Community violence exposure and post-traumatic stress reactions among Gambian youth: the moderating role of positive school climate.

BACKGROUND: Community violence exposure among youth can lead to various negative outcomes, including post-traumatic stress symptoms. Research in the Western world indicates that a number of social support factors may moderate the relation between violence exposure and internalizing symptoms. Little research has been carried out in non-Western countries. This study aimed to fill this gap by exploring the relations among violence exposure, parental warmth, positive school climate, and post-traumatic stress reactions among youth in The Republic of The Gambia, Africa. METHODS: A school-based survey of youth behaviors, feelings, attitudes, and perceptions was administered to 653 students at senior secondary schools in four Gambian communities. RESULTS: Students reported high levels of exposure to violence. Over half of students reported witnessing someone threatened with serious physical harm, beaten up or mugged, attacked or stabbed with a knife/piece of glass, or seriously wounded in an incident of violence. Nearly half of students reported being beaten up or mugged during the past year, and nearly a quarter reported being threatened with serious physical harm. There were no sex differences in levels of exposure. Traumatic stress symptoms were common, especially among females. Both violence witnessing and violent victimization significantly predicted post-traumatic stress symptoms, and positive school climate moderated the relationship. Among youth victimized by violence, positive school climate was most strongly correlated with lower levels of post-traumatic stress at low levels of exposure. Among youth who had witnessed violence, positive school climate was most strongly correlated with lower levels of post-traumatic stress at high levels of exposure. CONCLUSION: Community-based programs that bring together parents, schools, and youth may play an important role in combating the negative effects of some types of violence exposure among Gambian youth. Youth experiencing high levels of violent victimization represent a sample of particular concern and merit special research and clinical attention.

The mediating role of alienation in the development of maladjustment in youth exposed to community violence.

A study was conducted to determine predictors of high risk/delinquent behavior and psychoemotional maladjustment in 1,478 sixth and eighth graders who took part in a survey of high-risk and adaptive behaviors. The first goal was to determine the extent to which two distinct dimensions of alienation, normlessness, and isolation/self-estrangement mediated the emergence of maladjustment in youth exposed to community violence. The second goal was to distinguish between violence witnessing and violence victimization, and determine whether these subtypes of violence exposure may differentially affect the proposed mediational factors. The results indicated that normlessness partially mediated the relationship between violence exposure and high-risk/delinquent behavior and between violence exposure and psychoemotional maladjustment. Isolation/self-estrangement partially mediated the relation between violence exposure and psychoemotional maladjustment. Although witnessing of, and victimization by, violence were both significant predictors of normlessness, only violent victimization was significantly linked to isolation/self-estrangement. These results elucidate the mechanisms by which community violence exposure may exert negative influences on youth and suggest that there are distinct patterns of risk associated with different forms of exposure.

The protective effects of religiousness and parent involvement on the development of conduct problems among youth exposed to violence.

This study examined the protective effects of religiousness and parent involvement for the development of conduct problems beyond the effects of risk factors. Measures of violence exposure, conduct problems, parent involvement, and religiousness, from the longitudinal Social and Health Assessment survey, were completed by 1,703 high-risk urban adolescents (12.5 +/- 1.7 years; 53% female). Witnessing of and victimization by community violence appeared to be significant risk factors for an increase in conduct problems over a 1-year period. Religiousness and parental involvement were each uniquely associated with a decrease in conduct problems. Moreover, several dimensions of religiousness moderated the relationship between violence exposure and conduct problems, buffering the negative effects of violence exposure. Implications of these findings for prevention efforts are discussed.

Persistence of psychiatric disorders in pediatric settings.

OBJECTIVE: To examine the longitudinal course of subthreshold and full-criteria child psychiatric disorders. METHOD: Nine hundred ninety-six children, aged 4 to 9 years, from a representative sample of pediatric primary care practices participated in a 1-year follow-up in 1989-1990. Parent interviews included the Diagnostic Interview Schedule for Children, measures of psychosocial problems, stress, social support, possible child abuse, and sociodemographics. RESULTS: The initial prevalence of full and subthreshold disorders was 18.8% and 14.0%, respectively. Full and subthreshold disorders were associated with impairment. Approximately 37% of children with full disorders had persistent disorders. Persistence was more common among boys than girls, particularly when comorbidity was present. Children with initial subthreshold disorders only were five times more likely than those without disorder to develop a full disorder. Persistence of full disorders was associated with high initial symptoms. Among boys, persistence was linked to possible child abuse, whereas among girls it was associated with full externalizing disorders that were accompanied by subthreshold internalizing disorders. CONCLUSIONS: Intervention may be particularly crucial when a high number of symptoms and/or both internalizing and externalizing problems are present. Underscoring the importance of family-centered rather than child-centered interventions, boys whose parents reported possible child abuse were more likely to have persistent disorders.

Multidimensional resilience in urban children exposed to community violence.

The extent to which parent, school, and peer support differentially affected multiple domains of resilience was examined among 2,600 sixth, eighth, and tenth graders from an urban public school system who took part in a comprehensive survey of high-risk and adaptive behaviors. Structural equation modeling was used to specify the relation among seven domains of resilience and parent, school, and peer support among children who had been victimized by community violence, those who had witnessed such violence, and a no-exposure control group. Results upheld the validity of a multidimensional conceptualization of childhood resilience, and indicated that although both parent and school support factors were significantly positively associated with resilience in children who had been exposed to community violence, peer support was negatively associated with resilience in the domains of substance abuse and school misconduct/ delinquency. These results were most robust among victimized children, followed by children who had witnessed violence. Implications for social policy and community violence research are discussed.