Witnessing inter-parental violence in childhood and help-seeking behaviours in violence against women in Peru.

BACKGROUND: Violence against women (VAW) severely impacts their physical and mental health. In some cultures, women can normalize certain types of violence if they were linked to home models in childhood and, eventually, do not seek for help in adulthood. We aimed to determine, in Peruvian women, (1) the association between witnessing violence in their family of origin and VAW experienced in adulthood, (2) the extent to which women who have experienced VAW seek some help, and (3) identify VAW prevalence by Peruvian region. METHODS: Cross-sectional study of secondary data obtained from the 2019 National Demographic and Family Health Survey (ENDES). The outcome was VAW (psychological, physical and sexual violence), whereas the exposure was witnessing violence in the home of origin. Help-seeking behavior was a secondary outcome, for which VAW was the exposure. Prevalence ratios (PR) were estimated to assess both associations, unadjusted and adjusted for covariates (aPR). RESULTS: Data from 14,256 women aged 15 to 49 years were analysed. 51.5% reported having experienced VAW and 43.8% witnessed violence in the home of origin during childhood. Witnessing inter-parental violence in childhood was associated with psychological violence aPR = 1.25 (95% CI: 1.17-1.33), physical aPR = 1.52 (95% CI: 1.38-1.67), and sexual aPR = 1.99 (95% CI: 1.57-2.52). Women who have experienced both types of violence (physical and sexual) were more likely to help-seeking (aPR = 1.30, 95% CI: 1.14-1.50) than women suffering only one type of violence. CONCLUSION: Women who reported having witnessed home violence in their childhood are more likely to experience Violence Against Women (VAW) by their current partner. Physical and sexual violence with a current partner was more associated with witnessing inter-parental violence in childhood, and when physical and sexual violence jointly occurred women were more help-seeking. The southern region of Peru is identified as an area of high vulnerability for women. It is crucial to promote educative and community-based programs aimed at the prevention and early recognition of VAW.

Disclosure of Exposure to Violence in Urban Adolescents.

Research has documented high rates of exposure to violence in urban African American adolescents together with their negative effects on psychosocial adjustment. Coping with violence exposure may be facilitated by disclosure of these experiences to others, but little is known about the extent to which youth disclose their various experiences with violence. This study examined the prevalence of disclosure of violence experienced as a witness or victim in different contexts or locations to parents, friends, siblings, teachers, counselors, and relatives. Urban African American adolescents from Southeastern U.S. were interviewed at three time points (N = 81; average ages 13.3, 16.1, and 17.8). Across the three time points, 90% to 91% witnessed violence and 64% to 81% were victimized in the last year. Of these youth, 40% to 53% disclosed experiences of witnessing violence and 29% to 52% disclosed experiences of victimization. The results showed that disclosure of violence most often involved parents and friends, with fewer youth disclosing to teachers and counselors. Disclosure of violence victimization increased from early to late adolescence. Experiences of dating violence victimization were less likely to be disclosed by adolescents, especially among males. These findings support the need for more research on adolescents' disclosure of violence exposure and its links to adjustment, with implications for interventions aimed at improving coping in youth exposed to violence.

Quality of the Parent-Child Relationship as a Moderator of Witnessing Violence and Youth Trauma Symptoms.

Traumatic event exposure affects two in every three adolescents in the United States and there is the potential for numerous deleterious effects including higher levels of youth depression, anxiety, posttraumatic stress symptoms, and emotional and behavioral problems. Witnessing violence is one of the more common experiences associated with trauma exposure. Despite the ample research on mental health outcomes associated with witnessing violence, less is known about the extent to which parent-child relationships play a role in youth mental health outcomes when youth are exposed to violence. With a clinically relevant, diverse sample of 806 youth ages 12 years old who experienced maltreatment or were at risk of being maltreated, we tested hypotheses that the parent-child relationship quality would moderate the associations between witnessing violence and youth mental health outcomes. Results supported hypotheses for youths' symptoms of anxiety, depression, dissociation, and posttraumatic stress. The study contributes to the trauma literature by determining that the quality of the parent-child relationship moderated the effects of witnessing violence on trauma outcomes.

