Coping Zone Construction and Mapping

Abstract

This mixed-method study explored how urban children aged 11 to 14 cope with multicontextual violence exposures simultaneously and analyzed the immediate action steps these children took when faced with such violence over time. Participants’ (N = 12) narratives were initially analyzed utilizing a grounded theory framework as 68 violent incidents were coded for perceived threat and coping levels. Coping strategies were examined from a Transactional Model of Stress and Coping perspective taking into account the context and severity of each violent exposure itself. A comprehensive assessment map was developed to plot and visually reveal participants (N = 12) overall contextualized coping responses. Overall “coping zone” scores were generated to index perceived threat and coping responses associated with each violent incident described. These scores were then correlated with indicators of post-traumatic stress disorder (PTSD). Results indicated that urban children with less optimal coping zone scores across context have a greater likelihood of PTSD than do children who do not.

Keywords

urban children violence exposure post-traumatic stress disorder (PTSD)contextual coping assessment

In the United States, children are more likely to be exposed to violence and crime than adults (Finkelhor, Turner, Ormrod, & Hamby, 2008; Hashima & Finkelhor, 1999), and prevalence studies indicate that a majority of urban youth (75%-90%) witness at least one act of violence in their communities (Malik, 2008; McCabe, Lucchioni, Yeh, & Hazen, 2005). Exposure to violence is linked to aggression, depression, academic, and cognitive difficulties (Margolin & Gordis, 2004) and the development of post-traumatic stress disorder (PTSD) symptoms, especially among children and adolescents (Fowler, Tompsett, Braciszewski, Baltes, & Jacques-Tiura, 2009; Robboy & Anderson, 2011). Urban youth are exposed to prolonged periods of violence exposure over multiple contexts, and their families have a difficult time in moderating the impact of such stress and aggression on their children’s lives (Graham-Bermann, et al., 2009; Guerra, Huesmann, & Spindler, 2003; Horowitz, Weine, S., & Jenkel, 1995; Sheidow, Gorman-Smith, Tolan, & Henry, 2001; Schwab-Stone et al., 1995). Even though there is a growing body of evidence that identifies factors that may guard against the negative effects associated with childhood violence exposure, there still remains a limited number of studies that actually showcase how urban youth cope with violence in their home, school, and neighborhood on a daily basis (Finkelhor et al., 2008; Stein et al., 2003; Voisin & Neilands, 2010).

Childhood Violence Exposure and Coping

Children growing up in urban areas may be witness to or a victim of violent acts in a variety of different contexts at any one time as violence continues to be related to communities plagued by social problems and extremely limited resources (Gorman-Smith et al., 1996; Sheidow et al., 2001). At the time a child experiences a discrete traumatic or highly stressful event, selected coping responses can be the difference between adaptive or maladaptive coping (Boxer, Sloan-Power, Mercado & Schapell, 2012; Tolan & Grant, 2009). The term coping generally refers to adaptively changing cognitive and behavioral efforts to manage psychological stress (e.g., Lazarus & Folkman, 1984). Research suggests that particular characteristics of stressful situations appear to influence both coping choice and coping effectiveness (Compas, et al., 1988; Lazarus & DeLongis, 1983). To this end, the present study utilizes a Transactional Model of Stress and Coping (TMSC; Cohen, 1984) perspective to illustrate the process children experience when faced with an exposure to violence in their lives. This process will showcase a novel way to monitor an individual’s overall coping over time by qualitatively exploring their perceptions of both threat and coping responses when negotiating the threat of multicontextual violence exposure. According to TMSC, when someone is faced with a stressor, they evaluate the potential threat first, known as a primary appraisal. A secondary appraisal occurs shortly thereafter when the person begins to make an assessment of the stressor they are experiencing. During this second appraisal the individual tries to figure out what are their coping resources and options available to deal with such a stressor (Cohen, 1984). TMSC was utilized as a framework for this study to best understand the process of how these participants described their personal process of coping with the various stressors of violence exposures in their young lives. Framing coping as a process that includes threat assessments as well as coping responses can facilitate more nuanced observations and analyses of children’s narratives of their experiences with violence.

