The Rates and Characteristics of the Exposure of Palestinian Youth to Community Violence

Abstract

The article presents the results of a study that explored the rates and characteristics of exposure to community violence (CV) and its relevance to several sociodemographic factors among a sample of 1,930 Palestinian youth (1,018 girls and 912 boys), aged 12 to 19 years residing in diverse residential areas in the West Bank and East Jerusalem. Data were collected using a self-report questionnaire. The frequency of boys’ exposure to CV during the previous 12 months was significantly higher than among girls. The frequency of witnessing CV during that period was higher than the frequency of personally experiencing CV, and exposure to mild CV incidents during that period was higher than the frequency of exposure to severe CV incidents during the same period, with no significant relationship to sociodemographic factors. Participants reported higher rates of witnessing most CV incidents outside of the neighborhood. Nonetheless, they reported higher rates of experiencing most incidents of CV inside the participants’ neighborhood. The implications of the results for theory development and future research are discussed.

Keywords

community violence Palestinian children Palestinian youth sociodemographic characteristics

Literature Review

In this article, we aim to present findings of a study that examined the rates and characteristics of exposure to community violence (ECV) among Palestinian youth from the West Bank and East Jerusalem, as well as the relationship of such exposure to sociodemographic variables (mainly gender, age, place of residence, and size of locality). The past four decades have witnessed growing public, scientific, and professional interest in the problem of exposure of children and youth to community violence (CV) in many countries. Studies conducted primarily in the United States have documented that, in addition to the risk of significant medical consequences including death, ECV has been linked with a wide array of mental health and psychosocial sequelae such as increased risk for fighting and violence perpetration (e.g., Fowler, Tompsett, Braciszewski, Jacques-Tiura, & Baltes, 2009), heightened anxiety, depression, somatic complaints, and symptoms of posttraumatic stress disorder (PTSD; e.g., Cooley-Quille, Boyd, Frantz, & Walsh, 2001; Fitzpatrick, Piko, Wright, & LaGory, 2005), greater use of illicit psychoactive substances (e.g., Margolin & Gordis, 2000; Sanders-Phillips, 1997), and cognitive and academic delays (Ratner et al., 2006; Schwab-Stone et al., 1999). However, despite the recent public and professional discussions of CV in the Arab world, there is a serious dearth of research on this problem in the Arab world, including the Palestinian Authority. Extensive research has been conducted during the last three decades on the exposure of Palestinian children and youth to political and military violence in their communities (e.g., Qouta, Punamaki, & El Sarraj, 2008). This research focused on violence related to the Arab–Israeli conflict, whereas there is a serious lack of research on their exposure to violence within and outside of their communities (e.g., school violence, crime, violence between neighbors, etc.) that is not perpetrated against the background or in relation to the Arab–Israeli conflict.

CV is commonly defined as behavior or acts by an individual or group of individuals that aim to harm another person or group of people occurring in community settings, such as neighborhoods, schools, or public spaces (e.g., chasing, threatening, beating up, theft, robbery, rape, shooting, stabbing, and hitting—Buka, Stichick, Birdthistle, & Earls, 2001; Guterman, Cameron, & Staller, 2000). In the literature, a distinction is made between direct exposure and personal victimization (i.e., experiencing violence) on the one hand, and indirect exposure (i.e., witnessing violence) on the other (Guterman et al., 2000; Richters & Martinez, 1993). Further to that approach, the present study distinguished between experiencing and witnessing CV among Palestinian youth. In essence, we examined the total exposure of Palestinian youth to CV, as well as their personal experience with and witnessing of different acts of violence in various places in the community and by different people.

