Bullying: An Unexamined Cause of Assault-related Emergency Department Visits for Urban Adolescents

Johnson, Sarah Lindstrom; Ryan, Leticia Manning; Jones, Vanya; Fein, Joel A.; Cheng, Tina L.

doi:10.1007/s10560-020-00653-9

Cited by 5 publications

(5 citation statements)

References 24 publications

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“…7 For example, estimates from a systematic sample, the National Hospital Ambulatory Medical Care Survey, found that 340 000 children aged 0 to 17 years were treated in EDs in a typical year between 2000 and 2008 for violence-related injuries (a rate of 49 per 10 000), accounting for approximately 1% of all of pediatric ED visits for any reason. 8 However, most of the ED-based epidemiological analyses were focused on older youth, 9,10 or certain specific types of exposures such as sexual assault 11 or bullying, 12 and did not include health care settings beyond EDs. Documenting medical visits from violence-exposed children to EDs and other services is important, not simply because it allows an estimate of the scope of the seriously affected.…”

Section: Introductionmentioning

confidence: 99%

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Medical Treatment Following Violence Exposure in a National Sample of Children and Youth

2021

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IMPORTANCE Children and youth experience high rates of exposure to violence, which is associated with later poor physical and mental health outcomes. The immediate injuries and impacts from these exposures are often treated in emergency departments and medical offices. OBJECTIVE To characterize, using nationally representative data, the size and characteristics of the child and youth population being seen by medical authorities in the wake of violence exposure. DESIGN, SETTING, AND PARTICIPANTSThe survey study used a representative sample of children and youth aged 2 to 17 years, from 2 waves (2011 and 2014) of the National Survey of Children Exposed to Violence, drawn from a mix of random digit dialing and address-based sampling.Interviews were conducted (1) over the phone with caregivers of young children or (2) directly with the youth aged 10 to 17 years. Data analysis was performed from September to December 2020. MAIN OUTCOMES AND MEASURES Violence exposures were assessed with the 53-item JuvenileVictimization Questionnaire, which had follow-up questions that asked about injury and going "to the hospital, a doctor's office, or some kind of health clinic because of what happened." Additional questions were asked about lifetime and past-year childhood adversities and current trauma symptoms using the Trauma Symptom Checklist and the Trauma Symptom Checklist for Young Children. RESULTSThe combined 2-survey sample had 5187 children and youth who reported a lifetime violence exposure, of whom 45.6% (95% CI, 43.1%-48.2%) were aged 2 to 9 years, and 54.4% (95% CI, 51.8%-56.9%) were aged 10 to 17 years; 53.6% (95% CI, 51.0%-56.2%) were male. Based on the full sample of 8503 children and youth, 3.4% (95% CI, 2.6%-4.4%) had a violence-related medical visit at some time in their lives. The rate of past-year medical visits due to a violence exposure was 1.9% (95% CI, 1.2%-2.7%), equivalent to a point estimate of approximately 1.4 million children and youth. Of those with medical visits, 33.3% (95% CI, 23.1%-45.4%) were aged 2 to 9 years. Those with a past-year visit had higher levels of trauma symptoms (risk ratio, 1.71; 95% CI, 1.44-2.03) adverse childhood experiences (risk ratio, 2.55; 95% CI, 2.34-2.78) and multiple violence exposures (risk ratio, 3.91; 95% CI, 3.22-4.76) compared with the general sample of children and youth. CONCLUSIONS AND RELEVANCEThe estimated large number of violence-related visits with medical professionals offers an opportunity to address a source of frequent injury, and provide counseling and referral for a high-risk segment of the population to treat and prevent further physical and mental health and social consequences.

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Section: Introductionmentioning

confidence: 99%

“…However, most of the ED-based epidemiological analyses were focused on older youth, or certain specific types of exposures such as sexual assault or bullying, and did not include health care settings beyond EDs.…”

Section: Introductionmentioning

confidence: 99%

Medical Treatment Following Violence Exposure in a National Sample of Children and Youth

2021

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“…Generally, the assault injuries for which adolescents were treated did not involve weapons (84.5%), and only one adolescent was hospitalized due to their injury. More details about the injury incident can be found in Lindstrom Johnson et al (2020).…”

Section: Participantsmentioning

confidence: 99%

Posttraumatic Stress Symptoms among Assault-injured Youth: Parallel Process Models Addressing Comorbidity

et al. 2021

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Community violence and its physical health consequences are well known among youth living in urban settings. However, less is known about the cumulative effect of contextual and demographic risk factors on posttraumatic stress symptoms (PTSS) among vulnerable youth. Longitudinal data (baseline, 9-month, 21-month) were analyzed to investigate trajectories of PTSS, internalizing, and externalizing symptoms among 188 youth ( Mage 12.87, 60.6% male) treated for an assault injury in an emergency department. Youth exhibited decreased mental health problems over time. Higher levels of internalizing symptoms related to decreased PTSS over time, while higher levels of PTSS predicted increased externalizing symptoms over time, thus underscoring the importance of understanding comorbidity. Gender and stressful life events were significantly associated with initial levels of symptoms and trajectories. These findings suggest the importance of understanding PTSS in the context of environments and personal factors to support appropriate treatment.

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“…Forty percent of youths assaults are associated with bullying, and youths experiencing violence often seek care in the ED. 12,13 This makes the ED an ideal place to further our understanding of assault perpetration factors and firearm access among bullied youth. In an effort to deepen our understanding of bullying and associated future violent injury perpetration risk factors among adolescents seeking care in the ED, we sought to (1) describe differences between youths who experience bullying and those who did not experience bullying, (2) identify whether experiencing bullying is associated with firearm access, and (3) measure and compare risk of future assault perpetration factors between bullied teenagers and nonbullied teenagers.…”

mentioning

confidence: 99%

“…Forty percent of youths assaults are associated with bullying, and youths experiencing violence often seek care in the ED 12,13 . This makes the ED an ideal place to further our understanding of assault perpetration factors and firearm access among bullied youth.…”

mentioning

confidence: 99%

Experiencing Bullying Is Associated With Firearm Access, Weapon Carriage, Depression, Marijuana Use, and Justice Involvement in Adolescents

Donnelly

Rucker²,

Boyle³

et al. 2021

Pediatr Emer Care

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Objectives:The aims of this study were to assess whether bullying experience among youths is associated with firearm access and to evaluate assault perpetration risk factors between bullied and nonbullied adolescents.Methods: This was a secondary analysis of a cross-sectional survey designed to measure self-reported social determinants of health and behavioral health risks among adolescents (13-21 years) in a pediatric emergency department between July 2017 and August 2019. Participants were included in this subanalysis if they responded to a survey item that assessed bullying. Multivariable logistic regression was used to measure the association of firearm access, weapon carriage, and assault perpetration factors (violence, mental health, substance abuse, and justice involvement) with bullying after adjustment for sex, race/ethnicity, and insurance status.Results: Of the 369 participants meeting inclusion criteria, 147 adolescents (40.5%) reported experiencing bullying. Bullied teenagers had higher odds of a gun in the home (adjusted odds ratio [aOR

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Bullying: An Unexamined Cause of Assault-related Emergency Department Visits for Urban Adolescents

Cited by 5 publications

References 24 publications

Medical Treatment Following Violence Exposure in a National Sample of Children and Youth

Medical Treatment Following Violence Exposure in a National Sample of Children and Youth

Posttraumatic Stress Symptoms among Assault-injured Youth: Parallel Process Models Addressing Comorbidity

Experiencing Bullying Is Associated With Firearm Access, Weapon Carriage, Depression, Marijuana Use, and Justice Involvement in Adolescents

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