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Violence exposure and traumatic stress reactions can lead to poor health in children

Elsevier Health Sciences

The link between health problems and children in low income, single-mother families is not surprising; these children are also more apt to be exposed to violence and maltreatment within the community and their families. A study in the March issue of The Journal of Pediatrics examines whether traumatic stress reactions in children due to these adverse childhood experiences also play a role in predicting their health.

Sandra Graham-Bermann, Ph.D. and Julia Seng, Ph.D., CNM, from the University of Michigan interviewed the mothers and teachers of 160 children, ages four through six, recruited from Head Start programs in two Michigan counties. They found that 65% of the children were exposed to at least one incident of violence in their communities, which ranged from less severe (beatings and chasings) to severe (shootings, stabbings, and rapes). 47% were exposed to at least one incident of violence in their families, such as child maltreatment and domestic violence. 90% of those exposed to some form of violence had reactions characterized as traumatic stress (i.e. having nightmares, thumb-sucking, or bed-wetting), and 20% were at high risk for developing post traumatic stress disorder.

Nearly one-third of the children had allergies, asthma, or attention deficit hyperactivity disorder (ADHD). Children who had one or more of these three health problems were significantly more likely to have been exposed to violence within the family and to have shown signs of traumatic stress. Children with asthma or gastrointestinal problems were almost four times more likely to have post traumatic stress disorder than the children without these health problems. Dr. Graham-Bermann points out that the direction of these effects--in other words, whether post traumatic stress disorder causes illnesses or illnesses cause post traumatic stress disorder--is presently unknown. The research also indicated that substance abuse and the overall health of the mother were factors in predicting children's health problems.

While preventing family and community violence may be beyond the control of health care providers, the authors suggest that clinical interventions to increase the mothers' safety and health may improve their ability to protect their children. In addition, health care providers may be able to treat child traumatic stress symptoms or refer children exposed to violence to group or individual therapy, which may improve their health and well-being.

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The study is reported in "Violence exposure and traumatic stress symptoms as additional predictors of health problems in high-risk children" by Sandra A. Graham-Bermann, PhD and Julia Seng, PhD, CNM. The article appears in The Journal of Pediatrics, Volume 147, Number 3 (March 2005), published by Elsevier.

The Journal of Pediatrics is a primary reference for the science and ractice of pediatrics and its subspecialties. This authoritative resource of riginal, peer-reviewed articles oriented toward clinical practice helps physicians stay abreast of the latest and ever-changing developments in pediatric medicine. The Journal of Pediatrics ranks in the top 12% of the 5,907 scientific journals receiving the most citations (Science Citation Index). The Journal is published under the Mosby imprint by Elsevier, a leading global publisher of scientific, technical, and medical journals, books, and reference works. It is a member of the Reed Elsevier plc group. URL: http://www.mosby.com/jpeds

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