Heather A. Turner

The Victimization of Children and Youth: A Comprehensive, National Survey:

This study examined a large spectrum of violence, crime, and victimization experiences in a nationally representative sample of children and youth ages 2 to 17 years. More than one half (530 per 1,000) of the children and youth had experienced a physical assault in the study year, more than 1 in 4 (273 per 1,000) a property offense, more than 1 in 8 (136 per 1,000) a form of child maltreatment, 1 in 12 (82 per 1,000) a sexual victimization, and more than 1 in 3 (357 per 1,000) had been a witness to violence or experienced another form of indirect victimization. Only a minority (29%) had no direct or indirect victimization. The mean number of victimizations for a child or youth with any victimization was 3.0, and a child or youth with one victimization had a 69% chance of experiencing another during a single year.

Polyvictimization and trauma in a national longitudinal cohort.

This paper utilizes a national longitudinal probability sample of children to demonstrate how important exposure to multiple forms of victimization (polyvictimization) is in accounting for increases in childrens symptomatic behavior. The study is based on two annual waves of the Developmental Victimization Survey that began with a nationally representative sample of children and youth ages 2 to 17. A broad range of victimization experiences were assessed using the 34-item Juvenile Victimization Questionnaire. Eighteen percent of the children experienced four or more different kinds of victimization (polyvictims) in the most recent year. Polyvictimization in the most recent year was highly predictive of trauma symptoms at the end of the year, controlling for prior victimization and prior mental health status. When polyvictimization was taken into account, it greatly reduced or eliminated the association between most other individual victimizations and symptomatology scores.

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 Childrens 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 childrens 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.

The overlap of witnessing partner violence with child maltreatment and other victimizations in a nationally representative survey of youth

OBJECTIVE To examine the co-occurrence of witnessing partner violence with child maltreatment and other forms of victimization. METHOD Data are from the National Survey of Childrens Exposure to Violence (NatSCEV), a nationally representative telephone survey of the victimization experiences of 4,549 youth aged 0-17. RESULTS Witnessing partner violence (WPV) is very closely associated with several forms of maltreatment and exposure to other forms of family violence in this sample, with adjusted OR ranging from 3.88 to 9.15. WPV is also significantly associated with a wide variety of other forms of victimization, with OR ranging from 1.43 to 7.32. More than 1/3 (33.9%) of youth who witnessed partner violence had also been maltreated in the past year, compared with 8.6% of non-witnesses. For lifetime data, more than half (56.8%) of WPV youth had also been maltreated. Neglect and custodial interference were most closely associated with WPV. CONCLUSIONS These data support the poly-victimization model, indicating that many youth experience multiple forms of victimization. They also indicate that the various forms of family violence are especially closely linked. PRACTICE IMPLICATIONS These results provide new urgency to calls to better integrate services to adult and child victims of family violence. For example, screening to identify the needs of child witnesses could be done in domestic violence shelters, and screening to identify the needs of adult victims could be done in child protective service settings.

Trends in childhood violence and abuse exposure: evidence from 2 national surveys

OBJECTIVE To assess trends in childrens exposure to abuse, violence, and crime victimizations. DESIGN An analysis based on a comparison of 2 cross-sectional national telephone surveys using identical questions conducted in 2003 and 2008. SETTING Telephone interview. PARTICIPANTS Experiences of children aged 2 to 17 years (2030 children in 2003 and 4046 children in 2008) were assessed through interviews with their caretakers and the children themselves. Outcome Measure Responses to the Juvenile Victimization Questionnaire. RESULTS Several types of child victimization were reported significantly less often in 2008 than in 2003: physical assaults, sexual assaults, and peer and sibling victimizations, including physical bullying. There were also significant declines in psychological and emotional abuse by caregivers, exposure to community violence, and the crime of theft. Physical abuse and neglect by caregivers did not decline, and witnessing the abuse of a sibling increased. CONCLUSION The declines apparent in this analysis parallel evidence from other sources, including police data, child welfare data, and the National Crime Victimization Survey, suggesting reductions in various types of childhood victimization in recent years.