ECV is a multidimensional problem, and is related to several factors. In the US National Survey of Adolescents, 23% of the participants reported that they had been victims of and witnessed CV during their life time (Kilpatrick, Saunders, Resnick, & Smith, 1995). A recent study by Finkelhor, Ormrod, Turner, and Hamby (2005), which examined exposure to violence and crime among 1,000 children and adolescents aged 2 to 17 years, revealed that more than half of the participants had experienced physical violence during the year of the survey; over one fourth had experienced a property offense during that period, and about 14% of them had experienced some form of abuse. In addition, the findings of that study revealed that about 8% of the children and youth had experienced sexual abuse, over one third had witnessed or experienced another form of indirect abuse, and only 29% had not experienced any type of direct or indirect abuse. Other studies have revealed that over half of the children living in urban areas had witnessed violence such as robbery, stabbing, or shooting. In addition, 20% to 40% of the children living in urban areas had been victims of CV such as being chased, beaten, threatened by different types of nonlethal weapons, or even shooting (Fitzpatrick & Boldizar, 1993). A study conducted among American urban adolescents revealed that 67% of them had witnessed shooting, 50% had witnessed stabbing, and 25% had been victims of severe violence (Jenkins & Bell, 1997).

A study of youth in Belgium revealed that 54% had witnessed mild violence and about 38% had experienced such violence, where the annual rates of witnessing and directly experiencing severe violence were about 28% and about 9%, respectively (Vermeiren, Ruchkin, Leckman, Deboutte, & Schwab-Stone, 2002). A recent survey conducted among Arab youth from Israel revealed that nearly all of the participants (99.8%) reported that they had witnessed CV in their lifetimes, and 64.4% had personally experienced CV during their lives (Haj-Yahia, Leshem, & Guterman, 2011).

There are several characteristics that predict children’s exposure to CV. Of those, the major characteristics are sociodemographic, for example, the socioeconomic status of the children’s family and community, as well as race and ethnic affiliation, gender, and age (e.g., Vorhies, Guterman, & Haj-Yahia, 2011). In the following review, we will refer to these characteristics—except for race and ethnic affiliation, which were not examined in this study because all of participants were Palestinians and there are no racial or ethnic differences among them.

Socioeconomic status

CV is most likely to occur in urban neighborhoods, which are characterized by high concentrations of low-income families living in poor housing conditions, as well as by high rates of drug abuse (Groves, 1997; Overstreet, Dempsey, Graham, & Moely, 1999). Studies have revealed that in urban neighborhoods, about one third of the children and youth are victims of violence, and almost all of them have been exposed to CV (Margolin & Gordis, 2000). Campbell and Schwartz (1996) found that 57% of the children living in the suburbs and 88% of the children in the urban area of Philadelphia had been exposed to hitting, robbery, stabbing, shooting, or murder.

Inner-city areas are usually characterized by poverty, poor infrastructure, impoverished economic opportunities, and socioeconomic deprivation. This exacerbates levels of personal and social stress, and enhances tolerance of violence (Elliot, Wilson, Huizinga, & Sampson, 1996). Nonetheless, such violence can also occur in suburban areas (O’Keefe & Sela-Amit, 1997) as well as in rural areas, regardless of housing or other socioeconomic conditions (Slovak & Singer, 2002; Sullivan, Kung, & Farrell, 2004). Findings have revealed that about one fourth of the youth living in rural areas that are not defined as poor have been exposed at least once to violent incidents that involve shooting (Slovak & Singer, 2002).

Gender

Numerous studies conducted among children and youth have revealed that boys are more likely than girls to be exposed to CV (Fitzpatrick & Boldizar, 1993; Haj-Yahia et al., 2011; Schwab-Stone et al., 1995; Selner-O’Hagan, Kindlon, Buka, Raudenbush, & Earls, 1998). However, girls are at greater risk for ECV involving sexual abuse (Rudolph & Hammen, 1999). Besides these findings, which indicate that ECV is higher for boys than for girls (Rennison & Rand, 2003), there is also evidence that gender differences in ECV depend on age (Attar, Guerra, & Tolan, 1994; Shahinfar, Fox, & Leavitt, 2000).

