Gun Violence Exposure and Suicide Among Black Adults

Importance

Black individuals are disproportionately exposed to gun violence in the US. Suicide rates among Black US individuals have increased in recent years.

Objective

To evaluate whether gun violence exposures (GVEs) are associated with suicidal ideation and behaviors among Black adults.

Design, Setting, and Participants

This cross-sectional study used survey data collected from a nationally representative sample of self-identified Black or African American (hereafter, Black) adults in the US from April 12, 2023, through May 4, 2023.

Exposures

Ever being shot, being threatened with a gun, knowing someone who has been shot, and witnessing or hearing about a shooting.

Main Outcomes and Measures

Outcome variables were derived from the Self-Injurious Thoughts and Behaviors Interview, including suicidal ideation, suicide attempt preparation, and suicide attempt. A subsample of those exhibiting suicidal ideation was used to assess for suicidal behaviors.

Results

The study sample included 3015 Black adults (1646 [55%] female; mean [SD] age, 46.34 [0.44] years [range, 18-94 years]). Most respondents were exposed to at least 1 type of gun violence (1693 [56%]), and 300 (12%) were exposed to at least 3 types of gun violence. Being threatened with a gun (odds ratio [OR], 1.44; 95% CI, 1.01-2.05) or knowing someone who has been shot (OR, 1.44; 95% CI, 1.05-1.97) was associated with reporting lifetime suicidal ideation. Being shot was associated with reporting ever planning a suicide (OR, 3.73; 95% CI, 1.10-12.64). Being threatened (OR, 2.41; 95% CI, 2.41-5.09) or knowing someone who has been shot (OR, 2.86; 95% CI, 1.42-5.74) was associated with reporting lifetime suicide attempts. Cumulative GVE was associated with reporting lifetime suicidal ideation (1 type: OR, 1.69 [95% CI, 1.19-2.39]; 2 types: OR, 1.69 [95% CI, 1.17-2.44]; ≥3 types: OR, 2.27 [95% CI, 1.48-3.48]), suicide attempt preparation (≥3 types; OR, 2.37; 95% CI, 2.37-5.63), and attempting suicide (2 types: OR, 4.78 [95% CI, 1.80-12.71]; ≥3 types: OR, 4.01 [95% CI, 1.41-11.44]).

Conclusions and Relevance

In this cross-sectional study, GVE among Black adults in the US was significantly associated with lifetime suicidal ideation and behavior. Public health efforts to substantially reduce interpersonal gun violence may yield additional benefits by decreasing suicide among Black individuals in the US.

Development, construct validity, and measurement invariance of the Modified Classes of Racism Frequency of Racial Experiences Measure (M-CRFRE) to capture direct and indirect exposure to perceived racism-based police use of force for Black emerging adults

OBJECTIVES

To utilize focus groups, cognitive interviews, content expert panel, and computer-assisted surveys to develop and pilot survey items assessing exposure to perceived racism-based police violence to enhance the Classes of Racism Frequency of Racial Experiences (CRFRE).

METHOD

Focus groups and cognitive interviews were conducted with Black emerging adults (n = 44) in St. Louis, Missouri. Utilizing a grounded theory approach, a thematic analysis of the focus group and cognitive interview transcripts was conducted to identify key items to be added to the CRFRE. Three content experts assessed the face and content validity of survey items. Computer-assisted surveys were conducted to pilot the modified CRFRE with a sample of Black emerging adults (n = 300). Confirmatory factor analyses and structural paths were used to examine the construct validity of the modified CRFRE.

RESULTS

Participant's qualitative data and suggestions from content experts resulted in the development of 16 additional survey items regarding exposure to perceived racism-based police violence across three domains (victim, witness in person, and seen in media). The modified CRFRE measure showed construct validity, internal reliability, and measurement invariance between men and women.

CONCLUSIONS

This study advances our epidemiological methodology for quantifying exposure to perceived racism-based police violence. Future research is necessary to assess the prevalence of exposure to perceived racism-based police violence and associated mental and behavioral outcomes for Black emerging adults in the U.S. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Exposure to violence and asthma in Puerto Rican youth with high Th2 immunity

BACKGROUND

Little is known about the determinants of asthma among youth with high T helper 2 (Th2) immunity. We hypothesized that exposure to violence (ETV) and violence-related distress are associated with asthma in children and adolescents with high Th2 immunity.

