The effects and treatment of community violence in children and adolescents: what should be done?

Evaluation of Psychological and Physical Violence towards Children and Adolescents before and during the COVID-19 Pandemic in the Lodz Voivodship

BACKGROUND

It has been shown that the course of COVID-19 infection in the under-18 population was in many cases sparsely symptomatic. In contrast, the impact of the pandemic on the psychological state is quite different. The risk of psychopathological symptoms in children and adolescents increased and the course of already present psychiatric disorders has often been exacerbated.

OBJECTIVES

Thus, this study aimed to evaluate the prevalence of psychological and physical violence among children and adolescents and its change during the COVID-19 pandemic, as well as to investigate various factors that might affect violence.

METHODS

In this survey study, 782 responses were included, with 480 collected during the second and 302 during the fourth wave of COVID-19. In this cross-sectional study, an anonymous questionnaire was used to collect demographic data, medical history, mental state, psychopathological symptoms, as well as the presence of psychological, physical violence, and suicidal self-harm behaviors before (retrospectively) and during the COVID-19 pandemic in the under-18 population of the Lodz Voivodship. The survey was prepared using Google Forms.

RESULTS

A decrease in the prevalence of physical violence during both waves of the pandemic has been observed (6.39% vs. 3.45%; p < 0.001), with only a similar trend present for psychological violence 16.75% vs. 14.71%; p = 0.081). No difference between physical and psychological violence was present in different pandemic waves, type of flat or house individuals lived in, availability of one's room, number of people living in the house, number of siblings, and type of school classes (p > 0.050). Older children (>15 years old) were more likely to be victims of psychological violence before and during the pandemic (both p < 0.001). A statistically significant model was obtained for psychological violence before (p < 0.001, R2 = 0.011) and during the pandemic (p = 0.007, R2 = 0.032). Risk factors for psychological violence before the pandemic included male gender (B = 0.531, p = 0.009, OR = 1.700), older age (B = 0.869, p = 0.001, OR = 2.385), and smaller city size (B = -0.187, p = 0.004, OR = 0.829), while for psychological violence during the pandemic, the risk factors were only male gender (B = 0.482, p = 0.022, OR = 1.620) and older age (B = 0.555, p = 0.046, OR = 1.742). No statistically significant models were created for physical violence (p > 0.050).

CONCLUSIONS

The observed decrease in physical violence during the COVID-19 pandemic suggests that in the studied group, home environment was not the main source of physical violence. Yet, we did not find any predicting factors for this form of violence. Violence, both physical and psychological, is a dangerous phenomenon in the under-18 population both in the pre-pandemic period and in crisis situations such as the pandemic.

The Depression Prevention Initiative: Trauma as a Moderator of Prevention Outcomes

Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST) is an evidence-based indicated depression prevention program that has been shown to reduce depression symptoms. Research is needed to identify moderators of IPT-AST's effects. Although trauma history has emerged as a moderator of depression treatment outcomes, the impact of trauma on short- and long-term outcomes in the context of preventive interventions for adolescent depression is unknown. This study examines the impact of trauma on prevention outcomes in a school-based randomized controlled trial (RCT) in which 186 adolescents (mean age = 14.01 years, SD = 1.22; 67% female) were randomly assigned to IPT-AST delivered by research staff or group counseling (GC) provided by school counselors. Trauma history significantly moderated intervention outcomes during the active phase of the intervention, but not during long-term follow-up. During the active phase, youth in IPT-AST with low or no trauma exposure experienced significantly greater reductions in depression symptoms than youth in GC with low or no trauma exposure, but there were no significant differences in rates of change between the two interventions for youth with high or any trauma exposure. These findings highlight the importance of assessing trauma and investigating whether these interventions can be tailored or supplemented to enhance the effects for youth with trauma exposure.

Are Children Harmed by Being Locked up at Home? The Impact of Isolation during the COVID-19 Pandemic on the Phenomenon of Domestic Violence

The phenomenon of violence against children is a very complex one. There are many types of child abuse, and they are culturally dependent to a significant degree. Although studies show that children generally only suffer from mild COVID-19 infection, some social restrictions introduced during the pandemic, such as home isolation, may have many severe consequences on the population's mental health. Studies on this topic suggest that violence against children increased during lockdown due to the COVID-10 pandemic. This narrative review summarizes this available literature on the subject and discusses the different forms of violence against children, their cultural aspects, the impact of the COVID-19 pandemic on the phenomenon of violence, the long-term consequences of the above, and forms of assistance for abused minors.

