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Over one-third of all children had an experience with some form of threat or intimidation sometime in the last year, with one in ten incidents leading to actual injury, according to the latest results of a national, telephone-based survey on children's exposure to violence.
David Finkelhor, PhD, of the University of New Hampshire in Durham, N.H., and colleagues found that 37.3% of all youth ages 0-17 experienced physical assault, and 9.3% reported an assault with injury in the past year.
By the time children were teens ages 14-17, nearly two-thirds (63.5%) reported experiencing any physical assault and nearly a quarter (22.4%) had an assault with injury over their lifetimes, the authors wrote in JAMA Pediatrics.
While overall, the majority of assaults were from a sibling (21.8%) or a nonsibling peer (21.8%), over a third of youths 2-17 reported relational aggression (35.6%), or bullying. This number rose to 75% for teens 14-17 over their lifetime.
More than one in 10 teens reported such serious forms of assault in their lifetime, including:
- Assault with injury (22.4%)
- Assault by adult (21.6%)
- Assault with weapon (14.3%)
Examining types of assault by age, bullying was the most common type of assault for children ages 10-13, while physical intimidation was highest for children under 10; for teens 14-17, Internet harassment topped the list.
Not surprisingly, a greater portion of girls received Internet harassment than boys (10.1% versus 5.7%) in the past year, and 17.9% of teens reported receiving Internet harassment in their lifetime.
Teen girls also reported a larger percentage of sexual assault in their lifetime (14.3% versus 6.0%), including exposure to attempted/completed rape (12.9% versus 5.1%). The biggest discrepancy among girls and boys came from reported sexual harassment (20.5% versus 3.4% lifetime).
Overall, 15.2% of all youth reported maltreatment by a caregiver in the past year, though that jumped to 38.1% among older teens in their lifetime. More than one in 10 teens also reported any lifetime exposure to:
- Emotional abuse (23.9%)
- Neglect (18.4%)
- Physical abuse (18.1%)
More than two-thirds of teens 14-17 were witnesses to violence in their lifetime (68.1%). Nearly a quarter (24.5%) of all youth up to age 17 said they had witnessed violence in the last year. Older teens witnessed more serious forms of family violence in their lifetime, with 32.0% reporting any family assault and 25.0% reporting witnessing partner/domestic violence.
Though not involved with this study, Joy Friedman, MD, Section Head, Adolescent Pediatrics at Beaumont Children's Hospital in Royal Oak, Mich., said she was -- sadly -- not surprised by the large portion of children and teens exposed to assault and violence. Friedman added that this emphasized the importance of screening youth for the anxiety or depressive disorders that could arise out of these experiences.
"Mental health disorders are the most common diseases of childhood with nearly half of youth experiencing a diagnosable mental health condition before they are 18, and the majority of youth with anxiety and depressive disorders do not receive treatment," she told MedPage Today via e-mail. "Youth who have experienced bullying, assault or who have been witness to violence are at particularly high risk for developing mental health disorders like anxiety, depression, and PTSD which can be addressed by mental health providers if clinicians screen and provide such referrals."
This is the second study in less than a month to examine data from the National Survey of Children's Exposure to Violence (NatSCEV), but this study used the most recent survey data from 2014. The NatSCEV was comprised of 4,000 children ages 0-17, with answers compiled using the Juvenile Victimization Questionnaire. Caregivers provided information about children 0-10 and children 10-17 providing their own answers.
Limitations include the design of the survey, which relied on unsubstantiated reports from caregivers and children. The authors added that the brief questions may not be sufficient enough to trigger a memory in the respondent, especially if the incident happened years ago.
Friedman noted that, in some cases, a parent may simply not have known an assault had taken place, especially in the case of younger children.
"Parents of elementary school age children may not always know if their child is being bullied or if the child has experienced any assault or witnessed abuse as children may be ashamed to disclose this to a parent or to anybody. I can understand that the authors probably did not feel that they could ask such sensitive questions to young children by phone however," Friedman said.
The authors concluded that continued monitoring and prevention efforts are needed to prevent childhood exposure to violence.
"Despite these limitations, the approach taken by the NatSCEV provides a comprehensive portrait of children's exposure to violence, crime, and abuse," they wrote.
This study was supported by grants from the Office of Juvenile Justice and Delinquency Prevention, Office of Justice Programs, and the U.S. Department of Justice.
The authors disclosed no conflicts of interest.
- Reviewed by Henry A. Solomon, MD, FACP, FACC Clinical Associate Professor, Weill Cornell Medical College and Dorothy Caputo, MA, BSN, RN, Nurse Planner