Urban children are faced with extraordinary demands of how to deal with ongoing threats of violence on a daily basis. For children, the experience of acute, isolated, personal episodes of violence are often superimposed on chronic exposures to violence and that specific incidents of violence may lead to a range of emotional reactions, including the symptoms of PTSD (Cohen, 1984).

Research has found that early identification, intervention, and continued follow-up are valuable strategies to prevent or decrease the impact of exposure to violence (Finkelhor, Turner, Ormrod, & Hamby, 2008). This study proposes that understanding how to comprehensively assess a child’s overall experience with violence exposure is pivotal for proper assessment, intervention, and follow-up of children experiencing multicontextual violence. We suggest one way to achieve an in-depth and comprehensive assessment of a child’s violence exposure experience is through the use of a qualitative coding procedure called magnitude coding when analyzing transcriptions. Magnitude coding is used typically by researchers to enhance description by applying the use of supplemental alphanumeric codes to an existing category (e g., threat level, coping response) to indicate its intensity, frequency, presence, direction, or evaluative content (Miles & Huberman, 1994; Weston, Gandell, McAlpine, Wiseman, & Beauchamp, 2001). Increasing (or magnifying) focus on a child’s personal perceptions of violence can be extremely useful to the researcher or clinician particularly when a child is or has been exposed to violence in multiple settings at any one time.

Early and comprehensive assessment of a child’s lived experience could be beneficial for the successful treatment and follow-up of children facing violence exposure on a daily basis. This study seeks to understand how best to explore childhood violence exposure contextually so that most if not all childhood violence experiences are accounted for and validated by professionals and researchers alike so that proper intervention and treatment can be offered to these children in need.

Current Study

In this study, urban children (N = 12) aged 11 to 14 were asked to share their violence exposure experiences across various contexts in a semistructured open-ended interview. Following a grounded theory approach, we first explored children’s narratives for themes, concepts, and processes these children described when faced with violence in various settings. Next, we coded each violent incident stated in the child’s narrative for threat severity and context, then further coded for the child’s perceived threat and coping levels. We measured the perceived threat and coping levels per violent incident via a Likert-type scale developed and informed by our qualitative exploration. The overall “coping zone” scores generated through this procedure were validated against indicators of each participant’s PTSD score. We visualized coping scores through an innovative “mapping” method intended to reflect a child’s perceived ability to cope with their own context-specific violent exposures whether experienced in the home, school, neighborhood, or in-transit from one location to another. After the qualitative portion of this study was completed, we moved into the quantitative phase of the study where we hypothesized that urban children with higher-level PTSD scores would be more likely to exhibit lower-level overall coping across context and analyzed participants’ overall coping zone scores and PTSD scores for potential correlations.

Method

Participants

Participants of this qualitative study were selected randomly as a subset sample from a larger study analyzing relationships between childhood violence exposure and mental health outcomes. Participants for this present study consisted of 12 youth (28% male; M age = 12.5, range = 11-14 years; 100% Black/African American) and were stratified evenly across two groups: children who reported symptom scores consistent with the diagnosis of PTSD on a validated survey instrument and children who did not (described below).The larger study sample of 132 youth (43% male; M age = 12.56 years, SD = 1.08, range = 11-14 years; 86 % Black/African American, 10% Hispanic/Latino/a; 4% multiethnic) and their families were residents of a large urban city in northeastern United States. Children were recruited via a number of community outreach strategies including the distribution of project fliers, community group presentations, and “word of mouth” snowball recruitment.

