572474 research-article2015
JIVXXX10.1177/0886260515572474Journal of Interpersonal ViolenceGaylord-Harden et al.
Article
Profiles of Community Violence Exposure Among African American Youth: An Examination of Desensitization to Violence Using Latent Class Analysis
Journal of Interpersonal Violence 1–25 © The Author(s) 2015 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/0886260515572474 jiv.sagepub.com
Noni K. Gaylord-Harden,1 Daniel Dickson,1 and Cynthia Pierre1
Abstract The current study employed latent class analysis (LCA) to identify distinct profiles of community violence exposure and their associations to desensitization outcomes in 241 African American early adolescents (M age = 12.86, SD = 1.28) in the sixth through eighth grade from underresourced urban communities. Participants self-reported on their exposure to community violence, as well as on depressive and anxiety symptoms. The LCA revealed three distinct classes: a class exposed to low levels of violence (low exposure class), a class exposed to moderately high levels of victimization (victimization class), and a class exposed to high levels of all types of violence (high exposure class). Consistent with predictions, the high exposure class showed the lowest levels of depressive symptoms, suggesting a desensitization outcome. Gender and age were also examined in relation to the classes, and age was significantly associated with an increased risk of being a member of the high exposure class relative to the low exposure 1Loyola
University Chicago, IL, USA
Corresponding Author: Noni K. Gaylord-Harden, Department of Psychology, Loyola University Chicago, 1032 W. Sheridan Rd., Chicago, IL 60660, USA. Email: [email protected]
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class. Using person-based analyses to examine desensitization outcomes provides useful information for prevention and intervention efforts, as it helps to identify a specific subgroup of youth that may be more likely to show desensitization outcomes in the context of community violence. Keywords community violence, mental health and violence, violence exposure Although there have been some successful efforts to curtail violence and crime in urban communities, African American adolescents who reside in these communities remain vulnerable to high levels of exposure to community violence (Busby, Lambert, & Ialongo, 2013; Gibson, Morris, & Beaver, 2009). Furthermore, the pathologic adaptation model (PAM) suggests that youth exposed to high levels of community violence become desensitized by showing lower than expected levels of emotional distress (e.g., Ng-Mak, Salzinger, Feldman, & Stueve, 2004). Indeed, the existing research demonstrating desensitization outcomes for youth exposed to community violence show that community violence predicts lower levels of emotional distress, suggestive of emotional numbing (Ng-Mak et al., 2004). What is unclear is how variability in community violence exposure among African American youth from low-income, urban neighborhoods is related to differences in desensitization outcomes. Person-based statistical approaches can provide insight into patterns of variability (Masten, 1999) that may provide information about desensitization outcomes based on levels of violence exposure. Thus, the current study employed person-centered analytic procedures, namely latent class analysis (LCA), to identify distinct profiles of community violence exposure in African American youth.
Exposure to Violence in African American Youth As noted in several reviews of the literature, community violence research often groups youth’s exposure to violence into two main categories: being a victim of violence and witnessing violence that happens to others (Fowler, Tompsett, Braciszewski, Jacques-Tiura, & Baltes, 2009; McDonald & Richmond, 2008; Stein, Jaycox, Kataoka, Rhodes, & Vestal, 2003). Victimization is conceptualized as being the object of intentional acts initiated by another person to cause harm, such as being threatened, robbed, physically attacked, shot, or stabbed, whereas witnessing is conceptualized as hearing, seeing, or hearing about an event that involves loss of property,
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threat of physical injury, actual injury, or death (Fowler et al., 2009). Compared with youth from other ethnic and socioeconomic status groups, African American youth from under-resourced, urban communities are exposed to disproportionately higher levels of community violence (Zimmerman & Messner, 2013). Prior research shows that between 45% and 96% of African American youth have witnessed violence in their community, ranging from assault to murder (Gaylord-Harden, Cunningham, & Zelencik, 2011; Margolin & Gordis, 2000; Self-Brown et al., 2006), and estimates ranging from 16% to 37% report violent victimization (Farrell & Bruce, 1997; Spano & Bolland, 2013). Exposure is often repeated and ongoing, with 75% of African American youth reporting having witnessed four or more violent events during adolescence (Miller, Wasserman, Neugebauer, GormanSmith, & Kamboukos, 1999). The deleterious effects of exposure to violence on numerous emotional and behavioral outcomes in African American youth are well documented (Gorman-Smith, Henry, & Tolan, 2004; Kliewer et al., 2004; Ozer & Weinstein, 2004; Sullivan, Kung, & Farrell, 2004), consistent with current theory and practice asserting that high levels of community violence exposure lead to more emotional distress and more behavioral problems. However, these cumulative stress models do not explain why some African American youth exposed to high levels of community violence show lower than expected levels of emotional distress (Boxer et al., 2008). Specifically, several studies have found surprisingly low associations between community violence and depressive symptoms (Cooley-Quille, Boyd, Frantz, & Walsh, 2001; Farrell & Bruce, 1997; Fitzpatrick, 1993; Moses, 1999). In other words, higher levels of violence