Fleckman Julia M, Drury Stacy S, Taylor Catherine A, Theall Katherine P
Department of Global Community Health and Behavioral Sciences, Tulane School of Public Health and Tropical Medicine, 1440 Canal St., Suite 2300, New Orleans, LA, 70112, USA.
Department of Psychiatry and Behavioral Sciences, Tulane School of Medicine, 1440 Canal St., Suite 1000, New Orleans, LA, 70112, USA.
J Urban Health. 2016 Jun;93(3):479-92. doi: 10.1007/s11524-016-0052-y.
The objective of this study was to examine the association between externalizing behaviors and indirect violence exposure, assessed both within the household and at the community level, as well as the interaction effect of indirect and direct violence exposure. A sample of parents of children ages 4-15 who have not been referred or enrolled in child welfare (n = 82) were recruited from the greater New Orleans community. Externalizing behavior was assessed with the Child Behavior Checklist (CBCL). The child's indirect exposure to violence included witnessing community violence, witnessing physical assault, and witnessing fighting or domestic violence at home. Direct exposure to violence included the child experiencing physical aggression from a caregiver. All assessments were based on caregiver reports. To decrease potential for confounding, children were matched for analysis based on age, Hurricane Katrina exposure, and their propensity to be exposed to high indirect violence. Cumulative indirect exposure to violence was significantly positively correlated with CBCL scores. After controlling for key covariates, CBCL externalizing T score increased significantly by approximately 1.25 points for each level increase in indirect violence exposure (β = 1.25, SE = 0.57, p = 0.027). There also was a significant interaction between indirect and direct exposure to violence in the association with CBCL score (β = -0.08, SE = 0.03, p = 0.002). These findings extend previous research by demonstrating that exposure to both direct and cross-contextual indirect violence influences externalizing behaviors in children. Additionally, the findings suggest that community and household social environments are both important targets for interventions designed to decrease externalizing behaviors and improve long-term outcomes for youth at risk of exposure to violence.
本研究的目的是考察外化行为与间接暴力暴露之间的关联（在家庭和社区层面进行评估），以及间接和直接暴力暴露的交互作用。从大新奥尔良社区招募了82名4至15岁儿童的家长作为样本，这些儿童未被转介或纳入儿童福利体系。使用儿童行为量表（CBCL）评估外化行为。儿童间接接触暴力包括目睹社区暴力、目睹身体攻击以及目睹家中的打斗或家庭暴力。直接接触暴力包括儿童遭受照顾者的身体攻击。所有评估均基于照顾者的报告。为降低混杂因素的可能性，根据年龄、卡特里娜飓风暴露情况以及其暴露于高间接暴力的倾向对儿童进行匹配分析。暴力的累积间接暴露与CBCL得分显著正相关。在控制关键协变量后，间接暴力暴露每增加一个等级，CBCL外化T得分显著增加约1.25分（β = 1.25，标准误 = 0.57，p = 0.027）。在与CBCL得分的关联中，间接和直接暴力暴露之间也存在显著的交互作用（β = -0.08，标准误 = 0.03，p = 0.002）。这些发现扩展了先前的研究，表明直接和跨情境间接暴力暴露都会影响儿童的外化行为。此外，研究结果表明，社区和家庭社会环境都是旨在减少外化行为并改善有暴力暴露风险青少年长期结局的干预措施重要目标。