METHODS

We analyzed data from Puerto Ricans with high Th2 immunity aged 9-20 years in the Puerto Rico Genetics of Asthma and Lifestyle (PR-GOAL) and the Epigenetic Variation of Childhood Asthma in Puerto Ricans (EVA-PR) studies, and in a prospective study (PROPRA). High Th2-immunity was defined as ≥1 positive allergen-specific IgE and/or a total IgE ≥ 100 IU/mL and/or an eosinophil count ≥ 150 cells/μL. Asthma was defined as physician-diagnosed asthma and current wheeze. ETV and violence-related distress were assessed with the validated ETV Scale and Checklist of Children's Distress Symptoms (CCDS) questionnaires, respectively.

RESULTS

In multivariable analyses, each 1-point increment in ETV score was significantly associated with 1.13-1.17 times increased odds of asthma in PR-GOAL and in EVA-PR (both at p ≤ 0.01), and each 1-point increment in CCDS score was significantly associated with 1.53-1.54 increased odds of asthma in PR-GOAL and in EVA-PR (both at p ≤ 0.03). Further, a persistently high ETV score was significantly associated with asthma in PROPRA (odds ratio [OR] = 2.83, 95% confidence interval [CI] = 1.10-7.29). Similar results were obtained in a sensitivity analysis using an eosinophil count ≥ 300 cells/μL instead of ≥150 cells/μL to define high Th2 immunity.

CONCLUSIONS

ETV during childhood is associated with increased risk of persistent or new-onset asthma in youth with high Th2 immunity.

Understanding the link between child maltreatment and adolescent future expectations in Northern Uganda: A serial mediation analysis

BACKGROUND

Recent research has identified high levels of child maltreatment and harsh parenting in post-war societies which have had detrimental effects on children's development. Future expectations are an important aspect of adolescents' development particularly in the challenging contexts of post-war societies where social instabilities and violence are prevalent. To date, however, the link between child maltreatment and adolescent future expectations remains understudied.

OBJECTIVE

By applying a socio-ecological perspective, this study aimed to investigate risk (internalizing symptoms) and protective factors (community integration) linking experiences of harsh parenting with adolescents' future expectations.

PARTICIPANTS AND SETTING

Data was collected from N = 199 northern Ugandan adolescents (40.2 % females, M_age = 14.56 years) with structured interviews.

METHODS

Serial mediation analyses were calculated with child maltreatment as the predictor, future expectations as the outcome, and internalizing symptoms as well as community integration as mediating variables.

RESULTS

Results of the mediation model (R² = .22, F(5193) = 10.54, p <  .001, total effect (b = -0.28, p < .005) revealed a direct effect of child maltreatment on future expectations (effect size: -.20, 95 % bootstrap CI = -0.40, -.01) as well as an indirect effect of child maltreatment via internalizing symptoms and community integration on future expectations (effect size of -.07 (95 % bootstrap CI = -0.14, -0.01).

CONCLUSION

Child maltreatment was found to be linked to negative future expectations among Northern Ugandan adolescents, and both internalizing symptoms as well as community integration played mediating roles in the associations. Interventions should take psychopathology and community factors into account.

Exploring parent-child agreement on reports of exposure to community violence: Utilizing a latent profile approach

Exposure to community violence (ECV) has a number of implications for children including poor mental health functioning, impaired cognition, memory, learning, and school performance (Edlynn et al, 2008 Am. J. Orthopsychiat., 78, 249-258; Gardner et al., 1996, J. Consult. Clin. Psychol., 64, 602-609). Discrepancies in child and parent reports of the child's ECV may exacerbate these adverse effects (Hill & Jones, 1997 J. Natl Med. Assoc., 89, 270-276). This study aimed to categorize dyads based on the agreement in reports of ECV. Furthermore, this study aimed to identify ethnic differences within these groups in addition to mental health issues. Four profiles, based on average exposure to violence, emerged: Low exposure (LE), moderate exposure, high exposure, and severe exposure. Ethnic differences among these profiles indicate ethnic minorities are less likely to belong to the LE profile and more likely to represent the other profiles. There were differences among profiles based on mental health functioning.

