Poly-victimization: A neglected component in child victimization☆
Introduction
A considerable literature has developed documenting the serious negative effects on children of violence, crime, maltreatment and victimization (Osofsky, 1995, Osofsky, 1999; Trickett & Schellenbach, 1998). For the most part, this literature has examined the effects of specific, individual kinds of victimization, such as sexual abuse (Kendall-Tackett, Williams, & Finkelhor, 1993; Kilpatrick & Saunders, 1999; Paolucci, Genuis, & Violato, 2001), bullying (Nansel, Overpeck, Haynie, Ruan, & Scheidt, 2003), exposure to community violence (Gorman-Smith & Tolan, 1998), and witnessing domestic violence (Fantuzzo & Mohr, 1999; Fantuzzo et al., 1991; Kolbo, Blakely, & Engleman, 1996). Virtually all have been shown to be associated with mental health problems, delinquency and other difficulties, including serious subsequent health conditions (Kendall-Tackett, 2003, Widom, 2000, Wolfe, 1999).
A general problem with this literature, however, is that most such studies on individual types of victimization have failed to obtain complete victimization profiles. This creates the potential for several kinds of problems, particularly if children who experience one kind of victimization are at greater risk of experiencing other forms of victimization. Specifically, past studies: (1) may exaggerate the contribution of a single type of victimization to mental health problems, (2) do not delineate the interrelationships among victimizations and the contribution of these interrelationships to mental health problems, and (3) often fail to identify within victimized samples certain groups of chronically or multiply victimized children who may be at particular risk. The present study is an exploratory effort to consider the implications of exposure to multiple forms of victimization.
The literature does have much evidence that victimizations tend to cluster both among adults (Hope, Bryan, Trickett, & Osborn, 2001; Outlaw, Ruback, & Britt, 2002) and children (Nishina & Juvonen, 2005; Rossman & Rosenberg, 1998; Saunders, 2003). Research is paying increasing attention, for example, to the conjunction between child abuse and witnessing domestic violence (Appel & Holden, 1998; Bowen, 2000; Kitzmann, Gaylord, Holt, & Kenny, 2003; Sternberg et al., 2004; Wolfe, Crooks, Lee, McIntyre-Smith, & Jaffe, 2003) and also between sexual victimizations in childhood and adolescence (Grauerholz, 2000). Connections between intrafamily and extrafamily victimization have also been noted (Baldry, 2003; Perry, Hodges, & Egan, 2001). Nonetheless, with some exceptions (Appel & Holden, 1998), studies of victimization exposure have not typically incorporated these interconnections in the theory or research about victimization impact.
Much of the literature on the impact of victimization grows out of a theoretical framework based on the concept of traumatic stress (Finkelhor, 1988). The earliest studies in this field began with observations of rape victims who suffered many immediate and long-term difficulties (Burgess & Holmstrom, 1975). The prototypical traumatic victimization in this literature was one frightening, unpredictable event, like a stranger rape, occurring to an otherwise safe and untroubled person.
Since then the literature on victimization in childhood has painted a much more complicated picture showing many childhood victimizations not as single traumatizing events but as part of a pattern of on-going or multiple victimizations (Clausen & Crittenden, 1991). Previously victimized children, particularly those experiencing child maltreatment or family violence, also appear to be at greater risk of subsequent victimizations (Duncan, 1999a, Duncan, 1999b). Moreover, when observed over time in schools, some children appear to be chronically targeted year after year (Perry et al., 2001).
The clustering of victimizations for some children almost certainly has many explanations, too numerous to explore in detail here. Some pertain to environmental circumstances, families and neighborhoods that increase risk for varieties of victimizations (Cicchetti & Lynch, 1993). Others pertain to characteristics of children, themselves including those implicated in theories about social learning and attachment processes (see, Finkelhor, Ormrod, & Turner, in press; Perry et al., 2001; Tseloni & Pease, 2003). Together these observations suggest that for some victimized children, victimization is more of a “condition” than an “event” as portrayed in the early traumatic stress literature. Assessing multiple types of victimization may be important for distinguishing this group for whom victimization is a condition.
