Assessing impacts of community violence on children and adolescents

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Using the Social Ecological Model as a framework for evaluating the effects of community violence effects on children and template for prevention and intervention programs

The effects on children of community-based violence are consequences that raise grave concern in Jamaica and across the world. Various empirical work and reviews have well-documented the many negative effects. However, relations between community violence, the individual, the environment, and child development do not occur in a vacuum. The impact can be understood as related to changes in the society, communities, relationships, and other social contexts which children experience, and in the psychological processes activated by these social ecologies. To promote this inter-related process-oriented perspective, a social ecological model for the effects of community violence on children is presented, to indicate the need for prevention and intervention programs to tackle the issue of community violence from this perspective. 

Research questions: Are the impacts of community violence dimensional

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Hypothesis: Impacts of community violence are dimensional and have ripple effects across all dimensions as identified in Bronfenbrenner' Social Ecological Model

Community violence frequently refers to a wide range of events including riots, sniper attacks, torture, bombings war, ethnic cleansing, and widespread sexual, physical and emotional abuse (Logsdon, 2010).

Background/Problem

Living in chronically violent context has been a perennial problem in developed and developing countries. Community violence is recognized as a major public health problem (WHO, World Report on Violence and Health, 2000; Cooley, Lambert, & Ialongo, 2003), and affects all racial, ethnic, and socioeconomic groups, but its impact falls most heavily on poor, urban, and minority groups, particularly youth (Bureau of Justice Statistics, 1997; Christoffel, 1990, Stein et al, 2003). Much of the empirical work done on children's exposure to community-based violence has focused on implications such as the impacts, protective factors, cause for children's resilience, mediating and moderating factors among others, all evaluated as detached dimensions.

This review proposes that living in a chronically violent context has the potential to affect children's overall quality of life. Therefore, evaluating the implications of children's experience of living in chronically violent setting and the impact on their development need to be looked at from a multidimensional level with it all being interconnected. Notably, research that focuses on any one level underestimates the effects of other contexts (Klein et al., 1999; Rousseau & House, 1994; Stokols, 1996). The purpose of this review includes mutually greater insight into this particular context of living in chronically violent settings and the provision of a template for study of the impact of children's exposure to violence in the Caribbean and other regions of the world. Accordingly, the applicability of this approach is considered for the context of community violence in Jamaica.

This review seeks to evaluate the four levels as a mode of informing prevention and intervention programs on how to target community violence based on the interplay intra-context and inter-context.

The Social Ecological Model

The Social Ecological Model (SEM) allows for the integration of multiple levels and contexts to establish the overall impact and in conflict communication. (Oetzel, Ting-Toomey, & Rinderle, 2006)

In examining the effects of community violence, its most likely relevant to assess equally the individual's direct experience of violence as well as the actual amount of violence that is occurring in the surrounding environment, be it direct or indirectly. This distinction is analogous to Bronfenbrenner's distinction between the microsystem and the exosystem (Bronfenbrenner, 1977). Direct experiences of violence are part of the child's immediate environment (or microsystem). These direct experiences occur within a broader context-the exosystem-that provides a backdrop for the child's immediate experiences.

Rates of violent crime in a neighborhood, for example, provide a measure of how much violence is occurring in a community, even though the child may not be directly experiencing it himself or herself. But these more remote, ambient occurrences of violence still can exert influences on children's development-through how they affect the availability and adequacy of resources and supports, and how they affect the family's emotional well-being and approach to daily life. Both direct (microsystemic) and indirect (exosystemic) experiences of community violence are important and relevant to investigate, and they each may affect children's adaptation. It is important for researchers to be clear in specifying what they are measuring so that they can be more precise in their predictions and in their conclusions.

