Exposures to Violence and Trauma among Children and Adolescents in Our Global Society

doi:10.4236/psych.2013.42019

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Psychology

2013. Vol.4, No.2, 133-135

Published Online February 2013 in SciRes

(http://www.scirp.org/journal/psych) http://dx.doi.org/10.4236/psych.2013.42019

Exposures to Violence and Trauma among Children and

Adolescents in Our Global Society

Clarissa Agee Shavers

The Safer Tomorrows: Inju ry Prevention and Violence Reduct i o n Project©, Primary Care Office,

Detroit, USA

Email: [email protected]

Received July 1st, 2012; revised N ovember 6th, 2 01 2 ; a c c e p te d D e c ember 12th, 2012

Globally, hundreds of children and adolescents witness acts of violence and trauma on a daily basis. No-

tably, children and adolescents exposed to violence and trauma may display mild-to-severe psycho-social-

emotional and mental health care problems. Also, exposures to violence and trauma among children and

adolescents have resulted into an alarming global health care issue for our society. All health care provid-

ers (HCP’s) must continue to actively engage in early identification, screening, assessing, and treating

children and adolescents who self-disclose exposures to violence and trauma.

Keywords: Children; Adolescents; Violence; Trauma; Health Care Providers

Exposures to various forms of violence including homicide

and trauma among children and adolescents (youth) have re-

sulted in a significant burden on our global society (Shavers,

2009; Pinheiro, 2006; Fraser, 2012). Similarly, these reported

occurrences of exposures to violence and trauma among chil-

dren and youth remains to be an escalating or spiraling global

public health concern (Shavers, 2010). On a global scale, inves-

tigators have reported that thousands of youth report witnessing

or experiencing various acts related to violence and trauma on a

daily basis (Vernberg, Nelson, Fonagy, & Twemlow, 2011;

Children’s Defense Fund, 2012; World Health Organization,

2009). In fact, according to the aforementioned reports, glob-

ally, mortality and morbidity rates associated with exposures to

violence and trauma among children and youth have resulted in

a growing serious public health concern.

In addition, many investigators have denoted that with the

ongoing prevalence and incidence of exposures to various

forms of violence and trauma among children and youth may

result in serious threats to their overall psycho-social-emotional,

mental, and physical health including adverse long-term or

chronic effects (Cisler, Amstadter, & Nugent, 2011; Nader,

2011; Penn State, 2012; Felitti et al., 1998). Likewise, research

has shown that children and youth who self-disclose exposures

to violence and trauma either directly or as witnesses may be

at-risk for experiencing psycho-social-emotional and mental

health care issues including post-traumatic stress disorder (PTSD)

or post-traumatic stress symptomatology (Cook et al., 2007;

Shavers et al., 2005a; Task Force on Community Preventive

Services, 2008). Also, even more devastating is the fact that the

emotional trauma that may occur after a traumatic or violent

injury may place the survivor (i.e. child or youth) at an in-

creased risk for future injury, substance abuse and subsequently

death (Finkelhor et al., 2009). Further, studies have reported

that childhood or adolescent exposure to violence, victimization

(i.e. bullying) and traumatic events have been associated with

suicidal ideation among children and youth (Klo mek, So ur an der ,

& Gould, 2012; Turner et al., 2012).

Similarly, evidence suggests that children and youth exposed

to witnessing of violent and traumatic events in the home in-

cluding Domestic Violence (DV) or Intimate Partner Violence

(IPV) and/or in the community may also experience psycho-

social-emotional, mental, and physical symptomatology (Holt,

Buckley, & Whelan, 2008; McDonald & Richmond, 2008;

Jaycox et al., 2010). Moreover, children and youth of battered

or abused women have been noted to be significantly impacted

by exposure to episodes of violence and trauma in the home

(Shavers et al., 2005b). For much of the noted research reported

has identified that witnessing violence and trauma (i.e. DV or

IPV or Family Violence) in the home by children and youth

may significantly impact their overall psycho-social- emotional

health including their memory of these events or experiences

(Shavers et al., 2005b; Cloitre et al., 2010). Further, the f i n di n gs

from the literature has also identified that children and youth

witnessing violence or trauma in the home or other traumatic

interpersonal events have been found to manifest symptoms of

depression which may lead them to experience suicidal ideolo-

gies, cognitive deficits in attention and memory, anxiety and

sleep disorders, aggression and feelings of sadness, loss, and

anger (Cohen & Walthall, 2003; Schwarz, 2009; Fletcher,

2011).

While not all children and youth who self-report exposures to

violence and trauma may need health care intervention to effec-

tively deal with the aftermath of victimization or traumatization,

there are still a number of children and youth who will need to

receive appropriate health care intervention to help them heal

from such events. Thus, Health Care Providers (HCP’s) are in a

unique position to play a significant role in reducing the inci-

dence of violence, violent-related injuries or acts and adverse

traumatic events among this population. Similarly, not all chil-

dren or youth may self-disclose exposures to violence and

trauma for various reasons including fear (Shavers et al.,

2005b). Therefore, it is utmost importance that HCP’s be ac-

tively involved in measures that will allow early detection,

intervention, and treatment as indicated.

