Early adolescent development in the face of violence: A systematic review running

BACKGROUND

Exposure to violence has severe and lasting effects on development. Despite the body of research examining childhood exposures to violence and victimization, developmental outcomes during early adolescence are poorly understood.

OBJECTIVE

To synthesize existing research on the effects of violence exposure on early adolescent development (youth 9-14 years old) and highlight areas for future research.

METHOD

We conducted a systematic search of PubMed, CINAHL, Web of Science, Scopus, and EMBASE for articles published between 2012 and 2023. Included articles focused on violence exposure related to experiencing or observing community violence, witnessing domestic violence and/or being the victim of chronic physical abuse.

RESULTS

Twenty-eight articles spanning four developmental domains were included: behavioral, biological, neurological, and social development. Behaviorally, violence exposure posed significant effects on both internalizing and externalizing symptoms. Biologically, violence exposure was strongly associated with advanced epigenetic age, accelerated puberty, and insomnia. Neurologically, violence exposure had significant associations with both structural and functional differences in the developing brain. Socially, violence exposure was related to poor school engagement, peer aggression, and low social support.

CONCLUSION

This systematic review highlights varying effects of violence exposure on early adolescent development. The gaps presented should be addressed and implemented into clinical practice via evidence-based policies and procedures to ensure successful transition to adulthood.

Compensatory prosocial behavior in high-risk adolescents observing social exclusion: The effects of emotion feedback

Although exposure to violence has been consistently associated with deficits in prosocial behavior among adolescents, effective methods of mitigating these deficits have yet to be identified. The current investigation tested whether prosocial behavior could be promoted by providing adolescents with feedback about the emotional states of others and whether the effects of feedback varied between adolescents who had versus had not experienced violence in the home or in the community. Adolescents aged 8 to 17 years with (n = 87) and without (n = 61) histories of violence exposure completed a virtual social exclusion ball-tossing paradigm in which information about an excluded peer's emotions (sad, angry, or neutral) was experimentally manipulated. Among adolescents with histories of violence exposure, those who received feedback that the peer was sad due to being excluded compensated by throwing the ball more often to that peer. In contrast, adolescents without histories of violence exposure did not engage in compensatory prosocial behavior, instead maintaining a relatively even number of tosses to all players. Findings offer new insight into simple potential methods of eliciting prosocial behavior in adolescents for whom such responding may be compromised and may provide a potential starting point for interventions.

Longitudinal Patterns of Multidimensional Violence Exposure and Adolescent Early Sexual Initiation

Early sexual intercourse is associated with sexually transmitted infections, pregnancy, and depressive symptoms, and delay of intercourse allows adolescents opportunities to practice relationship skills (Coker et al., 1994; Harden, 2012; Kugler et al., 2017; Spriggs & Halpern, 2008). Thus, understanding predictors of early sexual intercourse is crucial. Prior research has suggested that violence exposure is associated with early initiation of sexual intercourse in adolescence (Abajobir et al., 2018; Orihuela et al., 2020). However, most studies have looked only at a single type of violence exposure. In addition, little research has examined longitudinal patterns of violence exposure in order to determine whether there are particular periods when the violence exposure may have the strongest impact on sexual behavior. Guided by life history and cumulative disadvantage theories, we use longitudinal latent class analysis and data from the Future of Families and Child Well-being Study (N = 3,396; 51.1% female, 48.9% male) to examine how longitudinal patterns of multiple types of violence exposures across ages 3 to 15 are associated with early sexual initiation in adolescence. Findings suggest that experiencing persistent physical and emotional abuse across childhood was associated with the greatest prevalence of early sexual initiation. Early exposure to violence was not consistently associated with greater likelihood of sexual initiation; instead, early abuse was more strongly associated with sexual initiation for boys, while late childhood abuse was more strongly associated for girls. These findings suggest that gender-sensitive programs are highly needed to address unique risk factors for boys' and girls' sexual behaviors.

Gender and Violence in the Daily Routine of Community Health Workers in Fortaleza, Brazil

Community Health Workers (CHWs) are the link between the Brazilian primary health care system and the community. Since CHWs live in the same neighborhoods they work, they are involved in what happens in the community, including observants and or potential targets of violence. However, it is not known if female and male CHWs perceive and suffer violence similarly. This study aimed to investigate the violence to which CHWs are exposed and if female CHWs experience and or perceive violence the same way as male CHWs. A structured questionnaire was used to collect information from CHWs. Two periods (2019 [n=1402] and 2021 [n=364]) were compared. The data show that more than 80% of CHWs were exposed to violence, either as victims or witnesses within the community they served. In general, while the occurrence of violence towards CHWs decreased, their perception of community violence increased. Over time, the perception of urban/community violence remained constant among male CHWs, but increased among female CHWs, as shown by the significant rise between 2019 and 2021 in the percentage of female CHWs reporting witnessing or hearing about manifestations of violence (e.g., physical aggression; assault; stabbing; lethal gunshot; non-lethal gunshot; and gang violence). Among male CHWs, perception only increased with regard to the item assault. Given the complexity of violence and its repercussions on the daily routines of CHWs, intersectoral and interdisciplinary partnerships between health workers and other stakeholders are needed to create strategies capable of dealing with expressions of violence in the territories served.

Academic Achievement After Violence Exposure: The Indirect Effects of School Attachment and Motivation to Succeed

Disparities in educational outcomes for students living in communities burdened with high rates of violence are striking as they are at an increased risk for misbehavior, low GPA, poor school attendance, and decreased standardized test scores. However, limited research identifies the role that schools play in exacerbating exposure to violence to inform changes that aid in mitigating violence exposure. As such, this study utilizes the Pathways to Desistance Study to explore the mediating roles of school attachment and motivation to succeed on students' academic outcomes after exposure to community violence. Using a serial mediation model, findings indicate that school attachment and motivation to succeed mediate the relationship between exposure to violence and grades. Implications for adapting school programs and policies as well as providing teacher training to increase school attachment and motivation are discussed.

Trajectories of Psychopathic Traits, Anxiety, and Violence Exposure Differentially Predict Antisociality in Legal System-Involved Youth

Psychopathic traits are associated with several forms of antisociality, including criminal offending, legal system involvement, and substance use. Some research suggests that primary (high psychopathic traits, low negative emotions) versus secondary (high psychopathic traits, high negative emotions and/or negative experiences and environments) variants confer different levels of risk for antisociality. However, research has not examined trajectories of co-occurring fluctuations in psychopathic traits, negative emotions, and negative experiences and environments or how trajectory membership relates to antisociality. We implemented group-based multi-trajectory modeling in a sample of 809 justice-involved male (n = 681) and female (n = 128) youth from the Pathways to Desistance Study to address these gaps. We identified four trajectories of co-occurring change in psychopathic traits, anxiety, and violence exposure spanning three years: Low (low levels of each factor); Moderate Psychopathic Traits, High Negative Emotions and Experiences (moderate-decreasing psychopathic traits and high-decreasing anxiety/violence exposure); Potential Primary Psychopathic Traits (elevated-decreasing psychopathic traits, moderate-decreasing anxiety, moderate-stable violence exposure); and High/Secondary Psychopathic Traits (high-stable psychopathic traits, elevated-stable anxiety, high-decreasing violence exposure). Compared to the Low trajectory, all trajectories predicted greater violent crime and substance use three and four years later. Additionally, compared to the Low trajectory, the Potential Primary Psychopathic Traits trajectory predicted more nonviolent offending three years later. Finally, the High/Secondary Psychopathic Traits trajectory showed the most persistent antisociality, predicting more nonviolent crime, higher substance dependence symptoms, and higher likelihood of arrest three and four years later. Youth with co-occurring high psychopathic traits, anxiety, and violence exposure appear most at risk for severe antisociality.

