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