Contexts and Characteristics of Imaged-Based Sexual Exploitation and Abuse of Children: Incident Dynamics in a National Sample

This paper describes incident characteristics and dynamics associated with six specific forms of image-based sexual exploitation and abuse of children (IBSEAC). Data were collected on a national sample of 2639 individuals aged 18-to-28 from a probability-based online panel. Respondents completed a self-administered survey questionnaire, providing detailed follow-up information on their experiences of image-based sexual victimization before the age of 18. A total of 607 incidents of IBSEAC were included in the analyses. Findings show substantial diversity in incident characteristics within and across the six forms of IBSEAC (nonconsensual sharing of sexual images, nonconsensual taking or making of images, forced image recruitment, threatened sharing, voluntary image sharing with an older adult, and commercial sexual exploitation involving images). Some notable patterns include frequent involvement of perpetrators who are other youth or young adults, who are known in-person to the victim, and who are intimate partners. The diversity and complexity of dynamics revealed in this study underscores the need for careful design and evaluation of prevention programs and the core messages directed at youth.

Prevalence of Technology-Facilitated Abuse Among Sexual and Gender Minority Youths

Importance

Digital communication and imaging technologies have created new opportunities for technology-facilitated abuse (TFA) and necessitate a better understanding of how and why the risk for TFA varies across different groups of youths.

Objectives

To compare the prevalence of TFA among youths across 5 different sexual and gender identity groups, and to identify risk factors that may explain variations in TFA risk.

Design, Setting, and Participants

A US nationally representative online survey was conducted among 2639 young adults recruited from the KnowledgePanel online panel from November 19 to December 29, 2021. Individuals aged 18 to 28 years were asked retrospectively about TFA and a variety of other youth experiences in childhood (aged <18 years).

Main Outcomes and Measures

Participants were asked about their sexual and gender identities, 11 types of TFA occurring before the age of 18 years, and several potential risk factors. Prevalence rates of any TFA were compared across sexual and gender identity groups, and analyses were conducted to identify risk factors that help explain group differences. Weights were developed to compensate for gender, education, race and ethnicity, household income, census region, and metropolitan status disproportions.

Results

Among the 2510 respondents (mean [SD] age, 24.8 [2.8] years) who provided gender and sexual identity information, 46.5% (95% CI, 41.9%-51.1%) were cisgender heterosexual females, 25.2% (95% CI, 21.6%-29.1%) were cisgender sexual minority females, 18.3% (95% CI, 14.4%-22.9%) were cisgender heterosexual males, 6.8% (95% CI, 4.6%-9.9%) were cisgender sexual minority males, and 3.3% (95% CI, 2.0%-5.4%) were gender minority individuals. The prevalence of TFA occurring before the age of 18 years was highest among sexual minority females (55.3%; 95% CI, 48.0%-62.4%) and gender minority individuals (53.4%; 95% CI, 33.5%-72.2%). Rates of sexting were highest among cisgender sexual minority females (38.8%; 95% CI, 19.1%-58.8%) and gender minority individuals (36.7%; 95% CI, 19.1%-58.8%) and represented the strongest risk factor for TFA exposure (odds ratio, 5.7; 95% CI, 4.0-8.0). However, it explained little variation in TFA across groups once early in-person adversity, sexual abuse, bullying, and maltreatment were taken into account.

Conclusions and Relevance

This study demonstrates the risk of TFA among sexual and gender minority youths and the need to target prevention efforts toward these vulnerable groups. In addition to strategies to reduce risky behavior, efforts to lower the risk of early sexual abuse, bullying, and maltreatment are likely to also be effective in decreasing TFA among these marginalized groups.

Help-Seeking From Websites and Police in the Aftermath of Technology-Facilitated Victimization

This study looked at experiences of help-seeking from websites and police following an episode of technology-facilitated abuse. It used data from a nationally representative online panel of adults aged 18 to 28, sampled from Ipsos Knowledge Panel. A total of 1,952 unique victimization episodes from childhood and adulthood were identified and used in analyses. Participants were asked about whether they experienced 11 different types of technology-facilitated abuse (TFA), whether the incident was reported to the website or police, barriers to reporting, and features of the website's or law enforcement's response. Other follow-up information included victim gender, age, relationship to the perpetrator, and negative emotional impact (NEI) associated with the incident. Results found very low rates of reporting to both websites (7.3%) and law enforcement (4.8%). Image-based offenses had higher rates of reporting. A greater NEI significantly increased the odds of reporting to each source. Participants were largely unsatisfied with response from websites and police. Only 42.2% said the website did something helpful and only 29.8% found police helpful. Our findings suggest a need for major improvements in how websites and law enforcement respond to victims of technology-facilitated offenses. They need to have more helpful information and more ways of offering support. Websites need more specifics about the types of violations that warrant reporting, clearer signposts, and encouragement about how to get help and a better publicized commitment to a rapid and serious review. Law enforcement needs more education and training to avoid dismissive and judgmental reactions and to ensure sympathetic and respectful responses.

Predictors of Online Child Sexual Abuse in a U.S. National Sample

As technology has become increasingly integrated into the everyday lives of young people and social interactions have moved online, so too have the opportunities for child sexual abuse. However, the risk factors for online sexual abuse, and their similarities or differences with those of offline sexual abuse have not been clarified, making it difficult to design prevention strategies. Using a nationally representative online survey panel of young adults ages 18 to 28, the current study sought to identify risk factors for online childhood sexual abuse and compare their relevance and strength in predicting offline sexual abuse. The 2,639 participants, ages 18 to 28, were sampled from the Ipsos KnowledgePanel and were asked questions about 11 different kinds of technology-facilitated online sexual abuse that occurred in childhood, follow-up questions about their dynamics and offenders, and a variety of potential risk factors. Results indicated that: (1) being cisgender female, nonheterosexual, and having parents with less than a high school education emerged as important demographic predictors of online child sexual abuse (OCSA); and (2) early offline sexual abuse was the strongest predictor of OCSA, when considering both its direct and indirect effects through online risky behavior. Findings suggest that prevention programs directed at reducing risk of sexual abuse, in general, are likely to be effective against online sexual abuse, provided they also incorporate efforts to educate youth on the need to avoid risky online behaviors.

Independent and Cumulative Effects of Recent Maltreatment on Suicidal Ideation and Thoughts of Self-harm in a National Sample of Youth

PURPOSE

This study examines the impact of several forms of past-year maltreatment on thoughts of self-harm and suicidal ideation and considers how these effects may vary by gender.

METHODS

Analyses are based on telephone interviews with a nationally representative sample of 6,364 youth aged 10-17 years, from three waves (2008, 2011, and 2014) of the National Survey of Children's Exposure to Violence. Suicidal and self-harm ideation were measured with items from the Trauma Symptoms Checklist for Children. Emotional maltreatment, physical maltreatment, neglect, and witnessing family violence were measured using items from the Juvenile Victimization Questionnaire.

RESULTS

Over 8% of the sample reported suicidal and/or self-harm ideation in the past month, with females more likely to report these outcomes than males. Youth who experienced recent emotional maltreatment, neglect, or witnessing family violence were more likely to report suicidal or self-harm ideation, independent of the other maltreatment types, presence of an internalizing disorder, and demographics. A dose-response relationship between the number of types of maltreatments and these outcomes was also evident. Finally, females were more negatively affected by emotional abuse and by experiencing two forms of past-year maltreatment than their male counterparts.

