Violence In The Home Leads To Higher Rates Of Childhood Bullying
Children who were exposed to violence in the home engaged in higher levels of physical bullying than youngsters who were not witnesses to such behavior, according to a study by researchers from the University of Washington and Indiana University.
The study is one of the first in the United States to specifically examine the association between child exposure to intimate partner violence and involvement in bullying. It also is one of the first to break down bullying into physical aggression (hitting, pushing and other forms outward aggression) and relational aggression (teasing, being mean and ostracizing peers).
Overall, 34 percent of the children studied engaged in bullying and 73 percent reported being the victim of some form of bullying in the previous year. Almost all of the bullies, 97 percent, said they were also victims of bullying.
"Children learn from seeing what their primary caregivers do. They are very attuned and very observant about what goes on in a household," said Dr. Nerissa Bauer, lead author of the study and a former UW pediatrician who is now an assistant professor of pediatrics at Indian and Riley Children's Hospital.
"Parents are very powerful role models and children will mimic the behavior of parents, wanting to be like them. They may believe violence is OK and they can use it with peers. After all, they may think, 'If Daddy can do this, perhaps I can hit this kid to get my way.' When parents engage in violence, children may assume violence is the right way to do things," she said.
"This study supports the idea that parental violence can lead to violence between children and their peers," added Todd Herrenkohl, a UW associate professor of social work and co-author of the paper published in the current issue of the journal Pediatrics. "Children develop a mindset when they see how parents deal with problems. It is a script based on early observations in the home."
Data for the study were drawn from the ongoing Seattle Social Development Project and the Intergenerational Projects, which are tracing youth development and social and antisocial behavior. Participants in these long-term studies were recruited from Seattle elementary schools, and 808 students (generation 2), their parents (generation 1) and their children (generation 3) have been followed since 1985. The bullying study looked at the behavior of 112 children from generation 3 who were 6 to 13 years old, an age group not normally examined in bullying research. Most previous bullying studies have focused on middle school-age children.
The study focused on intimate partner violence, a somewhat broader term than domestic violence, for physical, emotional or sexual acts of violence. It includes couples who may not be married or living together. A 2000 federal study estimated that between 3.3 and 10 million children are exposed to intimate partner violence annually. Overall, 51 percent of the households in the Seattle study reported intimate partner violence during either or both of two specified times over a five-year period.
It also found that:
* Girls reported higher rates than boys for bullying others, accounting for 61 percent of the reported incidents.
* Girls also were victims more frequently, accounting for 55 percent of the incidents.
* Children who are exposed to family violence are more likely to have internalizing behaviors such as early childhood depression, sadness and withdrawn behavior.
* There appears to be no link between witnessing family violence and relational bullying.
Bauer said the study of bullying is relatively new and issues such as domestic violence and intimate partner violence traditionally have been sticky subjects for pediatricians to talk about.
"Physicians may have been afraid of the answers they might get and may not know of community resources that are available. In the not so recent past, intimate partner violence was something physicians typically did not ask about. Today, it is recognized that family violence is common, with about 40 percent of women reporting they have been victims of it sometime in their lifetime," she said.
"Physicians and teachers should be sensitive that when children display behavior issues that the possibility of domestic violence in the family exists. Not all children exposed to violence will respond in the same way, but there are many indirect effects and problems that you can see, such as engaging in bullying, not being able to make friends, not eating or those with extended school absences. But not all bullies come from violent families," she said.
Herrenkohl said the study illustrates the importance of looking at how family events affect children over time and the power of the intergenerational transmission of violence.
"We know that bullying leads to further antisocial behavior and this study shows how family violence leads to bullying. When intimate partner violence happens we can work with parents to show them how it can impact their children," he said. "A key is early identification of this kind of problem, but it is never too late to intervene to break the cycle of violence."
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The research was funded by the National Institute of Drug Abuse and a National Research Service Award Primary Care Research Fellowship. Co-authors of the paper, all at the UW, are Drs. Paula Lozano and Frederick Rivara, associate professor and professor of pediatrics; Karl Hill, research associate professor in the Social Development Research Group; and J. David Hawkins, professor of social work and former director of the Social Development Research Group.
Contact: Joel Schwarz
University of Washington
Violence exposure and traumatic stress reactions can lead to poor health in children
The link between health problems and children in low income, single-mother families is not surprising; these children are also more apt to be exposed to violence and maltreatment within the community and their families. A study in the March issue of The Journal of Pediatrics examines whether traumatic stress reactions in children due to these adverse childhood experiences also play a role in predicting their health.
