Race, Ethnicity, and Adolescent Violent Victimization

Examining adverse childhood experiences and Black youth's engagement in a hospital-based violence intervention program using administrative data

BACKGROUND

Stemming from poverty and systemic racism, Black youth are disproportionately represented in hospital-based violence intervention programs (HVIPs) due to greater violence exposure. HVIPs are a critical intervention that have been shown to reduce rates of reinjury in urban hospitals and trauma centers across the United States; however, they are plagued by low enrollment and engagement rates. Few studies have examined factors related to engagement, particularly among Black youth.

METHODS

Guided by Trauma Theory and Critical Race Theory, this study uses a retrospective cohort design. Between-group differences of adverse childhood experiences (ACEs) among engaged youth compared to nonengaged youth who were violently injured and recruited for a HVIP were examined using chi-square and logistic regression. ACEs were approximated using a novel approach with administrative data.

RESULTS

Results indicated that the total ACE score was not significantly associated with engagement status. Individual ACEs were tested across age groups.

CONCLUSIONS

This study highlights a novel approach to understanding ACEs among a hard-to-reach population and illuminates the significant level of ACEs faced by violence-exposed Black youth at young ages. Considering theory, Black families may be more reluctant to engage due to fear and past harms in social service systems stemming from systemic racism. Though ACEs did not predict engagement in this study, considering the high rates of ACEs experienced by Black youth and their families in the context of systemic racism suggests that HVIPs should acknowledge historical harms and foster trauma-informed and healing-centered interactions during recruitment and later stages of engagement.

Disproportionate burden of violence: Explaining racial and ethnic disparities in potential years of life lost among homicide victims, suicide decedents, and homicide-suicide perpetrators

Research indicates that the burden of violent death in the United States is disproportionate across racial and ethnic groups. Yet documented disparities in rates of violent death do not capture the full extent of this inequity. Recent studies examining race-specific rates of potential years of life lost-a summary measure of premature mortality-indicate that persons of color may die at younger ages than their counterparts, leading to increased trauma among surviving family members, friends, and communities. This study examines racial and ethnic disparities in potential years of life lost among people who died by homicide and suicide. We calculated potential years of life lost using life expectancy values specific to each racial and ethnic group, thereby isolating racial differences in potential years of life lost due to violence. Findings indicated that persons of color were disproportionately impacted by violence. Non-Hispanic African American homicide victims, suicide decedents, and homicide-suicide perpetrators died eleven or more years earlier than their non-Hispanic White counterparts. Similar disparities were observed for non-Hispanic Asian or Pacific Islander decedents. Less pronounced differences were observed for Hispanic and non-Hispanic American Indian or Alaska Native decedents. These racial and ethnic disparities were partly accounted for by a broad array of individual differences, incident characteristics, and contextual factors. The results suggest that homicide and suicide exact a high societal cost, and the burden of that cost is disproportionately high among persons of color.

Distress about social problems and tobacco and cannabis use outcomes among young adults in Los Angeles County

OBJECTIVE

To examine associations of concern, worry, and stress about discrimination, shootings/violence, and police brutality and exclusive and dual tobacco and cannabis use among young adults.

METHODS

A prospective, racially/ethnically diverse cohort of young adults (n = 1960) living in Los Angeles, California completed a baseline survey in 2020 (age range: 19-23) and a follow-up survey in 2021. Exploratory factor analysis (EFA) was employed on nine variables assessing levels of concern, worry, and stress about societal discrimination, societal shootings/violence, and community police brutality at baseline. Past 30-day tobacco and cannabis use at follow-up was categorized as current exclusive tobacco, exclusive cannabis, and dual tobacco and cannabis (vs never/former) use based on eleven use variables. Multinomial logistic regressions estimated adjusted associations between each factor score (translated to standard deviation units) with exclusive and dual tobacco and cannabis use.

RESULTS

The EFA produced four factor scores representing concern/worry/stress (i.e., distress) about community police brutality (F1), distress about societal shootings/violence (F2), and distress about societal discrimination (F3), as well as generalized stress about police brutality, shootings/violence, and discrimination (F4). F1, F2, and F3 were associated with subsequent exclusive current cannabis use, with F1 having the strongest association (OR: 1.35, 95% CI: 1.18-1.55), while only F1 (OR: 1.51, 95% CI: 1.27-1.78) was associated with dual tobacco and cannabis use. None of the factors were associated with exclusive tobacco use.

CONCLUSIONS

Young adult concern, worry, and/or stress about social problems may increase risk of cannabis use with or without concurrent tobacco use 6-12 months later.