CONCLUSIONS

Emotional abuse was the type of maltreatment most strongly related to thoughts of self-harm and/or suicidal ideation and was particularly detrimental to females in this sample. Given the especially damaging effects of exposure to multiple forms of maltreatment, our research highlights the importance of including comprehensive maltreatment assessment in youth suicide and self-harm prevention efforts.

Understanding the Impact of Seeing Gun Violence and Hearing Gunshots in Public Places: Findings From the Youth Firearm Risk and Safety Study

There is a current public health emphasis on finding strategies for reducing the risks associated with children's gun violence exposure. This article examines the impact of seeing and hearing gun violence on youth of different ages and living in urban and nonurban areas. Participants were 630 youth, aged 2 to 17. Youth, ages 10 to 17, completed a self-report survey, and caregivers of young children, ages 2 to 9, completed the survey as a proxy for that child. Participants resided in Boston, MA; Philadelphia, PA; and rural areas of eastern TN. Participants were recruited through a variety of techniques including pediatric clinics, housing authorities, youth-serving agencies, festivals, word of mouth, and local e-mail lists for classified advertisements. Data were collected between October 2017 and April 2018 and analyzed in 2019. In total, 41% of youth in this study reported ever seeing or hearing gun violence; 32% had such an experience in the past year. Among exposed youth, 50% took protective action to keep themselves safe, and 58% reported being very or extremely afraid, sad, or upset as a result of the indirect gun violence. More youth living in urban compared with nonurban areas took some protective action. Females and younger children had increased odds of experiencing high fear as a result of the violence. Current gun violence prevention has typically targeted adolescents; however, current findings suggest the need to focus on younger children as well, including the distress resulting from indirect exposure to gun violence.

Exposure to Family and Friend Homicide in a Nationally Representative Sample of Youth

This study examines the lifetime prevalence and distribution of family/friend homicide exposure among children and adolescents age 2 to 17 in the United States, and assesses the impact of family/friend homicide on emotional and behavioral outcomes, while controlling for potential co-occurring factors. Data were collected by telephone about the experiences of youth in 2008, 2011, or 2014, as part of the National Surveys of Children's Exposure to Violence (NatSCEV). Analyses are based on a pooled sample (n =11,771) from these three surveys. Approximately 8% of all children and youth ages 2 to 17 were exposed to a family/friend homicide. Older adolescents, Black youth, those living in single parent and nonparent family households, those from lower socioeconomic status households, and youth living in large cities were overrepresented among youth experiencing family or friend homicide. Exposed youth were also substantially more likely to be poly-victims, experience other major adversities, and live in neighborhoods with more community disorder. Exposure to family/friend homicide was significantly related to trauma symptoms. However, when other co-occurring factors were taken into account, only family/friend homicide that occurred within the last 2 years remained significant. With respect to delinquency, only nonfamily homicide exposure remained significant with these other factors controlled. Findings suggest that family/friend homicide represents a powerful marker for a broad level of victimization risk and adversity, demonstrating that family/friend murder is often just one relatively small part of a more complicated life of adversity. Although recent exposure is certainly distressing to youth, it is the wider, co-occurring context of poly-victimization and other types of adversity that appears most impactful in the longer term.

Past Year Technology-Involved Peer Harassment Victimization and Recent Depressive Symptoms and Suicide Ideation Among a National Sample of Youth

This article aims to better understand the complex role of technology in peer victimization events with recent depressive symptomatology and suicide ideation (SI). Telephone interviews were conducted with a national sample of 791 youth in the United States, aged 10 to 20 years, collected from December 2013 to March 2014. Rates of any peer harassment victimization varied by past month depressive symptomatology and SI -28% of youth with no/low depressive symptomatology reported past year peer harassment as did 43% of youth with high depressive symptomatology without SI, and 66% of youth with SI. When examining the role of technology in peer harassment, youth experiencing any mixed harassment (i.e., those incidents that occurred both in-person and through technology) were almost 4 times more likely to report past month depressive symptoms without SI (RR_adj = 3.9, 95% confidence interval [CI] = [1.5, 10.0], p ≤ .01) and 7.5 times (95% CI = [1.9, 28.9], p ≤ .01) more likely to report past month SI compared with youth who had no past year peer harassment. Given the multilayered relationships among these variables, schools, medical, and mental health professionals might screen youth who are involved in higher risk peer victimization situations, for depressive symptoms and SI to improve their access to appropriate mental health services.

The Youth Firearm Risk and Safety Tool (Youth-FiRST): Psychometrics and Validation of a Gun Attitudes and Violence Exposure Assessment Tool

This study reports on the development of a comprehensive assessment of exposure to guns and gun-related violence for evaluating the risk of gun-related trauma. Gun access, gun attitudes, gun safety education, and exposure to gun violence were measured. Participants were 630 youth, aged 2-17. Youth, ages 10-17, completed a self-report survey and caregivers of young children, ages 2-9, completed the survey as a proxy for that child. The youth were from urban (n = 286) and rural (n = 344) areas. Factor analysis, item response theory, and structural equation modeling were used. Two factors described access to guns, two factors described gun attitudes, and a single construct captured gun safety education. The gun violence exposure factor showed strong associations with trauma symptomatology. The individual constructs showed good psychometric properties and measurement noninvariance by urbanicity.

Strengthening the predictive power of screening for adverse childhood experiences (ACEs) in younger and older children

BACKGROUND

There is increasing interest in routine screening for Adverse Childhood Experiences (ACEs) to help identify high-risk children who would benefit from interventions. However, there has not yet been sufficient research concerning which particular set of ACEs would be most predictive as a potential screening tool.

OBJECTIVE

This study compared 40 Adverse Childhood Experiences (ACEs), covering 11 different conceptual domains, in their ability to predict trauma symptoms in childhood.

PARTICIPANTS AND SETTING

The current study uses pooled data from three National Surveys of Children's Exposure to Violence (NatSCEV) conducted in 2008, 2011, and 2014. Each survey collected information on children aged one month to 17 years.

METHODS

Samples were obtained from a mix of random digit dialing and address based sampling methods. Telephone interviews were conducted with children 10 years and older and with caregivers, if the randomly selected child was under age 10.

RESULTS AND CONCLUSION

A different set of 15 items best predicted trauma symptoms for younger (2-9-year-old) compared to older (10-17-year-old) youth. Some conventional ACEs, like physical and emotional abuse, proved important for both age groups. However, family-related factors were more predictive for younger children, while community and peer violence exposures were more predictive for older children. Our new proposed measures explained substantially more variance in subsequent trauma symptoms than did the original ACE measure (R² = .31 vs .18 for 2-9 year olds; R² = .43 vs .26 for 10-17 year olds; p < .001 for all) and identified a larger percentage of children with high levels of trauma.

