Intergenerational Impact of Violence Exposure: Emotional-Behavioural and School Difficulties in Children Aged 5–17

Background and Objectives: The intergenerational impacts of parental exposure to violence during childhood and adulthood have largely been investigated separately. This limits our understanding of how cumulative violence exposure over a lifespan elevates the risk of subsequent generation's maladjustment. To address this, we examined if parental exposure to violence during childhood and during adulthood was associated with increased emotional-behavioural and school difficulties among the children of these parents. Further, we examined if parental exposure to cumulative violence increased the odds of their children experiencing difficulties.Participants and Setting: 705 participants (354 mothers and 351 fathers) from the 2019 New Zealand Family Violence Survey, a population-based study conducted in New Zealand between March 2017 and March 2019.Methods: Multivariable logistic regressions were conducted to ascertain the impact of parental exposure to violence on children's outcomes after adjustment for sociodemographic characteristics. The impact of parental cumulative violence exposure on children's outcomes was also explored.Results: Findings indicated that children of parents who had histories of exposure to violence during childhood were at increased risk for experiencing emotional-behavioural or school difficulties. However, where parents reported a history of childhood abuse but not adult experience of violence, their children had similar odds of experiencing difficulties as the children of parents who had not been exposed to any violence in their lifetime. Children of parents who had been exposed to violence only during adulthood were at higher risk of experiencing emotional-behavioural difficulties compared with children of parents with no violence exposure. Children of parents with histories of exposure to violence during both childhood and adulthood had the highest prevalence of experiencing emotional/behavioural and school difficulties.Conclusion: These findings highlight the intergenerational impacts of violence exposure and the complex intersections between parents' and children's life experiences. Our findings suggest the need for violence prevention initiatives to foster the development of safe, stable and nurturing relationships and to expand services for parents already exposed to violence to build resilience and to break the inter-generational cycle of disadvantage.

“Every Thought and Dream a Nightmare”: Violence and Trauma Among Formerly Imprisoned Gang Members

Persons involved in gangs disproportionately participate in violence, as both victims and perpetrators. However, much remains unknown about the prevalence and consequences of violence exposure among adult gang members, particularly among those who have been incarcerated. We draw on semi-structured interviews with formerly imprisoned gang members to provide a contextualized account of the continuum of violence before, during, and after prison and illuminate the consequences of cumulative violence exposure among an understudied subgroup at greatest risk for violence. Findings show that adult gang members experience frequent and ongoing exposure to serious violence, as both victims and perpetrators, before, during, and after prison, and directly and vicariously. Although direct involvement in violence dissipated after prison, exposure to vicarious victimization was substantial and ongoing. In addition, respondents reported physiological and psychological consequences related to their chronic exposure to violence and trauma, including nightmares, anxiety, fear, anger, and hypervigilance.

Cumulative Lifetime Violence Severity and Chronic Pain in a Community Sample of Canadian Men

Objective To create a descriptive profile of chronic pain severity in men with lifetime cumulative violence histories, as a target and/or a perpetrator, and investigate how chronic pain severity is associated with and predicted by lifetime cumulative violence severity and known determinants of chronic pain. Methods Analysis of variance and binary logistic regression were performed on data collected in an online survey with a community convenience sample of 653 men who reported experiences of lifetime violence. Results The prevalence of high-intensity / high-disability pain in men with lifetime violence was 35.8%. Total Cumulative Lifetime Violence Severity-44 (CLVS-44) scores were significantly associated with high-intensity / high-disability chronic pain measured by the Chronic Pain Grade Scale (odds ratio= 8.40). In a model with 10 CLVS-44 subscale scores, only psychological workplace violence as a target (adjusted odds ratio [aOR]= 1.44) and lifetime family physical violence as a target (aOR= 1.42) significantly predicted chronic pain severity. In a multivariate model, chronic pain severity was predicted by CLVS-44 total score (aOR= 2.69), age (aOR= 1.02), injury with temporary impairment (aOR= 1.99), number of chronic conditions (aOR= 1.37), and depressive symptoms (aOR= 1.03). Conclusion The association between lifetime cumulative violence severity and chronic pain severity in men is important new information suggesting the need for trauma- and violence-informed approaches to assessment and intervention with men. This is the first analysis using CLVS-44 subscales to understand which configurations of lifetime cumulative violence may be most predictive of chronic pain severity; further investigation is needed to confirm these findings.