Comparisons of violence exposure within and across contexts in predicting depression among Chinese children and adolescents

BACKGROUND

Existing research has identified violence exposure as a risk factor for depression among children and adolescents. To date, however, we know little about whether these associations are influenced by the forms (witnessing and victimization) of violence exposure across different contexts (family, school, and community).

OBJECTIVE

The present study thus aimed to compare the effects of two forms of violence exposure across and within three contexts. Sex and age differences were also tested in the above associations.

PARTICIPANTS AND SETTING

Participants (N = 906, 52.4 % boys, T1: M_age = 11.03) were children and adolescents recruited from elementary and junior schools in Zhejiang Province, China.

METHODS

All participants were asked to complete questionnaires about their experiences of various types of violence exposure and depression at two time points with a 12-month interval. SPSS and Mplus were used to analyze the data.

RESULTS

Considering the comparison within contexts, witnessing family violence was a more influential predictor than family violence victimization while school violence was the opposite. As for the comparison across contexts, no significant differences were found in the effects of different violence victimization, while the effect of witnessing family violence and community violence were more influential than witnessing school violence. No significant sex differences in the above associations were found. However, community violence victimization was more negatively related to depression among adolescents compared with children.

CONCLUSIONS

The associations between violence exposure and depression are influenced by the forms and contexts of violence as well as age groups.

Heterogeneous effects of spatially proximate firearm homicide exposure on anxiety and depression symptoms among U.S. youth

The burden of firearm homicide in the United States is not evenly distributed across the population; rather, it disproportionately affects youth in disadvantaged and marginalized communities. Research is limited relevant to the impacts of exposure to firearm violence that occurs near where youth live or attend school - spatially proximate firearm violence - on youths' mental health and whether those impacts vary by characteristics that shape youths' risk for experiencing that exposure in the first place. Using a dataset linking the Fragile Families and Child Wellbeing Study with the Gun Violence Archive (N = 3086), we employed propensity score matching and multilevel stratification to examine average and heterogeneous associations between spatially proximate firearm homicide exposure and anxiety and depression among all youth and then separately for boys and girls. We found a statistically significant average association between firearm homicide exposure and symptoms of depression among youth. Furthermore, heterogeneous effects analyses yielded evidence that the average association is driven by youth, and particularly boys, who are the most disadvantaged and have the highest risk of firearm homicide exposure. The results of this study suggest that the accumulation of stressors associated with structural disadvantage and neighborhood disorder, coupled with exposure to spatially proximate and deadly firearm violence, may make boys and young men, particularly Black boys and young men, uniquely vulnerable to the mental health impacts of such exposure. Ancillary analyses of potential effect moderators suggest possible future areas of investigation.

Parenting Among Women in Methadone Treatment: Contributions of Mental Health Problems and Violence Exposure

The aim of the current study is to explore factors associated with quality of parenting among women in treatment for opioid use disorders. 150 Black American women with 3-5 year old children were recruited through methadone treatment programs. Parenting representations were assessed through the Working Model of the Child Interview and parenting behavior through video recordings of mother-child interaction. Interviews were used to assess mothers' history of violence exposure and to make DSM diagnoses. Mothers' mood disorder was related to distorted representations and to expressions of concerned affect (anxiety, fear, guilt). Mothers' personality disorder was related to expressions of negative affect (anger and frustration) and inversely related to sensitive parenting behavior. Mothers' experience of family violence during childhood and partner violence during adulthood were related to concerned affect in their representations. Women in treatment for substance use disorder have complex and interconnected needs, including parenting supports and trauma-informed mental health services.

Patterns of Violence Exposure and Substance Use among Child Welfare Involved Youth

Emerging research suggests an association between exposure to violence, specifically indirect forms, and substance use among youth involved in the child welfare (CW) system. However, this has only been recently and tentatively explored. This study examined the associations among various forms of indirect violence exposure and substance use among subgroups of youth involved in the CW system. The analytic sample consisted of participants (aged 11 years or older) in the baseline year of the second National Survey of Child and Adolescent Well-Being (2008-2012), including youth and their caregivers. Latent class analysis was used to examine associations among distinct forms of indirect violence exposure and substance use and the potential identification of unique at-risk groups. Models for the overall sample suggested two classes of at-risk youth, with the higher-risk class having higher probabilities of alcohol, marijuana, and hard drug use, which coincided with higher probabilities of exposure to arrests, stealing, drug deals, and weapon use. However, stratified models suggested unique results for youth aged 13-14 and 15-17, suggesting that the confluence of these risks appears to differ developmentally. Prevention and intervention services for CW-involved youth should assess and address violence exposure types among youth as a potential opportunity to mitigate substance use and subsequent high-risk behavior.

Efficacy to avoid violence and parenting: A moderated mediation of violence exposure for African American urban-dwelling boys

We took a risk and resilience approach to investigating how witnessing physical violence influences adolescent violent behaviors overtime. We proposed efficacy to avoid violence as a major path of influence in this negative trajectory of adolescent development. We also focus on the protective roles of parenting behaviors for African American boys living in disadvantaged contexts. Most of our sample of 310 African American adolescent males (M age = 13.50, SD = .620) had experienced significant amounts of violence, but they also reported continued efficacy to avoid violence. We tested a first stage dual moderated mediation model and found that higher levels of witnessing violence lead to more violent behavior and less efficacy to avoid violence, and that efficacy was the mediator in that link. Youth who witness more violence may feel that engagement in violence is inescapable and thus may themselves end up engaging in it. These problematic long-term trajectories were moderated by parent's communication about violence and monitoring revealing possible protections for youth, and an enhancement of youths' internal strengths. Our findings propose pathways that can inform interventions that may protect African American adolescent boys against the vicious cycle of exposure to, and acts of, violence.

Exposure to family and domestic violence is associated with lower attendance and higher suspension in school children

BACKGROUND

Exposure to family and domestic violence (FDV) in childhood can have a detrimental effect on children's health and social outcomes. However, research on the school outcomes of children exposed to FDV is scant.

OBJECTIVES

To investigate the impact of FDV exposure on school attendance and suspension in Aboriginal and non-Aboriginal children.

METHODS

A population-based retrospective cohort study of school children, in grade 1 to 10, born from 1993 to 2006 in Western Australia (n = 26,743) using linked administrative data. Multivariate logistic regression analysis was used to calculate odds ratios and 95% confidence intervals to determine the association with school attendance and suspension outcomes for children exposed to FDV compared to non-exposed children.

RESULTS

Compared to non-exposed children, children exposed to FDV have an increase of poor school attendance: Aboriginal children adjusted odds ratio (aOR) = 1.91, 95% confidence interval (CI): 1.75-2.07, non-Aboriginal children aOR = 2.42, 95%CI: 2.12-2.75. FDV-exposed children also have an increased risk of school suspension: Aboriginal children aOR = 1.60, 95%CI: 1.47-1.74, non-Aboriginal children aOR = 2.68, 95%CI: 2.35-3.05, compared to non-exposed counterparts.