Parents/caregivers contacted our offices to determine their eligibility if interested. Eligibility included being residents of the city where data collection occurred and having legal custody or guardianship of the youth. The target youth had to be between the ages of 11 and 14 inclusive. At scheduled times, families (youth and at least one parent/caregiver) came to our university campus office and were guided through an informed consent/assent procedure. Once parents/caregivers provided consent and youth provided assent, formal data collection began. Caregiver demographics indicated average income range of US$10,000-US$30,000 per household and the average highest level of education among adults in household were between high school diploma/GED and some college education. Most families were headed by single parents, either alone (56%) or with other adult relatives (21%); most parents were biological (92%). Two trained research staff persons administered the measures and conducted the open-ended interview. The total time required was approximately two hours. All interviews were tape recorded with the participant’s permission to do so and then transcribed by trained research assistants. All procedures were conducted following approval by our university’s Institutional Review Board. At the end of the procedure, participants received US$80 (US$40 youth, US$40 parent/caregiver) for their time. After taped interviews were collected and transcribed by trained undergraduate and graduate students, we scheduled weekly coding meetings to analyze the participant’s narratives by conducting line-by-line coding during the initial open-coding phase of the study.

The content of the material and notes developed were kept for future exploration and theme development in a locked filing cabinet and any identifying features removed from the saved data to protect confidentiality of participant. As well, the researcher would also read the newly completed transcriptions while listening to the recorded interview to further validate that the content of the transcription was an accurate depiction of the interview narrative itself.

Grounded Theory

We chose to utilize a grounded theory research design when coding the narratives of each child (Strauss & Corbin, 1998), as it is a very useful method of inquiry to build knowledge about the topic studied. Grounded theory is a qualitative strategy whereby knowledge is built from theories, concepts, and themes that emerge from an inductive and iterative analysis of narrative data (Strauss & Corbin, 1998). Coding and analytic memo writing were concurrent with data analytic activities. All coded memos were collected and reviewed as a codebook editor was established to generate, maintain, and adjust a master list of codes within the codebook for review. We wrote about any problems, ethical considerations, and ongoing future directions of the study. As well, during the open-coding phase of the study a dramaturgical approach was utilized when reviewing and reading these transcripts as a team. This dramaturgical approach (See Goffman, 1959; Reason & Bradbury, 2000) was periodically used, as transcripts were read aloud by the research team that “acted” out certain parts of the texts that required further analysis to get an increased understanding of a child’s affective and emotional state (e.g., talking faster, holding pauses, mumbling, etc.). A dramaturgical approach is a useful way of conceptualizing qualitative interview data while transcribers and coders meet in groups to discuss ongoing progress and findings to date. For example, when our qualitative research team would meet in groups (usually every 2-4 weeks) we would utilize the dramaturgical approach as a way to minimize social dissonance to further understand the participant’s experience. It is suggested that this process reduces the social distance between coder and interviewee so as to improve understanding of participant disclosure (Ellington & Montiero, 2003). Our research team would periodically “dramatize” parts of dialogue (or read out loud different aspect of the dialogue in a dramatic or portrayed way) as a group to help us clarify our understanding of the interpretive world of the subject and concepts being discussed. Our goal was to develop a theory that was grounded in personalized accounts of the participant’s experience so that an eventual theoretical framework could emerge from a thorough analysis of the data (Charmaz, 2006).

Measures

Child PTSD symptom scale

Participants completed the Child PTSD Symptom Scale (CPSS; Foa, Johnson, Feeny, & Treadwell, 2001), a self-report survey measure tapping all 17 hallmark symptoms of PTSD as delineated in the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association, 2000).Youth first were asked to describe briefly “the most distressing (upsetting) thing that has happened in the last three months.” If they could not identify just one event they could write “a few words describing the kinds of things that have been upsetting [them] in the last three months.” We relied on a 3-month window for potentially stressful events to target the “acute” onset of post-traumatic stress (PTS) symptoms as described in the DSM-IV. Although PTS symptoms may persist beyond this period in line with a “chronic” or “delayed” PTSD presentation, our interest was in ensuring accurate recall tied to recent events. Survey items represented the three PTSD syndrome clusters of reexperiencing (5 items; e.g., “having bad dreams or nightmares,” “feeling upset when you think about or hear about the [traumatic] event”), avoidance (7 items; e.g., “try not to think about, talk about, or have feelings about the [traumatic] event,” “trying to avoid activities, people, or places that remind you of the upsetting event”), and hyperarousal (5 items; e.g., “having trouble falling or staying asleep,” “feeling irritable or having fits of anger”).