Using grounded theory to develop a theory of change for a violence intervention program

Hospital-based violence intervention programs (HVIP) are critical to interrupting the cycle of violence. These interventions are considered "complex" in that they have many mechanisms of change and related outcomes. Few HVIPs clearly identify the underlying mechanisms of intervention and explicitly link those with key outcomes however, limiting the field's ability to know what works best and for whom. To develop a program theory of change for these "complex interventions," a non-linear, robust methodology that is grounded in the lived experience of those delivering and receiving services is needed. To aid researchers, evaluators, students, and program developers, we describe the use of Grounded Theory as a methodology to enhance the development of complex interventions, illuminating a non-linear approach that engages key stakeholders. To illustrate application, we describe a case example of The Antifragility Initiative, a HVIP in Cleveland, Ohio. The development of the program theory of change was conducted in four phases: (1) review of existing program documents, (2) semi-structured interviews with program developers (n = 6), (3) a focus group with program stakeholders (n = 8), and (4) interviews with caregivers and youth (n = 8). Each phase informed the next and culminated in a theoretical narrative and visual model of the Antifragility Initiative. Together, the theoretical narrative and visual model identify the underlying mechanisms that can promote change by the program.

Ethnoracial Differences in Past Year Victimization Rates for a National Sample of Gender and Sexual Minority Adolescents

Little research exists on victimization for gender and sexual minority adolescents (GSMA) of color. This study identifies differences in past year rates across six victimization types for GSMA by ethnoracial identification. Descriptive analyses were conducted on 1,177 GSMA (14-19 years old), with victimization types stratified by ethnoracial identification and multiple logit regression was used to identify differences. Compared to White (non-Hispanic) peers, Black (non-Hispanic) GSMA reported lower victimization rates across multiple categories with two exceptions. Higher rates of racially biased physical assault were noted among Black (non-Hispanic) and bi/multi-ethnoracial GSMA. Higher rates of witnessing community violence were reported by Black (non-Hispanic), bi/multi-ethnoracial, and Latinx GSMA. To address GSMA's needs, we need to understand the differential risk so that our interventions are responsive to the diversity within this community.

School Discipline as a Consequence of Violent Victimization in Adolescence: Understanding the Mediating Roles of Head Injury and Behavior

Pathways from violence to head injury and poor long-term outcomes have been found among numerous populations, however, have not yet been widely examined with youth exposed to violence. Traumatic brain injuries (TBIs) are linked to a range of consequences salient to adolescent development and well-being, such as impulsivity, academic abilities, and emotional processing. This gap in research has led to a missed opportunity to understand the consequences of youth victimization, particularly within the academic setting. The current study examined whether head injury and problem behaviors mediate the relationships between victimization and suspension/expulsion using data from the Pathways to Desistance Study, a multi-site, longitudinal study of serious adolescent offenders age 14-18. A sample of male youth who had witnessed violence (n = 1,094) reported a total score of victimization, number of early behavior problems (i.e., cheating, fighting, etc.), ever having a head injury (32.9%), and number of times suspended (adjusted M = 13.13; SD = 19.31) or expelled (adjusted M = 0.65; SD = 0.99). Structural equation modeling was used to examine direct and indirect pathways from victimization to suspension and expulsion through head injury and behavior. Direct pathways from victimization to school discipline were significant; indirect pathways mediated by only head injury were not significant, but indirect pathways through only problem behavior and through TBI and problem behavior were significant for both expulsion and suspension. Results suggest that youth who have been victimized are at higher risk for both suspension and expulsion and that this risk may be, in part, explained through increased head injury and problem behaviors. TBI screenings/services for violence-exposed youth and trauma-informed school-based services may help to deter trajectories toward suspension and expulsion but should be developed with attention to the influence of racial bias on pathways to school discipline.

Margin for error: examining racial and ethnic trends in adolescent risk propensity

BACKGROUND

Relatively little research has accrued examining risk propensity across racial and ethnic groups, especially across time and at the population level.

AIMS

Using a margin for error framework to conceptualize risk variation among major racial and ethnic groups, we hypothesize that African American and Hispanic adolescents will be less likely to report engaging in dangerous risk taking acts compared to White adolescents.

METHODS

This study examines public-use data collected on risk propensity and risky behaviors among adolescents 12-17 between 2002 and 2018 as part of the National Survey on Drug Use and Health (NSDUH).