CONCLUSION

Exposure to FDV is associated with an increased odds of poor school attendance and school suspension. Evidence-based and innovative strategies are needed to support children who are exposed to FDV. This involves responding in ways that does not cause further trauma to children; a restorative and trauma-informed approach is vital.

Exposure to violence, polyvictimization and youth's mental health and alcohol use in El Salvador

BACKGROUND

Community and family violence are major global health problems. Approximately 1.3 million deaths around the world and 2.5% of global mortality are due to violence. In El Salvador, youth are exposed to multiple levels of physical and emotional violence, abuse, and crime.

OBJECTIVE

The objective of this study was to investigate the various sources of violence against youth and determine the associations with mental distress symptoms, suicidal ideation, and alcohol use outcomes.

PARTICIPANTS AND SETTING

We use information gathered in 2017 from a representative sample of 13- to 24-year-old adolescents and young adults from El Salvador.

METHODS

Data used in this analysis came from a nationally cross-sectional household survey called Violence Against Children Survey (VACS) in El Salvador. We used logistic regression models to determine the associations between lifetime witnessing violence, exposure to physical, sexual, emotional violence, and youth mental health outcomes.

RESULTS

Polyvictimization was associated with greater odds of each mental health outcome after adjusting for confounders. The strongest relative association was observed between emotional violence and mental distress. Sexual violence and emotional violence were predictors of suicidal ideation. Finally, physical violence and sexual violence were associated with alcohol use. The greatest associations were observed between sexual violence perpetrated by a parent, peer, or another adult in the community and suicidal ideation, at a magnitude of approximately six times higher odds.

CONCLUSIONS

Preventing violence against youth is likely to improve mental health and wellbeing in El Salvador and other similar contexts worldwide.

Suicide attempt and violence victimization in Korean adolescents with migrant parents: A nationwide study

BACKGROUND

Suicide and violence exposure are important health related issues in adolescents. This study aimed to investigate suicide attempt and violence victimization in Korean adolescents with migrant parents.

METHODS

Data from the 2016 to 2018 Korea Youth Risk Behavior Web-based Survey (KYRBS) were used. The migration status of the participating students' parents was defined based on parental birthplace, classified into the 'both native Korean parents,' 'mother born abroad,' 'father born abroad,' and 'both parents born abroad' groups. Suicide attempt and violence victimization included events that occurred in the past 12 months. The general characteristics of the population were investigated using chi-square test. The association between dependent and independent variables was examined using multiple logistic regression analysis, expressed as Odds Ratio (OR) and their 95 percent confidence interval (95% CI).

RESULTS

Of the 170,575 study participants, 4,012 (2.4%) attempted suicide and 3,038 (1.8%) experienced violence victimization. Highest proportions of suicide attempt and violence victimization were found in adolescents with both migrated parents born abroad. Compared to adolescents with both native Korean parents, individuals with both migrated parents were more likely to attempt suicide (OR 2.28, 95% CI 1.37-3.81) and experience violence victimization (OR 5.63, 95% CI 3.73-8.48).

LIMITATIONS

This study was cross-sectional in design. Information was unavailable on which immigrant generation the study participants belonged to.

CONCLUSION

Adolescents with both migrated parents were more likely to attempt suicide and experience violence victimization. The findings have important implications in the management of suicide and violence victimization in adolescents.

The relationship of pre- and post-resettlement violence exposure to mental health among refugees: a multi-site panel survey of somalis in the US and Canada

BACKGROUND

A large body of research highlights the lasting impact of pre-resettlement violence on the mental health of refugees after resettlement. However, there is limited research on violence exposure after resettlement and its association with mental health. We examine the association of pre- and post-resettlement violence with post-resettlement mental health symptoms in a survey of Somali refugees in the US and Canada.

METHODS AND FINDINGS

We collected survey data from 383 Somalis across five cities in the US and Canada (Boston, MA; Minneapolis, MN; Lewiston, NC; Portland, ME; Toronto, Canada). Wave 1 data were collected between May 2013 and January 2014, while Wave 2 was collected between June 2014 and August 2015. Data from both waves were used to examine whether the association of past violence exposures persists across time and with more recent violence exposures. The War Trauma Screening Scale assessed exposure to any pre- and post-resettlement violence at Wave 1, while the My Exposure to Violence scale assessed any past-year violence exposure at Wave 2. Mental health outcomes included symptoms of depression and anxiety (Hopkins Symptom Checklist) and post-traumatic stress symptoms (Harvard Trauma Questionnaire). Separate linear regression models at Waves 1 and 2 examined the relationship of past violence exposure to standardized scores of mental health symptoms. Participants were 22 years of age, on average. Fifty-six percent of our sample had been exposed to violence after resettlement by Wave 2. At Wave 1, the associations of pre- and post-resettlement violence with mental health were comparable in magnitude across depression [β = 0.39, 95% CI (0.21 0.57) vs. β = 0.36, 95% CI (0.10 0.62)], anxiety [β = 0.33, 95% CI (0.12 0.55) vs. β = 0.38, 95% CI (0.01 0.75)], and PTSD [β = 0.55, 95% CI (0.37 0.72) vs. β = 0.47, 95% CI (0.21 0.74)]. At Wave 2, pre-resettlement violence was associated with depressive symptoms only [β = 0.23, 95% CI (0.06 0.40)], while past-year exposure to violence had the largest association with all mental health outcomes [depression: β = 0.39, 95% CI (0.17 0.62); anxiety: β = 0.46, 95% CI (0.01 0.75); PTSD: β = 0.67, 95% CI 0.46 0.88)].

CONCLUSIONS

Our study is the first to examine refugees' exposure to post-resettlement violence across time, finding that Somali refugees' exposure is both persistent and prevalent after resettlement. Post-resettlement violence had a larger association with mental health than pre-resettlement exposure by Wave 2. Our study highlights the urgent need to understand the role of post-resettlement violence exposure for refugees in the US and Canada.

Childhood Sexual Trauma and Antiretroviral Therapy Adherence: A Mixed-Methods Systematic Review

Childhood sexual abuse (CSA) has been shown to be more prevalent among populations living with HIV. Antiretroviral therapy (ART) adherence is crucial for populations living with HIV as it significantly increases the likelihood of attaining and maintaining viral suppression. Previous findings on the association between CSA and ART adherence have been mixed. The current mixed-methods systematic review aimed to identify quantitative and qualitative studies from CINAHL, PsycInfo, PubMed, and Web of Science examining the relationship between CSA and ART adherence. Authors were also contacted if relevant data were unpublished. Studies had to be published from January 1, 2000 to April 1, 2019, written in English, and examined CSA as an exposure and ART adherence as an outcome. Four domains were combined: 1) childhood sexual abuse; 2) child; 3) antiretroviral; and 4) adherence. Eight quantitative and two qualitative studies were retained. The results showed that four quantitative studies found no association while the other four found factors such as timing of victimization, mental health and gender influenced the association between CSA and ART adherence. Themes emerging from the qualitative studies included use of ART evoking memories of CSA; CSA impacting mental health; and mental health treatment improving ART adherence. Mixed insights included the intricate links between CSA and ART adherence and the role of external factors on the relationship. ART adherence intervention programs may be needed for people who have experienced CSA. However, future studies are needed that will examine the association between CSA and ART adherence and include subgroup analyses.