Age

Studies have revealed that older youth are at more risk for exposure to CV than younger youth (Richters & Martinez, 1993; Weist, Acosta, & Youngstorm, 2001). Although these studies revealed a strong positive correlation between age and dimensions of exposure to CV, the research findings on this topic are inconsistent. It has been hypothesized that many children witness CV at a very young age when the incidence and prevalence of violence in their community is high (Bell & Jenkins, 1993). Several studies have provided empirical support for this claim. For example, 78% of the children aged 3 to 4 years participating in a study conducted by Shahinfar et al. (2000) had been exposed to at least one incident of CV. Furthermore, in a survey conducted among first, second, fifth, and sixth graders in Washington, DC, by Richters and Martinez (1993), more older children than younger children reported that they had been victims of violence (32% vs. 19%), and that they had witnessed violence or had been indirectly exposed to a violent assault (72% vs. 61%). However, a study conducted among children aged 7 to 15 years revealed no relationship between age and witnessing murder, shooting, or stabbing (Bell & Jenkins, 1993). Official homicide reports indicate that the risk of violent death as a result of assault by a nonfamily member remained low until adolescence and then increased dramatically, reaching a peak at age 20 years. After age 20, the risk was found to decline throughout the rest of the lifespan (Snyder & Sickmund, 2006). Several studies have revealed evidence in support of this trend. However, as mentioned, the findings are inconsistent, and depend to some extent on the subgroups that are examined (Vorhies et al., 2011). For example, studies conducted among urban minority populations have revealed high rates of exposure to CV among all age groups (Linares et al., 2001; Miller, Wasserman, Neugebauer, Gorman-Smith, & Kamboukos, 1999). In addition, the dimensions of ECV among African American elementary school students have been estimated at over 30% (Bell & Jenkins, 1993; Schiff & McKay, 2003). However, the dimensions of exposure to violence among African American high school students have been estimated at between 61% and 71% (Jenkins & Bell, 1994; Uehara, Chalmers, Jenkins, & Shakoor, 1996; Voisin, 2003).

Research Questions

Given the dearth of ECV studies in the Arab world, including research among Palestinian youth, the present study is the first to examine ECV among Palestinian youth, and to establish the links between ECV and demographic factors. This study examines the following questions: What are the rates and characteristics of exposure to different types of CV among Palestinian youth from the West Bank and East Jerusalem? Is there a correlation between the age, gender, and size of locality of residence of those youth and their exposure to different types of CV? It is hoped that this study will pave the way for more comprehensive research on the characteristics and risk factors of ECV among Palestinian youth as well as among youth in the wider Arab world.

Method

Participants

The study sample consisted of 1,930 Palestinian students (912 boys, 1,018 girls) in Palestinian junior and senior high schools in the West bank (N = 1,096) and East Jerusalem (N = 834). The age range of the participants was 12 to 19 years (M = 16.4, SD = 1.04). Although the age range in junior and senior high schools is usually 12 to 18 years, several participants in this study were 19 years old. This can often be attributed to the political situation in the area (e.g., some pupils miss years of schooling due to being arrested or closure of schools). Moreover, the Palestinian education system permits some pupils to repeat a year of studies if they fail in several topics.

Based on information available from the Palestinian Ministry of Education and Higher Education, a systematic random sample of localities was selected from four, out of 16 districts, taking into consideration the following factors: region (North, Middle, and South of the West Bank as well as East Jerusalem), number of residents and pupils in the district, size of locality, and type of locality of residence (i.e., urban areas, rural areas, refugee camps, and Bedouin areas). Since there are no secondary schools in the Palestinian refugee camps and Bedouin areas, attempts were made to choose schools that also absorb pupils from refugee camps as well as from Bedouin areas. The sample consisted of participants from a wide range of sizes of localities of residence, ranging from 4,000 to 250,000 residents (M = 122, 036, SD = 107,442). For purposes of data analysis, those localities have been divided into the following three groups of sizes: less than 15,000 residents (N = 643, 42.2%), 15,001 to 100,000 (N = 157, 10.3%), and 100,001 to 250,000 (N = 725, 47.5%) (because of missing values, the total of all three groups is not 1,930).

Questionnaire

The questionnaire was translated from English into Arabic, and pilot tested by five Arab professionals, who evaluated about the suitability, clarity, and relevance of the questions. Those professionals were experts in the fields of sociology, psychology, social work, and education, and specialized in the topics of violence, family, and adolescence. Afterwards, the questionnaire was back-translated into English by an independent expert in translation. The translated version was then pilot tested among Palestinian adolescents, and refined further for clarity. The questionnaire comprised the following sections:

Sociodemographic information included questions about the participant’s age, gender, and religion, as well as questions about the size and type of locality of residents and father’s and mother’s level of education.

Age of first exposure to CV was measured by asking the participants to recall their first time of exposure to various events of CV and specify their age at the time of exposure to every event.

