Community Violence
A National Center for PTSD Fact Sheet
By Jessica Hamblen, Ph.D. and Carole Goguen, Psy.D.
According to reports by the Centers for Disease Control1, the United States is the most violent country in the industrialized world. Homicide rates generally increased about 5% annually from 1987 to 1991. One-third of all homicides occur among persons aged 15 to 24, and it is the leading cause of death among black males in this age group. As a result, people are at risk for being the victim of, witnessing, or hearing about extreme violence. This fact sheet is intended to provide an overview of community violence and its effects.
What is community violence?
Community violence is a complex term that has been used to refer to a wide range of events including riots, sniper attacks, gang wars, drive-by shootings, workplace assaults, terrorist attacks, torture, bombings, war, ethnic cleansing, and widespread sexual, physical, and emotional abuse. Mental-health professionals often make a distinction between studies on crime-related events in which adults are often the focus (such as rape, assault, and homicide) and studies on exposure to violence in which children and adolescents are often the focus (such as school shootings, witnessing murder, and living in a war zone). Another distinction that is often made is between domestic violence, referring to abuse between two adults involved in a romantic relationship, and child sexual or physical abuse, referring to violence between a child and an adult. A third distinction that is made is between predatory violence, in which an individual (usually a stranger) tries to take something of value using physical threats or direct violence, and interpersonal conflicts, in which two acquaintances are involved in a violent altercation with the intent to harm each other. Both types of violence may include brutal acts such as shootings, rapes, stabbings, and beatings. One definition of community violence that has been used to encompass all of these types of violence is "frequent and continual exposure to the use of guns, knives, and drugs, and random violence."2
How is community violence different from other types of trauma?
Several aspects of community violence make it different from other types of
trauma. Although there are warnings for some traumas, community violence
usually happens without warning and comes as a sudden and terrifying shock.
Because of this, communities that suffer from violence often experience
increased fear and a feeling that the world is unsafe and that harm could come
at any time. Although some traumas only affect one individual or a small group
of people, community violence can permanently destroy entire neighborhoods.
Finally, although some types of trauma are accidental, community violence is
intentional, which can lead survivors to feel an extreme sense of betrayal and
distrust toward other people.
How many people are exposed to community violence?
A commonly held belief is that community violence only happens among gang members in inner-city neighborhoods. While it is true that the risk of exposure to community violence is higher among poor, nonwhite individuals living in densely populated urban areas, studies on rates of community violence are beginning to demonstrate that community violence affects a wider range of people. In a national survey of girls and boys 10 to 16 years old, over one-third reported being the direct victim of violence including aggravated assault, attempted kidnapping, and sexual assault.3 Another study compared the rate of exposure to violence of urban elementary school children living in low-violence neighborhoods to the rate of those living in high-violence neighborhoods4. Results indicated that over 75 percent of the total sample witnessed violent acts such as homicide, stabbings, physical assault, and gang violence. The only difference between the rates of exposure in the two groups was in exposure to homicide. Whereas 9% of the children living in the low-violence neighborhoods reported witnessing homicide, 32% of the children living in high-violence neighborhoods reported exposure to homicide. Interestingly, despite these high rates, more than 50 percent of the parents in both groups stated that their children had not been exposed to violence in the community. Finally, one study examined rates of exposure to community violence as compared to being the direct victim of violence. In a study of fifth and sixth grade children living in a moderately violent neighborhood in Washington, DC, 59% reported being the victim of violence while 97% reported witnessing violence such as a shooting, mugging, or drug trade.5
As for adults, a number of studies suggest that between 39% and 70% have experienced a traumatic event and that a large segment of these traumas are serious crimes.6 One large general population study of more than 4,000 adult women found that 36% of the sample reported exposure to rape, other sexual assault, aggravated assault, or the homicide of someone close to them. More than 12 million women, or 12.7% of the sample, lived through a completed rape (Resnick, Kilpatrick, Dansky, Saunders, & Best, 1993).
What are the effects of witnessing or experiencing community violence?
As is the case with other traumas, individuals often experience Posttraumatic
Stress Disorder (PTSD) as a result of community violence (for an overview see
"What is PTSD?" below). PTSD can affect people of all ages. Although
some people think that young children are not psychologically affected by exposure
to community violence because they are too young to understand or remember the
violence, studies have found posttraumatic symptoms and disorders among infants
and toddlers. Symptoms expressed by children tend to look different from those
expressed by adults. Children with PTSD display disorganized or agitated behavior
and have nightmares that may include monsters. They may become withdrawn, fearful,
or aggressive, and they may have difficulty paying attention. They may regress
to earlier behaviors such as sucking their thumbs and bed-wetting, and they
may develop separation anxiety. They may also engage in play that compulsively
reenacts the violence.