exposure do not always predict higher levels of depressive symptoms. The unexpected findings for depression may reflect a desensitization process, in which youth “adapt” to repeated exposure by normalizing violence and suppressing emotional distress, such as depressive affect or symptoms (Cooley-Quille & Lorion, 1999; Fitzpatrick & Boldizar, 1993; McCart et al., 2007; Mrug, Loosier, & Windle, 2008). The PAM (Ng-Mak et al., 2004) provides a framework for desensitization to community violence, but focuses on emotional desensitization. Emotional desensitization occurs when an individual experiences a numbing or blunting of emotional reactions to violence exposure, which should typically elicit a strong emotional response (Funk, Baldacci, Pasold, & Baumgardner, 2004). For youth exposed to community violence, affective symptoms of sadness, emptiness, or worthlessness may be blunted. This emotional desensitization process appears adaptive in the shortterm for decreasing emotional distress, but places youth at elevated risk for violence perpetration and additional violence exposure (Ng-Mak, Salzinger,
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Feldman, & Stueve, 2002, 2004). Specifically, youth who experience emotional desensitization may begin to view violent and aggressive behavior as normative, lose inhibitions about using violent behavior, and use more dangerous self-protective behaviors (e.g., carrying a weapon; Gorman-Smith & Tolan, 1998; Guerra, Huesmann, & Spindler, 2003; Jenkins & Bell, 1994; Reese, Vera, Thompson, & Reyes, 2001; Spano, Rivera, & Bolland, 2010), leading to other problems. Indeed, research has shown that higher levels of community violence exposure predict higher levels of delinquent behaviors in youth (e.g., Patchin, Huebner, McCluskey, Varano, & Bynum, 2006) and behavioral problems at school (Aisenberg & Mennen, 2000). While the PAM provides a framework for researchers to begin to examine emotional desensitization to community violence, the research on desensitization to media violence suggests that individuals may also become desensitized in other ways. For example, physiological desensitization occurs when there is a reduction in physiological reactivity (e.g., heart rate, galvanic skin response) to violence (Carnagey, Anderson, & Bushman, 2007; Funk et al., 2004). Physiological desensitization suggests that individuals experience less physiological arousal, indicative of anxiety or fear, as a result of violence exposure. This form of desensitization has been studied frequently in media violence research, and while this research shows that prolonged exposure to violent video games results in physiological desensitization (Carnagey et al., 2007), the literature on physiological desensitization to community violence is less clear. Specifically, in contrast to depressive symptoms, exposure to community violence has shown relatively consistent associations with higher levels of physiological hyperarousal (e.g., somatic tension, panic, and nervousness; Cooley-Quille et al., 2001; Margolin & Gordis, 2000; Singer, Anglin, Song, & Lunghofer, 1995). For youth in communities with elevated crime rates and violence, repeated exposure to community violence may increase hyperarousal or hypervigilance to help youth recognize and respond to threatening situations (LeDoux, 1993; Schell, Marshall, & Jaycox, 2004). Thus, decreases in depressive affect, indicative of emotional desensitization, coupled with increases in anxiety, indicative of physiological hypersensitization, may be a consequential pattern of outcomes for community violence exposure. Prior research with African American youth demonstrated that the association between community violence and depression was curvilinear (suggestive of emotional desensitization), whereas the association to anxiety was linear and positive (suggestive of physiological desensitization; GaylordHarden et al., 2011). These patterns of findings suggest that it may be important to examine separately the effects of community violence on depression and anxiety, as desensitization effects may be specific to depression. In addition, there is a need to understand how much variability exists within African
Downloaded from jiv.sagepub.com at WESTERN OREGON UNIVERSITY on June 7, 2015
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American youth from low-income communities with regard to violence exposure and violence-related outcomes, such as depression and anxiety.
The Use of Profile Analyses to Examine Desensitization to Community Violence Person-based statistical approaches, such as LCA, can provide insight into patterns of variability within data (Mandara, 2003; Masten, 1999) by identifying distinct groups or classes of youth. In person-based analysis, the relevant aspect of the analysis is the profile of scores, and not the impact of an individual variable (Bergman & Magnusson, 1997). Despite the utility of person-based analyses, these methods have not been widely used in exposure to community violence research and, to our knowledge, have not been used in an investigation of emotional desensitization to violence. Two existing studies using person-based analyses with African American adolescents from urban communities identified distinct profiles of participants based on community violence exposure (Copeland-Linder, Lambert, & Ialongo, 2010; Ronzio, Mitchell, & Wang, 2011). However, additional research is needed to build upon prior research, as these studies did not specifically assess desensitization to violence outcomes, and Ronzio et al. (2011) focused only on witnessing violence in African American mothers. Given the heightened risk of future violence perpetration by youth who become desensitized, identification of distinct groups of adolescents based on levels of violence exposure will provide information on the prevalence of desensitization, as well as which adolescents may be particularly vulnerable to emotional desensitization and should be targeted for intervention.
