Table of Contents

A Message From OJJDP

History of the National Survey of Children’s Exposure to Violence

Children’s Exposure to Violence: A Comprehensive National Survey

Children’s Exposure to Intimate Partner Violence and Other Family Violence

Polyvictimization: Children’s Exposure to Multiple Types of Violence, Crime, and Abuse

Questions and Answers About the National Survey of Children’s Exposure to Violence

Child and Youth Victimization Known to Police, School, and Medical Authorities

Children’s Exposure to Violence and the Intersection Between Delinquency and Victimization

A Message From OJJDP

Children are exposed to violence every day in their homes, schools, and communities. Such exposure can cause them significant physical, mental, and emotional harm with long-term effects that can last well into adulthood.

The Attorney General launched Defending Childhood in September 2010 to unify the Department of Justice’s efforts to address children’s exposure to violence under one initiative. Through Defending Childhood, the Department is raising public awareness about the issue and supporting practitioners, researchers, and policymakers as they seek solutions to address it. A component of Defending Childhood, OJJDP’s Safe Start initiative continues efforts begun in 1999 to enhance practice, research, training and technical assistance, and public education about children and violence.

Under Safe Start, OJJDP conducted the National Survey of Children’s Exposure to Violence, the most comprehensive effort to date to measure the extent and nature of the violence that children endure and its consequences on their lives. This is the first study to ask children and caregivers about exposure to a range of violence, crime, and abuse in children’s lives.

As amply evidenced in this bulletin series, children’s exposure to violence is pervasive and affects all ages. The research findings reported here and in the other bulletins in this series are critical to informing our efforts to protect children from its damaging effects.

Learn more about the Attorney General’s Defending Childhood Initiative at www.justice.gov/ag/defendingchildhood.

Find out more about OJJDP’s Safe Start Initiative at www.safestartcenter.org.

History of the National Survey of Children’s Exposure to Violence

Under the leadership of then Deputy Attorney General Eric Holder in June 1999, the Office of Juvenile Justice and Delinquency Prevention (OJJDP) created the Safe Start initiative to prevent and reduce the impact of children’s exposure to violence. As a part of this initiative, and with a growing need to document the full extent of children’s exposure to violence, OJJDP launched the National Survey of Children’s Exposure to Violence (NatSCEV) with the support of the Centers for Disease Control and Prevention.

NatSCEV is the first national incidence and prevalence study to comprehensively examine the extent and nature of children’s exposure to violence across all ages, settings, and timeframes. Conducted between January and May 2008, it measured the past-year and lifetime exposure to violence for children age 17 and younger across several major categories: conventional crime, child maltreatment, victimization by peers and siblings, sexual victimization, witnessing and indirect victimization (including exposure to community violence and family violence), school violence and threats, and Internet victimization. This survey marks the first comprehensive attempt to measure children’s exposure to violence in the home, school, and community across all age groups from 1 month to age 17 and the first attempt to measure the cumulative exposure to violence over the child’s lifetime. The survey asked children and their adult caregivers about not only the incidents of violence that children suffered and witnessed themselves but also other related crime and threat exposures, such as theft or burglary from a child’s household, being in a school that was the target of a credible bomb threat, and being in a war zone or an area where ethnic violence occurred.

The survey was developed under the direction of OJJDP and was designed and conducted by the Crimes against Children Research Center of the University of New Hampshire. It provides comprehensive data on the full extent of violence in the daily lives of children. The primary purpose of NatSCEV is to document the incidence and prevalence of children’s exposure to a broad array of violent experiences across a wide developmental spectrum. The research team asked followup questions about specific events, including where the exposure to violence occurred, whether injury resulted, how often the child was exposed to a specific type of violence, and the child’s relationship to the perpetrator and (when the child witnessed violence) the victim. In addition, the survey documents differences in exposure to violence across gender, race, socioeconomic status, family structure, region, urban/rural residence, and developmental stage of the child; specifies how different forms of violent victimization “cluster” or co-occur; identifies individual, family, and community-level predictors of violence exposure among children; examines associations between levels/types of exposure to violence and children’s mental and emotional health; and assesses the extent to which children disclose incidents of violence to various individuals and the nature and source of any assistance or treatment provided.

Children’s Exposure to Violence: A Comprehensive National Survey

David Finkelhor, Heather Turner, Richard Ormrod, Sherry Hamby, and Kristen Kracke

October 2009

This Bulletin discusses the National Survey of Children’s Exposure to Violence (NatSCEV), the most comprehensive nationwide survey of the incidence and prevalence of children’s exposure to violence to date, sponsored by the Office of Juvenile Justice and Delinquency Prevention (OJJDP) and supported by the Centers for Disease Control and Prevention (CDC). Conducted between January and May 2008, it measured the past-year and lifetime exposure to violence for children age 17 and younger across several major categories: conventional crime, child maltreatment, victimization by peers and siblings, sexual victimization, witnessing and indirect victimization (including exposure to community violence and family violence), school violence and threats, and Internet victimization. (For more detailed information on the types of violence that children were questioned about, see “Screening Questions.”) This survey is the first comprehensive attempt to measure children’s exposure to violence in the home, school, and community across all age groups from birth to age 17, and the first attempt to measure the cumulative exposure to violence over the child’s lifetime.

The survey confirms that most of our society’s children are exposed to violence in their daily lives. More than 60 percent of the children surveyed were exposed to violence within the past year, either directly or indirectly (i.e., as a witness to a violent act; by learning of a violent act against a family member, neighbor, or close friend; or from a threat against their home or school) (for full details on these and other statistics cited in this Bulletin, see Finkelhor et al., 2009). Nearly one-half of the children and adolescents surveyed (46.3 percent) were assaulted at least once in the past year, and more than 1 in 10 (10.2 percent) were injured in an assault; 1 in 4 (24.6 percent) were victims of robbery, vandalism, or theft; 1 in 10 (10.2 percent) suffered from child maltreatment (including physical and emotional abuse, neglect, or a family abduction); and 1 in 16 (6.1 percent) were victimized sexually. More than 1 in 4 (25.3 percent) witnessed a violent act and nearly 1 in 10 (9.8 percent) saw one family member assault another. Multiple victimizations were common: more than one-third (38.7 percent) experienced 2 or more direct victimizations in the previous year, more than 1 in 10 (10.9 percent) experienced 5 or more direct victimizations in the previous year, and more than 1 in 75 (1.4 percent) experienced 10 or more direct victimizations in the previous year.

Reports of lifetime exposure to violence were generally about one-third to one-half higher than reports of past-year exposure, although the difference tended to be greater for less frequent and more severe types of victimization. (For example, more than three times as many respondents reported being victims of a kidnapping over their lifetimes as did in the past year.) Nearly seven in eight children (86.6 percent) who reported being exposed to violence during their lifetimes also reported being exposed to violence within the past year, which indicated that these children were at ongoing risk of violent victimization. The reports of lifetime exposure also indicate how certain types of exposure change and accumulate as a child grows up; nearly one in five girls ages 14 to 17 (18.7 percent) had been the victim of a sexual assault or attempted sexual assault, and more than one-third of all 14- to 17-year-olds had seen a parent assaulted.

Background

The Problem of Violence Against Children

Children in the United States are more likely to be exposed to violence and crime than are adults (Finkelhor, 2008; Hashima and Finkelhor, 1999). In 2005, juveniles and young adults ages 12 to 19 were more than twice as likely to be victims of violent crimes as the population as a whole (Baum, 2005).1 Each year, millions of children and adolescents in the United States are exposed to violence in their homes, schools, and communities as both victims and witnesses. Even if they are not physically present, children may be affected by intentional harm done by another (for example, the murder of or an assault on a family member or close neighbor). Children react to exposure to violence in different ways, and many children show remarkable resilience. All too often, however, children who are exposed to violence undergo lasting physical, mental, and emotional harm. They suffer from difficulties with attachment, regressive behavior, anxiety and depression, and aggression and conduct problems. They may be more prone to dating violence, delinquency, further victimization, and involvement with the child welfare and juvenile justice systems. Moreover, being exposed to violence may impair a child’s capacity for partnering and parenting later in life, continuing the cycle of violence into the next generation.

Research has found that early identification, intervention, and continued followup are valuable strategies to prevent or decrease the impact of exposure to violence. Families, teachers, police, judges, pediatricians, mental health providers, child protection workers, domestic violence advocates, and others who interact with children have a responsibility to create interventions, both physical and psychological, that decrease or prevent the harms associated with exposure to violence.2 These include ways of interacting sensitively and expeditiously with children, ensuring protective environments and caregivers, and helping children use positive coping skills. Much more research is warranted about what works to mitigate the effects of exposure to violence.

Too little is known about the numbers of children exposed to violence. Although several studies have attempted to measure children’s exposure to violence, these estimates have varied greatly and have often measured only a subset of that exposure.3 Not only does this partial measurement fail to reveal the full extent of violence against children, it also fails to account fully for the multiple victimizations that many children experience; the co-occurrence of certain types of violence (for example, intimate partner violence and child maltreatment or neglect within a household); the extent to which exposure to one type of violence may make a child more vulnerable to other types of violence and victimization; and the cumulative effects of repeated exposure to violence as both a direct victim and a witness. Basic epidemiological data are important to determine the extent of the public health problem, the need for services, and a baseline for evaluating progress.

Screening Questions

The survey asked screening questions about 48 types of victimization in the following categories:

- ◆ Conventional crime. Nine types of victimization, including robbery, theft, destruction of property, attack with an object or weapon, attack without an object or weapon, attempted attack, threatened attack, kidnapping or attempted kidnapping, and hate crime or bias attack (an attack on a child because of the child’s or parent’s skin color, religion, physical problem, or perceived sexual orientation).

- ◆ Child maltreatment. Four types of victimization, including being hit, kicked, or beaten by an adult (other than spanking on the bottom); psychological or emotional abuse; neglect; and abduction by a parent or caregiver, also known as custodial interference.

- ◆ Peer and sibling victimization. Six types of victimization, including being attacked by a group of children; being hit or beaten by another child, including a brother or sister; being hit or kicked in the private parts; being chased, grabbed, or forced to do something; being teased or emotionally bullied; and being a victim of dating violence.

- ◆ Sexual victimization. Seven types of victimization, including sexual contact or fondling by an adult the child knew, sexual contact or fondling by an adult stranger, sexual contact or fondling by another child or teenager, attempted or completed intercourse, exposure or “flashing,” sexual harassment, and consensual sexual conduct with an adult.

- ◆ Witnessing and indirect victimization. These fall into two general categories, exposure to community violence and exposure to family violence. For exposure to community violence, the survey included 10 types of victimization, including seeing someone attacked with an object or weapon; seeing someone attacked without an object or weapon; having something stolen from the household; having a friend, neighbor, or family member murdered; witnessing a murder; witnessing or hearing a shooting, bombing, or riot; being in a war zone; knowing a family member or close friend who was fondled or forced to have sex; knowing a family member or close friend who was robbed or mugged; and knowing a family member or close friend who was threatened with a gun or knife.

For exposure to family violence, eight types of victimization were assessed: seeing a parent assaulted by a spouse, domestic partner, or boyfriend or girlfriend; seeing a brother or sister assaulted by a parent; threat by one parent to assault the other; threat by a parent to damage the other parent’s property; one parent pushing the other; one parent hitting or slapping the other; one parent kicking, choking, or beating up the other; and assault by another adult household member against a child or adult in the household.

- ◆ School violence and threat. Two types of victimization, including a credible bomb threat against the child’s school and fire or other property damage to the school.

- ◆ Internet violence and victimization. Two types of victimization, including Internet threats or harassment and unwanted online sexual solicitation.

Prior Attempts at Comprehensive Measurements

There have been many studies on the health and behavioral consequences of child maltreatment and, to a lesser extent, on other forms of violence against children.4 However, most of these studies focused on only one type of violence or on a few types within a single category such as child abuse.5 Two notable earlier studies attempted to measure children’s exposure to violence and its adverse effects in a more comprehensive fashion. The Adverse Childhood Experiences (ACE) study, cosponsored by CDC and Kaiser Permanente, looked at the consequences for future health and well-being of exposure to seven types of adverse childhood experiences^6 under the categories of abuse, neglect, and household dysfunction. Almost two-thirds of those surveyed had suffered at least one adverse childhood experience, and more than one in five respondents reported three or more such experiences. The survey found increased rates of a number of long-term harms to physical, mental, and emotional health associated with those experiences, including alcoholism, drug abuse, depression, severe obesity, and several chronic adult diseases. The survey further found that multiple adverse experiences compounded those harms. Although the ACE study was one of the first to document the long-term consequences of multiple childhood victimizations, it had a different focus than NatSCEV. For one, the study questioned adults on their memories of adverse childhood experiences rather than surveying children directly, and the set of adverse experiences was more limited than those included in NatSCEV.

The other major attempt to examine the prevalence and incidence of children’s exposure to violence was the Developmental Victimization Survey (DVS), a precursor to NatSCEV. DVS asked a nationally representative sample of 2,030 children ages 10 to 17 and caregivers of children ages 2 to 9 about their past-year exposure to crime and violence in five categories: conventional crime, child maltreatment, peer and sibling victimization, sexual assault, and witnessing and indirect victimization (Finkelhor et al., 2005; Kracke and Hahn, 2008). DVS was the first survey to simultaneously examine these various forms of victimization to obtain a comprehensive picture of children’s exposure to violence. It was also the first national survey to estimate the incidence of many specific forms of victimization such as bias attacks and witnessing physical abuse (Finkelhor et al., 2005; Kracke and Hahn, 2008). DVS generally found a higher rate of specific types of victimization than earlier studies such as the National Crime Victimization Survey. Nearly three-quarters of the respondents (71 percent) reported a direct or indirect victimization within the past year, and the average young victim reported three separate types of victimizations in separate incidents. More than one-third of those surveyed reported that they witnessed violence or were otherwise indirect victims of violence. DVS, however, provided only a limited assessment of lifetime incidence of exposure to violence; did not look specifically at items such as threats and Internet victimization; and had limited measurement of exposure to family violence, exposure to community violence, and school violence and threats. DVS also did not include children younger than age 2. NatSCEV expands on DVS by comprehensively assessing lifetime exposure, considering additional forms of violence, and including infants in the sample. With its much larger sample size, NatSCEV also allows for much more reliable estimates of rarer forms of victimization and more accurate rates within different subgroups of the population (Finkelhor et al., 2009).

History of the Current Study

Under the leadership of then Deputy Attorney General Eric Holder in June 1999, OJJDP created the Safe Start Initiative to prevent and reduce the impact of children’s exposure to violence. As a part of this initiative and with a growing need to document the full extent of children’s exposure to violence, OJJDP launched the National Survey of Children’s Exposure to Violence.

Safe Start’s NatSCEV is the first national incidence and prevalence study to examine comprehensively the extent and nature of children’s exposure to violence across all ages, settings, and timeframes (see “Methodology”). It measures their experience of violence in the home, school, and community. It asked children and their adult caregivers about not only the incidents of violence that children suffered and witnessed themselves but also other related crime and threat exposures, such as theft or burglary from a child’s household, being in a school that was the target of a credible bomb threat, and being in a war zone or an area where ethnic violence occurred. It includes both the past-year and lifetime exposure to violence of children of all ages up to age 17. The study was developed under the direction of OJJDP, and was designed and conducted by the Crimes against Children Research Center of the University of New Hampshire. It provides comprehensive data on the full extent of violence in the daily lives of children. The primary purpose of NatSCEV is to document the incidence and prevalence of children’s exposure to a broad array of violent experiences across a wide developmental spectrum. The research team asked followup questions about specific events, including where the exposure to violence occurred, whether injury resulted, how often the child was exposed to a specific type of violence, and the child’s relationship to the perpetrator and (when the child witnessed violence) the victim. In addition, the study documents differences in exposure to violence across gender, race, socioeconomic status, family structure, region, urban/rural residence, and developmental stage of the child; specifies how different forms of violent victimization “cluster” or co-occur; identifies individual, family, and community-level predictors of violence exposure among children; examines associations between levels/types of violence exposure and child mental and emotional health; and assesses the extent to which children disclose incidents of violence to various individuals and the nature and source of assistance or treatment provided (if any).

This study began in 2007 with funding from OJJDP’s Safe Start Initiative. OJJDP then partnered with CDC to collect additional data on safe, stable, and nurturing relationships—a key focus for CDC’s child maltreatment prevention activities. The combined approach by OJJDP and CDC is providing critical national data on levels of violence as well as data on key indicators of protective factors.

Highlights of the Survey Results

NatSCEV estimates both past-year and lifetime exposure to violence across a number of categories, including physical assault, bullying, sexual victimization, child maltreatment, dating violence, and witnessed and indirect victimization (See “Methodology” for more detailed definitions of these terms). Exhibit 1 illustrates the past-year exposure for all survey respondents to selected categories of violence. Some of the more notable findings are outlined below (see Finkelhor et al., 2009, for more details).

As noted earlier, the NatSCEV survey found that children’s exposure to violence is common; more than 60 percent of the children surveyed had been exposed to violence in the past year and more than 1 in 10 reported 5 or more exposures. This exposure occurs across all age ranges of childhood and for both genders. In general, however, the types of exposure that were most prevalent among younger children were less serious, such as assaults without a weapon or without injury, assaults by a juvenile sibling, or bullying and teasing, all of which were most common among 6- to 9-year-olds and declined thereafter. Older adolescents ages 14 to 17 were the most likely to experience more serious forms of violence, including assaults with injury, gang assaults, sexual victimizations, and physical and emotional abuse, and to witness violence in the community. (See Exhibit 2: Developmental Patterns in Exposure to Violence for a list of the most common victimizations for each age range from infancy to later adolescence.) This is not a hard and fast distinction; some serious forms of victimization, including kidnapping and assaults with a weapon, were most common among 10- to 13-year-olds. This age group was also the most likely to witness violence within the home, including domestic violence involving their parents and assaults by other family members.

The following sections provide more details about the findings of the study regarding children’s exposure to major categories of violence, including assaults, bullying, sexual victimization, child maltreatment, and witnessing and indirect victimization. The Bulletin then discusses the study’s findings about multiple and cumulative exposures to violence, including documentation that children who are exposed to one form of violence are at greatly increased risk for being exposed to violence in other forms.

Physical Assault

Nearly one-half (46.3 percent) of all the children surveyed were physically assaulted within the previous year, and more than one-half (56.7 percent) had been assaulted during their lifetime. Physical assaults are extremely common across the entire span of childhood and peak during middle childhood. Assaults by siblings especially show a marked developmental trend, peaking during the middle childhood years (ages 6 to 9) and then declining. Incidence for the most severe assaults, however, rises steadily with age. Among 14- to 17-year-olds, nearly one in five (18.8 percent) had been injured in the past year in a physical assault. New forms of violence, such as dating violence, also emerge during adolescence, reaching a 5.6-percent past-year incidence rate and an 8.8-percent lifetime rate for the oldest adolescents. The lifetime incidence of assault victimization generally rose steadily as children grew older, with more than 7 in 10 14- to 17-year-olds (71.1 percent) reporting that they had been assaulted during their lifetimes (Finkelhor et al., 2009).

In general, boys are somewhat more likely than girls to be victims of assault. The past-year incidence of assault is 50.2 percent for boys and 42.1 percent for girls, and the lifetime incidence of assault is 60.3 percent for boys and 52.9 percent for girls. These patterns are consistent with other data on criminal victimization, which typically show that males are the most common targets of physical assault (Finkelhor, 2008; Kilpatrick, Saunders, and Smith, 2003; Baum, 2005; Rand, 2008).

Bullying

The survey looked at bullying separately from assault and asked about multiple types of bullying: physical bullying, emotional bullying, and Internet harassment. Overall, 13.2 percent of those surveyed reported having been physically bullied within the past year, and more than one in five (21.6 percent) reported having been physically bullied during their lifetimes. The risk of bullying peaks during middle childhood in a pattern similar to that for sibling assault. The highest incidence occurs among 6- to 9-year-olds, who had rates of 21.5 percent past-year incidence and 28.0 percent lifetime incidence.

About 1 in 5 children (19.7 percent) reported having been teased or emotionally bullied in the previous year and nearly 3 in 10 reported having been teased or emotionally bullied in their lifetimes. Teasing or emotional bullying followed a similar pattern to physical bullying among age groups, rising to reach a peak among 6- to 9-year-olds, nearly one-third of whom (30.4 percent) reported having been teased in the past year and then falling steadily thereafter.

Internet harassment was less common than other forms of bullying. Questions about Internet harassment were asked only of youth age 10 and older, who might be most likely to independently use a computer. Unlike other forms of bullying, the peak risk period for Internet harassment was ages 14 to 17. In this group, 5.6 percent reported Internet harassment within the past year and 7.9 percent during their lifetimes.

Boys were more likely than girls to be physically bullied or threatened, but girls were more likely to be victims of Internet harassment. For past-year rates, there were no significant gender differences in emotional bullying; however, for lifetime rates, girls reported more cumulative exposure to emotional bullying than boys (Finkelhor et al., 2009).

Sexual Victimization

Overall, 6.1 percent of all children surveyed had been sexually victimized in the past year and nearly 1 in 10 (9.8 percent) over their lifetimes. Sexual victimizations included attempted and completed rape (1.1 percent past year, 2.4 percent lifetime); sexual assault by a known adult (0.3 percent past year, 1.2 percent lifetime), an adult stranger (0.3 percent past year, 0.5 percent lifetime), or a peer (1.3 percent past year, 2.7 percent lifetime); flashing or sexual exposure by an adult (0.4 percent past year, 0.6 percent lifetime) or peer (2.2 percent past year, 3.7 percent lifetime); sexual harassment (2.6 percent past year, 4.2 percent lifetime); and statutory sexual offenses (0.1 percent past year, 0.4 percent lifetime).7 Adolescents ages 14 to 17 were by far the most likely to be sexually victimized; nearly one in six (16.3 percent) was sexually victimized in the past year, and more than one in four (27.3 percent) had been sexually victimized during their lifetimes. The most common forms of sexual victimization were flashing or exposure by a peer, sexual harassment, and sexual assault.

Girls were more likely than boys to be sexually victimized: 7.4 percent of girls reported a sexual victimization within the past year, and nearly one in eight (12.2 percent) reported being sexually victimized during their lifetimes. Girls ages 14 to 17 had the highest rates of sexual victimization: 7.9 percent were victims of sexual assault in the past year and 18.7 percent during their lifetimes (Finkelhor et al., 2009).

