Violence-exposed Children Research Articles

Differentiating Between Us & Them: Reduced In-Group Bias as a Novel Mechanism Linking Childhood Violence Exposure with Internalizing Psychopathology.

Strong in-group bonds, facilitated by implicit favoritism for in-group members (i.e., in-group bias), promote mental health across development. Yet, we know little about how the development of in-group bias is shaped by early-life experiences. Childhood violence exposure is known to alter social information processing biases. Violence exposure may also influence social categorization processes, including in-group biases, in ways that influence risk for psychopathology. We examined associations of childhood violence exposure with psychopathology and behavioral and neural indices of implicit and explicit bias for novel groups in children followed longitudinally across three time points from age 5 to 10years old (n = 101 at baseline;n = 58 at wave 3). To instantiate in-group and out-group affiliations, youths underwent a minimal group assignment induction procedure, in which they were randomly assigned to one of two groups. Youth were told that members of their assigned group shared common interests (in-group) and members of the other group did not (out-group). In pre-registered analyses, violence exposure was associated with lower implicit in-group bias, which in turn was associated prospectively with higher internalizing symptoms and mediated the longitudinal association between violence exposure and internalizing symptoms. During an fMRI task examining neural responses while classifying in-group and out-group members, violence-exposed children did not exhibit the negative functional coupling between vmPFC and amygdala to in-group vs. out-group members that was observed in children without violence exposure. Reduced implicit in-group bias may represent a novel mechanism linking violence exposure with the development of internalizing symptoms.

The Association between Treatment Components and Mental Health Outcomes Among Young Children Exposed to Violence.

When treating violence-exposed children, clinicians often modify psychotherapy protocols or use only a subset of treatment components (e.g., a clinical technique, strategy). However, there is little evidence of the effectiveness of individual treatment components. Our study aimed to determine: i) the best fitting factor structure of individual treatment components; ii) the association of child characteristics (i.e., demographics, treatment dosage, environmental risk factors) with mental health outcomes (i.e., post-treatment internalizing and externalizing symptoms); and iii) the association of individual treatment factors (i.e., sets of treatment components) with mental health outcomes. A sample of 459 violence-exposed children aged 1.5-5 years was examined. Principal component analyses were conducted to factor-analyze 22 child treatment components and 18 caregiver treatment components, respectively. Multiple linear regression analyses were conducted to determine the relationship between child and caregiver treatment factors and outcomes. Children who received grief work showed significant improvement in externalizing symptoms. Children of caregivers who received parent training, attachment skills building, psychoeducation about domestic violence, safety planning, and anger management training showed significantly less externalizing symptom improvement. Gender, race/ethnicity, and treatment dosage were also associated with outcomes. This is the first study to examine treatment components in a sample of young children exposed to violence with a standardized quantitative measure. Our findings suggest that acknowledging children's loss and sorrow expressed through externalizing behavior and helping them process bereavement may help alleviate their symptoms. Clinical recommendations are discussed.

Amygdala responses to threat in violence-exposed children depend on trauma context and maternal caregiving.

Early life adversity (ELA) has been linked with increased arousal responses to threat, including increased amygdala reactivity. Effects of ELA on brain function are well recognized, and emerging evidence suggests that caregivers may influence how environmental stressors impact children's brain function. We investigated the hypothesis that positive interaction between mother and child can buffer against ELA effects on children's neural responses to threat, and related symptoms. N = 53 mother-child pairs (children ages 8-14 years) were recruited from an urban population at high risk for violence exposure. Maternal caregiving was measured using the Parenting Questionnaire and in a cooperation challenge task. Children viewed fearful and neutral face stimuli during functional magnetic resonance imaging. Children who experienced greater violence at home showed amygdala sensitization, whereas children experiencing more school and community violence showed amygdala habituation. Sensitization was in turn linked with externalizing symptoms. However, maternal warmth was associated with a normalization of amygdala sensitization in children, and fewer externalizing behaviors prospectively up to 1 year later. Findings suggested that the effects of violence exposure on threat-related neural circuitry depend on trauma context (inside or outside the home) and that primary caregivers can increase resilience.