Prevalence of Violence Victimization and Perpetration During Middle and High School in Underresourced, Urban Communities.

This study describes rates of violence victimization, perpetration, and witnessing in 6th-11th grade for a multisite sample (N = 3,466) of predominantly Black and Hispanic middle- and high-school students from urban areas with high rates of crime and economic disadvantage. Students completed surveys in middle and high school assessing teen dating violence, stalking, sexual violence and harassment, bullying, cyberbullying, and physical violence perpetration and victimization, as well as witnessing violence. The highest prevalence rates are observed most often in 8th or 9th grade. Youth reported high rates of witnessing serious assault and severe community violence throughout adolescence. These findings suggest that efforts to prevent violence among youth living in under-resourced communities need to start early and address community-level socioeconomic disparities.

Indirect Associations between Middle-Childhood Externalizing Behaviors and Adolescent Substance Use through Late-Childhood Exposure to Violence.

Longitudinal research to understand individual risk factors in childhood associated with exposure to violence and substance use is needed to inform prevention efforts. The present study tested indirect associations between age 8.5 externalizing behaviors and age 16 substance use through age 9.5 violence victimization and witnessing. Participants were 650 racially diverse (48.6% European American, 28.1% African American, 13.3% multiracial, and 10.0% other), predominantly socioeconomically disadvantaged youth (49% female). Externalizing behaviors were associated with higher levels of violence victimization and witnessing. The indirect path from externalizing behaviors to substance use was significant through victimization but not witnessing violence. Interventions aimed at reducing early externalizing behaviors may reduce risk for violence victimization, which may, in turn, reduce risk for adolescent substance use.

Peer Factors as Mediators of Relations Between Exposure to Violence and Physical Aggression in Middle School Students in a Low-Income Urban Community.

Objective: Although prior research has demonstrated that peers influence both physical aggression and exposure to violence during adolescence, few studies have investigated the extent to which peers play a role in relations between physical aggression and violence exposure. This longitudinal study examined peer pressure for fighting, friends' delinquent behavior, and friends' support for fighting as mediators of relations between exposure to violence through witnessing and victimization, and adolescents' frequency of physical aggression. Method: Participants were 2,707 adolescents attending three urban middle schools (Mage = 12.4; 52% female; 79% African American, 17% Hispanic/Latino). Participants completed measures of their frequency of physical aggression, witnessing community violence, victimization by violence, and negative life events, and peer variables at four waves within the same school year. Results: Cross-lagged analyses indicated that the role of peer variables as mediators varied as a function of the type of exposure and the direction of effects. Whereas peer pressure for fighting mediated relations between witnessing violence and changes in physical aggression, friends' delinquent behavior mediated relations between physical aggression and changes in witnessing violence and victimization. In contrast, violent victimization was not associated with changes in any of the peer factors when included in the same model as witnessing violence. Conclusions: These findings highlight the role of peers as both a cause and a consequence of adolescents' aggressive behavior and exposure to violence. They suggest focusing on peer variables as targets for interventions to disrupt connections between exposure to violence and physical aggression during early adolescence.

CHILDHOOD EXPERIENCES AND FACTORS ASSOCIATED WITH PERPETRATION OF VIOLENCE AMONG YOUNG ADULTS IN DELTA STATE PRISONS.