Child Maltreatment

Overall, more than 1 in 10 children surveyed (10.2 percent) suffered some form of maltreatment (including physical abuse other than sexual assault, psychological or emotional abuse, child neglect, and custodial interference) during the past year and nearly 1 in 5 (18.6 percent) during their lifetimes. Both the past-year and lifetime rates of exposure to maltreatment rose as children grew older, particularly for children age 10 and older: one in six 14- to 17-year-olds (16.6 percent) suffered maltreatment during the past year and nearly one in three (32.1 percent) during their lifetimes.

Patterns of child maltreatment were similar for girls and boys with the exception of psychological or emotional abuse, the incidence of which was somewhat higher for girls than for boys. Rates of sexual assault by a known adult (not limited to caregivers) were also higher for girls than for boys, in a pattern that was similar to other forms of sexual victimization.

Methodology

The National Survey of Children’s Exposure to Violence (NatSCEV) was conducted between January and May 2008. Researchers conducted interviews about the experiences of a nationally representative sample of 4,549 children and adolescents age 17 and younger. They interviewed by telephone youth ages 10 to 17 and adult caregivers of children age 9 and younger. Because telephone interviews afford greater anonymity and privacy than in-person interviews, they may encourage those interviewed to be more forthcoming about such sensitive matters as being exposed to violence or being victims of crime.

The interview sample (n = 4,549) consisted of 2 groups: a nationally representative sample of telephone numbers within the contiguous United States (n = 3,053) and an oversample of telephone exchanges with 70 percent or greater African American, Hispanic, or low-income households to ensure a proportion of minority and low-income households large enough for subgroup analysis. Both groups were sampled through random-digit dialing. The cooperation rate for the first group was 71 percent and the response rate was 54 percent. The oversample had somewhat lower cooperation (63 percent) and response rates (43 percent). A nonresponse analysis conducted on households that could not be contacted or that declined to participate indicated that the risk of victimization for those households did not differ systematically from the risk for households that took part in the survey.

An adult, usually a parent, provided demographic information for each participating household, including race/ethnicity (one of four categories: white, non-Hispanic; black, non-Hispanic; other race, non-Hispanic; and Hispanic, any race) and household income. The child in the household with the most recent birthday was then selected to be surveyed. Interviewers spoke directly with children age 10 and older; for children age 9 and younger, the parent or other adult caregiver “most familiar with the child’s daily routine and experience” was interviewed. Comparison of a number of indicators, including reports of child maltreatment or neglect and violence by family members, found no evidence that caregivers who answered for younger children failed to report neglect or violence that was occurring in the family.

Interviews averaged about 45 minutes in length and were conducted in both English and Spanish. Approximately 279 caregiver interviews were conducted in Spanish; almost all interviews with children and adolescents 10 and older were in English.

Types of Violent Victimization Surveyed

Interviewers asked the children or their caregivers about their exposure to selected types of violence in the past year and over their lifetimes (see “Screening Questions”). In addition, interviewers asked followup questions about the perpetrator, the use of a weapon, injury, and whether multiple events occurred together. Because different types of victimization can occur together and some events fall into more than one category (for example, physical abuse by a parent or caretaker can also be considered an assault), a number of items were rescored. A total of 51 victimization items were extracted in the following categories:

- ◆ Assaults. These included any physical assault, assault with a weapon, assault with injury, assault without a weapon, attempted assault, attempted or completed kidnapping, assault by a brother or sister, assault by another child or adolescent, nonsexual genital assault, dating violence, bias attacks, and threats.

- ◆ Bullying. This included physical bullying, teasing or emotional bullying, and Internet harassment.

- ◆ Sexual victimization. This included completed or attempted rape; sexual assault by an adult acquaintance, an adult stranger, or another child or adolescent; flashing by an adult or another child or adolescent; sexual harassment orally or in writing; statutory sexual offenses; and unwanted online sexual solicitation.

- ◆ Child maltreatment by an adult. This included physical abuse, psychological or emotional abuse, neglect, and custodial interference or family abduction.

- ◆ Witnessed and indirect victimization. Witnessed victimization included witnessing the following: an assault by one parent or family member against another, an assault by a parent on a brother or sister, an assault on a family member by someone outside the household, an assault outside the home, or a murder. Types of indirect victimization included exposure to shooting, bombs, or riots; exposure to war or ethnic conflict; being told about or seeing evidence of a violent event in the child’s household or community; theft or burglary from the child’s household; or a credible threat of a bomb or attack against the child’s school.

Limitations

The survey methodology has several limitations that may cause it to understate children’s actual exposure to violence. First, because the survey required the cooperation of the family, it ran the risk of missing those children who were most vulnerable to being exposed either to violence in general or to specific types of violence. Second, parents or caregivers who answer for younger children may not know about all of a child’s exposure to violence or may underreport or minimize certain types of victimization. Third, the screening and followup questions may miss some episodes of victimization and incorrectly classify others. Fourth, children may not recall some exposure to violence, particularly less serious exposure, or may not accurately recall the timing of their exposure (i.e., whether or not the exposure occurred within the past year). Despite these limitations, NatSCEV provides the most detailed and comprehensive data available on youth victimization.

Witnessing and Indirect Exposure to Violence

NatSCEV found that witnessing violence was a common occurrence for children, particularly as they grew older. Overall, more than one-quarter of children surveyed (25.3 percent) had witnessed violence in their homes, schools, and communities during the past year; and more than one-third (37.8 percent) had witnessed violence against another person during their lifetimes. The proportion of children who witnessed violence both within the past year and during their lifetimes rose from one age group to the next. Of all forms of victimization measured in NatSCEV, witnessing community violence showed the strongest age trends. There was more than a sevenfold increase in rates from toddlers (2- to 5-year-olds) to older adolescents (14- to 17-year-olds). More than 7 in 10 14- to 17-year-olds had witnessed violence against another person during their lives.

These age trends were due mostly to witnessing violence in the community. The past-year incidence of witnessing assaults in the community rose from 5.8 percent among 2- to 5-year-olds to 42.2 percent among 14- to 17-year-olds; lifetime incidence rose even more dramatically, from 9.0 percent of 2- to 5-year-olds to nearly two-thirds (64.2 percent) of 14- to 17-year-olds. Witnessing of shootings also rose sharply in both past-year and lifetime incidence from one age group to the next. Among children younger than 2 years old, 1.1 percent were exposed to shootings in the past year, whereas more than 1 in 10 14- to 17-year-olds (10.2 percent) witnessed a shooting in the past year. Similarly, 3.5 percent of 2- to 5-year-olds had witnessed a shooting during their lifetimes, whereas more than one in five 14- to 17-year-olds (22.2 percent) had witnessed a shooting.8 As striking as these age trends are, even the lower numbers among young children are cause for great concern.

In contrast to the patterns for witnessing community violence, few age trends in exposure can be seen for witnessing violence within the family. Rates for witnessing family violence were fairly constant across the span of childhood, with all age groups falling in a fairly narrow range of approximately 6 to 11 percent.

Over the course of their lifetimes, boys overall were slightly more likely than girls to witness violence (40.1 percent of boys and 35.4 percent of girls). Boys were more likely to witness violence in the community, murder, and shootings both in the past year and during their lifetimes. There were no gender differences in witnessing family violence (Finkelhor et al., 2009).

Multiple and Cumulative Victimizations

A large proportion of children surveyed (38.7 percent) reported more than one direct victimization (a victimization directed toward the child, as opposed to an incident that the child witnessed, heard, or was otherwise exposed to) within the previous year. Of those who reported any direct victimization, nearly two-thirds (64.5 percent) reported more than one. A significant number of children reported high levels of exposure to violence in the past year: more than 1 in 10 (10.9 percent) reported 5 or more direct exposures to violence, and 1.4 percent reported 10 or more direct victimizations. (Victimizations that could be counted in more than one category, such as physical abuse by a parent or caregiver that could also be considered an assault, were not included in the counting of multiple victimizations. See “Methodology” for a discussion of this point.)

Children who were exposed to one type of violence, both within the past year and over their lifetimes, were at far greater risk of experiencing other types of violence. For example, a child who was physically assaulted in the past year would be five times as likely to also have been sexually victimized and more than four times as likely also to have been maltreated during that period. Similarly, a child who was physically assaulted during his or her lifetime would be more than six times as likely to have been sexually victimized and more than five times as likely to have been maltreated during his or her lifetime.

Implications for Policymakers, Researchers, and Practitioners

The findings of the NatSCEV study confirm that for many children in the United States, violence is a frequent occurrence. Of the nationally representative sample of U.S. youth who participated in the study, more than 60 percent reported that they were victims of direct or indirect violence in the past year. Furthermore, nearly two-thirds of those participants were victimized more than once. Nearly one-half of the children surveyed reported that they were assaulted during the previous year, and more than 10 percent of them were injured as a result. More than one-fourth of the children witnessed another person being violently attacked. More than 10 percent of the children surveyed reported that they were indirectly exposed to violence.

More needs to be understood about how exposure to individual episodes of violence, repeated exposure to violence, and multiple types of exposure affect children and families, providing many avenues for research and policy development. As in this study, future research and policy development efforts must incorporate a broader perspective in documenting the full scope of children’s exposure to violence.

Understanding the Progression of Violence

NatSCEV detailed the extent to which children in this country are exposed to serious violence. The study found that in the year prior to being interviewed, 1 in 20 children witnessed someone being shot, 1 in 200 witnessed a murder, and 1 in 50 was sexually assaulted. The survey showed that as children grow older the incidences of victimization increase. Among 14- to 17-year-old participants, 1 in 10 witnessed a shooting in the past year, 1 in 75 witnessed a murder, and 1 in 20 was sexually assaulted. NatSCEV differs from earlier studies in that it looks across the full spectrum of violence, examining and comparing the incidence of different types of violence within broad categories and determining which types are more or less frequent. The study looks not only at when and how children become more vulnerable to increasingly serious types of violence as they grow older, it also tracks the cumulative effects of exposure to violence over time. For example, although all age groups are vulnerable to simple assault, older children and adolescents are several times more likely to be sexually assaulted or to witness a shooting than are younger children.

The NatSCEV study clearly illustrates the cumulative effects on children exposed to multiple incidents of violence and how exposure to one form of violence may make a child more vulnerable to other forms. Nearly two in five children surveyed were exposed to two or more types of violence in the previous year. More than 1 in 10 was exposed to 5 or more different types of violence during that year. These children are the most likely to suffer serious long-term physical, emotional, and mental harm (Finkelhor, Ormrod, and Turner, 2007a, 2007b, 2007c). Many previous studies have shown how exposure to violence has damaging consequences for the physical and mental health of youth (Gilbert et al., 2009; Widom, 1998; Fantuzzo and Mohr, 1998; Hurt et al., 2001) and their long-term functioning and well-being as adults (Fergusson, Boden, and Horwood, 2008; Fergusson and Horwood, 1998; Kendall-Tackett, 2003).

Expanding the Inquiry

Researchers and practitioners need to ask children more specific questions about a broader range of victimizations, including dating violence, emotional abuse, and exposure to violence within the family. It is also critical to ask children who are suffering from one form of victimization about additional forms of victimizations they may have experienced to fully address their mental and emotional health needs. Practitioners also need to investigate victimization across all age ranges with the help of instruments geared to younger children and (as was done in the NatSCEV study) the use of proxies, such as parents and caretakers.

NatSCEV differs from earlier studies in that it examines and compares the incidence of different types of violence within broad categories and determines which types of violence occur more or less frequently. For example, the research team broke assaults down into peer and sibling assaults, assaults without weapon or injury, and more serious types of assaults. Peer and sibling assaults were common across all age ranges and across both genders. More serious types of assaults included assaults with a weapon, assaults with injury, gang assaults, attempted assaults, genital assaults, dating violence, and bias attacks (which were less common).

Monitoring Exposure Over Time

More research is also needed that follows children into adulthood to assess the effects of violence on their long-term health and well-being. Such research would complement those studies, such as the ACE study discussed earlier, that have taken a retrospective look at the effects of adverse childhood experiences. NatSCEV’s findings affirm that more needs to be done to measure children’s exposure to violence on an ongoing and systematic basis using public surveillance mechanisms, including followup surveys and long-term monitoring (Kracke and Hahn, 2008).

The estimates of specific exposures in NatSCEV are roughly equivalent to or somewhat higher than the estimates in previous community survey studies of child physical abuse (Theodore et al., 2005); sexual victimization (Theodore et al., 2005); sexual assault (Kilpatrick, Saunders, and Smith, 2003; Finkelhor, Hammer, and Sedlak, 2008); physical assault with a weapon (Kilpatrick, Saunders, and Smith, 2003); witnessing violence (Kilpatrick, Saunders, and Smith, 2003); dating violence (Wolitzky-Taylor et al., 2008); and bullying (Nansel et al., 2003). Differences in age range and definition account for some variations between the findings of this and other studies. Because this is the first national study to ask children and their caregivers directly about exposure to certain types of family violence, such as assaults by one parent on another, the exposure rate of 6.2 percent is several times greater than estimates obtained from cases disclosed to child protection agencies (Administration on Children, Youth and Families, 2004) and law enforcement (Federal Bureau of Investigation, 2007).

Reaching Across Disciplines

This study’s findings confirm that more needs to be done at all levels of policy and practice to reach across disciplines to identify children at risk from exposure to violence and to coordinate the delivery of services to these children. For example, first responders and providers who are involved in incidents of domestic violence and deal with victims in their aftermath (e.g., police, emergency room physicians and nurses, social workers, domestic violence advocates, and judges) should be aware not only of the adult victims but also of the children who may have witnessed the incident. They may also need to work with childcare providers, teachers, and school counselors and psychologists to assess the effects on a child’s interaction with his or her classmates and to provide needed help.

Expanding Identification Capabilities

Researchers, practitioners, and policy-makers need to collaborate to develop and expand effective screening and assessment tools that are developmentally appropriate for children across all age ranges and types of violence. These instruments and tools can identify children who are suffering emotionally, socially, physically, and developmentally. More importantly, these instruments can aid practitioners, advocates, frontline service providers, and responders across all service sectors to reach and help those children. Understanding the full extent of children’s exposure to violence and the interactions among multiple types of violence more comprehensively can further practitioners’ ability to respond to those families who need support and to alleviate the harmful effects of exposure to violence (Kracke and Hahn, 2008).

Coordinating Across Sectors

Finally, just as the NatSCEV study by its comprehensive nature addresses the fragmentation that, until now, characterized many attempts to look at child victimization and exposure to violence, greater coordination of the efforts to combat the effects of that victimization are needed. For example, recent initiatives have formed to separately address bullying, dating violence, and sexual harassment. At the Federal, State, tribal, and local levels, responsibility for dealing with children’s exposure to violence is distributed across all service and response sectors (e.g., health departments, hospitals, child welfare and protection agencies, early childhood educators and childcare providers, schools and educational institutions, domestic violence service providers and advocates, law enforcement agencies, and the justice system). The Safe Start Initiative has worked toward a comprehensive approach across the continuum of prevention, intervention, treatment, and response for 10 years and has made significant progress in increasing knowledge, skills, and awareness of children’s exposure to violence. More work is needed.

The next step in addressing children’s exposure to violence and efforts to ameliorate or eliminate the harm it causes is to foster and sustain a comprehensive approach in both practice and research that builds on the groundwork established under Safe Start and this study. It is important to develop, implement, and evaluate programs and policies designed to prevent children’s exposure to violence; to craft and implement strategies and interventions to help children who have been exposed to violence and their families; and to replicate those programs, policies, and interventions that prove to be effective in preventing and lessening violence against children in communities across the Nation.

The NatSCEV study represents the best attempt to date to quantify children’s exposure to violence. Understanding categories and forms of violence is critical to creating appropriate interventions to prevent and suppress violence and to treat its victims. This study’s greatest contribution, however, is that it highlights the degree to which children in this country live with violence in their daily lives. Violence takes a toll on children whether as victims or witnesses. Seemingly minor incidents may have long-lasting and far-reaching consequences. If policymakers, practitioners, advocates, and the general public are to respond effectively to curb the negative effects of children’s exposure to violence, everyone must look at the problem in its totality and make a coordinated effort to help the children and their families who suffer these effects.

For Further Information

To learn more about the Safe Start Initiative, visit www.safestartcenter.org.

For more information about the National Survey of Children’s Exposure to Violence, visit the Crimes against Children Research Center Web site at www.unh.edu/ccrc.

Endnotes

1. According to the 2005 National Crime Victimization Survey, 44 per 1,000 juveniles ages 12 to 15 and 44.2 per 1,000 adolescents and young adults ages 16 to 19 were victims of violent crime, as compared with a victimization rate of 21.2 per 1,000 for all persons age 12 and older (Baum, 2005).

2. Background material adapted from information on the Safe Start Center Web site. For more detailed information, go to www.safestartcenter.org.

3. Kracke and Hahn (2008) cite studies that estimate children’s exposure to violence as ranging from 3 million to 17 million incidents. As they note, however, these studies measured only children’s witnessing of domestic violence. They did not measure violence that was inflicted on children directly or violence that children witnessed outside the home.

4. For an overview of these studies, see Kracke and Hahn (2008).

5. For an overview of research on child abuse and other forms of maltreatment and their long-term health and behavioral consequences, see Repetti, Taylor, and Seeman (2002).

6. The categories of adverse childhood experiences studied were psychological, physical, or sexual abuse; violence against mother; or living with household members who were substance abusers, mentally ill or suicidal, or ever imprisoned. For more information on the ACE study, see Centers for Disease Control and Prevention (2006) and Felitti et al. (1998).

7. The aggregate figure for any sexual victimization did not include unwanted online sexual solicitation (Finkelhor et al., 2009).

8. Previous studies have also noted that low-income and minority youth are many times more likely to have witnessed serious violence in the community. Kracke and Hahn (2008) cite studies noting that only 1 percent of upper-middle-class youth had witnessed a murder and 9 percent had witnessed a stabbing (Gladstein, Rusonis, and Heald, 1992), whereas 43 percent of low-income African American school-aged children had witnessed a murder and 56 percent had witnessed a stabbing (Fitzpatrick and Boldizar, 1993).

References

Administration on Children, Youth and Families. 2004. Child Maltreatment 2002: Reports From the States to the National Child Abuse and Neglect Data System. Washington, DC: U.S. Department of Health and Human Services, Administration on Children, Youth and Families.

Baum, K. 2005. Juvenile Victimization and Offending, 1993–2003. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics.

Centers for Disease Control and Prevention. 2006. Adverse Childhood Experiences Study: Major Findings. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. Available from www.cdc.gov/nccdphp/ace/findings.htm.

Fantuzzo, J., and Mohr, W. 1999. Prevalence and effects of child exposure to domestic violence. The Future of Children 9(3):21–32.

Federal Bureau of Investigation. 2007. Crime in the United States, 2006. Available from www.fbi.gov/ucr/cius/2006/. Retrieved from the Internet on February 11, 2009.

Felitti, V.J., Anda, R.F., Nordenberg, D., Williamson, D.F., Spitz, A.M., and Edwards, V. 1998. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine 14(4):245–258.

Fergusson, D.M., Boden, J.M., and Horwood, L.J. 2008. Exposure to childhood sexual and physical abuse and adjustment in early adulthood. Child Abuse & Neglect 32:607–619.

Fergusson, D.M., and Horwood, L.J. 1998. Exposure to interparental violence in childhood and psychosocial adjustment in young adulthood. Child Abuse & Neglect 22(5):339–357.

Finkelhor, D. 2008. Childhood Victimization: Violence, Crime, and Abuse in the Lives of Young People. New York, NY: Oxford University Press.

Finkelhor, D., Hammer, H., and Sedlak, A. 2008. Sexually Assaulted Children: National Estimates and Characteristics. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention.

Finkelhor, D., Ormrod, R.K., and Turner, H.A. 2007a. Poly-victimization: A neglected component in child victimization trauma. Child Abuse & Neglect 31:7–26.

Finkelhor, D., Ormrod, R.K., and Turner, H.A. 2007b. Poly-victimization and trauma in a national longitudinal cohort. Development and Psychopathology 19(1):149–166.

Finkelhor, D., Ormrod, R.K., and Turner, H.A. 2007c. Revictimization patterns in a national longitudinal sample of children and youth. Child Abuse & Neglect 31(5):479–502.

Finkelhor, D., Ormrod, R.K., Turner, H.A., and Hamby, S.L. 2005. The victimization of children and youth: A comprehensive, national survey. Child Maltreatment 10(1):5–25.

Finkelhor, D., Turner, H.A., Ormrod, R.K., and Hamby, S.L. 2009. Violence, crime, and exposure in a national sample of children and youth. Pediatrics 124(5)(November).

Fitzpatrick, K.M., and Boldizar, J.P. 1993. The prevalence and consequences of exposure to violence among African-American youth. Journal of the American Academy of Child and Adolescent Psychiatry 32:424–430.

Gilbert, R., Widom, C.S., Browne, K.D., Fergusson, D.M., Webb, E., and Janson, S. 2009. Burden and consequences of child maltreatment in high-income countries. The Lancet 373(9657):68–81.

Gladstein, J., Rusonis, E.J., and Heald, F.P. 1992. A comparison of inner-city and upper-middle-class youth’s exposure to violence. Journal of Adolescent Health 13:275–280.

Hashima, P., and Finkelhor, D. 1999. Violent victimization of youth versus adults in the National Crime Victimization Survey. Journal of Interpersonal Violence 14(8):799–820.

Hurt, H., Malmud, E., Brodsky, N.L., and Giannetta, J. 2001. Exposure to violence: Psychological and academic correlates in child witnesses. Archives of Pediatrics & Adolescent Medicine 155(12):1351–1356.

Kendall-Tackett, K. 2003. Treating the Lifetime Health Effects of Childhood Victimization. Kingston, NJ: Civic Research Institute.

Kilpatrick, D.G., Saunders, B.E., and Smith, D.W. 2003. Youth Victimization: Prevalence and Implications. Washington, DC: U.S. Department of Justice, Office of Justice Programs, National Institute of Justice.