Opportunities to improve sleep of children exposed to interpersonal violence: A social-ecological perspective

Over 25% of U.S. children are witness to traumatic intrafamilial or community violence each year, and sleep medicine and developmental research jointly suggest that trauma-exposed youth experience more sleep disturbance than their non-exposed counterparts. Sleep medicine literature emphasizes physical and social environmental factors affecting sleep, and trauma literature underscores children’s seeking out physically and emotionally safe and predictable environments during trauma recovery. This study employed a hermeneutic phenomenological framing to explore the lived experiences of 65 violence-exposed children and families, and to examine how youths’ social and physical sleep environments facilitated or impeded sleep in the aftermath of trauma. Children’s sleep experiences following violence exposure shared two primary essences of experience: a) navigating external threats that agitated sleep after trauma; and b) exercising agency over sleep and related environments to restabilize emotional security. Clinicians and social services coordinators working with children and families are uniquely positioned to indicate sleep assessments as part of treatment following trauma, and to also facilitate identification of tangible, sleep-supportive and changeable factors in sleep environments.

Insula Habituation to Threatening Faces Varies by Anxiety Symptoms in Urban Children Exposed to Violence

The prevalence of anxiety disorders increases during the transition from childhood to adolescence, making this a critical period for characterizing anxiety risk. The inability to habituate to repeated presentation of threatening stimuli is a proposed characteristic of anxiety. We investigated habituation patterns in regions of the salience network (SN) involved in affective processing in violence-exposed children who are at increased risk of anxiety.

Service needs of children exposed to domestic violence: Qualitative findings from a statewide survey of domestic violence agencies

ObjectiveEach year, more than 6% of all U.S. children are exposed to domestic violence and require intervention services from agencies that serve affected families. Previous research has examined detrimental biopsychosocial consequences of domestic violence exposure during childhood and the importance of effective prevention and intervention services for this population. However, less research has explored diverse intervention professionals’ own perspectives on the needs of the domestic violence-exposed children they serve. MethodThis study employed an inductive approach to thematic analysis to investigate intervention professionals’ reflections and advice regarding the service, policy, and research needs as well as overall strategies to better protect children exposed to domestic violence. ResultsRespondents articulated four primary themes of (a) building general education and awareness of the effects of domestic violence exposure on children; (b) the need for trauma-informed care; (c) the salience of cultural humility in serving affected families; and (d) essential collaboration across service domains. Respondents discussed these themes in the context of four key systems of care: the clinical or therapy, family, school, and judicial systems. ConclusionsFuture research should integrate the voices of affected children and families as well as examine models for effectively implementing these recommendations into practice settings.

Latina Mothers’ Awareness of Their Children’s Exposure to Community Violence

This study examines (a) the degree of agreement between mother-reported child community violence exposure and children’s self-reports and whether agreement changes over time; (b) whether child gender is associated with mother-child agreement; and (c) whether greater mother-child agreement is concurrently and longitudinally associated with children’s psychological well-being. We conducted secondary data analyses using longitudinal data with a socioeconomically diverse sample of 287 Latino adolescents ( MageW2= 11.2, 47% girls) and their mothers ( MageW1= 35.3) from the Project on Human Development in Chicago Neighborhoods. Mother-child agreement about nonexposure to violence was high. However, for violence-exposed children, mothers overestimated exposure in early adolescence and underestimated it in middle adolescence. Mothers had higher violence agreement scores with daughters than with sons. Greater mother-child agreement about witnessing community violence in early adolescence was associated with lower externalizing problems in early and middle adolescence. Agreement about children’s victimization was only concurrently associated with lower externalizing and internalizing behaviors in early adolescence. Developmental changes in adolescent disclosure and parental knowledge of children’s community violence may provide an important point of intervention for addressing the psychological sequelae of violence exposure in early adolescence.

