Princeton University

The Impact of Violence on Children

Author(s): Joy D. Osofsky
Source: The Future of Children, Vol. 9, No. 3, Domestic Violence and Children (Winter, 1999),
pp. 33-49
Published by: Princeton University
Stable URL: http://www.jstor.org/stable/1602780 .
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 33

The Impact of Violence

on Children
JoyD.Osofsky

Abstract
Existing research on the effects of children's exposure to violence covers a broad
range of community, family, and media violence. This research is relevant and useful Joy D. Osofsky,Ph.D.,
to an examination of domestic violence in two key ways. First, understanding how is a professorof public
exposure to various types of violence affects children and what best enables them to health,psychiatry,and
cope can point to important considerations when trying to help children cope with pediatricsat Louisiana
StateUniversity Health
exposure to domestic violence in particular.And second, many families experiencing
domestic violence are exposed to other types of violence as well. Exposure to violence SciencesCenteter
on multiple levels can affect the parents' behavior and can compound the effects on
children.
This article begins with an overview of the extent of children's exposure to various
types of violence, and then examines what is known about the effects of this exposure
across the developmental continuum. Key protective factors for children exposed to
violence are examined. Research indicates that the most important resource protect-
ing children from the negative effects of exposure to violence is a strong relationship
with a competent, caring, positive adult, most often a parent. Yet, when parents are
themselves witnesses to or victims of violence, they may have difficulty fulfilling this
role. In the final section, directions for future research are discussed.

ncreasinglyoverthe pastdecade,violencein the United Stateshas been

characterized as a "public health epidemic."' Children are exposed to
violence in their communities, in their families, and in the media.
According to the NationalSummaryoflnjuryMortalityData, the homicide rate
among young people ages 15 to 24 has more than doubled since 1950, up
to a rate of 37 homicides per 100,000 in 1991.2Despite the recent declines
in crime rates, the homicide rate among males 15 to 24 years old in the
United States is 10 times higher than in Canada, 15 times higher than in
Australia,and 28 times higher than in France or in Germany.3Only in some
developing countries in South America such as Colombia and Brazil,and in
actual war zones, is there a higher homicide rate among young males than
in the United States.Violent behavior, including physical, sexual, and emo-
tional abuse, also occurs frequentlywithin U.S. families. In some areas,more
than half of the calls for police assistance are for domestic disturbances.4

TheFutureof Children DOMESTIC

VIOLENCE Vol. 9 * No. 3 - Winter1999
ANDCHILDREN

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34 THEFUTURE - WINTER
OFCHILDREN 1999

Finally,the content of American media is the most violent in the world.5

Both real and manufactured images of violence bombard youths through
television, the cinema, and the Internet.

tims of physicalabuse by their parents.12In

Children'sExposure homes where domesticviolence occurs, chil-
to Violence dren are physicallyabused and neglected at
The extent of children's exposure to dif- a rate 15 times higher than the national
ferent types of violence varies. Some chil- average.4Severalstudies have found that in
dren, especially those living in low-income 60% to 75% of familiesin which a woman is
areas, experience "chronic community vio- battered, children are also battered.'s (The
lence"-that is, frequent and continual articleby Fantuzzoand Mohr in thisjournal
exposure to the use of guns, knives, drugs, issue discusses in greater detail the preva-
and random violence in their neighbor- lence and effects of children's exposure to
hoods. It is now rare in urban elementary domestic violence.)
schools notto find children who have been
exposed to such negative events. Children Exposure to violence in the media-
interviewed in studies throughout the through television, the cinema, and the
country tell stories of witnessing violence, Internet-touches virtually every child.
including shootings and beatings, as if Though often quoted, the statisticsfrom the
they were ordinary, everyday events (see American Psychiatric Association bear
Box 1). repeating: The typical American child
watches28 hours of televisiona week, and by
Exposure to community violence occurs the age of 18 will have seen 16,000 simulated
less frequentlyfor children who do not live murders and 200,000 acts of violence.14
in lower socioeconomic neighborhoods, Commercial television for children is 50 to
but exposure to family and media violence 60 times more violent than prime-timepro-
crosses socioeconomic and cultural bound- gramsfor adults,and some cartoonsaverage
aries, occurring in all groups within our more than 80 violent acts per hour.With the
of
society.6It has been estimated that between advent of videocassettesales and rentals
25% and 30% of American women are movies, pay-per-viewTV, cable TV, video
beaten at least once in the course of inti- games, and online interactive computer
mate relationships.7Women are more likely games, manymore children and adolescents
than men to be injuredand require medical are exposed to media with violent content
assistanceas a result of physicalviolence by than ever before.
an intimate partner, and their injuries are
likelyto be underreported.8Estimatesof the Exposure to violence can have signifi-
prevalenceof such violence vary,depending cant effects on children during their devel-
on the definitions of abuse and samples opment and as they form their own
studied. One study estimated that more intimate relationships in childhood and
than 3% (approximately 1.8 million) of adulthood. The following section discusses
women were severelyassaultedby male part- the growing number of studies on the
ners or cohabitants over the course of a effects of community violence, along with
year,9while other studies indicate the per- key findings from the literature on the
centage of women experiencing dating vio- effects of family and media violence on
lence, including sexual assault, physical children.
violence, or verbal or emotional abuse,
ranges as high as 65%.10Estimates show Behavioral and Emotional
that more than 3.3 million children witness
physical and verbal spousal abuse each Effectsof Exposure
year, including a range of behaviors from The number of studies on the impact of
insults and hitting to fatal assaults with children's exposure to violence is still rela-
guns and knives.11 tively limited due to various difficulties in
conducting research on behavioral and
Estimates also indicate that as many as emotional effects. For example, such
three million children themselves are vic- research often poses ethical difficulties if

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TheImpactof Violence on Children 35

Box1

Snapshotsof Children'sExposureto Community

Violence
In New Haven, Connectict, a 1992 survey of 6th, 8th, and 10th graders found that
very few were able to avoid being exposed to violence. Among these inner-citychil-
dren, 40% reported witnessing at least one violent crime in the past year, and almost
all eighth graders knew someone who had been killed in a violent incident.'
On theSouthsideof Chicago,Ilinois, surveysconducted in 1985 found that among 500
elementary school students, one in four had witnessed a shooting and one-third had
seen a stabbing.2 Among 200 high school students, almost two-thirds had seen a
shooting and close to one-half had seen a stabbing.3Three in five of those who wit-
nessed a shooting or stabbing indicated the incident resulted in a death. More than
one-fourth of these young people reported on the survey that they had themselves
been victims of severe violence-that is, they had been shot at, suffered a knife
attack, or been beaten or mugged.
In Boston,Massachusetts,a 1993 surveyof parents at a public hospital indicated 1 out
of every 10 children under the age of six had witnessed a shooting or stabbing.4
In Washington, D.C., a 1993 surveywas conducted with 165 mothers of children, ages
6 to 10, living in a low-income neighborhood characterized by police statistics as
having a moderate level of violence--where there might be an occasional murder
or violent incident, but such incidents were not a weekly event. The mothers sur-
veyed reported that 32% of their children had been victims of violence, ranging
from being chased or beaten to having a gun held to their head. They also reported
that 61% of their children in grades one and two, and 72% of their children in
grades five and six, had witnessed violence.5 Interviews directly with the children
indicated that the level of exposure may have been even higher.
In New Orleans,Louisiana, a 1993 study gathered interview data from 53 African-
American mothers of children, ages 9 to 12, in a low-income neighborhood char-
acterized by police statisticsas having a high level of violence-where a murder or
more than one violent incident occurred on a weekly basis. The study found that
51% of the children had been victims of, and 91% had been witnesses to, some type
of violence.6 When the children were asked to draw pictures of "whathappens" in
their neighborhoods, they drew in graphic detail pictures of shootings, drug deals,
stabbings, fighting, and funerals, and reported being scared of the violence and of
something happening to them.7

