Meta-analyses of studies yielding sex-specific risk of potentially traumatic events (PTEs) and posttraumatic stress disorder (PTSD) indicated that female participants were more likely than male participants to meet criteria for PTSD, although they were less likely to experience PTEs. Female participants were more likely than male participants to experience sexual assault and child sexual abuse, but less likely to experience accidents, nonsexual assaults, witnessing death or injury, disaster or fire, and combat or war. Among victims of specific PTEs (excluding sexual assault or abuse), female participants exhibited greater PTSD. Thus, sex differences in risk of exposure to particular types of PTE can only partially account for the differential PTSD risk in male and female participants.

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Sex differences in trauma and posttraumatic stress disorder: a quantitative review of 25 years of research.

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.

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The victimization of children and youth: a comprehensive, national survey

This review examines theoretical and empirical literature on children's reactions to three types of violence--child maltreatment, community violence, and interparental violence. In addition to describing internalizing and externalizing problems associated with exposure to violence, this review identifies ways that violence can disrupt typical developmental trajectories through psychobiological effects, post-traumatic stress disorder (PTSD), cognitive consequences, and peer problems. Methodological challenges in this literature include high rates of co-occurrence among types of violence exposure, co-occurrence of violence with other serious life adversities, heterogeneity in the frequency, severity, age of onset, and chronicity of exposure, and difficulties in making causal inferences. A developmental psychopathology perspective focuses attention on how violence may have different effects at different ages and may compromise children's abilities to face normal developmental challenges. Emphasis is placed on the variability of children's reactions to violence, on outcomes that go beyond diagnosable disorders, and on variables that mediate and moderate children's reactions to violence.

The effects of family and community violence on children.

OBJECTIVE: The objective of this research was to obtain national estimates of exposure to the full spectrum of the childhood violence, abuse, and crime victimizations relevant to both clinical practice and public-policy approaches to the problem. METHODS: The study was based on a cross-sectional national telephone survey that involved a target sample of 4549 children aged 0 to 17 years. RESULTS: A clear majority (60.6%) of the children and youth in this nationally representative sample had experienced at least 1 direct or witnessed victimization in the previous year. Almost half (46.3%) had experienced a physical assault in the study year, 1 in 4 (24.6%) had experienced a property offense, 1 in 10 (10.2%) had experienced a form of child maltreatment, 6.1% had experienced a sexual victimization, and more than 1 in 4 (25.3%) had been a witness to violence or experienced another form of indirect victimization in the year, including 9.8% who had witnessed an intrafamily assault. One in 10 (10.2%) had experienced a victimization-related injury. More than one third (38.7%) had been exposed to 2 or more direct victimizations, 10.9% had 5 or more, and 2.4% had 10 or more during the study year. CONCLUSIONS: The scope and diversity of child exposure to victimization is not well recognized. Clinicians and researchers need to inquire about a larger spectrum of victimization types to identify multiply victimized children and tailor prevention and interventions to the full range of threats that children face.

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Violence, abuse, and crime exposure in a national sample of children and youth.

Social service professionals are more frequently identifying children who witness adult domestic violence as victims of that abuse. This article expands common definitions of how children witness adult domestic violence. A total of 31 research articles that met established quality criteria were included in this review. A variety of behavioral, emotional, and cognitive-functioning problems among children were found to be associated with exposure to domestic violence. Factors that appear to moderate the impact of witnessing violence—such as whether the child was also abused, child gender and age, and the time since last exposure to violence—were identified. Concerns about research methodology used in this area of research and the application of this knowledge also are raised.