Adverse impact of multiple separations or loss of primary caregivers on young children

ABSTRACT Background: Young children may be adversely impacted by separation from and loss of caregivers and other loved ones. Such experiences often co-occur with interpersonal violence, unpredictability and other traumas. Whether separation/loss has unique effects independent of those other adversities is not known. Objective: This study aimed to establish whether separation/loss is associated with trauma-related symptoms, psychiatric disorders, and functional impairment in 18- to 48-month-old children independent of other adversities. Methods: Data from a cross-sectional community and clinical cohort were analyzed. Recruitment occurred in pediatric primary care, mental health, and developmental services sites. Children (33% female) were heterogeneous in ethnic background (55% minority) and family socioeconomic status (40% living in poverty). Results: Separation/loss was common (30.9% single type, 15.0% multiple types) and frequent amongst violence-exposed children (84.4% of violence-exposed children had experienced separation/loss from a loved one). However, violence exposure was uncommon amongst children with separation/loss experiences (only 23.9% were violence-exposed). Separation/loss was significantly associated with symptoms of posttraumatic stress and reactive attachment, as well as impairment and psychiatric disorders in models that controlled for sociodemographic and contextual risks, including other traumas. Psychiatric disorders were approximately 2.5 times more likely in children who had experienced multiple separations/losses, after accounting for interpersonal violence which was also significant. Conclusion: Professionals working with young children, policy-makers and caregivers should be aware that an accumulation of caregiver separations/losses, irrespective of violence and other traumatic exposure, may have detrimental effects on young children especially in the context of prior separations/losses or disruptions in their lives.

Altered development of hippocampus-dependent associative learning following early-life adversity

Little is known about how childhood adversity influences the development of learning and memory and underlying neural circuits. We examined whether violence exposure in childhood influenced hippocampus-dependent associative learning and whether differences: a) were broad or specific to threat cues, and b) exhibited developmental variation. Children (n = 59; 8–19 years, 24 violence-exposed) completed an associative learning task with angry, happy, and neutral faces paired with objects during fMRI scanning. Outside the scanner, participants completed an associative memory test for face-object pairings. Violence-exposed children exhibited broad associative memory difficulties that became more pronounced with age, along with reduced recruitment of the hippocampus and atypical recruitment of fronto-parietal regions during encoding. Violence-exposed children also showed selective disruption of associative memory for threat cues regardless of age, along with reduced recruitment of the intraparietal sulcus (IPS) during encoding in the presence of threat. Broad associative learning difficulties may be a functional consequence of the toxic effects of early-life stress on hippocampal and fronto-parietal cortical development. Difficulties in the presence of threat cues may result from enhanced threat processing that disrupts encoding and short-term storage of associative information in the IPS. These associative learning difficulties may contribute to poor life outcomes following childhood violence exposure.

‘They could have defended my mum and me’: children’s perspectives on grandparent responses to intimate partner violence

While children’s exposure to intimate partner violence (IPV) is a growing field of inquiry, their experiences of informal network responses have generally been overlooked. Particularly lacking are studies of grandchildren’s experiences of their relationship with their grandparents in the face of IPV. Drawing on interviews with 10 children aged 12–17, this article explores how violence-exposed children describe their relationships with their grandparents and how the older generation has responded to the abuse. The children’s stories can be interpreted as they expected their grandparents to ‘be there’ for them, to be important parts of their everyday lives, and wanted their grandparents to intervene and support them when learning of the IPV. Some grandparents intervened in helpful ways, for instance, they contributed to normality in the child’s everyday life, siding with the child and the adult victim and providing support and care. Others intervened in unhelpful ways, such as ignoring the violence, or taking the perpetrator’s side, and few intervened by attempting to end the violence. This article suggests that grandparents may, but not always, be a resource, both for violence-exposed children and professionals working with IPV.