Vulnerable children: Protection and social reintegration of child soldiers and youth members of gangs

In the 30 years since the adoption of the United Nation's Convention of the Rights of the Child (CRC), international policy and research has continuously examined the impact of community violence exposure on child development. This article uses the framework of the CRC to review how the world has studied the involvement of child soldiers in armed conflict. We then apply Article 38 of the CRC (which prohibits the use of child soldiers) to parallel the literature regarding youth involvement in gangs. We argue that due to high similarities of these groups, including in regards to risk factors, traumatic experiences, and post-experience sequelae, youth gang members should be included as a protected group under the CRC as are child soldiers. We conclude with a discussion of programs that may be effective at preventing recruitment into armed conflict and gang memberships, and programs that reduce traumatic symptoms of children who experience and perpetrate violence.

Emotional memory processing in post-traumatic stress disorder affected Colombian youth

Post-traumatic stress disorder (PTSD) is a neuropsychological condition caused by exposure to chronic stressors and extreme trauma. In past decades, Colombia (South America) has experienced high levels of armed conflict, which created an environment of chronic stress, resulting in an increased incidence of PTSD in children. Limited research exists on the effects of PTSD on emotional memory functioning of these Colombian youth living in chronically stressful environments. In the present study, 23 PTSD affected youth and 26 controls were asked to recall items from a memorised word list, as well as remembering details from a short emotional story. Although no significant differences were found for word list memory, deficits for emotional story content were found in the PTSD youth, particularly for facts involving negative emotional details. The latter may suggest a deficit in executive functioning for the integration of emotionally laden stimuli, perhaps induced as a by-product of their traumatic experiences.

Violence exposure, affective style, and stress-induced changes in resting state functional connectivity

Chronic childhood stress is linked to greater susceptibility to internalizing disorders in adulthood. Specifically, chronic stress leads to changes in brain connectivity patterns, and, in turn, affects psychological functioning. Violence exposure, a chronic stressor, increases stress reactivity and disrupts emotion regulation processes. However, it is unclear to what extent violence exposure affects the neural circuitry underlying emotion regulation. Individual differences in affective style also moderate the impact of stress on psychological function and can thus alter the relationship between violence exposure and brain function. Resting-state functional connectivity (rsFC) is an index of intrinsic brain activity. Stress-induced changes in rsFC between the amygdala, hippocampus, and prefrontal cortex (PFC) are associated with emotion dysregulation and may elucidate how affective style modulates the relationship between violence exposure and brain connectivity. Therefore, the present study examined the impact of violence exposure and affective style on stress-induced changes in rsFC. Participants (n = 233) completed two 6-minute resting-state functional magnetic resonance imaging scans, one before (pre-stress) and one after (post-stress) a psychosocial stress task. The bilateral amygdala, hippocampus, and ventromedial prefrontal cortex (vmPFC) were used as seed regions for rsFC analyses. Significant stress-induced changes in the prefrontal, fronto-limbic, and parieto-limbic rsFC were observed. Further, pre-stress to post-stress differences in rsFC varied with violence exposure and affective style. These findings suggest that prefrontal, fronto-limbic, and parieto-limbic connectivity is associated with the emotional response to stress and provide new insight into the neural mechanisms through which affective style moderates the impact violence exposure has on the brain.

Residential mobility, mental health, and community violence exposure among Somali refugees and immigrants in North America

Refugees and immigrants resettled in high income countries often later experience a new phase of residential uncertainty in search of safe and secure housing. This study investigated the effect of past year housing stability on symptoms of posttraumatic stress disorder (PTSD) and exposure to neighborhood violence among a sample of 1^st and 2nd generation Somali young adults (N = 198) living in urban areas in North America. In one year, 8.1% of the sample experienced a forced move and 20.7% of the sample moved voluntarily. Discrimination, neighborhood violence, economic insecurity, and interpersonal conflict precipitated forced moves. Forced moves were associated with worsening PTSD symptomology over one year, while voluntary moves were associated with improvements in symptoms. The current study provides evidence of the importance of safe, stable housing for the mental health of young adult immigrants.

Hopelessness and Delinquent Behavior as Predictors of Community Violence Exposure in Ethnic Minority Male Adolescent Offenders

Justice-involved boys from urban communities are disproportionately impacted by community violence exposure (ECV) and despite decades of research, rates of ECV in youth continue to increase particularly for youth involved in the juvenile justice system. Despite the increased risk of exposure, the majority of research focuses on what may protect youth from the deleterious outcomes associated with violence exposure, rather than strategies that may prevent the violence exposure from occurring. The current study seeks to shift the focus of research in this area to examining factors that may predict future violence exposure. Specifically, the purpose of the current study is to examine the role of hopelessness as a predictor of the risk for violence exposure in a sample of 831 justice-involved, urban boys ages 14-18 (52.2% African American, 42.1% Hispanic, 5.7% other). Results revealed that baseline levels of low aspirations and hopelessness towards the future indirectly predicted violence exposure 1 year later through engagement in delinquent behavior. Clinical implications for targeting youth with elevated risk and preventing future violence exposure are discussed.

Longitudinal pathway from violence exposure to firearm carriage among adolescents: The role of future expectation

INTRODUCTION

Exposure to violence is a risk factor for firearm carriage. Youth exposed to violence also have difficulty envisioning positive future outcomes (e.g., educational outcomes), which can increase the likelihood of firearm carriage over time. Researchers, however, have not yet examined whether changes in exposure to violence over time can influence the developmental trajectories of firearm carriage. To address this gap, we (1) examined the longitudinal association between exposure to violence and firearm carriage (grades 9 to 12) and then (2) examined whether changes in future expectations mediated this longitudinal association.

METHOD

The longitudinal association between exposure to violence and firearm carriage through future expectations was examined among 850 adolescents from the Flint Adolescent Study. Participants were recruited from four high schools in a midwestern city in the United States. Parallel latent growth models and latent growth mediation models were estimated.

RESULTS

A positive association was observed between the rate of change in exposure to violence and firearm carriage. Exposure to violence also indirectly increased the risk for firearm carriage over time by decreasing future expectation in the 9th grade.

CONCLUSIONS

Our results support the idea that helping youth develop positive attitude about educational success may help reduce firearm carriage. Increasing positive expectations about future may help prevent firearm carriage within the context of violence exposure.

Unmet health care needs among children of mothers exposed to violence

BACKGROUND

Existing literature shows that maternal exposure to violence has negative consequences on the health and behavioral outcomes of their children, but how it affects unmet child healthcare needs is unknown.

OBJECTIVES

To examine associations between maternal violence exposure and unmet child healthcare needs in vulnerable families.

PARTICIPANTS AND SETTING

We used data from the third and fifth years of Fragile Families and Child Wellbeing Study, a birth cohort study of urban children born between 1998 and 2000 n = 2848.

METHODS

Mothers completed a self-reported questionnaire or interview. Maternal violence exposure was measured through direct (victim) and indirect (witness) exposure. Unmet child healthcare needs was operationalized through: not having seen a doctor when needed, not having a well-child visit in the past year, and never had a dental check-up.

RESULTS

In adjusted logistic regression models, children of mothers who were victims of violence were more likely to not have seen a doctor when needed (odds ratio = 3.36, p < 0.01), not have a well-child visit in the past year (odds ratio = 2.50, p < 0.01), and never have a dental check-up (odds ratio = 1.54, p < 0.01). There was no association between maternal witnessing violence and unmet child healthcare needs.

CONCLUSIONS

In this study of urban children, having a mother who was a victim of violence was associated with unmet healthcare needs. These findings underscore the need to invest in efforts to reduce the prevalence of violence. Such efforts would reduce unmet child healthcare needs in vulnerable families.