Exposure to Multiple Forms of Bias Victimization on Youth and Young Adults: Relationships with Trauma Symptomatology and Social Support

Research has documented that a significant portion of youth are exposed to bias victimization. However, less is known about whether experiencing certain types of bias victimization (e.g., sexual orientation bias) is more or less likely to be related to a more extensive bias victimization history (i.e., experiencing multiple types of bias victimization) and whether exposure to multiple types of bias victimization explains any relationships between specific types of bias victimization and negative outcomes. To address these gaps, the current study explores relationships between exposure to multiple types of bias-motivated victimization, trauma symptomatology and perceived social support. Participants were 854 youth and young adults (60.9% female) from three higher risk communities who completed a survey on personal experiences with bias-related victimization. The average age of participants was 16.6 years; 28.5% of the sample described themselves as Black or African American; 13.4% as Hispanic or Latino (any race); 45.3% as White, and 12.8% as another race. Sixty-nine percent of the sample described their sexual orientation as heterosexual; 8.9% as gay, lesbian, or homosexual; 12.5% as bisexual; and 9.5% as another sexual orientation. Sixty-three percent of participants reported at least one type of bias victimization in their lifetime, and more than one in three youth (38.7%) experienced two or more types of bias victimization in their lifetimes (18.1% two types, 12.1% three types, and 8.5% four or more types). Experiencing multiple types of bias victimization was related to higher trauma symptomatology and less perceived social support. Experiencing multiple types of bias victimization attenuated or eliminated the association between individual types of bias victimization and well-being. The findings contribute to a growing body of research demonstrating the damaging mental health effects of occupying multiple marginalized statuses, and points to the cumulation of bias victimization experiences as an important factor contributing to significant differences in well-being and support among youth and young adults.

Peer Victimization Patterns and Trauma Symptoms in a National Longitudinal Sample of Youth

Using a nationally representative sample of 791 youth, ages 8-17 at baseline, this study identified patterns over a 2-year period in specific forms of peer victimization and examined differences in the mental health consequences of those patterns. Findings show that, among the victimized, physical assault had relatively high persistence compared to other forms, while physical intimidation and emotional bullying had relatively high rates of desistence. Emotional bullying at T1 was associated with increased risk of T2 Internet harassment and Internet harassment at T1 strongly predicted T2 dating violence. Patterns of victimization over time differed in their relationship with trauma symptoms. Findings emphasized the importance of recency and the distress of new victimization experiences, rather than the chronicity or repetition of victimization. Understanding variations in peer victimization patterns and outcomes over time can help to inform interventions that better target sources of risk across adolescence.

Gun Violence Exposure and Posttraumatic Symptoms Among Children and Youth

Although statistics on youth homicide and injury from gun violence are available, little research has focused on how gun violence overlaps with other victimizations or on the psychological impact of gun violence on children. Pilot survey data were collected on the experiences of 630 U.S. children (age range: 2-17 years) from Boston, Philadelphia, and rural areas of eastern Tennessee. Youth aged 10-17 years completed a self-report survey on a wide range of gun violence exposures, and parents of younger children (aged 2-9 years) completed the survey as a proxy for that child. Direct gun violence exposure, witnessing gun violence, and hearing gunshots were all significantly associated with other forms of victimization, rs = .10-.38, p < .001. The findings suggest that youth who experience direct gun violence are often exposed to multiple violent contexts. For older youth (ages 10-17 years) polyvictimization was most strongly associated with posttraumatic symptoms, β = .35, p < .001, although witnessing gun violence still uniquely predicted a higher level of symptoms, β = .18, p < .01. For younger children (ages 2-9 years), hearing and witnessing gun violence were both related to posttraumatic symptoms, β = .15, p < .01 for both, even after controlling for polyvictimization. Mental health professionals and trauma-informed services should be mindful that the traumatic impact of gun violence for children may not necessarily be attached to direct victimization experiences but may also result from simply seeing or hearing it in their neighborhoods.

Child Neglect and the Broader Context of Child Victimization

Using a pooled data set of two waves of the National Surveys of Children's Exposure to Violence, this study investigates links between indicators of socioeconomic resources and lifetime exposure to two different forms of child neglect (physical and supervisory), examines how neglect is associated with the risk of other types of victimization, and estimates the impact of neglect on trauma symptoms. Findings suggest that physical neglect is directly linked to economic stressors, while low parental education is consequential for both physical and supervisory neglect. Both types of neglect also were strongly associated with risk of other maltreatment and most other forms of victimization. Physical neglect was particularly strongly related to sexual abuse and witnessing sibling abuse, while supervisory neglect was most strongly related to risk for sexual victimization by a nonfamily adult. Although neglect is significantly associated with trauma symptoms, poly-victims had, by far, the highest levels of trauma symptoms.

Youth Exposure to Suicide Attempts: Relative Impact on Personal Trauma Symptoms

INTRODUCTION

The purpose of this study is to report the prevalence of youth lifetime exposure to suicide attempts by people close to them, and its association with personal nonvictimization adversities, suicidal ideation, thoughts of self-harm, and trauma symptoms.

METHODS

Data were collected as part of the National Surveys of Children's Exposure to Violence, comprising three cross-sectional studies conducted in 2008, 2011, and 2014 in the U.S. assessing the experiences of children ages 1 month to 17 years. The current analyses utilized the self-report data from youth, ages 10-17 years (n=6,366), and was analyzed in 2017.

RESULTS

Twelve percent (n=779) of youth said someone close to them had tried to kill themselves. Exposure varied by age: 4% of youth aged 10-12 years, 13% of youth aged 13-15 years, and 21% of youth aged 16-17 years reported such exposure. Exposure to suicide attempts also varied by sex with 8% of males and 16% of females reporting this experience. After adjusting for the total number of other types of adversity experienced, the association between exposure to suicide attempts and trauma symptoms (β=0.5, 95% CI=0.3, 0.7, p≤0.001); suicidal ideation (OR=2.4, 95% CI=1.4, 4.1, p≤0.001); and thoughts of self-harm (OR=3.1, 95% CI=1.9, 5.1, p≤0.001) remained significant, although attenuated.

CONCLUSIONS

Study findings that youth exposure to suicidal behavior is associated with negative emotional distress, and that it often co-occurs with other adversities and social risk factors, highlight the need to better understand the causal pathways among these risk factors to improve youth suicide prevention and response interventions.

Beyond residential mobility: A broader conceptualization of instability and its impact on victimization risk among children

Predictability in a child's environment is a critical quality of safe, stable, nurturing relationships and environments, which promote wellbeing and protect against maltreatment. Research has focused on residential mobility's effect on this predictability. This study augments such research by analyzing the impact of an instability index-including the lifetime destabilization factors (LDFs) of natural disasters, homelessness, child home removal, multiple moves, parental incarceration, unemployment, deployment, and multiple marriages--on childhood victimizations. The cross-sectional, nationally representative sample of 12,935 cases (mean age = 8.6 years) was pooled from 2008, 2011, and 2014 National Surveys of Children's Exposure to Violence (NatSCEV). Logistic regression models controlling for demographics, socio-economic status, and family structure tested the association between excessive residential mobility, alone, and with LDFs, and past year childhood victimizations (sexual victimization, witnessing community or family violence, maltreatment, physical assault, property crime, and polyvictimization). Nearly 40% of the sample reported at least one LDF. Excessive residential mobility was significantly predictive of increased odds of all but two victimizations; almost all associations were no longer significant after other destabilizing factors were included. The LDF index without residential mobility was significantly predictive of increased odds of all victimizations (AOR's ranged from 1.36 to 1.69), and the adjusted odds ratio indicated a 69% increased odds of polyvictimization for each additional LDF a child experienced. The LDF index thus provides a useful alternative to using residential moves as the sole indicator of instability. These findings underscore the need for comprehensive supports and services to support stability for children and families.

