Victimization Called Leading Cause Of Adolescent Violence

While statistics show that the United States has a serious problem with violence, Colombia has an even more severe plague of violence.

Thus, David Brook, M.D., an addiction psychiatrist by training and a professor of community and preventive medicine at Mount Sinai School of Medicine in New York, along with American and Colombian colleagues, decided that Colombia would be the appropriate setting for exploring the causes of adolescent violence.

What they have found is that the prime cause of adolescent violence appears to be having been victimized by violence oneself. The second major contributor is illicit drug use.

Their results were reported in the August American Journal of Psychiatry.

Brook and his coworkers decided to focus their investigation on three Colombian cities—Bogota, Medellin, and Barranquilla. Bogota was chosen because it has a population that is diverse in socioeconomic status, has large concentrations of adolescents living in communities at various levels of urbanization, and has one of the highest rates of homicide in Colombia. Medellin was selected because it is the second-largest city in Colombia, is a major commercial and industrial center and has one of the highest homicide rates in the world. Barranquilla was picked because it is one of Colombia’s largest cities, yet has a much lower homicide rate than the other two. Illicit drug use is prevalent in all three cities.

Brook and his team randomly selected adolescents from census data and asked them to participate. Free American sports apparel and the opportunity to be part of a scientific study were used as inducements. Eighty percent of these teens—about 2,800 out of 3,500—agreed to sign on. About half were male.

The investigators then administered a structured two-hour questionnaire that had been previously used to study adolescent violence in the United States. It asked questions having to do with a teen’s personality and behavior, family, peers, availability of illicit drugs in the community, prevalence of violence in the community, and whether he or she had engaged in various types of violent behaviors. The researchers made sure that all of the questions were relevant to Colombian culture and that the questions were translated correctly into Spanish.

The questionnaire was then administered to each subject in his or her home, in private if possible, by a Colombian interviewer. To maintain confidentiality, questionnaire answers were identified only with a code number.

Fighting Is Common

The scientists then analyzed their questionnaire findings to see what percentages of their subjects had engaged in violent behaviors. They found, for example, that some 48 percent had been in a serious fight at least once, 14 percent had held a weapon against someone at least once, 7 percent had cut someone with a knife at least once, and 6 percent had shot someone at least once.

Taking variables such as age, gender, ethnicity, and socioeconomic background into consideration, the scientists attempted to see whether there were any biopsychosocial factors that set apart the subjects who had engaged in violent behaviors from those who had not.

The answer was yes, they found. A number of factors were associated with adolescent violence to a statistically significant degree. These were a tolerance for deviance, lack of sensitivity, illicit drug use, father or sibling who used illicit drugs, parent-child conflict, tolerance of deviance in peers, use of illicit drugs by peers, drug availability, watching violence on television, and having been victimized by violence oneself. In fact, having been victimized by violence emerged as the leading cause of adolescent violence; using illicit drugs came in second.

The study also found that each of the above risk factors for adolescent violence remained a danger even when a teen possessed some other qualities that often protect against such violence. For example, family risk factors for violent behavior predisposed a teen to commit a violent act even when the teen did not have a violence-prone personality or lived in an area with little brutality.

Studies of adolescent violence in the United States have also identified some of the same risk factors that this study did. For example, one investigation found that beyond engaging in delinquent behavior, being a victim of violence is the most powerful predictor of adolescent violent behavior.

Thus, “our research suggests that key risk factors for violent behavior in adolescents are common to Colombia and the United States,” Brook and his team concluded.

Indeed, “there might be universal risk factors for violence,” Brook ventured during an interview with Psychiatric News, “based not only on this study but on others that we have done elsewhere, including the United States.”

Are There Protective Factors?

In contrast, if there are universal risk factors for violence, there may be universal factors that protect against it, too, Brook noted. For instance, this investigation yielded one finding that surprised him—whereas more than half of the youngsters who took part in the study had been victimized by violence at some point, only one-third of them went on to perpetuate violence themselves. “So being a victim does not necessarily mean that you will engage in violence,” Brook asserted. “There is a gap there that maybe can be worked with.”

The study was financed by the National Institute on Drug Abuse.

The study, “Early Risk Factors for Violence in Colombian Adolescents,” is posted on the Web at http://ajp.psychiatryonline.org/cgi/content/full/160/8/1470?. ▪

Am J Psychiatry 2003 160 1470