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Researchers examine the effects of family and community violence and risky behaviors on children and adolescents

Young people living in impoverished neighborhoods often are the victims of community violence, and sometimes they themselves are the perpetrators. For example, an estimated 10 million children in the United States witness the punching, kicking, and beating of a parent, usually their mother, each year. Some adolescents experiment with drugs or alcohol, or they engage in sexual activity or other risky behaviors. Two recent studies that were supported in part by the Agency for Healthcare Research and Quality examined the effects of violence on youths and families, and a third study looked at ways to reduce risky behaviors among adolescents. The three studies are summarized here.

McFarlane, J.M., Groff, J.Y., O'Brien, J.A., and Watson, K. (2003, September). "Behaviors of children who are exposed and not exposed to intimate partner violence: An analysis of 330 black, white, and Hispanic children." (AHRQ grant HS11079). Pediatrics 112(3), pp. e202.

This study found that children of abused mothers had far more behavior problems, anxiety, depression, and withdrawal than other children. As part of a study on treatments for abused women seen in urban primary care public health clinics, 258 abused mothers completed the Child Behavior Checklist (CBCL) for one of their children aged 18 months to 18 years. Sixty-nine percent of the children were Hispanic, and nearly half came from households with annual incomes below $10,000. An ethnically similar sample of 72 mothers who had not been abused also completed the CBCL (control group), and scores from the two groups were compared.

The CBCL asked about children's behaviors such as getting into fights, skipping school, cruelty to animals, physical attacks on people, and not wanting to sleep alone. Overall, children aged 6 to 18 years with abused mothers had significantly higher internalizing (anxiety, depression, and withdrawal), externalizing (attention problems, aggression, and rule-breaking), and total behavior problem scores than children in the control group. Doctors can use this information to talk with abused mothers about the potential effects of the abuse on their children's behavior. Early detection and treatment for intimate partner violence against women has the potential to interrupt and prevent behavioral problems for their children, conclude the researchers.

Howard, D.E., Kaljee, L., Rachuba, L.T., and Cross, S.I. (2003). "Coping with youth violence: Assessments by minority parents in public housing." (AHRQ grant HS07392). American Journal of Health Behavior 27(5), pp. 483-492.

Black parents in four Baltimore public housing projects live in constant fear of violence against their children, and they have developed several ways for coping with the dangers in their community, according to this study. Investigators analyzed audiotapes of focus group discussions with 38 predominantly black parents of adolescent children (aged 10 to 16 years) who resided in these public housing projects, in order to develop a community-based violence prevention program. They asked parents about their children's exposure to and distress from violence, their assessment of community resources, and strategies they used to protect their children from violence.

Parents cited violence from drug trafficking as the most pervasive neighborhood threat, as well as the easy accessibility of guns on street corners and from car trunks. They were bothered that children were often the first ones to arrive at a courtyard or field and see a dead body, by their chronic exposure to the sound of gunfire, and by their children's fear of being hit by a stray bullet. Most parents adopted a state of hypervigilance and responded to their fears with the resources available to them.

Some of the parents took their children away from the housing development in the summer. For after school care, some parents left their children in the care of family or friends in less dangerous neighborhoods. Others spoke of putting bars on their windows and active attempts to take back their buildings and neighborhoods. Parents looked for signals that children were fearful, such as not leaving the house. They spoke of the need to establish a reasonable curfew, to have children inside when it got dark, and in some cases, parents frisked their children for weapons. Parents sought community support from police and city agencies, but these pleas for assistance often proved futile.

Rai, A.A., Stanton, B., Wu, Y., and others (2003, August). "Relative influences of perceived parental monitoring and perceived peer involvement on adolescent risk behaviors: An analysis of six cross-sectional data sets." (AHRQ grant HS07392). Journal of Adolescent Health 35(2), pp. 108-118.

Parental monitoring can have a protective influence on substance use and sexual activity during mid-adolescence, conclude these authors. The investigators surveyed 1,279 low-income black youths (aged 13 to 16 years) who were involved in urban community-based studies that were conducted from 1992 to 1999. The young people were asked about their risk behaviors during the past 6 months and their perceptions of parental monitoring and peer involvement in risk behaviors. Risk behaviors included sexual experience, condom use, violence (fighting, beating), smoking cigarettes, drinking alcohol, using marijuana, selling drugs, and delivering drugs.

Survey results showed a significant increase with age in adolescent sexual activity, smoking, alcohol use, marijuana use, and drug selling. For example, 75 percent of 16-year-olds were sexually active compared with 36 percent of 13-year-olds, and marijuana use increased from 8 percent among 13-year-olds to 33 percent among 16-year-olds. Girls and 13-year-olds perceived greater parental monitoring of their behavior.

There was an overall negative association between perceived parental monitoring (parents usually knew where they were and with whom) and risky behavior among the youths. Parental monitoring had a protective influence on substance use behaviors and sexual activity, but it had no impact on condom use or drug trafficking. Youths who perceived high levels of peer involvement in a behavior (whether high-risk or protective) were more likely to report that behavior.

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