Exposure to Violence and Post-Traumatic Stress Disorder in Urban Adolescents

Article excerpt

Adolescence is commonly recognized as a stressful period. Vulnerability to stress is attributed to developmental changes including puberty, social role redefinition, cognitive development, school transitions, the emergence of sexuality (Eccles et al., 1993) and the tasks of separation and individuation (Harris, 1991). Normal developmental stress may be exacerbated by increased incidence of divorce and single-parent families, growing rates of poverty, homelessness, drug abuse, intrafamily violence, child abuse, and exposure to violent crime. Wilson and Joffe (1995) report that the health status of adolescents in this country is declining, and that major causes of adolescent morbidity and mortality are behavioral and psychosocial rather than purely biomedical. This study is an investigation of the incidence of symptoms in adolescents of Post-Traumatic Stress Disorder, a major psychiatric disturbance characterized by pathological responses to exposure to ongoing or single-episode traumatic stress.

Incidence of Traumatic Stress

There has been some disagreement regarding the necessity of a traumatic experience to be "outside the range of usual human experience" (American Psychiatric Association [APA], 1987) in order for it to produce stress reactions characteristics of PTSD (Breslau & Davis, 1987; Davidson & Foa, 1991; March, 1993; Solomon & Canino, 1990). Data show alarming prevalence and effects of exposure to violence on young children (Osofsky, 1995). More common stressors may have a wide range of effects on different individuals, and victimization statistics challenge the assertion that traumatic events are unusual experiences (Breslau, Davis, Andreski, & Peterson, 1991). Compared with major life events, daily stressors have been reported to play a more central role in the development and maintenance of psychological problems (Banez & Compas, 1990). Forehand et al. (1991) found that as the number of stressors increase, adolescent functioning deteriorates. Therefore, the prevalence and severity of chronic and everyday stressors in the lives of urban adolescents may predispose them to symptoms of psychological stress and PTSD.

Purpose

This study investigated the incidence of symptomatology characteristic of PTSD in adolescents in a major metropolitan area. Comparisons of this incidence were made with regard to gender, ethnicity, family constellation, self-reported exposure to violence, self-reported exposure to trauma, and incidence of violent crime in the vicinity of school attendance.

The research questions were: (1) What were the differences between gender, ethnicity, family constellation, level of self-reported exposure to violence, level of self-reported traumas experienced, in crime exposure and PTSD scores?; and (2) What set of variables best predicts PTSD scores? These questions were based on the hypothesis that a clinically significant number of adolescents would exhibit symptomatology characteristic of PTSD.

METHOD

Participants

The sample consisted of 97 high school juniors in a major metropolitan area in the South who volunteered and provided parental consent to participate in the study. The five participating high schools represented a heterogeneous cross-section of socioeconomic status, ethnicity, and geographic location. A nonrandom sample was selected based on schools' and students' willingness to participate. Exposure to violent crime was determined by the city annual police report of actual reported incidence of murder, rape, individual robbery, and assault reported in the police beat of the subjects' homes or schools. These statistics were used to determine the amount of exposure to actual criminal violence experienced directly or indirectly by each participant.

Instruments

Keane PTSD Scale. This scale was developed by Keane, Malloy, and Fairbank (1984) and is based on items from the Minnesota Multiphasic Personality Inventory (MMPI) that were differentially endorsed by PTSD patients in the validation sample. …