Traumatic stress symptoms in women exposed to community and partner violence

Prior research documents increased trauma symptoms associated with exposure to violence, primarily by examining types of violence separately. This study extends prior research by examining traumatic stress symptoms associated with two types of violence exposure, community violence and partner violence. A sample of 90 low-income African American women from an urban area completed measures assessing exposure to community violence, partner violence, and trauma symptoms. Exposure to community violence and partner violence were associated with increased reporting of trauma symptoms. Participants who experienced high levels of exposure to both types of violence reported more trauma symptoms than women who were exposed to only one type of violence or neither type of violence. The results suggest that the accumulation of exposures to violence is linked with greater distress. Thus, interventions with women exposed to violence should assess violence exposure in multiple domains and attend to the implications of multiple exposures to violence.     

The Importance of the Caregiver and Adolescent Relationship for Mental Health Outcomes Among Youth in Foster Care

Youth in foster care have often been exposed to in-home violence and violence exposure is associated with higher mental health concerns. This study used multiple regression mediation analyses with bootstrapping to identify specific current foster caregiver-adolescent relationship factors and their mediating qualities between in-home violence exposure and adolescent internalizing, externalizing, and trauma symptoms. Using a national dataset of adolescents in foster care (n?=?175), the results of this study suggested that an adolescent’s perception of feeling emotionally secure in their relationship with their caregiver mediated the relationships between exposure to violence and youth internalizing, externalizing, and trauma symptoms. Additionally, current foster caregiver involvement and structure mediated the associations between exposure to violence and adolescent internalizing and externalizing outcomes, but not trauma symptoms. Further discussion of the results is included. Findings have important implications for mental health interventions aimed towards youth in foster care.     

Nature-nurture interplay: genetically informative designs contribute to understanding the effects of trauma and interpersonal violence

The past two decades have seen an explosion in research in the fields of violence and trauma and behavior genetics. These two fields came into direct conflict when Lisabeth Fisher DiLalla and Irving I. Gottesman outlined a fundamental conceptual limitation of trauma and violence research: that rather than being causal, the well-documented relationship between exposure to trauma or violence and later negative outcomes could be explained by gene-environment correlation. In the past decade, researchers have addressed this limitation by studying the effects of trauma and violence using genetically informative designs. This report briefly discusses the gains made from this research approach and the promising future for genetically informative trauma and violence research.     

Relationship between type of trauma exposure and posttraumatic stress disorder among urban children and adolescents

This study examines the association between trauma exposure and posttraumatic stress disorder (PTSD) among 157 help-seeking children (aged 8-17). Structured clinical interviews are carried out, and linear and logistic regression analyses are conducted to examine the relationship between PTSD and type of trauma exposure controlling for age, gender, and ethnicity. Confrontation with traumatic news, witnessing domestic violence, physical abuse, and sexual abuse are each significantly associated with PTSD. Witnessing a crime, being the victim of a crime, and exposure to accidents, fire, or disaster are not associated with PTSD. These findings underscore the association between interpersonal violence and childhood PTSD.     

Subjective effect of September 11, 2001 among pregnant women: is cumulative history of interpersonal violence important?

Prior history of trauma may sensitize individuals to subsequent trauma, including terrorist attacks. Using a convenience sample of secondary, cross-sectional data, pregnant women were grouped based on lifetime interpersonal violence history. Cumulative risk theory was used to evaluate the association of lifetime interpersonal violence history and subjective impact of the September 11, 2001 (9/11) terrorists attacks. Using hierarchical linear regression, cumulative risk theory was partially supported. Women with a history of only one type of interpfersonal violence reported greater effect of 9/11 than did women without a history, but women with both types of violence did not report a greater effect of 9/11 compared to women endorsing history of one type. These data corroborate the literature in that level of exposure to terrorist-related trauma predicts subjective reaction to the attacks. Future research with a larger sample and standardized instruments is warranted.     