Effects of Gender and Age on Violence Exposure In general, boys of all ethnicities are exposed to higher rates of community violence than girls (Boyd, Cooley, Lambert, & Ialongo, 2003; Chen, 2009; Weist, Acosta, & Youngstrom, 2001), and one in four African American boys report being victimized (e.g., beaten or shot at), compared with 12% of African American females (Chen, 2009), often more than once during adolescence (Gaylord-Harden et al., 2011). Furthermore, gender socialization theories suggest that girls are more inclined to internalize their problems and boys to externalize their problems (Nolen-Hoeksema, 1994). Indeed, male adolescents report more self-protective (e.g., carrying a weapon) and aggressive behaviors in response to witnessing violence, while female adolescents report more depressive symptoms (Jenkins & Bell, 1994; Reese et al., 2001;
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Self-Brown et al., 2006). Given that males are exposed to higher levels of community violence than females, but show lower levels of internalizing symptoms in response to violence exposure, emotional desensitization in response to violence may be more likely to occur in males than in females (Ng-Mak et al., 2002). Although some findings show that older youth are exposed to more violence than younger youth (e.g., Weist et al., 2001), reviews of the literature suggest that the association between age and exposure to violence is equivocal (e.g., Stein et al., 2003). Alternatively, recent meta-analytic findings suggest that age may moderate the effects of violence exposure on outcomes. Specifically, younger children are more likely to experience internalizing symptoms in response to community violence, whereas adolescents are more likely to experience externalizing symptoms (Fowler et al., 2009). Therefore, desensitization to community violence may be more likely to occur as children and adolescents get older. Over time, as youth age, they may be more likely to normalize their experiences of violence and, in turn, experience less emotional distress and more aggressive means of coping with violence exposure (Gorman-Smith & Tolan, 1998; Guerra et al., 2003).
The Current Study As shown above, LCA can categorize youth based on their exposure to violence into different exposure groups and might provide insight into how different naturally occurring “profiles” of exposure to community violence (ECV) relate to outcomes. The identification of subgroups may provide critical information on subgroups of violence-exposed adolescents to target for prevention and intervention efforts (Copeland-Linder et al., 2010; Fowler et al., 2009). Adolescence is an ideal developmental stage to examine such patterns in violence exposure, as behavioral patterns related to violence and aggression, which may emerge during childhood or early adolescence, reach their peak prevalence during this time (e.g., Tolan, Gorman-Smith, & Henry, 2003). Community violence can be disruptive to optimal development by increasing the likelihood of violence perpetration, risky behaviors, and increased associations with deviant peer groups (Fowler et al., 2009; Ingoldsby & Shaw, 2002). The onset of internalizing symptomatology during adolescence, heightened by community violence exposure, predicts a more chronic course for symptoms, which has long-term implications for social, emotional, and cognitive development (e.g., Woodward & Fergusson, 2001). Thus, the purpose of the current study is to employ person-centered analytic procedures, namely LCA, to identify distinct profiles of community violence exposure in African American adolescents. Consistent with prior
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research (Copeland-Linder et al., 2010; Ronzio et al., 2011), we expected the LCA to result in at least two classes of participants, based on low and high levels of ECV. However, we did not have predictions about the specific compositions of other possible classes. Also based on prior research, it was predicted that classes with high exposure to community violence would include significantly more males than females and a significantly greater percentage of older youth than younger youth. It was also predicted that classes that report higher levels of ECV would show fewer symptoms of depression and higher symptoms of anxiety, indicative of emotional desensitization and physiological hypersensitization. Finally, it was predicted that males and older adolescents within high exposure classes would show fewer symptoms of depression (indicative of emotional desensitization) than females and younger adolescents in these classes.
Method Participants Participants in the current study were 241 (56% female; M age = 12.86, SD = 1.28) African American early adolescents in the sixth through eighth grade (ages 11-15) from five public schools in urban areas. Participants were part of a larger study designed to assess the effects of stress and coping on internalizing symptoms in African American youth from economically disadvantaged communities. Public schools were selected for participation based on high percentages of low-income students and Black students, as gathered from the school system’s annual reports, which include distributions of students’ socioeconomic status and race. The average percentage of Black students at the five schools was 93%, and the average percentage of low-income students, based on eligibility for free or reduced meals programs, was 90%. The participation rate across the five schools was approximately 50%. Thirtyeight percent of the participants were enrolled in the sixth grade, 26% were in the seventh grade, and 36% were in the eighth grade. Approximately 47% resided with their mother, 42% resided with both their parents, and the remaining 11% resided with other relatives (e.g., grandparent).
