Breaking the cycle of violence among youth living in metropolitan Atlanta: a case history of kids alive and loved

Youth Victims of Violence Report Worse Quality of Life Than Youth With Chronic Diseases

OBJECTIVES

Measuring health-related quality of life (HRQOL) provides the patient's perspective of his/her well-being and offers a unique outcome measure to demonstrate the impact of violence on the victim. To date, no study has described HRQOL in youth victims of violence in the United States. The purpose of this study was to describe HRQOL in youth victims of violence as compared with healthy youth and youth with chronic disease.

METHODS

We conducted an exploratory cross-sectional study of the HRQOL of victims of violence aged 8 to 18 years. Descriptive statistics were reported for participant and injury demographics. One sample t tests were used to compare the sample population's HRQOL to known HRQOL of healthy populations and specific disease populations.

RESULTS

Fifty-eight victims of violence participated in the study. Youth victims of violence had significantly worse mean HRQOL scores (mean, 71.4) compared with healthy youth in overall functioning (mean, 83.9), P < 0.001. Youth victims of violence reported worse psychosocial (mean, 67.6), emotional (mean, 62.9), and school (mean, 63.8) functioning than youth with obesity (mean, 72.1, 68.6, 75.0, respectively) and cancer (mean, 72.1, 72.2, 68.3, respectively). Mean Patient-Reported Outcomes Measurement Information System T scores for youth victims of violence were significantly worse in anxiety (T = 51.9) and depression (T = 52.4) compared with youth with obesity (T = 48.3, 49.2), cancer (T = 47.7, 47.6), and sickle cell disease (T = 43, 44).

CONCLUSIONS

Youth victims of violence suffer significant impairment in HRQOL compared with healthy populations and youth with specific disease burdens. Future studies into violence prevention effectiveness should use HRQOL as a comparative outcome measure to better tailor post injury management and interventions.

Youth exposure to violence involving a gun: evidence for adverse childhood experience classification

Adverse childhood experiences (ACEs) have historically included child maltreatment, household dysfunction, and other critical issues known to impact children negatively. Although youth experiences with violence are broadly captured in some ACE measures, youth exposure to violence involving a gun has not been included specifically in the operationalizing, and therefore scientific study, of ACEs. There are numerous implications of this omission, including limiting access to ACE interventions that are currently available and resources for individuals who have been exposed to gun violence. Thus, and given the persistent prevalence of gun violence in the US, we conducted a systematic review of the literature over the past two decades on the assessment of and response to ACEs and gun violence. Eighty-one journal articles across four search engines met our inclusion criteria. Our findings provide evidence that youth gun violence exposure should be classified as an ACE. In addition to increasing access to resources for youth affected by gun violence, these findings may improve the likelihood of funding and research into gun violence, with direct implications for prevention and intervention efforts.

[Domestic violence against Mexican teenagers]

OBJECTIVE

To assess students' perception of domestic violence.

METHODS

The study was carried out in a random sample representative (n=5,982) of high-school students aged between 13 and 19 years in Chiapas and San Luis Potosi, Mexico, in 2003. The students answered a self-administered questionnaire on sexual education, sexuality, pregnancy and risk behavior, and domestic violence. Considering the effects of the sample design, a logistic regression analysis was carried out in order to verify the association between socioeconomic and demographic characteristics and risk of domestic violence.

RESULTS

The multivariate statistical analysis confirmed that female students are more vulnerable to domestic violence in both states studied (Chiapas: OR=1.87, p=0.01; San Luis: OR=1.53, p=0.00). Moreover, alcohol (Chiapas: OR=2.52, p=0.00; San Luis: OR=1.93, p=0.00) or drug use (Chiapas: OR=2.27, p=0.02; San Luis: OR=1.82, p=0.01) were the two most significant variables for students exposure to domestic violence. The association between alcohol consumption and student's age increases the risk of violence. The youngest students had 51% (Chiapas) and 73% (San Luis) more risk of experience violence by a relative than older students.