Characteristics of bias-based harassment incidents reported by a national sample of U.S. adolescents

Using a national sample of youth from the U.S., this paper examines incidents of bias-based harassment by peers that include language about victims' perceived sexual orientation, race/ethnicity, religion, weight or height, or intelligence. Telephone interviews were conducted with youth who were 10-20 years old (n = 791). One in six youth (17%) reported at least one experience with bias-based harassment in the past year. Bias language was a part of over half (52%) of all harassment incidents experienced by youth. Perpetrators of bias-based harassment were similar demographically to perpetrators of non-biased harassment. However, bias-based incidents were more likely to involve multiple perpetrators, longer timeframes and multiple harassment episodes. Even controlling for these related characteristics, the use of bias language in incidents of peer harassment resulted in significantly greater odds that youth felt sad as a result of the victimization, skipped school, avoided school activities, and lost friends, compared to non-biased harassment incidents.

From Poly-Victimization to Poly-Strengths: Understanding the Web of Violence Can Transform Research on Youth Violence and Illuminate the Path to Prevention and Resilience

For many years, an overly "siloed" approach has hampered efforts to understand violence and minimize the societal burden of violence and victimization. This article discusses the limitations of an overly specialized approach to youth violence research, which has focused too much on violence in particular contexts, such as the family or the school. Instead, a child-centered approach is needed that comprehensively assesses all exposures to violence. This concept of the total cumulative burden of violence is known as poly-victimization. The poly-victimization framework reveals that many youth are entangled in a web of violence, experiencing victimization in multiple settings by multiple perpetrators. This more accurate view of children's exposure to violence has many advantages for advancing our scientific understanding of violence. Perhaps somewhat surprisingly, this more comprehensive view also points to new insights for resilience and prevention. This includes recognizing a parallel concept, "poly-strengths," which captures the number of resources and assets children and their families can use to help insulate youth from violence (prevention) or assist in coping and promoting well-being after victimization (intervention). Reconceptualizing how resilience is defined and understood among youth populations can help alleviate the true societal burden of youth victimization.

Poly-Victimization and Peer Harassment Involvement in a Technological World

This article explores the ways poly-victimized youth (those experiencing multiple different types of victimization over the course of 1 year) use technology to interact with peers. Particular attention is given to the peer harassment victimization and perpetration experiences of poly-victimized youth compared with less victimized and non-victimized youth-both overall and through technology. Data were collected as part of the Technology Harassment Victimization (THV) study; a national survey of 791 youth, ages 10 to 20 across the United States. Study results document the heightened risks that poly-victimized youth experience when interacting with peers. Low and high poly-victimized youth were both at significantly greater risk of being dual victims and perpetrators of peer harassment when compared with non-victimized youth even after taking into account other potentially explanatory factors. This was not found to be the case for less victimized youth. This was true for high poly-victims and technology-involved harassment risk as well. There were indications that poly-victimized youth were interacting with peers in more intense and risky ways in general using new technology. The increase in attention to poly-victimization in recent years has importantly identified the detrimental role that experiencing different forms of victimization have on youth. This study not only adds to that literature but suggests that there is an opportunity to interrupt additional victimization by understanding how poly-victimized youth interact with peers before and during adolescence. Although preliminary, the differences in technology use by poly-victimized youth versus others suggest that more information is needed to understand how they are relating to peers in both positive and risky ways in this environment.

Exposure to Medication Overdose as an Adversity in Childhood

PURPOSE

To determine the prevalence of youth exposure to medication or pill overdose by someone close to them, as well as how common this is within the spectrum of major stressful events and child victimization experienced by youth.

DESIGN AND METHODS

Data were collected as part of the Third National Survey of Children's Exposure to Violence, a nationally representative telephone survey of youth, ages 2-17years (N=3738) conducted in 2013. The analytical subset for the current paper is youth ages 10-17years (n=1959).

RESULTS

Estimates indicate that approximately 1 in 12 youth (8%), ages 10-17 have been exposed to medication overdose by someone close to them in their lifetimes. Overdose exposure is related to recent trauma symptoms, alcohol and other substance use. However, these relationships appear to be largely driven by the co-existence of major stressful events these youth are experiencing. Alcohol use is the exception; exposure to medication overdose continues to be related to past year personal alcohol use even after adjusting for other lifetime stressful events.

CONCLUSIONS

Having a close family member or friend overdose on a medication is a common experience among U.S. youth and related to high rates of co-occurring stressful events.

PRACTICE IMPLICATIONS

Health care providers should be aware that youth exposure to medication overdoses likely indicates exposure to other recognized adversities. Youth with a caregiver who has had an overdose may require an urgent response including referral to crisis intervention through child and family services.

Injuries From Physical Abuse: National Survey of Children's Exposure to Violence I-III

INTRODUCTION

Official data sources do not provide researchers, practitioners, and policy makers with complete information on physical injury from child abuse. This analysis provides a national estimate of the percentage of children who were injured during their most recent incident of physical abuse.

METHODS

Pooled data from three cross-sectional national telephone survey samples (N=13,052 children) included in the National Survey of Children's Exposure to Violence completed in 2008, 2011, and 2014 were used.

RESULTS

Analyses completed in 2016 indicate that 8.4% of children experienced physical abuse by a caregiver. Among those with injury data, 42.6% were injured in the most recent incident. No differences in injury were observed by sex, age, race/ethnicity, or disability status. Victims living with two parents were less likely to be injured (27.1%) than those living in other family structures (53.8%-59%, p<0.001). Incidents involving an object were more likely to result in injury (59.3% vs 38.5%, p<0.05). Injured victims were significantly more likely to experience substantial fear (57.3%) than other victims (34.4%, p<0.001).

CONCLUSIONS

A substantial percentage of physical abuse victims are physically hurt to the point that they still feel pain the next day, are bruised, cut, or have a broken bone. Self-report data indicate this is a more common problem than official data sources suggest. The lack of an object in an incident of physical abuse does not protect a child from injury. The results underscore the impact of childhood physical abuse and the importance of early prevention activities.

Victimization and adversity among children experiencing war-related parental absence or deployment in a nationally representative US sample

This study compares children and youth who have experienced lifetime war-related parental absence or deployment with those having no such history on a variety of victimization types, non-victimization adversity, trauma symptoms, and delinquency; and assesses whether cumulative adversity and victimization help to explain elevated emotional and behavioral problems among children of parents who have experienced war-related absence or deployment. The National Surveys of Children's Exposure to Violence (NatSCEV) are comprised of three cross-sectional telephone surveys conducted in 2008, 2011, and 2014. Data were collected on the experiences of children aged one month to seventeen years. In each survey, interviews were conducted with youth 10-17 years old and with caregivers of children 0-9 years old. The analyses use pooled data from all three U.S. nationally-representative samples (total sample size of 13,052). Lifetime parental war-related absence or deployment was a marker for elevated childhood exposure to a wide array of victimization and adversity types. Cumulative past year exposure to multiple forms of victimization and adversity fully explained elevated trauma symptoms and delinquency in this population of children. Given the breadth of victimization and adversity risk, children with histories of parental war-related absence or deployment, as well as their families, represent important target groups for broad-based prevention and interventions to reduce exposure and ameliorate consequences when it does occur.

