Killings in the neighborhood take toll on young minds

In the week that a homicide has occurred on their block, school-aged African American kids in predominately low-income neighborhoods suffer a steep slide in verbal and language skills that are key to reading, learning and thriving, a new study has found.

The study found that faced with similar levels of mayhem in their neighborhoods, Latino children did not appear to experience significant declines in academic performance. And slayings in study neighborhoods populated by white children were so rare the study could not discern an effect.

The effect was seen among African American children even when they were not directly exposed to the violence, suggesting that the fear and anxiety caused by proximity to an act of violence can, in some communities, ripple outward across social networks and disrupt the intellectual circuitry of entire neighborhoods. In neighborhoods where violence is endemic, the study suggests that children's academic progress can be severely stunted.

"The pattern of findings is consistent with the literature on acute stress disorder, which is defined as a response to a threatening event that induces fear, helplessness or horror," writes Patrick Sharkey, a New York University sociologist and author of the study, published this week in the Proceedings of the National Academy of Sciences. "Among other symptoms are reduced awareness and difficulties in concentration for a period last at least two days and as long as one month after the stressor."

The study combined several databases to arrive at its striking findings. It cross-checked data on all reported homicides between 1984 and 2002 in Chicago neighborhoods with children's performance on cognitive tests administered in the course of two University of Michigan studies: the Project on Human Development in Chicago Neighborhoods, and a three-city study of welfare, children and families (of which only Chicago-based children were scrutinized). 

Chicago's 6,041 homicides recorded during that period afforded lots of opportunities to discern the effects of such violence on children who lived on the block where it took place and within the census tract of the crime. Some of those assessments of language and verbal skills took place within days of the violence. Others happened to have been administered a week or later after the event.

The result allowed Sharkey to discern not only a proximity effect of neighborhood violence -- that the cognitive function of black children closer to a killing was more significantly affected than that of children farther away. The results also showed a temporal effect -- that in the days after a homicide, the effect of the violence on cognitive performance was dramatic. But a week after a slaying, African American schoolchildren began to regain their cognitive composure.

In the days after a slaying, however, the effects on children who lived nearby was profound and far-reaching. The performance of these African American children slid dramatically on several tests that are reliable predictors of a child's academic performance in the long term. In total, data from some 1,100 African American children 5 to 17 were used in the study.

For a helpful guide to the lasting effects that witnessing a horrific event can have, check out this well-written article. If a child you know has witnessed violence, check out this site, and this helpful guide to choosing a mental health professional who can help. 

--Melissa Healy

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Watch at your own risk: study finds reality TV heavier on aggression than fictional shows

We were still reeling from last night's episode of "The Real Housewives of New York," which was a one-way ticket to Crazyville, when we stumbled on a new study about scenes of aggression on television. Turns out that reality TV has it over non-reality programming when it comes to showing acts of aggression. After last night, we're not surprised.

Reality TV accounted for 61.5% of total aggressive acts, and non-reality TV shows came in at 38.5%.

Researchers watched 60 hours worth of five reality shows and 60 hours of five non-reality shows, some American and some UK-based (shows included "The Apprentice," "Big Brother," "The Vicar of Dibley," and "Torchwood"). Acts of aggression were categorized as physical, verbal or relational, and the kind of act (hitting, gossiping, name-calling) was recorded. The researchers also noted if the act was justified or rewarded, if it happened naturally or artificially, and what type of award the aggressor got.

In all, there were 5,099 separate acts of aggression recorded for the study period; reality TV had 3,138 acts, and non-reality TV had 1,961. Although non-reality programming had far more physical acts of aggression than reality TV, all programs had much higher instances of verbal and relational aggression. Reality shows greatly edged out non-reality programming on relational violence; in the paper the authors said, "Such aggression often helps the contestant to 'get ahead' in the program, for example, by defaming another contestant's reputation or by turning contestants against each other. However, the extremely high levels of relational aggression in reality programs are somewhat alarming, given the realistic portrayal of the aggression."

The UK version of "The Apprentice" had the highest number of aggressive acts per program of the reality shows (about 85), while on the non-reality side that honor went to "Eastenders" (about 50). Although the paper concludes by noting that given the vast appeal of reality programs they're sure to be around for a while, the lead author said in a news release even she was surprised by the findings: "I knew the level of aggression was going to be high, but I had no idea it was going to be this high," said Sarah Coyne, a professor of family life at Brigham Young University in Provo, Utah.

The study appears in the June issue of the Journal of Broadcasting & Electronic Media.

-- Jeannine Stein

Photo: Alan Sugar hosts the UK version of "The Apprentice." Credit: BBC

PG-13 films serving up way more violence, not much more sex

You don't need to be a raging pacifist to notice that American motion pictures have gotten way more violent, and that younger and younger audiences are seeing more intense violence on the big screen. You just need eyes (and enough scratch to buy a movie ticket). But for skeptics, a new study, published online in the Journal of Adolescent Health, offers some validation of the point.