Endnotes
I Marans,S., and Adelman, A. Experiencingviolence in a developmental context. In Childrenin a violentsociety. J.D.
Osofsky,ed. New York:GulifordPress,1997;Marans,S., and Cohen, D. Childrenand Inner-cityviolence: Strategiesfor
intervention.InPsychological effects of war and violence on children.L.Leavittand N. Fox,eds. Hillsdale,NJ:
Lawrence Eribaum,1993, pp. 281-302.
2 Bell,C.C, and Jenkins,E.J.Communityviolence and childrenon
Chicago's Southside. Psychiatry(1993) 56:46-54.
3 Jenkins,E.J.,and Bell,C.C. Exposureand response to communityviolence among childrenand adolescents. In
Childrenin a violentsociety. J.D. Osofsky,ed. New York:GulifordPress,1997;Jenkins,E.J.Violence exposure, psycho-
logical distressand riskbehaviors Ina sample of inner-cityyouth. In Trends,risks,and Interventions:Proceedings of the
ThirdAnnual SpringSymposiumof the Homicide WorkingGroup.R.Blockand C. Block eds. Washington,DC:U.S.
Department of Justice, 1995.
4Groves, B.,Zuckerman,B., Marans,S., and Cohen, D. Silentvictims:Childrenwho witnessviolence. Journalof the
AmericanMedicalAssociation
(1993)269:262-64.
5 Richters,J.E.,and Martinez,P. The NIMHcommunity violence project:1.Childrenas victimsof and witnesses to vio-
lence. Psychiatry(1993) 56:7-21;Richters,J.E.Communityviolence and children'sdevelopment: Towarda research
agenda for the 1990s.Psychiatry(1993) 56:3-6.
6 Osofsky,J.D.,Wewers,S., Hann, D.M.,and Fick A.C. Chroniccommunityviolence: What Is
happening to our chil-
dren? Psychiatry(1993) 56:36-45;Fick A.C., Osofsky,J.D., and Lewis,M.L.Perceptions of violence: Children,parents,
and police officers.in Childrenin a violent soclety. J.D. Osofsky,ed. New York:GuilfordPress,1997.
7 Lewis,M., Osofsky,J.D., and Moore, M. Violentcities, violent streets:Childrendraw their neighborhoods. In ChildrenIn
a violentsociety. J.D. Osofsky,ed. New York:GuillfordPress,1997.

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36 THEFUTURE - WINTER
OFCHILDREN 1999

it is to include a comparison or control discussed further below, these symptoms

group of children who are exposed to vio- varyby age, but include nightmares, clingi-
lence and not provided servicesto help mit- ness to parents or caregivers,fear of natural
igate this exposure. Also, research in this exploring beyond their immediate environ-
area often includes the collection of quali- ment, a numbing of affect, distractibility,
tative data through focus groups and inter- intrusive thoughts, and feelings of not
views to augment the quantitativedata on belonging. Whether a child's exposure to
child outcomes and help gauge the impact violence leads to withdrawalor to increased
of community-based interventions. While aggression and violence is likely to depend
the qualitative accounting of feelings and on a varietyof factors, including the age at
events may be the most meaningful way to which the traumaoccurred, the supportsin
assess change, the collection of such data the environment, and the characteristicsof
from many individuals in the child's world the child.'s
(parents, caregivers, teachers, police offi-
cers) takes more time than collecting quan- Developmental in
Differences
titative measures on children at one time the Effectsof Exposure
While children are affected by violence
exposure at all ages, less is known about the
Infantsand toddlerswho witnessviolence consequences of exposure at younger ages,
in theirhomesor communityshow especially any long-term consequences.
Many people assume that very young chil-
excessiveirritability,immaturebehavior, dren are not affected at all, erroneously
sleepdisturbances,emotionaldistress, believing that they are too young to know
or remember what has happened. In fact,
fears of beingalone, and regressionin however, studies indicate that there are
toiletingand language. links between exposure to violence and
negative behaviors in children across all
age ranges.
period, and may be difficult to conduct sys-
tematically and yet with sensitivity to the andToddlers
Infants
children, families, and the community. In Even in the earliestphases of infant and tod-
addition, unless researchers are experi- dler development, existing research indi-
enced in collecting such data, it may be dif- cates there are clear associations between
ficult for them to listen to the children's exposure to violence, and emotional and
stories, which are often horrendous. behavioral problems. Infants and toddlers
who witness violence either in their homes
Despite the limited researchin this area, or in their community show excessive irri-
however, much can still be gleaned from tability, immature behavior, sleep distur-
existing studies about the effects of chil- bances, emotional distress, fears of being
dren's exposure to violence. The literature alone, and regression in toileting and lan-
on familyviolence identifies adverse effects guage.'9 Exposure to trauma,especiallyvio-
on children's physical, cognitive, emo- lence in the family,interferes with a child's
tional, and social development. Studies on normal development of trust and later
the effects of exposure to media violence exploratory behaviors, which lead to the
also indicate an increase in negative behav- development of autonomy.20Recent reports
iors. More recently,there has been increas- have noted the presence of symptoms in
ing interest in the effects of violence on these young children very similar to post-
children living in urban areas who are traumatic stress disorder in adults, includ-
exposed to chronic community violence.15 ing repeated reexperiencing of the
Parallels have been drawn between chil- traumatic event, avoidance, numbing of
dren growing up in inner cities in the responsiveness,and increased arousal.21For
United States and those living in war example, in one study,young children were
zones.16In fact, findings from several stud- afraid to be near the scene of the violent
ies show posttraumatic stress disorder event they had witnessed, often were afraid
symptoms of children living in "urbanwar to go to sleep or woke up with nightmares,
zones" to be similar to the symptoms of and showed a limited range of emotion in
children living in actual war zones.17 As their play.