Attitudinal Acceptance of Intimate Partner Violence Among Adolescents and Young Adults in Nigeria and Tanzania: An Exploration Into Target Reference Groups Order and Affiliation of Authorship

PURPOSE

Attitudinal programming for the prevention of intimate partner violence (IPV) among adolescents and young adults often focuses on whom to target based on gender or age; yet other pivotal junctures may relate to when to intervene, such as critical events (e.g., marriage). Using data from the nationally representative Violence Against Children Survey in Nigeria and Tanzania, this study examines the gendered association of acceptance of IPV across 3 reference groups-age, marital status, and education attainment-for male and female adolescents and young adults.

METHODS

Data were analyzed from a sample of 2,437 and 1,771 males in Nigeria and Tanzania, respectively, and 1,766 and 1,968 females in each respective country. Logistic regressions were used to estimate the odds of agreeing with at least one of 5 scenarios when it is acceptable for a husband to beat his wife. A second model examined how experience of IPV in the prior 12 months influences the attitudinal outcome for females.

RESULTS

Age was not found to be a significant predictor for attitudinal acceptance of IPV in either country or for either gender. Level of schooling was found to be a significant predictor for decreased odds of attitudinal acceptance of IPV for males but not females in both countries. In contrast, being married was associated with IPV acceptance for females in Tanzania (adjusted odds ratio [aOR]: 1.56; confidence intervals [CIs]: 1.03-2.37) and Nigeria (aOR: 1.66; CIs: 1.19-2.30), but not for males. The significance of marriage for females in Nigeria remained (aOR: 1.67; CIs: 1.20-2.33), even adjusted for past 12-month IPV experience (aOR: 1.85; CIs: 1.11-3.07) and the interaction of IPV experience and marriage (aOR: 3.42, CIs: 1.72-6.80).

CONCLUSIONS

Among adolescents and young adults in Nigeria and Tanzania, there are gendered associations for attitudinal acceptance of IPV. Marriage appears to be a strong predictor for females, even adjusted for IPV experience, thus indicating that there is something unique to marriage among female adolescents and young adults that influences acceptance of IPV.

Distinct aspects of the early environment contribute to associative memory, cued attention, and memory-guided attention: Implications for academic achievement

Childhood socioeconomic status (SES) is associated with numerous aspects of cognitive development and disparities in academic achievement. The specific environmental factors that contribute to these disparities remain poorly understood. We used observational methods to characterize three aspects of the early environment that may contribute to SES-related differences in cognitive development: violence exposure, cognitive stimulation, and quality of the physical environment. We evaluated the associations of these environmental characteristics with associative memory, cued attention, and memory-guided attention in a sample of 101 children aged 60-75 months. We further investigated whether these specific cognitive abilities mediated the association between SES and academic achievement 18 months later. Violence exposure was specifically associated with poor associative memory, but not cued attention or memory-guided attention. Cognitive stimulation and higher quality physical environment were positively associated with cued attention accuracy, but not after adjusting for all other environmental variables. The quality of the physical environment was associated with memory-guided attention accuracy. Of the cognitive abilities examined, only memory-guided attention contributed to SES-related differences in academic achievement. These findings suggest specificity in how particular aspects of early environmental experience scaffold different types of attention and memory subserved by distinct neural circuits and shed light on a novel cognitive-developmental mechanism underlying SES-related disparities in academic achievement.

Community Violence Exposure, Sleep Disruption, and Insulin Resistance in Low-Income Urban Adolescents

BACKGROUND

Exposure to violence, which is experienced at disproportionally higher levels by black versus white youth, is associated with disruptions in sleep and elevated cardiovascular risk. Further, poor sleep hygiene is associated with insulin resistance. However, research to date examining disruptions in sleep and cardiovascular risk in African-American adolescents has not taken the impact of exposure to violence into account, nor considered how gender might affect patterns of association. The present study addressed this gap by testing a path model linking exposure to community violence, sleep disruption, and insulin resistance in a sample of African-American adolescents and evaluating model fit across gender.

METHOD

African-American adolescents (N = 107; 56% female; M_age = 14.29, SD = 1.17) completed structured interviews at home and provided a blood sample after fasting overnight.

RESULTS

The model fit connecting exposure to violence with sleep disruption and insulin resistance, adjusting for depressive symptoms and body mass index z score, was excellent. Multiple group analysis indicated gender differences in model fit. Path analysis revealed significant positive associations between exposure to violence and sleep disruption and sleep disruption and insulin resistance for females but not males.

CONCLUSION

These data indicate that low-income, urban African-American female adolescents who witness violence and experience sleep disruptions may already be at elevated risk for health problems compared with their male counterparts. Additional research should attempt to replicate and explicate the underlying reasons for the gender differences observed here, with the goal of improving health and disrupting the path leading to health disparities.

Violence Exposure and Sexual Risk Behaviors for African American Adolescent Girls: The Protective Role of Natural Mentorship and Organizational Religious Involvement

African American adolescent girls are at increased risk of being exposed to community violence and being diagnosed with a sexually transmitted infection. Fewer studies, however, have examined the protective roles of natural mentorship and organizational religious involvement as potential moderators that could lessen the effects of violence exposure on health risk behavior. Data from 273 African American ninth grade girls were used to test hypothesized independent and moderated-moderation models. Results suggest that natural mentorship and religious involvement were protective for girls who reported at least one mentor and moderate to high levels of religious involvement. Our findings may be relevant for community stakeholders and organizations that directly interact with religious institutions and community programs that focus on outreach to African American adolescent girls.

Exposure to violence across multiple contexts and health risk behaviours in South African adolescents: the moderating role of emotion dysregulation

Objective: The association between violence exposure and health risk behaviours in South African adolescents, and the moderating role of emotion dysregulation were investigated. Design: A multi-ethnic sample of adolescents (N = 925: boy: 47.3%, girl: 52.7%, M age = 16 years, SD = 1.54) completed a survey. Main outcome measures: Violence exposure across different contexts (home-, school-, community-, political victimisation), emotion dysregulation (inability to regulate sadness and anger) and a composite measure of health risk behaviours (smoking, substance use, risky sexual behaviour) were examined. Results: Boys reported more risk behaviours than girls, t (844) = 5.25, p < 0.001. Direct community victimisation was a predictor for boys' risk behaviours, B = 0.22, p < 0.001. Indirect school victimisation and direct community victimisation were predictors for girls' risk behaviours, B's = 0.19, p's < 0.01. Girls reported higher emotion dysregulation than boys, t (748) = -2.95, p < 0.01. Only for girls, emotion dysregulation moderated the associations of indirect home victimisation, B = 16, p < 0.01, and direct community victimisation, B = 15, p < 0.05, with risk behaviours. Conclusion: Interventions may target emotion regulation skills, particularly for girls, to enhance resilience to the negative effects of violence on behaviours.

Profiles of Future Orientation among Assault-injured Adolescents: Correlates and Concurrent Outcomes

Future orientation has been established as having positive associations with health and educational outcomes for adolescents exposed to violence. However, conceptualizations of future orientation have been inconsistent. This study uses latent profile analysis to understand the interrelationships between measures of future orientation (e.g., commitment to learning, goal orientation, hope, expectancies, fatalism). Participants were 188 primarily African American male early adolescents ranging from 10 to 15 years old (60.6% male; M_age = 12.87, SD_age = 1.52). Adolescents in the high- and low-future orientation profiles differed on academic behaviors and aggressive behavior. A discordant profile emerged with adolescents moderate on all measures of future orientation except expectancies. Relational aspects of parenting were associated with higher likelihood of adolescents being assigned to the high- and low-future orientation profiles. These findings suggest the importance of parental warmth in promoting future orientation for adolescents in risky environments, as improving future orientation might mitigate risk for future negative academic comes or engagement in violent behavior.

