Exposure of youth to violence in their families and communities is a serious societal problem because of the number of youth who experience violence and the documented toll of violence on youth's physical, emotional, and academic adjustment [1]. Approximately 5-16% of youth are recipients of parent's severe aggression or abuse, and over 50% experience minor parental aggression including corporal punishment [2]. Interparental aggression is experienced by 29% of youth in two-parent households [3], whereas community violence is directly experienced by 30-50% and witnessed by over 90% of youth [4].The need for integrated approaches to examining violence exposure arises from mounting evidence that children who experience violence in one domain have an increased likelihood of violence in other domains [5,6,7]. Hundreds of studies examining separate types of violence exposure show wide ranging negative outcomes including aggression and delinquency, emotional and mood disorders, post-traumatic stress symptoms, risk-taking behaviors, and compromised cognitive performance [8]. However, the compartmentalization of literatures on exposure to marital aggression, parent-to-child aggression, and community violence has limited our overall understanding of the impact of violence. The present study integrates these three interpersonal domains of violence exposure in two ways. First, using frequency counts, we examine whether different interpersonal domains of violence exposure are uniquely associated with specific symptoms. Second, we assess the impact of cumulative violence exposure that sums presence vs. absence of violence across domains and years.Direct comparisons linking specific violence exposure types with specific outcomes are relatively rare. In a study of youth receiving mental health services, community violence and maltreatment contributed uniquely to conduct disorders, whereas domestic violence did not, and community violence, but not maltreatment and domestic violence, predicted externalizing behavior [9]. In a sample of youth identified by child protective services, harsh physical discipline was associated with externalizing, whereas witnessing home violence was associated with internalizing behaviors [10]. A school-based study [11] examining school, home and neighborhood violence reported that school and home exposure predicted internalizing symptoms whereas only home exposure predicted delinquency and overt Corresponding Author: Gayla Margolin, Ph.D., University of Southern California, Psychology Department-SGM 930, 3620 McClintock, Los Angeles, CA 90089-1061, Telephone: 213-740-2308.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the con...

This study offers a preliminary look at e-cigarette use among state quitline callers and is perhaps the first to describe e-cigarette use in a large group of tobacco users seeking treatment. The notable rates of e-cigarette use and use of e-cigarettes as cessation aids, even though the U.S. Food and Drug Administration has not approved e-cigarettes for this purpose, should inform policy and treatment discussions on this topic.

Exposure to child physical abuse and parents' domestic violence can subject youth to pervasive traumatic stress and lead to Post-traumatic Stress Disorder (PTSD). The often repeating and ongoing nature of family violence exposure may result in youth exhibiting problems in multiple domains of functioning and meeting criteria for multiple disorders in addition to PTSD. These characteristics as well as unique factors related to children's developmental level and symptom presentation complicate a PTSD diagnosis. This paper describes evolving conceptualizations in the burgeoning field of trauma related to family violence exposure, and reviews considerations that inform assessment and treatment planning for this population. KeywordsPost-traumatic stress disorder (PTSD); child physical abuse; domestic violence; complex trauma; Developmental Trauma Disorder (DTD) Children's interpersonal violence exposure is now recognized as a potential precursor to posttraumatic stress disorder (PTSD) in youth with the acknowledgement that extraordinarily stressful events can occur as part of children's customary experiences. Early examples of children's PTSD focused on sudden, out-of-the-ordinary catastrophic events such as sniper attack and natural disaster (Pynoos, et al., 1987); however, recent definitions of trauma stressors have expanded to include events within the range of normal experience that are capable of causing death, injury, or threaten the physical integrity of the child or a loved one (American Academy of Child and Adolescent Psychiatry [AACAP], 1998; American Psychological Association [APA], 1994). Yet, children's violence exposure poses challenges to current understanding of PTSD: What if the violence exposure is life-long and there is not a discrete precipitating event? Does violence that is not "life-threatening" still qualify as a traumatic event? This paper addresses children's exposure to violence in the home, specifically domestic violence and child physical abuse, as potential precursors to PTSD in children, and provides a foundational framework of knowledge essential to working with youth traumatized by family violence. For a review of treatments with this population, please see Vickerman and Margolin, this issue. Child sexual abuse and community violence, other examples of youth violence exposure, have somewhat different mechanisms of impact and have received attention

With considerable literature establishing how separate types of violence disrupt the lives of children, there is emerging interest in examining violence across multiple interpersonal domains. This paper examines four commonly occurring and frequently researched domains of violence exposure: marital physical aggression, mother-to-youth aggression, father-to-youth aggression, and community violence. A community-based sample of 103 parents and youth provided three waves of data at annual intervals beginning when the youth were aged 9–10. We explored stability of exposure, co-occurrence across different types of violence exposure, and associations with co-occurring risk factors. Approximately 30–45% of youth reported intermittent exposure over the 3 years. In addition to overlap among types of violence exposure within the family, we found overlap between parent-to-youth aggression and community violence, an association that was exacerbated in families where fathers reported high levels of global distress symptoms. Mother-to-youth, father-to-youth, and community violence related to youth behavior problems beyond the contextual risk factors of low income, stressful life events, and parents’ global distress symptoms. These results highlight the importance of examining violence longitudinally, across multiple types, and with attention to contextual factors.

Exposure to child physical abuse and parents' domestic violence can subject youth to pervasive traumatic stress and can lead to posttraumatic stress disorder (PTSD). This article presents evolving conceptualizations in the burgeoning field of trauma related to family violence exposure and describes how the often repeating and ongoing nature of family violence exposure can complicate a PTSD diagnosis. In addition, recent literature indicates that children exposed to family violence may experience problems in multiple domains of functioning and may meet criteria for multiple disorders in addition to PTSD. Considerations salient to the recognition of traumatic stress in this population and that inform assessment and treatment planning are presented.