Background: Violent acts perpetrated by young people can cause physical and psychological harm to others and is of serious public health concern. This study was conducted to determine the prevalence of childhood trauma, and to assess the relationship between adverse childhood experiences and other predicting factors, and the perpetration of violence among young adults in Delta state prisons. Methods: A descriptive cross-sectional study design was conducted amongst 293 youths who were convicted prison inmates in Delta State Correctional facilities. Three out of the five facilities in Delta State were selected using simple random sampling, after which a total sampling of incarcerated inmates from the three selected facilities was carried out. Data were collected using the; Childhood Trauma Questionnaire (CTQ) to measure adverse childhood experiences, and a proforma to classify the offence of the inmate (whether violent or non-violent). Results: The mean age of the respondents was 28.4 ± 5.4 years. The overall prevalence of childhood trauma was 5.1%. The most common abuse/neglect experienced while growing up was physical neglect with 26.3% followed by emotional neglect (20.5%), physical abuse (7.2%), emotional abuse (2.4%) and sexual abuse (1%).The prevalence of violent offences was 46.1%. Age, (OR=0.3; CI= 0.2-0.6, p=0.001), attaining primary education (OR=3.4; CI= 1.5-7.8, p=0.004) and having witnessed violence while growing up (OR=2.0; CI= 1.2-3.3, p=0.007) were all significant predictors of the perpetration of violence. Conclusion: The overall prevalence of childhood trauma was low; however, the perpetuation of violence was found to be high in this study. Further research is required to develop study instruments for childhood trauma that are more context specific bearing in mind local sociocultural practices.

The comparative and cumulative impact of different forms of violence exposure during childhood and adolescence on long-term adult outcomes.

Violence exposure during childhood and adolescence is associated with a range of negative psychosocial outcomes. Research examining the impact of violence exposure has been limited by the compartmentalization into separate bodies of research (e.g., community violence, domestic violence). There is also a paucity of research examining long-term adult outcomes. Using a large and racially diverse sample (n = 754; male = 58%; Black = 46%), the current longitudinal study aimed to elucidate the comparative and cumulative effect of different types of violence exposure (witnessing vs. victimization) across different locations (home, school, neighborhood) in childhood and adolescence (lifetime through Grade 8) on long-term internalizing, externalizing, and attention problems; substance use; and intimate partner violence in adulthood (age 25). Victimization, but not witnessing violence, predicted all five adult outcomes. Specifically, being victimized at home was associated with the widest range of negative outcomes (internalizing, externalizing, and attention problems), while school victimization was associated with substance use. Further, when youth experienced multiple types of violence across multiple locations (cumulative violence exposure), they experienced a more diverse range of negative outcomes in adulthood (composite score). The current study highlights the stronger effects of violence exposure in more proximal contexts, and how these locations are important for emotional and behavioral development.

Gender Differences in Witnessing and the Prevalence of Intimate Partner Violence from the Perspective of Children in Finland.

Background-Intimate partner violence (IPV) has both direct and longer-term effects on children's well-being. Much of the research thus far has relied on caregiver reports of IPV and clinical samples of children. By contrast, minimal research has examined violence between parents from the perspective of children using nationwide samples. Objective-This study explored the frequency of IPV witnessed by children and gender variations regarding the victims, perpetrators, and witnesses. Methods-The data were derived from a sample of 11,364 children from the Finnish Child Victim Survey 2013. The children were between 11 and 17 years old and were enrolled in the Finnish school system. The main methods of analysis included crosstabulation and the chi-square test. Results-The results indicate that children witnessed more IPV against their mother (4.9%) than their father (3.5%). Girls reported having witnessed more violence against both their mother (7.0%) and father (5.1%) than boys did (mothers 2.7%, fathers 1.8%). Girls' reports of IPV against both parents were twice or more than twice as common as boys' reports. Conclusions-The above differences might result from gendered expectations and boys' and girls' different relationships to violence, as well as differences in the recognition and interpretation of violent incidents. Therefore, practitioners should adopt a gender-sensitive approach as a precondition and practice for working with children in social and health care.

Understanding the Impact of Seeing Gun Violence and Hearing Gunshots in Public Places: Findings From the Youth Firearm Risk and Safety Study.