“Love the kin you’re in?”: Kin network responses to women and children experiencing intimate partner violence

Intimate partner violence is often known to a wider social network. Still little research exists on the experiences of social networks, how they respond and how women and children experiencing intimate partner violence perceive these responses. This article draws on 16 qualitative interviews with women victims of intimate partner violence, intimate partner violence-exposed children and their relatives in three kin networks. The overall aim of this article is to study responses to intimate partner violence from a multivocal perspective where the possibly concurring and conflicting perspectives of both the victims and the networks are heard. More specifically, the article explores what responses are perceived as possible/impossible to end violence and create safety for women and children. The article shows how masculinity, in intersection with kin position and age, figures both as an obstacle and a possibility to end intimate partner violence. Moreover, the article shows that responses are shaped from intersections of age, kin and gender in victims, more specifically understandings of maturity and adulthood of female victims and how this linked to responsible motherhood. The study provided insights into responses to intimate partner violence as co-constructed in a wider social network and how a focus on multivocality may be useful for understanding the multidimensional character of responses to intimate partner violence.

Professionals’ Experiences With and Perceptions of Children Exposed to Severe and Homicidal Violence in Sweden

ABSTRACTThe present study aimed to examine professionals’ experiences, perceptions, and knowledge regarding violence-exposed children in order to clarify the status and opportunities these children have in the Swedish legal system. A questionnaire was distributed to 63 professionals, representing police, prosecutors, social personnel, and treatment personnel. Findings revealed several problems that hindered effective work. Routines and guidelines were lacking and knowledge gaps regarding these children were found among all professions. Perceptions that children remember and tell were widely held, although conditions enabling sufficient reports are seldom met. Results can be used to guide necessary changes in national routines and guidelines to ensure recovery and maintaining of societal rights of this group of psychologically abused victims.

Caregiver insightfulness and young children’s violence exposure: testing a relational model of risk and resilience

ABSTRACTThis study employed a relational post-traumatic stress frame to explore the co-contribution of young children’s exposure to violence and caregiver insightfulness on child behavioral outcomes in a high-risk, non-referred sample of caregivers and preschoolers (n = 64; mean age 3.83 years, SD = .77). Caregiver insightfulness did not have a main effect on child outcomes but did moderate the relation between violence exposure and child behavior across all observed outcomes. Violence-exposed children with non-insightful caregivers demonstrated higher caregiver-rated internalizing and externalizing behaviors and observer-rated negative affect than all other groups. Among children not exposed to violence, insightfulness was not related to children’s behavior problems or negative affect, suggesting violence-specific processes. Though cross-sectional, results suggest that the effects of violence and caregiver insightfulness on child outcomes are contingent on one another and that caregiver insightfulness may play a protective role in contexts of violence.

Are Community Violence-Exposed Youth at Risk of Engaging in Delinquent Behavior? A Review and Implications for Residential Treatment Research and Practice

Numerous studies have documented a direct association between children’s exposure to community violence and subsequent delinquent behavior. Regrettably, an understanding of the community violence exposure-delinquent behavior link is incomplete because violence-exposed children rarely engage in delinquency immediately. Rather, there are complex, developmental pathways in which these children experience behavioral problems before subsequently exhibiting delinquent behavior. Despite the importance of understanding the mechanisms that illuminate how children exposed to violence in the community might engage in delinquency, relatively few studies have investigated potential mechanisms. This review proposes four potential mechanisms: depression, anxiety/PTSD, conduct disorder, and aggression. More specifically, we examine how certain internalizing and externalizing behaviors can potentially mediate the relationship between community violence exposure and delinquent behavior. We also discuss implications for residential treatment research and practice.

Children television viewing and antisocial behaviour: Does the duration of exposure matter?