For all items, youth were prompted to indicate how often during the 2 weeks prior they experienced each symptom along a response scale of 0 = not at all, 1 = once a week or less, 2 = 2 to 4 times a week/half the time, or 3 = 5 or more times a week/almost always. Items can be combined as three separate indicator of syndrome severity and as a total PTSD symptom severity indicator. In our sample, internal reliability estimates for scale composites were well in line with original estimates reported by Foa et al. (2001) and were as follows: reexperiencing, α = .78; avoidance, α = .69; hyperarousal, α = .77; and total, α = .88. We also coded youths’ responses categorically to indicate the presence or absence of clinically meaningful symptoms to generate estimates of PTSD diagnoses per DSM-IV criteria. Item scores of 2 or 3 (i.e., symptoms experienced at least two times per week) were coded as “symptom present” and item scores of 0 or 1 were coded as “symptom absent.” We then summed these scores within syndrome clusters and followed DSM-IV criteria to create estimates of diagnoses. Although these sorts of quantitatively derived estimates cannot replace diagnoses generated through structured clinical interviews, they can represent reliable and valid proxies (Dubow, Boxer, Huesmann, et al., 2012).

Overall Coping Zone Score (OCZS): Magnified Coding for Perceived Threat and Coping

After the data was transcribed, we coded every violence exposure incident described in the text and explored how the participants (N = 12) coped with this exposure by analyzing the stated actions they took before, during, and after the incident. This was also accomplished by analyzing the participant’s perceptions of their violence exposure experience by utilizing the Overall Coping Zone Score (OCZS) Perceived Threat and Coping scale developed by the first author to evaluate the participant’s perceived level of threat and perceived ability to cope with such a threat when faced with violence exposure incidents across context. This measurement was a Likert-type scale that measured perceived threat level from (1) violence is happening/danger zone to (5) violence is not happening/danger-free as perceived coping level was measured on a Likert-type scale from (a) least effective to (e) most effective based on the initial actions or gerunds taken once a violence exposure incident was experienced by each child. The validity, independent intercoder reliability and intracoder reliability, was subject to intense methodological scrutiny as thorough and careful efforts as to the scoring of such incidents occurred in lengthy group sessions and over time as interrater discussion and agreement was confirmed and validated (see Krippendorff, 2004). Examples of such methodological scrutiny utilized in this study were frequent debriefing sessions with coders and research team, peer scrutiny of research project, and member checks (which, according to Guba and Lincoln [1989], are the single most important step to increasing a study’s credibility). Our team made constant and detailed checking of the investigator’s emerging theories and inferences. This type of analysis and verification was utilized throughout the transcription and coding process as well as when scoring participants for threat and coping levels per each violent incident they shared during the interview itself.

Coping Zone Assessment Procedures

A coping zone assessment procedural manual was prepared to build on the knowledge gained through transcribing, coding, and theme creation to carefully examine the dynamics and nuances of information received. As well, this procedural manual was created to have the coding team follow the particular steps necessary for uniform coding and subsequent plotting and mapping of participant’s coping zone scores to take place. Ongoing reliability checks were a way to train coders and ensure that the interpretations of codes were applied as consistently as possible across coders. We used procedures to establish reliability or agreement among team members and saw it as a means for multiple coders to develop a shared perception of the phenomenon we were studying establishing what is also known as a shared interpretive validity (Maxwell, 1992).

Mapping procedures for violence exposure assessment across context were as follows:

code every violent incident in the child’s narrative;

assess each child’s violent incident for where the incident is taking place (context);

assess each violent incident for types of violence occurring;

assess each violent incident for perceived threat level;

assess each violent incident for perceived level of coping;

tally perceived threat and coping level for each incident and place in specific context; and

tally all scores in each context and create the OCZS per context (i.e., home, school, neighborhood, and in-transit).

