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.
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