Effects of Poly-Victimization on Adolescent Social Support, Self-Concept, and Psychological Distress

Past research has demonstrated the particularly damaging effects of exposure to multiple forms of victimization, or "poly-victimization," on youth mental health. The primary objective of the present study is to begin to identify the mechanisms that help explain its powerful impact. Analyses are based on two waves of longitudinal data from the National Survey of Children's Exposure to Violence (NatSCEV), conducted in 2008 and 2010, that comprised a telephone sample of 1,186 youth ages 10 to 17. Using structural equation modeling, we examine direct and indirect effects on distress symptoms of increased, decreased, and stable high poly-victimization between Waves 1 and 2 compared to no or low victimization in both waves. Specifically, we consider the extent to which reductions in core psychosocial resources, including family support, peer support, self-esteem, and mastery, mediate the relationship between these poly-victimization conditions and distress. Relative to stable low victimization, both increased poly-victimization and stable high poly-victimization were associated with declines in all four resources. However, only self-esteem and mastery significantly mediated the association between poly-victimization and distress, with mastery showing the strongest effect. Although significant indirect effects were evident, poly-victimization still had a strong direct effect on distress with resource factors controlled. Findings support the hypothesis that the potent effect of poly-victimization on youth mental health is, in part, due to its damaging influence on core psychosocial resources.

Understanding variations in exposure to social stress

Although exposure to stress is a central component of the stress process paradigm, little research has explicitly sought to identify antecedents of stress exposure. Based on a probability sample of 1393 adults aged 18-55 residing in Toronto, Canada, this research examines the effects of social status, past adversity, social and personal resources and history of mental disorder on recent exposure to stress. Consistent with earlier findings, results indicate that younger adults, divorced individuals and those with lower socioeconomic status, experience greater levels of social stress. Although respondent’s history of major depressive disorder was related to all types of stress exposure, past cumulative adversity was the most powerful predictor of both total current stress (operant burden) and the subsequent onset of life events, independent of other antecedents. Findings suggest that the onset of chronic stress is more affected by personal characteristics, such as emotional reliance and disorder history, than is onset of life events. Implications of these findings are discussed.

Polyvictimization and Youth Violence Exposure Across Contexts

PURPOSE

The current research used latent class analysis to uncover groups of youth with specific victimization profiles and identify factors that are associated with membership in each victimization group.

METHODS

This study used data from National Survey of Children Exposure to Violence II. Random digit dialing and address-based sampling were used to obtain a nationally representative sample of 2,312 youth ages 10-17 years. Phone interviews, averaging 55 minutes in length, were conducted with caregivers to obtain both consent and background information and then with youths themselves.

RESULTS

Six groups of youth emerged: (1) nonvictims (26.4%), (2) home victims (8.4%), (3) school victims (20.8%), (4) home and school victims (21.3%), (5) community victims (5.4%), and (6) polyvictims (17.8%). Polyvictims were likely to have been victimized in multiple settings by multiple perpetrators and experienced the most serious aggravating characteristics, including incidents involving a weapon, injury, or a sexual component. Youth in the polyvictim class experienced the highest number of different victimizations types in the past year and had the most problematic profile in other ways, including greater likelihood of living in disordered communities, high probabilities of engaging in delinquency of all types, elevated lifetime adversity, low levels of family support, and the highest trauma symptom scores.

CONCLUSIONS

The study supports the contention that a core basis of the particularly damaging effects of polyvictimization is the experience of victimization across multiple domains of the child's life.

Polyvictimization and Youth Violence Exposure Across Contexts

PURPOSE

The current research used latent class analysis to uncover groups of youth with specific victimization profiles and identify factors that are associated with membership in each victimization group.

METHODS

This study used data from National Survey of Children Exposure to Violence II. Random digit dialing and address-based sampling were used to obtain a nationally representative sample of 2,312 youth ages 10-17 years. Phone interviews, averaging 55 minutes in length, were conducted with caregivers to obtain both consent and background information and then with youths themselves.

RESULTS

Six groups of youth emerged: (1) nonvictims (26.4%), (2) home victims (8.4%), (3) school victims (20.8%), (4) home and school victims (21.3%), (5) community victims (5.4%), and (6) polyvictims (17.8%). Polyvictims were likely to have been victimized in multiple settings by multiple perpetrators and experienced the most serious aggravating characteristics, including incidents involving a weapon, injury, or a sexual component. Youth in the polyvictim class experienced the highest number of different victimizations types in the past year and had the most problematic profile in other ways, including greater likelihood of living in disordered communities, high probabilities of engaging in delinquency of all types, elevated lifetime adversity, low levels of family support, and the highest trauma symptom scores.

CONCLUSIONS

The study supports the contention that a core basis of the particularly damaging effects of polyvictimization is the experience of victimization across multiple domains of the child's life.

Prevalence of Childhood Exposure to Violence, Crime, and Abuse: Results From the National Survey of Children's Exposure to Violence

IMPORTANCE

It is important to estimate the burden of and trends for violence, crime, and abuse in the lives of children.

OBJECTIVE

To provide health care professionals, policy makers, and parents with current estimates of exposure to violence, crime, and abuse across childhood and at different developmental stages.

DESIGN, SETTING, AND PARTICIPANTS

The National Survey of Children's Exposure to Violence (NatSCEV) includes a representative sample of US telephone numbers from August 28, 2013, to April 30, 2014. Via telephone interviews, information was obtained on 4000 children 0 to 17 years old, with information about exposure to violence, crime, and abuse provided by youth 10 to 17 years old and by caregivers for children 0 to 9 years old.

MAIN OUTCOME AND MEASURE

Exposure to violence, crime, and abuse using the Juvenile Victimization Questionnaire.

RESULTS

In total, 37.3% of youth experienced a physical assault in the study year, and 9.3% of youth experienced an assault-related injury. Two percent of girls experienced sexual assault or sexual abuse in the study year, while the rate was 4.6% for girls 14 to 17 years old. Overall, 15.2% of children and youth experienced maltreatment by a caregiver, including 5.0% who experienced physical abuse. In total, 5.8% witnessed an assault between parents. Only 2 significant rate changes could be detected compared with the last survey in 2011, namely, declines in past-year exposure to dating violence and lifetime exposure to household theft.

CONCLUSIONS AND RELEVANCE

Children and youth are exposed to violence, abuse, and crime in varied and extensive ways, which justifies continued monitoring and prevention efforts.

Weapon Involvement in the Victimization of Children

OBJECTIVE

To report the prevalence of weapons involved in the victimization of youth with particular emphasis on weapons with a "high lethality risk" and how such exposure fits into the broader victimization and life experiences of children and adolescents.