Forecasting homicide in the red stick: Risk terrain modeling and the spatial influence of urban blight on lethal violence in Baton Rouge, Louisiana

Incorporating features of the built environment, risk terrain modeling (RTM), is used to predict future criminal events in micro-units (i.e., city blocks). The current study examines the application of RTM to forecast homicide in the capital city of Baton Rouge, Louisiana while including a novel environmental risk factor, blighted properties. Based upon the extant literature and knowledge of the city, eighteen environmental risk factors are expected to spatially influence homicide. Results indicate that places most at risk of experiencing a homicide are located in areas where blighted properties are concentrated and in close proximity to convenience stores. RTM successfully identities and evaluates environmental risk factors that spatially influence lethal violence. Additionally, RTM is able to accurately forecast future acts of homicide. The results underscore how crime prevention through environmental design (CPTED) and blight remediation could be utilized as straightforward and prudent strategies to reduce lethal violence.

Negative Consequences Associated With Witnessing Severe Violent Events: The Role of Control-Related Beliefs

PURPOSE

Control-related beliefs are defined as beliefs in one's ability to cause an effect in one's environment. With recent increases in violence in some cities, understanding the impact of exposure to violence on these beliefs is important. The present study examined whether witnessing severe community violence during early adolescence was associated with trajectories of control-related beliefs, and whether these trajectories were associated with mental and behavioral health outcomes in early adulthood.

METHOD

Using data from a longitudinal preventive intervention study, we modeled trajectories of control-related beliefs using growth mixture modeling from 9th through 12th grade. The violence exposure of interest was witnessing severe community violence, defined as seeing someone being shot, stabbed, or killed. Early adulthood outcomes examined were post high school suicide attempt; having a criminal justice record; and having a diagnosis of substance use disorder, major depressive disorder, or antisocial personality disorder.

RESULTS

The latent growth mixture model identified three trajectories of control-related beliefs: a low stable trajectory, a high increasing trajectory, and a moderate stable trajectory. Participants who were exposed to severe violent events were significantly more likely to be in the low trajectory. Further, those in the low trajectory were significantly more likely to experience several negative outcomes.

CONCLUSION

Results suggest that witnessing severe forms of community violence impacts control-related belief trajectories and that trajectories characterized by low feelings of control are associated with adverse outcomes in early adulthood.

A Longitudinal Analysis of the Indirect Effect of Violence Exposure on Future Orientation Through Perceived Stress and the Buffering Effect of Family Participation

Exposure to violence (ETV) during adolescence has been associated with negative effects in later life, and may negatively affect an individual's future orientation. Future orientation has important health implications and warrants being studied. Yet, few researchers have examined how ETV affects an individual's future orientation as a young adult. The purpose of this study was to examine the indirect effect of ETV during adolescence on future orientation as a young adult through perceived stress. We also tested the moderating effect of family participation on the relationship between perceived stress and future orientation. Longitudinal data from a sample of 316 African American participants (42.10% male and 57.90% female, Mage = 14.76 at Wave 1) from low socioeconomic backgrounds recruited from a Midwestern school district were used in the analysis. Multigroup structural equation modeling (SEM) was used to test our hypotheses. Our findings indicated that greater ETV during adolescence is associated with higher levels of perceived stress and, in turn, a more negative outlook on one's future as a young adult. This indirect effect occurred for individuals with lower family participation, but was not evident for individuals with greater family participation. These findings provide important implications for youth development interventions.

The Effects of Musical Training on Child Development: a Randomized Trial of El Sistema in Venezuela

Many studies have explored the links between music and children’s outcomes; however, study designs have not been sufficiently rigorous to support causal findings. This study aims to assess the effects of a large-scale music program on children’s developmental functioning in the context of high rates of exposure to violence. The paper describes the results of an experimental evaluation of Venezuela’s National System of Youth and Children’s Orchestras. The curriculum of the program, better known as “El Sistema,” emphasizes social interactions through group instruction and group performances. The randomized control trial was conducted in 16 music centers between May 2012 and November 2013. In total, 2914 children ages 6–14 participated in the experiment, with approximately half receiving an offer of admission to the program in September 2012 and half in September 2013. The treatment group children participated for one semester more than the control group children. After 1 year, full-sample ITT estimates indicate improved self-control (by 0.10 standard deviations) and reduced behavioral difficulties (by 0.08 standard deviations), both significant at 10% after controlling for multiple hypothesis testing. There were no full-sample effects on other domains. Sub-sample effects are larger among (1) children with less-educated mothers and (2) boys, especially those exposed to violence at baseline. In the latter subgroup, we find lower levels of aggressive behavior. We find that the program improved self-control and reduced behavioral difficulties, with the effects concentrated among subgroups of vulnerable children. The results suggest the importance of devising mechanisms to target resources to the most vulnerable children.

Trial registration: https://clinicaltrials.gov/ct2/show/NCT02369315

A Secondary Spatial Analysis of Gun Violence near Boston Schools: a Public Health Approach

School neighborhood violence continues to be a major public health problem among urban students. A large body of research addresses violence at school; however, fewer studies have explored concentrations of violence in areas proximal to schools. This study aimed to quantify the concentration of shootings near schools to elucidate the place-based dynamics that may be focal points for violence prevention. Geocoded databases of shooting and school locations were used to examine locational patterns of firearm shootings and elementary, middle, and high schools in Boston, Massachusetts. Analyses utilized spatial statistics for point pattern data including distance matrix and K function methodology to quantify the degree of spatial dependence of shootings around schools. Results suggested that between 2012 and 2015, there were 678 shooting incidents in Boston; the average density was 5.1 per square kilometer. The nearest neighbor index (NNI = 0.335 km, p < .001, O = 0.95 km, E = 0.28 km) and G function analysis revealed a clustered pattern of gun shooting incidents indicative of a spatially non-random process. The mean and median distance from any school to the nearest shooting location was 0.35 and 0.33 km, respectively. A majority (56%, 74/133) of schools in Boston had at least one shooting incident within 400 m, a distance that would take about 5 min to walk if traveling by foot. The bivariate K function indicated that a significantly greater number of shootings were clustered within short distances from schools than would be expected under a null hypothesis of no spatial dependence. Implications for students attending schools in racially homogenous neighborhoods across all income levels are discussed.

Experience of gender-based violence to students in public and private secondary schools in Ilorin, Nigeria

OBJECTIVE

To determine and compare prevalence of Gender based Violence (GBV) in public and private secondary schools students and to identify factors associated with experience of GBV by the students.

DESIGN

Comparative cross-sectional survey of using a 60 item self-administered questionnaire.

SETTING

Ten public and private secondary schools in Ilorin South Local Government area of Kwara State.

PARTICIPANTS

640 students, (320 each) from public and private schools. Main outcome variable: Prevalence and factors influencing experience of physical, sexual and psychological violence.