Adolescents with PTSD also experience nightmares and intrusive thoughts
about the trauma. They may be easily startled and avoid reminders of the
trauma. They can become depressed, angry, distrustful, fearful, and alienated,
and they may feel betrayed. Many do not feel they have a future and believe
that they will not reach adulthood. This is especially common among adolescents
who are chronically exposed to community violence. Other trauma-related
reactions can include impaired self-esteem and body image, learning
difficulties, and acting out or risk taking behaviors such as running away,
drug or alcohol use, suicide attempts, and inappropriate sexual activities.
Children's and adolescents' risk for developing PTSD increases with the severity
of exposure, negative parental reactions to the exposure, and the child's physical
proximity to the community violence.
The impact of community violence exposure is not felt by the youth alone. A
child's or adolescent's exposure to community violence also affects his or her
family. Extreme anxiety concerning the child's health and well-being is a
common parental reaction. Resources for parents may be limited, which may lead
to frustration and anger. Many parents blame themselves for not protecting
their child adequately. They may become overprotective or use punitive
discipline in response to their child's trauma-related acting out behavior.
Relationships among family members can become strained. Parents find themselves
having to face the task of reassuring their child while trying to cope with
their own fears, especially if there is a chronic risk for future community
violence exposure.
Adults can also experience PTSD following exposure to community violence. In
addition to symptoms of PTSD, survivors of community violence often struggle
with (1) how to build trust again (which includes looking at issues of power,
empowerment, and victimization); (2) how to find meaning in life apart from the
desire for revenge; (3) how to find realistic ways to protect themselves, their
loved ones, and their homes and community from danger; and (4) how to deal with
feelings of guilt, shame, powerlessness, and doubt. A final concern regarding
the effects of community violence is whether there is a link between witnessing
violence and becoming violent, especially in intimate relationships. No studies
have determined whether there is a relationship between community violence and
domestic violence.
What treatments are available for individuals exposed to community violence?
Rapid, timely, and sensitive care for the community and affected individuals
and families is the key to preventing PTSD in the wake of violence. Such care
is also the key to reducing violence itself. Mental-health professionals with
expertise in community violence can contribute in several ways. They can help
community leaders develop violence-prevention and victim-assistance programs.
They can help religious, educational, and health care leaders and organizations
set up relief centers and shelters. They can provide direct psychological services
near the site of violence. These services may include debriefings, a 24-hour
crisis hotline, identifying survivors or bereaved family members who are at
high risk for developing PTSD, and getting individuals connected with appropriate
continuing treatment. Finally, mental-health professionals can often work with
teachers at children's schools to provide education, debriefing, and referrals
for affected children.
How can we prevent community violence?
Some progress has been made in developing violence prevention programs. The
current focus for these programs is gang prevention and conflict resolution
skill building for high-risk youths. However, violence prevention programs appear
to be more effective if children are engaged early (beginning before age 6)
and the program includes intervention in children's home and school social environments.
Programs should also continue to make specific efforts to reduce obvious high-risk
behaviors among adolescents, such as gang involvement, heavy drinking, and carrying
handguns.
Related Fact Sheets
PTSD in children
and adolescents
An overview of the effects of trauma on children and adolescents
Children
and community violence
A summary of the specific effects of community violence on children and adolescents
Treatment options
This fact sheet provides an in-depth overview of treatment options for those
with PTSD
What is
PTSD?
Answers basic questions about the signs and symptoms of PTSD, who gets it,
how common it is, and what treatments are available
References
1. Centers for Disease Control (1999). National Vital Statistics Reports, vol. 47.
2. Osofsky, J.D. (1995). The effects of exposure to violence on young children. American Psychologist, 50, 782-788.
3. Boney-McCoy, S., & Finkelhor, D. (1995). Psychosocial sequelae of violent victimization in a national youth sample. Journal of Consulting and Clinical Psychology, 63, 726-736.
4. Hill, H.M., & Jones, L.P. (1997). Children's and parents' perceptions of children's exposure to violence in urban neighborhoods. Journal of the National Medical Association, 89, 270-276.
5. Richters, J.E. & Martinez, P. (1993). The NIMH Community Violence Project: I. Children as victims of and witnesses to violence. Psychiatry, 56, 7-21.
6. Resnick, H. & Kilpatrick, D. (1994). Crime-related PTSD: Emphasis on adult general population samples. PTSD
Research Quarterly, 5, 1-7.
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