Assessing Risk for Mental Health among Maltreated Racially Diverse Adolescents Exposed to Community Violence

Few studies have examined the prevalence and effects of the co-occurrence of exposure to maltreatment and community violence (Aisenberg & Herrenkohl, 2008). Given that maltreated adolescents disproportionately reside in low-income, urban neighborhoods in which violence frequently occurs, the investigation of risks from exposure to community violence is an important consideration. This presentation focuses on addressing three primary questions: 1) Are maltreated adolescents exposed to community violence more often than those who are not maltreated? 2) Are maltreated youth with co-occurring exposure to community violence at higher risk to experience PTSD and/or behavior problems than non-maltreated youth? 3) Controlling for gender, age, and ethnicity, does child maltreatment act as a mediator of the effects of community violence upon PTSD and behavior problems?

We used data from the Impact of Neglect on Adolescent Development study which employed a cross-sequential design with a selectively adjusted random sample of young adolescent into maltreated and non-maltreated conditions. The maltreatment sample (n=251) consists of newly substantiated cases by the Department of Children and Family Services. A comparative sample of non-maltreated youth (n=142) residing in similar economically heterogeneous communities also enrolled in the study. African American, Latino, and Caucasian adolescents, with a mean age of 12.1 years (SD=1.21), completed the study's measures. These measures include: the Community Violence Exposure Index that measures lifetime exposure, the Youth Symptom Severity Checklist (Margolin, 1999) that assesses PTSD, and the Child Behavior Checklist 4-18 (Achenbach, 1991).

Adolescents reported substantial exposure to acts of community violence. Nearly 84% (n=324) had at least one experience of victimization and 78.5% (n=303) were witnesses to at least one act of community violence. Compared to other youth, African American adolescents were exposed to more acts of community violence (F(3, 382) = 5.301, p =.001). However, they were not at heightened risk for PTSD. Although maltreated adolescents were not significantly at higher risk than non-maltreated youth for community violence exposure, they had substantially more exposure to 3 or more discrete acts (70.7% to 29.3%) (X2 = 6.64, df =1, p<.05). Among maltreated youngsters, 32.1% met PTSD diagnostic criteria compared to 34.4% of non-maltreated youngsters. However, maltreated adolescents manifested behavior problems (34.9%) more than twice as often as non-maltreated adolescents (13.6%). Regression analysis reveals that maltreatment increases the likelihood of youngsters suffering from behavior problems (r = 185, p<.01). However, maltreatment status was not associated with depression or PTSD. Logistic regression reveals maltreatment lowers the direct effect of community violence exposure on behavioral problems. This partial mediating relationship accounts for 6.5% of the variance (F(7,378)= 3.770, p =.001).

Findings highlight the substantial exposure maltreated youngsters had to community violence. The finding of a partial mediating relationship of maltreatment reveals that maltreatment accounts for differences in the prevalence of behavior problems, more so than community violence exposure. Findings underscore the need for further assessment of the co-occurrence of child maltreatment and community violence by practitioners and researchers to inform effective intervention and policy efforts to promote the healthy development and well-being of adolescents.