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However, despite the burgeoning of the research area, the knowledge base remains fairly diverse. It is dominated by research employing a few select measures or their revisions, several of which have yet to have their psychometric properties documented. Rather than reflecting a consolidated body of findings which can be used to direct policymaking and program design and implementation, the available work constitutes "an increasingly complex and fragmented body of empirical findings, drawing from differing assumptions and operationalizations of what constitutes community violence" (Guterman et al., 2000, p. 572)

Social-ECOLOGICAL FRAMEWORK

Bronfenbrenner's (1979) ecological framework indicated that humans should be viewed in the context of their environment. Three of the levels within this ecology of human development are the macrosystem, exosystem, and microsystem. The broadest aspect, the macrosystem, consists of institutional patterns such as economic, social, educational, and political systems (Bronfenbrenner, 1979; Cicchetti & Lynch, 1993). Bronfenbrenner defined the exosystem as a system that includes social settings, such as interactions between the neighborhood, schools, and churches, along with issues such as a lack of employment opportunities and pervasive low socioeconomic status (Cicchetti & Lynch, 1993). Similarly, class status, chronic oppressive

experiences, and exposure to violence also fit within the exosystem. The microsystem is the most proximal and directly affects a child (Bronfenbrenner, 1979). This level encompasses the complex interactions between a child and his or her family environment.

To better understand relations between violence and child development it is crucial to examine the effects from multiple levels of societal functioning, including community and domestic conflict and psychological processes associated with violence exposure (Feerick and Prinz, 2003).

its concentration in poorer areas during prepubescence and in younger adulthood (parenting age) suggests that poorer children are exposed to much more aggressive communities. This is likely to contribute to the disproportionate escalation in violence they experience during adolescence. Effective interventions to prevent such escalations are available and need to be implemented particularly in poor communities.

Theoretical models need further development and testing. These models are needed for more compelling explanation on how and why exposure to violence affects child development at different levels (ie. Socially, emotionally, cognitively, neurologically). Such frameworks have the potential to better evaluate social, cultural, ethnic, and political contexts that are integral to understanding the impact of violence exposure (Feerick & Prinz, 2003).

Contextual theory attends to the influence from various contexts, especially the historical or socio-cultural climates. Ecological theory stresses the importance of various context or systems, including the Microsystems, mesosystems, exosystems and macrosystems. (internet cite)

Microsystems encompass a setting that includes where we live, our family, our schools, and our neighbourhoods. Mesosystems pertains to the interactions between experiences in the Microsystems. Exosystems are experiences in another social setting that we do not have an active role in, but that have an immediate influence on us. Community violence falls within this level. However, it is clear that even though at another the interrelatedness of its influence is not detached within the system.Macrosystems generally speaking is the culture in which we live.

The literature on community violence has shown that many negative outcomes are results from such exposure (Lynch, 2003, Stein, 2003 & Osofsky, 1999).

One suggestion for better examination of the effects of community violence is the use of longitudinal studies (Stein et. al). The researchers explained that the use of longitudinal studies would allow examination of the effects of violence on the developmental paths of children. Bearing in mind that the chronicity (when, how often, and over what time frame) of violence exposure may significantly influence a child's developmental trajectory longitudinal studies are essential to better understanding how early violence exposure relates to later violence exposure, symptoms development, school performance, violence perpetration, as well as other high risk behaviours (Stein et. al, 2003). This approach would tap into some levels of the systemic approach to examining the effects, but the interactions within and the influences of the macrosystem variables (poverty, lack of resources, socio-economic status, housing) are not factored here.

The Context for the individual

Exposure rates very high (Luthar & Goldstein, 2004)

Psychological effects

Among the psychological correlates of children's exposure to community violence are anxiety symptoms and disorders, depressive symptoms, academic failure, and school disengagement (Boyd, Cooley, Lambert & Ialongo, 2003 and Cooley-Quille, Boyd, Frantz, & Walsh, 2001)

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Diagram

The individual/Microsystem

PTSD

Post traumatic stress Disorder (PTSD) is the most common psychological impact identified in the field of literature. In one study the researcher explored the relationship between exposure to chronic community violence and the development of complex PTSD that occur as a result of repeated exposure to traumas (Jones, 2007)

Findings revealed despite community violence exposure was a daily part of living among the participants, formal kinship and spirituality, along with high levels of combined supports, demonstrated buffering effects on exposure to violence (Jones, 2007).