Kracke, K., and Hahn, H. 2008. The nature and extent of childhood exposure to violence: What we know, why we don’t know more, and why it matters. Journal of Emotional Abuse 8(1/2):29–49.

Nansel, T.R., Overpeck, M.D., Haynie, D.L., Ruan, W.J., and Scheidt, P.C. 2003. Relationships between bullying and violence among US youth. Archives of Pediatrics & Adolescent Medicine 157(4):348–353.

Rand, M.R. 2008. Criminal Victimization, 2007. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics.

Repetti, R.L., Taylor, S.E., and Seeman T.E. 2002. Risky families: Family social environments and the mental and physical health of offspring. Psychology Bulletin 128(2):330–366.

Theodore, A.D., Chang, J.J., Runyan, D.K., Hunter, W.M., Bangdiwala, S.I., and Agans, R. 2005. Epidemiologic features of the physical and sexual maltreatment of children in the Carolinas. Pediatrics 115(3):331–337.

Widom, C.S. 1998. Childhood victimization: Early adversity and subsequent psychopathology. In Adversity, Stress, and Psychopathology, edited by B.P. Dohrenwend. New York, NY: Oxford University Press.

Wolitzky-Taylor, K.B., Ruggiero, K.J., Danielson, C.K., Resnick, H.S., Hanson, R.F., Smith, D.W., Saunders, B.E., and Kilpatrick, D.G. 2008. Prevalence and correlates of dating violence in a national sample of adolescents. Journal of the American Academy of Child and Adolescent Psychiatry 47(7):755–762.

Acknowledgments

This Bulletin was written by David Finkelhor, Ph.D., Director, Crimes against Children Research Center, University of New Hampshire; Heather Turner, Ph.D., Professor, Crimes against Children Research Center, University of New Hampshire; Richard Ormrod, Ph.D., Research Professor, Crimes against Children Research Center, University of New Hampshire; Sherry Hamby, Ph.D., Research Associate Professor, Department of Psychology, Sewanee, University of the South; and Kristen Kracke, M.S.W., Safe Start Initiative Coordinator and Program Manager, Office of Juvenile Justice and Delinquency Prevention (OJJDP). OJJDP wishes to acknowledge the contributions to this Bulletin of James A. Mercy, Ph.D., Special Adviser for Strategic Directions, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention; and Rebecca T. Leeb, Ph.D., Epidemiologist, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention. OJJDP also wishes to acknowledge the support of CDC for the National Survey of Children’s Exposure to Violence and its partnership in the Safe Start Initiative to create safe, stable, and nurturing environments for children and their families. The authors wish to thank Brian Higgins, Writer/Editor, Lockheed Martin’s Office of Justice Programs Communication and Publication Support Services, for his assistance in editing and coordinating the production of this Bulletin.

Share With Your Colleagues

Unless otherwise noted, OJJDP publications are not copyright protected. We encourage you to reproduce this document, share it with your colleagues, and reprint it in your newsletter or journal. However, if you reprint, please cite OJJDP and the authors of this Bulletin. We are also interested in your feedback, such as how you received a copy, how you intend to use the information, and how OJJDP materials meet your individual or agency needs.

Please direct your comments and questions to:

National Criminal Justice Reference Service

P.O. Box 6000

Rockville, MD 20849–6000

800–851–3420

301–519–5500 (fax)

Email: responsecenter@ncjrs.gov

www.ncjrs.gov

This bulletin was prepared under grant number 2005–JL–FX–0048 from the Office of Juvenile Justice and Delinquency Prevention (OJJDP), U.S. Department of Justice.

Points of view or opinions expressed in this document are those of the authors and do not necessarily represent the official position or policies of OJJDP or the U.S. Department of Justice.

The Office of Juvenile Justice and Delinquency Prevention is a component of the Office of Justice Programs, which also includes the Bureau of Justice Assistance; the Bureau of Justice Statistics; the National Institute of Justice; the Office for Victims of Crime; and the Office of Sex Offender Sentencing, Monitoring, Apprehending, Registering, and Tracking.

Access OJJDP publications online at ojjdp.gov/publications/index.html.

NCJ 227744

Children’s Exposure to Intimate Partner Violence and Other Family Violence

Sherry Hamby, David Finkelhor, Heather Turner, and Richard Ormrod

October 2011

This bulletin discusses the data on exposure to family violence in the National Survey of Children’s Exposure to Violence (NatSCEV), the most comprehensive nationwide survey of the incidence and prevalence of children’s exposure to violence to date, sponsored by the Office of Juvenile Justice and Delinquency Prevention (OJJDP) and the Centers for Disease Control and Prevention (CDC) (see “History of the National Survey of Children’s Exposure to Violence”). An earlier bulletin (Finkelhor, Turner, Ormrod, Hamby, and Kracke, 2009) presented an overview of children’s exposure to conventional crime, child maltreatment, other types of physical and sexual assault, and witnessing community violence. For more information on the survey methodology, see “Methodology.”

This bulletin explores in depth the NatSCEV survey results regarding exposure to family violence among children in the United States, including exposure to intimate partner violence (IPV), assaults by parents on siblings of children surveyed, and other assaults involving teen and adult household members. These results confirm that children are exposed to unacceptable rates of violence in the home. More than 1 in 9 (11 percent) were exposed to some form of family violence in the past year, including 1 in 15 (6.6 percent) exposed to IPV between parents (or between a parent and that parent’s partner). One in four children (26 percent) were exposed to at least one form of family violence during their lifetimes. Most youth exposed to family violence, including 90 percent of those exposed to IPV, saw the violence, as opposed to hearing it or other indirect forms of exposure. Males were more likely to perpetrate incidents that were witnessed than females, with 68 percent of youth witnessing only violence by males. Father figures were the most common perpetrators of family violence, although assaults by mothers and other caregivers were also common. Children often witness family violence, and their needs should be assessed when incidents occur. These are the most comprehensive and detailed data ever collected at the national level on this topic.

Background

Exposure to IPV is distressing to children and is associated with a host of mental health symptoms both in childhood and in later life. The best documented mental health effects include symptoms of posttraumatic stress, depression, and anxiety (Kitzmann et al., 2003; Lang and Stover, 2008; Wolfe et al., 2003). Exposure to serious IPV as a child is also associated with offending as an adult. For example, one study found that, among a sample of IPV offenders, those who had as a child seen a parent use a weapon were more likely to commit an offense involving a weapon as an adult (Murrell et al., 2005). Despite the well-documented adverse consequences of IPV exposure and a growing discussion of the appropriate policy responses to IPV exposure (Jaffe, Crooks, and Wolfe, 2003; Nixon et al., 2007), surprisingly little information is available about how often such exposure occurs in the general population. Such information is important for determining the extent of the problem, assessing the need for services, and establishing a baseline for evaluating progress.

Previous Efforts To Estimate Children’s Exposure to Family Violence

More than 20 years ago, in the second National Family Violence Survey (conducted in 1985), Straus and Gelles asked adults whether they had witnessed IPV during their childhood; they obtained a rate of 13 percent for total childhood exposure (Straus, 1992). McDonald and colleagues (2006) estimated IPV exposure at 15.5 million U.S. youth by calculating the number of children in two-parent homes where IPV had occurred. This measure was indirect, however, as some children may not have been aware of these incidents, especially the types of IPV most commonly reported in national surveys (i.e., one or two incidents of pushes and slaps) (Straus and Gelles, 1990; Tjaden and Thoennes, 1998).

The Developmental Victimization Survey (DVS)1 included a single item on witnessing IPV (Finkelhor et al., 2005), which produced a 1-year incidence rate of 3 percent. Although this is probably the best existing estimate of 1-year incidence, it is well established that single items in surveys often underrepresent the true extent of violence (Bolen and Scannapieco, 1999). This percentage also counted only events that children saw, excluding other forms of exposure such as hearing or seeing evidence of the attack afterwards.

Most recently, Zinzow and colleagues (2009) obtained a lifetime estimate of 9 percent in the National Survey of Adolescents–Replication (NSA–R), but their sample included only adolescents and included only violence between parents. Further, they assessed only severe forms of physical violence, so in many ways their estimate is less comparable to most national data on IPV, which typically include a wide range of acts. Both the DVS and the NSA–R were also limited to the most direct forms of exposure (seen and seen or heard, respectively), and did not assess the relative frequency of different forms of exposure. Other estimates on exposure to family violence come from high-risk convenience samples, such as women residing in domestic violence shelters. Not surprisingly, exposure percentages are often high in these settings, frequently exceeding 50 percent (Hutchison and Hirschel, 2001), but they do not provide a picture of the national extent of the problem. Many of these studies collect data on only one parental relationship (often the mother or other primary caregiver and her current partner), but in today’s world, children may have multiple parents, stepparents, and other caregivers and are at risk for being exposed to violence between many family members. NatSCEV is one of the first studies to assess exposure for all key relationships in a child’s life.

Important Features of Family Violence Incidents

In addition to annual incidence and lifetime prevalence estimates, NatSCEV also provides the first nationally representative data on certain characteristics of IPV exposure that have been of interest to those concerned about the problem.

Type of exposure. Many authors have pointed out that children can be exposed to IPV in multiple ways. Although as many as 10 different types of exposure have been identified (Holden, 2003), some of the most commonly mentioned include seeing and hearing violent acts, seeing injuries resulting from the violence, and being told about the violence. Usually these are arranged hierarchically. The most direct forms of exposure are seeing or direct eyewitnessing, which may also include lower levels of exposure such as hearing. Seeing the violence implies the child’s presence, which may also put the child in danger, and is least subject to errors in interpretation. A child could also hear violence but not see it, for example, if the child is in another room in the house or apartment. This means the child was nearby during the assault, and so potentially in danger, but hearing is less likely to be accurate than seeing. For example, youth could mistakenly attribute violence heard on television to their parents, or, conversely, they might not hear an assault even though they are in the house or apartment where the assault occurs.

Youth can also become aware of violence after it occurs, for example, by seeing the victim’s injuries afterwards. This type of exposure will usually be fairly contemporaneous with the assault because most injuries eventually heal. Finally, youth could be told about the assault after it occurs, even years after the incident. Several authors have suggested that these types of exposure other than direct eyewitness exposure make up a significant proportion of children’s total exposure to family violence (Fantuzzo and Mohr, 1999; Holden, 2003); however, no nationally representative data on type of exposure have previously been collected.

Gender of perpetrator. There has been keen interest in gender patterns of IPV perpetration (Hamby, 2009), particularly whether women’s participation in IPV deserves clinical and policy attention. Data from witnessed events are important both for examining gender patterns in family violence and for characterizing children’s experience of gender-related aggression. Studies that assess the gender of the perpetrator of witnessed IPV find that males perpetrate most family violence, but females also can be aggressors. In the DVS, males perpetrated 86 percent of the IPV incidents that were witnessed and 67 percent of the witnessed incidents of physical abuse of a sibling (Hamby, Ormrod, and Finkelhor, 2005). Straus found that one-half (50 percent) of youth exposed to family violence reported that only their fathers were violent, 31 percent reported that both parents were perpetrators, and 19 percent reported that only their mothers were perpetrators (Straus, 1992). NatSCEV provides an opportunity to explore this issue using a larger sample with more items and, as a result, generate more reliable estimates of gender patterns of family violence (see “Screening Questions: Exposure to Intimate Partner Violence and Other Family Violence”).

Reaction to incident. Finally, the nature of children’s involvement in IPV episodes has been a topic of interest (Edleson, Shin, and Armendariz, 2008). The safety plans of many organizations recommend that parental victims of family violence teach their children how to seek help or get to safety during an attack (National Domestic Violence Hotline, 1998), but little information exists about how frequently they do this. One survey of police incidents revealed that 11 percent of calls to police were made by youth exposed to family violence (Fantuzzo et al., 1997). In a clinical sample, more than one-half of youth had yelled at their parents during a fight or tried to get away from the fighting (Edleson, Shin, and Armendariz, 2008). The current study includes an assessment of three responses: yelling, seeking help, and trying to get away.

Findings From the NatSCEV Study Regarding Children’s Exposure to IPV and Other Family Violence

The purpose of this bulletin is to report the first comprehensive, nationally representative estimates of youth’s exposure to IPV and other violence within the family. It presents information regarding types of exposure, the gender of the perpetrator, the relationship of the child witness to the perpetrator, and youth’s reactions to the incident. It then discusses the implications of the survey data for researchers, practitioners, and policymakers and makes policy recommendations, including better screening protocols for exposure to family violence, improved interventions for those exposed, increased coordination of services for adult and child victims of family violence, and more prevention and education programs to reduce family violence.

Percentages of Exposure to IPV and Other Family Violence

Table 1 shows the percentages of past-year and lifetime exposure to various forms of family violence for NatSCEV survey participants across both genders and four age groups: ages 0–5, 6–9, 10–13, and 14–17. The researchers looked at exposure to psychological violence between parents (threats and displaced aggression), physical violence between parents (including hitting or slapping or more serious violence, such as one parent kicking, choking, or beating up the other), and violence involving other family members (a parent hitting another child in the family or a grownup or teen in the family assaulting another family member). The researchers then aggregated the data to determine total past-year and lifetime percentages for exposure to psychological/emotional IPV between parents, physical IPV between parents, and any exposure to family violence.

Past-year exposure percentages. Approximately 1 in 15 youth, or 6.6 percent, had been exposed to some form of physical assault between their parents in the past year. A roughly equivalent percentage, 5.7 percent, was exposed to psychological/emotional IPV (verbal threats, punching walls, and throwing, breaking, or destroying household items) in the past year. If exposure to other forms of family violence is included, such as parental assaults on other children or assaults between teen or adult relatives in the household, then one in nine youth (11.1 percent) were exposed to physical or psychological violence in the family during the previous year. Not surprisingly, the most severe violence (one parent kicking, choking, or beating up the other) had the lowest exposure percentage (1.3 percent), while displaced aggression, including seeing a parent break something, punch a wall, or throw things, was reported most often (4.9 percent).

Lifetime exposure percentages. Lifetime percentages were higher, reflecting the longer period of possible exposure. The lifetime percentage was 17.9 percent for exposure to physical IPV alone. Lifetime and past-year percentages for exposure to different types of physical IPV can be compared in figure 1.

If, in addition to IPV exposure, parental assault of a sibling and violence between other teens and adults in the household are included, then lifetime exposure to physical or psychological violence within the family rises to 25.6 percent. As figure 2 shows, children are exposed to significant amounts of family violence other than IPV. A focus solely on IPV misses a substantial amount of the violence to which children are exposed.

These non-IPV incidents also were not infrequent. Among exposed youth, the mean number of lifetime exposures, aggregated across all screening questions, was 10.75 incidents (standard deviation = 21.22), and the median was 3 incidents.

Child age and gender. Age of youth was strongly associated with exposure to family violence. It is natural that this would be true for lifetime rates, as older age means longer exposure. If one looks only at the oldest group of children (ages 14–17), who have lived through most of their exposure period, 40.3 percent reported exposure to at least one form of family violence over their lifetimes, and 27.7 percent reported exposure to physical IPV.

Notably, however, there were also age-related patterns for past-year rates. Older youth (ages 14–17) had higher exposure rates for several forms of violence, particularly exposure to assaults on siblings and other (non-IPV) family violence. However, there were no significant differences by age in past-year exposure to physical IPV. Analyses by gender indicated that girls were somewhat more likely to report exposure to psychological and physical IPV over their lifetimes (see table 1).

Methodology

The National Survey of Children’s Exposure to Violence (NatSCEV) was conducted between January and May 2008. Researchers conducted interviews about the experiences of a nationally representative sample of 4,549 children and adolescents age 17 and younger. They interviewed by telephone youth ages 10 to 17 and adult caregivers of children age 9 and younger. Evidence shows that because telephone interviews afford greater anonymity and privacy than in-person interviews, they can encourage those interviewed to be more forthcoming about such sensitive matters as being exposed to violence or being victims of crime (Acierno et al., 2003; Shannon et al., 2007). The interview and analysis sample (n = 4,549) consisted of two groups: a nationally representative sample of telephone numbers within the contiguous United States (n = 3,053) and an oversample of telephone exchanges with 70 percent or greater African American, Hispanic, or low-income households to ensure a proportion of minority and low-income households large enough for subgroup analysis. Both groups were sampled through random-digit dialing. The cooperation rate for the first group was 71 percent and the response rate was 54 percent. The oversample had somewhat lower cooperation (63 percent) and response rates (43 percent). A nonresponse analysis conducted on households that could not be contacted or that declined to participate indicated that the risk of victimization for those households did not differ systematically from the risk for households that took part in the survey. An adult, usually a parent, provided demographic information for each participating household, including race/ethnicity (one of four categories: white, non-Hispanic; black, non-Hispanic; other race, non-Hispanic; and Hispanic, any race) and household income. The child in the household with the most recent birthday was then selected to be surveyed. Interviewers spoke directly with children age 10 and older; for children age 9 and younger, the parent or other adult caregiver “most familiar with the child’s daily routine and experience” was interviewed. Comparison of a number of indicators, including reports of child maltreatment or neglect and violence by family members, found no evidence that caregivers who answered for younger children failed to report neglect or violence that was occurring in the family. Comparison of proxy and self-reports using this instrument also found little evidence of reporter bias (Finkelhor et al., 2005; Finkelhor, Turner, Ormrod, and Hamby, 2009). Past studies have similarly found that caregivers are at least as likely as youth to disclose incidents of family violence (Grych, 1998; Jouriles and Norwood, 1995). Interviews averaged about 45 minutes in length and were conducted in both English and Spanish. Approximately 279 caregiver interviews were conducted in Spanish; almost all interviews with children and adolescents age 10 and older were in English.

Survey Assessment of Exposure to Family Violence

To determine rates of exposure to family violence, eight types of victimization were assessed: seeing, hearing, or otherwise learning of a parent being assaulted by a spouse, domestic partner, or boyfriend or girlfriend; seeing, hearing, or otherwise learning of a threat by one parent to assault the other; seeing, hearing, or otherwise learning of a threat by one parent to damage the other parent’s property; seeing, hearing, or otherwise learning of one parent pushing the other; seeing, hearing, or otherwise learning of one parent hitting or slapping the other; seeing, hearing, or otherwise learning of one parent kicking, choking, or beating up the other; seeing a brother or sister assaulted by a parent; and witnessing an assault by another adult household member against a child or adult in the household. The researchers collected data on past-year and lifetime exposure to each of these types of family violence and categorized them by gender and age group. They then aggregated that data to create total scores for any exposure to emotional/psychological intimate partner violence (IPV), physical IPV, and any exposure to family violence.

In addition, the researchers asked followup questions relating to how the survey participants were exposed to family violence (whether they saw the incident, heard the incident, saw injuries resulting from the incident, or heard about the incident after it occurred); who perpetrated the violence (including the gender of the perpetrator and the perpetrator’s relationship to the child surveyed); and the child’s reaction to the violent incident (including yelling at the perpetrator to stop, trying to get help, and hiding or leaving the scene). For more detailed information on individual questions, see “Screening Questions: Exposure to Intimate Partner Violence and Other Family Violence.”

Limitations

The survey methodology has several limitations that may cause it to understate children’s actual exposure to violence. First, because the survey required the cooperation of the family, it ran the risk of missing those children who were most vulnerable to being exposed either to violence in general or to specific types of violence. Second, parents or caregivers who answer for younger children may not know about all of a child’s exposure to violence or may underreport or minimize certain types of victimization. Third, the screening and followup questions may miss some episodes of victimization and incorrectly classify others. Fourth, children may not recall some exposure to violence, particularly less serious exposure, or may not accurately recall the timing of their exposure (i.e., whether or not the exposure occurred within the past year). The researchers note that although this survey, to their knowledge, includes the most questions ever asked about exposure to family violence in a nationally representative sample, these rates may not be comparable to rates obtained using longer questionnaires such as the Conflict Tactics Scales (Straus et al., 1996). Because of time limitations, the researchers collected incident data on only the most recent incident for each form of family violence. Despite these limitations, NatSCEV provides the most detailed and comprehensive data available on children’s exposure to violence.

Types of Children’s Exposure to Family Violence

Severity of exposure to family violence. These are the first national data to characterize how children are typically exposed to violence in the family, and they show that most children who were exposed to family violence (IPV in particular) were eyewitnesses. The study assessed four different types of exposure in a hierarchical fashion from most to least direct: eyewitnessing or seeing the violence, hearing but not seeing it, seeing injuries afterwards but not seeing or hearing the actual assault, and being told about the violence without any of the above. The most immediate type of exposure, eyewitnessing, was by far the most common, accounting for 65 to 86 percent of all exposure. Other types of exposure nonetheless add significantly to the total, especially hearing but not seeing the violence.

Within this general pattern, however, there was some variation. Psychological aggression was more likely to be heard and not seen than physical aggression. Over their lifetimes, being told about family violence comprises a larger percentage of exposure (9.4 to 16.2 percent) for older youth (ages 10–17) than for younger children (4 to 7.6 percent for children ages 1 month to 9 years). Specifically, older children were more likely to be exposed to the following types of family violence by being told about them: exposure to verbal threats, displaced aggression, a family member being pushed, and a family member being hit or slapped. This same pattern was observed in past-year data; however, because of the smaller number of cases, it achieved significance only for displaced aggression. Youth’s gender had no effect on the type of exposure.

Multiple types of exposure to family violence and eyewitnessing of family violence. Some youth may experience multiple types of exposure to family violence. For example, a youth could hear one act of violence (such as a verbal threat) and see another act (such as a slap). Although this youth would be coded at the “heard” level for verbal threat, he or she is also an eyewitness of IPV. To account for this, the researchers calculated lifetime percentages for eyewitnessing—the most direct exposure among those who reported exposure to a particular type of family violence: 72.7 percent of those exposed to psychological/emotional IPV were eyewitnesses, 90.1 percent of those exposed to physical IPV were eyewitnesses, and 87.1 percent of those exposed to other types of family violence were eyewitnesses. When youth are exposed to family violence, they usually witness at least some assaults. Nine out of ten children who were exposed to physical IPV in their lifetimes were eyewitnesses (see figure 3).