A Phenomenological Study on the Experience of Syrian Asylum-Seekers and Refugees in the United States

Violence in Syria has displaced an unprecedented number of people from their homes. While couple/family therapy (C/MFT) scholars have explored migration experiences, particularly among refugees, there is still limited research using a bioecological framework. This exploratory study examined the experiences of Syrian asylum-seekers and refugees living in the United States using a qualitative phenomenological approach. Twelve Syrians (n = 8 men, n = 4 women) between 20 and 52 years of age (M = 35.8, SD = 10.7) were interviewed about their experiences across three stages of resettlement: (1) pre-resettlement, (2) resettlement/migration, and (3) post-resettlement. Findings suggest that the effects of conflict-induced displacement and resettlement permeate across multiple ecologies. These range from the individual and his or her interpersonal relationships to their larger community and society. C/MFTs should account for contextual factors while becoming familiar with the sociopolitical impact of displacement and resettlement in their clinical work with this population.

Negative life experiences contribute to racial differences in the neural response to threat

Threat-related emotional function is supported by a neural circuit that includes the prefrontal cortex (PFC), hippocampus, and amygdala. The function of this neural circuit is altered by negative life experiences, which can potentially affect threat-related emotional processes. Notably, Black-American individuals disproportionately endure negative life experiences compared to White-American individuals. However, the relationships among negative life experiences, race, and the neural substrates that support threat-related emotional function remains unclear. Therefore, the current study investigated whether the brain function that supports threat-related emotional processes varies with racial differences in negative life experiences. In the present study, adolescent violence exposure, family income, and neighborhood disadvantage were measured prospectively (i.e., at 11-19 years of age) for Black-American and White-American volunteers. Participants then, as young adults (i.e., 18-23 years of age), completed a Pavlovian fear conditioning task during functional magnetic resonance imaging (fMRI). Cued and non-cued threats were presented during the conditioning task and behavioral (threat expectancy) and psychophysiological responses (skin conductance response; SCR) were recorded simultaneously with fMRI. Racial differences were observed in neural (fMRI activity), behavioral (threat expectancy), and psychophysiological (SCR) responses to threat. These threat-elicited responses also varied with negative life experiences (violence exposure, family income, and neighborhood disadvantage). Notably, racial differences in brain activity to threat were smaller after accounting for negative life experiences. The present findings suggest that racial differences in the neural and behavioral response to threat are due, in part, to exposure to negative life experiences and may provide new insight into the mechanisms underlying racial disparities in mental health.

Social Isolation, Loneliness, And Violence Exposure In Urban Adults

Social isolation is a key predictor of mortality in the US and may be heightened in communities affected by violence. Qualitative studies have documented that people living in high-crime neighborhoods often report being confined to their homes because of safety concerns. However, few quantitative studies have empirically assessed relationships between violence exposure and social isolation. In 2018 we conducted hour-long, in-person surveys with 504 adults in Chicago, Illinois. Prior exposure to community violence was associated with a 3.3-point reduction (on a 100-point scale) in the frequency of interaction with network confidantes, a 7.3-point reduction in perceived social support from friends, and a 7.8-point increase in loneliness. At a time when public health and policy leaders are calling for solutions to the "epidemic of loneliness," identifying populations at higher risk because of violence could help target interventions and ensure equitable access to social and medical support.

Exploring Empathy and Callous-Unemotional Traits as Predictors of Animal Abuse Perpetrated by Children Exposed to Intimate Partner Violence

We explored the relation between empathy, callous-unemotional (CU) traits, and animal abuse in a sample of 290 seven- to twelve-year-old children whose mothers were exposed to intimate partner violence (IPV). The sample comprises mostly Latino and White participants, and 55% of the children's mothers were born outside the United States (primarily Mexico). To our knowledge, among studies examining child-perpetrated animal abuse, this study is the first to examine empathy levels and one of only a few to examine CU traits. When comparing Griffith Empathy Measure (empathy) and Inventory of Callous-Unemotional Traits (callous-unemotional [CU] traits) scores with those from studies of White schoolchildren, our sample scored lower on affective empathy, higher on cognitive empathy, and lower for overall CU scores as well as Callous and Unemotional subscales. Of 290 children, 47 (16.2%) harmed an animal at least once according to either mother or child report. There were no significant sex or age differences between Abuse and No Abuse groups. The Abuse group scored significantly higher on affective empathy, CU, and Callousness/Unemotional subscales, and significantly lower on cognitive empathy. However, in regression analyses that controlled for income, only lower cognitive empathy and higher CU significantly predicted having abused an animal. In summary, low cognitive empathy (but not affective empathy) and CU traits may serve as reliable predictors of child animal abuse. However, replication of these results is necessary. A larger sample with a high percentage of Latino children whose mothers were exposed to IPV, along with a non-exposed comparison group, would be ideal.