Psychological effects

Not surprisingly, many studies have demonstrated that exposure to community violence can be traumatic for children. Exposure to community violence has been positively correlated with symptoms of Posttraumatic Stress Disorder in children ranging in age from the early elementary years through adolescence (Fitzpatrick & Boldizar, 1993; Horowitz, Weine, & Jekel, 1995; Lynch & Cicchetti, 1998a). All forms of exposure appear to have some effect- hearing about violence in the community, witnessing it, and being personally victimized. However, chronic exposure to community violence and personal victimization by violence in particular may be especially relevant in the development of symptomatology (Lynch & Cicchetti, 1998a; Terr, 1991). Victimization by community violence has been shown to predict levels of traumatic stress even when demographic variables and prior symptomatology have been controlled (Lynch & Cicchetti, 1998a). In addition, victimization by community violence predicted symptoms of traumatic stress in a sample of urban children who had been maltreated by a caregiver, even after the effects of maltreatment severity were

Substance abuse

(Lynch, 2003)

Behavioural problems are also linked with exposure to community violence (Stein, 2003) Among these are externalizing problems and internalizing problems.

Notably, though there is a distinct association between behavioural problems and exposure to violence, the direction of that association is probably bi-directional. In essence, behavioural problems are simultaneously a predictor to exposure to violence and a result of exposure (Lynch, 2003).

Mesosystem

Similarly, exposure to community violence has been found to be associated with a wide range of serious problems that influence almost every area of a child's life. They include internalizing and externalizing problems, substance abuse, disturbances of cognition, poor peer relationships, lowered educational outcomes, and higher rates of juvenile justice offences (for reviews see Osofsky, Wewers, Hann, & Fick, 1993; Osofsky, 1995; Lynch, 2003).

Children are at high risk of for both internalizing and externalizing problems (Luthar & Goldstein 2004).

In the face of high community violence, positive family processes may have modest protective potential (Luthar & Goldstein 2004); in addition to PTSD and more modest ones with depressive symptoms.

Social Cognition

More urban youths have been caught in gun crossfire than non-urban adolescents ( 24% vs 4%; Schwarz, 1996). Reseachers have noted that low income communities are likely have higher rates of community violence with inner-city children at higher risk of being exposed to criminal offences (Jipguep & Sanders-Phillips, )  Robbery was an almost universal experience affecting children from all schools and socio-economic groups (Samms-Vaughan, Jackson, & Ashley, 200). The researchers explained that the high level of community violence in Jamaica is likely to expose Jamaican children to violence. Their study reported that a quarter of the children who completed given questionnaires had witnessed severe acts of physical violence such as robbery, shooting and gang wars, a fifth had been victims of serious threats or robbery and one in every twelve had been stabbed. The researchers recommended that intervention strategies to reduce children's exposure to violence should include community education on the impact of exposure to violence on children, and the development of a range of school-based violence prevention programmes (Samms-Vaughan et al, 2005). This suggestion clearly tracts an ecological approach and valuing the relevance of the exosystem.

Relationships/Mesosystem

Among families living in conditions of poverty, positive parenting, encompassing high monitoring, support and cohesiveness, can help children maintain adequate levels of adjustment, but even the "best" of families will be limited in shielding their children when living in neighbourhoods where violence is a constant fact of life (Luthar & Goldstein, 2004) This strengthens the point of the need for impacts of community violence not be evaluated in a piecemeal fashion, but as a cohesive whole system. For interventions the findings underscore the need to control violence in communities with efforts at both national policy and community levels addressing issues such as good control, neighbourhood, cohesiveness, communities and safety in schools (Luthar & Goldstein, 2004); in essence a systemic approach.

According to Pottinger, "Many children exposed to chronic violence in their community are also beaten regularly at home and school. Feelings of unworthiness, inferiority and low self-esteem were prevalent reports along with expressions of depression. Girls who were shunned or isolated from their peers and boys who were sexually abused were likely to report depression.

