Anyone who watches local or national news knows that violence is a fairly common occurrence. And, violence is not confined to the big cities. While it is a part of daily life in cities, violent acts also take place in the suburbs and small towns. Moreover, teens are not spared this violence. According to the Palo Alto Medical Foundation, almost 16 million teens have witnessed some form of violent assault. About one in eight people murdered in the United States each year is younger than 18 years old. Generally, violent acts occur between people who know each other; stranger violence is far less common. And, homes that have guns place family members at increased risk for gun violence against a family member. 1
Teens who are raised in homes with violence are more likely to be violent. Even if parents do not discuss violence, they are teaching by example. Parents need to demonstrate how to solve problems without resorting to violence. Parents should model nonphysical solutions to problems. It is also important to eliminate exposure to violent programming. In fact, all types of screen time should be limited, especially on school days.
Between school, after-school activities, part-time jobs, and other responsibilities, teens spend much of their day away from home. As a result, they must learn to avoid potentially dangerous and violent situations. If they become overwhelmed with anger and feel they might become violent, teens need to learn to step back and take a time out to regain control. Teens should understand that it is okay to turn to a third party to help resolve a potentially violent situation.
In an article published in 2013 in the journal Adolescent Medicine: State of the Art Reviews, researchers from New York City outlined some of the behaviors that characterize adolescent victims and perpetrators of violence. A common theme in victims and perpetrators is maltreatment. Adolescents who visit Internet chat rooms, meet unknown individuals, and are later sexually assaulted have often been a victim of sexual assault earlier in childhood. Teens who are perpetrators of violence tend to have a history of childhood physical abuse and ongoing exposure to violence in their homes. When medical providers recognize that a child is being mistreated, they may take action to stop the situation before the child grows into a teen victim or perpetrator. “Identification and provision of services to families involved in domestic violence situations can help children establish positive adult roles with peers and future partners.” 2
In a study published in 2015 in the Journal of Interpersonal Violence, researchers from several different locations in the United States noted that there is a program, Coaching Boys into Men (CBIM), that trains coaches to deliver violence prevention messages to male athletes. The researchers wondered if it was really working. Was the program teaching nonviolence and having an impact? To determine the answer, the researchers asked 176 coaches in 16 high schools in Northern California to complete baseline surveys. Coaches were then randomly assigned to receive the CBIM materials (intervention group) or to continue to coach as usual (control group). While 59 coaches were lost to follow-up, the remaining coaches completed postseason surveys that assessed their attitudes and confidence in delivering the program. A smaller group of 36 intervention coaches participated in semistructured face-to-face interviews that addressed “program acceptability, feasibility, and impact.” When compared to the control coaches, the intervention coaches demonstrated more confidence in intervening when they saw abusive behaviors in their athletes. They also had more bystander intervention and more violence-related discussions with athletes and other coaches. The coaches reported that the program was easy to implement and a valuable addition to athletics. The researchers commented that “this brief curriculum appears to impact both coach confidence to enact behavior change and actual positive behavior changes.” 3
In a study published in 2015 in the Journal of School Health, researchers from New York City wanted to determine the prevalence of aggressive and violent behaviors in the schools that teens in the United States attend. When they analyzed multiple years of data from 84,734 participants in the Youth Risk Behavior Surveillance System, the researchers found that many teens feel unsafe in their schools. They bring weapons to school and engage in physical fights at school. Minority teens are more affected by the violence than nonminority teens. Hispanic males and females have the highest rates of feeling unsafe in school, 8.5 percent and 9.6 percent respectively. Hispanic and black teens were more likely to report that they had recently been threatened in school. Males are more likely than females to carry weapons to school. The researchers noted that many schools and communities are addressing issues of school safety. However, they are not uniformly effective. According to the researchers, in order to improve the violence that occurs in schools, “schools must have the support and resources to facilitate a caring environment that encourages connectedness, academic engagement, and positive relationships among youth and with school staff.” 4