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TheImpactof Violence on Children 37

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School-Age Children sample said their children were worried

Severalstudies support a link between expo- about being safe. Similarproportions of the
sure to community violence and symptoms children reported feeling 'jumpy" and
of anxiety,depression, and aggressivebehav- "scared."
iors in school-age children living in violent
urban neighborhoods.22As with preschool- Other studies have reported that school-
ers, school-age children exposed to violence age children who are exposed to familyvio-
are more likely to show increases in sleep lence are affected similarly to those
disturbances, and less likely to explore and exposed to community violence.26 Such
play freely and to show motivation to master children often show a greater frequency of
their environment.23They often have diffi- internalizing (withdrawal, anxiety) and
culty paying attention and concentrating externalizing (aggressiveness,delinquency)
because they are distracted by intrusive behavior problems in comparison to chil-
thoughts. In addition, school-age children dren from nonviolent families. Overall
are likely to understand more about the functioning, attitudes, social competence,
intentionality of the violence and worry and school performance are often affected
about what they could have done to prevent negatively.In addition, studies show that as
or stop it.24 children get older, those who have been
abused and neglected are more likely to
In extreme cases of exposure to chronic perform poorly in school; to commit
community violence, school-age children crimes; and to experience emotional prob-
may also exhibit symptoms akin to post- lems, sexual problems, and alcohol/sub-
traumatic stress disorder, similar to the stance abuse.27
symptoms described for infants and tod-
dlers above. In both the study of children Studiesof school-age children exposed to
ages 6 to 10 in Washington, D.C., and the media violence have also identified adverse
study of children ages 9 to 12 in New effects over time. For example, a longitudi-
Orleans (see Box 1), children's reports nal study of eight-year-oldboys that tracked
indicated a significant link between the wit- viewing habits and behavior patterns found
nessing of violence and such symptoms as that those who viewed the most violent pro-
nightmares, fears of leaving their homes, grams growing up were the most likely to
anxiety, and a numbing of affect.25Forty engage in aggressiveand delinquent behav-
percent of the mothers in the New Orleans ior by the time they were age 18 and seri-
sample and 20% in the Washington, D.C., ous criminal behavior by age 30.28Reports

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38 THEFUTURE
OF CHILDREN
- WINTER
1999

indicate that exposure to media violence youths may attach themselves to peer
may increase negative behaviorsbecause of groups and gangs as substitute family and
the potential for social learning and model- incorporateviolence as a method of dealing
ing of inappropriatebehaviorsby youths.2 with disputes or frustration."
Evenwhen fictionalized,violence that is dra-
maticallyportrayedand glamorized is likely For example, one study of low-income
to have negative impacts on children and black urban preteens and teens (children
increase their propensity for violence. ages 9 to 15) found that those who wit-
Despite the differences between fictional- nessed or were victims of violence showed
ized portrayalsof violence and the realityof symptoms of posttraumatic stress disorder
experiencing violence, researchers have similar to those of soldiers coming back
found that real-lifeevents shown in a sensa- from war, with the distress symptoms
tionalizedmanner mayoverwhelmor numb increasing according to the number of
the senses.5 violent acts witnessed or experienced.
Symptoms included distractibility,intrusive
Adoleocents and unwantedfears and thoughts, and feel-
In contrast to the relativelylimited amount ings of not belonging.35
of research on younger children, consider-
able research has been done on adolescent Studies of children exposed to war con-
youth violence." Such research indicates sistently show that separation from family
and destruction of important early rela-
tionships is one of the most potentially
Themostimportant protective resource damaging consequences of war for chil-
to enablea childto copewithexposure to dren, but that the children in war zones
who are cared for by their own parents or
violenceis a strongrelationshipwith a familiar adults suffered far fewer negative
competent,caring,positiveadult, most effects. Similar findings have been shown
a
often parent. in studies of children exposed to other
types of violence. In the following section,
research identifying the key protective fac-
that adolescents exposed to violence, partic- tors that can help children cope with vari-
ularlythose exposed to chronic community ous types of violence in their lives is
violence throughout theirlives,tend to show discussed.
high levels of aggression and acting out,
accompanied by anxiety, behavioral prob- KeyFactors Contributing to
lems, school problems, truancy, and revenge Resilience
seeking.3s An important, but little understood, area
concerns the issue of invulnerability or
The more severe effects of violence resilience--that is, the ability to determine
exposure on adolescents may be related to which children will experience fewer nega-
the fact that they are exposed to much more tive effects in response to exposure to vio-
violence than younger children. In 1995, lence. Results from several studies of
the U.S. Department of Justice reported resilientinfants,young children, and youths
that teenagers between the ages of 12 and exposed to communityviolence consistently
15 are victimsof crime more than any other identifya small number of crucialprotective
age group, and that adolescents of all ages factors for development a caring adult, a
are victims at twice the national average.32 community safe haven, and a child's own
Although some adolescents who witness internal resources.6
community violence may be able to over-
come the experience, many others are TheCrucialRodle of Parents
deeply scarred. For example, some report The most important protective resource to
givingup hope, expecting that they may not enable a child to cope with exposure to vio-
live through adolescence or early adult- lence is a strong relationshipwith a compe-
hood.33 Such chronically traumatized tent, caring, positive adult, most often a
youths often appear deadened to feelings parent.37As shown in studies of children
and pain, and show restricted emotional exposed to war (and other catastrophic
development over time. Alternatively,such stressors such as premature birth, trauma,

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TheImpactof Violence on Children 39

and loss), such events can threaten the shield children from exposure to violence
development of a child's abilityto think and and can aid in their resilience.4sTraditional
solve problems. But with the support of protected areas for children have included
good parenting by either a parent or other schools, community centers, and churches.
significant adult, a child's cognitive and Most children spend as much waking time
social development can proceed positively at schools as at home; therefore, schools
even with adversity. and teachers have an enormous potential
for providing emotional support and nur-
For example, a study from 1943, which turing for children exposed to violence.
provided some of the earliest reports on Several studies have shown the positive
children exposed to trauma during World effects gained when a favorable school cli-
War II, found that despite the potential for mate is provided despite its location in a vio-
severe traumatization for children living in lent neighborhood.44 In addition, both
the midst of bombardment, far fewer nega-
tive effects occurred among those who
were cared for by their own parents or Schoolsand communitycenterscan provide
familiar adults where some semblance of
order was maintained in their lives.38More opportunitiesfor childrento benefitfrom
recently, in 1986, researchers reported that the supportofpeers, which has beenshown
while children who had been exposed to to be instrumentalin reducinganxiety
the stress of extreme violence during the
war in Cambodia revealed mental health amongchildrenexposedto violence.
disturbances years after the immediate
experience was over, those who did not
reside with a family member were most schools and community centers can provide
likely to show posttraumatic stress symp- opportunities for children to benefit from
toms and other psychiatric symptoms.39A the support of peers, which has been shown
similar finding was reported by a psychia- to be instrumental in reducing anxiety
trist working in Uganda during times of among children exposed to violence.41
conflict.40 Churches not only provide safe meeting
places, but also provide belief systems that
Similarly,studies of children exposed to have been shown to help children cope
chronic community violence have also with trauma.42
identified parenting as a key protective
factor. For example, one 1996 study of Characteristics
of the Child
school-age children living in Washington, Finally, various individual characteristics
D.C., neighborhoods with varying levels of have been associated with increased resil-
violence found that the children who per- ience among vulnerable children, enabling
ceived greater support from their families them to use their own internal resources
showed less anxiety, even when living in effectively as well as reach out to others for
more violent neighborhoods;41Case stories support when needed. The child's most
of young children exposed to violence rein- important personal quality is average or
force this finding. For example, researchers above-average intellectual development
assessing the stories of children involved in with good attention and interpersonal
a therapeutic project at Boston City skills.45Additional protective factors cited in
Hospital concluded that parents are the studies include feelings of self-esteem and
first-line buffers and protectors of children, self-efficacy,attractivenessto others in both
and that children restabilized most success- personality and appearance, individual tal-
fully when parents communicate that they ents, religious affiliations, socioeconomic
understand their children's fears and are advantage, opportunities for good school-
establishing a plan of action to deal with ing and employment, and contact with
the problem.42 people and environments that are positive
for development. To a large extent, how-
Benefits
of Community
SafeHavens ever, the ability of a child to realize the
Children living in high-violence areas can value of such protective factors is linked to
benefit from having a protected place in the family and institutional supports dis-
the neighborhood. Such "safe havens" can cussed above.

