Content area
Full text
Exposure of children to violence is a major public heal tli concern. Children who arc direct victims and witnesses of violence frequently exhibit posltraumatic stress symptoms and other symptomatic reactions.1"1 It is less well-known that children who have friends involved in violent acts may have similar responses. These symptoms can be disruptive to u child's functioning and can influence his or her future development. For example, the challenge Lo a young child's impulse control in witnessing violence potentially has long-term effects on regulating aggressive behavior, including a propensity to violence or victimization.
Furmair1 Iound that when children had difficulty mourning, the difficulty lay primarily in coping with anxieties about the circumstances of death. Many childhood losses of a parent, sibling, or friend result from traumatic incidents involving either violent, accidental, or sudden death. WiUi children and adolescents, therefore, it is especially important to understand the potential complications imposed on the grieving process by the traumatic circumstances.
Specific postlraumatic stress reactions may adversely affect normal bereavement. For example, tiiey may actively interfere with reminiscing or reduce the emotional resources required by the child to grieve. Within a single family, differenl exposures to the trauma can create different time courses ibr recoveiy and adaptation. These discrepancies within the family may influence the type of support available to the child and create a shift in family interactions.
The UCIA Neuropsychiatrie Institute and Hospital has established a research and clinical prevention intervention program on violence, trauma, and sudden bereavement in childhood. The program responds to requests for assistance from a number of communi tics, both locally and nationally, alter extreme acts of violence or disaster. These include a sniper attack on an elemental} school playground, a hostage-taking and bombing al an elementary school, .shootings at sch(K)ls. shootings at churches, and restaurant and shopping center murders. The program also follows several populations of children exposed to different types of violence. including witnessing spousal abuse, homicide, rape, and suicidal behavior, is well as being victimized by juvenile gang violence and community violence.
During our initial clinical descriptive work at lhe L1CLA Neuropsychiatrie Institute and Hospital, we developed a slanciarci semi-structured interview formal for children exposed to violent events.0 We also adapted a postlraumatic stress reaction index iov use with children,1 developed...