Abstract
In an effort to decrease the incidence of violence in this country, multiple prevention and intervention programs have been established. As a result, the rate of violence among male adolescents has been leveled. Among female adolescents, however, violent behavior is increasing, despite the implementation of conventional programs. The purpose of this study is to examine factors that motivate adolescent girls to exhibit or to refrain from exhibiting violent behaviors. Using a health behavior model as its framework, the research focused on the linkage of a perceived sense of competence to protective factors and risk behaviors related to violence, and the identification of variables amenable to health promotion strategies.
This research, conducted as an analysis of secondary data from a national database, included a sample of 9,829 females whose average age was 16 years. Multiple racial groups and ethnicities were represented, and all subjects lived in households that included their mothers. Violent behavior was measured from a group of particular activities that were each given a weight to form a composite. Additional measurements included aspects of social and environmental characteristics, media influences, peer and school influences, family situation, health-related experiences, cognitive functioning, and affective responses. Descriptive and multivariate regression analyses were done to determine factors contributing to violence and those protective factors affecting perceived sense of competence, which lessens motivation to engage in violent behaviors.
Previous victimization by violence was found to be the most important contributing factor for predicting violence in adolescent females. The researcher indicated that girls who had earlier onset of puberty and were in networks of older peers were susceptible to sexual victimization and might respond with self-protecting, but violent, behavior. Additional significant predictors of violence included cocaine use, previous unlawful behavior, prior psychological issues such as suicide attempt, and social situations such as association with persons identified as delinquents, and having friends who fought.
Protective factors affecting the sample’s perceived sense of competence and resulting in decreased motivation to practice violent behaviors included communication with parents, experiencing school connectedness, and conflict resolution abilities. Other predictors of perceived sense of competence were physical and emotional well-being.
TAKE TO WORK MESSAGE
School nurses can use the findings from this study both to predict those female students who may choose violent behaviors and to identify available resources to bolster those protective factors that can increase adolescent females’ sense of competence, which decreases motivation to act in a violent manner. Girls who exhibit sexual maturity at a younger age, especially those who associate with older students, are at risk for dating violence, including rape. This type of victimization, as well as other types such as witnessing family violence or experiencing child abuse, increases a girl’s risk for engaging in violence. The school nurse should also be attuned to additional predictive behaviors of violence, including drug use, delinquency, and psychological dysfunction. Through awareness of the social interactions of students and candid discussion with preadolescents and adolescents, the school nurse will discover those girls at risk and provide the appropriate education to strengthen their ability to avoid provocative situations.
In addition to recognizing predictive factors and intervening with girls who are at risk for the development of violent behaviors, the school nurse should also foster adolescent girls’ perceived sense of competence. Girls should be encouraged at a young age to maintain open communication with their parents and other trusted adults, such as teachers and the school nurse. The school nurse can assist with the communication process by being a nonjudgmental listener who discusses potential solutions to dilemmas rather than autocratically delivering unsolicited advice. In some situations, the school nurse could serve as an intermediary or liaison between the girl and her family to assist with their communication process. Encouraging girls to participate in academic and extracurricular activities will also augment their sense of competence, as will assisting them in practicing conflict resolution skills. Role-playing with particular situations of conflict is a common method of improving conflict resolution abilities.
School nurses can use the findings from this study to identify predictors for violent behavior in adolescent girls. Using this information, school nurses can develop and implement both individual and group strategies to decrease the incidence of violence in this population.
In recent years, the medical community has become increasingly aware of the frequency with which violence is witnessed or experienced by children. These situations are described as violence exposure and often result in behavior problems, alteration in school performance, and psychological dysfunction such as depression or posttraumatic stress disorder (PTSD). Additionally, children with violence exposure may experience delays in achieving developmental milestones. Although it is imperative that interventions be instituted with these children to diminish the negative consequences of violence, no studies on the effectiveness of particular interventions have been initiated.
The purpose of this study was to test the effectiveness of a group intervention for the reduction of manifestations of PTSD and depression in middle-school children who had been exposed to violence. A sample of 113 6th-grade subjects completed the study. Subjects were randomly assigned to groups receiving either early or delayed intervention provided by mental health clinicians. The intervention consisted of a multiple-session standardized cognitive-behavioral therapy to provide skills and techniques to deal with PTSD, anxiety, and depression symptoms. Subjects were tested prior to initiation of the study and after the intervention for self-reported evidence of PTSD and depression, parent-reported psychosocial disruption, and teacher-reported classroom problems. The early intervention group received the therapy and was retested after 3 and 6 months, whereas the late intervention group was retested after 3 months, received therapy during the second 3-month period, and was retested after that time. Findings from the two groups were compared.
The early intervention group had fewer symptoms of PTSD, depressive symptoms, and psychosocial dysfunction when compared to the late intervention group at 3 months. The two groups had no differences at 6 months after both groups had received the intervention. The researchers concluded that “a carefully implemented community-based intervention can significantly reduce symptoms of PTSD in the short term” (p. 608).
Take to Work Message
Exposure to violence, either as a recipient or as a witness, is commonplace throughout childhood and frequently results in mental health dysfunction in this population. School nurses must recognize this problem and remain vigilant for evidence of its aftereffects. Whenever a student exhibits evidence of depression, acts out in the classroom, or manifests a change in personality or other behavior, the student should be assessed for exposure to violence. Screening for exposure to violence can also be incorporated into the school nurse’s usual screening procedures. Additionally, familiarity with the symptoms of childhood depression and PTSD is essential for recognition of these disorders.
It is vital that the school nurse investigate the availability of resources for the provision of mental health interventions for students experiencing the effects of violence exposure. If such resources do not exist, the school nurse could assume a leadership position within the community to influence appropriate individuals and groups necessary for the establishment of mental health programs within schools that could provide appropriate therapy. For those situations in which no school-based resources are available, referral to other sources for emotional assistance, such as hospitals or children’s services, should be made.