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40 THEFUTURE - WINTER
OF CHILDREN 1999

TheImpactofViolenceon chronic communityviolence, the continued

ParentsandTheir physical reality of the violent environment
Capacity cannot be ignored.
to Parent
In neighborhoods with high levels of com- In the New Orleans study (see Box 1),
munity violence, as in situations involving the majority(62%) of parents felt that their
domestic violence, parents are often trau- children were very safe at home, but only
matized along with their children. It is cru- 30% felt that they were very safe at school,
cial to recognize that when experiencing and only 17% felt that they were very safe
trauma, a parent's ability to play a stable, walking to and from school and playing in
consistent role in the child's life and, there- their neighborhood.47 The children also
fore, to support the child's resilience, may reported that they felt much safer at home
be compromised. There are two basic and in school than walking to or from
aspects to the problem: (1) parents may be school or playing in their neighborhood.
Ninetypercentof theirparentsfelt thatvio-
lence was a serious problem or crisis in
Itis crucial thatwhen
torecognize their community.
experiencingtrauma,a parent'sabilityto
When parentsare living in constantfear,
playa stablerolein thechild'slifeand, they may deny their children normal devel-
therefore,supportthe child'sresilience, opmental transitionsand the sense of basic
may be comprmnised. trust and security that is the foundation of
healthy emotional development.48 For
example, an importantpsychologicalaspect
unable to protect their children and keep of parenting an infant or toddler is being
themsafe,and (2) parentsthemselves
may able to provide a "holdingenvironment"in
be numbed, frightened, and depressed, which a parent can both protect a child and
unable to deal with their own trauma allow and encourage appropriate indepen-
and/or grief, and emotionally unavailable dence.49Yet,parentsmust be able to trustin
for their children. In such situations, the safety of their children's independence
community
strengthening forpar-
supports before encouraging autonomy.5?For fami-
ents has been shown to be an effectiveinter- lies livingwith chronic communityviolence,
vention approach,as discussedat the end of children's growing independence and
this section. normal exploration of their neighborhood
maybe anythingbut safe and, therefore, not
to Ensure
TheInability Safety allowed. When violence occurs in their
Protecting children and facilitating their neighborhood, to their child or to a child
development is a family's most basic func- they know,parents may become overprotec-
tion. Although systematicresearch has not tive, hardly allowing their children out of
yet been done on the effects of violence their sight. Under such circumstances,par-
exposure on parenting and the caregiving ents may have difficultybehaving in other
environment, anecdotal reports indicate than a controlling, or even authoritarian,
that parents who are living with chronic manner.
community violence frequently describe a
sense of helplessness and frustration with BeingEmotionally Unavailable
their inabilityto protect their children and Researchisjust beginning to revealthe mag-
keepthemsafe,evenin theirownneighbor- nitude of the problem when children who
hoods.4 Parents who are aware that they witnessviolence live in familieswho are also
may not be able to protect their children traumatized. Families, regardless of their
from violence are likelyto feel frustratedand composition, are uniquelystructuredto pro-
helpless, and to communicate that helpless- vide the attention, nurturing,and safetythat
ness and hopelessness to their children. children need to growand develop. But par-
Clinical work with traumatizedyoung chil- enting is, at best, a complex process, and in
dren and their families must begin treat- situations of high risk, it is even more so.
ment by addressingthe issue of whether the Poverty,job and family instability,and vio-
child and the family can feel safe. However, lence in the environmentadd immeasurably
for children and parents subjected to to the inherent difficulties.For some parents

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TheImpactof Violence on Children 41

and children, the stress associated with

having to cope with community violence as
an everydayevent may affect both the par-
ents' ability to parent and the children's
capacity to form attachment relationships .iL•.
necessary for their later healthy emotional
development.51
?
~~ ~
:::•. ..........
~ ~ :

When parents witness violence or are

themselvesvictimsof violence, they are more
likely to have difficulty being emotionally
available, sensitive, and responsive to their
children. They may become depressed and
unable to provide for their young children's
needs. When children of any age cannot
depend on the trust and security that come
from caregivers who are emotionally avail-
able, they may withdrawand show disorga-
nized behaviors. Because early relationships
form the basis for all later relationship expe- .7._•
riences, difficult experiences early in life
may be problematic for the child's later :_;:CO)
development.

Parents who have been traumatized by

violence exposure must cope with their
own trauma before they are able to help
their children.52Even with heroic efforts, if
the parent is sad and anxious, it will be
more difficult to respond positively to the
smiles and lively facial expressions of a
young child. Depressed parents may be
more irritable and may talk less often and
with less intensity. While understandable, (D

these parental behaviors may lead young

children to be less responsive themselves
and to feel that they may have done some- unaware of their children's difficulty with
thing "bad"to contribute to their parents' concentration and other school problems
behavior.53 that frequently follow traumatization from
violence exposure.
Mothers in several studies have shared
anecdotal data related to their feelings TheImportanceof Community
about their children's exposure to commu- Supports
nity violence and the waysthey have tried to In many urban neighborhoods with high
handle the problem.54 As they reiterated levels of chronic violence, parents may
numerous examples of violence, a matter- experience additional burdens because the
of-fact quality often permeated their traditional societal protectors of children-
reports. Parents' interviews indicate that including schools, community centers, and
very early in life, children must learn to churches-are also overwhelmed and are
deal with loss and to cope with grieving for not able to assure safe environments for
family members or friends who have been their children. Yet, supports outside of the
killed.55When such events become a part of family are very important for parents as well
everyday life, some parents may resort to as children exposed to violence. For par-
coping mechanisms that involve a mini- ents, such outside supports can provide
mization of, or a failure to acknowledge, opportunities to talk about their own feel-
the consequences of violence.56 For exam- ings and trauma,which often enables them
ple, it is not unusual for parents to be to be more available to help their children