RESULTS

At least one form of GBV was experienced by 89.1% of public and 84.8% private schools students (p=0.32). Psychological violence was commonest type of GBV experienced (Public -72.5% vs. Private -69.2%; p=0.37), while sexual violence was least (Public -41.4% vs. Private -37.4%; p=0.3). Females were less likely to experience physical violence (OR 0.3; 95% CI 0.2-0.4) and psychological violence (aOR 0.6; 95%CI 0.4-0.8). Students who were in a relationship and who had history of parental violence were more likely to experience sexual (aOR 1.7; 95%CI 1.2-2.4) and aOR 1.5; 95%CI 1.2-2.2) and psychological (aOR 1.3; 95%CI 1.1-1.5 and aOR 1.3; 95%CI respectively) violence.

CONCLUSIONS

GBV was a common experience of students in both groups of schools. Multi-disciplinary interventions emphasising ending physical and psychological violence among private school students and sexual violence in public school are recommended. Interventions that involve the parents, school authorities and students on non-violence conflict resolution are urgently required. Parents and students who perpetrate violence should be referred for counselling.

FUNDING

Author funded.

Violence exposure is associated with adolescents' same- and next-day mental health symptoms

BACKGROUND

Young people exposed to violence are at increased risk for mental health and behavioral problems. However, very little is known about the immediate, or same-day, associations between violence exposure and adolescents' mental health symptoms or whether daily symptom or behavioral reactivity marks future problems.

METHODS

Young adolescents were assessed three times a day for 30 consecutive days using mobile-phone-based Ecological Momentary Assessment (EMA) (N = 151 adolescents). Over 12,500 assessments and 4,329 person days were obtained via the EMA. Adolescents were recruited from low-income neighborhoods based on parent-reported risk for externalizing symptoms. Mental health symptoms were assessed via parent and child report at baseline, multiple times per day via EMA assessments of the adolescents, and again 18 months later when 93% of the adolescents were reinterviewed.

RESULTS

Results from multilevel models illustrated that young adolescents were more likely to experience symptoms of anger (OR = 1.74, CI: 1.31-2.30), depression (OR = 1.66, CI: 1.26-2.19), and conduct problems (OR = 2.63, CI: 1.71-4.04) on days that they were exposed versus not exposed to violence. Increases in depressive symptoms were also observed on days following violence exposure (OR = 1.46, CI: 1.09-1.97). Adolescents with the highest levels of violence exposure across the 30-day EMA were less behaviorally reactive to violence exposures in daily life, and heightened behavioral reactivity predicted increased risk for substance use across early adolescence.

CONCLUSIONS

Findings support the need to focus on both the immediate and long-term associations between violence exposure and adolescents' mental health and behavior. Results also suggest that heightened behavioral reactivity during early adolescence may signal emerging substance use problems.

Trajectories of post-traumatic stress and externalizing psychopathology among maltreated foster care youth: A parallel process latent growth curve model

Few longitudinal studies have analyzed how violence exposure (e.g. child maltreatment, witnessing community violence) influence both externalizing and Post-Traumatic Stress (PTS) symptoms among children in foster care. Data from three waves of the National Survey of Child and Adolescent Well-Being (1999-2007) (NSCAW; National Data Archive on Child Abuse and Neglect, 2002) were analyzed to investigate the change trajectories of both externalizing and PTS symptomatology among children with a substantiated report of child maltreatment by Child Protective Services (CPS) between October 1999 and December 2000. This study uses data collected at three time points: baseline and approximately 18 (Wave 3) and 36 (Wave 4) months post-baseline. The Child Behavior Checklist (CBCL) scale measured externalizing symptoms and the Post Traumatic Stress Disorder section of a version of the Trauma Symptom Checklist for Children (TSCC) provided the measure of current trauma-related symptoms or distress. Analyses were conducted using a parallel process growth curve model with a sample of n=280 maltreated youth between the ages of 8 and 15 following home removal. Findings revealed that initial levels of externalizing and PTS symptomatology were both significantly and positively related and co-develop over time. Externalizing symptom severity remained in the borderline range during the first two years in out-of-home care. Both direct and indirect forms of interpersonal violence exposure were associated with initial level of externalizing symptom and PTS symptom severity, respectively. Taken together, our results suggest an underlying process that links early violence exposure to the co-development and cumulative impact of PTS on externalizing behavior above and beyond experiences of maltreatment. We conclude by discussing the key points of intervention that result from a more nuanced understanding of the longitudinal relationship between PTS and externalizing symptoms and the effect of complex trauma on growth in these symptoms over time.

Health-Related Issues in Latina Youth: Racial/Ethnic, Gender, and Generational Status Differences

PURPOSE

Few studies have examined the early development of a broad range of health issues of importance in adolescence in Latina (female) youth, despite their being potentially a vulnerable group. This study compared suicide and depressive symptoms, substance use, violence exposure, injury prevention, obesity, and health-related quality of life among Latina, African-American, and white females as well as Latino (male) youth in fifth grade, as well as differences related to immigrant generational status for Latinas.

METHODS

Data were from the Healthy Passages study, including 3,349 African-American, Latina, and white females as well as Latino male fifth graders in three U.S. metropolitan areas. Self-report items and scales were used to compare status on health-related issues. Generational status was classified based on the parent report of birth location. Logistic and linear regression analyses were conducted, including adjustment for sociodemographic differences.

RESULTS

Latinas showed higher vulnerability than white females for several health issues, whereas few remained after adjustments for sociodemographic differences (higher obesity, lower bike helmet use, and lower physical health-related quality of life). Latina's lower vulnerability compared with African-American females generally persisted after adjustments. Third generation Latinas, after adjustments, reported lower prevalence of alcohol use and fewer friends using alcohol, yet higher future intentions of alcohol use, than first and second generation Latinas. There were few differences between Latina and Latino youth.

CONCLUSIONS

Latina youth generally report low vulnerability across health issues in preadolescence. To the extent they appear at higher vulnerability than white females, this may be related to their disadvantaged sociodemographic status.

And I Shot Her: On War, and the Creation of Inequities in the Development of Youths' Moral Capacities

War creates a multifaceted web of inequities that encompass most levels of the ecology of youth development. These include psychosocial inequities bearing on war-exposed youth's limited access to medical and educational services and job-training and employment opportunities, as well as some of the unique psychological sequelae of trauma exposure. In this chapter we put forth a twofold argument. First, we argue that the protracted hardships of war also create enduring psychological inequities that go beyond the well-documented psychosocial needs and psychological trauma, and encompass other aspects of youths' healthy development; these are inequities inasmuch as they represent profound alterations of the developmental pathways available to war-affected youth. Second, we maintain that the psychological sciences must strive to understand such longstanding developmental inequities even if we do not, at this time, have the tools to fully address them.

The influence of childhood polyvictimization on disordered eating symptoms in emerging adulthood

Children who endure multiple victimization experiences, or "polyvictims," are vulnerable to maladaptive outcomes. Yet, little research exists evaluating the relationship between childhood polyvictimization and disordered eating symptoms (DES) in emerging adulthood. The current study examines the relationship between childhood polyvictimization and DES in emerging adults. Data were collected from 288 participants across two universities using online self-report measures. Hierarchical regression analyses revealed a significant positive relationship between number of childhood victimization experiences and DES in young adulthood (ß=0.14; p=0.016). Female participants were more likely to demonstrate DES (ß=0.14; p=0.008). Further, high levels of emotion dysregulation during young adulthood were associated with more DES (ß=0.33; p<0.001). Findings suggest that exposure to victimization experiences in childhood increases individuals' risk for exhibiting DES in young adulthood. Results also highlight the strong relationship between individuals' emotion regulation abilities and the presence of DES. Findings align with the theory that children who have endured high levels of victimization often feel overwhelmed by their emotions and circumstances, demonstrate emotion regulation difficulties, and may rely on maladaptive coping strategies, including disordered eating, to manage adversities. Study results emphasize the importance of considering victimization history when working with emerging adults displaying disordered eating symptomatology.