After the specific violent incidents were scored for threat and coping levels they then were contextually tallied as to the overall score each child revealed per context. Each child’s overall score was then plotted on the Overall Coping Zone (OCZ) Assessment Map (see Figure 1) and overall coping zones were created for two separate groupings of participants (children above and below the PTSD score estimates on the survey measure) for group comparisons (see Figures 2 and 3). To examine the relationships between PTSD and OCZS, and to further test the reliability of the OCZS measure, OCZS means were correlated with each child’s PTSD scores. Correlations were accepted as significant if they attained a p < .05.

Figure 1.

Overall coping zone assessment map.

Figure 2.

Completed coping zone mapping for children without PTSD.

Figure 3.

Completed coping zone mapping for children with PTSD.

Mapping Tool and Magnitude Coding

As stated, we initially paid specific attention to the participant’s action or “ing” words otherwise known as gerunds (e.g., punching in face, running away etc.) the participants used to describe the actions and experiences they implemented when they were faced with violence in their immediate environments. A gerund is an action word or phrase. For the purposes of this study, gerunds were explored in each child’s narrative when violence exposure was initially experienced. These gerunds ranged from preparing for the impending incident, waiting for it to start, observing the violence, participating or not participating, running away from the violence and/or waiting for it to end, preparing for aftermath of violent incident, or realizing violence has just been put on hold until a later date. After mining the text for gerunds, all violent episodes described by the participants were documented and coded accordingly.

To account for the complexity and perceived magnitude of these violent events across context, a mapping tool (see Figure 1) was developed so that the researchers could visually “map” out and document the participant’s perceived threat and coping levels employed when faced with violence across four main contexts: (a) home, (b) school, (c) neighborhood, and (d) in-transit. Magnitude coding or objectively magnifying the text ultimately brings more focus and clarity to a researchers understanding of a participant’s narrative. As stated earlier, this coding method was used to enhance description by applying the use of supplemental alphanumeric codes to an existing category to indicate its intensity, frequency, presence, direction, or evaluative (Miles &Huberman, 1994; Weston et al., 2001). Next, children who were above and below the PTSD diagnostic score cutoffs on the survey instrument were compared in terms of their coping zone levels to analyze the perceived coping zone similarities and differences of each group (see Figure 2 and 3).

When coding was completed in its entirety, each context was given a tallied OCZS for that context as the score then was plotted on the assessment map itself. Letters that were horizontally located on the map indicated the participant’s perceived coping level with violence exposure whereas numeric scores located vertically on the map indicated participant’s perceived threat level on the assessment map (i.e., home = 2B; school =3E, etc.). Coping zone scores were revealed when averages were calculated for the sum total of overall perceived coping levels and overall perceived threat levels in each context. We converted the letters to numbers when assessing the mean score of a child’s overall perceived threat with overall coping. The overall coping score = a child’s perceived threat level + a child’s perceived coping level with that particular threat. In essence you could have a child with high threat level yet also have a high coping level and would have a higher overall score than a child with a high threat level and low coping level. Literally you could have the same threat level and depending how that child deals with that threat you can have a different overall coping core. This is a nuanced way to look at the subtle and not so subtle dimensions of how children cope with various degrees of threat in various contexts of their lives.

Lastly, a straight line could connect the scores on the map from context to context (home, school, neighborhood, and/or in-transit) and an actual coping zone or area could be visualized accordingly. For example, visualizing a child with a smaller coping zone would indicate that they may not be coping as well with various exposures to violence as a child who exhibited a larger coping zone would suggest (see figures 2 and 3).

Results

Gerunds—Initial Action Steps

As stated earlier, gerunds were mined in the narratives to explore the immediate action steps taken by children faced with violence. An example of immediate action steps mined in the participant’s narrative can be described by a 13-year-old female participant we shall call Shannon (all participants quoted in this article will be given a pseudonym to protect confidentiality). Shannon was faced with a serious threat of violence to her father that involved an armed robbery in their home (he was on the first floor and Shannon was on the second when robbery occurred). When Shannon first became aware of this event she said she responded as follows:

I was just yelling, and screaming, like yelling “ahhhh” like that. I was crying “hot” tears. They were like burning my face.