Procedure The current study was granted ethical approval by a university-based institutional review board (IRB). Researchers visited the selected schools and met with faculty and staff to introduce the project and describe the procedures of recruitment and data collection. A recruitment letter and consent form were
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sent home with all sixth- through eighth-grade students. Active parental consent and youth assent were obtained for all study participants. Youth receiving parental consent and providing youth assent were taken to a room designated by the school staff (e.g., classroom, library) to complete a packet of questionnaires in a group setting. At least two research assistants were available to administer the surveys, answer questions, and monitor the progress of participants. Teachers were not present during data collection. To manage the range in reading levels of the participants, the research assistants read all questions aloud. Each participant received a movie pass for his or her participation in the study.
Measures Demographic form. Participants reported their age, grade, gender, race/ethnicity, primary caregiver, and number of people living in the home. Victimization and witnessing community violence. Participants’ experiences of victimization and witnessing violence in the community were assessed using the Multicultural Events Schedule for Adolescents (MESA; Gonzales, Gunnoe, Jackson, & Samaniego, 1995). The MESA is an 82-item self-report measure of stress for adolescents living in an urban environment. Participants rate the occurrence of the stressful events that have happened over the past 3 months by selecting “happened” or “did not happen.” The current study utilized the specified time range, rather than lifetime exposure, consistent with the recommendation that researchers interested in minimizing recall bias for reports of victimization should use specified time ranges (Finkelhor, Ormrod, & Turner, 2009). Two-week test–retest reliability of the MESA was .71 (Gonzales et al., 1995), and for African American youth, it was .81 (Gonzales et al., 1995). The MESA includes four items that assess victimization in the community. A sample item includes, “You were threatened with a knife or gun.” Higher scores indicate a higher level of victimization. In the current sample, Cronbach’s alpha for the four victimization items was .47. However, given that the current study used an item-level LCA, individual items assessing victimization, rather than an overall subscale score, were used in the analyses. The MESA includes six items that assess witnessing community violence. A sample item includes, “Someone close to you was shot or attacked.” Higher scores indicate a higher level of witnessing violence. In the current sample, Cronbach’s alpha for the six witnessing violence items was .77. However, given that the current study used an item-level LCA, individual items assessing witnessing, rather than an overall subscale score, were used in the analyses.
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Depressive symptoms. Depressive symptomatology was assessed with the 27-item Child Depression Inventory (CDI; Kovacs, 1992). For each item, respondents select one of three sentences that most closely describes him or her over the past 2 weeks (“I am sad once in a while, I am sad many times, I am sad all the time”). The 27 items are combined to provide an overall depression score; higher scores indicate higher levels of depression. Reliability and validity of the CDI are well-established (Kovacs, 1992). Internal consistency estimates for the overall depression score in African American youth have ranged from .81 to .84 (Dempsey, 2002; Fitzpatrick, 1993; Johnson & Kliewer, 1999; McMahon & Watts, 2002). Cronbach’s alpha for the overall depression score in the current sample was .85. Anxiety symptoms. Anxiety symptoms were assessed with the Revised Children’s Manifest Anxiety Scale (RCMAS; Reynolds & Richmond, 1997). The RCMAS contains 37 sentences to which the respondent is asked to respond “yes” or “no.” Of the 37 items, 28 measure anxiety symptoms (“I worry a lot of the time”), and 9 assess socially desirable responding. The 28 items are combined to provide an overall anxiety score. Higher scores indicate higher levels of anxiety. The reliability and validity of the measure are wellestablished (Reynolds & Richmond, 1997). Internal consistency estimates for the overall anxiety score in African American youth have ranged from .84 to .86 (Kliewer & Kung, 1998; McMahon & Watts, 2002; White, Bruce, Farrell, & Kliewer, 1998). Cronbach’s alpha for the overall anxiety score in the current sample was .89.
Results Analysis Procedure LCA was used to analyze community violence exposure among the participants. Similar to cluster analysis, LCA is a person-centered analytical approach that detects unobserved heterogeneous subpopulations, which are latent classes, in the given sample. LCA differs from cluster analysis as classes are based on response probabilities as opposed to distances from the group mean. In essence, this probability model accommodates unequal degrees of variance for each individual cluster. One of the complexities of LCA is that there are difficulties comparing LCA models with different numbers of classes because they are not “nested” within one another. To determine the optimal number of latent classes, likelihood ratio tests cannot be used to make comparisons, and therefore the Akaike Information Criterion (AIC; Akaike, 1987), Bayesian Information
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Table 1. Information Criteria, Entropy, and Likelihood Ratio Test Values. Fit Indices and Entropy of the Growth Mixture Models Model
Log Likelihood
AIC
BIC
ABIC
Entropy
BLMR LR
1 class 2 class 3 class 4 class
−1,415.432 −1,226.095 −1,200.041 −1,190.827
2,850.864 2,494.190 2,464.081 2,467.655
2,885.711 2,567.370 2,575.595 2,617.501
2,854.014 2,500.805 2,474.162 2,481.200
.811 .736 .756
JIVXXX10.1177/0886260515572474Journal of Interpersonal ViolenceGaylord-Harden et al.
