“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.
