Prospective effects of violence exposure across multiple contexts on early adolescents’ internalizing and externalizing problems

Abstract

Background Violence exposure within each setting of community, school, or home has been linked with internalizing and externalizing problems. Although many children experience violence in multiple contexts, the effects of such cross-contextual exposure have not been studied. This study addresses this gap by examining independent and interactive effects of witnessing violence and victimization in the community, home, and school on subsequent internalizing and externalizing problems in early adolescence. Methods A community sample of 603 boys and girls (78% African American, 20% Caucasian) participated in a longitudinal study of youth violence. During two assessments 16 months apart, adolescents reported on witnessing violence and victimization in the community, school, and home, and their internalizing and externalizing problems. Results Multiple regressions tested the independent and interactive effects of witnessing violence or victimization across contexts on subsequent adjustment, after controlling for initial levels of internalizing and externalizing problems and demographic covariates. Witnessing violence at school predicted anxiety and depression; witnessing at home was related to anxiety and aggression; and witnessing community violence predicted delinquency. Victimization at home was related to subsequent anxiety, depression, and aggression; victimization at school predicted anxiety; and victimization in the community was not independently related to any outcomes. Finally, witnessing violence at home was associated with more anxiety, delinquency, and aggression only if adolescents reported no exposure to community violence. Conclusions Violence exposure at home and school had the strongest independent effects on internalizing and externalizing outcomes. Witnessing community violence attenuated the effects of witnessing home violence on anxiety and externalizing problems, perhaps due to desensitization or different norms or expectations regarding violence. However, no comparable attenuation effects were observed for victimization across contexts.

Role of Direct and Indirect Violence Exposure on Externalizing Behavior in Children

“…As few studies have addressed the risk for externalizing behaviors due to cumulative violence exposure, it is an important next research step to expand our understanding of the reciprocal relation between cumulative violence exposure and externalizing behaviors. 59,61 Further, an individual's temperament or personality traits, as well as social support and a variety of other factors including age and gender, are also likely moderators of the relationship between both acute and chronic stressors, such as exposure to violence and externalizing behaviors, and should be examined. Finally, there should be an emphasis on identification of potential sources of buffering for the effects of exposure to violence.…”

“…12 Although it is likely that both direct and indirect violence exposures across multiple contexts may contribute both independently and interactively to behavioral outcomes specifically in youth, particularly externalizing behaviors, few studies have directly tested this theory. [58][59][60][61] Incorporation of such a cumulative risk approach 62 into our understanding of the impact of violence exposure on children's health is paramount. The present analysis builds upon the existing literature linking independent violence exposures to externalizing and examines instead the combined impact of indirect violence exposures across individual, family, and neighborhood contexts.…”

Spatial Proximity to Incidents of Community Violence Is Associated with Fewer Suicides in Urban California

“…[32][33][34] Suicidal behavior and interpersonal violence share several common risk factors, and there is evidence that troubled individuals tend to specialize in either inward-or outward-directed violence. [35][36][37] This study may be capturing differences in patterns of this expression across communities. In urban neighborhoods where norms surrounding interpersonal violence are less prohibitive, distress may be expressed outward-directed violence, while those living in urban neighborhoods with more restrictive norms may respond to similar feelings with suicidal behavior.…”

Exposição de adolescentes à violência em diferentes contextos: relações com a saúde mental

“…Além disso, fatores de proteção podem estar presentes, moderando os efeitos da violência, entre os quais estão rede de apoio, estratégias de coping, alta autoefi cácia, boa autoestima, entre outros. Aspectos sociais e culturais, além de econômicos, também são fatores relevantes a serem considerados (Avanci et al, 2007;Koller & De Antoni, 2004;Mrug & Windle, 2010). Ainda, no que diz respeito à saúde mental, fatores genéticos também apresentam infl uência sobre a saúde mental (Avanci et al, 2007;Bahls & Bahls, 2002;Ministério da Saúde, 1996).…”

“…Entre os principais transtornos mentais que resultam da violência, estão: Transtorno de Estresse Pós--Traumático (TEPT), transtornos de ansiedade, transtornos de humor (especialmente a depressão) e transtornos de personalidade (Mrug & Windle, 2010). Relatório da WHO (2014) revela que houve, em 2012, mais de um milhão de mortes de adolescentes decorrentes, principalmente, de problemas de saúde mental e da violência.…”