Violence Exposure as a Mediator Between Parenting and Adolescent Mental Health

For youth exposed to community violence, parenting has been found to play a significant role in protecting adolescents from associated mental health symptoms. Yet little is known about the potential of parenting to prevent such exposure in the first place and thereby reduce the likelihood of adolescents' mental health symptoms. This study examined two parental practices that have often been examined as moderators, but not yet as predictors, of youth exposure to community violence associations with adolescent mental health, namely parental control and parental harshness. Analyses of self-reported data from 908 adolescents (M _age = 16.5, SD = 1.71; 52 % girls; 13 % non-Hispanic White) revealed that harsh parenting was indirectly associated with youth mental health symptoms through higher levels of exposure to community violence, whereas links between controlling parenting and mental health symptoms were either non-significant or mediated through lower levels of adolescent violence exposure. These findings highlight the potential positive role parental control may play by preventing adolescents from exposure to potentially dangerous situations. Conversely, our results suggest that harsh parenting appears to pose a risk for adolescents by driving youth away from the home environment and potentially into places where violence may be more prevalent.

Exposure to Violence in the Community Predicts Friendships with Academically Disengaged Peers During Middle Adolescence

Adolescents who have been exposed to violence in the community often experience subsequent difficulties with academic achievement. Because competence in the classroom is a salient developmental task during the adolescent years, outcomes in this critical context can then have broader implications for social and psychological functioning. In the current study, we tested a hypothesized progression in which the association between violence exposure and deficient achievement is presumed to potentiate friendships with academically disengaged peers. We followed 415 urban adolescents (53 % girls; average age of 14.6 years) for a one-year period, with two annual assessment of psychosocial functioning. Exposure to violence in the community and academic engagement were assessed with a self-report inventory; reciprocated friendships were assessed with a peer interview; and achievement was indexed based on a review of school records. Consistent with our hypotheses, neighborhood violence was associated with deficient classroom achievement. Poor achievement, in turn, mediated associations between community violence exposure and low academic engagement among friends. Our findings highlight pathways though which exposure to community violence potentially predicts later dysfunction.

Conditional and indirect effects of age of first exposure on PTSD symptoms

Childhood violence exposure (CVE) in formative developmental years may have potent effects on severity and complexity of post-traumatic stress symptoms (PTSS) in adulthood, yet little research has examined the role of age of first exposure in the context of polyvictimization or gone beyond an examination of direct effects. The current study examines the specific associations between age of first exposure, total CVE, and posttraumatic stress symptoms in adulthood. Further, the conditional and indirect effects of age of first exposure on posttraumatic stress symptoms were examined. We hypothesized that age of first exposure to violence would be associated with higher total violence exposure across childhood, thereby predicting current posttraumatic stress symptom severity (i.e., indirect effect). We also postulated that age of first exposure would affect the relationship between total violence exposure and posttraumatic stress symptoms such that earlier exposure would exacerbate the effects of violence exposure (i.e., conditional effect). Participants included 269 violence-exposed adults recruited through MTurk; the mean age of first CVE was 6 years (SD=3.29). Conditional process models indicated that age of first exposure was significantly associated with higher total childhood violence exposure, which in turn, was significantly associated with current posttraumatic stress symptoms in all domains. Further, a conditional effect of age of first exposure was present such that the relationship between total exposure to violence and symptoms of hyperarousal was stronger for those first exposed at earlier ages. Findings provide support suggesting the particular potency of early trauma on regulatory response systems.

The impact of neighborhood disorganization on neighborhood exposure to violence, trauma symptoms, and social relationships among at-risk youth

Previous research has demonstrated that exposure to violence (ETV) is a serious concern across the north-south socioeconomic divide. While studies have found that social support is a protective factor for youth exposed to violence and trauma, little is known about the impact of trauma symptoms on forming and maintaining social relationships which are key to accessing a vital social resource that fosters resilience in youth experiencing trauma symptomatology. Building on previous models that examine the impact of neighborhoods on exposure to violence and trauma, the current study examines the impact of neighborhood disorganization on ETV among youth and ETV's effects on trauma symptoms and social relationships. Data were collected on 2242 juvenile justice-involved youth with behavioral health issues in 11 urban and rural counties in the Midwestern United States. Using structural equation modeling (SEM), our data demonstrated that living in highly disorganized neighborhoods was associated with higher levels of ETV and that ETV was positively associated with trauma symptoms. Mediational analysis showed that trauma symptoms strongly mediated the effect of ETV on social relationships. Freely estimating structural paths by gender revealed that hypothesized associations between these variables were stronger for females than males. Findings here highlight the need to provide trauma-informed care to help youth to build and maintain social relationships. Identification and treatment of trauma symptoms that is culturally informed is a critical first step in ensuring that identified protective factors in local contexts, such as social relations and social support, have opportunities to minimize the impact of ETV among youth across northern and southern nations.

Protective factors associated with resilient functioning in young adulthood after childhood exposure to violence

Children may be subjected to many forms of violence and a significant number will experience multiple victimizations. These children are at high risk for developing psychological and emotional difficulties that may last into adulthood. Despite the increased risk for psychopathology, a substantial percentage of young adults exhibit resilient functioning following a history of childhood violence. This study examines the role of social support, spirituality, and emotional intelligence in promoting resilience during emerging adulthood. Participants included 321 young adult American college students, age 18-24, who experienced childhood violence, including community violence, interpersonal aggression, child maltreatment, peer/sibling victimization, and/or sexual assault. Findings revealed that this sample was highly victimized, with an average of 9 violent experiences reported during childhood. Hierarchical multiple regression analyses indicated that after controlling for exposure to childhood victimization, other potentially traumatic events, and current depression and anxiety symptoms, higher resilience during emerging adulthood was associated with greater spirituality, greater emotional intelligence, and support from friends (but not from family). Findings suggest that the potency of protective factors outweighs that of adversity and psychopathology when predicting resilient functioning. By identifying variables that can enhance resilience, this study offers unique insight into how functioning may be improved by both individual and environmental factors.

Externalizing behavior and substance use related problems at 15 years in prenatally cocaine exposed adolescents

The effect of prenatal cocaine exposure (PCE) on externalizing behavior and substance use related problems at 15 years of age was examined. Participants consisted of 358 adolescents (183 PCE, 175 non-cocaine exposed (NCE)), primarily African-American and of low socioeconomic status, prospectively enrolled in a longitudinal study from birth. Regression analyses indicated that the amount of PCE was associated with higher externalizing behavioral problems (β = .15, p = .02). Adolescents with PCE were also 2.8 times (95% CI = 1.38-5.56) more likely to have substance use related problems than their NCE counterparts. No differences between PCE adolescents in non-kinship adoptive/foster care (n = 44) and PCE adolescents in maternal/relative care (n = 139) were found in externalizing behavior or in the likelihood of substance use related problems. Findings demonstrate teratologic effects of PCE persisting into adolescence. PCE is a reliable marker for the potential development of problem behaviors in adolescence, including substance use related problems.