In a cross-sectional study published in 2015 in the Journal of Family and Community Medicine, researchers from Seattle, Washington, and Baghdad, Iraq, wanted to estimate the effect of childhood experiences, at age 15 years or younger, on the physical health of adults in Baghdad. The study was conducted from January 2013 to January 2014 on 1,000 people, between the ages of 18 and 59 years, living in Baghdad, the capital of Iraq. Slightly less than half of the respondents reported that they witnessed a parent or household member being yelled at, screamed at, sworn at, insulted, or humiliated in their home. A third of the respondents reported seeing or hearing a parent or household member being slapped, kicked, punched, or beaten. Almost half of the respondents have observed someone being beaten, and almost 20 percent have been threatened with a knife or gun. And, about half of the respondents lived in a violent environment in their childhood. Meanwhile, more than one-third of the respondents had gastrointestinal diseases and symptoms, and more than one-fifth had cardiovascular diseases. The researchers found that the respondents exposed to a high level of community violence and household dysfunction and abuse had a dramatically increased risk of a chronic physical disease. At the same time, higher levels of family bonding were associated with a lower risk of chronic physical disease. The researchers concluded that “adverse childhood experiences increase the risk of a chronic physical illness in adult life.” But, “family bonding appears an important protective factor against physical diseases.” 5
In a longitudinal study published in 2013 in the Journal of Adolescent Health, researchers from Illinois, Arizona, and Washington evaluated the ability of a middle school program, known as Second Step: Student Success Through Prevention (SS-SSTP), to reduce violent acts among sixth-grade students. The violent acts included peer aggression, peer victimization, homophobic name calling, and sexual violence perpetration. The researchers randomly assigned 18 matched pairs of 36 middle schools in Illinois and Kansas to receive the SS-SSTP program or serve as controls. The program included 15 lessons on social emotional learning skills such as empathy, communication, bully prevention, and problem-solving skills. All of the sixth graders in both the intervention and control groups, a total of 3,616 students, completed questionnaires on various aspects of violence. The researchers learned that students in the intervention schools were 42 percent less likely to report physical aggression than students in the control schools. The researchers emphasized that “the magnitude of this finding should not be minimized.” In 2009, almost one-third of all students in the United States in grades 9 through 12 reported that they had engaged in physical fighting in the previous 12 months. On the other hand, the intervention did not appear to have an effect on verbal/relational bully perpetration peer victimization, homophobic teasing, and sexual violence. 6
In a study published in 2014 in Child Abuse & Neglect, researchers from New Hampshire and Tennessee investigated the percentages of children who are exposed to violence prevention programs as well as the potential benefits of these programs. Their data were obtained from the National Survey of Children’s Exposure to Violence II, which consisted of 4,503 children between the ages of one month to 17 years in 2011. For their study, the researchers used a subset of 3,391 children between the ages of 5 and 17 years. The researchers found that 65 percent of the children had been exposed to a violence prevention program; 55 percent had been exposed during the previous year. Seventy-one percent of the respondents rated the programs as very or somewhat helpful. Children between the ages of 5 and 9 years who had been exposed to higher quality prevention programs had lower levels of peer victimization and perpetration. But, this association did not exist for older youth or youth exposed to lower quality programs. Children exposed to higher quality programs who had experienced peer victimization or conventional crime victimization were more likely to disclose what happened to authorities. Disclosure is a key component. It allows parents and authorities to intervene. So, good programs have clear benefits. But, it is also evident that there are programs in need of serious improvement. Apparently, “too few programs currently include efficacious components.” 7
In a study published in 2013 in the Journal of Adolescent Health, researchers from San Antonio, Texas, examined the violence protection effects of two different school-based programs in an economically disadvantaged and predominantly Latino school district. One program, El Joven Noble, was a “culturally tailored character development program.” It was the intervention program. The other offering, Teen Medical Academy, was a health career promotion program that focused on common medical conditions. It was the control. Both programs consisted of a series of 18 45-minute sessions that were conducted twice a week. The participants self-reported acts of nonphysical aggression, physical violence, and intimate partner violence during the previous 30 day at baseline and at three months and nine months. At baseline, when El Joven Noble had 96 students and the Teen Medical Academy had 127 students, there were no significant differences between the students in the groups. After nine months in the programs, there were uneven results. The high school students who participated in the Teen Medical Academy reported fewer acts of aggression and violence. As a result, positive results were observed in the control but not the intervention program. The researchers concluded that “participating in a health career promotion program may be an effective youth violence strategy for high-risk high school students in Latino communities.” 8
1. Palo Alto Medical Foundation, www.pamf.org.
2. Lori Legano and Margaret McHugh, “Adolescents as Victims and Perpetrators of Violence,” Adolescent Medicine: State of the Art Reviews 24, no. 1 (2013): 155-66.