Multiple traumatic experiences and the development of posttraumatic stress disorder

This study assesses the differential and combined impacts of multiple lifetime stressors in the development and severity of posttraumatic stress disorder (PTSD) symptoms. One hundred and four clinical and 64 nonclinical participants were assessed for their exposure to four types of interpersonal trauma: physical and sexual abuse in childhood, lifetime community violence, and domestic violence in adulthood. PTSD symptomatology was assessed using the Los Angeles Symptom Checklist (LASC). Results indicated that exposure to lifetime multiple traumatic experiences was positively correlated with severity of PTSD symptoms. Clinical participants had experienced significantly more multiple traumas and had a higher rate of PTSD than the nonclinical participants. Results also suggested that adults who had experienced childhood sexual abuse were at higher risk for the development of PTSD related to interpersonal violence than adults who were not sexually abused as children.     

20 years of research into violence and trauma: past and future developments

This reflection on major developments in the past, present, and future of the wider field of violence and trauma is a personal (and probably biased) sampling of what the authors hold to be important. The authors reviewed advances for victims and perpetrators of violence separately. For victims, the authors note that empirical research has established the potential traumatic impact of violence as well as various predictors of what makes persons vulnerable to adverse psychological consequences. The authors also note that the definitions of violence and trauma have evolved to include such behavioral patterns as stalking. Finally, encouraging evidence regarding the efficacy of exposure-based treatments for victims of violence is reviewed, as well as discouraging evidence regarding the efficacy of single-session debriefing following trauma. For the perpetrators, the importance of individual assessment in planning interventions is underscored, and advances in explicit and implicit assessment techniques are discussed.     

Child Maltreatment and Intimate Partner Violence Among Indigenous and Non-Indigenous Canadians

Indigenous peoples of Canada face an elevated risk of intimate partner violence (IPV) compared to non-Indigenous Canadians. Few empirical studies have been conducted to understand this elevated risk, and none have examined child maltreatment (CM) as a predictor. This study used data on a nationally representative sample of 20,446 Canadians to examine CM and proximal risk factors for IPV against Indigenous and non-Indigenous respondents. Results showed that Indigenous respondents had greater risk of experiencing both CM and IPV. All three forms of CM (exposure to violence, direct physical and/or sexual abuse victimization, as well as both exposure and direct victimization) were associated with increased odds of IPV in adulthood. CM along with proximal risk factors accounted for Indigenous peoples’ elevated odds of IPV (AOR = 1.62; NS). These results were consistent with the theory that Indigenous peoples’ elevated risk of IPV is largely due to effects of historical trauma from past and continuing colonization. Reducing Indigenous peoples’ disproportionate risk of IPV requires efforts to reduce CM and its negative developmental effects among Indigenous peoples as well as resolving the manifestations of historical and contemporary trauma within Indigenous society.     

History of interpersonal violence, abuse, and nonvictimization trauma and severity of psychiatric symptoms among children in outpatient psychiatric treatment

In a clinical sample of child psychiatry outpatients, chart review data were collected for 114 consecutive admissions over a 1-year period at a Child and Adolescent Outpatient Psychiatry Clinic. Data included history of documented maltreatment, potentially traumatic domestic or community violence, neglect or emotional abuse, and noninterpersonal stressors as well as demographics, psychiatric diagnoses, and parent-rated child emotional and disruptive behavior problems. On a bivariate and multivariate basis, any past exposure to interpersonal violence-but not to noninterpersonal traumas-was related to more severe disruptive behavior problems, independent of the effects of demographics and psychiatric diagnoses. Noninterpersonal trauma and psychiatric diagnoses were associated with emotional problems; exposure to interpersonal violence appeared to partially account for this relationship despite not being independently associated with emotional problem severity. History of exposure to interpersonal violence warrants clinical and research attention as a severity marker and potential treatment focus in psychiatric outpatient services for children, particularly those with disruptive behavior problems.     

Contributions to the study of violence and trauma: multisystemic therapy, exposure therapy, attachment styles, and therapy process research

The prevention of future violence through engaging violent adolescents in multisystemic therapy and the treatment of trauma with exposure therapy are two of the most important scientific advances in the field of interpersonal violence in the past 20 years. A particularly significant methodological innovation is the development of reliable and valid measures of childhood and adult attachment because attachment deficits and their remediation are central to understanding and treating perpetrators of violence. In the coming decades, we need to refine existing treatment programs to make them effective for cases currently classified as treatment resistant. This will involve psychotherapy process research on the interaction between therapeutic mechanisms of change and unique personal vulnerabilities of treatment-resistant cases.     