Article
Profiles of Community Violence Exposure Among African American Youth: An Examination of Desensitization to Violence Using Latent Class Analysis
Journal of Interpersonal Violence 1–25 © The Author(s) 2015 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/0886260515572474 jiv.sagepub.com
Noni K. Gaylord-Harden,1 Daniel Dickson,1 and Cynthia Pierre1
Abstract The current study employed latent class analysis (LCA) to identify distinct profiles of community violence exposure and their associations to desensitization outcomes in 241 African American early adolescents (M age = 12.86, SD = 1.28) in the sixth through eighth grade from underresourced urban communities. Participants self-reported on their exposure to community violence, as well as on depressive and anxiety symptoms. The LCA revealed three distinct classes: a class exposed to low levels of violence (low exposure class), a class exposed to moderately high levels of victimization (victimization class), and a class exposed to high levels of all types of violence (high exposure class). Consistent with predictions, the high exposure class showed the lowest levels of depressive symptoms, suggesting a desensitization outcome. Gender and age were also examined in relation to the classes, and age was significantly associated with an increased risk of being a member of the high exposure class relative to the low exposure 1Loyola
University Chicago, IL, USA
Corresponding Author: Noni K. Gaylord-Harden, Department of Psychology, Loyola University Chicago, 1032 W. Sheridan Rd., Chicago, IL 60660, USA. Email: [email protected]
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class. Using person-based analyses to examine desensitization outcomes provides useful information for prevention and intervention efforts, as it helps to identify a specific subgroup of youth that may be more likely to show desensitization outcomes in the context of community violence. Keywords community violence, mental health and violence, violence exposure Although there have been some successful efforts to curtail violence and crime in urban communities, African American adolescents who reside in these communities remain vulnerable to high levels of exposure to community violence (Busby, Lambert, & Ialongo, 2013; Gibson, Morris, & Beaver, 2009). Furthermore, the pathologic adaptation model (PAM) suggests that youth exposed to high levels of community violence become desensitized by showing lower than expected levels of emotional distress (e.g., Ng-Mak, Salzinger, Feldman, & Stueve, 2004). Indeed, the existing research demonstrating desensitization outcomes for youth exposed to community violence show that community violence predicts lower levels of emotional distress, suggestive of emotional numbing (Ng-Mak et al., 2004). What is unclear is how variability in community violence exposure among African American youth from low-income, urban neighborhoods is related to differences in desensitization outcomes. Person-based statistical approaches can provide insight into patterns of variability (Masten, 1999) that may provide information about desensitization outcomes based on levels of violence exposure. Thus, the current study employed person-centered analytic procedures, namely latent class analysis (LCA), to identify distinct profiles of community violence exposure in African American youth.
Exposure to Violence in African American Youth As noted in several reviews of the literature, community violence research often groups youth’s exposure to violence into two main categories: being a victim of violence and witnessing violence that happens to others (Fowler, Tompsett, Braciszewski, Jacques-Tiura, & Baltes, 2009; McDonald & Richmond, 2008; Stein, Jaycox, Kataoka, Rhodes, & Vestal, 2003). Victimization is conceptualized as being the object of intentional acts initiated by another person to cause harm, such as being threatened, robbed, physically attacked, shot, or stabbed, whereas witnessing is conceptualized as hearing, seeing, or hearing about an event that involves loss of property,
Downloaded from jiv.sagepub.com at WESTERN OREGON UNIVERSITY on June 7, 2015
Gaylord-Harden et al.
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threat of physical injury, actual injury, or death (Fowler et al., 2009). Compared with youth from other ethnic and socioeconomic status groups, African American youth from under-resourced, urban communities are exposed to disproportionately higher levels of community violence (Zimmerman & Messner, 2013). Prior research shows that between 45% and 96% of African American youth have witnessed violence in their community, ranging from assault to murder (Gaylord-Harden, Cunningham, & Zelencik, 2011; Margolin & Gordis, 2000; Self-Brown et al., 2006), and estimates ranging from 16% to 37% report violent victimization (Farrell & Bruce, 1997; Spano & Bolland, 2013). Exposure is often repeated and ongoing, with 75% of African American youth reporting having witnessed four or more violent events during adolescence (Miller, Wasserman, Neugebauer, GormanSmith, & Kamboukos, 1999). The deleterious effects of exposure to violence on numerous emotional and behavioral outcomes in African American youth are well documented (Gorman-Smith, Henry, & Tolan, 2004; Kliewer et al., 2004; Ozer & Weinstein, 2004; Sullivan, Kung, & Farrell, 2004), consistent with current theory and practice asserting that high levels of community violence exposure lead to more emotional distress and more behavioral problems. However, these cumulative stress models do not explain why some African American youth exposed to high levels of community violence show lower than expected levels of emotional distress (Boxer et al., 2008). Specifically, several studies have found surprisingly low associations between community violence and depressive symptoms (Cooley-Quille, Boyd, Frantz, & Walsh, 2001; Farrell & Bruce, 1997; Fitzpatrick, 1993; Moses, 1999). In other words, higher levels of violence exposure do not always predict higher levels of