Exposure to CV was measured using an adapted version of the My Exposure To Violence Scale (My ETV; Selner-O’Hagan et al., 1998). The original English version has reported satisfactory psychometric properties (Selner-O’Hagan et al., 1998), and examines exposure to different types of violence experienced by older children and adolescents as victims, perpetrators, or witnesses. Selner-O’Hagan et al. (1998) maintain that the six scales that compose the My ETV were found to have high internal consistency (r = 0.68 to 0.93), test–retest reliability (r = 0.75 to 0.94), and good evidence of construct validity.

Based on consultations with the professional judges, as well as on the results of the pilot studies among adolescents, a number of changes were made in the original version of the scale. In particular, several items were removed, because the definition of CV in this study did not include the participants’ violent behavior or their exposure to accidents.

In the original My ETV, exposure was measured in three locations: at home, at school, and in the neighborhood. Violence in the home of the participants was not assessed in this study, because the main purpose of this study was to examine exposure to violence in the nonpersonal, nonprivate, and public spheres rather than in the private familial sphere. ECV was assessed in five areas: “at the home of a non-relative acquaintance,” “at the home of a stranger,” “in school,” “in the neighborhood,” and “outside the neighborhood.” Frequency of exposure to violence was assessed across five levels: no exposure, one-time exposure, 2 to 3 exposures, 4 to 10 exposures, and more than 10 exposures during the past 12 months. In addition to questions about the annual incidence of exposure to violence, participants were asked to indicate whether they had been ever in their lifetimes exposed to each type of violence.

To measure the degree of closeness with the victim and perpetrator of violence, and to focus on exposure to violence outside of the home, a three-item subscale was used to ascertain whether the victim was “a close acquaintance who is not a family member,” “an acquaintance,” or “a stranger.” The same three items were used in reference to the perpetrator. The degree of exposure to violence in the community was measured via three scales:

Lifetime chronicity of exposure to violence was calculated as the dichotomized (yes = 1, no = 0) sum of the final 12 items to which the participant may have responded positively, on the basis of a dichotomous scale: 0 (no) and 1 (yes). The Cronbach’s α internal reliability of the Arabic version in this study was 0.76. This scale consisted of two subscales: lifetime witnessed CV (Cronbach’s α = 0.71), and lifetime personally experienced violence (Cronbach’s α = 0.58). The low αs most likely reflect that the items were all dichotomous.

Exposure to violence over the past year was rated on a 12-item scale (Cronbach’s α = .83), included seven-item of subscale of the frequency of witnessed CV during the past year (Cronbach’s alpha = 0.76), as well as the five-item subscale of frequency of personally experienced CV during the past year (Cronbach’s α = 0.69).

Procedure

A self-administered questionnaire was completed anonymously by students during one class period of a school day. To minimize bias or distortion in reporting as a result of exposure to political violence, which is very common in the area, participants were informed before they started filling-out the questionnaires that questions do not refer to any type of political violence committed as related to the Arab–Israeli conflict. This was also clearly indicated at the beginning of the questionnaire (i.e., on the introduction and instructions page). Although the communities were selected by type of location, religious heterogeneity (Muslim and Christian residents), districts, and numbers of residents in the district, they could not be stratified by socioeconomic status because no such information was available about the strata of communities in the Palestinian National Authority. However, a heterogeneous sample of Palestinian youth was reached in terms of the above mentioned variables, that is, gender, age, and religion, as well as the location and type of residence. Hence, it can be argued with some level of confidence that the results of this study can be generalized to all populations of Palestinian youth in the West Bank and East Jerusalem.

Data were collected between October and December 2004, and the communities were sampled simultaneously from four districts, with no self-selection bias. In each sampled district, two schools (one senior high school and one junior high school) were selected. In cases when the school administration of the selected school refused to participate in the study, another school of the same size, from the same district, was approached—until the school principal provided consent for the survey to be conducted at the school. Six out of eight school principals who were approached consented to let their students take part in the study. The sample in every school consisted of one or two classes for each age group, from 7th to 12th grade, from eight schools.