3. Maria Catrina D. Jaime, Heather L. McCauley, Daniel J. Tancredi et al., “Athletic Coaches as Violence Prevention Advocates,” Journal of Interpersonal Violence 30, no. 7 (2015): 1090- 1111.
4. Sonali Rajan, Rachel Namdar, and Kely V. Ruggles, “Aggressive and Violent Behaviors in the School Environment Among a Nationally Representative Sample of Adolescent Youth,” Journal of School Health 85, no. 7 (2015): 446-57.
5. Ameel F. Al-Shawi and Riyadh K. Lafta, “Effect of Adverse Childhood Experiences on Physical Health in Adulthood: Results of a Study Conducted in Baghdad City,” Journal of Family and Community Medicine 22, no. 2 (2015): 78-84.
6. Dorothy L. Espelage, Sabina Low, Joshua R. Polanin, and Eric C. Brown, “The Impact of a Middle School Program to Reduce Aggression, Victimization, and Sexual Violence,” Journal of Adolescent Health 53 (2013): 180-86.
7. David Finkelhor, Jennifer Vanderminden, Heather Turner et al., “Youth Exposure to Violence Prevention Programs in a National Sample,” Child Abuse & Neglect 38 (2014): 677-86.
8. Manuel Ángel Oscós-Sánchez, Janna Lesser, and L. Dolores Oscós-Flores, “High School Students in a Health Career Promotion Program Report Fewer Acts of Aggression and Violence,” Journal of Adolescent Health 52 (2013): 96-101.
Al-Shawi, Ameel F., and Riyadh K. Lafta. “Effect of Adverse Childhood Experiences on Physical Health in Adulthood: Results of a Study Conducted in Baghdad City.” Journal of Family and Community Medicine 22, no. 2 (2015): 78-84.
Chapman, R. L., L. Buckley, B. Reveruzzi, and M. Sheehan. “Injury Prevention Among Friends: The Benefits of School Connectedness.” Journal of Adolescence 37 (2014): 937-44.
Espelage, Dorothy L., Sabina Low, Joshua R. Polanin, and Eric C. Brown. “The Impact of a Middle School Program to Reduce Aggression, Victimization, and Sexual Violence.” Journal of Adolescent Health 53 (2013): 180-86.
Finkelhor, David, Jennifer Vanderminden, Heather Turner et al. “Youth Exposure to Violence Prevention Programs in a National Sample.” Child Abuse & Neglect 38 (2014): 677-86.
Jaime, Maria Catrina D., Heather L. McCauley, Daniel J. Tancredi et al. “Athletic Coaches as Violence Prevention Advocates.” Journal of Interpersonal Violence 30, no. 7 (2015): 1090-1111.
Legano, Lori, and Margaret McHugh. “Adolescents as Victims and Perpetrators of Violence.” Adolescent Medicine: State of the Art Reviews 24, no. 1 (2013): 155-66.
Mikton, C., H. Maguire, and T. Shakespeare. “A Systematic Review of the Effectiveness of Interventions to Prevent and Respond to Violence Against Persons with Disabilities.” Journal of Interpersonal Violence 29, no. 17 (2014): 3207-26.
Oscós-Sánchez, Manuel Ángel, Janna Lesser, and L. Dolores Oscós-Flores. “High School Students in a Health Career Promotion Program Report Fewer Acts of Aggression and Violence.” Journal of Adolescent Health 52 (2013): 96-101.
Rajan, Sonali, Rachel Namdar, and Kelly V. Ruggles. “Aggressive and Violent Behaviors in the School Environment Among a Nationally Representative Sample of Adolescent Youth.” Journal of School Health 85, no. 7 (2015): 446-57.
Sharp, Adam, Lisa A. Prosser, Maureen Walton et al. “Cost Analysis of Youth Violence Prevention.” Pediatrics 133, no. 3 (2014): 448-53.
Palo Alto Medical Foundation. www.pamf.org .