Children’s Exposure to Violence in the Family and Community

Exposure to family and community violence is linked with aggression, depression, posttraumatic stress symptoms, and academic and cognitive difficulties. It has the potential to permeate many dimensions of children’s day-to-day lives and to erode possible sources of social support. Although the literature focuses on deleterious outcomes, many children fare well in the face of exposure to violence. Research attending to developmental processes, the co-occurrence of multiple forms of violence, and psychobiological mechanisms will clarify why outcomes are better for some children than for others. Greater understanding of children’s risk and resilience in the face of such exposure will inform intervention efforts. KEYWORDS—children; child abuse; interparental violence; community violence; risk and resilience Violence is a public-health problem, and children are particularly vulnerable to its effects. Besides being a leading source of injury, violence takes a toll on more subtle aspects of functioning, such as cognitive, behavioral, social, and emotional functioning. Disruption in these domains can affect children’s progression through typical developmental processes, with the nature of the impact dependent on the timing, type, and chronicity of the exposure to violence. Violence affects children even if they are not the direct victim but have a close relationship with the victim. Because exposure to violence typically occurs in familiar settings, the safe havens of family and community are marred by danger. Parents have not been able to prevent the violence and may be the perpetrators, the victims, or themselves affected in ways that compromise their caretaking. Distressing consequences of violence may include breakup or relocation of the family or repercussions following disclosure of abuse. Children living with violence may also experience family conflict and other life stresses, such as poverty, parents’ unemployment, or parents’ substance abuse and psychopathology. In an iterative fashion, these life stresses increase the risk for continued violence, and violence increases the likelihood of these stresses. SCOPE OF CHILDREN’S EXPOSURE TO VIOLENCE Definitions Violence is defined in many different ways in the research on its effects on children. Major categories of violence that have been investigated are (a) child maltreatment, including physical abuse, sexual abuse, and neglect; (b) aggression between parents; and (c) community violence, including direct victimization and witnessing of violence. Despite high rates of co-occurrence among exposure to different types of violence (Appel & Holden, 1998; Margolin & Gordis, 2000), published works have typically examined child abuse, domestic violence, and community violence separately. A key issue is the wide range of severity in the violence that children observe or experience. Some forms of severe aggression, such as beatings or use of weapons, can be traumatic to the victim and to observers. Other forms of aggression, such as pushing or shoving and corporal punishment, are considered normative by much of society. In samples drawn from the population at large, low-severity aggressive behaviors may suffice as the criterion for violence. Other studies compare people recruited from shelters, treatments, or child protective services who have been exposed to violence with people who have not received such services. In these studies, the violence-exposed groups typically have experienced severe, injurious behaviors. However, lower-severity aggressive behaviors may have occurred in both groups. Rates of Exposure Estimates of the rate of children’s exposure to violence vary because of different definitions and methods of data collection. Using official and unofficial reports of professionals working with children, The National Center of Child Abuse and Neglect (NCCAN) estimated that approximately 23 per 1,000 children are victims of maltreatment, including physical abuse, sexual abuse, and neglect (Sedlack & Broadhurst, 1996). Rates of severe physical abuse, based on national studies of the population at large, are 49 per 1,000, or five times the NCCAN estimate (Straus, Hamby, Finkelhor, Moore, & Runyan, 1998). Straus (1992) extrapolated that each year more than 10 million U.S. children witness physical aggression between their parents. Rates of community violence are generally based on interviews or surveys with children and sometimes corroborated by parents. Richters and Martinez (1993) reported that exposure to community violence is quite common, with at least one third of children victimized and more than 90% witnessing violence at least once during their Address correspondence to Gayla Margolin, University of Southern California, Department of Psychology, SGM 930, Los Angeles, CA 90089-1061; e-mail: [email protected]. CURRENT DIRECTIONS IN PSYCHOLOGICAL SCIENCE 152 Volume 13—Number 4 Copyright r 2004 American Psychological Society childhoods. With the majority of children having some type of violence exposure, researchers need to distinguish between severe and mild exposure and between chronic and one-time events. EFFECTS OF EXPOSURE TO VIOLENCE Short-Term Effects Although each type of violence has its own literature, studies have shown some common short-term effects. (For a detailed review of the effects of family and community violence, see Margolin & Gordis, 2000.) Children who are exposed to violence of any kind may exhibit behavioral disorders such as aggression and delinquency; emotional and mood disorders such as depression and anxiety; posttraumatic stress symptoms such as exaggerated startle, nightmares, and flashbacks; health-related problems and somatic symptoms such as sleep disturbances; and academic and cognitive problems. Some forms of violence tend to have