Media violence is related to media presentation of aggressive and violent behaviour directed at characters in the media story. Specifically, researchers have identified evidence that children's exposure to television violence is directly related to immediate and later aggressive behaviour. The relationship between television exposure and students; aggression behavior has not been studied extensively in Iranian elementary students. The purpose of this study was to assess the relative effects of television exposure on aggression behaviour among elementary students in Iran.A cross-sectional survey was conducted on 424 primary school students (aged 7-12 years) in the five provinces of Iran which selected trough a multi-stage random sampling from different geographical areas comprising of North, South, West, East and central area of Iran. This survey investigated whether exposure to television program was related to children's use of social aggression that explored using Buss- Perry standard questionnaire. The results of the study revealed a significant relationship between amount of exposure to television program and aggressive behaviours among primary school students (p<0.05). In addition, students’ aggression was positively associated with watching movies with action genre (p<0.05). Furthermore students’ leisure time filling with television was moderately correlated with their aggression level. The findings suggest that young people’s aggressive behaviours may be related to their frequent exposure to television programs and its violent contents. Results of this study suggested the need for further attention on television children’s program production to protect them from antisocial behaviours and interventions for violence-exposed children in order to reduce negative outcomes.

How Much Does “How Much” Matter? Assessing the Relationship Between Children’s Lifetime Exposure to Violence and Trauma Symptoms, Behavior Problems, and Parenting Stress

The study explores whether and how lifetime violence exposure is related to a set of negative symptoms: child internalizing and externalizing behavior problems, child trauma symptoms, and parenting stress. Using a large sample of violence-exposed children recruited to participate in intervention research, the study employs different methods of measuring that exposure. These include total frequency of all lifetime exposure, total frequency of lifetime exposure by broad category (i.e., assault, maltreatment, sexual abuse, and witnessing violence), and polyvictimization defined as exposure to multiple violence categories. The results indicate that only polyvictimization, constructed as a dichotomous variable indicating two or more categories of lifetime exposure, emerged as a consistent predictor of negative symptoms. The total lifetime frequency of all violence exposure was not associated with negative symptoms, after controlling for the influence of polyvictimization. Likewise, in the presence of a dichotomous polyvictimization indicator the total lifetime frequency of exposure to a particular violence category was unrelated to symptoms overall, with the exception of trauma symptoms and experiences of sexual abuse. Taken together, these findings suggest that total lifetime exposure is not particularly important to negative symptoms, nor is any particular category of exposure after controlling for polyvictimization, with the single exception of sexual abuse and trauma symptoms. Instead, it is the mix of exposure experiences that predict negative impacts on children in this sample. Further research is needed to continue to explore and test these issues.

Attention Bias to Emotional Faces in Young Children Exposed to Intimate Partner Violence

Children exposed to intimate partner violence are at increased risk for posttraumatic stress disorder. The goal of the study was to test whether attention bias to threat was associated with a diagnosis of posttraumatic stress disorder in young children exposed to intimate partner violence. The probe detection task, which uses reaction times in response to probes to assess attention orientation to emotional faces, was administered to intimate partner violence-exposed children to measure their attention bias to angry and happy faces, relative to neutral faces. The results indicated that violence-exposed children with posttraumatic stress disorder had greater attention bias toward angry faces than violence-exposed children without posttraumatic stress disorder. This suggests that attention bias to threat is associated with the development of posttraumatic stress disorder in children exposed to intimate partner violence.

Academic and school health issues among children exposed to maternal intimate partner abuse.

To determine the association between children's exposure to maternal intimate partner violence (IPV) and academic problems and school health concerns. The study population consisted of 153 children aged 5 to 16 years who attended public school and whose mothers experienced police- or court-reported IPV. The comparison group consisted of public school peers of the exposed children. Generalized linear modeling using a binomial distribution and log-link function served as the primary method of analysis. Urban public school district. The occurrence of academic problems and type-specific school nurse visits during the 1-year study period. Children whose mothers experienced IPV were more likely to be suspended from school (relative risk [RR], 1.8; 95% confidence interval [CI], 1.2-1.7) and to have had frequent non-suspension-related absences (RR, 1.6; 95% CI, 1.0-2.3) than comparison children after adjusting for relevant confounders. Intimate partner violence-exposed children were more likely to have a school nurse visit for social or emotional complaints (RR, 2.2; 95% CI, 1.3-3.9), a visit that resulted in being sent home from school (RR, 1.6; 95% CI, 1.1-2.3), or a visit that led to referral to the school speech pathologist (RR, 7.5; 95% CI, 1.9-29.6) relative to comparison schoolchildren after adjusting for relevant confounders. Children's exposure to maternal IPV is significantly associated with the occurrence of academic problems and school health concerns. Describing the increased risk of the academic and health problems exhibited by IPV-exposed children relative to nonexposed children offers the possibility of improving the likelihood that clinicians will identify the woman who experienced abuse and her children, and promote referral to appropriate resources.