There is a current public health emphasis on finding strategies for reducing the risks associated with children's gun violence exposure. This article examines the impact of seeing and hearing gun violence on youth of different ages and living in urban and nonurban areas. Participants were 630 youth, aged 2 to 17. Youth, ages 10 to 17, completed a self-report survey, and caregivers of young children, ages 2 to 9, completed the survey as a proxy for that child. Participants resided in Boston, MA; Philadelphia, PA; and rural areas of eastern TN. Participants were recruited through a variety of techniques including pediatric clinics, housing authorities, youth-serving agencies, festivals, word of mouth, and local e-mail lists for classified advertisements. Data were collected between October 2017 and April 2018 and analyzed in 2019. In total, 41% of youth in this study reported ever seeing or hearing gun violence; 32% had such an experience in the past year. Among exposed youth, 50% took protective action to keep themselves safe, and 58% reported being very or extremely afraid, sad, or upset as a result of the indirect gun violence. More youth living in urban compared with nonurban areas took some protective action. Females and younger children had increased odds of experiencing high fear as a result of the violence. Current gun violence prevention has typically targeted adolescents; however, current findings suggest the need to focus on younger children as well, including the distress resulting from indirect exposure to gun violence.

Psychological Intervention and Prevention Programs for Child and Adolescent Exposure to Community Violence: A Systematic Review.

The purpose of this article is to systematically review the existing literature regarding intervention and prevention programs that ameliorate the negative effects of exposure to community violence (ECV) on children and adolescents. Using the Preferred Reporting Items for Systematic Review (PRISMA) Guidelines, we conducted a systematic review of the literature aimed at providing a synthesis of the extant Randomized Control Trials (RCT) and peer-reviewed empirical literature on intervention and prevention programs for those affected by ECV. Nine randomized controlled trials were identified: seven studies with elementary school students in the USA, one study with elementary school students in Colombia, and one study with middle school students in the USA. Most trials compared intervention and no-treatment control groups; three studies compared active interventions. The intervention and prevention trials conducted in school settings in the USA showed most impact on reducing internalizing and PTSD symptoms. The evidence base of intervention and prevention programs for child and adolescent exposure to community violence is very limited. This systematic review synthesizes extant evidence of the effectiveness of intervention programs in reducing internalizing and externalizing symptoms, PTSD, exposure to community violence, and in enhancing academic performance. More studies are needed to provide a better understanding of how interventions might ameliorate the adverse consequences of exposure to community violence.

Young witnesses of intimate partner violence: screening and intervention.

Intimate partner violence is a public health problem worldwide. Many children witness intimate partner violence at home and are affected by it. Regardless of the degree of exposure, children growing up in violent homes experience negative effects in the form of externalising behaviour and internalising symptoms which call for targeted interventions for children. The aim of the study is to map i) the available methods of detecting child and adolescent witnesses of intimate partner violence and ii) the interventions to support them. Three databases, PubMed, PsychInfo and Social Services Abstracts, were searched for scientific publications spanning over 20 years (1997-2017). This resulted in 2,406 publications of which 15 were finally selected after screening. Analysis of the articles resulted in three categories. The process of detecting children and adolescents who witnessed IPV in their homes varied in the included studies. The children were most commonly identified through their mother or other caregivers. Very few studies were based on children's own reporting of their experiences, but were rather based on the mothers' proxy reports. Studies distinguishing between the different forms of violence witnessed by children were few. It was uncommon that children were directly identified or screened for witnessing IPV in the family.

Examining the Impact of Victimization on Girls' Delinquency: A Study of Direct and Indirect Effects.

Previous research has acknowledged that there is a relationship between victimization and later delinquency, but the specific attributes of this relationship are unclear because measures of both direct and indirect victimization are rarely explored in a single study. We included both indirect and direct victimization to examine which form of victimization was a stronger predictor of substance use, fighting, running away, and sex work among girls committed to a juvenile justice facility. Findings indicated that direct victimization was typically a more salient predictor of delinquency than indirect forms of victimization. Further, running away and sex work appear to be unique outcomes that are particularly likely when girls experience direct rather than indirect victimization. Findings are summarized with implications for health and public policy.

Post-traumatic stress symptom development as a function of changing witnessing in-home violence and changing peer relationship quality: Evaluating protective effects of peer relationship quality.