Influencing Factors of Depression among Adolescent Asians in North America: A Systematic Review

Background: Asian American adolescents experience rates of depression comparable to or greater than those of other ethnic minorities. The purpose of this systematic review is to summarize psychosocial factors related to depressive symptoms of Asian American adolescents between the ages of 10 to 19. Methods: Various electronic databases were systematically searched to identify research articles published from 2000 to 2021, and the psychosocial factors influencing depression among Asian adolescents in North America were examined. Results: A total of 81 studies were included in this systematic review. Consistent findings on relationships between depressive symptoms and influencing factors included (a) acculturative stress, (b) religious or spiritual significance for females, (c) parent–child cohesion, (d) harsh parenting style, (e) responsive parenting style, (f) racial or ethnic discrimination, (g) being bullied, (h) positive mentor presence, and (i) exposure to community violence. Collectively, the majority of included studies suggest that depressive symptoms were more likely found among Asian American adolescents who (a) are older, (b) are female, (c) have immigrant status, (d) exhibit coping behaviours, (e) face academic challenges, (f) face a poor socioeconomic situation, (g) perceive parent–child conflict, (h) perceive maternal disconnectedness, and (i) perceive negative peer relations. A number of conflictive findings also existed. Discussion/Conclusions: This systematic review provides a summary of the various psychosocial factors on individual, familial, and social levels, which influenced the depressive symptoms of Asian American adolescents. Such findings offer a starting point to examine what factors should be necessarily included in related depression-preventive intervention design and evaluation. Culturally sensitive care, strengthened family–school–community collaboration, and targeted research efforts are needed to meet the needs of Asian adolescents experiencing a range of depressive symptoms.

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.

Interpersonal Trauma and Risk of Depression Among Adolescents: The Mediating and Moderating Effect of Interpersonal Relationship and Physical Exercise

Interpersonal trauma in adolescent is an important public health concern. Depression can be a main consequence of interpersonal trauma, which subsequently results in various negative mental health outcomes. Previous research has investigated the independent effects of interpersonal trauma, interpersonal relationships and physical exercise on the risk of depression. However, the interaction effect of the three factors on depression remains unclear. We aim to investigate the associations between these potential factors and depression in adolescents, and explore the interaction effect of the three aforementioned factors. A cross-sectional study was conducted in Shenzhen, China, in 2017. A total of 1,883 adolescents from 11 middle schools and high schools were recruited. Demographic information, depressive symptoms, physical exercise, interpersonal relationships, interpersonal trauma, and academic record were collected through the use of standardized questionnaires. A linear regression model was performed to explore the association between these variables and depression. Pathway analysis was used to explore the role of potential mediators and moderators. The results showed that interpersonal trauma and poorer interpersonal relationships were significantly associated with depression (p < 0.05). We identified a mediating role of interpersonal relationships in the relationship between interpersonal trauma and depression, and a moderating role of physical exercise between interpersonal trauma and interpersonal relationships. This is the first study to examine the interaction effects of interpersonal trauma, interpersonal relationships and physical exercise on depression in adolescents. The current study therefore provides insights into factors which impact the mental health of adolescents. Through examining these factors one can gain further insight into potential factors associated with depression and therefore then develop more tailored interventions in order to support adolescents' mental well-being.

The moderating effect of parental support: internalizing symptoms of emerging adults exposed to community violence

Evidence suggests parental support mitigates the association between community violence exposure and internalizing symptoms in adolescents. This study investigates this moderation of parental support for emerging adults and compares it with that for adolescents. Data were drawn from the Pathways to Desistence Study using community violence, parental support, and their interaction to predict internalizing symptoms in a series of regression models for adolescents and emerging adults. Results suggest that exposure to community violence during adolescence and emerging adulthood had a significant association with internalizing symptoms. Mother support during adolescence moderated this relationship. Emerging adulthood was marked by an increase in parental support; however, this support did not moderate the relationship between community violence and internalizing symptoms. Interventions, programs, and policies that leverage the parental support of emerging adults may be a useful strategy to mitigate the negative impacts of community violence.