Parallel-process trajectories of exposure to violence and psychological distress among justice-involved youth

BACKGROUND

Researchers have raised awareness of high levels of violence exposure among justice-involved adolescents and its association with psychological distress, yet the relationship between the violence and psychological distress has rarely been studied longitudinally.

AIM

This study aimed to gain understanding of the relationship between long-term exposure to violence and the development of psychological distress among justice-involved adolescents.

METHODS

We examined exposure to violence and emergent psychological distress among adolescents using latent growth model analyses with a sample of 1,336 young people-male and female-who completed 10 follow-up interviews over 7 years as part of the Pathways to Desistance study. We tested four models: (a) changes in exposure to violence over time, (b) changes in psychological distress over time, (c) the contemporaneous, parallel processes of changes in exposure to violence and psychological distress over time, and (d) differences in the evolution of violence exposure and psychological distress across sex and race/ethnicity.

RESULTS

For the sample as a whole, exposure to violence decreased over time, as did psychological distress, but their relationship to each other was consistent. There were individual differences, however, and the subgroup of young African Americans did not experience the reduction in exposure to violence reported by the young Whites and Hispanics.

CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

Trajectories of exposure to violence and related psychological distress did not escalate over time as expected. In light of these findings, more research is needed on the heterogeneity of violence exposure and its negative psychological impacts.

Disruptions in Emotion Regulation as a Mechanism Linking Community Violence Exposure to Adolescent Internalizing Problems

Although community violence is an established risk factor for youth aggression, less research has examined its relation with internalizing psychopathology. This study examined associations of community violence exposure with internalizing symptoms, and state and trait emotion dysregulation as mechanisms underlying these associations, in 287 adolescents aged 16-17 (45.6% male; 40.8% White). Community violence exposure was associated with internalizing symptoms, negative affect during peer evaluation, trait emotional reactivity, and infrequent problem solving. Multiple emotion dysregulation indices were also associated with internalizing symptoms. In simultaneous multiple mediator models, indirect effects of community violence on internalizing problems were significantly explained by state and trait emotion dysregulation. Findings implicate emotion dysregulation as one mechanism linking community violence exposure to adolescent internalizing symptoms.

The impact of domestic violence exposure on South Asian children in the United States: Perspectives of domestic violence agency staff

The South Asian community is the fastest growing ethnic group in the United States, and past research suggests that South Asian domestic violence (DV) survivors may require culturally-specific resources. Similarly, South Asian children in the US exposed to DV may have unique responses and needs, but this has not been explored to date. The objective of this study was to examine the specific needs of South Asian children exposed to DV from the vantage point of staff from South Asian DV agencies across the United States. Thirty interviews were conducted, with data coded and consolidated into larger themes using thematic analysis. Participants described several factors important to understanding the impact of DV on South Asian children including the role of the extended family, identifying with two cultures, fear about what the South Asian community will think, gender differences, and the importance of projecting an image of perfection. Participants also discussed development of culturally-tailored resources. This study suggests the importance of framing South Asian children's experiences within the context of interweaving South Asian and American cultural values, with careful attention paid to how potential culture clashes between parents and children may impact the way children process trauma. Further work should triangulate these themes with children, parents, and extended family, as well as collaborate with South Asian DV agencies to design child-focused programs.

Enhancing health care equity with Indigenous populations: evidence-based strategies from an ethnographic study

BACKGROUND

Structural violence shapes the health of Indigenous peoples globally, and is deeply embedded in history, individual and institutional racism, and inequitable social policies and practices. Many Indigenous communities have flourished, however, the impact of colonialism continues to have profound health effects for Indigenous peoples in Canada and internationally. Despite increasing evidence of health status inequities affecting Indigenous populations, health services often fail to address health and social inequities as routine aspects of health care delivery. In this paper, we discuss an evidence-based framework and specific strategies for promoting health care equity for Indigenous populations.