In the present study, witnessing in-home violence and peer relationship quality are evaluated as to their relative impact on Post Traumatic Stress (PTS) symptoms among children aged 8 to 17 investigated by child protective services (CPS) for maltreatment exposure. The sample included 2151 children from the National Survey of Child and Adolescent Well-Being II (NSCAW II). Linear growth models were estimated to assess associations between changes in PTS symptoms, witnessing in-home violence, and peer relationship quality over time. Greater frequency of witnessing in-home violence at baseline (i.e. wave 1) was associated with higher baseline PTS symptoms (ß = 0.44). Increases in witnessing in-home violence frequency over time (average annual change across three years) had a strong association with increases in PTS symptoms over time (ß = 0.88). Baseline peer relationship quality was associated with fewer PTS symptoms at baseline (ß = -0.45). Increases in peer relationship quality over time were strongly associated with declines in PTS symptoms over time (ß = -0.68). Peer relationship quality at baseline did not moderate baseline or over time associations between witnessing in-home violence and PTS symptoms. The average decline in PTS symptoms due to decreases in witnessing in-home violence and increases in peer relationship quality was 0.51 and 0.65 standard deviations respectively, over the three-year study period. Reducing chronic witnessing in-home violence and promoting the development of healthy social relationships with peers are critical for PTS symptom recovery.

Longitudinal Trajectory of Adolescent Exposure to Community Violence and Depressive Symptoms Among Adolescents and Young Adults: Understanding the Effect of Mental Health Service Usage.

Research on the impact of exposure to community violence tends to define victimization as a single construct. This study differentiates between direct and indirect violence victimization in their association with mental health problems and mental health service use. This study includes 8947 individuals from four waves of the National Longitudinal Study of Adolescent to Adult Health and examines (1) whether sub-types of adolescent victimization are linked to depressive symptoms; (2) whether adolescent victimization is linked with mental health service use; and (3) the role of mental health service use in attenuating symptoms arising from victimizations. Adolescents witnessing community violence were more likely to experience depressive symptoms during adolescence but not during their young adulthood; direct exposure to violence during adolescence does not predict depressive symptoms in adolescence but does in adulthood. Use of mental health service mediates report of depressive symptoms for adolescent witnessing community violence.

Patterns of cortisol and alpha-amylase reactivity to psychosocial stress in maltreated women.

BACKGROUND: Childhood maltreatment can trigger enduring changes in major stress response systems, particularly in the context of major depressive disorder (MDD). However, the relative impact of maltreatment versus MDD on hypothalamic-pituitary-adrenal axis and sympathetic-adrenal-medullary system stress reactivity is not well understood. METHOD: This study examined salivary cortisol and alpha-amylase responses to the Trier Social Stress Test (TSST) in 26 maltreated (15 with current MDD) and 26 non-maltreated (17 with current MDD) women. RESULTS: Maltreated women showed greater anticipatory cortisol reactivity during the TSST protocol compared to non-maltreated women. Maltreated women also showed rapid deceleration in cortisol levels. Whereas non-maltreated women showed initial declines in alpha-amylase levels but rapidly increasing alpha-amylase levels during the TSST protocol, maltreated women did not exhibit changes in alpha-amylase levels during the TSST protocol. Contrary to expectation, MDD did not impact cortisol or alpha-amylase responses. LIMITATIONS: The present study is limited by retrospective report of childhood maltreatment, cross-sectional design, and modest sample sizes. CONCLUSIONS: These findings suggest that childhood maltreatment plays a greater role driving alterations in cortisol and alpha-amylase stress reactivity than MDD. Understanding the biological embedding of maltreatment is critical for elucidating mechanisms linking these experiences to risk for negative mental and physical health outcomes.

Witnessing violence among high school students in Thailand.

The goal of this study was to explore the levels of witnessing violence among Thai youths and to examine whether a Western model of witnessing violence that relates to personal and family characteristics, peer relationships, own violence, violence in the family, violence in the school, and in the community, is appropriate for the Thai reality. The random sample consisted of 2,897 youths: 1,107 (38.2%) males and 1,722 (59.4%) females. Results indicated that witnessing violence rates among the Thai youths are high, but in general, quite similar to those reported in the west. The most frequently witnessed violent act was hitting and punching in school. Peer characteristics and their advice were the most related factor to witnessing violence followed by own violence activities, violence in the family, and the surrounding subsystems, supporting the similarities of the Thai reality to the Western one. No significant differences were indicated between the rural and inner-city settings. The results were interpreted in light of the cultural characteristics of Thailand.