"Low self-esteem, identified more in our boys, may be reflecting the disenfranchisement of some children, as they learn from early that they are not worthy of being protected from violence. These students may then 'progress' to delinquent and aggressive behaviours during their adolescent years," Pottinger said.

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Peer Relations

Exsosystem

Repeated general population studies would allow us to better understand how children's exposure to violence is changing overtime (Stein et. al, 2003). The question here would be are community violence types different now. A clear answer would come from looking at the overall dynamics of interactions within each levels of the SEM. To reiterate, contextual factors are important in determining the impact of violence exposure on children (Stein et. al, 2003). This could be used to better inform violence prevention programmes for both schools and community, and to move the research field toward better science around the interplay between violence exposure, emotional and behavioural outcomes, the impact of prevention and intervention programmes, and needed changes in public policy (Stein et. al, 2003).

Educational Outcomes

Also reiterated are the impacts of community violence on education and leisure activities . When children experience violence at concentrated levels, in so many doses, and from so many directions, they are affected holistically- emotionally, psychologically and cognitively. This situation undermines their ability to be educated as well as access to education that is available (Crawford-Browne, 2010). It is common that children would miss school because community violence preventing them from doing so/ as a result of violence in communities children are often prevented from going to school or attending other leisure activities such as camp or after school programmes.

According to Gayle, United Nations research shows a direct correlation between spending on education and levels of crime.

"In the Caribbean, Barbados has the lowest violence and highest education. Haiti has the highest crime and the lowest education. One of the strategies to get people to participate less in crime is to educate them. Education leads to character building. At the same time, loss of revenue caused by crime means that less can be used on education," Gayle said.

Pauletta Chevannes, a lecturer in the Department of Education, University of the West Indies, noting that crime continues to impact greatly on the education system, insists that only with wider social change can the problem be solved.This wider change reiterates the argument of this paper that implementations has to consider the wider levels of the socio-ecological model.

microcosm

"The school is a microcosm of the society and a lot of the violence experienced in these schools is directly related to what is happening in society.

Juvenile justice outcomes

While risk of exposure to violence is higher among poor, densely populated urban areas, it is not restricted to this group. In addition, the effects of exposure to community violence on health and functioning are vast, particularly in vulnerable populations. Exposure to community violence was strongly related to PTSD, for both victim and witness had adverse mental health outcomes (Fowler, Tompsett, Braciszewski, Jacques-Tiura, & Bates, 2009). Personal and family contextual factors may protect an individual from the adverse impact of exposure to community violence (Gorma-Smith, Henry, & Tolan, 2004)

Exposure to community violence does not occur in isolation. Further research needs to be conducted on social, environmental and contextual factors that protect vulnerable populations, such as women, adolescents and children from adverse outcomes related to violence (Aisenberg & Herrenkohl, 2008).

Despite these tremendous stressors, some children appear to be less affected than others (Barbarin, 1993; Barbarin, Richter, & deWet, 2001). Coping mechanisms enmeshed in family and peer support are protective factors (Jones, 2007).

Macrosystem

Many children and adolescents in America continue to be exposed to many types of community violence. Some factors such as sex, age, race and socioeconomic status are associated with higher rates of exposure. Community violence affects children from all backgrounds and communities (Stein, Jaycox, Kataoka, Rhodes, & Vestal, 2003).

The whole system is interrelated. Multiple risk factors such as poverty, overcrowding, inadequate medical care, scarcity of community resources, and parental problem all contribute to the strain within the exo-system within the context of development.

It is important to examine the challenges victims and perpetrators may have. However, to widen understanding of effects of chronic violence on children focus need also be place on the "ripple effects" of the psychological impacts on children who are affected indirectly (Osofsky, 1999).

From a prevention and intervention the most significant implication drawn from the body of literature is that in prevention efforts, the primary focus must be on the environment rather than the individuals experiencing the violence (Gorman-Smith et. al, 2003 and Luthar & Goldstein 2004)However both environment and individual factors need to be focused on in tandem as both are equally important in dealing with the crux of the matter in making informed and balanced interventions. The highest recommendation is the prevention of community violence (Luthar & Goldstein, 2004). Targeting the issue of community violence as a whole from an ecological model perspective is the more probable successful way to tap every domain that influence its pervasiveness.