METHODS

Data were collected as part of the Second National Survey of Children's Exposure to Violence, a nationally representative telephone survey of youth ages 2 to 17 years and caregivers (N = 4114) conducted in 2011.

RESULTS

Estimates from the Second National Survey of Children's Exposure to Violence indicate that almost 14 million youth, ages 2–17, in the United States have been exposed to violence involving a weapon in their lifetimes as witnesses or victims,or .1 in 5 children in this age group [corrected]. More than 2 million youth in the United States (1 in 33) have been directly assaulted in incidents where the high lethality risk weapons of guns and knives were used. Differences were noted between victimizations involving higher and lower lethality risk weapons as well as between any weapon involvement versus none. Poly-victims, youth with 7 or more victimization types, were particularly likely to experience victimization with any weapon, as well as victimization with a highly lethal weapon compared with nonpoly-victims.

CONCLUSIONS

Findings add to the field's broadening conceptualization of youth victimization highlighting the potentially highly consequential risk factor of weapon exposure as a component of victimization experiences on the mental health of youth. Further work on improving gun safety practices and taking steps to reduce children's exposure to weapon-involved violence is warranted to reduce this problem.

Beyond bullying: Aggravating elements of peer victimization episodes

This study sought to identify features of peer victimization that aggravate negative outcomes in children. The features that were assessed include "power imbalance," a commonly used criterion in defining bullying, and 5 other characteristics: injury, weapon involvement, Internet involvement, sexual content, and bias content. Three outcomes were assessed: level of fear, missing school, and trauma symptoms. A nationally representative sample of 3,164 children and youth ages 6-17 (51.8% male; 68.4% white, 12.5% black, 13.5% Hispanic, 5.7% other race) was obtained through Random Digit Dial and supplemented with an address-based sample to capture cell-phone-only households. One child was randomly selected from each household. Interviews were conducted with parents of children age 6-9 and with the youths themselves if they were age 10-17. Peer victimization was assessed with the Juvenile Victimization Questionnaire (JVQ). Almost half (48.4%) of the entire sample of school-age children experienced at least 1 form of peer victimization in the past year. Injury and power imbalance independently increased the impact on children for all 3 outcomes. Additionally, weapon involvement and sexual content were associated with trauma symptoms, with sexual content having the strongest effect (B = .23, p < .001). This diversity of aggravating features suggests a need to reconsider the current emphasis on prioritizing bullying with its exclusionary power imbalance definition as the central focus for prevention and intervention. We recommend a broader focus on peer victimization along with more research to identify the aggravating features that signal the greatest need for intervention.

The lifetime prevalence of child sexual abuse and sexual assault assessed in late adolescence

PURPOSE

To estimate the likelihood that a recent cohort of children would be exposed to sexual abuse and sexual assault by age 17 in the United States.

METHODS

This analysis draws on three very similarly designed national telephone surveys of youth in 2003, 2008, and 2011, resulting in a pooled sample of 708 17-year-olds, 781 15-year-olds, and 804 16-year-olds.

RESULTS

The lifetime experience of 17-year-olds with sexual abuse and sexual assault was 26.6% (95% confidence interval [CI] 19.8-33.5) for girls and 5.1% (95% CI 2.6-7.6) for boys. The lifetime experience with sexual abuse and sexual assault at the hands of adult perpetrators exclusively was 11.2% (95% CI 6.4-16.1) for females and 1.9% (95% CI .5-3.4) for males. For females, considerable risk for sexual abuse and assault was concentrated in late adolescence, as the rate rose from 16.8% (95% CI 11.5-22.2) for 15-year-old females to 26.6% (95% CI 19.8-33.5) for 17-year-old females. For males, it rose from 4.3% (95% CI 1.9-6.8) at 15 years to 5.1% (2.6-7.6) at 17 years.

CONCLUSIONS

Self-report surveys in late adolescence reveal high rates of lifetime experience with sexual abuse and sexual assault at the hands of both adults and peers. Because of high continuing victimization during the late teen years, assessments are most complete when conducted among the oldest youth.

Trends in children's exposure to violence, 2003 to 2011

IMPORTANCE

The study suggests that years of public policy designed to reduce the burden of violence and victimization among youths is having some success.

OBJECTIVE

To identify trends in children's exposure to violence, crime, and abuse from 2003 through 2011.

DESIGN, SETTING, AND PARTICIPANTS

Three national telephone surveys of representative samples of children and caregivers from 2003, 2008, and 2011 were compared, all obtained using the Juvenile Victimization Questionnaire; samples included parents of children 2 to 9 years old and youth 10 to 17 years old.

EXPOSURES

Direct and indirect experiences of violence, abuse, and victimization during the previous year.

MAIN OUTCOMES AND MEASURES

Change in rates between 2003 and 2011 and between 2008 and 2011.

RESULTS

Of 50 trends in exposure examined, there were 27 significant declines and no significant increases between 2003 and 2011. Declines were particularly large for assault victimization, bullying, and sexual victimization. There were also significant declines in the perpetration of violence and property crime. For the recession period between 2008 and 2011, there were 11 significant declines and no increases for 50 specific trends examined. Dating violence declined, as did one form of sexual victimization and some forms of indirect exposure.

CONCLUSIONS AND RELEVANCE

Victimization surveys with general population samples confirm patterns seen in police data and adult surveys. Crime and violence have been declining in the child and youth population as well.

Violence, crime, and abuse exposure in a national sample of children and youth: an update

IMPORTANCE

Because exposure to violence, crime, and abuse has been shown to have serious consequences on child development, physicians and policymakers need to know the kinds of exposure that occur at various developmental stages.

OBJECTIVES

To provide updated estimates of and trends for childhood exposure to a broad range of violence, crime, and abuse victimizations.

DESIGN

The National Survey of Children's Exposure to Violence was based on a cross-sectional, US national telephone survey conducted in 2011.

SETTING

Interviews by telephone.

PARTICIPANTS

The experiences of 4503 children and youth aged 1 month to 17 years were assessed by interviews with caregivers and with youth in the case of those aged 10 to 17 years.

RESULTS

Two-fifths (41.2%) of children and youth experienced a physical assault in the last year, and 1 in 10 (10.1%) experienced an assault-related injury. Two percent experienced sexual assault or sexual abuse in the last year, but the rate was 10.7% for girls aged 14 to 17 years. More than 1 in 10 (13.7%) experienced maltreatment by a caregiver, including 3.7% who experienced physical abuse. Few significant changes could be detected in rates since an equivalent survey in 2008, but declines were documented in peer flashing, school bomb threats, juvenile sibling assault, and robbery and total property victimization.

CONCLUSIONS AND RELEVANCE

The variety and scope of children's exposure to violence, crime, and abuse suggest the need for better and more comprehensive tools in clinical and research settings for identifying these experiences and their effects.