Other related fields have made important clinical and research advances in recent years by identifying individuals with intersecting adversities. Concepts such as “poly-drug users” (Bower, 1985, Kaufman, 1977) in the substance abuse field and “dual-diagnosis” or “co-occurring disorders” (Sacks, 2003) in the mental health field have been widely adopted. The designation and analysis of a group of “poly-victims” may similarly help the child victimization field come to a better understanding of victimization trauma (Rossman & Rosenberg, 1998; Saunders, 2003).
The notion that multiple stressors combine and accumulate in various ways that lead to more deleterious and less reversible outcomes is a common one in the developmental literature (Felitti, Anda, & Nordenberg, 1998; Rutter, 1983; Turner & Lloyd, 1995). Many possible mechanisms may be part of the explanation. For example, multiple victimizations may mean that more people and more environments in a child's life are associated with traumatic reminders that interfere with normal coping. After a certain threshold of victimizations, a child's defensive coping may become generalized to virtually every one of his or her interpersonal contexts. In addition, since self-blame seems to be an important component to victimization trauma (Mannarino & Cohen, 1996), children may have a much harder time resisting this negative self attribution when they experience victimization from multiple sources. Another possibility is that, because victimization is fairly common in childhood, children do not see themselves as deviant or disadvantaged on this dimension until they are experiencing multiple sorts of victimization. A recent study suggested that seeing other children being victimized actually serves as a buffer against humiliation and anger, perhaps because it helped children discount their personal culpability and deviance (Nishina & Juvonen, 2005). These generalization mechanisms suggest that children victimized in different ways and in different contexts might be more affected than children repeatedly victimized by just one person or in just one context. Such multiply victimized children may also be the ones most likely to experience less reversible impacts at the psychobiological level (Cohen, Perel, DeBellis, Friedman, & Putnam, 2002).
Other less direct mechanisms may account for findings about multiple traumas and negative outcomes. For example, multiple victimizations may be a sign that children are poorly supervised or socially isolated and thus unprotected targets, have poor social interactional skills or a variety of pre-existing psychological problems. In such cases, multiple victimizations may be more markers than agents of the children's difficulties.
While the present study is not intended to delve extensively into the mechanisms of effect, it is an exploratory effort to test whether the concept of “poly-victimization” has relevance to the assessment of victimization trauma. Our key hypothesis is that poly-victimization accounts for a considerable portion of explainable variation in traumatic symptoms. We also tests the idea that relationships between individual victimization types and traumatic symptoms may be misrepresented when a child's broader victimization profile is not taken into account.
Section snippets
Developmental Victimization Survey
This analysis uses data from the Developmental Victimization Survey (DVS). The survey, conducted between December 2002, and February 2003, assessed the experiences of a nationally representative sample of children age 2–17 living in the contiguous United States. Interviews with parents and youth were conducted by telephone by the employees of an experienced survey research firm. Telephone interviewing is a cost-effective methodology (Weeks, Kulka, Lessler, & Whitmore, 1983) that has been
Results
It was common for children and youth to have experienced multiple types of victimization in the last year. Of the 71% who had experienced any victimization, 69% had experienced at least one additional, different type of victimization also in the last year. The mean number of victimizations among victimized children for the 1-year period was 3.0 with the range extending all the way to 15. The most common victimizations (as well as the most common kinds of additional victimizations) were peer and
Discussion
Poly-victims, children with a large number of different kinds of victimization in a single year, make up a substantial proportion of any group of children who would be identified by screening for an individual victimization type (such as victims of bullying or sexual assault). For example, over 92% of the rape victims and 76% of the dating violence victims in this national sample were poly-victims. Moreover, recent poly-victimization was a very important predictor of trauma symptoms. When taken
Conclusion
The conceptualization and findings of this study, if confirmed by other research, suggest that future research and practice in the field of child victimization might benefit from a more comprehensive approach to assessment, one that takes into account a broader range of victimizations. The benefit for research may be a better ability to account for the effects of victimization and a better ability to understand the sequences or pathways that lead to victimization vulnerability. The benefit for
References (76)
Bullying in schools and exposure to domestic violence
Child Abuse & Neglect
(2003)- et al.