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42 THEFUTURE
OFCHILDREN 1999
- WINTER

and to seek help from others in their symptoms, have been used widely with the
extended family and community. groups most often exposed to violence and
are well accepted to measure change in
Comprehensive approaches, involving high-risk groups.59However, some of the
multiple agencies and individuals through- standardized measures that are availableto
out the community,have been found to be study outcomes and validate the violence
useful in creating effective interventions to exposure measures have been developed
urban violence. For example, in the Vio- on populations coming from different
lence Intervention Project,implemented in racialand socioeconomic groups than most
New Orleans in 1993, community police children exposed to community violence;
and schools play important roles in sup- therefore, their validity may be question-
porting children and families.57In many able. An epidemiological approach to col-
communities, extended families including lecting data on more diverse populations is
needed to establish greater reliability and
validityof these measures. Progressis being
Community supporltcanhelpchildrenand made in this area, but it will take some time
to have well-established and meaningful
familiesfe lessisolatedandoverwhelmed,measures of outcomes following violence
andmoreableto copewithte chronic exposure.
violencein theirlives.
Second, broad-based epidemiological
studies are needed to determine the differ-
grandparents may be important, aided by ential effects of witnessingviolence as com-
programs such as Big Brothers and Big pared to being victimized by violence, and
Sisters. By providing a network of people of being exposed to an acute trauma as
who care, such community supports can compared to chronic, ongoing violence. If
help children and families feel less isolated possible, the epidemiological work should
and overwhelmed, and more able to cope attempt to distinguish the impact of chil-
with the chronic violence in their lives. dren's exposure to community violence
from the impact of exposure to domestic
ResearchNeedsfor
Future violence. Samplesshould include childrenof
different ages, socioeconomic backgrounds,
Exposedto
Children and ethnic or cultural backgrounds. The
Violence inclusion of information about violence
The findings reviewed throughout this arti- exposure in national surveys would be
cle come primarilyfrom the small but grow- useful to professionalswho work with chil-
ing number of carefully controlled studies dren, as well as in planning prevention and
on children's exposure to violence com- intervention strategies.
pleted in the past few years. The findings
from these studies are quite consistent and Third, studies are needed to learn more
confirm many of the initial impressions of about the factors that lead to and mitigate
researcherswho conducted surveysand clin- violence in high-risk situations.60To date,
ical studies in the late 1980s and early little is known from a research perspective
1990s.%5 The research work that has been about the processesleading to violent behav-
done to date, as well as the careful clinical ior. It is probable thatjuvenile courtjudges
observations,point to important directions and probation officers know a great deal
for future research. about the causes of youth violence from
their professional experience and daily
First, measures with greater reliability exposure to anecdotal reports and qualita-
and validityare needed. Research method- tive assessments. However, to understand
ology on violence exposure and the effects more fully the causes of violent behavior
on children is in its infancy, and relatively and to develop meaningful prevention and
few measures are currentlyavailable.Some intervention programs, carefully designed
assessment measures, including the Child studies focused on causes are needed.
Behavior Checklist and measures of chil-
dren's or parents' depressive symptoms, Fourth, far too little attention has been
anxiety, or posttraumatic stress disorder given to the potential long-term impact on

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TheImpactof Violence on Children 43

:ijI
~LLJ
SI-

LI
?; ?

LL

urban children of living in environments effects of severityof exposure, proximity to

of chronic violence. In clinical work with the event, and the child's familiaritywith the
children under the age of five who have victim and/or perpetrator.
been exposed to chronic violence, con-
cerns have been raised about the chil- Fifth, research is needed on factors
dren's ability to negotiate developmental that support the resilience of children
transitions in later life.61For example, how and buffer them against adverse effects of
will young children exposed to severe early violence exposure. Significant longitudi-
trauma cope when they deal with anger nal research has been done on determi-
and aggression as well as affection toward nants of resilience and conditions that
others, when they struggle with sexuality serve as protective factors.62 However,
during adolescence, or when they are con- careful longitudinal studies within pri-
fronted with later experiences of death marily high-risk inner-city populations,
and mortality? This is an area sorely in where much of the violence in the United
need of careful research and clinical States occurs, have yet to be done. In such
follow-up studies. Retrospective studies studies of the impacts of community vio-
may provide some useful information lence among high-risk populations, not
about the effects of violence exposure on only must the children be included, but
youths, but most study samples to date also the family members who are closest
have been selective-that is, interviewing to these children. The evidence to date
juvenile offenders or prisoners who have indicates that while the child's individual
committed violent crimes. This approach resources and temperament influence the
does not provide an opportunity to under- outcomes of violence exposure to some
stand the effects on victims and witnesses extent, family support is crucial. The evi-
of violence who do not commit violence dence also seems to indicate that more
themselves. Studies should include comprehensive approaches that utilize
prospective longitudinal designs to investi- resources from multiple agencies, such as
gate the long-term psychological effects of schools, police, and community groups,
exposure to violence on children. Studies are most likely to have a positive long-
should also include children of different term impact on children exposed to vio-
ages, socioeconomic backgrounds, and lence. Continued research on mediating
ethnic and cultural backgrounds. Evalua- factors related to the impact of violence
tion is needed of the cumulative effects exposure will aid in developing effective
of repeated exposure, the differential prevention efforts.63

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44 THEFUTURE - WINTER
OFCHILDREN 1999

Finally,many prevention and interven- In summary, to better understand the

tion programsdo not currentlyinclude effects of children's exposure to violence,
evaluationcomponents.In some instances, it is important to broaden the primary
program staffareresistantto research,
are focus on victims and perpetrators to
not knowledgeable abouthowto evaluate include the important "ripple effects" of
programs, or do not makethe necessary the psychological impacts on children
effortto buildthe relationships thatare who may be witnesses. Law enforcement
neededto carryoutthiscrucialcomponent officers, families, and others frequently
of a program.In otherinstances,theinter- overlook the significance of children's
ventionprogram andit is exposure to violence. Yet, the negative
is setup quickly,
then difficult to build in an evaluation, effects for children exposed to violence
if staffarenotfamiliar
especially withorori- in their communities, in their families,
ented toward In
evaluation. otherprograms and in the media can range from tempo-
that are primarily clinical,programstaff rary upset, to clear symptoms of post-
haveneitherthe knowledge nor the incli- traumatic stress disorder, to increased
nation to evaluate the programs. aggressive and violent behavior. How a
Evaluationsshould include the develop- child's long-term development is affected
ment of criteriaand assessment tools to by exposure to different types and multi-
thataremost ple levels of violence requires further sys-
helpidentifythosestrategies
shouldbe con- tematic study.
effective.Suchevaluations
ductedacrossthe broadrangeof interven-
tion programs, including school-based The author expesses much appreciation to
programs,educationalinitiativesfor law the Entergy Corporationand the local founda-
enforcementofficers,and therapeuticcrisis tions that haveprovidedgeneroussupportfor this
interventions. work.