Community disorder, victimization exposure, and mental health in a national sample of youth

This study considers whether elevated distress among youth living in more disordered neighborhoods can be explained by personal exposure to violence and victimization, level of non-victimization adversity, and family support. Analyses were based on a sample of 2,039 youth ages 10 to 17 who participated in the National Survey of Children's Exposure to Violence, a national telephone survey conducted in 2008. Using structural equation modeling, we find no direct effects of community disorder on distress, once the significant mediating effects of victimization, family support, and adversity are taken into account. Using a comprehensive measure of victimization covering several domains of experiences, we show that past-year exposure to child maltreatment, sexual victimization, peer assault and bullying, and property crime each significantly mediate the community disorder-distress association. A measure of the total number of victimization types to which youth were exposed (i.e., level of "poly-victimization") had the strongest mediating effect.

Recent victimization exposure and suicidal ideation in adolescents

OBJECTIVE

To examine the independent and cumulative effects of past-year exposure to several different types of child victimization (peer victimization, witnessing family violence, community violence, sexual assault, and maltreatment) on suicidal ideation in a nationally representative sample of adolescents.

DESIGN

The study used 2 waves of longitudinal data from the National Survey of Children's Exposure to Violence.

SETTING

Conducted in 2008 and 2010 on the telephone with respondents from the contiguous United States.

PARTICIPANTS

National sample of 1186 youth aged 10 to 17 years in wave 1.

MAIN EXPOSURES

Peer victimization, sexual assault, witnessing family violence, exposure to community violence, and maltreatment by a parent/caregiver.

OUTCOME MEASURE

Self-report suicidal ideation in the past month.

RESULTS

Controlling for demographic characteristics, internalizing disorder diagnoses, and wave 1 suicidal ideation, findings showed independent effects of peer victimization, sexual assault, and maltreatment by a parent/caregiver on suicidal ideation at wave 2. The risk of suicidal ideation was 2.4 times greater among youth who experienced peer victimization in the past year, 3.4 times greater among those who were sexually assaulted, and 4.4 times greater among those exposed to maltreatment, relative to children who were not exposed to these types of victimization. Findings also showed substantial effects of polyvictimization (exposure to 7 or more individual types of victimization in the past year), with polyvictims almost 6 times more likely to report suicidal ideation.

CONCLUSION

Findings point to the importance of recent victimization in increasing risk of suicidal ideation in adolescents and suggest the need for victimization assessments among all youth who are believed to be at risk for suicidal ideation.

Family context, victimization, and child trauma symptoms: variations in safe, stable, and nurturing relationships during early and middle childhood

Based on a nationally representative sample of 2,017 children age 2-9 years, this study examines variations in "safe, stable, and nurturing" relationships (SSNRs), including several forms of family perpetrated victimization, and documents associations between these factors and child trauma symptoms. Findings show that many children were exposed to multiple forms of victimization within the family (such as physical or sexual abuse, emotional maltreatment, child neglect, sibling victimization, and witnessing family violence), as evidenced by substantial intercorrelations among the different forms of victimization. Moreover, victimization exposure was significantly associated with several indices of parental dysfunction, family adversity, residential instability, and problematic parenting practices. Of all SSNR variables considered, emotional abuse and inconsistent or hostile parenting emerged as having the most powerful independent effects on child trauma symptoms. Also, findings supported a cumulative risk model, whereby trauma symptom levels increased with each additional SSNR risk factor to which children were exposed. Implications for research and practice are discussed.

Disability and victimization in a national sample of children and youth

Although past research has found higher rates of violence, crime, and abuse among children with disabilities, most studies combine diverse forms of disability into one measure and assess exposure to only one particular type of victimization. Based on a representative national sample of 4,046 children aged 2-17 from the 2008 National Survey of Children's Exposure to Violence, the present study examines the associations between several different types of disability and past-year exposure to multiple forms of child victimization. Results suggest that attention-deficit disorder/attention-deficit with hyperactivity disorder elevates the risk for peer victimization and property crime, internalizing psychological disorders increase risk for both child maltreatment and sexual victimization, and developmental/learning disorders heighten risk only for property crime. In contrast, physical disability did not increase the risk for any type of victimization once confounding factors and co-occurring disabilities were controlled. It appears that disabilities associated with interpersonal and behavioral difficulties are most strongly associated with victimization risks.

Disasters, victimization, and children's mental health

In a representative sample of 2,030 U.S. children aged 2-17, 13.9% report lifetime exposure to disaster, and 4.1% report experiencing a disaster in the past year. Disaster exposure was associated with some forms of victimization and adversity. Victimization was associated with depression among 2- to 9-year-old disaster survivors, and with depression and aggression among 10- to 17-year-old disaster survivors. Children exposed to either victimization only or both disaster and victimization had worse mental health compared to those who experienced neither. More research into the prevalence and effects of disasters and other stressful events among children is needed to better understand the interactive risks for and effects of multiple forms of trauma.

Infant victimization in a nationally representative sample

OBJECTIVE

The objectives of this research were to (1) obtain estimates of child maltreatment and other forms of personal, witnessing of, and indirect victimization among children aged 0 to 1 year in the United States and (2) examine associations between infant victimization exposure and the infant's level of emotional and behavioral symptoms.

METHODS

The study is based on a cross-sectional national telephone survey that included caregivers of a sample of 503 children under 2 years of age.

RESULTS

Nearly one-third of the sample of infants (31.6%) had experienced some form of personal, witnessing, or indirect form of victimization. The rate of infant maltreatment by caregivers (2.1%) was significantly lower than among older preschool-aged children. However, the rate of infant assault by siblings was considerable at 15.4%. The greatest risk of assault occurred in households with young siblings; nearly 35% of the infants with a sibling aged 2 to 3 years were assaulted in the year before the interview. Witnessing family violence was also relatively common among the infants (9.5%). Victimization was associated with emotional and behavioral problems; sibling assault and witnessing family violence had the highest correlations with infant symptom scores.

CONCLUSION

The results of this study highlight the need for attention to infant victimization that considers a wider array of victimization sources and a broader scope of prevention efforts than has been typical in the child-maltreatment field.

Child mental health problems as risk factors for victimization

The current study examines the effects of child internalizing and externalizing symptoms on increases in victimization over a 1-year period. Using longitudinal data from the Developmental Victimization Survey (DVS), analyses are based on a national probability sample of 1,467 children aged 2-17. Results indicate that children with high levels of co-occurring internalizing and externalizing symptoms were particularly likely to experience increased exposure to several forms of victimization, including peer victimization, maltreatment, and sexual victimization, controlling for earlier victimization and adversity. The relationship of symptoms to victimization exposure differed across developmental stage. Elementary school-age children with high levels of symptoms were especially vulnerable to victimization by peers, whereas distressed youth in early adolescence were particularly vulnerable to sexual victimization. Mental health problems in childhood and adolescence appear to represent important risk factors for increased victimization. Future interventions might consider targeting youth with co-occurring internalizing and externalizing symptoms during especially vulnerable developmental stages.

Psychological distress as a risk factor for re-victimization in children

OBJECTIVE

The goal of this study is to examine the role of psychological distress in predicting child re-victimization across various forms including conventional crime, peer/sibling violence, maltreatment, sexual violence, and witnessed violence.

METHODS

Longitudinal data from the Developmental Victimization Survey, which surveyed children between the ages of 2 and 17 using random digit dial (RDD) methodology, was used to ask about child victimization and psychological distress. The sample for this analysis was 1,025 children who had experienced at least one form of victimization in the first wave of data collection.

