Richard Thompson Juvenile Protective Association Jonathan Kotch, Terri Lewis, Des Runyan, Jamie Smith University of North Carolina at Chapel Hill Richard Thompson Juvenile Protective Association Jonathan Kotch, Terri Lewis, Des Runyan, Jamie Smith University of North Carolina at Chapel Hill Listening to children from LONGSCAN: What 12-year olds tell us about witnessing violence

AcknowledgementsAcknowledgements U.S. Department of Health and Human Services Administration for Children, Youth, and Families Children's Bureau Office on Child Abuse and NeglectU.S. Department of Health and Human Services Administration for Children, Youth, and Families Children's Bureau Office on Child Abuse and Neglect U.S. Department of Health and Human Services National Institutes of Health National Institute of Child Health and Human DevelopmentU.S. Department of Health and Human Services National Institutes of Health National Institute of Child Health and Human Development

The Prevalence of Witnessed Violence Nearly 40% of American teenagers witness violence every year (Kilpatrick et al., 2000).Nearly 40% of American teenagers witness violence every year (Kilpatrick et al., 2000). 15% witness violence using a weapon, and 30% witness violence without a weapon (Finkelhor et al., 2005).15% witness violence using a weapon, and 30% witness violence without a weapon (Finkelhor et al., 2005). In areas dealing with war or high rates of violence, child exposure to violence is likely to be much higher.In areas dealing with war or high rates of violence, child exposure to violence is likely to be much higher.

Impact of Witnessed Violence Mental health problems: depression, PTSDMental health problems: depression, PTSD Social problems: poor peer relationships, school failureSocial problems: poor peer relationships, school failure Risk-taking/aggression: juvenile justice involvement, substance useRisk-taking/aggression: juvenile justice involvement, substance use WHO: Witnessing violence predisposes youth to engage in violence, and to be victims of violence later on (Krug et al., 2002).WHO: Witnessing violence predisposes youth to engage in violence, and to be victims of violence later on (Krug et al., 2002).

Child Report vs. Parent Report Problems with reliability of child report in very young (age 6) children (Thompson et al. 2006).Problems with reliability of child report in very young (age 6) children (Thompson et al. 2006). Parents underestimate child exposure to violence, relative to child report (Litrownik et al., 2003).Parents underestimate child exposure to violence, relative to child report (Litrownik et al., 2003). Child reports of witnessed violence better than parent reports of child witnessing in prediction of child outcomes: aggression, depression, anger, anxiety (Johnson et al., 2002).Child reports of witnessed violence better than parent reports of child witnessing in prediction of child outcomes: aggression, depression, anger, anxiety (Johnson et al., 2002).

Main Hypotheses Modest agreement between children and parents on child exposure to violence.Modest agreement between children and parents on child exposure to violence. Child reports of exposure will predict child outcomes, even after controlling for parent reports and for other risk factors (demographics and maltreatment history).Child reports of exposure will predict child outcomes, even after controlling for parent reports and for other risk factors (demographics and maltreatment history). Effects will be present for both family and non-family violence.Effects will be present for both family and non-family violence.

Measures: Overview Independent variablesIndependent variables  Demographic information RaceRace GenderGender Adult male in homeAdult male in home  Other control variables Caregiver Depression: CES-DCaregiver Depression: CES-D Child Maltreatment history: Official recordsChild Maltreatment history: Official records  Child exposure to violence Caregiver reportCaregiver report Child reportChild report Dependent variables: Child behavioral outcomes:Dependent variables: Child behavioral outcomes:  YSR: Child report (internalizing and externalizing)  CBCL: parent report (internalizing and externalizing)  TSC-C: Trauma Symptom Checklist for Children

Independent Variables: Demographics Race/Ethnicity African American54% White27% Hispanic 6% Other13% Child’s Gender Male49% Female51% Adult male in home59%

Independent Variables: Other Control Variables Maltreatment67% Caregiver Depression M Score (SD) 11.0 (9.9)

Independent Variables: Exposure to Violence Child Report: History of Witnessed Violence ScaleChild Report: History of Witnessed Violence Scale  8 items assessing witnessed violence  Clarified whether violence included family or non-family  Frequency ever witnessed: Likert scale from none (0) to 4 or more times (3).

Independent Variables: Exposure to Violence (cont.) Caregiver Report: Child Life EventsCaregiver Report: Child Life Events  6 items focused on witnessed violence from longer scale  Clarified whether violence included family or non-family  Frequency witnessed in last year: Likert scale from none (0) to 4 or more times (3).