specific consequences. For example, sexual acting out sometimes is a specific consequence of sexual abuse. However, exposure to other forms of violence also may lead to this problem, but the connections are not as theoretically salient, and not all of the connections have been investigated. Exposure to family and community violence is linked with aggressive behavior. One of the theoretical perspectives that explains this link is social learning theory, according to which children learn from the aggressive models in their environments. Additionally, victimization may compromise children’s ability to regulate their emotions, and as a result they may act out aggressively. Sexual abuse, physical abuse, and exposure to violence between parents and in the community have all been linked to aggression, with links particularly well documented for physical abuse. Considerable literature documents links between exposure to violence and problems such as depression and anxiety. A child may interpret violence at home and in the community to mean that the world is unsafe and that he or she is unworthy of protection. This interpretation may engender helplessness and lead to negative selfperceptions. Community violence also is linked to anxiety and depression, though one methodological issue is that studies of community violence frequently include intrafamilial as well as extrafamilial violence. Posttraumatic stress symptoms and posttraumatic stress disorder (PTSD) are important consequences of exposure to violence because they can impair social and behavioral functioning. Many children who do not meet diagnostic criteria for PTSD may experience troublesome symptoms. Physical and sexual abuse, community violence, and exposure to domestic violence are linked with posttraumatic stress symptoms, with links particularly well documented for sexual abuse. The degree to which exposure leads to posttraumatic stress symptoms in children may vary with the intensity of the violence and the degree to which the violence has lasting effects on the people most important to them (e.g., witnessing a stranger being punched vs. seeing a parent being assaulted vs. being directly victimized). Family violence and community violence also relate to academic and cognitive difficulties, possibly through their impact on psychological functioning. For example, PTSD and depression may interfere with learning and with the ability to perform well in the classroom. Neglect has a particularly negative impact on academic and cognitive performance. Long-Term Effects A few prospective studies in this area have explored whether exposure to violence during childhood increases the likelihood of either perpetrating or being the victim of aggression during adulthood. In a 20year prospective study by Ehrensaft et al. (2003), children who were exposed to violence between their parents subsequently were more likely to perpetrate violence against an adult partner and to be treated violently by an adult partner than were children who were not exposed to violence; children who were physically abused had an increased rate of injuring a partner. However, Kaufman and Zigler’s (1987) early review of prospective studies concluded that although a history of abuse increases the rate of abuse toward children from 5% to approximately 30%, 70% of children exposed to violence do not become abusive adults. Moreover, Widom (1998) concluded that childhood victimization increases the risk of criminal behavior and other mental health problems, but the ‘‘cycle of violence is not deterministic or inevitable’’ (p. 226). KEY DIRECTIONS FOR RESEARCH The variability across children in the effects of exposure to violence is largely unexplained. Many children do not exhibit negative outcomes at the time they are studied. For example, using meta-analytic procedures to combine statistically the results of 118 studies on children’s exposure to domestic violence, Kitzmann, Gaylord, Holt, and Kenny (2003) found that 63% of child witnesses to violence were doing worse than nonwitnesses, whereas 37% were doing comparably or better. The fundamental question remains: Why do some children show negative outcomes and other children appear to be more resilient? Although early research primarily examined the outcomes associated with violence, research recently has begun to explore the mechanisms that explain these outcomes. Developmental Processes An important consideration is how exposure to violence alters the typical developmental course. For example, risk taking typically increases in adolescence, but studies need to examine whether risk taking differs between teenagers who have and have not been exposed to violence. It is possible, for instance, that exposure to violence is associated with increased, prolonged, or earlier onset of risk taking. Moreover, researchers need to identify the developmental processes underlying linkages between exposure to violence and later developmental problems. If the short-term effects are exhibited in emotional dysregulation, cognitive difficulties, and disruptions in important relationships with caregivers, these effects may increase risk for subsequent failure in two key developmental tasks: establishing a supportive peer network and effective work habits at school. Disruption of these tasks places the adolescent at risk for further problems, including school failure, depression, involvement with deviant peers, substance abuse, and delinquent behaviors. A developmental perspective highlights the following types of questions: Does early exposure to violence trigger more profound disruption in development than later exposure? Does exposure have delayed effects, and do delayed effects occur regardless of whether the exposure continues? The study of developmental processes could Volume 13—Number 4 153 Gayla Margolin and Elana B. Gordis