1. Flannery, D., and Huff, C.R. Youthviolence:Prevention,intervention,and socialpolicy.

Washington,DC:AmericanPsychiatricPress,1998;Osofsky, in a violent
J.D., ed. Children
New
society. York: GuilfordPress,1997;Finkelhor,D., and Dziuba-Leatherman,J.
Victimizationof children.American (1994) 49:173-83;Bell, C.C.,andJenkins,
Psychologist
E.J.Communityviolenceand childrenon Chicago'sSouthside.Psychiatry (1993) 56:46-54;
Federal Bureau of Investigation. UniformCrimeReportsfor the UnitedStates.Washington, DC:
U.S. GovernmentPrintingOffice, 1992;Fingerhut,L.A.,Ingram,D.D.,and Feldman,J.J.
Firearmhomicideamongblackteenagemalesin metropolitancounties.Journalof the
American (1992) 267:3054-58;Rosenberg,M.L.,O'Carroll,P.,and
MedicalAssociation
Powell,K.Let'sbe clear:Violenceis a publichealth problem.Journalof theAmerican
(1992) 267:3071-72;Rosenberg,M.L.,and Fenley,M.A.Violence
MedicalAssociation in
NewYork:
A publichealthapproach.
America: Oxford UniversityPress,1991;Prothrow-Stith,
NewYork:HarperCollins,1991.
D. Deadlyconsequences.
2. Centers for Disease Control and Prevention. National summaryof injurymortalitydata,
1987-1994.Atlanta,GA:U.S. Departmentof Healthand HumanServices,NationalCenter
for InjuryPreventionand Control,CDC,November1996;Rosenberg,M.L.Violence
prevention:Integratingpublichealthand criminaljustice. Paperpresentedat the U.S.
Attorney'sConference.Washington,DC,January1994.
3. World Health Organization. Worldhealthstatisticsannual, 1994. Geneva, Switzerland:World
HealthOrganization,1995.
4. Osofsky,J.D. Childrenwho witnessdomesticviolence:The invisiblevictims.SocialPolicy
Reports:Societyfor Researchin ChildDevelopment(1995) 9:3.
5. AmericanAcademyof Pediatrics,Committeeon Communications. Policystatement:Media
violence.Pediatrics
(June 1995) 95:949-51.
6. Murray,J.P. Mediaviolence J.D. Osofsky,ed. New
in a violentsociety.
and youth.In Children
York:GuilfordPress,1997;Huesmann,L.R.,and Moise,J. Mediaviolence:A demonstrated
publichealth threatto children.TheHarvardMentalHealthLetter(June1996) 12:5-7;
Eron,L., and Huesmann,L.R.Televisionas a sourceof maltreatmentof children.School
Review(1987) 16:195-202.
Psychology

This content downloaded from 152.14.136.96 on Fri, 8 Nov 2013 05:32:30 AM

All use subject to JSTOR Terms and Conditions
TheImpactof Violence on Children 45

7. Pagelow, M.D. Familyviolence.New York: Praeger Publishing, 1984; Straus, M., and Gelles,
R., eds. Physicalviolencein Americanfamilies: Riskfactors and adaptationsto violencein 8,145
families. New Brunswick, NJ: Transaction Publishers, 1990; Frieze, I.H., and Browne, A.
Violence in marriage. In Familyviolence.L. Ohlin and M. Tonry, eds. Chicago: University of
Chicago Press, 1989, pp. 163-218.
8. Cascardi, M., Langhinrichsen, J., and Vivian, D. Marital aggression: Impact, injury,and
health correlates for husbands and wives. Archivesof InternalMedicine(1992) 152:1178-84.
9. See note no. 7, Straus and Gelles; Plichta, S. The effects of woman abuse on health care
utilization and health status:A literature review. Women'sHealthIssues (1992) 2:154-63.
10. National Center for Injury Prevention and Control, Division of Violence Prevention, Family
and Intimate Violence. Fact sheeton dating violence.Atlanta, GA: U.S. Department of Health
and Human Services, NCIPC, Centers for Disease Control and Prevention, 1998.
11. Jaffe, P.G.,Wolfe, D., and Wilson, S. Childrenof batteredwomen.Newbury Park, CA: Sage
Publications, 1990; Carlson, B.E. Children's observations of interparental violence. In
Batteredwomenand theirfamilies.A.R. Roberts, ed. New York:Springer Publishing, 1984,
pp. 147-67.
12. English, D. The extent and consequences of child maltreatment. TheFutureof Children
(Spring 1998) 8,1:39-53.
13. Fantuzzo,J., Boruch, R., Beriama, A., et al. Domestic violence and children: Prevalence
and risk in five major U.S. cities. Journal of theAmericanAcademyof Childand Adolescent
Psychiatry(1997) 36:116-22; McKibben, L., DeVos, E., and Newberger, E. Victimization of
mothers of abused children: A controlled study. Pediatrics(1989) 84:531-35; Bowker, L.H.
On the relationship between wife beating and child abuse. In Feministperspectiveson wife
abuse.K.Yllo and M. Bograd, eds. Newbury Park, CA: Sage Publications, 1988; Straus, M.
Measuring intrafamilial conflict and violence: The Conflict Tactics Scales. Journal of
Marriageand Family (1979) 41:75-88; see note no. 7, Straus and Gelles.
14. American Psychiatric Association. Psychiatriceffectsof media violence. APA fact
sheet series. APA Online Public Information. Available online at
http://www.psych.org/public_info/media_violence.html. Last modified
October 1998.
15. Lynch, M., and Cicchetti, D. An ecological-transactional analysis of children and contexts:
The longitudinal interplay among child maltreatment, community violence, and children's
symptomatology. Developmentand Psychopathology (1998) 10:235-58; Duncan, D.F. Growing
up under the gun: Children and adolescents coping with violent neighborhoods. The
Journal of PrimaryPrevention(1996) 16:343-56; Osofsky,J.D., and Fenichel, E., eds. Islands
of safety: Assessing and treating young victims of violence. Zeroto Three(April/May 1996)
16:1-48; Attar, B.K, Guerra, N.G., and Tolan, P.H. Neighborhood disadvantage, stressful
life events, and adjustment in urban elementary school children. Journal of Clinical Child
Psychology(1994) 23:391-400; Taylor, L., Zuckerman, B., Harik, V., and Groves, B.
Witnessing violence by young children and their mothers. Journal of Developmentaland
BehavioralPediatrics(1994) 15:120-23; Cicchetti, D., and Lynch, M. Toward an
ecological/transactional model of community violence and child maltreatment:
Consequences for children's development. Psychiatry(1993) 56:96-118; Fitzpatrick, KM.,
and Boldizar,J.P. The prevalence and consequences of exposure to violence among
African-American youth. Journal of theAmericanAcademyof Childand AdolescentPsychiatry
(1993) 32:424-30; see note no. 1, Osofsky.
16. Osofsky,J.D., and Fenichel, E., eds. Caring for infants and toddlers in violent environ-
ments: Hurt, healing, and hope. Zeroto Three(December 1993/January 1994) 14:1-48;
Leavitt, L.A., and Fox, N.A. Thepsychologicaleffectsof war and violenceon children.Hillsdale,
NJ: Lawrence Erlbaum, 1993; Garbarino,J., Dubrow, N., Kostelny, K, and Pardo, C.
Childrenin danger:Copingwith the consequencesof communityviolence.San Francisco:Jossey-
Bass, 1992; Bell, C.C., andJenkins, E.J. Traumatic stress and children. Journal of Health Care
for thePoor and Underserved(1991) 2:175-85.
17. Pynoos, R.S. Traumatic stress and developmental psychopathology in children and adoles-
cents. In AmericanPsychiatricPressreviewof psychiatry.Vol. 12. J.M. Oldham, M.B. Riba, and
A. Tasman, eds. Washington, DC: American Psychiatric Press, 1993, pp. 205-38; Nader,

This content downloaded from 152.14.136.96 on Fri, 8 Nov 2013 05:32:30 AM

All use subject to JSTOR Terms and Conditions
46 THEFUTURE
OFCHILDREN
- WINTER
1999