The Trauma Symptoms Checklist for Young Children (TSCYC): Reliability and association with abuse exposure in a multi-site study
Child Abuse & Neglect
(2001) - et al.
A multi-site, randomized controlled trial for children with sexual abuse-related PTSD symptoms
Journal of the American Academy of Child and Adolescent Psychiatry
(2004) - et al.
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 Preventative Medicine
(1998) - et al.
The JVQ: Reliability, validity, and national norms
Child Abuse & Neglect
(2005) - et al.
Measuring poly-victimization using the JVQ
Child Abuse & Neglect
(2005) - et al.
Pattern of teen exposure to a community-based violence prevention project
Journal of Adolescent Health
(1992) - et al.
Behavioral problems among children whose mothers are abused by an intimate partner
Child Abuse & Neglect
(2003) - et al.
The measurement of maltreatment: A comparison of approaches
Child Abuse & Neglect
(1995) - et al.
Maltreatment and trauma: Tracking the connections in adolescence
Child and Adolescent Psychiatric Clinics of North America
(2003)
The co-occurrence of spouse and physical child abuse: A review and appraisal
Journal of Family Psychology
Analysis of sexual behavior in France (ACSF): A comparison between two modes of investigation: Telephone survey and face-to-face survey
AIDS
Effects of telephone & face-to-face communication on rated extent of self-disclosure by female college students
Psychological Reports
Child abuse and domestic violence in families of children seen for suspected sexual abuse
Clinical Pediatrics
Multiple drug use: A dangerous trend
Science News
Bias in list-assisted telephone samples
Public Opinion Quarterly
Trauma Symptoms Checklist for Children (TSCC): Professional manual
Rape: Victims of crisis
Toward an ecological/transactional model of community violence and child maltreatment: Consequences for children's development
Psychiatry
Physical and psychological maltreatment: Relations among types of maltreatment
Child Abuse & Neglect
Treating traumatized children: Clinical implications of the psychobiology of posttraumatic stress disorder
Trauma Violence & Abuse
Asking sensitive behavioral questions in telephone interviews
International Quarterly of Community Health Education
Maltreatment by parents and peers: The relationship between child abuse, bully victimization, and psychological distress
Child Maltreatment
Peer and sibling aggression: An investigation of intra- and extra-familial bullying
Journal of Interpersonal Violence
Prevalence and effects of child exposure to domestic violence
The Future of Children
Effects of interpersonal violence on the psychological adjustment and competencies of young children
Journal of Consulting and Clinical Psychology
Resilience to childhood adversity: Results of a 21-year study
The trauma of child sexual abuse: Two models
The victimization of children and youth: A comprehensive, national survey
Child Maltreatment
Poly-victimization and trauma in a developmental context
Development and Psychopathology
The role of exposure to community violence and developmental problems among inner-city youth
Development and Psychopathology
Positive adaptation among youth exposed to community violence
An ecological approach to understanding sexual revictimization: Linking personal, interpersonal, and sociocultural factors and processes
Child Maltreatment
The power of friendship: Protection against an escalating cycle of peer victimization
Developmental Psychology
The phenomena of multiple victimization: The relationship between personal and property crime risk
British Journal of Criminology
Cited by (1477)
Factors differentiating risk of sexual abuse victimization by adults and peers among adolescents
2024, Child Abuse and NeglectUnique and shared risk factors for early childhood victimisation and polyvictimisation in a Brazilian population-based birth cohort
2024, Lancet Regional Health - AmericasSelf-compassion, childhood emotional neglect, and posttraumatic growth: Parental well-being during COVID-19
2024, Journal of Affective DisordersThe prevalence of child sexual abuse with online sexual abuse added
2024, Child Abuse and Neglect
- ☆
For the purposes of compliance with Section 507 of PL 104-208 (the “Stevens Amendment”), readers are advised that 100% of the funds for this program are derived from federal sources (US Department of Justice). The total amount of federal funding involved is $353,233.