PTSD: National Center for PTSD
What is community violence?
Community violence is a complex term that has been used to refer to a wide range of events including riots, sniper attacks, gang wars, drive-by shootings, workplace assaults, terrorist attacks, torture, bombings, war, ethnic cleansing, and widespread sexual, physical, and emotional abuse. Mental-health professionals often make a distinction between studies on crime-related events in which adults are often the focus (such as rape, assault, and homicide) and studies on exposure to violence in which children and adolescents are often the focus (such as school shootings, witnessing murder, and living in a war zone).
Another distinction that is often made is between domestic violence, referring to abuse between two adults involved in a romantic relationship, and child sexual or physical abuse, referring to violence between a child and an adult. A third distinction that is made is between predatory violence, in which an individual (usually a stranger) tries to take something of value using physical threats or direct violence, and interpersonal conflicts, in which two acquaintances are involved in a violent altercation with the intent to harm each other. Both types of violence may include brutal acts such as shootings, rapes, stabbings, and beatings.
How is community violence different from other types of trauma?
Several aspects of community violence make it different from other types of trauma. Although there are warnings for some traumas, community violence usually happens without warning and comes as a sudden and terrifying shock. Because of this, communities that suffer from violence often experience increased fear and a feeling that the world is unsafe and that harm could come at any time. Although some traumas only affect one individual or a small group of people, community violence can permanently destroy entire neighborhoods. Finally, although some types of trauma are accidental, community violence is intentional, which can lead survivors to feel an extreme sense of betrayal and distrust toward other people.
What are the effects of witnessing or experiencing community violence?
As is the case with other traumas, individuals often experience PTSD as a result of community violence. PTSD can affect people of all ages. Although some people think that young children are not psychologically affected by exposure to community violence because they are too young to understand or remember the violence, studies have found posttraumatic symptoms and disorders among infants and toddlers.
Children and families
Although some people think that young children are not psychologically affected by exposure to community violence because they are too young to understand or remember the violence, studies have found posttraumatic symptoms and disorders among infants and toddlers.
Children's and adolescents' risk for developing PTSD increases with the severity of exposure, negative parental reactions to the exposure, and the child's physical proximity to the community violence. To learn more, see PTSD in Children and Adolescents.
The impact of community violence exposure is not felt by the youth alone. A child's or adolescent's exposure to community violence also affects his or her family. Extreme anxiety concerning the child's health and well-being is a common parental reaction. Resources for parents may be limited, which may lead to frustration and anger. Many parents blame themselves for not protecting their child adequately. They may become overprotective or use punitive discipline in response to their child's trauma-related acting out behavior. Relationships among family members can become strained. Parents find themselves having to face the task of reassuring their child while trying to cope with their own fears, especially if there is a chronic risk for future community violence exposure.
Adults can also experience PTSD following exposure to community violence. In addition to symptoms of PTSD, survivors of community violence often struggle with:
- How to build trust again (which includes looking at issues of power, empowerment, and victimization)
- How to find meaning in life apart from the desire for revenge
- How to find realistic ways to protect themselves, their loved ones, and their homes and community from danger
- How to deal with feelings of guilt, shame, powerlessness, and doubt
A final concern regarding the effects of community violence is whether there is a link between witnessing violence and becoming violent, especially in intimate relationships. No studies have determined whether there is a relationship between community violence and domestic violence.
What treatments are available for individuals exposed to community violence?
Rapid, timely, and sensitive care for the community and affected individuals and families is the key to preventing PTSD in the wake of violence. Such care is also the key to reducing violence itself. Mental-health professionals with expertise in community violence can contribute in several ways:
- Help community leaders develop violence-prevention and victim-assistance programs.
- Help religious, educational, and health care leaders and organizations set up relief centers and shelters.
- Work with teachers at children's schools to provide education, debriefing, and referrals for affected children.
- Provide direct psychological services near the site of violence, such as:
- 24-hour crisis hotline
- Identifying survivors or bereaved family members who are at high risk for developing PTSD
- Getting individuals connected with appropriate continuing treatment
How can we prevent community violence?
Some progress has been made in developing violence prevention programs. The focus for these programs is prevention of gangs and building conflict resolution skills in high-risk youths. However, violence prevention programs appear to be more effective if children are engaged early (beginning before age 6) and the program includes intervention in children's home and school social environments. Programs should also continue to make specific efforts to reduce obvious high-risk behaviors among adolescents, such as gang involvement, heavy drinking, and carrying handguns.