Protective Factors Against Child Victimization in the School and Community: An Exploratory Systematic Review of Longitudinal Predictors and Interacting Variables

Protective factors against the victimization of children and young people within the school and community environments (extrafamilial victimization) have received less attention than risk factors. To date, there has been no systematic review on protective factors. This systematic review therefore aimed to synthesize the prospective longitudinal research findings on the protective factors against extrafamilial victimization. A systematic search of multiple sources led to the identification of 19,053 studies. Following application of a predefined inclusion and quality assessment criteria, 13 studies exploring protective factors against peer victimization and exposure to violence were included in this review. Across these studies, 19 protective factors were explored: 9 individual factors and 10 contextual factors. Four studies also explored the impact of mediating and moderating variables on the relationship between predictors and extrafamilial victimization. Findings highlight inconsistencies in the definition and measurement of victimization, along with bias in a number of areas. Nevertheless, a small number of variables (perceptions of social competence, physical strength, and aggression) were identified as potential protective factors against extrafamilial victimization. Additionally, mediating and moderating variables were identified, and the interaction between individual and contextual protective and risk factors were highlighted. These findings are explored under the theoretical framework of the ecological systems theory and their practical and research-based implications are discussed.

The prevalence of childhood victimization experienced outside of the family: Findings from an English prevalence study

There has been little research carried out in the United Kingdom (UK) aimed at providing a holistic exploration of the victim experiences of young people within the school and community environments (extrafamilial victimization). This study therefore examined the prevalence of 24 different types of extrafamilial victimization experienced by a sample of 730 young people, aged 13-16 years (mean 13.8 years), from one county in the UK. The findings show that the vast majority of young people experienced some form of extrafamilial victimization over their lifetime (84.1%) and past year (67.2%). Looking at individual categories of victimization experienced over the lifetime, 7 out of 10 young people witnessed or experienced indirect victimization, 1 in 3 experienced property victimization, more than 1 in 4 physical victimization, almost 1 in 2 experienced bullying, 1 in 28 dating violence and 1 in 7 experienced sexual victimization. The findings also suggest that victimization is not an isolated event; participants experienced an average 2.8 different types of victimization across their lifetime. These research findings are compared to those from national victimization surveys in the USA and UK to compile a picture of the victimization prevalence rates across studies. The findings highlight the importance of adopting a holistic approach to the exploration of extrafamilial victimization in future research, assessment of victim experiences, and prevention of extrafamilial victimization.

Interpersonal youth violence perpetration and victimization in a diverse Asian American and Pacific Islander adolescent sample

This study was the first to examine ethnic, sex, and ethnicity-by-sex differences for under-researched, Asian American and Pacific Islander, adolescent groups on youth violence outcomes other than cyberbullying. This effort included the less researched, emotional violence, and included socioeconomic status (SES) measures as covariates. The sample size from 2 high schools in spring 2007 was 881, using an epidemiologic survey design. The pattern of results was higher rates of violence victimization for ethnic groups, with lower representation in the 2 schools' population, and ethnic groups that more recently moved or immigrated to Hawai'i. For emotional victimization, girls of European American and "other", ethnicities self-reported higher rates than boys. Several implications (e.g., need for ethnically and gender-based approaches) and further research (e.g., ethnocultural identity) are discussed.

Improving implementation of mental health services for trauma in multicultural elementary schools: stakeholder perspectives on parent and educator engagement

Although more schools are offering mental health programs, few studies have involved the school community in research to improve their successful implementation. In this community-partnered study, focus groups were conducted with school staff and parents to explore issues related to community engagement and feasibility of a mental health intervention for elementary school students exposed to trauma. Four educator focus groups, including 23 participants, and 2 parent focus groups, consisting of 9 Spanish-speaking and 7 English-speaking parents were conducted. Participants discussed facilitators and barriers to successful implementation of the program. Participants identified the importance of pre-implementation parent education, raising awareness of the impact of student mental health among educators, maintaining ongoing communication during the intervention, and addressing logistical concerns. Participants described clear considerations for parent and educator engagement, both at the pre-implementation phase and during implementation of the program. Implications for next steps of this community-partnered approach are described.

