An Ecological Examination of Cumulative Violence Exposure On Children's Trauma and Depression Symptoms

Purpose: Children who experience multiple types of violence are at greater risk for maladaptive outcomes compared to children who have experienced only one type. Nevertheless, most research has not taken an ecological approach to conceptualizing cumulative violence exposure to understand how violence exposure at different levels of the ecology may be related to maladaptive child outcomes. The current study aimed to understand: 1) how cumulative violence exposure by ecological domain (maltreatment, witnessing violence in the home, and neighborhood violence) is related to child trauma and depressive symptoms, and 2) for children who have experienced maltreatment, whether the addition of violence exposure at higher ecological levels is related to greater trauma and depressive symptoms.

Method: A sample of 1,022 children aged 8-12 years was drawn from the National Survey of Child and Adolescent Well-Being I dataset. Children reported trauma symptoms (Trauma Symptom Checklist for Children) and depressive symptoms (Children’s Depression Inventory) at two time points. Children and mothers reported child maltreatment (Violence Exposure Scale for Children; Conflict Tactics Scale-Parent Child), witnessing violence in the home (Violence Exposure Scale for Children; Conflict Tactics Scale), and living in a violent neighborhood (Community Environment Questions) at both time points. OLS with robust standard errors, fixed effects, and fixed effects with time-varying covariates regression were used to test the effect of cumulative violence exposure (number of ecological domains the child was exposed to violence) on the outcomes. To test the additive effect of higher ecological types of violence on the outcomes for children who were maltreated, the same analyses were conducted comparing children who were only maltreated, children who were maltreated and witnessed violence, and children who were maltreated, witnessed violence, and lived in violent neighborhoods.

Results: Cumulative violence exposure models indicated that children with a greater number of ecological violence exposure domains self-reported greater trauma and depressive symptoms, even after accounting for baseline levels of all variables. The additive effect models indicated that, compared to children who were only maltreated, those who additionally witnessed violence and those who additionally witnessed violence and lived in violent neighborhoods were more likely to report greater trauma and depressive symptoms. Nevertheless, compared to children who were maltreated and witnessed violence in the home, children who were maltreated, witnessed violence, and lived in violent neighborhoods were more likely to report greater depressive symptoms but not greater trauma symptoms.

Conclusion: Children’s cumulative violence exposure based on ecological domain demonstrated similar findings to other studies that used raw indicators of violence exposure to operationalize cumulative violence. This ecological approach bolsters the phenomenon of polyvitcimization while advancing a framework from which to conceptualize the problem. Furthermore, even for children who have been maltreated, witnessing violence in the home as well as living in violent neighborhoods appears to contribute to greater trauma and depressive symptoms. Practitioners working with maltreated children should assess for higher ecological violence exposure. Further, designing interventions that address maltreatment and higher ecological violence exposure domains may contribute to the reduction of maladaptive outcomes for children.