Elsevier

Child Abuse & Neglect

Volume 24, Issue 4, April 2000, Pages 449-464
Child Abuse & Neglect

Original Articles
Social support and the relationship between family and community violence exposure and psychopathology among high risk adolescents

https://doi.org/10.1016/S0145-2134(00)00117-4Get rights and content

Abstract

Objective: The objective of this study was to examine the protective effect of social support in the relationship between exposure to violence and psychopathology. Exposure to violence in the family and exposure to violence in the community were examined separately. Exposure to violence was further divided according to whether violence was experienced as a victim or as a witness. Internalizing and externalizing forms of psychopathology, as well as post-traumatic stress symptomatology were examined.

Method: Participants consisted of 65 high-risk adolescents admitted consecutively to psychiatric inpatient units. Data were collected by means of individual interviews, self-report questionnaires, and hospital charts.

Results: Social support emerged as a protective factor with respect to the maladaptive effects of family violence, experienced as either a victim or as a witness. In contrast, social support did not appear to buffer the maladaptive effects of community violence, regardless of whether violence was experienced as a victim or as a witness. In fact, the relationship between community violence and psychopathology was found to be generally nonsignificant regardless of social support status.

Conclusions: These findings suggest that exposure to family violence may affect development differently than exposure to community violence, allowing social support to effectively buffer the effects of family, but not community violence. This finding highlights the importance of examining violence exposure that occurs within the family separately from violence exposure that occurs within the community.

Introduction

THE RATES AT which children are exposed to violence within both the family and the community are alarmingly high. Based on reports to child protective service agencies nationwide in 1995, an estimated 15 out of 1000 children below the age of 18 were victims of substantiated physical abuse, sexual abuse, or neglect that year (US Department of Health and Human Services, 1995). Exposure to domestic violence is estimated at approximately 10 million children per year (Straus, 1991). Studies of children’s exposure to community violence report very high rates, especially among inner city and African American youth. These studies report that between 35% and 64% of children reported witnessing a shooting or stabbing, between 24% and 43% had witnessed someone being killed, and as high as 96% of children reported hearing gunfire in their neighborhoods Bell and Jenkins 1993, Farrell and Bruce 1997, Fitzpatrick and Boldizar 1993, Schubiner et al 1993, Shakoor and Chalmers 1991. Many children are also the direct victims of community violence. For example, Berman, Kurtines, Silverman, and Serafini (1996) reported that 38% of their sample of youths ages 14 to 18 had been mugged, 20% had been stabbed, and 11% had been shot. Many studies indicate that children exposed to various forms of violence are at an increased risk for negative developmental outcomes and psychopathology.

One of the most significant forms of violence studied in developmental psychopathology has been that of child maltreatment. Cicchetti (1990) described the consistent and problematic effects of maltreatment on the child’s ability to negotiate stage-salient developmental tasks. These include severe disturbances in several domains of adaptive functioning such as the development of a secure attachment with the primary caregiver, affect and physiological self-regulation, the development of autonomy and sense of self, the establishment of peer relationships, and the hierarchical integration of attachment, autonomy and peer relationships. These tasks are relevant across the life-span, and require ongoing coordination and integration (Cicchetti, 1990).

The effects of child maltreatment have been the topic of numerous studies. Victims of child abuse have been found to display both greater internalizing and externalizing behavior problems McGee et al 1997, Hoffman-Plotkin and Twentyman 1984. In the case of childhood sexual abuse, high rates of post traumatic stress disorder (PTSD) also have been connected to the experience of victimization. Most clinical descriptions of maltreated children’s interactions with peers have found that they behave toward them in either an aggressive provocative manner or with withdrawal and avoidance (Mueller & Silverman, 1990). Victims of maltreatment within the family are not only at an increased risk for victimization as adolescents and adults, but they are also at an increased risk for the adoption of maladaptive conflict resolution styles in their own future relationships (Wolfe & McGee, 1994).

Much less is known about the consequences of marital conflict on child development Zuckerman et al 1995, Rossman et al 1997. Preliminary research indicates that a proportion of children who are witnesses to domestic violence show signs of emotional disturbance, behavior problems, and social adjustment difficulties (Jaffe, Wolfe, Wilson, & Zak, 1986). Research on school-age children exposed to domestic violence have found that these children exhibit greater internalizing and externalizing behavior problems, similar to children who have been direct victims of child abuse Jaffe et al 1986, Wolfe and Korsch 1994. Although currently little is known about the reactions of adolescents to witnessing domestic violence, research has suggested a link between witnessing domestic violence and an increased risk for being either a victim or perpetrator of violence during adolescence (Wolfe & Korsh, 1994). Although it is clear that some children appear to be more resilient to the effects of witnessing domestic violence, the reason for this is still not clear (Zuckerman, Augustyn, Groves, & Parker, 1995). Research by Holden and Ritchie (1991) did find that lower levels of parental distress and greater parental availability were related to better adjustment in situations of witnessing domestic violence.

Another source of violence whose effects have only recently begun to be explored is that of community violence. Although still in its early stages, research indicates a modest relationship between exposure to community violence and the development of psychopathology (Kliewer, Lepore, Oskin, & Johnson, 1998). Recent studies indicate that children who are victims of community violence are at risk for developing symptoms of PTSD Kliewer et al 1998, Richters and Martinez 1993a, as well as suffering from low self-esteem, academic difficulties, and aggressive behavior problems (Kliewer et al., 1998). Not only are victims of community violence at risk for the development of psychopathology, but it has recently become evident that this association holds true for witnesses of community violence as well. Similar to children who have been victims of community violence, a significant proportion of children who witness community violence experience symptoms of PTSD Dyson 1990, Fitzpatrick and Boldizar 1993, Garbarino 1995, as well as learning difficulties.