Mutuality, severity, and chronicity of violence by Father-Only, Mother-Only, and mutually violent parents as reported by university students in 15 nations.

This article aims to provide a more complete description of the violence between parents experienced by children than is usual in research and to suggest the practicality and importance of doing so. It presents results on the percent of parents in each of three Dyadic Types: Father-Only (the father assaulted the mother and the mother did not assault), Mother-Only (mother assaulted and the father did not assault), and Both-Assault; and on differences between these three types in the chronicity and severity of assaults. Questionnaires were completed by convenience samples of university students in 15 nations (N=11,408). Violence between parents was measured by the short form of the Conflict Tactics Scales. Fourteen percent of the students reported one or more instances of physical violence between their parents, including 6% who reported a severe assault. Cross classification of assaults by the father and the mother to identify Dyadic Types found 25% Father-Only, 22% Mother-Only, and 52% Both-Assaulted. The percentage in each Dyadic Type based on reports by male or female students were similar. They were also consistent with percentages found by previous studies identifying the Dyadic Types of violent couples. In respect to chronicity, when violence between parents occurred, in 82% of the cases, it occurred more than once. Research on children experiencing violence between parents, and prevention and treatment of inter-parental violence, are likely to be enhanced if it takes into account that Both-Violent is the most frequent pattern to which children are exposed and that Mother-Only is about as frequent as Father-Only. Consideration of the severity, and chronicity, of the inter-parental violence needs to replace simply classifying parents as violent. Achieving this is possible using instruments which take only three to five minutes and which can be completed by only one of the parents or by the child.

From family to friends: does witnessing interparental violence affect young adults' relationships with friends?

PURPOSE: Childhood exposure to violence in one's family of origin has been closely linked to subsequent perpetration and victimization of intimate partner violence. There is, however, little research on the relationship between witnessing violence and subsequent peer violence. This study investigates the effects of witnessing interparental violence among Filipino young adults on their use and experience of psychological aggression with friends. METHODS: The data source for this study was the Cebu Longitudinal Health and Nutrition Survey. Recent perpetration and victimization of friend psychological aggression among young adults ages 21-22 years was assessed through self-reports from the 2005 survey; witnessing interparental violence during childhood was assessed through self-reports from the 2002 survey. Multinomial logistic regression was used to examine the effects of witnessing interparental violence on subsequent use and experience of friend psychological aggression. Analyses were stratified by gender. RESULTS: About 13% of females and 4% of males perpetrated psychological aggression toward close friends, and about 4% of females and males were victims. Fourteen percent of females and 3% of males experienced bidirectional psychological aggression. About 44% of females and 47% of males had, during childhood, witnessed their parents physically hurt one another. Witnessing maternal and reciprocal interparental violence during childhood significantly predicted bidirectional friend psychological aggression among males. Among females, witnessing interparental violence did not significantly predict involvement with friend psychological aggression. CONCLUSIONS: Violence prevention programs should consider using family-centered interventions, and apply a gendered lens to their application. Further research on gender differences in friend aggression is recommended.

Community disorder, victimization exposure, and mental health in a national sample of youth.

This study considers whether elevated distress among youth living in more disordered neighborhoods can be explained by personal exposure to violence and victimization, level of non-victimization adversity, and family support. Analyses were based on a sample of 2,039 youth ages 10 to 17 who participated in the National Survey of Children's Exposure to Violence, a national telephone survey conducted in 2008. Using structural equation modeling, we find no direct effects of community disorder on distress, once the significant mediating effects of victimization, family support, and adversity are taken into account. Using a comprehensive measure of victimization covering several domains of experiences, we show that past-year exposure to child maltreatment, sexual victimization, peer assault and bullying, and property crime each significantly mediate the community disorder-distress association. A measure of the total number of victimization types to which youth were exposed (i.e., level of "poly-victimization") had the strongest mediating effect.