After receiving permission from school administrators, the researchers visited each classroom, together with its homeroom teacher and the educational counselor of the school, and explained the research to the students. Explanatory notes and consent forms were distributed to the students, which were to be signed by the students and one of their parents. Students were asked to give the notes to their parents and return the signed consent forms prior to the date that the survey was scheduled to be administered; 76% of all recruited families agreed to let their children participate in the study. After returning signed consent forms, all of the adolescent participants whose families consented to their participation in the study completed the questionnaires in the classroom anonymously, with no identifying information.

Results

Lifetime chronicity of exposure to violence in the community

Table 1 displays results on the exposure of participants to various types of CV throughout their lives, and gender differences. The big majority of the participants (87.4%) reported they had witnessed CV in their lifetimes, and 72.8% of the participants reported they had personally experienced CV during their lives. Almost all of the participants (99.1%) were exposed to at least one form of CV throughout their lives. Boys were significantly more exposed to all types of violence assessed than girls, except for hearing shots, where girls reported a higher rate of exposure (χ² = 20.82, p < .001).

Table 1.

Lifetime Exposure to Witnessed and Personally Experienced Community Violence Among Palestinian Youth, by Gender (N = 1,930).

Violence and Type of Exposure	Exposed N ( %)	Boys N = 912	Girls N = 1018	χ²
Witnessing
Chasing	1316 (72.1%)	78.5%	66.3%	33.39***
Beating	1397 (73.9%)	76.3%	71.7%	5.33*
Assault with weapon	1187 (62.6%)	68.5%	57.4%	24.98***
Assault with firearms	1022 (53.6%)	57.2%	50.3%	9.16**
Injury by firearms	704 (37.2%)	42.8%	32.2%	21.91***
Hearing shots	1698 (89.1%)	85.6%	92.2%	20.82***
Violent death	567 (29.8%)	34.0%	26.0%	14.24***
Total witnessing	1488 (87.4%)	90.6%	83.8%	17.96***
Personal experience
Chasing	810 (42.5%)	54.5%	31.9%	98.67***
Beating	1036 (55.1%)	61.3%	49.6%	25.99***
Assault with weapon	465 (24.4%)	34.8%	15.1%	99.63***
Firearm assault	418 (22.0%)	31.5%	14.0%	80.12***
Injured by firearm	126 (6.6%)	11.3%	2.5%	59.96***
Total personal experience	1373 (72.8%)	82.0%	64.5%	72.90***

p < .05. * p < .01. *** p < .001.

Exposure to violence during the past year

As shown in Table 2, boys reported that during the past 12 months, they had witnessed approximately 21 incidents of violence on the average (M = 20.64, SD = 17.21) and personally experienced approximately five incidents (M = 5.26, SD = 7.75). Palestinian girls reported witnessing approximately 17 incidents on the average (M = 17.45, SD = 16.34) and personally experiencing three incidents of violence (M = 3.00, SD = 5.76) during the past year. Boys reported significantly higher frequency of exposure (witnessing and personal experience) than did girls, across all types of violence, except for hearing shots, were both genders reported the similar rates of exposure.

Table 2.

Means and Standard Error Mean (SE) of Frequency of Exposure to Different Types of Community Violence Among Palestinian Youth during the Past Twelve Months, by Gender (N = 1,930)

	Boys		Girls
Type of Violence	M	SE	M	SE	Z
Witnessing
Chasing	2.56	1.29	2.07	1.24	−8.30***
Beating	2.42	1.23	2.19	1.21	−4.43***
Hearing shots	3.53	1.63	3.54	1.55	−.17
Assault with weapon	2.04	1.17	1.84	1.08	−3.88***
Assault with firearms	2.07	1.31	1.86	1.22	−3.80***
Injury by firearms	1.75	1.63	1.55	1.07	−5.10***
Violent death	1.59	1.05	1.49	1.03	−3.02**
Total witnessing	20.64	17.21	17.45	16.34	−4.82***
Personal experience
Chasing	1.83	1.07	1.59	.91	−8.10***
Beating	1.94	1.14	1.71	1.12	−5.89***
Assault with weapon	1.48	.85	1.20	.62	−9.95***
Assault with firearms	1.49	.88	1.18	.54	−9.45***
Injury by firearms	1.22	.65	1.04	.25	−9.15***
Total personal experience	5.26	7.75	3.00	5.76	−9.37***
Total exposure	25.90	22.53	20.70	19.37	−5.47***

p < .01. *** p < .001.