Pathways to Poly-Victimization:

Some children, whom we have labeled poly-victims, experience very high levels of victimizations of different types. This article finds support for a conceptual model suggesting that there may be four distinct pathways to becoming such a poly-victim: (a) residing in a dangerous community, (b) living in a dangerous family, (c) having a chaotic, multiproblem family environment, or (d) having emotional problems that increase risk behavior, engender antagonism, and compromise the capacity to protect oneself. It uses three waves of the Developmental Victimization Survey, a nationally representative sample of children aged 2—17 years. All four hypothesized pathways showed significant independent association with poly-victim onset. For the younger children, the symptom score representing emotional problems was the only significant predictor. For the older children, the other three pathway variables were significant predictors—dangerous communities, dangerous families, and problem families—but not symptom score. Poly-victimization onset was also disproportionately likely to occur in the year prior to children’s 7th and 15th birthday, corresponding roughly to the entry into elementary school and high school. The identification of such pathways and the ages of high onset should help practitioners design programs for preventing vulnerable children from becoming poly-victims.

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 Childrens 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.

Gender and social support: Taking the bad with the good?

In examining past research, a paradox can be found in the relationships between gender, social support, and depression. Although women report higher levels of depression than men, they also generally report more social support—a factor found to reduce depressive symptoms. In efforts to explain this seeming inconsistency, it was hypothesized that women report both more support and more depression because they are more likely than men to experience both positive and negative aspects of social relationships. Based on a community sample of predominantly Caucasian respondents, findings indicate that greater perceived support among women can be explained by more frequent contact with network members and a tendency to possess relationships characterized by greater intimacy, emotional disclosure, and empathy. However, women also report more frequent negative interactions with network members and are more adversely affected by marital conflict than are men. While negative interactions and conflict cannot account for gender differences in depression, they do help to explain how women can experience both more support and more depression. Among women, the health-enhancing effects of support on depression may be balanced by the detrimental effect of conflict.

Direct and Indirect Effects of Childhood Adversity on Depressive Symptoms in Young Adults.

While researchers have provided evidence that recent stressors in adulthood and single traumatic events in childhood predict psychological disorder, few have examined the cumulative impact of childhood adversity on later well-being. Using a sample of 649 college students from New England, this research examines whether cumulative trauma in childhood and adolescence is related to depressive symptoms in young adults, and explores the mediating factors that operate in this association. Results indicate clear differences in cumulative trauma by sociodemographic characteristics, with males, nonwhites, and those with less than college-educated parents, reporting significantly greater levels of adversity. We also find that higher trauma is associated with both early onset of depressive disorder and later depressive symptoms. Path analyses reveal that, while some of the association between childhood adversity and depression in young adults is direct, most is explained by the mediating effects of later stress, low self-esteem, and early onset of disorder.

Improving the Adverse Childhood Experiences Study Scale

OBJECTIVE To test and improve upon the list of adverse childhood experiences from the Adverse Childhood Experiences (ACE) Study scale by examining the ability of a broader range to correlate with mental health symptoms. DESIGN Nationally representative sample of children and adolescents. SETTING AND PARTICIPANTS Telephone interviews with a nationally representative sample of 2030 youth aged 10 to 17 years who were asked about lifetime adversities and current distress symptoms. MAIN OUTCOME MEASURES Lifetime adversities and current distress symptoms. RESULTS The adversities from the original ACE scale items were associated with mental health symptoms among the participants, but the association was significantly improved (from R2 = 0.21 to R2 = 0.34) by removing some of the original ACE scale items and adding others in the domains of peer rejection, peer victimization, community violence exposure, school performance, and socioeconomic status. CONCLUSIONS Our understanding of the most harmful childhood adversities is still incomplete because of complex interrelationships among them, but we know enough to proceed to interventional studies to determine whether prevention and remediation can improve long-term outcomes.