Exposure to Community Violence as a New Adverse Childhood Experience Category: A Summary of a New Study

The current adverse childhood experience (ACE) survey does not include exposure to community violence (ECV) as a category. A new study by Lee, Larkin, and Esaki (2017) point to evidence that ECV fits the World Health Organization (WHO)’s classification for an ACE category, that it must: cause biological stress response, be sensitive to policies, be common across societies, be able to be measured quickly and easily, and be proximal in respect to causality (WHO, 2011).

Lee et al. (2017) analyzed data collected as part of the 2009 New York State (NYS) Omnibus survey to assess ECV’s occurrence and its implications. The 10 standard ACE items were asked in the survey as well as an additional ECV question: “Did you ever see someone in your neighborhood threaten or seriously hurt another person?” Use of behavioral health services and sociodemographic variables were also obtained.

The results indicate that ACE scores and ECV are significantly associated; 24% of the participants with 1 or 2 ACEs reported ECV and 51% of the participants with 3 or more ACEs witnessed community violence. Behavioral health service use was also significantly more likely among respondents with a high exposure to community violence than those who rarely or ever witnessed it. In addition, those who reported any ECV were 2.7 times more likely to use behavioral health services than those who did not. The only sociodemographic variable found to be significant was that African Americans were half as likely to use services compared to Whites.

These results point to adverse long-term effects of ECV and to its utility as an additional ACE category. Given the high service costs of ACEs, including ECV, this research can help to inform policymakers and service providers. Early intervention, particularly in school settings, for youth with exposure to community violence would help to prevent its adverse effect in adulthood.

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Karen:

I think it is important to not use the term toxic stress or trauma too loosely. It is important that actual research like what is shared in this post, is used to accurately identify sources of toxic stress. We need to rely on behavioral and biological measures that show that regular experiences of violence within one's own home or community causes poor outcomes for individuals.

But just because something is difficult or stressful---ie. political protest-- doesn't make it trauma. In fact, conflict can be an opportunity for learning and growth. It is when violence becomes ongoing and affects children's sense of safety in their daily lives that it is toxic to their wellbeing. More over, I would argue that children need to understand how anger and voicing that anger works in the real world--in all its messiness--for better or worse. There is an opportunity here to teach children about healthy use of their voices to protest what they see as injustice vs. violent and damaging uses of "free speech." Being able to use one's voice to speak up and create change is one of the skills that help mitigate the effects of violence, trauma, and disempowerment.

 

I'm glad to see that community violence is again being recognized as a childhood adversity.  This paper, added to the Finkelhor paper and two papers from the Philadelphia ACEs group (Cronholm, 2015 and Wade 2015), demonstrate that community level toxic stressors (e.g., exposure to community violence, racism/discrimination, being bullied, etc) expand the conceptualization and measurement of ACEs.

This would seem to be particularly useful from a research perspective (the stumbling block for Complex Trauma reviewed for DSM5)

-- and maybe only from that perspective

I know many paramedical officers in our services would want a broader set of criteria to be used in clinical practice -- "a childhood experience that disables or distorts adaptive attachment relations" perhaps, and so they are pleased to see the forthcoming ICD 11.  Many of our older staff are also cognizant of the decades-long research, from the '60s --- children from the ghettos -- long predating the ACEs research, yet reaching much the same conclusions. Similarly, world wide studies also "mention in passing" the effects of psychological and family stressors, yet resources, including food and social services, have to be prioritized in terms of immediate physical survival -- Phillip Baiden has done some good work in this "cross-cultural" area.

And why is the term "ACEs science" used? It doesn't have the "cohesion" of other branches of science, and seems to be used only on this site, and on ACEsTooHigh -- an alternative expression is used on this site "NEAR science" (perhaps a better aide memoire and this may be a more functional, and broadly acceptable, term), which ACEs science might not be

NEAR Science

 

 

Karen Polehn posted:
The hostile political environment of our elected leaders should also qualify as a ECV. We traumatize children with the hate mongering and escalation of protests and negative messages from the public about our government that we are supposed to trust. What message are we sending to our most vulnerable populations, when violence becomes a household name that is just an event, or pursued to be how we are acceptably dealing with "what we want"?..
Toxic stress not only to our leaders, but our children see it as "the only way to make a change" is far from the message we want to deliver too our most vulnerable!
Hate mongering, and violent toxic attacks on our elected leaders becomes a negative model of what respect looks like in our modern world.


Sent from my iPad

> On Apr 13, 2017, at 7:00 PM, ACEsConnection <communitymanager@acesconnection.com> wrote:
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this is intriguing -- this is the first time I've seen the email address for anyone actually given -- "communitymanager"  = Jane Stevens?

Hi, Karen. Thanks for your comment. Violent and/or toxic attacks on anyone aren't useful. Free speech by people to express their disagreement with what our elected leaders are doing is an integral part of who we are as Americans. And it can be accomplished in a trauma-informed/resilience-building way that sets a good example for our children to become involved citizens.

The hostile political environment of our elected leaders should also qualify as a ECV. We traumatize children with the hate mongering and escalation of protests and negative messages from the public about our government that we are supposed to trust. What message are we sending to our most vulnerable populations, when violence becomes a household name that is just an event, or pursued to be how we are acceptably dealing with "what we want"?..
Toxic stress not only to our leaders, but our children see it as "the only way to make a change" is far from the message we want to deliver too our most vulnerable!
Hate mongering, and violent toxic attacks on our elected leaders becomes a negative model of what respect looks like in our modern world.


Sent from my iPad

> On Apr 13, 2017, at 7:00 PM, ACEsConnection <communitymanager@acesconnection.com> wrote:
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