Note. Due to nonnormal distribution, especially regarding exposure to incidents of low frequency, the Wilcoxon–Mann–Whitney test was used to examine the significance of gender related differences in the frequency of exposure to the different incidents of violence.

Age of first exposure

Table 3 summarizes results concerning age of first exposure to different types of CV by gender. The average age for first witnessing a person beaten was 13.14 (SD = 3.07), the average age for personally experiencing a beating was 11.72 (SD = 3.31), and the average age for witnessing a person being chased was 12.13 (SD = 3.24). The average age for being personally chased for the first time was 12.53 (SD = 3.15). The average age for personally being assaulted with firearms was the highest, 14.49 years (SD = 2.20). Results reveal that the first age of boys’ witnessing chasing, beating, and hearing shots, as well as experiencing chasing, was significantly earlier than their female counterparts. There were no significant differences among boys and girls in their first age of exposure to other acts of CV.

Table 3.

Characteristics of Age of First Exposure Among Palestinian Youth (N = 1,930).

	Total N = 1,930			Boys N = 912			Girls N = 1,018
	M	SD	SE	M	SD	SE	M	SD	SE	F
Witnessing
Chasing	12.13	3.239	0.090	11.70	3.286	0.127	12.59	3.126	0.125	24.96***
Beating	13.14	3.073	0.084	12.90	3.151	0.122	13.37	2.979	0.115	7.77**
Hearing shots	12.87	3.213	0.081	12.52	3.345	0.124	13.17	3.067	0.105	15.97***
Assault with weapon	13.28	3.006	0.088	13.24	3.022	0.123	13.32	2.990	0.128	0.243
Assault with firearms	13.94	2.822	0.090	13.80	3.114	0.139	14.09	2.480	0.113	2.527
Injury by firearms	13.98	2.640	0.101	13.93	2.744	0.142	14.05	2.511	0.143	0.387
Violent death	13.96	2.848	0.122	13.83	3.190	0.184	14.12	2.373	0.150	1.420
Personal experience
Chasing	12.53	3.146	0.114	12.17	3.096	0.144	13.05	3.151	0.181	14.72***
Beating	11.72	3.312	0.106	11.71	3.295	0.145	11.74	3.334	0.157	0.021
Assault with weapon	12.97	4.528	0.217	13.26	4.918	0.284	12.35	3.474	0.296	3.813
Assault with firearms	14.49	2.197	0.109	14.34	2.326	0.142	14.78	1.889	0.163	3.639
Injury by firearms	13.84	3.017	0.269	13.73	2.960	0.290	14.34	3.300	0.704	0.739

M, mean age (years); SD, standard deviation; SE, standard error mean.

p < .01. *** p < .001.

Differences in exposure during the past year among Palestinian participants from different sizes of localities

As reported in Table 4, comparisons of ECV among participants from the following three sizes of localities were conducted: Palestinian youth living in small localities (4,000-15,000 residents), in medium size localities (15,001-100,000 residents), and in large localities (100,001 residents and over). Notably, the sizes of the localities were not heterogeneous enough to warrant another categorization.

Table 4.

Means and Standard Error Mean (SE) of Frequency of Exposure to Different Types of Community Violence Among Palestinian Youth during the Past Twelve Months, in Small, Medium, and Large Localities (N = 1,930)