Researchers from the Annenberg Public Policy Center of the University of Pennsylvania painstakingly coded each year's top-grossing 30 films from 1950 to 2006 to gauge the extent and intensity of sexual content and violence. They then sought to discern trends within ratings categories, and the migration of sexual and violent content into movies intended for the broadest circulation -- P, PG and PG-13 movies.

The sexual content of PG and R movies started accelerating in the late 1960s, when the Motion Picture Assn. of America's ratings system was instituted. It stabilized in the late 1970s and even declined somewhat after that. Since then, movies bearing PG and PG-13 ratings have not become more sexually explicit, the study found.

Not so with violent content. In fact, it exploded across the PG-and-up ratings categories, cascading heavily into a new category introduced in 1984 -- PG-13. And as movies in the PG-13 category surged -- in recent years, they have come to represent about half of all top-grossing movies -- so did the violence in them.

Before the PG-13 rating arrived, a movie that included scenes of rampaging destruction, intense fist-fighting or frenzied exchange of gunfire would routinely have earned a movie an R rating -- in principle, barring teens under 17 from seeing it unless accompanied by an adult. With the new rating, not only did more films with substantial violence land a PG-13 rating; from 2001 to 2006, "ratings creep" resulted in PG-13 movies that had more violence and more intense violence than did R-rated movies, compared with the 1977-1984 period.

The trend worries the Annenberg researchers, who summarize a welter of evidence suggesting that youth exposed to extensive media violence are more likely to engage in aggressive behavior, that they are less likely to reject violence as a means of solving disputes and have less empathy for victims of violence. While some of this research has been called into question, few researchers deny the weight of evidence: exposing younger and younger kids to more images of greater violence is probably not healthy for them or for the society they live in. 

The Classification and Ratings Administration, or CARA, a film industry group that oversees the rating of films, has always maintained it does not use rigid rules to determine what rating to assign a film. Rather, it says, the rating of movies should "reflect the current values of the majority of American parents."

When it comes to sex, says study author Daniel Romer, CARA seems at pains to reflect American parents' values -- largely to the exclusion of concern about violence. If the growth in violence reflected in movies aimed at teens is any indication of parents values, he said, it's hard to say what that means: Their values have very likely been shaped by steadily rising levels of media mayhem.

-- Melissa Healy

Photo: Angelina Jolie in 20th Century Fox's 2005 "Mr. and Mrs. Smith." Credit: 20th Century Fox

Reproductive coercion is a factor in unintended pregnancies

It's sometimes assumed that unmarried teenagers and young women become pregnant because they don't use contraception or because they want a baby. But the authors of a new study say there's another reason. Some women are coerced into pregnancy by their boyfriends. Young women even report that their boyfriends sabotage birth control to get them pregnant.

Researchers at UC Davis conducted a survey of 1,300 young women at five reproductive health clinics in Northern California. The women ranged in age from 16 to 29. They were asked questions about birth-control sabotage, pregnancy coercion and partner violence. The study found that one in five women said they had experienced pregnancy coercion and 15% had experienced birth-control sabotage. More than half had experienced physical or sexual violence from an intimate partner. The researchers concluded that the rate of unintended pregnancy was double among women who experienced reproductive coercion and partner violence. The study is published online today in the journal Contraception.

"This study highlights an under-recognized phenomenon where male partners actively attempt to promote pregnancy against the will of their female partners," Elizabeth Miller, a co-author of the study, said in a news release.

"What this study shows is that reproductive coercion likely explains why unintended pregnancies are far more common among abused women and teens," Jay Silverman, a co-author of the study and a professor at Harvard School of Public Health, said in a news release.

Perhaps we've been over-focused on contraceptives. Rates of unintended pregnancy might decline if more young women learned to recognize, avoid or leave abusive relationships or were given the skills and support to do so.

-- Shari Roan

Photo credit: Stefano Peralta  /  For the Times

Girls! Girls! Use your words!

Aren't girls supposed to be the more verbal of the genders? That's the popular theory. (Having lately spent what seems to be an inordinate amount of time around chattering 13-year-olds, I would be inclined to agree.) But that willingness to talk apparently doesn't preclude a willingness to come out swinging. 

A new report from the Substance Abuse and Mental Health Services Administration finds that, in the past year, more than a fourth of U.S. girls ages 12 to 17 took part in a serious fight, in a group fight or in an attack meant to physically hurt someone.

Here's the full report.

As with boys, the propensity to violence is linked to lousy school performance (and, especially, to no school performance -- that is, kids who didn't bother going to school were dramatically more likely to take a swing), alcohol and drug use, and poverty.