C. A. SHAVERS

Likewise, HCP’s should be aware of the fact that exposures

to various forms of violence and trauma occur among children

and youth from all socioeconomic, ethnic, religious and cultural

backgrounds (Shavers, 2009). Furthermore, HCP’s should

know and understand the ethnic and cultural attitudes, feelings,

values, beliefs, and behaviors in response to reported exposures

to various forms of violence and trauma among children and

youth in the communities that they serve or provide health care

in order to be effective in meeting the needs of their patients or

clients and in an effort to be culturally sensitive. Equally,

HCP’s should be cognizant of the fact that exposures to vio-

lence or acts related to violence and trauma among children and

youth are common health care problems and concerns. In addi-

tion, HCP’s should recognize that exposures to violence and

trauma among children and youth may pose as risk factors for

psycho-social-emotional, mental, and physical health care prob-

lems.

Further, HCP’s are in a key position to screen, recognize, and

assess for exposures to violence and trauma among children,

youth, and their families. Also, HCP’s need to provide and have

readily available a variety of resources including community-

based, as well as, evidence-based resources that will promote a

sense of health, safety and security, support, and advocacy for

children and youth who disclose or are at-risk for exposures to

violence and trauma. In the same way, HCP’s need to know the

local or governmental existing laws and procedures for report-

ing to respective authorities’ children and youth who self-report

or are at-risk for exposure to violence and trauma to ensure

their safety. Finally, HCP’s should work towards empowering

children and youth to effectively address the issues of violence

and trauma in their young lives.

So in summary, forlornly, exposures to various forms of vio-

lence and trauma among today’s children and youth have been

noted to be a serious threat to their psycho-social-emotional,

mental, and overall physical health and wellbeing. Similarly,

exposures to various forms of violence and trauma among to-

day’s children and youth cross all socioeconomic statuses, reli-

gious, ethnic-cultural, and geographical milieu (Shavers, 2009).

Hence, HCP’s should be cognizant of the fact that voluntarily

or non-voluntarily self-reports of exposures to various forms of

violence and trauma among children and youth are inevitable.

Therefore, it is absolutely imperative that HCP’s routinely

screen, early identify, assess, and appropriately treat those chil-

dren and youth who self-report exposures to violence and

trauma in an effort to possibly circumvent or alleviate the pre-

viously noted adverse psycho-social-emotional, mental health

and physical consequences.

Thus, in conclusion, it is of essence that HCP’s should be

cognizant of the actual, probable or potential detrimental im-

pact of exposures to various forms of violence and trauma

among children and youth in our global society. Moreover,

HCP’s are called to be proactively involved in all endeavors to

promote the psycho-social-emoti onal, mental, physical and ov er-

all well-being of children and youth who disclose actual, pre-

vious or past, and probable or potential exposures to various

forms of violence and trauma in our global society. This may be

accomplished by HCP’s incorporating routine screening, early

identification, assessment, and appropriate therapeutic treat-

ment modalities. Finally, one must remember that the future

rests with our children and youth and therefore, the best ap-

proach on their behalf should be health promotion and preven-

tion of exposures to violence and adverse traumatic events.

Acknowledgements

This article was supported by an academic publication grant

from the Text and Academic Authors Association Inc. (TAA)

URL:

http://www.taaonline.net/membersonly/publication_grants/inde

x.html. Also, the author would like to acknowledge the follow-

ing membe rs of T he Safer Tomorrows Project Research Team©:

C.A. Archer-Gift, Ph.D., L.M. Green, M.A., L.L.P.C., B.S.W.,

J.E. Onyskiw, Ph. D. and M. Price, Ph.D. for their assistance

and dedication to our mission and vision.

REFERENCES

Children’s Defense Fund (2012). Protect children, not guns 2012.

Washington, DC: Children’s D ef en se F und .

Cisler, J. M., Amstadter, A. B., & Nugent, N. R. (2011). Genetic and

environmental influences on posttrauma adjustment in children and

adolescents: The role of personality constructs. Journal of Child &

Adolescent Trauma, 4, 301-317. doi:10.1080/19361521.2011.609154

Cloitre, M., Stovall-McClough, K. C., Nooner, K., Zorbas, P., Cherry,

S., Jackson, C. L. et al. (2010). Treatment for PTSD related to child-

hood abuse: A randomized controlled trial. American Journal of

Psychiatry, 167, 915- 924. doi:10.1176/appi.ajp.2010.09081247

Cohen, E., & Walthall, B. (2003). Silent realities: Supporting young

children and their families who experience violence. Washington,

DC: National Child Welfare Resource Center for Family-Centered

Practice.

Cook, A., Spinazzola, J., Ford, J., Lanktree, C., Blaustein, M., & Spra-

gue, C. (2007). Complex trauma in children and adolescents. Focal

Point, 21, 4-8.