RESULTS

Results show that psychological distress (defined as a composite score of the depression, anger, and anxiety scales) was a unique significant predictor of subsequent overall victimization, as well as victimization across the different categories of victimization (conventional crime, maltreatment, peer and sibling victimization, sexual victimization, and witnessed/indirect victimization), while controlling for demographic variables and prior year victimization.

CONCLUSIONS

These results suggest that the psychological consequences of victimization may also serve as precipitants for re-victimization. We discuss the implications this may have on the understanding of the psychological sequelae of victimization and its role in the risk of future victimization.

PRACTICE IMPLICATIONS

This research suggests that practitioners should expand the forms of victimization that are assessed when working with victimized children. Treatment should not only focus on alleviating psychological distress, but also on the role it may play in raising the risk for re-victimization. Treatment providers should be attentive to bolstering protective qualities when treating victimized children.

Poly-victimization in a national sample of children and youth

BACKGROUND

Most studies of children's exposure to violence focus on separate, relatively narrow categories of victimization (such as sexual abuse, physical maltreatment, or bullying), paying less attention to exposure to multiple forms of victimization.

PURPOSE

This study documents children's lifetime exposure to multiple victimization types (i.e., "poly-victimization") and examines the association between poly-victimization and extent of trauma symptomatology.

METHODS

Analyses were based on telephone interviews conducted between January 2008 and May 2008 with a nationally representative sample of 4053 children aged 2-17 years and their caregivers.

RESULTS

Exposure to multiple forms of victimization was common. Almost 66% of the sample was exposed to more than one type of victimization, 30% experienced five or more types, and 10% experienced 11 or more different forms of victimization in their lifetimes. Poly-victims comprise a substantial portion of the children who would be identified by screening for an individual victimization type, such as sexual assault or witnessing parental violence. Poly-victimization is more highly related to trauma symptoms than experiencing repeated victimizations of a single type and explains a large part of the associations between individual forms of victimization and symptom levels.

CONCLUSIONS

Studies focusing on single forms of victimization are likely to underestimate the full burden of victimization that children experience and to incorrectly specify the risk profiles of victims. Research, clinical practice, and intervention strategies are likely to improve with more comprehensive assessments of victimization exposure.

The effects of adolescent victimization on self-concept and depressive symptoms

Using two waves of the Developmental Victimization Survey (DVS), this research examined the effects of different forms of child victimization on changes in self-concept in a national sample of 11- to 18-year-old youth. Specifically, we (a) assessed the independent effects of past-year sexual victimization, nonsexual child maltreatment, peer victimization, and nonvictimization adversity on changes in mastery and self-esteem, (b) investigated the effects of these stressors on levels of depressive symptoms, and (c) determined the extent to which changes in mastery and/or self-esteem mediate associations between victimization and depression. Results indicate that only sexual victimization independently reduced self-esteem, and there were no significant changes in mastery in response to victimization exposure. Declines in self-esteem partially mediated the association between past-year sexual victimization exposure and levels of depressive symptoms. Strong direct effects of each form of victimization and nonvictimization adversity on depression were also evident. Results suggest that sexual victimization experiences may have uniquely powerful effects on self-esteem that are not apparent for other types of victimization and stress.

Lifetime assessment of poly-victimization in a national sample of children and youth

OBJECTIVE

To use a lifetime assessment of victimization experiences to identify children and youth with high cumulative levels of victimization (poly-victims). Also to compare such children to other victims and non-victims, and assess the contribution of cumulative victimization to levels of psychological distress.

DESIGN

A national sample of 1,467 children aged 2-17 recruited through random digit dialing and assessed via telephone interviews (with caretakers and youth themselves) about a comprehensive range of 33 types of victimization experiences in the previous year and at any time in their lives.

RESULTS

Nearly 80% of the children and youth reported at least one lifetime victimization. The mean number of lifetime victimizations was 3.7 and the median 2.6. The total number of different lifetime victimizations was highly predictive of symptoms of current distress. The best linear prediction of distress on the basis of cumulative victimization entailed weighting child maltreatment and sexual assault by factors of 4 and 3 respectively compared to other victimizations. We proposed classifying poly-victims as those 10% of children and youth with the highest victimization scores, and calculating different thresholds for children at different ages. Poly-victims designated in this way had significantly more distress, more non-victimization adversities than other youth and were less likely to come from an intact family.

CONCLUSION

Lifetime assessment of victimization has value as a means of identifying groups of highly victimized children and youth.

PRACTICE IMPLICATIONS

This paper describes a procedure under which practitioners can assess for a group of children, termed "poly-victims," who have a very high burden of lifetime victimization. These children merit identification because they have high levels of psychological distress, some of the most serious victimization profiles, and a presumed vulnerability for further victimization.

The developmental epidemiology of childhood victimization

This article examines developmental trends in the rates of different kinds of victimization across the span of childhood. The Developmental Victimization Survey was a national telephone survey of the victimization experiences of 2,030 children from ages 2 to 17. The overall mean number of victimizations during a single year increased with age, as did the percentage of children with polyvictimizations (4 or more different kinds of victimization). However, some specific types of victimization, physical bullying and sibling assaults, were highest prior to adolescence and then declined. Other types had different developmental patterns by gender. Peer assaults increased in adolescence for boys but not for girls. Child maltreatment and sexual victimization increased in adolescence for girls but not for boys. The complex and diverse patterns of developmental vulnerability to different kinds of victimization at different ages need more exploration and explanation in order to better target prevention and intervention policies.

Juvenile delinquency and victimization: a theoretical typology

It is a widely voiced notion that juvenile delinquency and victimization co-occur extensively in the youth population, in particular because delinquent youth engage in risky activities. But theory from the bullying and traumatic stress literatures suggests that there may be additional pathways by which delinquency and victimization are connected. This analysis looks for possible subtypes of delinquents and victims consistent with such pathways. Using the Developmental Victimization Survey, a national sample of 1,000 youth aged 10 to 17 were interviewed over the phone. Support emerges for three distinct types of delinquent-victims, who are termed bully-victims, delinquent sex/maltreatment- victims, and property delinquent-victims. There is also evidence for substantial groups of youth who are primarily delinquent but not seriously victimized, as well as youth who are primarily victimized but not delinquent.

The significance of employment for chronic stress and psychological distress among rural single mothers

Considerable research has found elevated levels of stress and psychological distress among single mothers. However, little research has addressed the relevance of employment for stress processes in this population, and few studies have focused on links between employment, stress, and mental health among single mothers living in rural areas. Based on a probability sample of 508 single mothers age 18-39 living in rural Northern New England, this study: (1) documents variations in chronic stress and psychological distress for employed and unemployed single mothers, (2) considers the extent to which different forms of chronic stress mediate or explain the employment-distress relationship, and (3) examines whether employment status modifies associations between chronic stress and psychological distress. Findings indicated that rural single mothers who were employed reported significantly less financial stress, childcare stress, and rural residence stress, relative to mothers who were not employed, independent of variety of other factors. Employed mothers also experienced significantly less psychological distress which was partially mediating by their lower financial stress. However, there was also a statistical interaction between employment status and financial stress such that the harmful effect of financial stress on well-being was greater for employed women. Implications of the findings are discussed.