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Exposure to community VIOLENCE

Exposure to community VIOLENCE. Inga Brege PSYC 1016 - Trauma and Development. Main Topics for Discussion. Overview of Exposure to Violence Forms and Prevalence Consequences Psychological, Behavioral & Academic Moderators Conclusion. Overview. Forms & Prevalence. Exposure to Violence.

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Exposure to community VIOLENCE

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  1. Exposure to community VIOLENCE Inga Brege PSYC 1016 - Trauma and Development

  2. Main Topics for Discussion • Overview of Exposure to Violence • Forms and Prevalence • Consequences • Psychological, Behavioral & Academic • Moderators • Conclusion Exposure to Community Violence | Inga Brege

  3. Overview Forms & Prevalence Exposure to Community Violence | Inga Brege

  4. Exposure to Violence • 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) Exposure to Community Violence | Inga Brege

  5. 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) Exposure to Community Violence | Inga Brege

  6. Forms & Levels • Environment of Exposure • Domestic Violence (Familial and Home) • Community Violence (Residential or School) • Zinzow et al. (2009) Exposure to Community Violence | Inga Brege

  7. Community Violence • “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) Exposure to Community Violence | Inga Brege

  8. Forms of Community Violence • Severe • Shootings • Threats with a weapon • Mugging/Robbery • Stabbing • Homicide • Mild • Chasing • Beating • Shoving/Grabbing • Shahinfar et al. (2000) Exposure to Community Violence | Inga Brege

  9. 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) Exposure to Community Violence | Inga Brege

  10. Prevalence of Community Violence • 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) Exposure to Community Violence | Inga Brege

  11. 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 Exposure to Community Violence | Inga Brege

  12. Prevalence of Community Violence • Dyson (1990) • 530 Chicago elementary school children • 33% witnessed shooting • 31% witnessed stabbing • 84% witnessed a beating Exposure to Community Violence | Inga Brege

  13. 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) Exposure to Community Violence | Inga Brege

  14. 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 Exposure to Community Violence | Inga Brege

  15. 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 Exposure to Community Violence | Inga Brege

  16. 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) Exposure to Community Violence | Inga Brege

  17. 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) Exposure to Community Violence | Inga Brege

  18. 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) Exposure to Community Violence | Inga Brege

  19. Discussion • What could be some limitations in assessing the prevalence of exposure to violence? Exposure to Community Violence | Inga Brege

  20. 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) Exposure to Community Violence | Inga Brege

  21. Consequences Psychological, Behavioral and Academic Exposure to Community Violence | Inga Brege

  22. 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 Exposure to Community Violence | Inga Brege

  23. 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) Exposure to Community Violence | Inga Brege

  24. 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) Exposure to Community Violence | Inga Brege

  25. 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 Exposure to Community Violence | Inga Brege

  26. 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 (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 Exposure to Community Violence | Inga Brege

  27. 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 Exposure to Community Violence | Inga Brege

  28. 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 Exposure to Community Violence | Inga Brege

  29. 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 (>1 standard deviation less) Exposure to Community Violence | Inga Brege

  30. 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 Exposure to Community Violence | Inga Brege

  31. 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 Exposure to Community Violence | Inga Brege

  32. Schwab-Stone et al. (1999) Exposure to Community Violence | Inga Brege Violence in School and Community 7/7/2009

  33. Discussion • How do the authors account for the results regarding anxiety? • How else might you explain these findings? Exposure to Community Violence | Inga Brege

  34. Discussion • Would expect the same effects for both victimization and witnessing violence? Exposure to Community Violence | Inga Brege

  35. 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 Exposure to Community Violence | Inga Brege

  36. 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 Exposure to Community Violence | Inga Brege

  37. 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) Exposure to Community Violence | Inga Brege

  38. 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) Exposure to Community Violence | Inga Brege

  39. 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) Exposure to Community Violence | Inga Brege

  40. 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) Exposure to Community Violence | Inga Brege

  41. Discussion • What other factors could affect academic performance in adolescents exposed to community violence? Exposure to Community Violence | Inga Brege

  42. 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) Exposure to Community Violence | Inga Brege

  43. Moderators of Consequences Exposure to Community Violence | Inga Brege

  44. 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) Exposure to Community Violence | Inga Brege

  45. 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 Exposure to Community Violence | Inga Brege

  46. Moderators: Family Size • Overstreet et al. (1999) • Smaller family size moderated depressive symptoms in those previously exposed to community violence Exposure to Community Violence | Inga Brege

  47. 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? Exposure to Community Violence | Inga Brege

  48. 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) Exposure to Community Violence | Inga Brege

  49. 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) Exposure to Community Violence | Inga Brege

  50. 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 Exposure to Community Violence | Inga Brege

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