Locality Size	Small N = 643		Medium N = 157		Large N = 725
Type of Violence	M	SE	M	SE	M	SE	χ² (df = 2)
Witnessing
Chasing	2.24	0.046	2.59	0.090	2.32	0.045	14.2**
Beating	2.32	0.046	2.48	0.091	2.27	0.043	6.3
Hearing shots	3.98	0.056	4.45	0.090	2.84	0.054	269.4***
Assault with weapon	2.03	0.045	2.18	0.094	1.85	0.037	18.1***
Assault with firearms	2.30	0.054	2.27	0.095	1.63	0.037	133.6***
Injury by firearms	1.94	0.051	1.84	0.085	1.36	0.028	123.4***
Violent death	1.82	0.050	1.58	0.072	1.28	0.025	110.3***
Total witnessing	22.89	0.701	23.79	1.16	13.83	0.536	168.3***
Personal experience
Chasing	1.74	0.039	1.90	0.090	1.59	0.034	22.5***
Beating	1.91	0.045	2.06	0.094	1.67	0.037	34.4***
Assault with weapon	1.42	0.032	1.61	0.078	1.22	0.021	56.3***
Assault with firearms	1.48	0.034	1.49	0.068	1.17	0.019	102.2***
Injury by firearms	1.20	0.024	1.13	0.032	1.07	0.014	35.3***
Total personal experience	4.93	0.295	5.74	0.560	3.10	0.217	79.4***
Total exposure	27.96	0.890	29.45	1.53	16.92	0.669	159.6***

p < .01. *** p < .001.

Note. Due to nonnormal distribution, especially regarding exposure to incidents of low frequency, the Kruskal—Wallis test was used to examine the significance of differences in the frequency of exposure to the different incidents of violence, between Palestinian youth from small, medium, and large towns.

Residents of smaller localities reported significantly higher frequency of ECV than did residents of larger localities (i.e., residents of medium and large towns); except for witnessing beating, where no significant difference was found among participants from localities of different sizes.

Palestinian youth from small localities reported that during the past 12 months, they had witnessed approximately 23 incidents of violence on the average (M = 22.89, SD = 17.8) and personally experienced almost five incidents (M = 4.93, SD = 7.6). Palestinian youth living in large localities reported witnessing almost 14 incidents on the average (M = 13.83, SD = 14.6) and personally experienced three incidents of violence (M = 3.1, SD = 6.2) during the past year.

Location of exposure to CV during the past year

As reported in Table 5, participants reported that the primary location for witnessing most types of CV was outside their neighborhood. More than 60% of the participants indicated that they had witnessed a person being beaten, being assaulted by firearms, being injured by firearms, witnessed a violent death, or heard shots outside of the neighborhood. However, they reported that the primary site of their witnessing chasing (60.9%) was in their neighborhood. Results in Table 5 also reveal that a high percentage of the Palestinian youth were chased, beaten, assaulted, and/or injured in their neighborhood or outside their neighborhood. Nonetheless, less than 10% of the participants reported personal experience with CV at the home of a stranger, while between 10.5% and 17.2% of them were victimized at the home of nonrelative acquaintance.

Table 5.

Prevalence of Exposure to CV in Different Locations, Among Palestinian Youth, Over the Past Twelve Months (Percentage of Participants Who Reported Exposure to Violence at Each Location in the Entire Sample, N = 1,930)

	Location of Witnessing Community Violence					Location of Experiencing Community Violence
Type of Incident	Home of a Nonrelative Acquaintance	Home of a Stranger	At School	In the Neighborhood	Outside the Neighborhood	Home of a Nonrelative Acquaintance	Home of a Stranger	At School	In the Neighborhood	Outside the Neighborhood
Chasing	14.8%	10.1%	38.9%	60.9%	56.4%	10.5%	6.3%	27.3%	52.6%	53.4%
Beating	11.9%	9.7%	24.4%	52.2%	60.7%	16.8%	5.5%	36.4%	47.4%	26.9%
Hearing shots	12.9%	11.6%	18.4%	65.2%	65.1%	N/A	N/A	N/A	N/A	N/A
Assault with weapon	14.1%	9.8%	18.2%	53.6%	57.7%	13.0%	8.8%	29.1%	52.3%	39.3%
Assault with firearms	7.5%	7.3%	13.7%	49.9%	62.6%	10.4%	7.8%	23.7%	49.7%	51.6%
Injury by firearms	7.2%	9.1%	14.3%	43.7%	63.8%	17.2%	8.4%	29.7%	51.0%	47.7%
Witnessing violent death	10.7%	14.0%	9.4%	41.2%	66.0%	N/A	N/A	N/A	N/A	N/A

Note: N/A = not applicable.