Intersecting Dimensions of Violence, Abuse, and Victimization

Many victimization studies have focused on one dimension of violence at a time, such as looking at the effect of a specific violence type on a health outcome. But the term common best describes the occurrence of intersecting violent experiences or, more specifically, intersecting dimensions of violence, abuse, and victimization. Over time, bodies of literature about this phenomenon have morphed in terms of conceptualization and operationalization. In this context, silos have developed that place barriers within and between fields and disciplines that concern the study and treatment of violence at various levels. However, shared catalysts and inhibitors, the common nature of experiencing more than one victimization event, and the possible concurrence of certain violence experiences offer points of disruption to these silos. In this light, there are many components, or dimensions, of violence that span from the most basic unit (the individual act of violence) to various means of categorization: violence type, severity or frequency, duration, and number of violence-perpetrating individuals. These dimensions, when identified within research, can help researchers map out how two acts (as well as their broader categorizations) intersect to influence lived experiences. Researchers use various terms to describe this phenomenon (e.g., poly-victimization, revictimization, cascading maltreatment, hybrid exploitation, cumulative violence exposure, cumulative patterns, constellations, and dose-response). This multidimensional approach offers the hope of (a) deconstructing the silos between and among fields and disciplines, (b) bringing research methods and analytical treatments of violence within studies closer to reality, (c) holistically acknowledging that violence varies, (d) deconstructing stereotypes, (e) identifying shared risk factors, (f) advocating for collaboration, (g) cultivating resilience, and (h) examining victims and survivors’ experiences through a lens that draws connections between intersecting abuse experiences and intersecting systems of oppression. Likewise, although there are some common instruments utilized for operationalization, these measurement tools vary greatly, as well. Analytical treatments of intersecting dimensions of violence, abuse, and victimization can be categorized into six overarching data analysis strategies: relationships between violent experiences, counting violence types, variety scores and indices, combinations of violent events or types, schemes, and person-centered approaches. Although these dimensions, terminologies, instruments, and analytical treatments can be identified within the literature, overlaps and mixtures of terms and analytical treatments become apparent when comparing studies. Implications for research include testing familiar cumulative relationships across fields, incorporating a broader policy context, and more thoroughly examining variation within and between violence types. Through the multidimensional perspective, violence prevention and intervention can be improved and advanced through thoroughness in application.

Cumulative Violence and PTSD Symptom Severity Among Urban Street-Based Female Sex Workers

Female sex workers (FSW) are a marginalized and vulnerable population at high risk of gender-based violence within and outside of their occupation. However, FSW remain underrepresented in the trauma and mental health literature. The aims of this study were to (a) characterize exposure to violence among street-based FSW, including violence type, patterns over the life course, and key perpetrator groups, and (b) examine the multivariate associations between posttraumatic stress disorder (PTSD) symptom severity and two constructs (revictimization across life stages and cumulative violence). Data were drawn from the Sex Workers and Police Promoting Health in Risky Environments (SAPPHIRE) study, an observational community-based cohort of street-based FSW recruited through targeted sampling across Baltimore, Maryland (USA) in 2016 to 2017. PTSD symptom severity was measured using the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders–Fifth Edition (PCL-5). At baseline, 61% of FSW screened positive for PTSD symptoms. The mean PCL-5 score was 38.6. We documented extensive histories of sexual and physical violence (lifetime: 81.8%; childhood and adult revictimization: 15.0% for sexual and 37.7% for physical). The vast majority of perpetrators were male and included paying clients, police officers, family members, and intimate partners. Exposure to childhood and adult sexual violence were independently associated with higher PTSD severity ( p < .05), with marginal associations observed for physical violence. Data supported a cumulative violence model of PTSD severity ( p < .05). Binge drinking also appeared to be a contributing factor ( p < .05). The levels of PTSD observed among our sample were comparable with that reported among treatment-seeking war veterans. Our findings underscore the urgent need for tailored trauma-informed interventions and policies to address violence among urban street-based FSW, a population experiencing extremely high levels of violence, PTSD, and substance use.

EMDR Therapy With Children and Adolescents

This special issue aims to highlight the importance of exploring the empirical base for eye movement desensitization and reprocessing (EMDR) therapy with children and adolescents. Such an endeavor is set within a context where the American Psychological Association recommends trauma-focused cognitive behavioral therapy (TF-CBT) as the treatment of choice and the National Institute of Health and Care Excellence (NICE) recommends EMDR for children when TF-CBT fails to be effective. Studies in this special issue suggest otherwise and represent EMDR’s global reach over seven different countries. The studies address a range of conceptual gaps and evaluate differing EMDR protocols for individual and group delivery. Participants from preschool to adolescence experienced single event, cumulative violence, and trajectories of trauma and present with a range of trauma symptoms. Although studies with differing methodologies highlight the efficacy of EMDR with differing populations, recommendations are made for rigorous research designs in order to influence professional guidance organizations.