As this child shared this traumatic experience she also shared that her initial reaction continued as her father was being taken to the hospital by ambulance after the robbery. Later she suggested when her father was home, she would follow him wherever he would go for about two months just to make sure he was okay and no one would hurt him.

Mapping Procedure Results for Violence Exposure Assessment

There were in total 68 violent incidents revealed in the 12 interviews explored. This averaged to 5.7 violent exposures per participant. These 68 violent incidents were then coded for threat and coping levels, as 14.71% of these violent incidents were described as happening in the home, 33.82% described as happening in the school, 44.12% occurred in the participant’s neighborhood, and 7.35% were described as happening while the participant was in-transit. The exposures to violence described while coding were then collapsed into five overarching and distinct categories to streamline analysis and focus on how these children experienced such violence depending on where the violence occurred (see Table 1).

Table 1.

Described Categories of Violence Per Context.

Context	%	Violence Category %	Subcategory	%
Home	10.53	Witness 27.94	Direct	8.82
School	15.79		Indirect	2.94
Neighborhood	68.42		Bystander	11.76
In-transit	05.26%		Neighborhood Crime	4.41
Home	19.05	Fighting 30.88	With out weapon	20.59
School	47.62		With weapon	1.47
Neighborhood	19.05		Fighting	8.82
In-transit	14.29
Home	16.67	Bullying 8.82	With out weapon	4.41
School	83.33		With weapon	2.94
Neighborhood	0.00		Gang involved	1.47
In-transit	0.00
Home	11.11	Inflicted abuse 13.24	Peer	4.41
School	55.56		Older youth	1.47
Neighborhood	22.22		Parent	1.47
In-transit	11.11		Nonparent	5.88
Home	15.38	Gun-related violence 19.12	Heard	4.41
School	0.00		Witnessed	2.94%
Neighborhood	84.62		Victimized by (i.e., armed robbery)	4.41%
In-transit	0.00		Murder/witness	7.35%

Magnitude Coding of Perceived Childhood Threat and Coping Levels

As stated, after each violence incident was coded for type and context, we utilized magnitude coding to measure the extent of the child’s perceived threat and coping levels exhibited in their violence exposure narratives. This was done utilizing a Perceived Threat and Perceived Coping scale developed by the first author where numbers indicated threat levels and letters indicated coping levels of participants. For example, a score of 1 or A indicated the greatest risk of threat and lowest perceived ability to cope and 5 or E indicated the least risk of threat and highest perceived ability to cope on their respective Likert-type scales. For example, interrater agreement suggested that the 13-year-old child named Shannon described above was also coded for perceiving great risk and low level coping (1A) even when she knew the initial event of her father’s armed robbery had already happened and the police were at her front door to explain to the family what had happened and that their father was okay. Shannon’s immediate actions to such violence exposure indicated to multiple independent coders that she had a lower level coping response than a child who may have realistically concluded that the robbery had happened already by the police report, Instead, Shannon stated to the interviewer that:

I was scared; I thought they [the armed robbers] had killed him [meaning her dad] or something. I was scared. I thought “oh my gosh,” they are going to kill my mom, they are going to take us, they are going to do disgusting things with us.

However, when faced with a serious threat of her family being brutally beaten up with glass bottles in the street, Justine (11-year-old female) perceived a great threat but also perceived she was coping with this threat somewhat better by choosing not to get further involved and pretending to sleep while the violence was happening. She then received an interrater score of (1C). In the case of Justine, she described herself as being exposed to a lot of home violence and said the following:

I heard it [meaning the fight] but I did not want to go to my window. I heard it but I faked I was sleeping but I heard it.

Whereas this type of coping may be correlated with avoidance types of coping behaviors it still may or may not be associated with a child’s PTS as well. However, the intent of measuring a child’s OCZS was to see how a particular child may be coping overall in various contexts of their lives and to see how that overall coping zone relates to a child’s PTSD score not to assign cause and affect of either context or pathology. For example, An 11-year-old male named Arthur received an interrater score of (1D) for having perceived a high threat level while also perceiving a strong ability to cope when witnessing a shooting in his neighborhood. After witnessing this shooting, Arthur quickly ran into a nearby building and picked up a toddler on the sidewalk to bring to safety as well. Arthur stated the following when asked about the gunman’s whereabouts:

We know nothing, but no one got shot yesterday or today, nobody.

