Exposure to community VIOLENCE

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Exposure to community VIOLENCE

• Inga Brege
• PSYC 1016 - Trauma and Development

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Main Topics for Discussion

• Overview of Exposure to Violence
• Forms and Prevalence
• Consequences
• Psychological, Behavioral Academic
• Moderators
• Conclusion

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Overview

• Forms Prevalence

4
Exposure to Violence

• Exposure to interpersonal violence in ones
  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)

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Direct vs. Indirect

• 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)

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Forms Levels

• Environment of Exposure
• Domestic Violence (Familial and Home)
• Community Violence (Residential or School)
• Zinzow et al. (2009)

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Community Violence

• The presence of violence and violence related
  events within an individuals 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)

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Forms of Community Violence

• Severe
• Shootings
• Threats with a weapon
• Mugging/Robbery
• Stabbing
• Homicide
• Mild
• Chasing
• Beating
• Shoving/Grabbing
• Shahinfar et al. (2000)

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Prevalence of Community Violence

• 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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Prevalence of Community Violence

• Homicide second leading cause of death in 15-24
  year olds at 20.3100,000
• Inner-city youth at 143.9100,000
• 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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Prevalence of Community Violence

• 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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Prevalence of Community Violence

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

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Prevalence of Community Violence

• 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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Prevalence of Community Violence

• 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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Prevalence of Community Violence

• 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

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Other Community Violence

• 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)

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Prevalence of School Violence

• 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)

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Prevalence of School Violence

• 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)

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Discussion

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

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Discussion

• 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)

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Consequences

• Psychological, Behavioral and Academic

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Consequences

• 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

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Psychological Consequences

• Posttraumatic Stress Disorder (PTSD)
• Re-experiencing/intrusive thoughts
• Avoidance
• Arousal
• Posttraumatic Stress (PTS) symptoms
• Anxiety
• Depressive symptoms
• Somatization
• Major Depressive Disorder
• Generalized Anxiety Disorder
• Mazza Overstreet (2000)

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Psychological Consequences

• 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)

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Posttraumatic Stress Symptoms

• 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

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PTSD/PTS Comorbidty

• 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
  (plt.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

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Depression

• 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

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Suicidal Ideation

• 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

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Anxiety

• 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 (gt1 standard deviation less)

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External Consequences

• 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

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Schwab-Stone et al. (1999)

• 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

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Schwab-Stone et al. (1999)
7/7/2009
Violence in School and Community
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Discussion

• How do the authors account for the results
  regarding anxiety?
• How else might you explain these findings?

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Discussion

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

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Direct vs. Indirect Exposure

• 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

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Direct vs. Indirect Exposure

• 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

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Academic Consequences

• 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 Consequences

• 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)

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Academic Consequences PTS/PTSD

• 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)

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Academic Consequences Depression

• 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)

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Discussion

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

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Academic Consequences

• 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)

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Moderators of Consequences
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Resiliency Risk Factors

• 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)
• Mazza Overstreet (2000)

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Moderators Maternal Figures

• 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

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Moderators Family Size

• Overstreet et al. (1999)
• Smaller family size moderated depressive symptoms
  in those previously exposed to community violence

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Discussion

• 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?

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Moderators Family Dynamics

• 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)

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Moderators Family Dynamics

• 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)

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Moderators Social Cognition

• 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

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Moderators Social Cognition

• Social cognition mediated relationship between
  violence exposure and aggression
• Community violence effects children over time in
  their development of associated cognitions

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Conclusions
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Preventative Measures

• Head Start Program
• Exposure to Violence Screening Process
• Head Start Program
• Redirect Cognitions

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Main Topics for Discussion

• Overview of Exposure to Violence
• Forms and Prevalence
• Consequences
• Psychological, Behavioral Academic
• Moderators
• Conclusion

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Thank you.