Perhaps some comfort could be taken in the fact that these numbers are holding steady, with about the same amount of violence found in studies from 2002-2004. But it would be cold comfort.
 
So, please, girls, use your words. I know you can.

-- Tami Dennis

Photo: If only they used gloves.... Credit: Los Angeles Times

Tying up the week's loose ends -- broken noses, antigens and more

Context may be everything when it comes to news coverage, but sometimes, the health and medical specifics are fascinating on their own. Just this week for instance, you might have asked yourself the following questions... 

- What should I do if my nose and teeth are broken by a hurled statuette? (Relevant story: Italian Premier Silvio Berlusconi attacked at rally)

Here's what WebMD has to say about the former. Best tip: "Take an over-the-counter nasal decongestant to aid in breathing through the nostrils."

And here's an offering from eMedicineHealth on the latter, complete with explanation of the Ellis classification of tooth fractures. Best tip: "If a tooth is completely knocked out, it should be quickly rinsed off with water, but never scrubbed. The tooth should be held by the crown (top), not the root, so you do not damage the ligaments. In a cooperative adult, the tooth should be put back in the socket." The operative word is "cooperative."

Neither site mentions souvenirs of cathedrals as possible causes, but the advice should hold nonetheless.

- What can I do about this inability to see the bedside clock in the middle of the night? (Relevant story: Distance vision is all a blur to more of us)

Here are facts on myopia (nearsightedness) from the American Optometric Assn., complete with an explanation of refractive surgery and orthokeratology, in which rigid contact lenses are used to reshape the cornea.

Best tip: "People who do an excessive amount of near vision work may experience a false or “pseudo” myopia. Their blurred distance vision is caused by over use of the eyes’ focusing mechanism.... The symptoms are usually temporary and clear distance vision may return after resting the eyes. However, over time constant visual stress may lead to a permanent reduction in distance vision."

This is something you may have wanted to know before you spent a couple of decades at the computer.

Also of note, from the Mayo Clinic. "If you're significantly nearsighted, it's possible that the retina of your eye is thin. The thinner your retina, the higher your risk of developing a retinal tear or retinal detachment. If you experience a sudden onset of flashes, floaters or a dark curtain or shadow across part of your eye, seek medical assistance immediately."

- Just what is a flu antigen anyway and how is it relevant? (Relevant story: 800,000 doses of swine flu vaccine recalled)

Check out this glossary of flu-related terms from the Neiman Foundation for Journalism at Harvard University. Don't stop with antigen. Learn about adjuvants. Hemagglutinin. Reassortment.

-- Tami Dennis

Photo: Italian Premier Silvio Berlusconi waves from his car Thursday after leaving a Milan hospital.

Credit: Associated Press
 

Health professionals debate screening for intimate partner violence

Many doctors and hospitals have implemented procedures to screen women for intimate partner violence. The practice, however, is controversial. The U.S. Preventive Services Task Force makes no recommendation on screening because of a lack of evidence that it can do much good.

A study published today in the Journal of the American Medical Assn. concurs with that assessment. Researchers in Canada conducted a study at 11 emergency rooms, 12 family practices and three ob-gyn clinics in Ontario, Canada. The study involved 6,743 women age 18 to 64. Half the women completed an abuse screening tool. If the woman reported past abuse, that information was given to her clinician before the healthcare visit. The other group of women completed the same screening tool but after the healthcare visit. The women were surveyed over a period of 18 months about incidents of violence and quality of life.

The study found no difference in the two groups in incidents of violence, quality of life and use of violence-related health and social services.

"It is certainly understandable that clinicians and health care facilities have implemented universal screening programs, given the prevalence and potential severity of intimate partner violence," doctors from the University of North Carolina wrote in an editorial accompanying the study. "However, the results of this study ... should dispel any illusions that universal screening with passive referrals to community services is an adequate response to violence in intimate relationships."

Perhaps this idea should be tested: Officials at St. Joseph's Regional Medical Center and the Passaic County Courthouse in Passaic County, N.J., have launched a joint program that allows victims of intimate partner violence to obtain temporary restraining orders from a judge on the spot. The hospital staff simply connects victims to a judge via teleconferencing. The story is reported today in the Bergen Record.

-- Shari Roan

Photo: Dr. James Pruden, director of telemedicine at St. Joseph's Regional Medical Center, left, and state family court Judge Richard M. Freid, seen on the monitor, are seen in Paterson, N.J. Domestic violence victims will get treatment and can obtain temporary restraining orders at a New Jersey hospital. The emergency room at St. Joseph's Regional Medical Center is linked with the Passaic County Courthouse by video conference. Photo credit: Elizabeth Lara / The Bergen Record / AP photo