METHODS

Using an ethnographic design and mixed methods, this study was conducted at two Urban Aboriginal Health Centres located in two inner cities in Canada, which serve a combined patient population of 5,500. Data collection included in-depth interviews with a total of 114 patients and staff (n = 73 patients; n = 41 staff), and over 900 h of participant observation focused on staff members' interactions and patterns of relating with patients.

RESULTS

Four key dimensions of equity-oriented health services are foundational to supporting the health and well-being of Indigenous peoples: inequity-responsive care, culturally safe care, trauma- and violence-informed care, and contextually tailored care. Partnerships with Indigenous leaders, agencies, and communities are required to operationalize and tailor these key dimensions to local contexts. We discuss 10 strategies that intersect to optimize effectiveness of health care services for Indigenous peoples, and provide examples of how they can be implemented in a variety of health care settings.

CONCLUSIONS

While the key dimensions of equity-oriented care and 10 strategies may be most optimally operationalized in the context of interdisciplinary teamwork, they also serve as health equity guidelines for organizations and providers working in various settings, including individual primary care practices. These strategies provide a basis for organizational-level interventions to promote the provision of more equitable, responsive, and respectful PHC services for Indigenous populations. Given the similarities in colonizing processes and Indigenous peoples' experiences of such processes in many countries, these strategies have international applicability.

An application of an ecological framework to understand risk factors of PTSD due to prolonged conflict exposure: Israeli and Palestinian adolescents in the line of fire

OBJECTIVE

Adolescents living in Israel and the Palestinian authority are exposed to political violence. This review examines psychosocial risk factors for posttraumatic stress disorder (PTSD) organized within an ecological framework.

METHOD

Relevant articles were identified through PubMed and PsycINFO. Studies measuring risk and/or protective factors for PTSD in the Palestinian and/or Israeli adolescent populations because of conflict exposure from 1990 to present were included.

RESULTS

A total of 20 studies met inclusion criteria. Greater violence exposure, poor economic resources, living in rural compared with urban areas, poor family and peer relations, and poor coping skills were associated with PTSD symptoms.

CONCLUSIONS

The ecological framework is a useful approach to understanding factors affecting adolescent PTSD. Future research should focus on socioecological levels that have received limited attention. (PsycINFO Database Record

Psychological distress, drug use, sexual risks and medication adherence among young HIV-positive Black men who have sex with men: exposure to community violence matters

In the USA, Black males are disproportionately affected by community violence and HIV. The aim of this study was to assess whether exposures to community violence are related to psychological distress, drug use, sexual risk behaviors, and medication adherence among a sample of HIV-positive young Black men who had sex with men (YBMSM). Data are from 98 YBMSM ages 18-29 years recruited from Chicago who completed measures on demographics, exposures to community violence, psychological distress, drug use, condomless anal intercourse, and medication adherence. Rates of exposure to community violence were high and youth reported victimization and witnessing numerous types of violence in their lifetime. In adjusted logistic regression analyses, models indicate that YBMSM reporting higher levels of exposure to community violence had significantly higher rates of condomless anal intercourse in the previous 6 months (AOR: 5.33, 95%CI: 1.38-20.55). Additionally, exposure to community violence was positively associated with psychological distress, hard drug use, and use of marijuana as a sex drug. Adherence to HIV antiretroviral medication was negatively associated with community violence (AOR: 0.36, 95%CI: 0.13-0.97). Rates of exposure to community violence are especially high in urban communities. Overall findings suggest that treatment, intervention, and programmatic approaches that include initiatives to address exposure to community violence might correlate with better health-related outcomes for HIV-positive YBMSM.

Posttraumatic stress symptoms in context: Examining trauma responses to violent exposures and homicide death among Black males in urban neighborhoods

Concentrated disadvantage in urban communities places young Black men at disproportionate risk for exposure to violence and trauma. Homicide, a health disparity, positions Black males vulnerable to premature violent death and traumatic loss, particularly when peers are murdered. Posttraumatic stress disorder (PTSD) has been demonstrated as a health consequence for middle-income and White homicide survivors; however, understandings of traumatic stress among young Black men situated in contexts of chronic violence exposure remains limited. Guided by phenomenological variant of ecological systems theory (PVEST), the current study used in-depth qualitative interviews (average length: 90 min) to examine the presence and expression of traumatic stress symptoms among 37 young Black men (18-24) in Baltimore who experienced the homicide death of a loved one. Participants were recruited over 18 months through fieldwork at a large organization that serves Baltimore youth and young adults. Confidential participant interviews were audio recorded, transcribed verbatim, coded, and analyzed in ATLAS.ti. Pseudonyms were assigned to all participants. More than 70% of participants reported experiencing 2 or more Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V)-defined posttraumatic stress symptoms. Hypervigilance was most frequently experienced and expressed as being on point. Findings identify the prevalence of traumatic stress symptoms among young Black men in urban contexts; identify contextually specific expressions of traumatic stress; and, present implications for the mental health and clinical treatment of Black males living in environments where no "post" exists. (PsycINFO Database Record