African American adolescents living and coping with community violence on Chicago's southside

This study explores community violence exposures among African American adolescents and whether coping strategies were gendered. In-depth interviews are conducted with a sample of 32 African American high school students. Data are analyzed using a thematic analysis. The primary forms of violence exposures are physical attacks, fighting, and incidents involving police, gun violence, and murders. Boys report more exposure to violence as victims and witnesses, whereas girls are more likely to hear about violent acts. Coping styles range from "getting through," which included both an acceptance of community conditions; "getting along," which included self-defense techniques; "getting away," which included avoidance coping strategies; and "getting back," which consisted of confrontational coping strategies. Boys report more confrontational coping styles than are girls, who utilized more avoidance approaches. Widespread school-based interventions are warranted, given the high prevalence of community violence exposure among these youth and may provide important supports for coping against such trauma.     

Advances in violence and trauma: toward comprehensive ecological models

The most important things learned about violence and trauma in the past 20 years are that interpersonal violence is prevalent, with different forms co-occurring, and that victims' reactions are complex. Researchers are called to consider models that include the ecological context within which victims experience violence and trauma to gain a better understanding of the variation seen in psychological outcomes. Multivariate data-analytic techniques such as structural equation modeling and cluster analysis are suggested as promising ways to explore questions framed by comprehensive models. These recommendations are predicted to provide comprehensive and individualized ways to intervene and prevent interpersonal violence.     

The relationship between trauma and violence in a jail inmate sample

Research suggests there is a link between trauma and violence, although the nature of the relationship is rather equivocal. This study explored this relationship by examining self-reported trauma as a predictor of self-reported violence in 93 jail inmates. Ninety-six percent of the sample reported experiencing a traumatic event, and 67% reported having been violent during the year preceding incarceration. Inmates reporting trauma were more than twice as likely to report having been violent than nonviolent. Stepwise multiple regression analyses suggested traumatic events, as a combined model, significantly contributed to violence perpetration. In addition, witnessing serious violence predicted perpetration of violence. Implications and limitations of the present study are discussed.     

The most important things learned about violence and trauma in the past 20 years

In the past 2 decades, important insights have been gained regarding violence and trauma. Complications occur in how violence and trauma, their causes, and their effects on victims should be defined. Violence and abuse to women--physical, sexual, and emotional--are not rare events and are most often perpetrated by partners or acquaintances rather than strangers and occur in nonmarital as well as marital relationships, including same-sex relationships. A promising methodological innovation in the study of violence and trauma is the use of longitudinal designs. Innovations in treatments for victims such as evidence-based interventions have been slow to emerge; they include eye movement desensitization and reprocessing (EMDR) and the Seeking Safety group intervention for drug-abusing women with trauma histories. Future research should address increased understanding of variation in individual responses to violence and trauma, matching of treatment to different types of male offenders, better understanding of how culture affects violence perpetration and victimization, and evaluation of domestic violence interventions.     

NEIGHBORHOOD CONTEXT AND NONLINEAR PEER EFFECTS ON ADOLESCENT VIOLENT CRIME*

Although evidence of the strong correlation between deviant behavior and exposure to deviant peers is overwhelming, researchers have yet to investigate whether a nonlinear functional form better captures this relationship than does a linear form. Researchers also have yet to examine the extent to which peer effects vary as a function of the neighborhood context. To address these issues, we use data from the Project on Human Development in Chicago Neighborhoods (PHDCN) to examine 1) the functional form of the relationship between peer violence exposure and self‐reported violent crime and 2) the extent to which the effect of exposure to violent peers on violence is ecologically structured. Estimates from logistic hierarchical models indicate that the effect of peer violence exposure on violent crime decreases at higher values of peer violence, as reflected in a nonlinear relationship (expressed in terms of log‐odds). Furthermore, exposure to violent peers increases along with neighborhood disadvantage, and the effect of peer violence exposure on violent crime is attenuated as neighborhood disadvantage increases, which is reflected in a cross‐level peer violence/disadvantage interaction.     