The contribution of community and family contexts to African American young adults' romantic relationship health: a prospective analysis

Accumulating evidence suggests that African American men and women experience unique challenges in developing and maintaining stable, satisfying romantic relationships. Extant studies have linked relationship quality among African American couples to contemporaneous risk factors such as economic hardship and racial discrimination. Little research, however, has examined the contextual and intrapersonal processes in late childhood and adolescence that influence romantic relationship health among African American adults. We investigated competence-promoting parenting practices and exposure to community-related stressors in late childhood, and negative relational schemas in adolescence, as predictors of young adult romantic relationship health. Participants were 318 African American young adults (59.4% female) who had provided data at four time points from ages 10-22 years. Structural equation modeling indicated that exposure to community-related stressors and low levels of competence-promoting parenting contributed to negative relational schemas, which were proximal predictors of young adult relationship health. Relational schemas mediated the associations of competence-promoting parenting practices and exposure to community stressors in late childhood with romantic relationship health during young adulthood. Results suggest that enhancing caregiving practices, limiting youths' exposure to community stressors, and modifying relational schemas are important processes to be targeted for interventions designed to enhance African American adults' romantic relationships.

Community perceptions of safety in relation to perceived youth violence-delinquency in a primarily native Hawaiian and Asian American community in Hawai'i

Perception of safety is an important component to the well-being of community members in their own neighborhood. The present study was the first of its kind to model community perception of safety utilizing a primarily Native Hawaiian and Asian American community sample (N = 101) and with perceived youth violence and delinquency as prominent potential influences. The study found that the majority of participants felt that several types of youth violence and delinquency were problems in the community. The overall social-ecological model evidenced a strong fit and indicated that community perception of safety was adversely impacted by perceived youth violence and delinquency and increased through positive relations with neighbors. The implications included the need for a more comprehensive approach to positive youth development and community capacity-building, including incorporation of cultural components, and to determine whether the model is applicable to other minority communities.

Early detection of children at risk for antisocial behaviour using data from routine preventive child healthcare

Background

Youth antisocial behaviour is highly prevalent. Young people are usually not willing to disclose such behaviour to professionals and parents. Our aim was to assess whether child health professionals (CHP) working in preventive child healthcare could identify pre-adolescents at risk for antisocial behaviour through using data that they obtain in routine practice.

Methods

CHPs examined a national sample of 974 pre-adolescents aged 8-12 years (response 79.1%), and interviewed parents and children during routine well-child assessments. We obtained data on family background and current health of the child from the CHP; on developmental concerns from parents, and on social and emotional well-being, injuries, and substance use from the children. Antisocial behaviour concerned the adolescent-reported 15 item International Self-Reported Delinquency study questionnaire, among which are 5 items on violence against people.

Results

The prevalence of 2+acts of any antisocial behaviour was 21.8%, and 33.9% for 1+acts of violence (10.5% for 2+). Children who were male, had a young mother, no parent employed, recent injuries, poor performance at school or who were bored by school, and who had parental concerns more often reported 2+antisocial acts and 1+violence against people. Detection algorithms on the basis of these variables were moderately able to classify outcomes, with Areas-Under-the-Curves ranging from 0.66 to 0.71.

Conclusions

Data from routine well-child assessment can help CHPs to detect pre-adolescents at risk for antisocial behaviour, but detection algorithms need to be further improved. This could be done by obtaining additional information on factors that are associated with antisocial behaviour.

Epidemiology of mixed martial arts and youth violence in an ethnically diverse sample

Mixed martial arts' (MMAs) growing international popularity has rekindled the discussion on the advantages (e.g., exercise) and disadvantages (e.g., possible injury) of contact sports. This study was the first of its kind to examine the psychosocial aspects of MMA and youth violence using an epidemiologic approach with an Asian American and Pacific Islander (AAPI) adolescent sample (N = 881). The results were consistent with the increased popularity of MMA with 52% (adolescent males = 73%, adolescent females = 39%) enjoying watching MMA and 24% (adolescent males = 39%, adolescent females = 13%) practicing professional fight moves with friends. Although statistically significant ethnic differences were found for the two MMA items on a bivariate level, these findings were not statistically significant when considering other variables in the model. The bivariate results revealed a cluster of risk-protective factors. Regarding the multiple regression findings, although enjoying watching MMA remained associated with positive attitudes toward violence and practicing fight moves remained associated with negative out-group orientation, the MMA items were not associated with unique variances of youth violence perpetration and victimization. Implications included the need for further research that includes other diverse samples, more comprehensive and objective MMA and violence measures, and observational and intervention longitudinal studies.