RESULTS

While we observed decreased trends in risk propensity, controlling for demographic factors, we see significantly greater odds of reporting "never" engaging in risk for fun among NH Black (AOR 2.01, 95% CI 1.85-2.18) and Hispanic youth (AOR 1.47, 95% CI 1.37-1.58) as compared to NH White youth. NH Black (AOR 0.74, 95% CI 0.61-0.89) and Hispanic (AOR 0.83, 95% CI 0.71-0.98) youth are also less likely than NH White youth to report "always" taking risks for fun. Moreover, the risk propensity-risky behaviors link was weaker among African American and Hispanic adolescents.

CONCLUSIONS

We find compelling evidence that African American and Hispanic adolescents are less likely to endorse deriving positive reinforcement from potentially dangerous risk taking acts compared to White adolescents. These findings suggest that African American and Hispanic youth may perceive less "margin for error" when navigating their environments.

Adolescent Exposure To Deadly Gun Violence Within 500 Meters Of Home Or School: Ethnoracial And Income Disparities

To identify the prevalence of and disparities in past-year exposure to deadly gun violence near adolescents' homes and schools, we linked national data on deadly gun violence incidents from the Gun Violence Archive to the age-fifteen wave of the Fragile Families and Child Wellbeing Study, a cohort of children born during 1998-2000 in large US cities. We found that 21 percent of adolescents in this cohort resided or attended school within 500 meters of a prior-year deadly gun violence incident during 2014-17. Rates of exposure were higher for Black and Hispanic adolescents than for White adolescents and higher for poor and near-poor adolescents than middle-to-high-income adolescents. Middle-to-high-income Black and Hispanic adolescents were more likely to be exposed to violence near home or school than poorer White adolescents. Because exposure to violence is detrimental to health, policies that reduce gun violence could improve population health disparities.

Is Delinquency Associated With Subsequent Victimization by Community Violence in Adolescents? A Test of the Risky Behavior Model in a Primarily African American Sample

OBJECTIVE

Victimization is common in adolescence and is associated with negative outcomes, including school failure, and poor emotional, behavioral, and physical health. A deeper understanding of the risk of victimization can inform prevention and intervention efforts. This study tests the risky behavior model in adolescents, examining prospective associations between mean levels of and changes in delinquency and risk for victimization over four annual data collections.

METHOD

Low-income adolescent (53.6% female; M _age = 12.13 years, SD = 1.62 years; 91.9% African American) and maternal caregiver dyads (N = 358) residing in urban neighborhoods in the mid-Atlantic region of the United States that had moderate-to-high levels of violence and/or poverty completed separate annual home interviews for 4 years. Maternal caregivers reported on adolescents' delinquent behavior; adolescents reported on their victimization by community violence experiences.

RESULTS

Using a latent difference score model, results supported the risky behavior model for the first 2 years, but not the final data collection period. That is, levels of and changes in delinquent behavior were associated with more victimization by community violence at the subsequent time point for the first 2 study years. In contrast, there was no evidence for the opposite, specifically that victimization by community violence predicted delinquency.

CONCLUSION

Knowing that both levels of delinquency and increases in delinquency place youth at heightened risk for victimization by community violence provides impetus to intervene. Screening for increases in delinquency among youth may be one way to target youth at high risk for victimization by community violence for fast-tracked intervention.

Subtypes of Girls Who Engage in Serious Delinquency and Their Young Adult Outcomes

Girls are increasingly becoming involved with the juvenile justice system; however, what brings girls to engage in delinquency or what obstacles these girls face later in life resulting from adolescent criminal behavior is understudied. In the present study, we used latent class analysis to identify subtypes of risks among adolescent girls ( N = 1,174) who have engaged in delinquent behaviors and mixture modeling to determine what distal psychological, social, educational, and economic outcomes in young adulthood are associated with each subtype. Four adolescent subtypes were identified, which were distinguished primarily based on the severity of their self-reported victimization experiences and mental health concerns. Classes with higher levels of victimization experiences tended to report more engagement with delinquent behavior in adolescence and had a larger proportion of Black and Hispanic girls than lower-victimization classes. Identified classes differed from each other on distal (i.e., young adulthood) measures of economic instability, educational attainment, drug use, depression, and adult arrests. Generally, latent classes which were characterized by higher rates of victimization and mental health concerns and lower educational performance in adolescence fared worse in young adulthood. Implications for those who care for girls who engage in delinquency, including suggestions for using trauma and culture informed screening, prevention, and intervention services, and directions for future research are discussed. Additional online materials for this article are available on PWQ’s website at http://journals.sagepub.com/doi/suppl/0361684320918243 .