depressive symptoms. The unexpected findings for depression may reflect a desensitization process, in which youth “adapt” to repeated exposure by normalizing violence and suppressing emotional distress, such as depressive affect or symptoms (Cooley-Quille & Lorion, 1999; Fitzpatrick & Boldizar, 1993; McCart et al., 2007; Mrug, Loosier, & Windle, 2008). The PAM (Ng-Mak et al., 2004) provides a framework for desensitization to community violence, but focuses on emotional desensitization. Emotional desensitization occurs when an individual experiences a numbing or blunting of emotional reactions to violence exposure, which should typically elicit a strong emotional response (Funk, Baldacci, Pasold, & Baumgardner, 2004). For youth exposed to community violence, affective symptoms of sadness, emptiness, or worthlessness may be blunted. This emotional desensitization process appears adaptive in the shortterm for decreasing emotional distress, but places youth at elevated risk for violence perpetration and additional violence exposure (Ng-Mak, Salzinger,
Downloaded from jiv.sagepub.com at WESTERN OREGON UNIVERSITY on June 7, 2015
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Journal of Interpersonal Violence
Feldman, & Stueve, 2002, 2004). Specifically, youth who experience emotional desensitization may begin to view violent and aggressive behavior as normative, lose inhibitions about using violent behavior, and use more dangerous self-protective behaviors (e.g., carrying a weapon; Gorman-Smith & Tolan, 1998; Guerra, Huesmann, & Spindler, 2003; Jenkins & Bell, 1994; Reese, Vera, Thompson, & Reyes, 2001; Spano, Rivera, & Bolland, 2010), leading to other problems. Indeed, research has shown that higher levels of community violence exposure predict higher levels of delinquent behaviors in youth (e.g., Patchin, Huebner, McCluskey, Varano, & Bynum, 2006) and behavioral problems at school (Aisenberg & Mennen, 2000). While the PAM provides a framework for researchers to begin to examine emotional desensitization to community violence, the research on desensitization to media violence suggests that individuals may also become desensitized in other ways. For example, physiological desensitization occurs when there is a reduction in physiological reactivity (e.g., heart rate, galvanic skin response) to violence (Carnagey, Anderson, & Bushman, 2007; Funk et al., 2004). Physiological desensitization suggests that individuals experience less physiological arousal, indicative of anxiety or fear, as a result of violence exposure. This form of desensitization has been studied frequently in media violence research, and while this research shows that prolonged exposure to violent video games results in physiological desensitization (Carnagey et al., 2007), the literature on physiological desensitization to community violence is less clear. Specifically, in contrast to depressive symptoms, exposure to community violence has shown relatively consistent associations with higher levels of physiological hyperarousal (e.g., somatic tension, panic, and nervousness; Cooley-Quille et al., 2001; Margolin & Gordis, 2000; Singer, Anglin, Song, & Lunghofer, 1995). For youth in communities with elevated crime rates and violence, repeated exposure to community violence may increase hyperarousal or hypervigilance to help youth recognize and respond to threatening situations (LeDoux, 1993; Schell, Marshall, & Jaycox, 2004). Thus, decreases in depressive affect, indicative of emotional desensitization, coupled with increases in anxiety, indicative of physiological hypersensitization, may be a consequential pattern of outcomes for community violence exposure. Prior research with African American youth demonstrated that the association between community violence and depression was curvilinear (suggestive of emotional desensitization), whereas the association to anxiety was linear and positive (suggestive of physiological desensitization; GaylordHarden et al., 2011). These patterns of findings suggest that it may be important to examine separately the effects of community violence on depression and anxiety, as desensitization effects may be specific to depression. In addition, there is a need to understand how much variability exists within African
Downloaded from jiv.sagepub.com at WESTERN OREGON UNIVERSITY on June 7, 2015
Gaylord-Harden et al.
5
American youth from low-income communities with regard to violence exposure and violence-related outcomes, such as depression and anxiety.
The Use of Profile Analyses to Examine Desensitization to Community Violence Person-based statistical approaches, such as LCA, can provide insight into patterns of variability within data (Mandara, 2003; Masten, 1999) by identifying distinct groups or classes of youth. In person-based analysis, the relevant aspect of the analysis is the profile of scores, and not the impact of an individual variable (Bergman & Magnusson, 1997). Despite the utility of person-based analyses, these methods have not been widely used in exposure to community violence research and, to our knowledge, have not been used in an investigation of emotional desensitization to violence. Two existing studies using person-based analyses with African American adolescents from urban communities identified distinct profiles of participants based on community violence exposure (Copeland-Linder, Lambert, & Ialongo, 2010; Ronzio, Mitchell, & Wang, 2011). However, additional research is needed to build upon prior research, as these studies did not specifically assess desensitization to violence outcomes, and Ronzio et al. (2011) focused only on witnessing violence in African American mothers. Given the heightened risk of future violence perpetration by youth who become desensitized, identification of distinct groups of adolescents based on levels of violence exposure will provide information on the prevalence of desensitization, as well as which adolescents may be particularly vulnerable to emotional desensitization and should be targeted for intervention.