Identification of Perpetrators of Family Violence

Violence by intimate partners. Survey respondents were asked to identify the perpetrator’s gender and relationship to the youth. Lifetime data are presented, as the patterns are very similar to past-year data and these include all available incidents. The report of gender was relatively straightforward. Modern family relationships, however, proved to be somewhat complex. Open-ended descriptions of perpetrators have been combined into four broad categories: “father,” “mother,” “other males,” and “other females” (see figure 4).2 “Father” and “mother” include biological parents, adoptive parents, stepparents, foster parents, and cohabiting partners of any parents. The “other” categories include noncohabiting partners, caregiving relatives (e.g., grandparents), and occasional mentions of others in caregiving or parental roles, broadly construed, such as “godfather” or “foster mother’s ex-husband” (to give specific examples). It is important to capture incidents involving all of these people to understand the true extent of children’s exposure to family violence.

Males were identified as perpetrators in 78 percent of IPV incidents (with a range of 72 to 88 percent across different forms of IPV). The most severe violence (kicking, choking, or beating) had the highest percentage of male perpetrators (88 percent). Of specific perpetrator categories, fathers were the most commonly reported perpetrators, accounting for 61 to 71 percent of incidents involving males. The single largest category within “other males” was noncohabiting boyfriends of mothers, accounting for 45 to 76 percent of other males. The single largest category within “other females” was caregiving relatives such as grandmothers and aunts, accounting for 29 to 51 percent of other female perpetrators, although it should be noted that these were fairly rare reports—all other females together only accounted for about 5 percent of incidents.

Aggregated perpetrator patterns for IPV incidents. A youth could be exposed to both male and female IPV perpetrators. For example, a youth might hear his or her father threaten his girlfriend and see his or her mother slap her ex-husband. This turned out to be infrequent, however. Of all youth exposed to IPV, most (68.8 percent) encountered only male IPV perpetrators. The next largest group (22.6 percent) consisted of those who described only female perpetrators, and few (8.6 percent) reported exposures to both male and female IPV perpetrators (see figure 5). In another indicator showing that both genders were seldom identified as perpetrators, the open-ended response of “both parents” was recorded only nine times, or in less than 1 percent of IPV incidents.

Perpetrators of other family violence. Fathers were again the most common perpetrators when a child witnessed the parental assault of a sibling, but the rate for mothers was somewhat higher than for IPV exposure. For other family violence that did not involve one parent’s violence against the other parent or a sibling of the study participant, the largest proportion of the perpetrators were adolescent brothers, accounting for 56 percent of “other males” and 24 percent of the total. Fathers comprised a substantial portion of perpetrators (23 percent), mothers comprised 10 percent, and all other females comprised 24 percent.

These findings align with most criminological data on IPV (Hamby, 2009; Snyder and McCurley, 2008) and are consistent with the “moderate asymmetry hypothesis” (Hamby, 2009), which indicates that males perpetrate most IPV and females perpetrate a substantial minority. It is also possible that youth are not true independent observers but are identifying the primary aggressor in ways that are influenced by the judgments of people calling the police or police officers making arrests (Snyder and McCurley, 2008). These findings nonetheless indicate how important it is to understand exposure to family violence from the child’s perspective. Some children have many “parents”—biological parents, stepparents, adoptive parents, foster parents, and other caregivers—and it is clear that they are being exposed to violence perpetrated by a wide variety of caregivers and family members.

Children’s Reactions to Family Violence

The information from the survey on children’s reactions to violence by one parent against another indicates that large numbers were not simply passive observers, as shown in figure 6. Almost one-half of the youth surveyed reported yelling to try to stop the violence or trying to get away from the violence: 49.9 percent of exposed youth had yelled at their parents to stop at least once, and 43.9 percent had tried to get away at least once (the range across individual IPV items was 34.2 to 65.7 percent for yelling at parents to stop and 36 to 47.5 percent for trying to get away). Calling for help was less prevalent but still fairly common at 23.6 percent or almost one in four youth (it ranged from 16.6 to 26.2 percent across individual forms of IPV).

Very similar reactions were also found to parental assaults of a sibling (49.3 percent yelled at the parent to stop, 41.6 percent tried to get away from the fighting, and 20.2 percent called for help) and violence between other household teens and adults (48.9 percent yelled, 30.3 percent tried to get away, and 26.1 percent called for help). These findings support clinical reports that children often yell at the perpetrators, try to get away, and call for help in response to family violence (Edleson, Shin, and Armendariz, 2008).

Comparison of NatSCEV Findings With Previous Estimates of Exposure to Family Violence

Exposure to family violence was common in this nationally representative sample of youth, with 1 in 9 (11 percent) reporting any exposure in the past year and 1 in 15 (6.6 percent) reporting exposure to physical violence between their parents (see table 1). Extended to the entire U.S. youth population, this yields an estimate of approximately 8.2 million children and youth who were exposed to family violence in the past year alone. Lifetime exposures were even higher, already reaching 1 in 4 youth even in this fairly young sample, or 18.8 million children extrapolated to the population as a whole. Most of these exposures involved direct eyewitnessing (90 percent for IPV; 76 percent for other family violence). Approximately half of the youth yelled at their parents during a violent episode between the parents or tried to get away; nearly a quarter had called for help at least once (see figure 6).

The addition of more detailed questions in NatSCEV (see “Screening Questions: Exposure to Intimate Partner Violence and Other Family Violence”) resulted in estimates that are more than double the estimates from the earlier DVS survey (Finkelhor et al., 2005). The NatSCEV survey’s 1-year point estimate is somewhat lower than that provided by McDonald and colleagues (2006), although the total lifetime estimates are considerably higher than those produced by other national surveys (Straus, 1992; Zinzow et al., 2009). Methodological factors probably account for these differences. McDonald and colleagues’ (2006) analysis assumed that if IPV occurred in a household with children, the children were necessarily exposed to that violence, which would be unlikely given the private nature of some violence. The NatSCEV survey’s higher lifetime estimates, compared to those of Straus (1992) and Zinzow and colleagues (2009), are probably due to assessing a wider array of violent acts and including more forms of possible exposure.

Implications for Policymakers, Researchers, and Practitioners

These comprehensive national estimates about children exposed to IPV and other family violence have several important ramifications. First, they provide a new, more scientifically grounded basis on which education, advocacy, and public policy can be advanced with authority and urgency. Second, they provide a baseline estimate using a sound and replicable methodology to monitor trends as professionals and policymakers attempt to reduce the toll of exposure to family violence. Third, they move the field toward a more systematic understanding of all types of exposure to IPV and other family violence.

Based on the epidemiology of exposure to family violence reflected in this research, several major public policy initiatives deserve consideration. These include:

• Better protocols to screen for children exposed to IPV and other family violence that can be used in many settings, including health care, education, mental health, family services, and the criminal justice system.

• Improved interventions to assist exposed children, particularly those who have been exposed to the most severe forms of violence or who experience chronic exposure to violence. These interventions could include safety planning that is targeted at children’s safety, and evidence-based therapeutic programs to help children cope with their exposure (Graham-Bermann et al., 2007).

• Increased efforts to coordinate services between adult and child victims and witnesses, such as those advocated by the Greenbook and Safe Start Initiatives (Association for the Study and Development of Community, 2005; Schechter and Edleson, 1999).

• Prevention programs to reduce the amount of family violence to which children are exposed, through school-based education, parenting education, and public awareness campaigns.

These new findings offer some guidance on issues that these protocols and programs should address. Perhaps most importantly, protocols and programs need to recognize that exposure to violence occurs in a wide array of family relationships. In today’s society, many children have more than two parents, and assessments should be sure to document exposures to noncustodial parents, stepparents, boyfriends or girlfriends of parents, and other in-home caregivers (such as grandparents). Likewise, NatSCEV provides the strongest available data so far to indicate that children are witnessing violence between other family members, and this exposure should also be addressed. Evidence showing that nearly all exposed children are direct eyewitnesses to at least some violence in the home provides new urgency to longstanding calls to continue working on model protocols and programs.

Screening Questions: Exposure to Intimate Partner Violence and Other Family Violence

The National Survey of Children’s Exposure to Violence (NatSCEV) used an enhanced version of the Juvenile Victimization Questionnaire (JVQ) (referred to as the JVQ–R1), an inventory that covers five general areas of youth victimization: conventional crime, maltreatment, victimization by peers and siblings, sexual victimization, and witnessing and indirect victimization (Finkelhor et al., 2005; Hamby, Ormrod, and Finkelhor, 2005). The original JVQ had two items on witnessing family violence; NatSCEV asked six more questions on the topic. The directions to the additional questions read, “The next set of questions are about people who have taken care of you [or ‘your child,’ substituted throughout]—that would include your parents, stepparents, and your ‘parents’ boyfriends or girlfriends, whether you lived with them or not. It would also include other grownups, like grandparents or foster parents if they took care of you on a regular basis. When we say ‘parent’ in these next questions, we mean any of these people.”* If respondents reported family perpetrators and victims in response to other more general screeners, these episodes were also included in the rates.

Questions Regarding Types of Exposure

In the six new NatSCEV items regarding exposure to family violence, respondents were asked, “How did you know it happened?” The response options were: “Did you see it?”; “Did you hear it, but not see it?”; “Did you not see or hear it, but see the person’s bruise or injury?”; and “Did you not see or hear anything, but someone told you?” Additional incident data were collected only for the first three types of exposure. Respondents were directed to describe the most recent episode of family violence that they saw, heard, or saw a resulting injury from.

Questions Regarding Perpetrator Identity

Respondents were asked, “Who did this?” Interviewers coded respondents’ open-ended answers into several categories, including father, mother, sibling, other relative who lives with the youth, other relative who does not live with the youth, a parent’s boyfriend or girlfriend, and other grownup. “Father” and “mother” included biological parents, adoptive parents, stepparents, and cohabiting partners of a parent. Responses that the interviewers could not categorize were recorded verbatim and coded later.

Fathers were recorded as males, mothers as females. If the perpetrator’s gender was not clear, respondents were asked, “Was this a man, woman, boy, or girl?”

Questions Regarding Reactions to Incidents of Family Violence

Three questions based on the Child Exposure to Domestic Violence scale (Edleson, Shin, and Armendariz, 2008) were asked: “When this happened, did you yell at them to stop?”; “When this happened, did you call someone else for help, like calling someone on the phone or going next door?”; and “When this happened, did you try to get away from the fighting by hiding or leaving the house?” The last two questions were asked only about youth age 2 and older. These questions were asked only of respondents who first described these incidents during the family violence portion of the interview (not if the episode was disclosed in response to one of the more general screening questions).

* For the exact wording of the questions, see Finkelhor, Turner, Ormrod, and Hamby, 2009.

Endnotes

1. The DVS, a precursor to NatSCEV, asked a nationally representative sample of 2,030 children ages 10 to 17 and caregivers of children ages 2 to 9 about their past-year exposure to crime and violence in five categories: conventional crime, child maltreatment, peer and sibling victimization, sexual assault, and witnessing and indirect victimization. The DVS was the first national survey to estimate the incidence of witnessing physical abuse (Finkelhor et al., 2005; Kracke and Hahn, 2008).

2. Because mothers’ noncohabiting boyfriends constitute such a large proportion of perpetrators of IPV that children are exposed to (11 percent, versus 8 percent for all other males in the “other males” category), they are broken out into a separate category in figure 4.

References

Acierno, R., Resnick, H., Kilpatrick, D.G., and Stark-Riemer, W. 2003. Assessing elder victimization—Demonstration of a methodology. Social Psychiatry and Psychiatric Epidemiology 38(11):644–653.

Association for the Study and Development of Community. 2005. National Evaluation of the Safe Start Demonstration Project, January Through December 2004, Volume 1: Cross-Site Process Evaluation. Gaithersburg, MD: Association for the Study and Development of Community.

Bolen, R.M., and Scannapieco, M. 1999. Prevalence of child sexual abuse: A corrective meta-analysis. Social Services Review 73(3):281–313.

Edleson, J.L., Shin, N., and Armendariz, K. 2008. Measuring children’s exposure to domestic violence: The development and testing of the Child Exposure to Domestic Violence (CEDV) Scale. Children and Youth Services Review 30:502–521.

Fantuzzo, J., Boruch, R., Beriama, A., Atkins, M., and Marcus, S. 1997. Domestic violence and children: Prevalence and risk factors in five major U.S. cities. Journal of the American Academy of Child and Adolescent Psychiatry 36(1):116–122.

Fantuzzo, J., and Mohr, W.K. 1999. Prevalence and effects of child exposure to domestic violence. The Future of Children 9(3):21–32.

Finkelhor, D., Turner, H., Ormrod, R., and Hamby, S.L. 2005. The victimization of children and youth: A comprehensive, national survey. Child Maltreatment 10(1):5–25.

Finkelhor, D., Turner, H.A., Ormrod, R.K., and Hamby, S.L. 2009. Violence, crime, and exposure in a national sample of children and youth. Pediatrics 124(5):1411–1423.

Finkelhor, D., Turner, H., Ormrod, R., Hamby, S., and Kracke, K. 2009. Children’s Exposure to Violence: A Comprehensive National Survey. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention.

Graham-Bermann, S.A., Lynch, S., Banyard, V., DeVoe, E.R., and Halabu, H. 2007. Community-based intervention for children exposed to intimate partner violence: An efficacy trial. Journal of Consulting and Clinical Psychology 75(2):199–209.

Grych, J.H. 1998. Children’s appraisals of interparental conflict: Situational and contextual influences. Journal of Family Psychology 12:437–453.

Hamby, S.L. 2009. The gender debate on intimate partner violence: Solutions and dead ends. Psychological Trauma 1(1):24–34.

Hamby, S.L., Ormrod, R., and Finkelhor, D. 2005. Victim gender, perpetrator gender and victim-offender relationship in a nationally representative study of youth victimization. Paper presented at the Ninth International Family Violence Research Conference, Portsmouth, NH, July 10–13.

Holden, G.W. 2003. Children exposed to domestic violence and child abuse: Terminology and taxonomy. Clinical Child and Family Psychology Review 6(3):151–160.

Hutchison, I.W., and Hirschel, J.D. 2001. The effects of children’s presence on woman abuse. Violence and Victims 16(1):3–17.

Jaffe, P.G., Crooks, C.V., and Wolfe, D.A. 2003. Legal and policy responses to children exposed to domestic violence: The need to evaluate intended and unintended consequences. Clinical Child and Family Psychology Review 6(3):205–219.

Jouriles, E.N., and Norwood, W.D. 1995. Physical aggression toward boys and girls in families characterized by the battering of women. Journal of Family Psychology 9:69–78.

Kitzmann, K.M., Gaylord, N., Holt, A., and Kenny, E. 2003. Child witnesses to domestic violence: A meta-analytic review. Journal of Consulting and Clinical Psychology 71(2):339–352.

Kracke, K., and Hahn, H. 2008. The nature and extent of childhood exposure to violence: What we know, why we don’t know more, and why it matters. Journal of Emotional Abuse 8(1/2):29–49.

Lang, J.M., and Stover, C.S. 2008. Symptom patterns of youth exposed to intimate partner violence. Journal of Family Violence 23:619–629.

McDonald, R., Jouriles, E.N., Ramisetty-Mikler, S., Caetano, R., and Green, C.E. 2006. Estimating the number of children living in partner-violent families. Journal of Family Psychology 20(1):137–142.

Murrell, A.R., Merwin, R.M., Christoff, K.A., and Henning, K.R. 2005. When parents model violence: The relationship between witnessing weapon use as a child and later use as an adult. Behavior and Social Issues 14:128–133.

National Domestic Violence Hotline. 1998. Safety planning. Available online at: www.thehotline.org/get-help/safety-planning.

Nixon, K.L., Tutty, L.M., Weaver-Dunlop, G., and Walsh, C.A. 2007. Do good intentions beget good policy? A review of child protection policies to address intimate partner violence. Children and Youth Services Review 29:1469–1486.

Schechter, S., and Edleson, J.L. 1999. Effective Intervention in Domestic Violence and Child Maltreatment: Guidelines for Policy and Practice. Reno, NV: National Council of Juvenile and Family Court Judges.

Shannon, E.E., Mathias, C.W., Marsh, D.M., Dougherty, D.M., and Liguori, A. 2007. Teenagers do not always lie: Characteristics and correspondence of telephone and in-person reports of adolescent drug use. Drug and Alcohol Dependence 90(2–3): 288–291.

Snyder, H.N., and McCurley, C. 2008. Domestic Assaults by Juvenile Offenders. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention.

Straus, M.A. 1992. Children as witness to marital violence: A risk factor for lifelong problems among a nationally representative sample of American men and women. In Children and Violence: Report of the Twenty-Third Ross Roundtable on Critical Approaches to Common Pediatric Problems, edited by D.F. Schwarz. Columbus, OH: Ross Laboratories, pp. 98–104.

Straus, M.A., and Gelles, R.J. 1990. Physical Violence in American Families: Risk Factors and Adaptations to Violence in 8,145 Families. New Brunswick, NJ: Transaction Publishers.

Straus, M.A., Hamby, S.L., Boney-McCoy, S., and Sugarman, D.B. 1996. The Revised Conflict Tactics Scales (CTS2). Journal of Family Issues 17:283–316.

Tjaden, P., and Thoennes, N. 1998. Prevalence, Incidence, and Consequences of Violence Against Women: Findings from the National Violence Against Women Survey. Washington, DC: U.S. Department of Justice, Office of Justice Programs, National Institute of Justice.

Wolfe, D.A., Crooks, C.V., Lee, V., McIntyre-Smith, A., and Jaffe, P.G. 2003. The effects of children’s exposure to domestic violence: A meta-analysis and critique. Clinical Child and Family Psychology Review 6(3):171–187.

Zinzow, H.M., Ruggiero, K.J., Resnick, H., Hanson, R., Smith, D., Saunders, B., and Kilpatrick, D. 2009. Prevalence and mental health correlates of witnessed parental and community violence in a national sample of adolescents. Journal of Child Psychology and Psychiatry 50(4):441–450.

For Further Information

To learn more about the Safe Start Initiative, visit www.safestartcenter.org.

For more information about the National Survey of Children’s Exposure to Violence, visit the Crimes Against Children Research Center Web site at www.unh.edu/ccrc. Detailed supplementary tables of the rates reported here can be obtained by contacting Sherry Hamby at sherry.hamby@sewanee.edu.

Acknowledgments

This bulletin was written by Sherry Hamby, Ph.D., Research Associate Professor, Department of Psychology, Sewanee: The University of the South; David Finkelhor, Ph.D., Director, Crimes against Children Research Center, University of New Hampshire; Heather Turner, Ph.D., Professor, Crimes against Children Research Center, University of New Hampshire; and Richard Ormrod, Ph.D., Research Professor, Crimes against Children Research Center, University of New Hampshire. OJJDP wishes to acknowledge the contributions to this bulletin of Rebecca T. Leeb, Ph.D., Epidemiologist, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (CDC). OJJDP also wishes to acknowledge the support of CDC for the National Survey of Children’s Exposure to Violence and its partnership in the Safe Start Initiative to create safe, stable, and nurturing environments for children and their families.

Share With Your Colleagues

Unless otherwise noted, OJJDP publications are not copyright protected. We encourage you to reproduce this document, share it with your colleagues, and reprint it in your newsletter or journal. However, if you reprint, please cite OJJDP and the authors of this Bulletin. We are also interested in your feedback, such as how you received a copy, how you intend to use the information, and how OJJDP materials meet your individual or agency needs.

Please direct your comments and questions to:

National Criminal Justice Reference Service

P.O. Box 6000

Rockville, MD 20849–6000

800–851–3420

301–519–5500 (fax)

Email: responsecenter@ncjrs.gov

www.ncjrs.gov

This bulletin was prepared under grant number 2005–JL–FX–0048 from the Office of Juvenile Justice and Delinquency Prevention (OJJDP), U.S. Department of Justice.

Points of view or opinions expressed in this document are those of the authors and do not necessarily represent the official position or policies of OJJDP or the U.S. Department of Justice.

The Office of Juvenile Justice and Delinquency Prevention is a component of the Office of Justice Programs, which also includes the Bureau of Justice Assistance; the Bureau of Justice Statistics; the National Institute of Justice; the Office for Victims of Crime; and the Office of Sex Offender Sentencing, Monitoring, Apprehending, Registering, and Tracking.

Access OJJDP publications online at ojjdp.gov/publications/index.html.

NCJ 232272

Polyvictimization: Children’s Exposure to Multiple Types of Violence, Crime, and Abuse

David Finkelhor, Heather Turner, Sherry Hamby, and Richard Ormrod

October 2011

All too often, children are victims of violence, crime, and abuse. This victimization may take the form of physical assault, child maltreatment, sexual abuse, or bullying. They may also witness such events in their homes, schools, and communities. Some children suffer several different kinds of such victimization even over a relatively brief timespan. These children and youth are at particularly high risk for lasting physical, mental, and emotional harm.

The National Survey of Children’s Exposure to Violence (NatSCEV) was the first comprehensive national survey to look at the entire spectrum of children’s exposure to violence, crime, and abuse across all ages, settings, and timeframes. NatSCEV examined past-year and lifetime exposure to physical and emotional violence through both direct victimization and indirect exposure to violence (either as an eyewitness or through other knowledge).

A focus of NatSCEV was multiple and cumulative exposures to violence. A large proportion of children surveyed (38.7 percent) reported in the previous year more than one type of direct victimization (a victimization directed toward the child, as opposed to an incident that the child witnessed, heard, or was otherwise exposed to). Of those who reported any direct victimization, nearly two-thirds (64.5 percent) reported more than one type. A significant number of children reported high levels of exposure to different types of violence in the past year: more than 1 in 10 (10.9 percent) reported 5 or more direct exposures to different types of violence, and 1.4 percent reported 10 or more direct victimizations.

Children who were exposed to even one type of violence, both within the past year and over their lifetimes, were at far greater risk of experiencing other types of violence. For example, a child who was physically assaulted in the past year would be five times as likely also to have been sexually victimized and more than four times as likely also to have been maltreated during that period. Similarly, a child who was physically assaulted during his or her lifetime would be more than six times as likely to have been sexually victimized and more than five times as likely to have been maltreated during his or her lifetime (Finkelhor, Turner, Ormrod, Hamby, and Kracke, 2009). This helps explain why victimizations cumulate.

More attention needs to be paid to children who are exposed to multiple types of violence, crime, and abuse. Most research has looked only at individual forms of child victimization—such as sexual abuse or bullying—without investigating the other exposures these same children may face. A new emphasis on the study of what is being called “polyvictimization” offers to help teachers, counselors, medical professionals, psychologists, child welfare advocates, law enforcement, juvenile justice system personnel, and others who work with children identify the most endangered children and youth and protect them from additional harm.