Sandra Graham-Bermann, Ph.D. and Julia Seng, Ph.D., CNM, from the University of Michigan interviewed the mothers and teachers of 160 children, ages four through six, recruited from Head Start programs in two Michigan counties. They found that 65% of the children were exposed to at least one incident of violence in their communities, which ranged from less severe (beatings and chasings) to severe (shootings, stabbings, and rapes). 47% were exposed to at least one incident of violence in their families, such as child maltreatment and domestic violence. 90% of those exposed to some form of violence had reactions characterized as traumatic stress (i.e. having nightmares, thumb-sucking, or bed-wetting), and 20% were at high risk for developing post traumatic stress disorder.
Nearly one-third of the children had allergies, asthma, or attention deficit hyperactivity disorder (ADHD). Children who had one or more of these three health problems were significantly more likely to have been exposed to violence within the family and to have shown signs of traumatic stress. Children with asthma or gastrointestinal problems were almost four times more likely to have post traumatic stress disorder than the children without these health problems. Dr. Graham-Bermann points out that the direction of these effects--in other words, whether post traumatic stress disorder causes illnesses or illnesses cause post traumatic stress disorder--is presently unknown. The research also indicated that substance abuse and the overall health of the mother were factors in predicting children's health problems.
While preventing family and community violence may be beyond the control of health care providers, the authors suggest that clinical interventions to increase the mothers' safety and health may improve their ability to protect their children. In addition, health care providers may be able to treat child traumatic stress symptoms or refer children exposed to violence to group or individual therapy, which may improve their health and well-being.
The study is reported in "Violence exposure and traumatic stress symptoms as additional predictors of health problems in high-risk children" by Sandra A. Graham-Bermann, PhD and Julia Seng, PhD, CNM. The article appears in The Journal of Pediatrics, Volume 147, Number 3 (March 2005), published by Elsevier.
The Journal of Pediatrics is a primary reference for the science and ractice of pediatrics and its subspecialties. This authoritative resource of riginal, peer-reviewed articles oriented toward clinical practice helps physicians stay abreast of the latest and ever-changing developments in pediatric medicine. The Journal of Pediatrics ranks in the top 12% of the 5,907 scientific journals receiving the most citations (Science Citation Index). The Journal is published under the Mosby imprint by Elsevier, a leading global publisher of scientific, technical, and medical journals, books, and reference works. It is a member of the Reed Elsevier plc group. URL: http://www.mosby.com/jpeds
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Children who see/experience violence have behavioral problems
Children who observe violence or are victims of it show more behavior problems than other children, according to a study of 175 children aged 9 to 12.
"There is a relationship between the physical proximity of exposure to violence and psychosocial maladjustment among urban school-aged children," say Oscar H. Purugganan, M.D., M.P.H., and colleagues from Albert Einstein College of Medicine/Children's Hospital at Montefiore in New York.
However, the children's personal closeness or distance to victims of violence had only a small effect on their behavior. Among those who had seen or heard reports of violence from other people or in the media, the authors found little connection between the children's psychological problems and their relationship to victims
Their work appears in the December issue of the Journal of Developmental and Behavioral Pediatrics.
The researchers recruited patients from an urban pediatric primary care clinic, interviewing them and their mothers from January 1997 to February 1998. Children were asked if they had been victims of violence, had witnessed it directly or had heard reports of violence from other people or through the media.
Purugganan used two questionnaires to measure child behavior. Children who were victims of violence scored the worst on both scales. "Those who were direct victims of violence had the most behavioral problems, followed by those who were witnesses, and then by those who were exposed through other people's report or the media," Purugganan says.
The researchers found that 16 of the 86 victims (18 percent) and seven of the 60 witnesses (12 percent) reached the clinical cutoff point for psychosocial maladjustment. However, none of the 29 children exposed through reports of others scored poorly enough to meet the same cutoff standard.
Most of the families in the study were from inner-city minority groups - 55 percent Hispanic and 33 percent African-American. However, Purugganan says that other studies, including one in a suburban Pennsylvania middle school, found that children there had witnessed similar levels of violence.
Thus the results of this study should serve as an alert for all physicians caring for children, regardless of where they live, he says.
"In the backdrop of high rates of exposure to violence, pediatricians should be vigilant in recognizing maladaptive patterns of behaviors in children exposed to violence," he concludes.
The Maternal and Child Health Bureau of the U.S. Department of Health and Human Services provided support for this study.
Health Behavior News Service: (202) 387-2829 or www.hbns.org. Interviews: Contact Karen Gardner (718) 430 3101 or kgardner@aecom.yu.edu. Journal of Developmental and Behavioral Pediatrics: Contact Mary Sharkey at (212) 595-7717.
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