Effects of Gender and Age on Violence Exposure In general, boys of all ethnicities are exposed to higher rates of community violence than girls (Boyd, Cooley, Lambert, & Ialongo, 2003; Chen, 2009; Weist, Acosta, & Youngstrom, 2001), and one in four African American boys report being victimized (e.g., beaten or shot at), compared with 12% of African American females (Chen, 2009), often more than once during adolescence (Gaylord-Harden et al., 2011). Furthermore, gender socialization theories suggest that girls are more inclined to internalize their problems and boys to externalize their problems (Nolen-Hoeksema, 1994). Indeed, male adolescents report more self-protective (e.g., carrying a weapon) and aggressive behaviors in response to witnessing violence, while female adolescents report more depressive symptoms (Jenkins & Bell, 1994; Reese et al., 2001;
Downloaded from jiv.sagepub.com at WESTERN OREGON UNIVERSITY on June 7, 2015
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Self-Brown et al., 2006). Given that males are exposed to higher levels of community violence than females, but show lower levels of internalizing symptoms in response to violence exposure, emotional desensitization in response to violence may be more likely to occur in males than in females (Ng-Mak et al., 2002). Although some findings show that older youth are exposed to more violence than younger youth (e.g., Weist et al., 2001), reviews of the literature suggest that the association between age and exposure to violence is equivocal (e.g., Stein et al., 2003). Alternatively, recent meta-analytic findings suggest that age may moderate the effects of violence exposure on outcomes. Specifically, younger children are more likely to experience internalizing symptoms in response to community violence, whereas adolescents are more likely to experience externalizing symptoms (Fowler et al., 2009). Therefore, desensitization to community violence may be more likely to occur as children and adolescents get older. Over time, as youth age, they may be more likely to normalize their experiences of violence and, in turn, experience less emotional distress and more aggressive means of coping with violence exposure (Gorman-Smith & Tolan, 1998; Guerra et al., 2003).
The Current Study As shown above, LCA can categorize youth based on their exposure to violence into different exposure groups and might provide insight into how different naturally occurring “profiles” of exposure to community violence (ECV) relate to outcomes. The identification of subgroups may provide critical information on subgroups of violence-exposed adolescents to target for prevention and intervention efforts (Copeland-Linder et al., 2010; Fowler et al., 2009). Adolescence is an ideal developmental stage to examine such patterns in violence exposure, as behavioral patterns related to violence and aggression, which may emerge during childhood or early adolescence, reach their peak prevalence during this time (e.g., Tolan, Gorman-Smith, & Henry, 2003). Community violence can be disruptive to optimal development by increasing the likelihood of violence perpetration, risky behaviors, and increased associations with deviant peer groups (Fowler et al., 2009; Ingoldsby & Shaw, 2002). The onset of internalizing symptomatology during adolescence, heightened by community violence exposure, predicts a more chronic course for symptoms, which has long-term implications for social, emotional, and cognitive development (e.g., Woodward & Fergusson, 2001). Thus, the purpose of the current study is to employ person-centered analytic procedures, namely LCA, to identify distinct profiles of community violence exposure in African American adolescents. Consistent with prior
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research (Copeland-Linder et al., 2010; Ronzio et al., 2011), we expected the LCA to result in at least two classes of participants, based on low and high levels of ECV. However, we did not have predictions about the specific compositions of other possible classes. Also based on prior research, it was predicted that classes with high exposure to community violence would include significantly more males than females and a significantly greater percentage of older youth than younger youth. It was also predicted that classes that report higher levels of ECV would show fewer symptoms of depression and higher symptoms of anxiety, indicative of emotional desensitization and physiological hypersensitization. Finally, it was predicted that males and older adolescents within high exposure classes would show fewer symptoms of depression (indicative of emotional desensitization) than females and younger adolescents in these classes.
Method Participants Participants in the current study were 241 (56% female; M age = 12.86, SD = 1.28) African American early adolescents in the sixth through eighth grade (ages 11-15) from five public schools in urban areas. Participants were part of a larger study designed to assess the effects of stress and coping on internalizing symptoms in African American youth from economically disadvantaged communities. Public schools were selected for participation based on high percentages of low-income students and Black students, as gathered from the school system’s annual reports, which include distributions of students’ socioeconomic status and race. The average percentage of Black students at the five schools was 93%, and the average percentage of low-income students, based on eligibility for free or reduced meals programs, was 90%. The participation rate across the five schools was approximately 50%. Thirtyeight percent of the participants were enrolled in the sixth grade, 26% were in the seventh grade, and 36% were in the eighth grade. Approximately 47% resided with their mother, 42% resided with both their parents, and the remaining 11% resided with other relatives (e.g., grandparent).