While it is evident that a certain proportion of children and adolescents exposed to various forms of violence within their families and communities display significant emotional and behavioral difficulties, some individuals demonstrate better adaptation in the face of severe violence exposure. Researchers attempting to explain such resilient outcomes have begun to explore the role that various protective factors may play.

Researchers studying victims of child maltreatment have asserted that there is good evidence corroborating the protective effects of social support Gold et al 1994, Jones 1997, Kinard 1995. Several studies have illustrated that social support reduces the impact of both child sexual abuse Astin et al 1993, Conte and Scherman 1987, Testa et al 1992 and physical abuse Kurtz et al 1993, Runtz and Schallow 1997 on the development of psychopathology. For individuals who are victims of violence within their families, social support from a nonabusive parent or from an alternative caregiver may provide them not only with cognitive and emotional support, but also with a model of appropriate social interaction (Caliso & Milner, 1994). Hunter and Kilstrom (1979) found that survivors of child maltreatment who reported strong childhood social supports were less likely to abuse their own children.

Although the role of social support as a protective factor for victims of child maltreatment has been a topic of research over the past decade, the role of social support as a buffer against the effects of witnessing family violence has only recently begun to be examined. Initial research in this area has identified maternal support as an important factor in predicting child outcome. These studies have found that in cases of witnessing domestic violence, maternal support predicted fewer internalizing and externalizing behavior problems and fewer PTSD symptoms Rossman et al 1997, McCloskey et al 1995. When placed in a situation of danger or fear, children generally turn to adults, usually their parents, for protection, support, and understanding (Bowlby, 1969). In the case of domestic violence, many parents may not be able to play the supportive role because they are in the roles of perpetrator and victim (Zuckerman et al., 1995), and therefore they are unlikely to properly assess and address their child’s emotional needs. Thus, for children who are witnesses to domestic violence, alternate support providers also may be important for protecting against maladaptive outcomes.

Similar to the current state of research on witnessing domestic violence, very few studies have yet examined the role that social support may play in buffering the maladaptive effects of exposure to community violence. Results of the few preliminary studies published so far indicate that social support may play a buffering role, at least to some extent Berman et al 1996, Hill et al 1996. Not only has there been very little previous research on exposure to community violence and the protective role of social support, but there is also a significant problem associated with the research that has been conducted in this area. That is, studies either have failed to separate violence exposure within the family from violence exposure within the community, or they have only examined one or the other type of violence exposure (Horn & Trickett, 1998). In a recent review of the literature on community violence and child development, Horn and Trickett (1998) indicated that future research must examine both family and community separately. The failure to examine both family and community violence exposure separately results in an inability to determine the extent to which symptoms of psychopathology are associated with exposure to community violence, or instead associated with family violence that was either not measured or was included, but not examined separately. Also, this failure to examine both family and community violence separately suggests that the true protective role of social support cannot be determined yet. For example, several studies that examined the protective effect of social support on community violence Berman et al 1996, Hill et al 1996 failed to examine separately participants’ exposure to violence within the family. As such, the extent to which social support is buffering the effects of community violence stemming from outside the family, or whether it is really buffering the effects of violence within the family remains undetermined.

Examining violence that occurs in the family separately from violence that occurs in the community can offer a more concise and complete perspective on the possible protective effect of social support on the development of psychopathology. It should not be assumed that exposure to violence within the family will have the same effects as exposure to violence within the community, nor that protective factors will necessarily be the same for both types of violence. The experience of family versus community violence may be very different. Family violence for example, involves violations of relationship boundaries; community violence may or may not involve this type of violation (Putamen & Trickett, 1993). Family violence is also quite different from community violence in that family violence often is surrounded by extreme secrecy due to embarrassment and fear of repercussions. This fear of disclosing the occurrence of family violence may result in less social support. Victims and witnesses to community violence may be more likely to share their experience with peers or parents, resulting in a greater availability of social support to deal with their experience (Putamen & Trickett, 1993).

The purpose of the current investigation was to examine the role of social support in family and community violence among high-risk adolescents. The protective or buffering effect of social support was examined in the relationships between violence exposure and both internalizing and externalizing measures of psychopathology. Violence exposure was measured in terms of its occurrence within the family or community, and in terms of experiencing this violence as a victim or witness. It was expected that social support would emerge as a protective factor in the relationship between exposure to violence and psychopathology measures. Since prior social support studies have not yet differentiated between family and community violence, this study was regarded as exploratory; as such, no further differential hypotheses were proposed.

Section snippets

Participants

Participants for this study were consecutive admissions to the Child Assessment Unit (CAU) at Cambridge Hospital and Adolescent Unit at Somerville Hospital, both affiliates of Harvard Medical School. Participants were not chosen on the basis of gender, ethnic background, or health status. Nine individuals declined participation (six females and three males). For four of these individuals, their guardians refused consent. For the remaining five, the patients themselves declined participation.

Results

For all scales used in this study, means and standard deviations were calculated and may be found in Table 3. For all analyses, significance levels have been Bonferroni-corrected.

Discussion

The purpose of the current investigation was to examine the role of social support in the relationship between exposure to violence and psychopathology. Results suggest that social support acted as a buffer of the maladaptive effects of family violence, but did not appear to buffer the maladaptive effects of exposure to community violence. Regardless of the type of analysis used to examine the role of social support, exposure to family violence was found to be more consistently associated with

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