CONCLUSIONS

Teenagers remain one of the most vulnerable population groups to domestic violence due to their physical, affective, economic and social dependence on other adults. The study was one of the first attempts to measure domestic violence against students.

Psychosocial needs of African American youth presenting to a pediatric emergency department with assault-related injuries

OBJECTIVE

The purpose of this study was to identify the psychosocial needs confronting African American youth assaulted in their community.

METHODS

A convenience sample of 36 African American youth (mean age, 14.8 years; range, 10-18 years) who presented to a pediatric emergency department with violent interpersonal injuries was interviewed to identify the psychosocial issues they were facing. Participants also completed self-report measures of violence exposure and trauma symptoms, and their parents completed a screening measure of the youths' emotional and behavioral functioning.

RESULTS

During the interview, the youth reported 178 different concerns that were content-analyzed and placed into 10 thematic categories labeled anger/aggressive behavior (78% of respondents), general internalizing symptoms (61%), peer difficulties (53%), parent/family conflict (50%), posttraumatic stress symptoms (47%), academic concerns (42%), physical health concerns (39%), safety concerns (39%), and public service concerns (17%). Elevated rates of historical violence exposure and trauma symptoms were observed on the self-report measures, and one third of the youths' parents reported levels of emotional and behavioral problems that would warrant further clinical attention.

CONCLUSION

African American assault victims are experiencing a broad range of psychosocial needs. To bolster youth recovery and reduce the risk of future injury, researchers and practitioners need to identify effective methods of assessing these needs in the emergency department so that youth victims of interpersonal violence can be referred for appropriate follow-up services.

Parenting style and adolescent's reaction to conflict: is there a relationship?

PURPOSE

To determine if the reactions of adolescents toward hypothetical situations that can lead to conflict and violence varied by parenting style of their mothers.

METHODS

This study was part of a larger research project involving adolescents and their mothers participating in a longitudinal HIV-prevention program. Mothers and their adolescents were recruited from a community-based organization (CBO) and interviewed separately. Data were analyzed using the responses of 439 African-American adolescents ranging from ages 11 to 14 years. The responses of adolescents to questions about parenting were used to classify mothers into one of three parenting styles: authoritative, authoritarian, or permissive. The "anticipated reactions to hypothetical situations" scale consists of 11 items with 6 response categories. The six responses were reclassified into three categories ranging from "not at all violent" to "extremely violent." Higher scores indicate more violent reactions to the hypothetical situations. The parenting scale consists of two subscales: a 13-item parental involvement scale and a 13-item parental control scale. Items were rated on a 5-point Likert scale from "strongly disagree" to "strongly agree." Analysis of variance was used to determine if the anticipated reactions of adolescents toward hypothetical situations varied by parenting style of their mothers.

RESULTS

Adolescent participants who reported a more permissive parenting style expressed more intense negative reactions toward the hypothetical situations that can provoke conflict. Male adolescents also expressed more intense reactions than females to the situations. There was no difference in intensity of reaction by age after controlling for gender and parenting style.

CONCLUSIONS

Parenting style is associated with adolescents' reactions to hypothetical situations that can provoke conflict. This finding highlights the importance of considering parents and their approach to child-rearing as a factor in the adolescent's ability to react to conflict.

Coming up in the boogie down: the role of violence in the lives of adolescents in the South Bronx

This article presents data gathered from young people in a poor urban community in New York City, the South Bronx. It seeks to help public health professionals better understand young people's perceptions of violence in the context of their daily lives. Sources of data include a street survey, five focus groups, interviews with incarcerated young males, and observations of several youth programs. These data suggest that violence is pervasive in the lives of both young men and women, although gender plays an important role in shaping the experience of violence. Other factors that influence the experience of violence include patterns of substance use, availability and use of weapons, and a perception that the police do not respect young people. Despite numerous challenges, many young people do take actions to reduce violence. The article suggests actions public health professionals can take to strengthen the ability of families, schools, youth organizations, and young people themselves to reduce violence in low-income urban communities.