K.O., Pynoos, R.S., Fairbanks,LA., et al. A preliminary study of PTSD and grief among the
children of Kuwaitfollowing the Gulf crisis. BritishJournal of ClinicalPsychology(1993)
32:407-16; Terr,L. Tooscaredto cry.New York:Harper and Row, 1990; Pynoos, R.S., and
Eth, S. Developmental perspectives on psychic trauma in childhood. In Traumaand its
wake.R.C. Figley, ed. New York:Brunner/Mazel, 1985; see note no. 16, Osofsky and
Fenichel; see note no. 16, Garbarino, Dubrow, Kostelny,and Pardo.
18. Research data on outcomes of children's adaptationfollowing exposure to violence are not
available;however,reactions are likely to be similar to those of children who suffer early abuse
and neglect, and such research has emphasized that early abusive and neglectful experiences
may not lead directly to increased aggression and violence. See Widom, K Does violence
beget violence? A criticalexamination of the literature.Psychological Bulletin(1989) 106:3-28.
19. Zeanah, C.Z., and Scheeringa, M. Evaluation of posttraumatic symptomatology in infants
and young children exposed to violence. Zeroto Three(April/May 1996) 16:9-14; Bell, C.
Exposure to violence distresses children and may lead to their becoming violent. Psychiatric
News (January6, 1995) 6-8, 15; Drell, M., Siegel, C., and Gaensbauer, T. Posttraumatic
stress disorders. In Handbookof infant mentalhealth.C. Zeanah, ed. New York:The Guilford
Press, 1993, pp. 291-304; Jaffe, P., Wilson, S., and Wolfe, D. Promoting changes in atti-
tudes and understanding of conflict resolution among child victims of family violence.
CanadianJournalof BehaviorSciences(1986) 18:356-66; see note no. 15, Osofsky and
Fenichel; see note no. 17, Pynoos.
20. See note no. 16, Osofsky and Fenichel.
21. Osofsky,J.D., Cohen, G., and Drell, M. The effects of trauma on young children: A case of
two-year-oldtwins. InternationalJournalof Psychoanalysis(1995) 76:595-607; see note no. 19,
Drell, Siegel, and Gaensbauer; see note no. 16, Osofsky and Fenichel.
22. Gorman-Smith, D., and Tolan, P. The role of exposure to community violence and
developmental problems among inner-city youth. Development and Psychopathology
(1998)
10:99-114; Cooley-Quille, M.R., Turner, S.M., and Beidel, D.C. Emotional impact of
children's exposure to community violence: A preliminary study. TheAmericanAcademyof
Childand AdolescentPsychiatry(1995) 34:1362-68; Schwab-Stone, M.E., Ayers, T.S., Kasprow,
W., et al. No safe haven: A study of violence exposure in an urban community.Journal of the
AmericanAcademyof Childand AdolescentPsychiatry(1995) 34:1343-52.
23. Osofsky,J.D. The effects of exposure to violence on young children. AmericanPsychologist
(September 1995) 50:782-88; see note no. 17, Pynoos.
24. See note no. 19, Drell, Siegel, and Gaensbauer.
25. In the Washington, D.C., study, r=.39, p<.05; in the New Orleans study, r=.42, p<.01.
Richters,J.E., and Martinez, P. The NIMH community violence project: I. Children as
victims of and witnesses to violence. Psychiatry(1993) 56:7-21; Osofsky,J.D., Wewers, S.,
Hann, D.M., and Fick, A.C. Chronic community violence: What is happening to our
children? Psychiatry(1993) 56:36-45.
26. See note no. 16, Bell andJenkins; see note no. 19, Bell.
27. Cicchetti, D., and Toth, S. Developmental on trauma:Theory,research,and
perspectives
intervention.Rochester, NY:University of Rochester Press, 1997; National Research Council,
Commission on Behavioral and Social Sciences and Education. Understandingchildabuse
and neglect.Washington, DC: National Academy Press, 1993; see note no. 12, English; see
note no. 15, Cicchetti and Lynch.
28. Eron, L. Testimony before the Senate Committee on Commerce, Science, and
Transportation, Subcommittee on Communications. Washington, DC, June 2, 1995.
29. Paik, H., and Comstock, G. The effects of television violence on antisocial behavior: A
meta-analysis. CommunityResources(1994) 21:516-46; see note no. 6, Murray;see note
no. 6, Huesmann and Moise.
30. Jenkins, E.J., and Bell, C.C. Exposure and response to community violence among
children and adolescents. In Childrenin a violentsociety.J.D. Osofsky,ed. New York:
Guilford Press, 1997; see note no. 1, Flannery and Huff.
31. Fonagy, P., Target, M., Steele, M., and Steele, H. The development of violence and crime
as it relates to security of attachment. In Childrenin a violentsociety.J.D. Osofsky, ed. New

This content downloaded from 152.14.136.96 on Fri, 8 Nov 2013 05:32:30 AM

All use subject to JSTOR Terms and Conditions
TheImpactof Violence on Children 47

York: Guilford Press, 1997; Loeber, R., Wung, P., Keenan, K., et al. Developmental
pathways in disruptive child behavior. Developmentand Psychopathology (1993) 5:101-33;
Loeber, R., and Dishion, T. Early predictors of male delinquency: A review. Psychological
Bulletin (1983) 94:68-99; see note no. 30,Jenkins and Bell.
32. Jenkins, E.J. Violence exposure, psychological distress and risk behaviors in a sample of
inner-city youth. In Trends,risks,and interventions:Proceedingsof the ThirdAnnual Spring
Symposiumof theHomicideWorkingGroup.R. Block and C. Block, eds. Washington, DC: U.S.
Department ofJustice, 1995, pp. 287-98.
33. Osofsky,J.D. Children who witness domestic violence: The invisible victims. SocialPolicy
Report(1995) 9:1-18; see note no. 16, Bell andJenkins.
34. Parsons, E.R. Inner-city children of trauma: Urban violence traumatic stress response
syndrome (U-VTS) and therapists' responses. In Countertransference in the treatmentof PTSD.
J. Wilson andJ. Lindy, eds. New York: Guilford Press, 1994, pp. 151-78; see note no. 1,
Prothrow-Stith; see note no. 17, Pynoos.
35. Li, X., Howard, D., Stanton, B., et al. Distress symptoms among urban African-American
children and adolescents: A psychometric evaluation of the Checklist of Children's Distress
Symptoms. Archivesof Pediatricsand AdolescentMedicine(1998) 152:569-77. Similarly, such
symptoms were identified in an evaluation of children in Kuwait during the occupation
and the Gulf War. Though the sample was relatively small and selective, the results are
informative. Forty-five children ranging in age from 5 to 13 years who were exposed to the
horrors of war were interviewed and drew pictures of their experiences. The study found
that the majority of the children (62%) reported direct experience with a traumatic event,
and many children (at least 20%) experienced the death of a close relative. More than
half of the children reported psychological effects of the trauma with repetitive dreams,
fears, uncontrollable crying, and/or sleep disturbances. The study also found that girls
were more sheltered during the occupation and less likely to witness traumatic events, but
that all children felt vulnerable and fearful of future harm or occupation/war. See
Garbarino,J. The experience of children in Kuwait:Occupation, war and liberation.
The Child, Youthand FamilyServicesQuarterly(1991) 14:2.
36. Masten, A.S., Hubbard, J.J., Gest, S.D., et al. Competence in the context of adversity:
Pathways to resilience and maladaptation from childhood to late adolescence.
DevelopmentalPsychology(1999) 1:143-70; Masten, A.S. Resilience in individual
development: Successful adaptation despite risk and adversity.In Educationalresiliencein
inner-cityAmerica:Challengesand prospects.M.C. Wang and E.W. Gordon, eds. Hillsdale, NJ:
Lawrence Erlbaum, 1994, pp. 3-25; Masten, A.S., Best, KM., and Garmezy, N. Resilience
and development: Contributions from the study of children who overcame adversity.
Developmentand Psychopathology (1990) 2:425-44; Rutter, M. Resilience: Some conceptual
considerations. Contemporary Pediatrics(1994) 11:36-48; Werner, E. Overcoming the odds.
Developmentaland BehavioralPediatrics(1994) 15:131-36.
37. Groves, B.M., and Zuckerman, B. Interventions with parents and caregivers of children
who are exposed to violence. In Childrenin a violentsociety.J.D. Osofsky, ed. New York:
Guilford Press, 1997; Marans, S., and Cohen, D. Children and inner-city violence:
Strategies for intervention. In Psychologicaleffectsof war and violenceon children.L. Leavitt
and N. Fox, eds. Hillsdale, NJ: Lawrence Erlbaum, 1993, pp. 281-302; Osofsky,J.D., and
Thompson, D. Adaptive and maladaptive parenting: Perspectives on risk and protective
factors. In Handbook of early intervention. 2nd ed. J.P. Shonkoff and S.J. Meisels, eds.
Cambridge: Cambridge University Press, in press; see note no. 15, Duncan; see note
no. 16, Osofsky and Fenichel; see note no. 25, Richters and Martinez.
38. Freud, A., in collaboration with D. Burlingham. Infants without families: Reports on the
Hampstead Nurseries, 1939-1945. In Thewritingsof Anna Freud.Vol. III. New York:
International Universities Press, 1973; Burlingham, D., and Freud, A. Youngchildrenin war
time.London: Allen and Unwin, 1942.
39. Goleman, D. Terror'schildren: Mending mental wounds. New Yok Times,September 2, 1986,
at A15, A19; Kinzie,J.D., Sack, W.H., Angell, RH., et al. The psychiatriceffects of massive
trauma on Cambodian children. Journalof theAmericanAcademyof ChildPsychiatry(1986)
25:370-76.