Dependent Variables: Child Behavioral Outcomes M (SD) YSR: Internalizing48.4 (9.6) YSR: Externalizing47.8 (10.5) CBCL: Internalizing51.3 (10.9) CBCL: Externalizing55.2 (11.1) TSC: PTSD41.1 (8.4) TSC: Anxiety41.0 (9.4) TSC: Depression39.8 (8.6)

Method: Analysis All subjects with age 12 interviewAll subjects with age 12 interview Subjects with incomplete data droppedSubjects with incomplete data dropped CorrelationsCorrelations Series of hierarchical regression analysesSeries of hierarchical regression analyses  Step 1: Models with caregiver reports Family violenceFamily violence Non-family violenceNon-family violence  Step 2: Child reports added Family violenceFamily violence Non-family violenceNon-family violence

Subjects: Complete vs. Incomplete Data LONGSCAN sample with age 12 data: 949LONGSCAN sample with age 12 data: 949 Analysis sample (complete data): 781Analysis sample (complete data): 781 Analysis sample less likely to be Hispanic (6% vs. 12% in sample with missing data)Analysis sample less likely to be Hispanic (6% vs. 12% in sample with missing data) Analysis sample lower mother depression (11.0 vs. 13.9)Analysis sample lower mother depression (11.0 vs. 13.9) Analysis sample less internalizing (YSR): (48.4 vs. 51.5)Analysis sample less internalizing (YSR): (48.4 vs. 51.5) Site DifferencesSite Differences No differences on other factors.No differences on other factors.

Child Exposure to Family Violence: Parent-Child Agreement Agreement significant BUT very modestAgreement significant BUT very modest Parent-Child Correlation Family Violence.14 Non-Family Violence.15

Violence Exposure as a Predictor of Child Outcome (YSR) InternalizingExternalizin g Std B Maltreatment Caregiver Depression Caregiver Report: Non-Family Caregiver Report: Family Child Report: Non-Family Child Report: Family.13.14

Violence Exposure as a Predictor of Child Outcome (CBCL) InternalizingExternalizin g Std B Maltreatment Caregiver Depression Caregiver Report: Non-Family Caregiver Report: Family Child Report: Non-Family Child Report: Family.01

Violence Exposure as a Predictor of Child Outcome (TSC) PTSDAnxietyDepression Std B Maltreatment Caregiver Depression Caregiver Report: Non-Family Caregiver Report: Family Child Report: Non-Family Child Report: Family

Summary of Results Child reports of both family and non-family violence predict child reports of internalizing and externalizing behaviors and trauma symptoms.Child reports of both family and non-family violence predict child reports of internalizing and externalizing behaviors and trauma symptoms. Neither caregiver reports of family or non-family violence predict child reports of internalizing or externalizing behaviors, or trauma symptoms.Neither caregiver reports of family or non-family violence predict child reports of internalizing or externalizing behaviors, or trauma symptoms. Caregiver report only of family violence predicts caregiver report of internalizing and externalizing behaviors.Caregiver report only of family violence predicts caregiver report of internalizing and externalizing behaviors. child report only of non-family violence predicts caregiver report of internalizing and externalizing behaviors.child report only of non-family violence predicts caregiver report of internalizing and externalizing behaviors.

Summary of Results (cont.) There is a significant but modest correlation between child and caregiver report of both family and non-family witnessed violence.There is a significant but modest correlation between child and caregiver report of both family and non-family witnessed violence. Caregiver depression predicts five of seven adverse child behavioral outcomes and depression.Caregiver depression predicts five of seven adverse child behavioral outcomes and depression. Child maltreatment predicts only two (caregiver report of externalizing behavior and child report of depression) of the seven outcomes.Child maltreatment predicts only two (caregiver report of externalizing behavior and child report of depression) of the seven outcomes.

LimitationsLimitations Systematic, not representative, sampleSystematic, not representative, sample Cross-sectional, not longitudinalCross-sectional, not longitudinal Some differences between total sample and sample used in analysis (differences controlled for)Some differences between total sample and sample used in analysis (differences controlled for) Site differences (controlled for)Site differences (controlled for) Difference measures used for caregiver witnessing and child witnessingDifference measures used for caregiver witnessing and child witnessing

Implications for Research and Clinical Practice Pay attention to child reports of witnessing violencePay attention to child reports of witnessing violence  Child report is a better predictor of child’s self-reported behaviors than caregiver report.  Caregiver may be a valid source of child- witnessed family violence, but not of child- witnessed non-family violence, especially as the child grows older.

Implications for Research and Clinical Practice (cont.) Among children at risk of maltreatment, witnessed violence happening to others in the family and the community may be associated with adverse outcomes.Among children at risk of maltreatment, witnessed violence happening to others in the family and the community may be associated with adverse outcomes. Researchers should include children’s reports of witnessing violence in studies of maltreatment outcomes.Researchers should include children’s reports of witnessing violence in studies of maltreatment outcomes. For more information, visit our website at more information, visit our website at

ReferencesReferences 1.Finkelhor et al The victimization of children and youth: A comprehensive, national survey. Child Maltreatment 10: Johnson et al Adverse behavioral and emotional outcomes from childhood exposure to violence. Child Maltreatment 7: Kilpatrick et al Risk factors for adolescent substance abuse and dependence: Data from a national sample. Journal of Consulting and Clinical Psychology 68: Krug et al., eds. World report on violence and health. Geneva : World Health Organization, Litrownik et al Exposure to family violence in young at- risk children: A longitudinal look at the effects of victimization and witnessed physical and psychological aggression. Journal of Family Violence 18: Thompson et al., Children’s self-reports about violence exposure: An examination of the Things I Have Seen and Heard scale. Manuscript under review.