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Children's Witnessing of Adult Domestic Violence

Objective. —To examine the extent to which adolescents are exposed to various types of violence as either victims or witnesses, and the association of such exposure with trauma symptoms; specifically, the hypotheses that exposure to violence will have a positive and significant association with depression, anger, anxiety, dissociation, posttraumatic stress, and total trauma symptoms. Design and Setting. —The study employed a survey design using an anonymous self-report questionnaire administered to students (grades 9 through 12) in six public high schools during the 1992-1993 school year. Participants. —Sixty-eight percent of the students attending the participating schools during the survey participated in the study (N=3735). Ages ranged from 14 to 19 years; 52% were female; and 35% were African American, 33% white, and 23% Hispanic. Results. —All hypotheses were supported. Multiple regression analyses of the total sample revealed that violence exposure variables (and to a lesser extent, demographic variables) explained a significant portion of variance in all trauma symptom scores, including depression (R2=.31), anger (R2=.30), anxiety (R2=.30), dissociation (R2=.23), posttraumatic stress (R2=.31), and total trauma (R2=.37). Conclusions. —A significant and consistent association was demonstrated linking violence exposure to trauma symptoms within a diverse sample of high school students. Our findings give evidence of the need to identify and provide trauma-related services for adolescents who have been exposed to violence. (JAMA. 1995;273:477-482)

Adolescents' exposure to violence and associated symptoms of psychological trauma

The United States imprisons a larger proportion of its population than any other industrialized nation, including South Africa and the former Soviet Union ("U.S. Expands Its Lead," 1992). In the United States, the rate of growth for female inmates has exceeded that for male inmates each year since 1981. From 1980 to 1989, the male inmate population increased by 112 percent, and the female population increased by 202 percent. However, women still represent a relatively small segment of the prison and jail populations (5.7 percent and 9.0 percent, respectively) (Stephan & Jankowski, 1991; U.S. Department of Justice, 1991). The majority of incarcerated women are sentenced for nonviolent offenses--crimes such as prostitution, fraud, or drug offenses (U.S. Department of Justice, 1991). Many of these female inmates come from impoverished backgrounds, are addicted to drugs or alcohol, and have emotional and mental health problems. In short, the crimes these women commit are often a reaction to negative life events, a response to a crisis or to prolonged disadvantage. Unfortunately, our society has paid little attention to the female inmate population. They have been seen as "expendable," "evil," "women gone bad," "not really 'women'," and "incapable of change." Yet, in truth, we know too little about women serving time. There have been a paltry number of clinical and research investigations of this population, and the services rendered to them have been woefully deficient. Literature Review A review of the literature reveals that female criminality remained a much-neglected area of research until the 1970s. This paucity of research stems from at least three factors. First, women tend to commit nonviolent crimes; therefore, they are not considered a significant threat to society. Second, women constitute only nine percent of the average daily adult population in local jails in the United States and thus represent only a small proportion of inmates (Stephan & Jankowski, 1991). Third, women have had unequal economic and political status and have therefore have had unequal access to both services and research (Rasche, 1974). As previously stated, the adult female inmate population has increased at a faster rate than the male inmate population. Arrests for offenses such as petty theft, passing bad checks, welfare fraud, driving while intoxicated, and prostitution have accounted for the increased rate of incarceration (Immarigeon & Chesney-Lind, 1992). Some information is available on the characteristics of this population of women. The American Correctional Association's 1987 National Survey of Women Offenders found that 57 percent are women of color, the majority are between 25 and 29 years of age, 62 percent are single parents of one to three minor children, and 60 percent have been welfare recipients (American Correctional Association, 1990). Jails have become a receiving facility for a host of disguised health, welfare, and social problem cases (Mattick, 1974). As the literature reflects, the critical social problems emerging in the 1980s and continuing into the 1990s, such as substance abuse, mental illness, family fragmentation, economic instability, and social isolation, have particular impact on incarcerated women. These problems are difficult to address during jail stays of frequently less than two months (American Correctional Association, 1990). Incarcerated women are reported to have extensive experience with both the criminal justice and the mental health services systems (Lamb & Grant, 1983). One-third to two-thirds of women newly admitted to jails suffer sufficient psychological distress to require mental health services (American Correctional Association, 1990; Guy, Platt, Zwerling, & Bullock, 1985; James, Gregory, Jones, & Rundell, 1985). Mood-altering drugs are prescribed two to three times more for women in jails than for men (National Coalition for Jail Reform, no date). …

Lisa Lunghofer

Papers

Adolescents' exposure to violence and associated symptoms of psychological trauma

The Psychosocial Issues of Women Serving Time in Jail