The impact of parental trauma exposure on community violence exposed adolescents

Previous research has documented an association between adolescent community violence (CV) exposure and poor psychological functioning. The purpose of this study was to delineate the relations of adolescent CV, parent trauma exposure (PTE), and adolescent internalizing and externalizing symptomatology while controlling for adolescent-reported home violence and parental self-reported posttraumatic stress disorder (PTSD). Participants consisted of 101 pairs of junior high school and high school students and their parents or caretakers. Adolescents completed measures to assess their history of violence exposure in the community and home setting and current internalizing symptoms. Parents or caretakers completed a demographic questionnaire, a measure assessing their trauma exposure and related symptomatology, and a measure of child externalizing symptoms. Hierarchical regression analyses were conducted; results indicated that after controlling for demographic variables, home violence exposure, and parental PTSD symptoms, PTE emerged as a moderator variable in the relationship between CV and adolescent-rated internalizing symptoms but not in the association between adolescent CV and externalizing symptoms.

Development of a multi-layered psychosocial care system for children in areas of political violence

Few psychosocial and mental health care systems have been reported for children affected by political violence in low- and middle income settings and there is a paucity of research-supported recommendations. This paper describes a field tested multi-layered psychosocial care system for children (focus age between 8-14 years), aiming to translate common principles and guidelines into a comprehensive support package. This community-based approach includes different overlapping levels of interventions to address varying needs for support. These levels provide assessment and management of problems that range from the social-pedagogic domain to the psychosocial, the psychological and the psychiatric domains. Specific intervention methodologies and their rationale are described within the context of a four-country program (Burundi, Sri Lanka, Indonesia and Sudan). The paper aims to contribute to bridge the divide in the literature between guidelines, consensus & research and clinical practice in the field of psychosocial and mental health care in low- and middle-income countries.

Community violence victimization and depressed mood: the moderating effects of coping and social support

The objectives of the current study were to (a) determine how lifetime community violence (CV) victimization, coping behavior, social support (SS), and depressed mood are related in young adults, and (b) assess whether the relationship between CV victimization and depressive reactions is moderated by perceived SS and coping style. Five hundred fifty college students (160 men, 355 women) completed questionnaires measuring lifetime experiences with violence, current depressed mood, perceptions of SS from family and friends, and general coping styles. Results of a series of hierarchical regressions indicated a positive relationship between frequency of CV victimization and depressed mood. Low levels of perceived SS and problem-focused coping and high levels of disengagement coping were associated with increased depression scores overall, but there was an interaction effect such that high disengagement coping strengthened the relationship between CV and depressed mood. Moreover, when controlling for the effect of posttraumatic stress, high-perceived friend support and low disengagement coping served as protective factors for depressed mood. These results were particularly strong in individuals whose last CV experience occurred within the previous 2 years. Findings suggest that perceptions of support and ability to actively cope with stressors are very important in the adjustment to CV victimization.

Maternal depression and adolescent behavior problems: an examination of mediation among immigrant Latino mothers and their adolescent children exposed to community violence

This study examines the psychological and behavioral effects of exposure to community violence of 47 Latino mothers and their young adolescent children. Using data gathered from multiple sources, this study tests the associations between lifetime exposure to community violence, maternal depression, and child behavior problems. More than 80% of the youngsters ranging from age 11 to 14 years and 68% of the mothers reported being exposed to at least one act of community violence either as a victim or as a witness. Analyses reveal that maternal depression is a mediator of child behavior problems, reducing the direct effect of community violence exposure by more than 50%. Findings suggest that maternal depression is a factor more important than child's community violence exposure in contributing to young adolescents' behavioral problems.

Child and Adolescent Social-Emotional Development Within the Context of School

Children and adolescents exposed to violence may develop mental health problems, impacting their ability to develop appropriate social-emotional skills. Limited development of social-emotional skills has been associated with poor performance in school. A review of the literature was conducted to better understand social-emotional development in children and its role in a child's ability to function in the school setting. The developmental psychopathology framework is used to illuminate the dynamic relationship between children and their contexts. Specifically, the context of school is explored to identify its role in providing services that address the needs of children and adolescents with social-emotional limitations.