Arthur felt a sense of pride for being quick on his feet and that in part due to his perceived courageousness, he was able to care for not only himself but a child he did not even know. However, his pride was somewhat tempered by an understanding that his personal safety could still be at-risk in the future since at least for “today” no one got shot.

Overall Coping Zone Scores (OCZS)

OCZS were calculated for each participant across all contexts studied (home, school, neighborhood, and in-transit) as their mean score and standard deviation was calculated. Due to its limited scope, this present study does not suggest context plays a role in a child’s coping response; rather, it suggests that children may or may not cope differently based on their experiences with violence exposures in these various contexts. Context without any violence exposure mentioned received a score of 0 in that particular context. The means were then computed to exclude any zeros from the overall mean itself (see Table 2).

Table 2.

Overall Coping Zone Scores (OCZS) by Context.

				Home	School	Neighborhood	In-Transit
#	PTSD	Age	Sex	OCZS C1	OCZS C2	OCZS C3	OCZS C4	OCZS Mean	SD
1	No	13	F	0.00	4.00	2.17	4.00	3.39	1.06
2	No	11	M	0.00	4.50	1.83	0.00	3.17	1.89
3	No	14	F	0.00	3.25	2.00	0.00	2.63	0.88
4	No	13	F	2.17	0.00	2.50	0.00	2.34	0.24
5	No	14	M	0.00	2.50	2.00	0.00	2.25	0.35
6	Yes	14	M	3.00	1.67	1.75	0.00	2.14	0.75
7	No	12	F	2.00	3.00	1.00	0.00	2.00	1.00
8	Yes	11	F	1.50	2.13	2.00	2.00	1.91	0.28
9	Yes	13	F	0.00	2.50	1.67	1.50	1.89	0.54
10	Yes	12	F	2.00	0.00	1.71	0.00	1.86	0.21
11	Yes	11	F	0.00	1.50	2.50	1.50	1.83	0.58
12	Yes	13	F	1.83	1.00	0.00	0.00	1.42	0.59
Mean				2.08	2.61	1.92	2.25	2.23

Overall Coping Zone Maps

Each child’s coping zone assessment map revealed a particular “coping zone” or coping gestalt that showcased how each child perceived they coped across context (see Figure 2 and 3).

PTSD and OCZS Correlations

To examine the relation between PTS and OCZS, OCZS means were correlated with each child’s PTSD scores. This correlation was negative (r = –.62) and significant (p = .01), indicating that lower (or less functional) OCZS scores were associated with higher levels of PTSD symptoms. By way of corroboration, a t-test comparing the OCZS means of the PTSD and non-PTSD diagnostic groups confirmed that children with clinically significant levels of PTSD had significantly less functional OCZS scores (t = 3.22, p = .005; see Figure 4).

Figure 4.

OCZS and PTSD correlations.

Discussion

As discussed, the main purpose of this article was to qualitatively explore childhood perceptions of individual violence exposures as they related to overall coping across context. Participant’s (N = 12) revealed that even if a perceived threat level of a violent incident was somewhat equal the perceived ability to cope with such a threat could be different depending on the context and vice versa. This study showcased the usefulness of a statistically significant violence exposure assessment indicating the need for a multicontextual and perception-based measurement by depicting the extent and variability of childhood coping with violence across context itself. To further assess how participants (N = 12) coped with these violent events across context, we qualitatively contextualized or magnified the two main themes of threat and coping since these were two main areas of action observed when analyzing how these children handled and negotiated such violence in their lives. The PTSD–OCZS correlations indicated that there was a high correlation between children who have PTSD and overall lower coping zone scores. This finding indicated that children with somewhat lower coping zones may be faced with similar threats as children with higher coping zones, but their perceptions of being able to cope with such a threat was lower. Participants with scores indicating PTSD revealed lower levels of OCZS, and less variety of coping levels across context. Results of this study suggest that the OCZS tool may be a valid and reliable measurement of child’s perceived safety and coping abilities. These significant results also imply that low OCZS results call for PTSD evaluation.