This bulletin summarizes some of the key findings on polyvictimized youth, based on NatSCEV (see “History of the National Survey of Children’s Exposure to Violence”) and the closely related Developmental Victimization Survey (DVS) (see “Methodology”). Among the key findings: 8 percent of all youth in the nationally representative NatSCEV sample had seven or more different kinds of victimization or exposures to violence, crime, and abuse in the past year. These polyvictimized youth had a disproportionate share of the most serious kinds of victimizations, such as sexual victimization and parental maltreatment. They also had more life adversities and were more likely to manifest symptoms of psychological distress. Polyvictimization tended to persist over time. It was most likely to start near the beginning of grade school and the beginning of high school, and was associated with a cluster of four prior circumstances or pathways: living in a violent family, living in a distressed and chaotic family, living in a violent neighborhood, and having preexisting psychological symptoms.

Adversities Related to Polyvictimization

A number of independent lines of thinking have pointed to the importance of examining polyvictimization in childhood. The research on cumulative adversity suggests that especially intense and long-lasting effects occur when problems aggregate, particularly in childhood (Dong et al., 2004; Rutter, 1983). Other research shows that victimizations are not randomly distributed but tend to cumulate for certain individuals and in certain environments (Tseloni and Pease, 2003). Observers have proposed mechanisms for understanding why such adversities may cumulate and some children are victimized repeatedly, including “ecological-transactional” models (Lynch and Cicchetti, 1998) and models that emphasize the impact of victimization on the formation of “cognitive schemas” (Perry, Hodges, and Egan, 2001) or on the “dysregulation” of emotions (Shields and Cicchetti, 1998). At the same time, traumatic stress theory—the dominant framework for understanding the impact of victimization—has evolved toward the notion that for some children victimization is not a single overwhelming event (like a sexual assault) but a condition like neglect or bullying (Finkelhor, Ormrod, and Turner, 2007a). This concept is sometimes referred to as “complex trauma” (Cook et al., 2003). Children who experience repeated victimizations and several types of victimizations may be at greater risk for suffering this complex trauma.

Methodology

National Survey of Children’s Exposure to Violence

The National Survey of Children’s Exposure to Violence (NatSCEV) is based on a cross-sectional national telephone survey^1 involving a target sample of 4,549 children and youth conducted between January and May 2008, including an oversample of 1,500 respondents from areas with large concentrations of black, Hispanic, and low-income populations. Participants included youth ages 10 to 17, who were interviewed about their own experiences, and the parents or other primary caregivers of children ages 9 and younger, who provided information about these younger children (Finkelhor, Turner, Ormrod, and Hamby, 2009; Finkelhor, Turner, Ormrod, Hamby, and Kracke, 2009).

Interviewers asked the children or their caregivers about their exposure to selected types of violence, crime, and abuse in the past year and over their lifetimes. In addition, interviewers asked followup questions about the perpetrator; the use of a weapon; injury; and whether multiple incidents of violence, crime, and abuse occurred together. A total of 51 victimization items were extracted in the following categories: assaults, bullying, sexual victimization, child maltreatment by an adult, and witnessed and indirect victimization.

Developmental Victimization Survey

The Developmental Victimization Survey (DVS) was based on a cross-sectional national telephone survey involving a target sample of 2,030 children and youth between December 2002 and February 2003. Participants included youth ages 10 to 17, who were interviewed about their own experience, and the parents or other caregivers of children ages 2 to 9, who provided information about these younger children (Finkelhor, Ormrod, et al., 2005b).

Researchers also conducted two followup surveys of the same population, the first from December 2003 to May 2004 (approximately 1 year after the baseline survey) and the second from December 2005 to August 2006. A total of 989 respondents (49 percent of the original sample) took part in all three waves. Attrition was greater among younger children, nonwhites, and lower socioeconomic status families, but did not differ by initial level of victimization (Finkelhor, Ormrod, Turner, and Holt, 2009).

All three waves of the DVS questioned the respondents about past-year victimizations, using identically worded questions. In addition, in wave 2 (the first followup survey), researchers asked respondents the same set of questions about lifetime victimization experiences prior to the past-year data collection period for that wave.

Juvenile Victimization Questionnaire

In both surveys, the research team measured victimization with versions of the Juvenile Victimization Questionnaire (JVQ) (Finkelhor, Hamby, Ormrod, and Turner, 2005; Finkelhor, Ormrod, et al., 2005b). The basic questionnaire, used in the DVS, contains questions about 34 different kinds of victimization that cover 5 general areas of concern: conventional crime, child maltreatment, peer and sibling victimization, sexual victimization, and witnessing and indirect victimization. The researchers asked respondents who indicated that they had been victimized in any of these ways a series of followup questions about the frequency of the exposure, the identities of offenders, and whether injury occurred, among other things.2 NatSCEV used an enhanced version of the JVQ (JVQ–R1) with 14 additional questions about further types of victimization, including an item about threatening and several items each about exposure to community violence, exposure to family violence, school violence and threats, and Internet victimization.3

Measurement of Distress

In both surveys, the researchers measured distress with items from the Trauma Symptom Checklist for Children (TSCC) (for children ages 10–17) (Briere, 1996) and the closely related Trauma Symptom Checklist for Young Children (TSCYC) (for children younger than 10 years old) (Briere et al., 2001). These checklists evaluate posttraumatic symptoms and other symptom clusters in children and adolescents, including the effects of child abuse (sexual, physical, and psychological) and neglect, other interpersonal violence, peer victimization, witnessing violence or other trauma to others, major accidents, and disasters.

Notes

1 Because telephone interviews afford greater anonymity and privacy than in-person interviews, they may encourage those interviewed to be more forthcoming about such sensitive matters as being exposed to violence or being victims of crime (Acierno et al., 2003; Shannon et al., 2007).

2 For a complete list of the questions in the JVQ, see appendix A to Finkelhor, Ormrod, and Turner, 2007c. For information about administration and scoring, see Hamby et al., 2004.

3 For a list of all NatSCEV questions, see appendix A to Finkelhor, Ormrod, Turner, and Hamby, 2009.

Determining the Threshold for Polyvictimization

Polyvictimization can be defined as having experienced multiple victimizations of different kinds, such as sexual abuse, physical abuse, bullying, and exposure to family violence. This definition emphasizes different kinds of victimization, rather than just multiple episodes of the same kind of victimization, because this appears to signal a more generalized vulnerability. The field has not yet developed a consensus about what the exact numerical threshold should be for a child to qualify as a polyvictim. The threshold used in research connected to NatSCEV designates approximately the most victimized 10 percent of the survey sample as polyvictims (Finkelhor, Ormrod, and Turner, 2009).

Much of the research on polyvictimization has been based on the Juvenile Victimization Questionnaire (JVQ), an instrument that asks about almost three dozen kinds of different victimization exposures (Finkelhor, Ormrod, and Turner, 2007b; Finkelhor, Ormrod, et al. 2005a). The JVQ was the basis for the questions in both the DVS and NatSCEV (see “Methodology”). Both the JVQ and NatSCEV’s JVQ–R1 asked children and youth about exposures to conventional crime, including property crime, child maltreatment, peer and sibling victimization, sexual victimization, and the witnessing of family and community violence.

NatSCEV found a significantly greater level of distress among children and youth who suffered seven or more kinds of victimization in a single year (figure 1). This cutoff designates 8 percent of the sample and is used for exploratory purposes as the threshold for defining polyvictimization.

Past-Year Versus Lifetime Exposures as a Measure of Polyvictimization

Some researchers have preferred to assess for polyvictimization in the context of a child’s full lifetime experience rather than simply for a single year. When defining polyvictimization over the course of childhood, one must keep in mind that older youth will accumulate more victimizations than younger children simply because they have lived longer. One option when using lifetime measures of polyvictimization is to establish lower thresholds for younger children if a goal is to identify vulnerable children at an earlier age (Finkelhor, Ormrod, and Turner, 2009).

Some have wondered whether weighting more heavily some victimization experiences that are presumed to be more serious, such as sexual abuse, would be more advantageous when assessing vulnerability. Various schemes for weighting victimizations made little difference in predicting distress when working with past-year victimizations (Finkelhor, Ormrod, et al., 2005a). In lifetime assessments, however, weighting the experiences of sexual assault and child maltreatment more heavily improved prediction of distress from victimization (Finkelhor, Ormrod, and Turner, 2009).

Past-Year and Lifetime Polyvictimization Rates Among NatSCEV Respondents

In NatSCEV’s representative sample of U.S. children, 49 percent of children and youth surveyed suffered two or more types of victimization (including both direct and indirect victimizations) in the past year. The largest number of different types of victimizations was 18. The median number of past-year exposures to violence among victims was three. Figure 1a, which illustrates the relationship between past-year exposure to violence and the number of trauma symptoms, shows that distress scores rise significantly from the overall trend at the level of seven or more victimization types in the past year. These children and youth (about 8 percent of the sample) are designated as polyvictims.

A graph of the number of different victimizations over the child’s lifetime (figure 1b) shows a similar, if more extended distribution. The median number of lifetime exposures to violence among victims was three. The plot for distress symptoms shows an elevation above the linear trend at the level of 11 or more exposures, which designates 10 percent of the survey participants, totaling the percentage of all participants who had a given number of lifetime exposures.

The remainder of the bulletin will primarily discuss polyvictims as classified by their past-year experiences. Nearly three-quarters (72 percent) of these children would also qualify as lifetime polyvictims using the cutoff of 11 or more lifetime exposures to violence. This bulletin focuses on past-year polyvictims for two reasons: (1) the multiple exposures are closer in time to each other and to the survey for this group, and thus signify a high level of current vulnerability; and (2) this group has a less skewed age distribution, as lifetime calculations tend to overrepresent older youth who accumulate more exposures over time. (For an analysis of the experiences of children who qualify as polyvictims on the basis of lifetime experiences, see Turner, Finkelhor, and Ormrod, 2010.)

Characteristics of Polyvictims

Among the characteristics that distinguish polyvictims from children who are less exposed to violence are the more serious nature of their victimizations; the greater range of victimizations they suffered; and their overrepresentation among certain demographic groups: boys, older children, children of medium socioeconomic status (SES), African American children, and children in single-parent, stepparent, and other adult caregiver families.

Incidence of Serious Victimizations Among Polyvictims

Polyvictims not only have many victimizations, they also suffer more serious victimizations. As figure 2 shows, in the past year, 55 percent of polyvictims had a victimization injury, 42 percent faced an assailant who carried a weapon or other harmful object, 36 percent experienced sexual victimization, and 53 percent had been victimized by a caretaker. These levels of serious victimization were four to six times greater than the levels for other victimized children.

Exposure to Multiple Domains of Victimization

The polyvictims had also experienced victimization across a broad range of different types of victimization. Nearly three out of five polyvictims (58 percent) had victimizations in five or more “domains” (e.g., maltreatment, sexual victimization, bullying) (see figure 3). Such victimization exposure across so many domains may be what leaves these children so particularly distressed. There are relatively few areas of safety for them.

Demographic Characteristics of Polyvictims

Polyvictims are somewhat more likely to be boys than girls: 54 percent of polyvictims were boys, whereas 46 percent of polyvictims were girls. They are also overrepresented among older youth (41 percent of polyvictims were in the 14–17 age group, comprising 13.0 percent of all youth surveyed in that age group) (see table 1). NatSCEV found lower polyvictimization rates among both higher and lower SES families compared to families in the middle. It found no difference in polyvictimization rates in urban and rural areas. However, there were higher rates among African Americans and lower rates among Hispanics. Youth living in single-parent and stepparent families had higher rates of polyvictimization.

Other Lifetime Adversities and Levels of Distress Among Polyvictims

A notable characteristic of polyvictimization is the far greater level of additional lifetime adversities and levels of distress these children experience. Polyvictims were more likely to have had other kinds of lifetime adversities such as illnesses, accidents, family unemployment, parental substance abuse, and mental illness (an average of 4.7 adversities versus 2.1 for nonpolyvictims).

Polyvictims were clearly experiencing high levels of distress as measured by a checklist of symptoms that included indicators of anxiety, depression, anger, and posttraumatic stress disorder (PTSD). The symptom score for polyvictims was more than one standard deviation higher than for other victims and nonvictims. Further, polyvictims were well represented among distressed children. Among children who were in the top 10 percent of the distressed children, 30 percent could be classified as polyvictims.

Polyvictims were not only more distressed than other victims in general; they were also more distressed than those who experienced frequent victimization of a single type. Figure 4 shows symptom levels for four groups of children with different kinds of victimization profiles: (1) those who had experienced no victimization, (2) those who were exposed to less than the average frequency of one type of victimization (e.g., bullying), (3) those with a more than average frequency of one type of victimization (e.g., chronic bullying), and (4) those exposed to a specific type of victimization who were also polyvictims (meaning, for example, that they had been bullied and had also been exposed to victimizations of several other types). The polyvictims were considerably more distressed than the children who were victims of one type of chronic victimization but did not have additional different kinds of victimization.

As figure 4 shows, this was true for virtually every individual form of victimization. Having multiple sexual victimizations, for example, was not associated with nearly as much distress as having any sexual victimization in combination with several other different kinds of victimization. This suggests that among children identified with a single kind of victimization (such as sexual assault), the ones with the most distress will generally be those with other kinds of victimization as well. This may be because these children have no or few environments in which they feel truly safe. It suggests that studies and intervention programs targeted at any particular kind of victimization, like bullying or exposure to family violence, need also to assess children for other kinds of victimization. Exposure to multiple types of victimization may be the most important feature underlying high levels of distress.

Development and Persistence of Polyvictimization

Given how serious polyvictimization appears to be, little is now known about how it develops and progresses. In the Developmental Victimization Survey (DVS) (Finkelhor, Ormrod, et al. 2005b), a similar but smaller national survey that preceded NatSCEV, researchers followed up with children three times during a 4-year period to learn more about such developmental patterns. They found that polyvictimization tended to persist. Of the children the researchers categorized as polyvictims prior to the first wave of the study, 55 percent were still polyvictims in one of the next two waves (Finkelhor, Ormrod, Turner, and Holt, 2009). This suggests that many youth find it hard to escape polyvictimization.

Onset of Polyvictimization

The DVS also looked at the characteristics of children who became new polyvictims over the course of the followup period. Children ages 7 and 15 at the time they were interviewed were most likely to have become polyvictims for the first time during the previous year (i.e., during the year that generally corresponded to their first year of grade school or high school) (see figure 5). It may be that some children are particularly vulnerable when they make the transition into a new school environment. It is a time when they have to deal with many new people and navigate new environments without knowing yet where the dangers are.

Children who became new polyvictims during the course of the DVS tended to average more victimizations in the year prior to their onset than other children who were not polyvictims. However, no particular constellation of victimizations seemed to predict the onset of polyvictimization. In their year of onset, new polyvictims registered on average four different kinds of new victimizations and disproportionate increases in sexual victimizations, property victimizations, and physical assaults.

Pathways to Polyvictimization

Using the DVS, the researchers developed and tested a conceptual model that specifies four distinct pathways for children culminating in polyvictimization (see figure 6). These four pathways are: (a) living in a family that experiences considerable violence and conflict (dangerous families); (b) having a family beset with problems around such things as money, employment, and substance abuse that might compromise a child’s supervision or create unmet emotional needs (family disruption and adversity); (c) residing in or moving into a dangerous community (dangerous neighborhoods); and (d) being a child with preexisting emotional problems that increase risky behavior, engender antagonism, and compromise the capacity to protect oneself (emotional problems). The study confirmed that each of these appears to contribute independently to the onset of polyvictimization (Finkelhor, Ormrod, Turner, and Holt, 2009). The emotional problems pathway was most prominent for children younger than 10 years old, and the other pathways appeared to be more predictive for children 10 and older.

Implications for Practitioners, Policymakers, and Researchers

Awareness about polyvictimization has many potential implications for those who work with juvenile victims and what they can do to identify and intervene on behalf of children who are exposed to multiple forms of violence:

• Assess for more victimizations. Children need to be assessed for a broader range of victimizations. When children are identified as victims of sexual abuse or bullying, professionals who work with them need to find out what else is going on, as these children often experience other victimizations and adversities.

• Priority for polyvictims. Professionals who work with children need to pay particular attention to polyvictims because of their vulnerability to mental health, behavioral, school performance, and other problems. These children can be identified in schools, in social welfare and mental health caseloads, and in the foster care and juvenile justice systems; and they warrant priority in victimization interventions. When child welfare and other professionals intervene on these children’s behalf, they need to ensure that they are not minimizing polyvictims’ victimization histories (e.g., treating them simply as victims of child abuse when they are also being bullied, or simply as victims of bullying when they are also being sexually abused). In addition, as studies have shown that bully-victims (victims of violence who also bully others) have the worst outcomes and are more likely to have multiple victimizations, educators and other child welfare professionals who work with children who bully should recognize the need for more comprehensive assessments to identify them as potential polyvictims and for treatment that takes into account their multiple domains of victimization (Holt, Finkelhor, and Kaufman Kantor, 2007).

• Polyvictim interventions. Interventions need to be developed to encompass multiple victimizations. Therapies should not just focus on (for example) sexual abuse alone, but should be multifaceted, addressing multiple types of victimizations, as many of the risk factors for one type of victimization are shared among multiple types of victimization. Therefore, prevention interventions that focus on addressing common underlying risk factors are likely to have the greatest benefit. Strategies for reducing stigma or traumatic reminders also need to be applied to the full range of victimization exposure.

• Treat underlying vulnerabilities. Professionals who conduct interventions with polyvictims must recognize that such children not only suffer from victimization trauma but may also be caught in an overall environment or individual-environmental-interactive conditions that perpetuate victimization. Therefore, intervention professionals must assess for these conditions and develop strategies—such as teaching parenting and guardianship skills to parents and other adult caregivers—that address them.

• Broaden child protection. Awareness of the importance of polyvictimization suggests that the traditional child protective services (CPS) approach might benefit from some broadening of its capacities. An intervention system that helps children only in regard to threats from family members may be too narrow. Although it is unrealistic to expand CPS to respond to reports of all forms of child victimization, children within the current CPS system may benefit if child protection workers are trained to assess children for exposure to multiple forms of victimization in the same way that police are trained to assess for multiple crimes. CPS systems could then design and implement service responses that are pertinent to the variety of threats children face. They have to be prepared to work with law enforcement, educators, and mental health professionals.

• Interrupt onset sequences. Because polyvictimization is associated with so much distress, it should be a priority to figure out how to interrupt the pathways into this condition. Early intervention and primary prevention are needed, along with an awareness that dangerous and disrupted families, dangerous neighborhoods, and emotional problems can all be early warning indicators of current or future polyvictimization. Professionals who work with children need to help build the supervision and protection capacities of family members, legal guardians, caregivers, teachers, and other adults who may be in a position to intervene to help children, and thus stop the onset of and progression toward polyvictimization.

One strategy may be to target the transition to new schools, particularly elementary and high schools. It may be useful to sensitize teachers and other school staff to quickly identify children in these entering classes who may be victimized to ensure that prevention and intervention approaches that address multiple forms of victimization experiences and focus on the prevention of perpetration are in place for children during these important transitional phases.

The findings also suggest another strategy, to encourage teachers and child welfare professionals to be more aware of younger children with emotional distress symptoms. In addition to whatever mental health interventions these children might receive to address their victimization experiences and associated symptoms, these professionals can take advantage of the opportunity to refer children and their families to preventive interventions that can address individual, relationship, and community factors that predict perpetration and prevent repeated or additional forms of victimization experiences from occurring. Another implication is that school staff and child welfare workers should pay particular attention when children report sexual victimization, including sexual harassment by peers. These events may signal broader victimization vulnerability, and responding adults may need to extend their focus beyond the specific sexual report to include an assessment of other forms of exposure to victimization.

References

Acierno, R., Resnick, H., Kilpatrick, D.G., and Stark-Riemer, W. 2003. Assessing elder victimization—Demonstration of a methodology. Social Psychiatry and Psychiatric Epidemiology 38(11):644–653.

Briere, J. 1996. Trauma Symptoms Checklist for Children (TSCC): Professional Manual. Odessa, FL: Psychological Assessment Resources.

Briere, J., Johnson, K., Bissada, A., Damon, L., Crouch, J., Gil, E., Hanson, R., and Ernst, V. 2001. The Trauma Symptom Checklist for Young Children (TSCYC): Reliability and association with abuse exposure in a multi-site study. Child Abuse & Neglect 25:1001–1014.

Cook, A., Blaustein, M., Spinazzola, J., and van der Kolk, B. 2003. Complex Trauma in Children and Adolescents (White Paper). Los Angeles, CA: National Child Traumatic Stress Network, Complex Trauma Task Force.

Dong, M., Anda, R.F., Felitti, V.J., Dube, S.R., Williamson, D.F., Thompson, T., Loo, C., and Giles, W.H. 2004. The interrelatedness of multiple forms of childhood abuse, neglect, and household dysfunction. Child Abuse & Neglect 28(7):771–784.

Finkelhor, D., Hamby, S.L., Ormrod, R.K., and Turner, H.A. 2005. The JVQ: Reliability, validity, and national norms. Child Abuse & Neglect 29(4):383–412.

Finkelhor, D., Ormrod, R.K., and Turner, H.A. 2007a. Poly-victimization: A neglected component in child victimization trauma. Child Abuse & Neglect 31:7–26.

Finkelhor, D., Ormrod, R.K., and Turner, H.A. 2007b. Poly-victimization and trauma in a national longitudinal cohort. Development and Psychopathology 19(1):149–166.

Finkelhor, D., Ormrod, R.K., and Turner, H.A. 2007c. Revictimization patterns in a national longitudinal sample of children and youth. Child Abuse & Neglect 31: 479–502.

Finkelhor, D., Ormrod, R.K., and Turner, H.A. 2009. Lifetime assessment of poly-victimization in a national sample of children and youth. Child Abuse & Neglect 33:403–411.

Finkelhor, D., Ormrod, R.K., Turner, H.A., and Hamby, S.L. 2005a. Measuring poly-victimization using the JVQ. Child Abuse & Neglect 29(11):1297–1312.