As Violence Unfolds: A Space-Time Study of Situational Triggers of Violent Victimization among Urban Youth

OBJECTIVES

This study clarifies three important issues regarding situational or opportunity theories of victimization: 1) whether engaging in risk activities triggers violent assault during specific, often fleeting moments, 2) how environmental settings along individuals' daily paths affect their risk of violent assault, and 3) whether situational triggers have differential effects on violent assault during the day versus night.

METHODS

Using an innovative GIS-assisted interview technique, 298 young male violent assault victims in Philadelphia, PA described their activity paths over the course of the day of being assaulted. Case-crossover analyses compared each subject's exposure status at the time of assault with his own statuses earlier in the day (stratified by daytime and nighttime).

RESULTS

Being at an outdoor/public space, conducting unstructured activities, and absence of guardians increase the likelihood of violent victimization at a fine spatial-temporal scale at both daytime and nighttime. Yet, the presence of friends and environmental characteristics have differential effects on violent victimization at daytime versus nighttime. Moreover, individual risk activities appeared to exhibit better predictive performance than did environmental characteristics in our space-time situational analyses.

CONCLUSIONS

This study demonstrates the value of documenting how individuals navigate their daily activity space, and ultimately advances our understanding of youth violence from a real-time, real-life standpoint.

Social and Non-social Reward Processing and Depressive Symptoms Among Sexual Minority Adolescents

Sexual minority adolescents (SMA) are more likely to suffer from depression, putatively through experiences of social stress and victimization interfering with processing of social reward. Alterations in neural reward networks, which develop during adolescence, confer risk for the development of depression. Employing both social and monetary reward fMRI tasks, this is the first neuroimaging study to examine function in reward circuitry as a potential mechanism of mental health disparities between SMA and heterosexual adolescents. Eight SMA and 38 heterosexual typically developing adolescents completed self-report measures of depression and victimization, and underwent fMRI during monetary and peer social reward tasks in which they received positive monetary or social feedback, respectively. Compared with heterosexual adolescents, SMA had greater interpersonal depressive symptoms and exhibited blunted neural responses to social, but not monetary, reward in socioaffective processing regions that are associated with depressive symptoms. Specifically, compared with heterosexual adolescents, SMA exhibited decreased activation in the right medial prefrontal cortex, left anterior insula (AI), and right temporoparietal junction (TPJ) in response to being liked. Lower response in the right TPJ was associated with greater interpersonal depressive symptoms. These results suggest that interpersonal difficulties and the underlying substrates of response to social reward (perhaps more so than response to monetary reward) may confer risk for development of depressive symptoms in SMA.

Associations of Parental Monitoring and Violent Peers with Latino Youth Violence

This study aimed to examine the associations of parental monitoring and violent peers with violence among Latino youth, and whether these associations varied by acculturation. 133 adolescents were surveyed. Associations between parental monitoring, peer violence, and physical and non-physical violence were examined using bivariate and multivariable negative binomial regression. Multivariable analysis was stratified by age and acculturation. A path model examined whether peer violence mediated the relationship between parental monitoring and youth violence. Stratified analysis demonstrated that peer violence increased the risk of physical (RR = 1.24; 95% CI 1.02-1.20) and non-physical violence (RR = 1.32; 95% CI 1.08-1.62) for high-acculturated youth, whereas parental monitoring was protective for low-acculturated youth (physical RR = 0.88; 95% CI 0.78-0.99; non-physical RR = 0.80; 95% CI 0.68-0.93). In path analysis, low parental monitoring increased risk of involvement with violent peers, which was associated with increased risk of youth violence. Interventions may benefit from focusing on parental monitoring, peer violence, and tailoring by acculturation.

Personality and Adolescent School-Based Victimization: Do the Big Five Matter?

Self-control has provided a useful framework for understanding both offending behavior and victimization risk. As a theory of victimization, research has established that low self-control is directly related to victimization risk beyond a range of other factors. This finding raises the issue of whether other personality traits are associated with an increased risk of victimization. Using a sample of ninth-grade adolescents (N = 2,912) from the Rural Substance Abuse and Violence Project (RSVP), we tested whether the Big Five Inventory (BFI) of personality traits predicted adolescent school-based victimization above and beyond low self-control and rival explanations of victimization. The results indicate that, after controlling for risky behaviors, school attachment, and low self-control, neuroticism is positively related to victimization. This finding suggests that examining traits other than low self-control is important to capture fully what makes someone vulnerable to crime. Further, we consider the theoretical and policy implications of the findings.