Implications of Findings for Theory, Practice, and Policy

It is imperative that researchers, practitioners, and policy-makers work together to develop and expand upon effective screening and assessment tools for children exposed to violence. More significantly, these instruments can aid practitioners, advocates, frontline workers, and responders across all service sectors to reach and help those children (Kracke & Hahn, 2008). The overall coping zone map is a novel assessment tool and can give an overall view of a child’s coping across context. It is suggested that by providing overall scores of contextual coping for children exposed to violence may have remarkable implications for clinical practice, research, and policy development. Specialists in urban child mental health have a particularly important role at this time in history. Understanding the role of contextual coping (particularly for children living with PTSD) could assist professionals in caring for these children more effectively and comprehensively. This research suggests that the OCZS assessment can provide a preliminary but viable way to for researchers and practitioners alike to explore violence exposure across multiple contexts.

Limitations of Study

This study initially utilized a grounded theory approach that has many benefits when exploring the in-depth experiences of children facing violence exposure but it does not come without its limitations. For example, this research was exploratory in nature, and thus the findings should be considered preliminary observations in a largely uncharted area in research particularly in the use of such techniques such as the dramaturgical approach as it may be prone to researcher bias. Future research should continue to examine the nature of youths’ exposure to violence as it relates to severity of perceived threat as well as coping. Unresolved issues of this study include the implications of relying on self-report versus other reports, subjective versus objective measures, and exposure type versus number of exposure events (Rasmusen, Aber, & Arvinkumar, 2004). Lastly, results of this study could be made more generalizable with the inclusion of increased diversity in the selection of participants. That being said, caution always needs to be taken when self-selection bias of the participants is present.

Future Research

Since this research explored a novel approach to assessment of childhood violence exposure across contexts it is pivotal that further research be conducted to validate the reliability of the OCZS measurement itself. Furthermore, it would be essential for both quantitative and a qualitative research to study the role PTSD has on lower coping zone scores and overall contextual coping. Understanding that this tool has the potential to be utilized for other populations, future research will be needed to explore those areas as well.

Conclusion

In conclusion, this research qualitatively examined the narratives of how 12 urban children (aged 11-14) cope with urban violence across the contexts of home, school, neighborhood, and in-transit. Children who perceived they coped somewhat better and who had larger coping zones were more apt to withdrawal from stressful situations, postpone an immediate response, and seemed to make more sense out of their threatening experience by understanding the negative consequences of further involvement. However, participants who met certain criteria for PTSD according to a validated survey measure did not perceive themselves as coping as well with their various exposures to violence. Instead they were more prone to experiencing higher levels of threat without having the perceived coping abilities to deal with such a threat.

Unfortunately both groups of urban children studied had lower overall levels of coping across context indicating an emergent need to intervene on the behalf of all children exposed to violence, PTSD diagnosed or not.

Footnotes

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was supported, in part, by a grant from the National Institute of Health (grant number R21MH085209).

Author Biographies

Elizabeth Sloan-Power, PhD, received her doctorate in clinical social work from New York University and is presently an assistant professor in the Department of Social Work at Rutgers University, Newark, New Jersey. Sloan-Power studies narrative inspired progressive pedagogies as a form of coping and meaning-making especially with children coping with violence and chronic health issues in urban areas.

Paul Boxer, PhD, is associate professor of psychology at Rutgers University. Boxer studies the development and treatment of antisocial behavior in children and adolescence as well as the impact of violence on children’s mental health. He is a clinical-developmental psychologist.

Colleen McGuirl is a BSW student and research assistant in the Department of Social Work, Rutgers University, New Jersey.

Ruslana Church, MSW, received her MSW from the Rutgers School of Social Work and has been a member of the Phi Alpha Social Work Honor Society since 2011.

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