Finkelhor, D., Ormrod, R.K., Turner, H.A., and Hamby, S.L. 2005b. The victimization of children and youth: A comprehensive, national survey. Child Maltreatment 10(1):5–25.

Finkelhor, D., Ormrod, R.K., Turner, H.A., and Holt, M.A. 2009. Pathways to poly-victimization. Child Maltreatment 14(4):316–329.

Finkelhor, D., Turner, H.A., Ormrod, R., and Hamby, S.L. 2009. Violence, abuse, and crime exposure in a national sample of children and youth. Pediatrics 124(5):1–13.

Finkelhor, D., Turner, H.A., Ormrod, R., Hamby, S.L., and Kracke, K. 2009. Children’s Exposure to Violence: A Comprehensive National Survey. Bulletin. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention.

Hamby, S.L., Finkelhor, D., Ormrod, R., and Turner, H. 2004. The Juvenile Victimization Questionnaire (JVQ): Administration and Scoring Manual. Durham, NH: Crimes against Children Research Center.

Holt, M.K., Finkelhor, D., and Kaufman Kantor, G. 2007. Multiple victimization experiences of urban elementary schoolstudents: Associations with psychosocial functioning and academic performance. Child Abuse & Neglect 31:503–515.

Lynch, M., and Cicchetti, D. 1998. An ecological transactional analysis of children and contexts: The longitudinal interplay among child maltreatment, community violence, and children’s symptomatology. Development and Psychopathology 10:235–257.

Perry, D.G., Hodges, E.V.E., and Egan, S.K. 2001. Determinants of chronic victimization by peers: A review and new model of family influence. In Peer Harassment in School: The Plight of the Vulnerable and Victimized, edited by J. Juvonen and S. Graham. New York, NY: Guilford Press, pp. 73–104.

Rutter, M. 1983. Statistical and personal interactions: Facets and perspectives. In Human Development: An Interactional Perspective, edited by D. Magnusson and V. Allen. New York, NY: Academic Press, pp. 295–319.

Shannon, E.E., Mathias, C.W., Marsh, D.M., Dougherty, D.M., and Liguori, A. 2007. Teenagers do not always lie: Characteristics and correspondence of telephone and in-person reports of adolescent drug use. Drug and Alcohol Dependence 90(2–3): 288–291.

Shields, A., and Cicchetti, D. 1998. Reactive aggression among maltreated children: The contributions of attention and emotion dysregulation. Journal of Clinical Child and Adolescent Psychology 27(4):381–395.

Tseloni, A., and Pease, K. 2003. Repeat personal victimization: ‘Boosts’ or ‘flags’? British Journal of Criminology 43:196–212.

Turner, H.A., Finkelhor, D., and Ormrod, R. 2010. Poly-victimization in a national sample of children and youth. American Journal of Preventive Medicine 38(3): 323–330.

Acknowledgments

This bulletin was written by David Finkelhor, Ph.D., Director, Crimes against Children Research Center, University of New Hampshire; Heather Turner, Ph.D., Professor, Crimes against Children Research Center, University of New Hampshire; Sherry Hamby, Ph.D., Research Associate Professor, Department of Psychology, Sewanee: The University of the South; and Richard Ormrod, Ph.D., Research Professor, Crimes against Children Research Center, University of New Hampshire. OJJDP wishes to acknowledge the contributions to this bulletin of Melissa T. Merrick, Ph.D., Epidemiologist, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (CDC). OJJDP also wishes to acknowledge the support of CDC for the National Survey of Children’s Exposure to Violence and its partnership in the Safe Start initiative to create safe, stable, and nurturing environments for children and their families.

Share With Your Colleagues

Unless otherwise noted, OJJDP publications are not copyright protected. We encourage you to reproduce this document, share it with your colleagues, and reprint it in your newsletter or journal. However, if you reprint, please cite OJJDP and the authors of this Bulletin. We are also interested in your feedback, such as how you received a copy, how you intend to use the information, and how OJJDP materials meet your individual or agency needs.

Please direct your comments and questions to:

National Criminal Justice Reference Service

P.O. Box 6000

Rockville, MD 20849–6000

800–851–3420

301–519–5500 (fax)

Email: responsecenter@ncjrs.gov

www.ncjrs.gov

This bulletin was prepared under grant number 2005–JL–FX–0048 from the Office of Juvenile Justice and Delinquency Prevention (OJJDP), U.S. Department of Justice.

Points of view or opinions expressed in this document are those of the authors and do not necessarily represent the official position or policies of OJJDP or the U.S. Department of Justice.

The Office of Juvenile Justice and Delinquency Prevention is a component of the Office of Justice Programs, which also includes the Bureau of Justice Assistance; the Bureau of Justice Statistics; the National Institute of Justice; the Office for Victims of Crime; and the Office of Sex Offender Sentencing, Monitoring, Apprehending, Registering, and Tracking.

Access OJJDP publications online at ojjdp.gov/publications/index.html.

NCJ 235504

Questions and Answers About the National Survey of Children’s Exposure to Violence

David Finkelhor, Heather Turner, and Sherry Hamby

October 2011

In June 1999, the Office of Juvenile Justice and Delinquency Prevention (OJJDP) created the Safe Start Initiative to prevent and reduce the impact of children’s exposure to violence. As part of this initiative and with the support of the Centers for Disease Control and Prevention (CDC), OJJDP launched the National Survey of Children’s Exposure to Violence (NatSCEV) to document the full extent of children’s exposure to violence. The Crimes Against Children Research Center of the University of New Hampshire designed and conducted the survey between January and May 2008. NatSCEV is the first nationwide study to examine comprehensively the extent and nature of children’s exposure to violence across all ages and settings. The following questions and answers introduce the study and its findings. For a more detailed overview of NatSCEV, see the OJJDP bulletin, Children’s Exposure to Violence: A Comprehensive National Survey, available online at www.ncjrs.gov/pdffiles1/ojjdp/227744.pdf.

What is the objective of NatSCEV?

The survey provides comprehensive estimates of children’s exposure to a wide variety of violence, crime, and abuse, including child maltreatment, bullying, community violence, domestic violence, and sexual victimization.

What are the key features of NatSCEV?

NatSCEV bases its estimates on a large, nationally representative sample of more than 4,500 children ages 17 and younger, including interviews of caregivers of children ages 9 and younger and children age 10 and older about 45 different kinds of violence, abuse, and victimization in the past year and over the course of their lifetime.

What new information does NatSCEV provide about children’s exposure to violence?

For the first time, NatSCEV provides information on the overall scope of children’s exposure to violence nationwide, both past-year and lifetime, across all ages from birth through age 17. Aggregating all of the direct and indirect exposures to different types of violence assessed in the study, it found that more than three in five children (61 percent) had at least some exposure to violence, crime, or abuse, direct or witnessed, during the previous year. As discussed below, however, this number includes many forms of exposure to violence, including indirect exposure (e.g., seeing an assault in the home or a shooting in the neighborhood) and psychological or emotional violence (e.g., neglect or bullying), that are not counted in more traditional measures of violence.

In addition, NatSCEV provides estimates of various kinds of childhood exposure to violence that were not available before. Researchers learned that nearly 1 in 10 children witnessed an assault in their family over the course of a year and that 1 in 10 had a violence-related injury in the past year. In addition, 6 percent of children and youth were victimized sexually in the past year, and 10 percent were maltreated by a caregiver in the past year.

What does the survey say about changes in exposure to violence as children grow up?

NatSCEV provides estimates of exposure to violence across the whole span of childhood. As figure 1 shows, children are exposed to high levels of physical assault and, to a somewhat lesser extent, property victimization even before their teens. By contrast, sexual assault victimization is relatively less common for younger children and increases as they grow up. Witnessing and indirect exposure to violence also rise sharply as children grow older. Nearly one-half of youth ages 14–17 witnessed violence in the previous year, and one-quarter of those youth were indirect victims of violence in the previous year (Finkelhor, Turner, Ormrod, and Hamby, 2009).

What happens when children are exposed to more violence and more kinds of violence?

The study reveals how many children are exposed to multiple kinds of victimization even in a short timespan. Eleven percent of children had five or more different kinds of victimization exposure in a single year. These are the children (called “polyvictims”) whose victimization is most associated with other adversities and mental health problems. Another bulletin in the NatSCEV series that discusses multiple exposures to violence describes the plight of these children more extensively.

The survey findings make it clear that when children are exposed to one form of violence, they are at increased risk for other kinds of violent victimization. For example, a child who was physically assaulted in the past year would be five times as likely to also be sexually assaulted in the same year.

In addition, though all exposures increase the risk of problems, children who are exposed to multiple types of violence, crime, and abuse have been found to suffer from particularly elevated levels of anxiety and depression, and aggression and conduct problems. They are prone to dating violence, delinquency, further victimization, and involvement with the child welfare and juvenile justice systems. Moreover, being repeatedly exposed to violence may impair a child’s capacity for partnering and parenting later in life, continuing the cycle into the next generation (Finkelhor, Turner, Ormrod, Hamby, and Kracke, 2009).

Are all these exposures that NatSCEV measured really “violence”?

Most social scientists define violence as acts of physical aggression, like a punch or a sexual assault. Some child advocates and professionals who work with children think of violence as including nonphysical acts that have the potential to harm children, including psychological abuse and neglect. NatSCEV assesses exposure to a broad range of victimizations that concern child advocates, including bullying (both physical and emotional), neglect, property crime, and Internet victimization. For clarity, the researchers recommend referring to all of these together not just as “violence,” but rather “exposure to violence, crime, and abuse.” Thus, 61 percent of children in this sample were exposed to violence, crime, or abuse in the past year. Because this statistic includes such a variety of exposures of differing kinds and degrees, it is apt to be misunderstood. Therefore, the researchers recommend that citations from the study always mention not only the global 61 percent for all exposures, but also other statistics that reflect more familiar categories of violence, such as children who were physically assaulted or were physically abused by a caregiver.

What is “indirect” exposure and why was it counted?

Mental health and trauma experts agree that children experience harm when they witness violence against others close at hand and in their neighborhood (Suglia et al., 2010). The study counted how many children saw or heard intimate partner violence in their households in the past year (6 percent) or violence among peers and in the community (19 percent). It also counted children whose school had been threatened with a bomb or attack in the past year (5 percent) or children exposed to wars and civil disturbances (0.7 percent), which would include recent refugees from war-ravaged areas of the world. The study did not, however, examine or count exposure to media violence.

The study counts it as an assault when siblings and young children hit one another. Is this really assault?

Some people wonder whether children hitting other children should be considered exposure to violence and abuse, in part because it is so common. In many cases, hitting among young children and siblings evokes considerable pain, fear, and humiliation. In terms of harm to the victims, research suggests that peer assaults by 4-year-olds differ little from peer assaults by 16-year-olds or 33-year-olds (Finkelhor, Turner, and Ormrod, 2006). Experts agree that peer and sibling violence can cause serious developmental problems. However, police and other authorities do not generally consider it a criminal assault when siblings and young children hit one another because they appreciate that family or schools can deal better with young aggressors than the criminal justice system. Although these acts are not criminal assaults, they are important to inventory as part of an assessment of children’s exposure to violence and abuse.

Why would a parent tell the interviewers about child maltreatment?

First, the study promised respondents complete confidentiality. Second, many studies have shown that parents under conditions of confidentiality tell survey researchers about a great deal of their hitting, punching, and yelling at their children, in some cases because they do not see it as unusual or wrong (Grych, 1998; Kruttschnitt and Dornfeld, 1992). Third, the interviewees were often disclosing maltreatment that other parents or caregivers committed. Nonetheless, some maltreatment almost certainly was not reported because of embarrassment, fear of consequences, or lack of awareness on the part of the parent or caregiver. But a considerable amount was honestly disclosed.

Can NatSCEV estimates be compared to “official” estimates?

In general, NatSCEV estimates for crime victimization and abuse are tremendously higher than estimates from official sources such as police reports or child protection agencies. This is in part because most of the episodes that parents and children disclosed to NatSCEV are not reported to police or other authorities. For example, only 10 percent of physical assaults and 19 percent of sexual assaults disclosed in the survey were reported to police. It should also be noted that official agencies can use somewhat different criteria for classifying exposures. Therefore, many child protection agencies require evidence of harm before classifying something as abuse or maltreatment. It is inaccurate to describe all the unreported NatSCEV episodes as cases that official counts missed.

Are NatSCEV estimates available for individual states or localities?

The sample size used in NatSCEV is not large enough to afford reliable estimates for individual states or localities. States and localities, however, are free to use the NatSCEV questionnaire or portions of it to complete studies to estimate local rates. A toolkit for using the questionnaire and methodology are available at www.unh.edu/ccrc/jvq/index_new.html.

What plans are there to publish additional findings from NatSCEV? Are there plans for followup surveys to NatSCEV?

This fact sheet is part of a series that OJJDP and CDC are publishing jointly on the NatSCEV findings, including bulletins on children’s exposure to family and intimate partner violence, school victimization, and multiple exposures to violence (polyvictimization). In addition, the researchers have published articles on the NatSCEV study under the auspices of the Crimes Against Children Research Center. Plans are also underway for additional surveys to track longitudinal data as well as trends in children’s exposure to violence, crime, and abuse.

References

Finkelhor, D., Turner, H., and Ormrod, R. 2006. Kid’s stuff: The nature and impact of peer and sibling violence. Child Abuse and Neglect 30:1401–1421.

Finkelhor, D., Turner, H.A., Ormrod, R., and Hamby, S.L. 2009. Violence, abuse, and crime exposure in a national sample of children and youth. Pediatrics 124(5):1–13.

Finkelhor, D., Turner, H.A., Ormrod, R., Hamby, S.L., and Kracke, K. 2009. Children’s Exposure to Violence: A Comprehensive National Survey. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention.

Grych, J.H. 1998. Children’s appraisals of interparental conflict: Situational and contextual influences. Journal of Family Psychology 12(3):437–453.

Kruttschnitt, C., and Dornfeld, M. 1992. Will they tell?: Assessing preadolescents’ reports of family violence. Journal of Research in Crime and Delinquency 29(2):136–147.

Suglia, S.F., Staudenmayer, J., Cohen, S., and Wright, R.J. 2010. Posttraumatic stress symptoms related to community violence and children’s diurnal cortisol response in an urban community-dwelling sample. International Journal of Behavioral Medicine 17:43–50.

Acknowledgments

This fact sheet was written by David Finkelhor, Ph.D., Director, Crimes against Children Research Center, University of New Hampshire; Heather Turner, Ph.D., Professor, Crimes against Children Research Center, University of New Hampshire; and Sherry Hamby, Ph.D., Research Associate Professor, Department of Psychology, Sewanee: The University of the South, as part of the National Survey of Children’s Exposure to Violence project under OJJDP cooperative agreement number 2005–JL–FX–0048.

Share With Your Colleagues

Unless otherwise noted, OJJDP publications are not copyright protected. We encourage you to reproduce this document, share it with your colleagues, and reprint it in your newsletter or journal. However, if you reprint, please cite OJJDP and the authors of this Bulletin. We are also interested in your feedback, such as how you received a copy, how you intend to use the information, and how OJJDP materials meet your individual or agency needs.

Please direct your comments and questions to:

National Criminal Justice Reference Service

P.O. Box 6000

Rockville, MD 20849–6000

800–851–3420

301–519–5500 (fax)

Email: responsecenter@ncjrs.gov

www.ncjrs.gov

This fact sheet was prepared under grant number 2005–JL–FX–0048 from the Office of Juvenile Justice and Delinquency Prevention (OJJDP), U.S. Department of Justice.

Points of view or opinions expressed in this document are those of the authors and do not necessarily represent the official position or policies of OJJDP or the U.S. Department of Justice.

The Office of Juvenile Justice and Delinquency Prevention is a component of the Office of Justice Programs, which also includes the Bureau of Justice Assistance; the Bureau of Justice Statistics; the National Institute of Justice; the Office for Victims of Crime; and the Office of Sex Offender Sentencing, Monitoring, Apprehending, Registering, and Tracking.

Access OJJDP publications online at ojjdp.gov/publications/index.html.

NCJ 235163

Child and Youth Victimization Known to Police, School, and Medical Authorities

David Finkelhor, Richard Ormrod, Heather Turner, and Sherry Hamby

April 2012

Considerable efforts have been made during the last generation to encourage children and their families to report victimization to authorities. Nonetheless, concern persists that most childhood victimization remains hidden. The 2008 inventory of childhood victimization—the National Study of Children’s Exposure to Violence (NatSCEV) (see “History of the National Survey of Children’s Exposure to Violence.”)—allowed an assessment of whether authorities, including police, school, and medical authorities, are identifying victimizations. The victim, the victim’s family, or a bystander may have disclosed the victimization to those authorities, or the authorities may have directly observed the victimization or evidence of that victimization. Among the survey findings:

• Thirteen percent of children victimized in the previous year had at least one of their victimizations known to police, and 46 percent had one known to school, police, or medical authorities.

• Authorities knew about a majority of serious victimizations, including incidents of sexual abuse by an adult, gang assaults, and kidnappings, but they were mostly unaware of other kinds of serious victimizations, such as dating violence and completed and attempted rape.

• In general, school officials knew about victimization episodes considerably more often (42 percent) than police (13 percent) or medical personnel (2 percent). However, police were the most likely to know about kidnapping, neglect, and sexual abuse by an adult.

• More victimization and abuse appears to be known to authorities currently than was the case in a comparable 1992 survey.

Efforts To Increase Reporting of Child Abuse and Victimization

The National Crime Victimization Survey (NCVS) finds that violent crimes against juveniles are less likely to be known to authorities than are crimes against adults, and they are particularly unlikely to be known to the police (Finkelhor and Ormrod, 1999). Authorities are less likely to know about childhood victimizations for a number of reasons (Finkelhor and Wolak, 2003; Finkelhor, Wolak, and Berliner, 2001). Clearly children, both victims and bystanders, are easily intimidated by offenders and fear retaliation. In addition, children and their families often wish to deal with crime and victimization informally. They sometimes fear the consequences of disclosure to authorities, including interviews with child protection authorities and involvement with the police, courts, and child welfare agencies. In other cases, victims, families, and bystanders do not perceive the victimizations as something that would interest authorities.

One of the major public policy efforts of the past generation has been to increase the proportion of abuse and victimization cases known to authorities. The mandatory reporting statutes enacted in the wake of the Child Abuse Prevention and Treatment Act (CAPTA) of 1974^1 had this as a goal (O’Neill Murray and Gesiriech, 2010; Stoltsfus, 2009). The message of virtually all education programs dealing with child maltreatment, bullying, dating violence, and a host of other problems has been to “tell someone and get help” (Finkelhor, 2009). In addition, criminal justice and child protection agencies have instituted various reforms to try to increase victim and family confidence in those agencies as a way to promote disclosure (Cheung, 2008; Jones et al., 2005).

Despite these policy initiatives, limited research on authorities’ knowledge of child victimization has hampered efforts to promote disclosure and track its patterns. Cited research frequently refers to studies completed decades ago or is based on adult retrospective recollection (London et al., 2005).2 It is not at all clear that such data reflect current experience after a generation of mobilization and increased awareness about child victimization in its many forms.

NatSCEV is the first comprehensive national survey to report on children’s exposure to violence and its effects for both past-year and lifetime victimizations from age 1 month to age 17. As part of the study, the researchers examined past-year victimizations that were known to authorities. This bulletin looks first at what and how much authorities know about child victimization; and then, at what the implications of the study findings are for increasing disclosure of child victimizations and for effective prevention and treatment.

Methodology

The National Survey of Children’s Exposure to Violence (NatSCEV) was designed to obtain past-year and lifetime prevalence estimates of a wide range of childhood victimizations and was conducted between January and May 2008. The survey recorded the experiences of a nationally representative sample of 4,549 children from ages 1 month to 17 years living in the contiguous United States.

Sampling Techniques

The interviews with parents and youth were conducted over the phone. Sample households were drawn from a nationwide sampling frame of residential telephone numbers through random digit dialing. To ensure that the study included an adequate number of minority and low-income respondents for more accurate subgroup analyses, the researchers oversampled telephone exchanges that had high concentrations of African American, Hispanic, or low-income households. Sampling methods and procedures have been described in greater detail elsewhere (Finkelhor, Turner, Ormrod, and Hamby, 2009; Finkelhor, Turner, Ormrod, Hamby, and Kracke, 2009).

Interviewers first spoke with an adult caregiver in each household to obtain family demographic information. They then randomly selected the child with the most recent birthday to be interviewed. Interviewers spoke directly with children ages 10 to 17. For children younger than 10, they interviewed the caregiver who “is most familiar with the child’s daily routine and experiences.”

Questions Regarding Authorities’ Knowledge of Victimization

This survey used an enhanced version of the Juvenile Victimization Questionnaire (JVQ), an inventory of childhood victimization (Finkelhor, Hamby, Ormrod, and Turner, 2005; Finkelhor, Ormrod, Turner, and Hamby, 2005a; Hamby et al., 2004). The JVQ obtains reports on 48 forms of youth victimization covering 5 general areas of interest: conventional crime, maltreatment, victimization by peers and siblings, sexual victimization, and witnessing and exposure to violence (Finkelhor, Ormrod, Turner, and Hamby, 2005b).

Followup questions for each victimization item gathered additional information about each event, including whether, to the respondent’s knowledge, school officials or police knew about the event. Authorities could learn about a victimization event from reports by the victim, the family, or another participant or bystander or by witnessing the incident or seeing evidence of the incident.

Victimizations Analyzed for Authorities’ Knowledge of Events

The analysis for this bulletin examined past-year victimizations. The researchers aggregated two categories of victimizations known to authorities: physical assaults and sexual victimizations. Physical assaults included assault with a weapon, assault without a weapon, attempted assault, threatened assault, kidnapping, bias-motivated attack, physical abuse, gang/group assault, peer/sibling assault, nonsexual genital assault, and dating violence. Sexual victimizations included sexual assault by a known adult, sexual assault by a nonspecified adult, sexual assault by a peer, completed or attempted rape, sexual exposure/flashing, and sexual harassment.

Authorities’ Knowledge of Child Victimization

According to the NatSCEV survey, 46 percent of the victimized youth had at least one victimization in the past year that was known to school, police, or medical authorities. Being known to an authority could mean that victims, family members, or other bystanders disclosed the victimization or an authority like a teacher or police officer directly observed it. The study looked at authorities’ knowledge of victimization from three perspectives:

• Which types of victimizations were authorities most likely to know about?