Isolating Adult Psychological Correlates of Witnessing Parental Violence: Findings from a Predominantly Latina Sample

This study examined the relationship between childhood exposure to parental violence and adult psychological functioning in a sample of predominantly Mexican American participants. Questionnaires assessing childhood maltreatment, family environment, and current psychological symptomatology were completed by 142 female undergraduates. Findings revealed that witnessing parental violence in childhood was associated with depressive symptoms, low self-esteem, and trauma symptoms in adulthood, even after controlling for child physical and sexual abuse. However, in subsequent analyses, also controlling for levels of nonphysical family conflict, previous associations between exposure to parental violence and adult symptomatology were reduced, such that trauma-related symptoms remained the sole outcome still predicted by a history of witnessing parental violence. Implications of these findings, issues related to the use of statistical control procedures in abuse effects research, and directions for future investigation are discussed.     

Traumatic Events and Maternal Education as Predictors of Verbal Ability for Preschool Children Exposed to Intimate Partner Violence (IPV)

Despite research on the effects of intimate partner violence (IPV) on children, little is known about its impact on cognitive development. In this study, 87 preschool-aged children and their mothers exposed to IPV within the last two years participated in interviews to ascertain verbal ability, history of violence, and exposure to trauma. When compared to a national sample of 1,700 same-age children not evaluated for exposure to traumatic events, children exposed to IPV scored significantly lower on verbal ability, as assessed with standardized measures. In order to understand variation in verbal ability, multiple regression models were tested. Both prior exposure to traumatic events and the level of mother’s education were significant predictors of verbal ability. However, level of education mediated the relationship between traumatic events and the child’s verbal ability.     

PTSD Symptom Trajectories among Mothers Reporting Interpersonal Trauma: Protective Factors and Parenting Outcomes

The childbearing years are further complicated when experiences of interpersonal trauma from childhood and/or adulthood lead to symptoms of posttraumatic stress disorder (PTSD). Maternal symptoms of PTSD over time were examined in relation to supportive adult relationships and parenting experiences. Ninety-five primarily economically disadvantaged mothers reporting exposure to childhood maltreatment and/or intimate partner violence were assessed from pregnancy through 2-years postpartum. Latent class growth analysis of PTSD symptoms indicated a 2-group model: stable low (82%) and moderate dysfunction (18%). The stable low group reported higher levels of support from romantic partners and family members, but not friends, and lower levels of parenting distress compared to the moderate dysfunction group. Results highlight individual variability in adaptation after violence exposure; current support from romantic partners and family members may have helped maintain lower PTSD symptoms for some trauma-exposed mothers. Psychological interventions aimed at reducing the impact of trauma exposure on parenting should consider promoting ongoing social support.     

Trauma and violence research: taking stock in the 21st century

Thirty years after the first national estimates of intimate partner violence were published, the field has reached such a level of maturity that complex questions can be posed and sophisticated research studies can be designed to answer them. Out of this body of research, one of the most important things that researchers have learned is that violence and trauma are experienced in different ways by different individuals and as a result, require different types of prevention and intervention approaches. With this greater understanding of the problems of violence and trauma, together with a commitment to inclusive and practical research, the field is poised to move forward toward the ultimate goal of violence prevention.     

Clinically Significant Trauma Symptoms and Behavioral Problems in a Community-based Sample of Children Exposed to Domestic Violence

This study assessed the associations of characteristics of domestic violence incidents with clinically significant levels of traumatic symptoms and behavioral problems in a socio-economically and ethnically mixed sample of 687 children participating in a community-service program for children witnessing violence. Study predictors included child/family demographic characteristics, type and chronicity of exposure, and child’s perceptions of control over the event and threat to personal safety. Outcomes consisted of traumatic symptoms and behavior problems. Results showed that perceived threat and control were associated with greater odds of clinically significant levels of several trauma symptoms (and behavior problems in the case of perceived threat) after adjusting for effects of demographic factors and violence characteristics. Child co-victimization increased odds of reaching clinically significant levels of traumatic symptoms compared to children who witnessed the event but were not victimized. Female sex and White ethnicity increased odds of specific trauma symptoms and behavior problems. Increasing age reduced odds of some trauma symptoms. Associations between predictors and one outcome measure did not generalize across the other outcome measure. Implications of study findings, and directions for future research are discussed.