Procedure The current study was granted ethical approval by a university-based institutional review board (IRB). Researchers visited the selected schools and met with faculty and staff to introduce the project and describe the procedures of recruitment and data collection. A recruitment letter and consent form were
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sent home with all sixth- through eighth-grade students. Active parental consent and youth assent were obtained for all study participants. Youth receiving parental consent and providing youth assent were taken to a room designated by the school staff (e.g., classroom, library) to complete a packet of questionnaires in a group setting. At least two research assistants were available to administer the surveys, answer questions, and monitor the progress of participants. Teachers were not present during data collection. To manage the range in reading levels of the participants, the research assistants read all questions aloud. Each participant received a movie pass for his or her participation in the study.
Measures Demographic form. Participants reported their age, grade, gender, race/ethnicity, primary caregiver, and number of people living in the home. Victimization and witnessing community violence. Participants’ experiences of victimization and witnessing violence in the community were assessed using the Multicultural Events Schedule for Adolescents (MESA; Gonzales, Gunnoe, Jackson, & Samaniego, 1995). The MESA is an 82-item self-report measure of stress for adolescents living in an urban environment. Participants rate the occurrence of the stressful events that have happened over the past 3 months by selecting “happened” or “did not happen.” The current study utilized the specified time range, rather than lifetime exposure, consistent with the recommendation that researchers interested in minimizing recall bias for reports of victimization should use specified time ranges (Finkelhor, Ormrod, & Turner, 2009). Two-week test–retest reliability of the MESA was .71 (Gonzales et al., 1995), and for African American youth, it was .81 (Gonzales et al., 1995). The MESA includes four items that assess victimization in the community. A sample item includes, “You were threatened with a knife or gun.” Higher scores indicate a higher level of victimization. In the current sample, Cronbach’s alpha for the four victimization items was .47. However, given that the current study used an item-level LCA, individual items assessing victimization, rather than an overall subscale score, were used in the analyses. The MESA includes six items that assess witnessing community violence. A sample item includes, “Someone close to you was shot or attacked.” Higher scores indicate a higher level of witnessing violence. In the current sample, Cronbach’s alpha for the six witnessing violence items was .77. However, given that the current study used an item-level LCA, individual items assessing witnessing, rather than an overall subscale score, were used in the analyses.
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Depressive symptoms. Depressive symptomatology was assessed with the 27-item Child Depression Inventory (CDI; Kovacs, 1992). For each item, respondents select one of three sentences that most closely describes him or her over the past 2 weeks (“I am sad once in a while, I am sad many times, I am sad all the time”). The 27 items are combined to provide an overall depression score; higher scores indicate higher levels of depression. Reliability and validity of the CDI are well-established (Kovacs, 1992). Internal consistency estimates for the overall depression score in African American youth have ranged from .81 to .84 (Dempsey, 2002; Fitzpatrick, 1993; Johnson & Kliewer, 1999; McMahon & Watts, 2002). Cronbach’s alpha for the overall depression score in the current sample was .85. Anxiety symptoms. Anxiety symptoms were assessed with the Revised Children’s Manifest Anxiety Scale (RCMAS; Reynolds & Richmond, 1997). The RCMAS contains 37 sentences to which the respondent is asked to respond “yes” or “no.” Of the 37 items, 28 measure anxiety symptoms (“I worry a lot of the time”), and 9 assess socially desirable responding. The 28 items are combined to provide an overall anxiety score. Higher scores indicate higher levels of anxiety. The reliability and validity of the measure are wellestablished (Reynolds & Richmond, 1997). Internal consistency estimates for the overall anxiety score in African American youth have ranged from .84 to .86 (Kliewer & Kung, 1998; McMahon & Watts, 2002; White, Bruce, Farrell, & Kliewer, 1998). Cronbach’s alpha for the overall anxiety score in the current sample was .89.
Results Analysis Procedure LCA was used to analyze community violence exposure among the participants. Similar to cluster analysis, LCA is a person-centered analytical approach that detects unobserved heterogeneous subpopulations, which are latent classes, in the given sample. LCA differs from cluster analysis as classes are based on response probabilities as opposed to distances from the group mean. In essence, this probability model accommodates unequal degrees of variance for each individual cluster. One of the complexities of LCA is that there are difficulties comparing LCA models with different numbers of classes because they are not “nested” within one another. To determine the optimal number of latent classes, likelihood ratio tests cannot be used to make comparisons, and therefore the Akaike Information Criterion (AIC; Akaike, 1987), Bayesian Information
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Table 1. Information Criteria, Entropy, and Likelihood Ratio Test Values. Fit Indices and Entropy of the Growth Mixture Models Model
Log Likelihood
AIC
BIC
ABIC
Entropy
BLMR LR
1 class 2 class 3 class 4 class
−1,415.432 −1,226.095 −1,200.041 −1,190.827
2,850.864 2,494.190 2,464.081 2,467.655
2,885.711 2,567.370 2,575.595 2,617.501
2,854.014 2,500.805 2,474.162 2,481.200
.811 .736 .756