The Cycle of Violence: Associations Between Exposure to Violence, Trauma-Related Symptoms and Aggression--Findings from Congolese Refugees in Uganda

War-related trauma exposure has been linked to aggression and enhanced levels of community and family violence, suggesting a cycle of violence. Reactive aggression--an aggressive reaction to a perceived threat--has been associated with posttraumatic stress disorder (PTSD). In contrast, appetitive aggression--a hedonic, intrinsically motivated form of aggression--seems to be negatively related to PTSD in offender and military populations. This study examined the associations between exposure to violence, trauma-related symptoms and aggression in a civilian population. In semistructured interviews, 290 Congolese refugees were questioned about trauma exposure, PTSD symptoms, and aggression. War-related trauma exposure correlated positively with exposure to family and community violence in the past month (r = .31, p < .001), and appetitive (r = .18, p = .002) and reactive aggression (r = .29, p < .001). The relationship between war-related trauma exposure and reactive aggressive behavior was mediated by PTSD symptoms and appetitive aggression. In a multiple sequential regression analysis, trauma exposure (β = .43, p < .001) and reactive aggression (β = .36, p < .001) were positively associated with PTSD symptoms, whereas appetitive aggression was negatively associated (β = -.13, p = .007) with PTSD symptoms. Our findings were congruent with the cycle of violence hypothesis and indicate a differential relation between distinct subtypes of aggression and PTSD.

Coping resources and extra-curricular activity as explanatory factors of exposure to violence: comparing Jewish and Arab youth in Israel

Violent behavior is a well-known social phenomenon among youth around the world including Israel. Adolescence is a crucial developmental period in which youth experience various developmental tasks while being exposed to many risks. Previous studies have shown that community involvement could be an asset for reduced violence among youth. Thus, the aim of this study was to explore the level of participation in extra-curricular activities as well as individual and community coherence and exposure to or victimization by violence among Jewish and Arab youth living in southern Israel. The links between these variable were explored as well. Six-hundred-and-twenty-two adolescents (265-Jews; 357-Arabs) completed self-reported questionnaires which investigated demographics, sense of coherence, sense of community coherence, participation in extra-curricular activities, and exposure to violence. Results show that Jewish adolescents report a significantly stronger sense of coherence and sense of community coherence, they participate more in extra-curricular activities and they are more exposed to and victimized by violence. Moreover, while sense of coherence is reported to be an asset in both groups, participating in extra-curricular activities is an asset only for the Arab youth. Results will be discussed with regard to the salutogenic theoretical foundation as well as the different cultural backgrounds of the groups.

Prevalence of different forms of child maltreatment among Taiwanese adolescents: a population-based study

Reported cases of child maltreatment are increasing in Taiwan. Yet, comprehensive epidemiological characteristics of adolescents' exposure over the wide spectrum of violence are still lacking. The purpose of this study was to estimate the prevalence and magnitude of child maltreatment among Taiwanese adolescents. A population-based study was conducted with 5,276 adolescents aged 12-18 from 35 schools in 17 cities and townships to determine the prevalence of five forms of child maltreatment in Taiwan. A total of 5,236 adolescents completed anonymous, self-report, structured questionnaires. Most adolescents (91%, n=4,788) experienced at least one form of maltreatment with 83% (n=4,347) exposed during the previous year. Violence exposure was the most common type of child maltreatment experienced, followed by psychological abuse, physical abuse, neglect, and sexual abuse. Adolescents reported an average of 7.4 (SD=5.87) victimizations over their lifetime and 4.8 (SD=4.82) victimizations during the past year. Females reported a higher rate of neglect, while males reported a higher rate of sexual abuse. Most of the sexual abuse perpetrators were known by their victims. Adolescents' victimization and polyvictimization from child maltreatment in Taiwan deserves a review and modification of national control and prevention policies.