This content downloaded from 152.14.136.96 on Fri, 8 Nov 2013 05:32:30 AM

All use subject to JSTOR Terms and Conditions
48 THEFUTURE - WINTER
OFCHILDREN 1999

40. Harvard Medical School and Judge Bates Guidance Center, Boston. Personal
communication with GloriaJohnson-Powell, Professor of Psychiatry,December 1996.
41. Hill, H.M., Levermore, M., Twaite,J., and Jones, L. Exposure to community violence and
social support as predictors of anxiety and social and emotional behavior among African-
American children. Journalof Childand FamilyStudies(1996) 5:399-414.
42. See note no. 37, Groves and Zuckerman.
43. See note no. 16, Garbarino, Dubrow, Kostelny,and Pardo.
44. Garmezy,N. Children in poverty: Resilience despite risk. Psychiatry(February 1993)
56:127-35.
45. See note no. 37, Marans and Cohen.
46. Osofsky,J.D., and Jackson, B. Parenting in violent environments. Zeroto Three(December
1993/January 1994) 14:8-11; Lorion, R., and Saltzman, W. Children's exposure to commu-
nity violence: Following a path from concern to research to action. In Childrenand violence.
D. Reiss,J.E. Richters, M. Radke-Yarrow,and D. Scharff, eds. New York:Guilford Press,
1993, pp. 55-65; National Commission on Children. Speakingof kids.Washington, DC:
National Commission on Children, 1991; see note no. 16, Garbarino, Dubrow, Kostelny,
and Pardo; see note no. 25, Osofsky,Wewers,Hann, and Fick; see note no. 25, Richters
and Martinez.
47. Fick, A.C., Osofsky,J.D., and Lewis, M.L. Perceptions of violence: Children, parents,
and police officers. In Childrenin a violentsociety.J.D. Osofsky,ed. New York:Guilford
Press, 1997.
48. See note no. 19, Drell, Siegel, and Gaensbauer; see note no. 16, Osofsky and Fenichel.
49. Winnicott, D.W. The mother-infant experience of mutuality. In Parenthood,its psychology
1st ed. E.J.Anthony and T. Benedek, eds. Boston: Little Brown, 1970,
and psychopathology.
pp. 245-56.
50. Erikson, E.H. Childhoodand society.New York:Norton, 1950.
51. See note no. 16, Osofsky and Fenichel.
52. Lewis, M. Trauma reverberates:Psychosocial evaluation of the caregiving environment of
young children exposed to violence and traumatic loss. Zeroto Three(April/May 1996)
16:21-28.
53. See note no. 16, Osofsky and Fenichel.
54. See note no. 25, Osofsky,Wewers,Hann, and Fick; see note no. 25, Richters and Martinez;
see note no. 46, Lorion and Saltzman.
55. Thompson, D., Osofsky,J.D., and Heller, S. Evaluation of the Violence Intervention
Program. Unpublished manuscript. Louisiana State University Medical Center, 1998; see
note no. 46, Osofsky and Jackson.
56. See note no. 47, Fick, Osofsky,and Lewis.
57. Osofsky,J.D. The Violence Intervention Project for families and children. In Childrenin a
violentsociety.J.D. Osofsky,ed. New York:Guilford Press, 1997.
58. Groves, B., Zuckerman, B., Marans, S., and Cohen, D. Silent victims: Children who witness
violence. Journalof theAmeraicanMedicalAssociation(1993) 269:262-64; see note no. 1, Bell
andJenkins; see note no. 25, Osofsky,Wewers,Hann, and Fick; see note no. 16,
Garbarino, Dubrow, Kostelny, and Pardo; see note no. 16, Bell andJenkins; see note no.
17, Pynoos; see note no. 25, Richters and Martinez;see note no. 37, Marans and Cohen.
59. Achenbach, T.M. Manualfor the ChildBehaviorChecklist4-18 and 1991 Profile.Burlington,
VT: University of Vermont, Department of Psychiatry,1991; Fox, N.A., and Leavitt, L.A.
The violence exposure scale for children. Unpublished manuscript. College Park, MD:
University of Maryland, 1995; see note no. 17, Pynoos; see note no. 25, Richters and
Martinez.
60. See note no. 1, Bell andJenkins; see note no. 16, Bell andJenkins; see note no. 31, Loeber
and Dishion; see note no. 31, Loeber, Wung, Keenan, et al.
61. See note no. 16, Osofsky and Fenichel.

This content downloaded from 152.14.136.96 on Fri, 8 Nov 2013 05:32:30 AM

All use subject to JSTOR Terms and Conditions
TheImpactof Violence on Children 49

62. Masten, A. Resilience in children at risk. In Research/practice:

A publicationfrom the Centerfor
AppliedResearchand EducationalImprovement. Minneapolis, MN: College of Education and
HumanDevelopment,Universityof Minnesota,1997;see note no. 36, Masten,Hubbard,
Gest,et al.; see note no. 36, Masten,Best, and Garmezy.
63. See note no. 37, Osofskyand Thompson.

This content downloaded from 152.14.136.96 on Fri, 8 Nov 2013 05:32:30 AM

All use subject to JSTOR Terms and Conditions