UNICEF's office in Jamaica estimates that violence costs the country over US$236 million or JA$15 billion annually.

IN LOCAL communities affected most by violence, economic and social activities have been considerably reduced. Schools are underpopulated and when there is a flare-up of violence businesses, as well as schools close, the Statistical Institute of Jamaica (STATIN) stated in a 2007 report on violence and its costs.

Audrey Pottinger, a consultant clinical psychologist at the Department of Child Guidance attached to the University of the West Indies said that the most frequent and traumatizing experiences students have are cruel tea-sing or verbal humiliation, followed by robbery and physical attack. She was making reference to a recent study done with a sample of more than 200 students from primary and secondary schools.

Meanwhile, Dr Herbert Gayle, University of the West Indies-based anthropologist who produced the recent study on early training of males in criminal behaviour, suggested that the Government should invest more in education as one means of reducing crime. (Jamaica's Burden of crime, 2009).

The consequences of community violence interrelatedness and broad propensity cannot be overemphasized. Consequences of not providing the necessary preventative, ameliorative or rehabilitative services will put additional strain on Jamaica's economy in terms of Jamaican dollars needed. Apart from the negative emotional health impact on the nation, the quality of life of the citizens will remain at continued risk (Crwaford-Browne, 2010).

Macro implications of the impact of violence are insidious. Children develop dysfunctional interpersonal patterns in their relationships as it relates to violence and understanding their world.

Psychological impacts through overexposure and trauma is difficult to quantify and this presents far-reaching limitations. Evaluating the system as a whole from the ecological model perspective ease this challenge as factors from the varying levels of the model can be targeted to cushion insidious effects of community violence.

Recommendations

Feerick and Prinz posited that specific issues for research issues in relation to community violence need to be probed (2003). Suggested issues include consequences of co-occurring risk factors, mediators, moderators and mechanisms. The premise of this review cautions this "specific issues" approach from the perspective that issues should not be investigated in a detached fashion, but rather enmeshed.

Violence Prevention

There are individual and community approaches to violence prevention (World Health Organization, 2002). On an individual level, public health authorities should encourage healthy behaviours that do not include violence as well as educating individuals in order to persuade them to change violent behaviours. In the community there are many opportunities to raise public awareness and stem community violence. Advocating for policy changes that address larger environmental issues (See Logsdon, 2010). Only with change that address the issue of community violence from the dimensions of the socio-ecological model- in making informed planning and implementing with regard to prevention and intervention programming.

Summary/Conclusion

This paper seeks to provide an overview of the current literature regarding effects exposure to community violence on children in systemic framework, and to identify the interrelatedness of the impacts at all levels on the social ecological model. In addition, recommendations are made that prevention and intervention programs use this systemic approach to better address and curtail the impacts of community violence.

Violence in its various forms have been taking a heavy toll on the physical, emotional and mental health of Jamaican children, who exhibit symptoms of depression, PSTSD, aggressive impulsive behaviour, difficulty concentrating, bedwetting, and attachment problems. It is important to note that many of these symptoms exist within the context of unstable familial environments and are factors that are associated with aggressive and delinquent behaviours (Samms-Vaughan, 2005), further fuelling our present endemic of violence (Crawford-Browne, 2010).

Poor quality of life and marginalization are some social impact of chronic violence exposure (Crawford-Browne, 2010). The researcher expounded that children get caught in the symbolic net of the different forms of violence which interact with each other with gruesome consequences. In explaining further, it is noted that the different types of violence emanates and ricochet from the various systems that interface and intercedes. The impact from a systemic level is quite distinct here. Clear it is that the child's experience here at all levels, the home, family, communities and society are impacted (Crawford-Browne, 2010).

Peer Relations

Community violence as daily variable offers negative role models that place of the government and community-building organizations (Crawford-Browne, 2010). Role models as such are the perennial figures of a "Community Don" or notorious gang leader. These negative role models act as agent of socialization.

Hypthesis