• Which authorities were more likely to know of various types of child victimizations?

• What factors were associated with authorities’ knowledge of child victimizations?

Types of Victimizations Known to Authorities

Direct victimization. The degree to which authorities knew about victimizations varied according to victimization type (table 1). Typically, authorities were most likely to know about more serious victimizations like sexual assault by a known (69 percent) or nonspecific adult (76 percent), kidnapping (74 percent), and gang or group assault (70 percent). Authorities also often knew about types of nonphysical victimization that are likely to occur in school, such as relational aggression (52 percent) and property theft (47 percent), or that leave signs that a teacher in the classroom or a doctor in the course of a medical examination might see, such as neglect (48 percent). Authorities were least likely to know about victimizations that peers were most likely to commit, including peer and sibling assault (17 percent), dating violence (15 percent), being flashed (17 percent), and completed and attempted rape (14 percent).

Indirect victimization. Authorities’ knowledge of indirect victimization also varied considerably. Obviously, murders that children were exposed to and other very public offenses, such as threats or vandalism against schools, were widely known. Also, authorities knew about approximately one-half (49 percent) of the episodes of children witnessing domestic violence.

Knowledge of Victimization by Police, School, and Medical Authorities

School authorities were the officials most likely to know about past-year victimization events (42 percent of victims had a victimization known to school authorities). Police knew about 13 percent of children who had been victimized in the past year. Medical authorities were the least likely to know about victimizations (2 percent of victims reported that medical authorities knew of past-year victimizations).

Although police were generally less likely to know about victimization events than school authorities, they were more likely to know about incidents of several types, including kidnapping (71 percent police versus 46 percent school), neglect (37 percent police versus 29 percent school), sexual abuse by a known (65 percent police versus 30 percent school) or nonspecific adult (76 percent police versus 29 percent school), and witnessing of domestic violence (42 percent police versus 23 percent school).

Although few episodes were known to medical authorities, the most common were sexual abuse by a known (7 percent) or nonspecific adult (19 percent), gang assault (9 percent), physical abuse by a caretaker (10 percent), and assault with a weapon (8 percent).

The finding that schools are more likely to find out about child victimization than other authorities is consistent with several earlier studies (Finkelhor and Dziuba-Leatherman, 1994; Sedlak and Broadhurst, 1996). This is understandable, given how much time children spend in school and interact with school professionals.

Factors Associated With Authorities’ Knowledge of Victimization

The researchers used multivariable analyses to identify the characteristics of child victims and victimization episodes that made it more likely for authorities to know of those incidents.

Police. Police were more likely to know about physical assaults (see “Methodology” for specific types of victimization that were defined as physical assaults) that had the following characteristics compared to those without those characteristics: ones that occurred outside the home or school, involved a serious injury or nonfamily or adult perpetrator, had a bias motivation, or made the child very scared. They were also more likely to know about crimes against victims who were female, of lower socioeconomic status (SES), or living in a rural area. Police were more likely to know of sexual victimizations (see “Methodology” for a list of sexual victimizations) when an adult committed the offense; when the child was afraid; or when the victim was black, mixed race, or other race (including Asian American, American Indian, and Pacific Islander).

School officials. School officials were more likely to know about physical assaults that had the following characteristics compared to those without those characteristics: ones that occurred in school, involved a serious injury or a nonfamily or an adult perpetrator, had a bias motivation, or made the victim afraid or feel bad. They were more likely to know about attempts and threats than actual assaults. School authorities were also more likely to know about physical assaults on girls, children younger than 13, children who were victims of other assaults in the past year, and lower SES youth. They were less likely to know about physical assaults on Hispanic victims.

School officials were more likely to know of sexual victimizations that occurred in school, were committed by an unidentified perpetrator, occurred to a child victim between 2 and 9 years old, or occurred to a child who lived with a stepparent or an unmarried partner of a parent.

Disclosure of Child Victimization to Authorities

Looking at the NatSCEV data from the perspective of disclosure of child victimization, some patterns emerge:

• The proportion of child victimizations that are disclosed to authorities appears to be increasing as compared with two decades ago.

• Victims of multiple victimizations may be more likely to come to authorities’ notice.

• Authorities were less likely to learn of victimization episodes that involved certain groups of victims (boys, Hispanic youth, and higher SES youth) or peer or family perpetrators.

Increases in Victimizations Known to Authorities During the Past Two Decades

Comparing the NatSCEV study findings with another national survey of victimization completed in 1992 (Finkelhor and Dziuba-Leatherman, 1994) suggests that victimizations known to authorities have increased over time. In the 1992 telephone survey of youth ages 10 to 16 only 25 percent of all victimizations of 10- to 16-year-olds were known to police or school authorities (versus 51 percent in the NatSCEV study for that age group), only 29 percent of kidnappings (versus 73 percent in the NatSCEV study), and only 6 percent of incidents of sexual assault or sexual abuse (versus 11 percent in the NatSCEV study). These changes may reflect efforts by authorities and advocates to promote disclosure. Because early disclosure is believed to facilitate prevention, increased disclosure rates are consistent with the findings that childhood victimization rates have fallen considerably since the early 1990s (Finkelhor, 2008; Finkelhor, Turner, Ormrod, and Hamby, 2010).

Knowledge of Multiple Child Victimizations

According to the youth and caregivers interviewed in the NatSCEV study, a considerable proportion of child victims are known to authorities. However, the figure given earlier—that school officials, police, or medical authorities knew about 46 percent of children who were victimized in the previous year—overstates the level of knowledge somewhat in that some of these victims had multiple victimizations, not all of which were disclosed. Moreover, the variable used in this study, “known to authorities,” does not necessarily mean that the victim disclosed the victimization. A bystander may have reported it, or an authority, such as a teacher, may have witnessed it. Nonetheless, properly trained officials who know about at least one victimization have the opportunity to identify a child and ask about other victimizations. Moreover, the finding that school officials were more likely to know about victims of more than one episode of physical abuse within the past year indicates that youth with multiple victimizations were some of those most likely to be known to authorities in general.

Factors That Impede Disclosure of Child Victimization

Victim characteristics. Authorities are less likely to know about victimizations of boys, probably reflecting male social norms, sometimes referred to as “the boy code,” of self-sufficiency that stigmatizes help seeking, norms that some educational programs are now trying to counteract (Pollack and Pipher, 1999). They are also less likely to know about Hispanic victims, perhaps reflecting specific Hispanic cultural concerns as well as issues about citizenship status and legitimacy. Authorities are less likely to know about higher SES victims, perhaps reflecting suspicion among these families about the negative impact on their children, combined with having the resources and status to deflect authorities’ involvement. Efforts to emphasize the helpful rather than stigmatizing features of professional intervention might be useful to counteract some of the concerns in these groups.

Perpetrator characteristics. In general, the study shows that authorities are less likely to know about victimizations involving peer and family perpetrators than those involving adult and nonfamily perpetrators. As noted earlier, authorities were least likely to know about peer or sibling assault, dating assault, and attempted or completed rape, all of which peers are more likely to commit. In particular, authorities are far more likely to know about sexual offenses that adults commit than those that youth commit. This may be because adult sexual offenses are seen as more criminal, whereas peer allegiances may inhibit reporting of sexual crimes by younger perpetrators.

Implications for Authorities and Practitioners

The findings suggest both progress and challenges in the effort to identify abused and victimized children. The higher rates of victimizations known to authorities found in the NatSCEV study may mean that past efforts to promote disclosure have been working and need to be sustained. But the study also shows that a considerable portion of childhood exposure to victimization is still unknown to authorities. It suggests that more outreach is needed to boys, Hispanic youth, and higher SES groups in particular. It also suggests that disclosure promotion needs to be directed toward episodes that involve family members and peer perpetrators. Educators have long recognized the need to promote disclosures about such family and peer episodes. An important task for authorities is to persuade children and families that they have resources available to help in these situations and that they can protect victims against retaliation.

A benefit of increased disclosure of victimization to authorities is greater access to effective prevention and treatment. More interventions that are truly helpful in preventing future victimizations and treating the negative effects of victimization on development are being developed, tested, and deemed effective. These include conflict resolution programs (Grossman et al., 1997), parenting education (Chaffin et al., 2004), and cognitive-behavioral treatments for victimization trauma (Cohen, Mannarino, and Deblinger, 2006; Kolko and Swenson, 2002; Stein et al., 2003). Therefore, in addition to more education and awareness to encourage disclosure, communities need also to ensure that they have professionals trained in such evidence-based programs to work with children and families once victimization is disclosed. Not all communities have such resources, and when they do not, it may undermine the value of gaining disclosures and reports. To improve access to services, more collaboration is needed among agencies that work with children. In particular, because so many victimizations come to the attention of school authorities, it is crucial that schools be connected to multidisciplinary resources, including mental health, social service, medical, and law enforcement resources (Asnes and Leventhal, 2011).

Endnotes

1. Public Law 93–247, 88 Stat. 5, as amended (codified at 42 U.S.C. 5101–5119c). For information about the Act, see U.S. Department of Health and Human Services (2004). For an overview of federal and state child welfare programs under the Act, see Stoltsfus (2009).

2. For an overview of research on childhood exposure to violence and its aftermath, see Kracke and Hahn (2008).

References

Asnes, A.G., and Leventhal, J.M. 2011. Editorial: Connecting the dots in childhood and adolescent trauma. Archives of Pediatrics and Adolescent Medicine 165(1):87–88.

Chaffin, M., Silovsky, J.F., Funderburk, B., Valle, L.A., Brestan, E.V., Balachova, T., Jackson, S., Lensgraf, J., and Bonner, B.L. 2004. Parent-child interaction therapy with physically abusive parents: Efficacy for reducing future abuse reports. Journal of Consulting and Clinical Psychology 72(3):500–510.

Cheung, M. 2008. Promoting effective interviewing of sexually abused children: A pilot study. Research on Social Work Practice 18(2):137–143.

Cohen, J.A., Mannarino, A.P., and Deblinger, E. 2006. Treating Trauma and Traumatic Grief in Children and Adolescents. New York, NY: Guilford Press.

Finkelhor, D. 2008. Childhood Victimization: Violence, Crime, and Abuse in the Lives of Young People. New York, NY: Oxford University Press.

Finkelhor, D. 2009. The prevention of childhood sexual abuse. The Future of Children 19(2):169–194.

Finkelhor, D., and Dziuba-Leatherman, J. 1994. Children as victims of violence: A national survey. Pediatrics 94(4):413–420.

Finkelhor, D., Hamby, S.L., Ormrod, R.K., and Turner, H.A. 2005. The JVQ: Reliability, validity, and national norms. Child Abuse and Neglect 29(4):383–412.

Finkelhor, D., and Ormrod, R.K. 1999. Reporting Crimes Against Juveniles. Juvenile Justice Bulletin. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention. NCJ 178887.

Finkelhor, D., Ormrod, R.K., Turner, H.A., and Hamby, S.L. 2005a. Measuring poly-victimization using the JVQ. Child Abuse and Neglect 29(11):1297–1312.

Finkelhor, D., Ormrod, R.K., Turner, H.A., and Hamby, S.L. 2005b. The victimization of children and youth: A comprehensive, national survey. Child Maltreatment 10(1):5–25.

Finkelhor, D., Ormrod, R., Turner, H., and Hamby, S. 2011. School, police, and medical authority involvement with children who have experienced victimization. Archives of Pediatrics and Adolescent Medicine 165(1):9–15.

Finkelhor, D., Turner, H.A., Ormrod, R., and Hamby, S.L. 2009. Violence, abuse, and crime exposure in a national sample of children and youth. Pediatrics 124(5):1–13.

Finkelhor, D., Turner, H., Ormrod, R., Hamby, S., and Kracke, K. 2009. Children’s Exposure to Violence: A Comprehensive National Survey. Juvenile Justice Bulletin. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention. NCJ 227744.

Finkelhor, D., Turner, H.A., Ormrod, R., and Hamby, S.L. 2010. Trends in childhood violence and abuse exposure: Evidence from two national surveys. Archives of Pediatrics and Adolescent Medicine 164(3):238–242.

Finkelhor, D., and Wolak, J. 2003. Reporting assaults against juveniles to the police: Barriers and catalysts. Journal of Interpersonal Violence 18(2):103–128.

Finkelhor, D., Wolak, J., and Berliner, L. 2001. Police reporting and professional help for child victims: A review. Child Maltreatment 6(1):17–30.

Grossman, D.C., Neckerman, H.J., Koepsell, T.D., Liu, P.Y., Asher, K.N., and Beland, K. 1997. Effectiveness of a violence prevention curriculum among children in elementary school: A randomized controlled trial. Journal of the American Medical Association 277:1605–1611.

Hamby, S.L., Finkelhor, D., Ormrod, R.K., and Turner, H.A. 2004. The Juvenile Victimization Questionnaire (JVQ): Administration and Scoring Manual. Durham, NH: Crimes against Children Research Center.

Jones, L.M., Cross, T.P., Walsh, W., and Simone, M. 2005. Criminal investigations of child abuse: The research behind “best practices.” Trauma, Violence, and Abuse 6(3):254–268.

Kolko, D.J., and Swenson, C.C. 2002. Assessing and Treating Physically Abused Children and Their Families: A Cognitive Behavioral Approach. Thousand Oaks, CA: Sage Publications.

Kracke, K., and Hahn, H. 2008. The nature and extent of childhood exposure to violence: What we know, why we don’t know more, and why it matters. Journal of Emotional Abuse 8(1/2):29–49.

London, K., Bruck, M., Ceci, S.J., and Shuman, D.W. 2005. Disclosure of child sexual abuse: What does the research tell us about the ways that children tell? Psychology, Public Policy, and Law 11(1):194–226.

O’Neill Murray, K., and Gesiriech, S. 2010. A brief legislative history of the child welfare system. Available online at http://pewfostercare.org/research/docs/Legislative.pdf.

Pollack, W., and Pipher, M. 1999. Real Boys: Rescuing Our Sons From the Myths of Boyhood. Markham, Ontario, Canada: Fitzhenry and Whitside Ltd.

Sedlak, A.J., and Broadhurst, D.D. 1996. Third National Incidence Study of Child Abuse and Neglect. Washington, DC: U.S. Department of Health and Human Services.

Stein, B.D., Jaycox, L.H., Kataoka, S., Wong, M., Tu, W., Elliott, M.N., and Fink, A. 2003. A mental health intervention for school children exposed to violence: A randomized controlled trial. Journal of the American Medical Association 290(5):603–611.

Stoltsfus, E. 2009. The Child Abuse Prevention and Treatment Act (CAPTA): Background, Programs, and Funding. Washington, DC: Congressional Research Service.

U.S. Department of Health and Human Services. 2004. The Child Abuse Prevention and Treatment Act, Including Adoption Opportunities & the Abandoned Infants Assistance Act, as Amended by the Keeping Children and Families Safe Act of 2003. Washington, DC: U.S. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children’s Bureau, Office of Child Abuse and Neglect.

Acknowledgments

This bulletin was written by David Finkelhor, Ph.D., Director, Crimes against Children Research Center, University of New Hampshire; Richard Ormrod, Ph.D., Research Professor, Crimes against Children Research Center, University of New Hampshire; Heather Turner, Ph.D., Professor, Crimes against Children Research Center, University of New Hampshire; and Sherry Hamby, Ph.D., Research Associate Professor, Department of Psychology, Sewanee, University of the South. OJJDP wishes to acknowledge the contributions to this bulletin of Melissa T. Merrick, Ph.D., Epidemiologist, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (CDC). OJJDP also wishes to acknowledge the support of CDC for the National Survey of Children’s Exposure to Violence and its partnership in the Safe Start initiative to create safe, stable, and nurturing environments for children and their families.

Share With Your Colleagues

Unless otherwise noted, OJJDP publications are not copyright protected. We encourage you to reproduce this document, share it with your colleagues, and reprint it in your newsletter or journal. However, if you reprint, please cite OJJDP and the authors of this Bulletin. We are also interested in your feedback, such as how you received a copy, how you intend to use the information, and how OJJDP materials meet your individual or agency needs.

Please direct your comments and questions to:

National Criminal Justice Reference Service

P.O. Box 6000

Rockville, MD 20849–6000

800–851–3420

301–519–5500 (fax)

Email: responsecenter@ncjrs.gov

www.ncjrs.gov

This bulletin was prepared under grant number 2005–JL–FX–0048 from the Office of Juvenile Justice and Delinquency Prevention (OJJDP), U.S. Department of Justice.

Points of view or opinions expressed in this document are those of the authors and do not necessarily represent the official position or policies of OJJDP or the U.S. Department of Justice.

The Office of Juvenile Justice and Delinquency Prevention is a component of the Office of Justice Programs, which also includes the Bureau of Justice Assistance; the Bureau of Justice Statistics; the National Institute of Justice; the Office for Victims of Crime; and the Office of Sex Offender Sentencing, Monitoring, Apprehending, Registering, and Tracking.

Access OJJDP publications online at ojjdp.gov/publications/index.html.

NCJ 235394

Children’s Exposure to Violence and the Intersection Between Delinquency and Victimization

Carlos A. Cuevas, David Finkelhor, Anne Shattuck, Heather Turner, and Sherry Hamby

October 2013

The association between delinquency and victimization is a common focus in juvenile justice research. Some observers have found that victimization and delinquency largely overlap, with most victims engaging in delinquency and most delinquents being victimized at some point in their lives (Lauritsen, Laub, and Sampson, 1992; Lauritsen, Sampson, and Laub, 1991; Singer, 1986). The literature in the bullying and peer victimization field paints a different picture. It points to three distinct groups of children: in addition to the children who are both victims and offenders (often referred to as bully-victims or, as in this bulletin, delinquent-victims), a second group are primarily victims and a third group are primarily offenders (Dodge et al., 1990; Olweus, 1978, 2000). One may explain the contrast in this way: many studies have relied simply on measures of association between delinquency and victimization (e.g., correlation or regression analyses) (see, e.g., Chang, Chen, and Brownson, 2003; Jensen and Brownfield, 1986; Sullivan, Farrell, and Kliewer, 2006). When researchers look beyond the association between delinquency and victimization (even when that association is strong), they are likely to find groups of children who are primarily victims or primarily offenders. Research has not fully explored how large these groups are and how their characteristics and experiences differ.

Defining Delinquents, Victims, and Delinquent-Victims in the NatSCEV Study Group

The National Survey of Children’s Exposure to Violence (NatSCEV) is a national study that is both large and comprehensive in its assessment of victimization and delinquency (see “History of the National Survey of Children’s Exposure to Violence”). Thus, it provides a look at how victimization and delinquency converge or diverge among youth of different ages.

Using the interview data from NatSCEV (see “Methodology”) (Finkelhor, Turner, Ormrod, and Hamby, 2009), the research team categorized adolescents ages 10 to 17 into one of four groups: those youth who were primarily delinquents and not victims (primarily delinquents), those who were primarily victims and not delinquents (primarily victims), those who were both delinquents and victims (delinquent-victims), and those who were neither victims nor delinquents. The criteria for defining these groups are based on work done in an earlier study (Cuevas et al., 2007) and take into account that many children have minor victimizations and that they engage in different kinds of delinquency, including violent delinquency, property delinquency, and forms of mild delinquency, such as skipping school or getting drunk.

In the interest of clarity, the researchers defined the subgroups in terms of key characteristics that the literature on victimization and delinquency suggests (Dodge et al., 1990; Jennings, Piquero, and Reingle, 2012; Malinosky-Rummell and Hansen, 1993; McGrath, Nilsen, and Kerley, 2011; Olweus, 1978, 2000; Windle and Mason, 2004). Table 1 illustrates the typology groups and defining criteria.

Definition of Victimized Versus Nonvictimized Youth

From previous analyses (Finkelhor, Hamby et al., 2005; Finkelhor, Ormrod et al., 2005a; Hamby et al., 2004), the researchers determined that one of the best measures of victimization intensity is the number of types of victimization per respondent based on the screening categories that the Juvenile Victimization Questionnaire (JVQ) uses (see “Methodology”). Although simply adding up the number of different types of victimization (including parental abuse, sex offenses, property offenses, and peer victimizations) does not take into account repeated victimizations of the same type, analyses have suggested that factoring in repeated victimizations and other measures of victimization severity does not produce substantively different results in identifying highly victimized youth (Finkelhor, Hamby et al., 2005; Finkelhor, Ormrod, and Turner, 2007).

For the purposes of this study, the researchers defined victimized youth as those who suffered three or more victimizations in the past year. They chose this number because the mean number of types of victimization in the past year per respondent in the NatSCEV study was 2.68 and because the JVQ and NatSCEV include many common kinds of victimizations, such as being hit by a sibling or having property stolen. Consequently, the researchers categorized non-/low-victimized youth as those who suffered two victimizations or fewer in the past year.

Definition of Delinquent Versus Nondelinquent Youth

Based on the literature on delinquency (e.g., Snyder and Sickmund, 2006; Windle and Mason, 2004), the researchers considered it important to distinguish among types of delinquent behavior. The researchers clearly delineated the study’s delinquency measures into the following types: those that involved violent behavior (assaults and carrying weapons), those that involved property delinquency (breaking something, stealing from a store), those that involved drug and alcohol use (drinking, smoking marijuana), and those that involved minor delinquency (truancy, cheating on tests). Violent behavior and property delinquency are categorized as separate types, and for the most part delinquency involving substance use or minor forms of rule violating is categorized as mild delinquency (see table 1).

As with victimized youth, some categories of delinquent youth are defined as those who committed more delinquent acts than the past-year mean (i.e., two or more types of delinquent acts within the past year). Given the inclusion of relatively minor and perhaps normative delinquent acts in the Frequency of Delinquency Behavior (Loeber and Dishion, 1983) (see “Methodology”), the researchers decided that defining those who committed fewer than the mean number of delinquent acts in the past year as nondelinquent would adequately identify youth with no or only minor delinquency.

