100 adolescents participated in both 1994 and 1996 studies

Exposure correlated significantly to both internal and external symptoms

Same across gender and ethnicity Stronger correlation for internal

symptoms in younger group Stronger correlation for external

symptoms in older group

Schwab-Stone et al. (1999)

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Discussion


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How do the authors account for the results regarding anxiety?

How else might you explain these findings?

Discussion


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Would expect the same effects for both victimization and witnessing violence?

Direct vs. Indirect Exposure


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Kliewer et al. (1998) Both types of exposure accounted for

similar variance in internal symptoms Martinez & Richters (1993)

Same level of depression and distress reports in children

Direct vs. Indirect Exposure


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Mrug & Windle (2009) Prospective study of 603 early adolescents in

Birmingham, AL; two sets of data 16 months apart Higher levels of witnessing violence in first phase

positively predicted early initiation of alcohol use Victimization reports in first phase decreased risk

of early alcohol initiation over time Schwartz & Proctor (2000)

4th - 6th graders in urban schools Witnessing violence associated with generally

positive beliefs about aggression, including it is appropriate response to ambiguous peer behavior

Victimization instead associated with emotional regulation and social difficulties

Academic Consequences


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Negatively affects performance in schools, measured by decrease in grades, standardize testing, and attendance

Henrich et al. (2004) Hurt et al. (2001) Schwartz & Gorman (2003)



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Academic decline may be result of psychological consequences

Henrich et al. (2004) Schwartz & Gorman (2003)

Deficient emotion and behavior regulation could impair academic performance

Re-experiencing, increased arousal, and difficulty attending to present surroundings

Fear of traveling to school or even of school itself

Oppositional behavior resulting in suspension

Mathews et al. (2009)

Academic Consequences: PTS/PTSD


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Positive relationship between exposure and PTS and negative relation between PTS and test scores

Thompson & Massat (2005) 47 low-income African American children,

ages 10-13, moderated performance on schoolwork & tests

Mathews et al. (2009) Students with significant PTS symptoms

performed worse academically than those without

Saigh et al. (1997)

Academic Consequences: Depression


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Mediated relation between exposure and academic performance in standardized test scores and GPA

Schwartz and Gorman (2003) Longitudinal study showed no

mediating effects Henrich et al. (2004)

Discussion


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What other factors could affect academic performance in adolescents exposed to community violence?



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Absenteeism may be affected by exposure to violence, independent of psychological effects

Violence and victimization in schools results in avoidance

30 - 40% of middle school students chronically absent in impoverished areas

Chang & Romero (2008) Only predictor of absences was poverty

Mathews et al. (2009)

Moderators of Consequences

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Resiliency & Risk Factors


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Community violence concurrent with other factors Poverty Minority status Limited resources

Garbarino et al. (1992) Exposure to Violence may consequently

outweigh pre-existing resilience factors (i.e. high self-esteem)


Moderators: Maternal Figures


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Richters & Martinez (1993) Maternal education moderated distress

symptoms Fitzpatrick & Boldizar (1993)

Maternal presence did impact depressive symptoms, but did act as moderator for exposure to violence

Overstreet et al. (1999) Maternal presence moderated for violence

exposure and depressive symptoms

Moderators: Family Size


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Overstreet et al. (1999) Smaller family size moderated depressive

symptoms in those previously exposed to community violence

Discussion


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Smaller families typically result in higher academic performance and better behavioral adjustment in at-risk populations.

Werner & Smith (1982) Why would larger family size serve

as a protective factor in this case? What does this suggest about

interventions addressing community violence exposure?

Moderators: Family Dynamics


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Family Support Emotional/Behavioral & academic success

moderated by family stable and safety, not exposure Richters & Martinez (1993)

Positive perceptions of parent-child relationships & ability to talk to parent/caretaker about violence served as protective factor in moderating exposure and PTSD, anxiety and depression symptoms Kliewer et al. (1998)

Moderators: Family Dynamics


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Family Structure & Cohesion 245 African-American boys disadvantaged,

urban communities Exposure related to aggression in highly

structured families Lower level of cohesion associated with

increase internal symptoms Gorman-Smith & Tolan (1998)

Positive qualities & less democratic parenting

Baldwin et al. (1990)

Moderators: Social Cognition


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Guerra et al. (2003) 4,458 children living in urban neighborhoods,

ages 5 – 12 years and measured aggressive cognitions and behaviors Aggressive fantasy (Rosenfeld, Huesmann, Eron &

Torney-Purta, 1982) Normative beliefs Approving Aggression

(Huesmann & Guerra, 1997) Exposure effect in higher rates of

aggression, normative beliefs about aggression, and aggressive fantasy

The effects on social cognition were evident in ages 9-12

Moderators: Social Cognition


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Social cognition mediated relationship between violence exposure and aggression

Community violence effects children over time in their development of associated cognitions

Conclusions

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Preventative Measures


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Head Start Program Exposure to Violence Screening

Process Head Start Program Redirect Cognitions

Main Topics for Discussion

Overview of Exposure to Violence Forms and Prevalence

Consequences Psychological, Behavioral & Academic

Moderators Conclusion

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Thank you.


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Exposure to community VIOLENCE