Children in a Violent Society

Back to table of contents Previous article Next article Book Forum: CHILD PSYCHIATRYFull AccessChildren in a Violent SocietyALBERT J. SOLNIT, M.D., ALBERT J. SOLNITSearch for more papers by this author, M.D., New Haven, Conn.Published Online:1 Feb 2000AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail This is a timely, well-edited collection of essays reflecting the observations and studies of dedicated active researchers concerned with children in a violent society. It has the strengths and weaknesses of a multiauthored volume, but the strengths greatly outweigh the weaknesses. This book will serve as an essential reference for advancing studies focused on this painful, complex, and compelling area of human tragedy. Throughout there are productive efforts to explore interventions that can ameliorate grave consequences of violence to several generations of children, adolescents, and adults.In these seminal essays, the following recurring themes are vividly and persuasively presented:1. The culture of poverty attracts and magnifies violence. More important, these essays demonstrate that children in poverty who are exposed to violence do not have options that middle- and upper-class children have to cope with and to mitigate as well as to overcome the trauma caused by exposure to violence. As the editor states, “The environment, that is, the social and cultural context in which families live, can help either to promote or buffer violence” (p. 263).2. No one method or theory is sufficient or adequate to evaluate and provide a treatment rehabilitation plan for those children who are psychologically and emotionally damaged by violence. In that sense, we must remain as humble and curious about individual cases as August Aichhorn was in his 1925 classic Wayward Youth(1), while admiring and learning from the authors of this book about population-centered studies. Soon after Children in a Violent Society was published in 1997, Violence in American Schools(2) was published; the two volumes complement each other in the spectrum of perspectives they provide, from clinical to sociological.3. To a great extent, the evaluation and treatment of the individual child must be tailored to that unique child and his or her experiences, family, and neighborhood. As Jenkins and Bell state, “The issue is not to treat all violence-exposed children as if they will be devastated by the experience, but rather to approach each exposed child as one at-risk and one for whom there must be some attempt to establish his or her level of potential morbidity” (p. 27). As eloquently stated by Marans and Adelman, “When there is no one available to listen, children are alone with the distress and disorganization that so often follows their close encounters with interpersonal violence. On their own, attempts to recover from overwhelming fear, uncertainty, and helplessness may be at a very high price to children’s developmental potential as well as to the communities that have been unable to protect or support them” (p. 220).Moving from the individual child exposed to violence to the “culture of violence,” Garbarino and Kostelny state, “One of the conclusions we draw from our observations of children coping with chronic violence in the United States today [is that] children are capable of coping with one or two major risk factors in their lives. But when risk accumulates—as with the addition of a third, fourth and fifth risk factor—we see a precipitation of developmental damage, particularly relevant to understanding the impact of chronic community violence on inner-city children” (p. 34).As one reads this book, it is well to keep in mind that in the United States, as reported by the Centers for Disease Control, the Department of Education, and the Justice Department (3), there is a trend toward less violence in the schools and a decrease in violent crimes committed by children and teenagers. However, due to the shocking violence of these incidences, especially because of the availability and efficiency of the weapons employed, surveys indicate that children feel less safe in schools and adults are more fearful of adolescents.This book is a necessary and highly readable resource for those who are concerned with children in a violent society, especially if they wish to be aware of where we are and how far we have yet to travel in assuring that children receive the high priority they need and deserve.edited by Joy D. Osofsky, Ph.D. New York, Guilford Publications, 1997, 338 pp., $40.00; $19.95 (paper).