Categories of Delinquent-Victims

The researchers first defined three groups of youth who fell into the delinquent-victim overlap category (see table 1). They defined “Violent Delinquent-Victims,” consistent with descriptions from other studies of victimization and delinquency (Haynie et al., 2001; Olweus, 1978, 2000; Schwartz, Proctor, and Chien, 2001), as youth who in the past year engaged in violent, interpersonal acts or carried weapons and who experienced three or more violent victimizations in the past year. As suggested in the trauma response literature (Briere et al., 1997; Finkelhor, 1990; Kilpatrick et al., 2003; Wilsnack et al., 2004; Windle and Mason, 2004), the research team termed the second defined group as “Delinquent Sex/Maltreatment Victims,” who had experienced sexual victimization or a form of child maltreatment and had engaged in two or more delinquent acts in the past year. They defined the third group, “Property Delinquent-Victims,” as delinquent and highly victimized youth whose delinquencies were related solely to property crime and who had three or more victimizations of any type in the past year.

Categories of Primarily Delinquent Youth

In contrast to these three groups of delinquent-victims, the study also categorized some youth as primarily delinquent. These were youth who had rates of victimization below the mean of three in the past year, but who had engaged in violent (youth categorized as “Assaulters”) or property delinquency (youth categorized as “Property Delinquents”), which were the most serious and least frequent delinquencies (see table 1).

Categories of Youth Who Are Primarily Victims

The researchers defined two groups who were primarily victims but not delinquents. These were the “Mild Delinquency Victims,” who had greater than mean levels of victimization (three or more victimizations within the past year) but no property or violent delinquency, and “Nondelinquent Sex/Maltreatment Victims,” who had experienced a sexual victimization or a form of child maltreatment but had committed fewer than two delinquent acts in the past year (see table 1). This last group was distinguished as a separate category because the victimization literature suggests special seriousness for youth who experience even one incident of sexual victimization or child maltreatment, which are also acts that lead to the involvement of child protective services or police referrals (Briere et al., 1997; Egeland et al., 2002; Finkelhor, 1990; Kilpatrick et al., 2003; Wilsnack et al., 2004; Windle and Mason, 2004; Wood et al., 2002).

The grouping criteria illustrate, to some degree, the intricacy of establishing these categories given the complexity of victimization and delinquent behavior. As such, the categorizing approach examines both the number of types of behavior (above or below the mean for victimization and delinquency) and the type of delinquency or victimization (e.g., violent, property, sexual, or maltreatment). As a result, some youth may fit into more than one of the established categories. To keep the groups mutually exclusive, the researchers established a hierarchy for categorizing individuals who fell into more than one typology group (e.g., a youth who committed a violent act or carried a weapon within the previous year and had been sexually victimized in addition to under- going three or more violent victimizations, and who therefore would fall into both the violent delinquent-victim and delinquent sex/maltreatment victim typology groups). The hierarchy is as follows, from the most severe to the least severe combination of delinquency and victimization: violent delinquent-victims, delinquent sex/maltreatment victims, assaulters, nondelinquent sex/maltreatment victims, property delinquent-victims, property delinquents, mild delinquency victims, and mild delinquency non-/low-victimized youth (note that assaulters and nondelinquent sex/maltreatment victims, although they are categorized as primarily delinquent and primarily victims, respectively, are regarded as higher in the hierarchy than property delinquent-victims). This ordering was presented in the original typology using the Developmental Victimization Survey (DVS) data (Cuevas et al., 2007), which established this order according to which group of individuals was most similar based on their demographic characteristics. For consistency, the ordering remained the same for the purposes of this analysis based on the NatSCEV data.

Findings by Gender and Typology Group for Delinquents, Victims, and Delinquent-Victims

Victimization and Delinquency Patterns Among Boys

Among boys overall, the primarily delinquent group comprised 20.8 percent of the total sample (see “Methodology” for sample size). Boys who were primarily victims with little or no delinquency comprised 17.9 percent of the total sample, and the group who were both victimized and delinquent comprised 18.1 percent (figure 1). Substantial percentages of all three groups were evident throughout the developmental course for boys ages 10 to 17 (figure 2). However, the proportion of boys in the primarily victim group differed between ages 12 and 13 (declining from 27.8 percent to 15.5 percent). At ages 13 and 14, the proportion of boys in the delinquent-victim group increased from 14.7 percent to 28.2 percent and was elevated through age 17.

The boys in the delinquent-victim group had considerably more victimization than the boys who were primarily victims, disclosing 6.3 and 4.5 different kinds of victimization in the past year, respectively (table 2). This delinquent-victim group had a greater percentage of victims than the primarily victim group in every category of victimization except for bullying victimization. These boys had particularly greater percentages of sexual victimization (which includes sexual harassment) (40 percent for delinquent-victim boys versus 13 percent for primarily victim boys), witnessing family violence (26 percent for delinquent-victim boys versus 12 percent for primarily victim boys), and Internet victimization (14 percent for delinquent-victim boys versus 1 percent for primarily victim boys). The primarily victim group of boys had a greater percentage of victims than the delinquent-victim group in only one victimization category—bullying victimization (58 percent versus 40 percent).

The boys in the delinquent-victim group were also more delinquent than the primarily delinquent group (3.9 and 2.7 delinquent activities in the past year, respectively) (see table 2), which may be in part a function of the definitional criteria that set a higher threshold of delinquent activities for delinquent-victim boys than for primarily delinquent boys. The elevation of their drugs/minor delinquency score was particularly large (1.4 for delinquent-victims versus 0.8 for the primarily delinquent group).

Victimization and Delinquency Patterns Among Girls

Girls had different patterns in both typology groups and age of changes in victimization and delinquency. Except for the group of girls who were neither victims nor delinquents (52.5 percent), the largest group of girls was the primarily victim group (21.2 percent). The primarily delinquent group (13 percent) and delinquent-victim group (13.3 percent) were smaller than the comparable groups among boys, reflecting that girls tend to engage in less delinquency than boys. A rise in both delinquency and victimization for girls appeared particularly notable between ages 11 and 12 (figure 3); as girls got older, the victimization component remained stable and then rose, while the delinquency component rose and then fell.

The patterns of victimization and delinquency for girls are generally similar to those for boys in terms of both the number and types of victimizations and delinquent acts. The delinquent-victim girls were more victimized than the primarily victim girls, disclosing 6.4 and 4.2 different victimizations in the past year, respectively (table 2). (This is not a function of the definitional criteria that set a higher threshold of victimizations for delinquent-victim girls than for primarily victim girls.) The delinquent-victim girls had greater percentages of victimization in every category of victimization except bullying victimization. Their victimization rates were particularly higher for sexual victimization, for which the rate among delinquent-victim girls (58 percent) was more than twice that among the primarily victim girls (27 percent); and Internet victimization, for which the rate among delinquent-victim girls was more than four times higher than among the primarily victim girls (33 percent versus 7 percent) and much higher than the equivalent rate among delinquent-victim boys (14 percent).

Delinquent-victim girls were also more delinquent than the primarily delinquent girls (3.3 and 2.0 delinquent activities in the past year, respectively). As with the boys, their drugs/minor delinquency scores were particularly elevated (1.7 for delinquent-victim girls versus 0.6 for primarily delinquent girls).

Findings Regarding Other Dimensions of Adversity

As table 2 shows, the groups differ on some additional dimensions as well. Among both boys and girls, delinquent-victims tended to experience more life adversities and mental health symptoms than other groups. They also received less social support. Delinquent-victimgirls experienced higher rates of inconsistent/harsh parenting. There were few significant differences among the primarily delinquent, primarily victim, and delinquent-victim groups on features such as socioeconomic status, ethnicity, family structure, disability status, school performance, or physical features.

Methodology

The National Survey of Children’s Exposure to Violence (NatSCEV) was designed to obtain past-year and lifetime prevalence estimates of a wide range of childhood victimizations and was conducted between January and May 2008. NatSCEV documented the experiences of a nationally representative sample of 4,549 children ages 1 month to 17 years living in the contiguous United States. This study focuses on the 2,090 children (1,039 male and 1,051 female) who were 10 to 17 years old at the time of the survey. These children were surveyed on both their victimization experiences and their participation in 15 different kinds of delinquent behavior.

Sampling Techniques

The interviews with parents and youth were conducted over the phone. Sample households were drawn from a nationwide sampling frame of residential telephone numbers through random-digit dialing. To ensure that the study included an adequate number of minority and low-income respondents for more accurate subgroup analyses, the researchers oversampled telephone exchanges that had high concentrations of African American, Hispanic, or low-income households. Sample weights were applied to adjust for differential probability of selection due to (1) study design, (2) demographic variations in nonresponse, and (3) variations in eligibility within households. Additional information on sampling methods and procedures has been provided elsewhere (Finkelhor, Turner, Ormrod, and Hamby, 2009; Finkelhor, Turner, Ormrod, Hamby, and Kracke, 2009).

Interviewers first spoke with an adult caregiver in each household to obtain family demographic information. They then randomly selected the child with the most recent birthday to be interviewed. Interviewers spoke directly with children ages 10 to 17. For children younger than age 10, they interviewed the caregiver who “is most familiar with the child’s daily routine and experiences.”

Sources and Analysis of Information Regarding Victimization

Researchers obtained reports of victimization using the Juvenile Victimization Questionnaire (JVQ), an inventory of childhood victimization (Finkelhor, Hamby et al., 2005; Finkelhor, Ormrod et al., 2005a; Hamby et al., 2004). The JVQ obtains reports on 48 forms of youth victimization covering 5 general areas of interest: conventional crime, maltreatment, victimization by peers and siblings, sexual victimization, and witnessing and exposure to violence (Finkelhor, Ormrod et al., 2005b).

Followup questions for each victimization item gathered additional information about each event, including perpetrator characteristics, weapon use (use of a knife, gun, or other object that could cause physical harm), injury, whether the event occurred in the past year, and whether it was known to school officials or police.

The analysis for this bulletin examined victimizations that occurred in the past year. The researchers constructed 8 aggregate types of victimization from 32 of the JVQ’s 48 victimization screeners: physical assault, sexual victimization, maltreatment, property victimization, witnessing family violence, exposure to community violence, bullying, and Internet victimization.

Sources and Analysis of Information Regarding Delinquency

Researchers used the Frequency of Delinquency Behavior (FDB) that Loeber and Dishion (1983) originally developed to measure self-reported delinquency. For this study, the researchers adapted the FDB scale from its most recently published format (Dahlberg, Toal, and Behrens, 1998; Loeber and Stouthamer-Loeber, 1987).* The adapted form asked participants only whether they had committed the listed delinquency in the past year rather than how often they had committed each delinquent behavior. Researchers asked all NatSCEV participants between the ages of 5 and 17 about a total of 15 delinquency items. This study focuses on the 2,090 respondents aged 10 to 17.

*For a sample of the Frequency of Delinquent Behavior survey and scoring instrument, see  www.djj.state.fl.us/docs/jjdp-performance-measurement/frequency_of_delinquent_behavior.pdf?sfvrsn=0.

Implications for Adolescent Development and for Intervention by Practitioners

Age Onset of Increasing Risk for Victimization and Delinquency

Delinquency and victimization are widespread among youth ages 10 to 17, and they are statistically associated. However, in addition to those who experience both, it is possible to identify large groups within this age range who are victimized but not delinquent as well as those who are delinquent but experienced few types of victimization.

The relative sizes of these various groups appear to change as children age; they also differ by gender. The delinquent-victim group among boys is larger overall and increases substantially between ages 13 and 14. This may reflect an increase in delinquent activities around the time they enter high school among those who had previously been primarily victims. The high school environment may expose them to older delinquent role models and present them with conditions of more independence and less supervision than middle school.

For girls, the pattern change appears to occur earlier (between ages 11 and 12) and is associated with an increase in both victimization and delinquency, but particularly victimization. This is likely related to the onset of pubertal changes in girls and shows up in the data as a particularly marked increase in sexual harassment.

Increased Risk of Both Delinquency and Victimization for Delinquent-Victims

For both genders, the data reveal worrying facts about the group who are both victimized and delinquent. This group manifests higher levels of both victimization and delinquency than either the primarily victim or primarily delinquent group. This group also has more additional adversities, lower levels of social support, and higher rates of mental health symptoms (see table 2). This is consistent with observations from the bullying literature that the so-called “bully-victims” are often the most distressed children (Cuevas et al., 2007; Haynie et al., 2001; Olweus, 1978, 2000; Schwartz, Proctor, and Chien, 2001). Improving strategies for identifying and helping this group of children is an obvious priority.

Timing of Interventions To Reduce Victimization and Delinquency

The current study is not longitudinal, and so it is limited in the inferences that can be made about how to identify children who are on track to become distressed delinquent-victims. This group does not appear to be discernible on the basis of demographic, family, or school variables collected in this study. The age comparisons suggest that victims who have additional adversities and higher levels of victimization and mental health symptoms may also be those at greatest risk of moving into delinquent activities. Targeting prevention at highly victimized youth with mental health symptoms may be important.

The study points clearly to the importance of early intervention. For girls, a large jump in victimization and delinquency occurs between ages 11 and 12; for boys, the delinquent-victim group increases between ages 13 and 14. This strongly suggests that delinquency and victimization prevention efforts need to be marshaled around or before the fifth grade, and they need to include components that minimize sexual aggression and harassment.

The transition to high school may also be a crucial juncture, especially for boys. Further study may better determine how children at this juncture both are targeted as victims and initiate multiple delinquent activities. Better early-warning systems may identify students who need special guidance and education from early in their high school careers.

References

Briere, J. 1996. Trauma Symptoms Checklist for Children (TSCC): Professional Manual. Odessa, FL: Psychological Assessment Resources.

Briere, J., Woo, R., McRae, B., Foltz, J., and Sitzman, R. 1997. Lifetime victimization history, demographics, and clinical status in female psychiatric emergency room patients. Journal of Nervous and Mental Disease 185:95–101.

Chang, J.J., Chen, J.J., and Brownson, R.C. 2003. The role of repeat victimization in adolescent delinquent behaviors and recidivism. Journal of Adolescent Health 32(4):272–280.

Cuevas, C., Finkelhor, D., Turner, H.A., and Ormrod, R.K. 2007. Juvenile delinquency and victimization: A theoretical typology. Journal of Interpersonal Violence 22:1581–1602.

Dahlberg, L.L., Toal, S.B., and Behrens, C.B. 1998. Measuring Violence-Related Attitudes, Beliefs, and Behaviors Among Youth: A Compendium of Assessment Tools. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control.

Dodge, K.A., Coie, J.D., Pettit, G.S., and Price, J.M. 1990. Peer status and aggression in boys’ groups: Developmental and contextual analyses. Child Development 61(5):1289–1309.

Egeland, B., Yates, T., Appleyard, K., and van Dulmen, M. 2002. The long-term consequences of maltreatment in the early years: A developmental pathway model to antisocial behavior. Children’s Services: Social Policy, Research, and Practice 5:249–260.

Finkelhor, D. 1990. Early and long-term effects of child sexual abuse: An update. Professional Psychology Research and Practice 21:325–330.

Finkelhor, D., Hamby, S.L., Ormrod, R.K., and Turner, H.A. 2005. The JVQ: Reliability, validity, and national norms. Child Abuse & Neglect 29(4):383–412.

Finkelhor, D., Ormrod, R.K., and Turner, H.A. 2007. Poly-victimization: A neglected component in child victimization trauma. Child Abuse & Neglect 31:7–26.

Finkelhor, D., Ormrod, R.K., Turner, H.A., and Hamby, S.L. 2005a. Measuring poly-victimization using the JVQ. Child Abuse & Neglect 29(11):1297–1312.

Finkelhor, D., Ormrod, R.K., Turner, H.A., and Hamby, S.L. 2005b. The victimization of children and youth: A comprehensive, national survey. Child Maltreatment 10(1):5–25.

Finkelhor, D., Turner, H., Ormrod, R., and Hamby, S.L. 2009. Violence, abuse, and crime exposure in a national sample of children and youth. Pediatrics 124(5):1–13.

Finkelhor, D., Turner, H., Ormrod, R., Hamby, S., and Kracke, K. 2009. Children’s Exposure to Violence: A Comprehensive National Survey. Bulletin. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention.

Hamby, S.L., Finkelhor, D., Ormrod, R.K., and Turner, H.A. 2004. The Juvenile Victimization Questionnaire (JVQ): Administration and Scoring Manual. Durham, NH: Crimes against Children Research Center.

Haynie, D.L., Nansel, T., Eitel, P., Crump, A.D., Saylor, K., Yu, K., and Simons-Morton, B. 2001. Bullies, victims, and bully/victims: Distinct groups of at-risk youth. The Journal of Early Adolescence 21:29–49.

Jennings, W.G., Piquero, A.R., and Reingle, J.M. 2012. On the overlap between victimization and offending: A review of the literature. Aggression and Violent Behavior 17:16–26.

Jensen, G.F., and Brownfield, D. 1986. Gender, lifestyles, and victimization: Beyond routine activity, Violence and Victims 1(2):85–99.

Kilpatrick, D.G., Ruggiero, K.J., Acierno, R., Saunders, B.E., Resnick, H.S., and Best, C.L. 2003. Violence and risk of PTSD, major depression, substance abuse/dependence, and comorbidity: Results from the national survey of adolescents. Journal of Consulting and Clinical Psychology 71:692–700.

Lauritsen, J.L., Laub, J.H., and Sampson, R.J. 1992. Conventional and delinquent activities: Implications for the prevention of violent victimization among adolescents. Violence and Victims 7(2):91–108.

Lauritsen, J.L., Sampson, R.J., and Laub, J.H. 1991. The link between offending and victimization among adolescents. Criminology 29:265–292.

Loeber, R., and Dishion, T.J. 1983. Early predictors of male delinquency: A review. Psychological Bulletin 94:68–94.

Loeber, R., and Stouthamer-Loeber, M. 1987. The prediction of delinquency. In Handbook of Juvenile Delinquency, edited by H.C. Quay. New York, NY: Wiley, pp. 325–382.

Malinosky-Rummell, R., and Hansen, D.J. 1993. Long-term consequences of childhood physical abuse. Psychological Bulletin 114:68–79.

McGrath, S.A., Nilsen, A.A., and Kerley, K.R. 2011. Sexual victimization in childhood and the propensity for juvenile delinquency and adult criminal behavior: A systematic review. Aggression and Violent Behavior 16:485–492.

Olweus, D. 1978. Aggression in the Schools: Bullies and Whipping Boys. Oxford, England: Hemisphere.

Olweus, D. 2000. Bullying. In Encyclopedia of Psychology, vol. 1, edited by A.E. Kazdin. Washington, DC: American Psychological Association, pp. 487–489.

Schwartz, D., Proctor, L.J., and Chien, D.H. 2001. The aggressive victim of bullying: Emotional and behavioral dysregulation as a pathway to victimization by peers. In Peer Harassment in School: The Plight of the Vulnerable and Victimized, edited by J. Juvonen and S. Graham. New York, NY: Guilford Press, pp. 147–174.

Singer, S.I. 1986. Victims of serious violence and their criminal behavior: Subcultural theory and beyond. Victims and Violence 1:61–70.

Snyder, H.N., and Sickmund, M. 2006. Juvenile Offenders and Victims: 2006 National Report. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention.

Sullivan, T.N., Farrell, A.D., and Kliewer, W. 2006. Peer victimization in early adolescence: Association between physical and relational victimization and drug use, aggression, and delinquent behaviors among urban middle school students. Development and Psychopathology 18(1):119–137.

Wilsnack, S.C., Wilsnack, R.W., Kristjanson, A.F., Vogeltanz-Holm, N.D., and Harris, T.R. 2004. Child sexual abuse and alcohol use among women: Setting the stage for risky sexual behavior. In From Child Sexual Abuse to Adult Sexual Risk: Trauma, Revictimization, and Intervention, edited by L.J. Koenig, L.S. Doll, A. O’Leary, and W. Pequegnat. Washington, DC: American Psychological Association, pp. 181–200.

Windle, M., and Mason, W.A. 2004. General and specific predictors of behavioral and emotional problems among adolescents. Journal of Emotional and Behavioral Disorders 12:49–61.

Wood, J., Foy, D.W., Goguen, C.A., Pynoos, R., and James, C.B. 2002. Violence exposure and PTSD among delinquent girls. Journal of Aggression, Maltreatment, and Trauma 6:109–126.

Acknowledgments

This bulletin was written by Carlos A. Cuevas, Ph.D., Associate Professor, School of Criminology and Criminal Justice, Northeastern University; David Finkelhor, Ph.D., Director, Crimes against Children Research Center, University of New Hampshire; Anne Shattuck, Data Analyst, Crimes against Children Research Center, University of New Hampshire; Heather Turner, Ph.D., Professor, Department of Sociology, University of New Hampshire; and Sherry Hamby, Ph.D., Research Associate Professor, Department of Psychology, Sewanee: The University of the South. OJJDP wishes to acknowledge the contributions to this bulletin of Melissa T. Merrick, Ph.D., Epidemiologist, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (CDC). OJJDP also wishes to acknowledge the support of CDC for the National Survey of Children’s Exposure to Violence and its partnership in the Safe Start initiative to create safe, stable, and nurturing environments for children and their families.

Share With Your Colleagues

Unless otherwise noted, OJJDP publications are not copyright protected. We encourage you to reproduce this document, share it with your colleagues, and reprint it in your newsletter or journal. However, if you reprint, please cite OJJDP and the authors of this Bulletin. We are also interested in your feedback, such as how you received a copy, how you intend to use the information, and how OJJDP materials meet your individual or agency needs.

Please direct your comments and questions to:

National Criminal Justice Reference Service

P.O. Box 6000

Rockville, MD 20849–6000

800–851–3420

301–519–5500 (fax)

Email: responsecenter@ncjrs.gov

www.ncjrs.gov

This bulletin was prepared under grant number 2005–JL–FX–0048 from the Office of Juvenile Justice and Delinquency Prevention (OJJDP), U.S. Department of Justice.

Points of view or opinions expressed in this document are those of the authors and do not necessarily represent the official position or policies of OJJDP or the U.S. Department of Justice.

The Office of Juvenile Justice and Delinquency Prevention is a component of the Office of Justice Programs, which also includes the Bureau of Justice Assistance; the Bureau of Justice Statistics; the National Institute of Justice; the Office for Victims of Crime; and the Office of Sex Offender Sentencing, Monitoring, Apprehending, Registering, and Tracking.

Access OJJDP publications online at ojjdp.gov/publications/index.html.

NCJ 240555