Felitti, V., Anda, R., Nordenberg, D., Williamson, D., Spitz, A., Ed-

wards, V. et al. (1998). Relationship of childhood abuse and house-

hold dysfunction to many of the leading causes of death in adults:

The adverse childhood experiences (ACE) study. American Journal

of Preventive Medicine, 14, 245-257.

doi:10.1016/S0749-3797(98)00017-8

Fin k e l h o r , D . , T u r n e r , H., O rmro d, R . , H amb y, S., & Kracke, K. (2009).

Children’s exposure to violence: A comprehensive national survey.

Washington, DC: US Department of Justice, Office of Justice Pro-

grams, Office of Juvenile Justice and Delinquency Preven t i on.

Fletcher, K. E. (2011). Understanding and assessing traumatic re-

sponses of guilt, shame, and anger among children, adolescents, and

young adults. Journal of Child & Adolescent Trauma, 4, 339-360.

doi:10.1080/19361521.2011.623146

Fraser, B. (2012). (World Report). Latin America looks to violence

prevention for answers. The Lancet, 380 (9850), 1297-1298.

doi:10.1016/S0140-6736(12)61745-0

Holt, S., Buckley, H., & Whelan, S. (2008). The impact of exposure to

domestic violence on children and young people: A review of the lit-

erature. Child Abuse & Neglect, 32, 797-810.

doi:10.1016/j.chiabu.2008.02.004

Jaycox, L. H., Cohen, J. A., Mannarino, A. P., Walker, D. W., Langley,

A. K., Gegenheimer, K. L. et al. (2010). Children’s mental health

care following hurricane Katrina: A field trial of trauma-focused

psychotherapies. Journal of Traumatic Stress , 23, 223-231.

Macdonald, C. C., & Richmond, T. R. (2008). The relationship between

community violence exposure and mental health symptoms in urban

adolescents. Journal of Psychiatric Mental Health Nursing, 15, 833-

849. doi:10.1111/j.1365-2850.2008.01321.x

Klomek, A. B., Sourander, A., & Gould, M. S. (2011). Bullying and

suicide: Detection and intervention. Psychiatric Times, 28. URL (last

checked 4 December 2012).

http://www.psychiatrictimes.com/print/article/10168/1795797?printa

ble=true

Nader, K. (2011). The assessment of associated features important to

understanding childhood trauma. Journal of Child & Adolescent

Trauma, 4, 259-273. doi:10.1080/19361521.2011.614923

Penn State (2012). Exposure to violence has long-term stress effects

134

C. A. SHAVERS

among adolescents. Science Daily. URL (last checked 4 December

2012).

http://www.sciencedaily.com/releases/2012/07/120703162630.htm

Pinheiro, P. S. (2006). World report on violence against children. Ge-

neva: United Nations.

Schwarz, S. W. (2009). Adolescent mental health in the United States:

Facts for policymakers. New York: National Center for Children in

Poverty (NCCP) Mailman School of Public Health Columbia Uni-

versity.

Shavers, C. A. (2009). (Commentary). Minimize the impact of violence

for youth. The Clinical Advisor: A Forum for Nurse Practitioners,

74.

Shavers, C. A. (2010). (Point of View). Promoting the health of chil-

dren and adolescents exposed to trauma and violence. Primary Is-

sues™. URL (last checked 9 February 2013).

http://www.primaryissues.org/2010/09/

Shavers, C. A., Levendosky, A. A., Dubay, S. M., Basu, A., & Jenei, J.

(2005b). Domestic violence research: Methodological issues related

to a community-based intervention with a vulnerable population.

Journal of Applied Biobehaviora l Research, 10, 27-38.

doi:10.1111/j.1751-9861.2005.tb00002.x

Shavers, C. A., Levendosky, A. A., Dubay, S. M., Basu, A., Malone, J.,

Thomas, B., & Rostant, O. S. (2005a). Child witnesses of domestic

violence: Suffering in silence (unpublished manuscript).

Task Force on Community Preventive Services (2008). Recommenda-

tions to reduce psychological harm from traumatic events among

children and adolescents. American Journal of Preventive Medicine,

35, 314-316. doi:10.1016/j.amepre.2008.06.025

Turner, H. A., Finkelhor, D., Shattu c k, A., & Hamby, S. (2012). Recent

victimization exposure and suicidal ideation in adolescents. Archive

of Pediatric Adolescent Medicine (in press), E1-E6. URL (last

checked 29 November 2012). http: //archpedi.jamanetwork.com/

Vernberg, E. M., Nelson, T. D., Fonagy, P., & Twemlow, S. W. (2011).

Victimization, aggression, and visits to the school nurse for somatic

complaints, illnesses, and physical injuries. Pediatrics, 127, 842-848.

doi:10.1542/peds.2009-3415

World Health Organization (2009). Violence prevention: The evidence.

Geneva: World Health Organization.