The relationship with the victim and perpetrator of violence

Table 6 displays results regarding participants’ acquaintance with victims and perpetrators of CV. Emphasis is placed on those who witnessed different incidents of violence during the past year, while distinguishing between the various types of violence. For example, 38.0% and 60.8% of the participants indicated that they had witnessed a person being chased by an acquaintance and a stranger, respectively; and 36.8% and 61.3% of the participants indicated that they had witnessed a person being beaten by an acquaintance and a stranger, respectively. For all of the reported CV events, both perpetrator and victim were unknown to the participants witnessing the act. However, participants who personally experience beating (46.1% of beating events) or knifing (47.3% of knifing events) had reported that the perpetrators were familiar to them.

Table 6.

Acquaintance With the Perpetrator, Among Palestinian Youth Who Witnessed and Experienced Community Violence During the Past Twelve Months (Percentage of Participants in the Entire Sample, N = 1,930)

	Witnessing Community Violence						Experiencing Community Violence
Type of Incident	Perpetrator is a Close Acquaintance	Perpetrator is an Acquaintance	Perpetrator is a Stranger	Victim is a Close Acquaintance	Victim is an Acquaintance	Victim is a Stranger	Perpetrator is a Close Acquaintance	Perpetrator is an Acquaintance	Perpetrator is a Stranger
Chasing	20.2%	38.0%	60.8%	23.6%	33.1%	57.4%	21.4%	35.1%	55.5%
Beating	18.2%	36.8%	61.3%	22.9%	35.9%	56.2%	30.7%	46.1%	27.2%
Assault with weapon	20.7%	37.3%	57.1%	25.2%	35.0%	56.1%	25.1%	47.3%	38.9%
Assault with Firearms	11.3%	23.1%	73.9%	24.1%	31.2%	60.2%	8.8%	25.5%	76.3%
Injury by firearms	11.3%	23.3%	71.2%	26.1%	30.0%	55.9%	18.1%	28.4%	67.1%
Witnessing violent death	11.6%	23.5%	72.8%	21.8%	28.6%	61.7%	N/A	N/A	N/A

Note: N/A = not applicable.

Table 6 also displays results regarding the type of relationship with the perpetrator (level of acquaintance with the perpetrator) among adolescents who personally experienced CV during the past year, while distinguishing between different types of violence. In most cases of witnessing CV, participants reported that the perpetrator and the victim were strangers to them.

Victims of CV reported that in most of the events the perpetrator was a stranger (55.5% of chasing reports, 76.3% of firearm assault reports, and 67.1% of firearm injuries reports). However, 46.1% and 46.3%, of the participants who had experienced beating and knifing respectively, during the last year, reported that the perpetrator was an acquaintance.

Discussion

Summary and Discussion

The findings of this study revealed that high percentages of Palestinian youth had experienced CV in their lifetime, and that about nine out of 10 of them had witnessed different violent incidents in the community. The findings also indicate that high percentages of the Palestinian youth had witnessed CV over the past year, and that substantial percentages of them had personally experienced CV during that period. Overall, the rates of ECV among Palestinian youth—both in their lifetime and over the past year—were much higher than the rates found among youth from other countries in the world, although the rates of exposure to certain types or acts of CV are similar among Palestinian youth and their counterparts from other countries (Finkelhor et al., 2005; Osofsky, 1995; Ozer, 2005; Ozer & Weinstein, 2004; Scarpa, 2003; Scarpa, Hurley, Shumate, & Haden, 2006; Vermeiren et al., 2002).

The present study also revealed that the frequency of witnessing CV was greater than the frequency of experiencing such violence. These findings are consistent with the results of studies conducted in other countries, which have identified similar patterns with regard to the rates of witnessing and experiencing CV (Brown, Hill, & Lambert, 2005; Ozer, 2005; Scarpa, Hurley et al., 2006; Vermeiren et al., 2002). In addition, the findings of this study, like the results of previous research (e.g., Cooley-Quille et al., 2001), indicate that recurrent or chronic ECV has a more significant impact than one-time exposure. It is also noteworthy that on the average, the Palestinian youth examined in this study had experienced over five acts of CV over the past year: boys and girls witnessed about 21 and about 17 incidents of CV during that period, respectively. These findings can be explained by the fact that the number of people who witness a violent incident is usually greater than the number of people who actually experience it, or get involved in it directly, as revealed in this study (e.g., Tables 1, 2, 5, and 6), as well as in other similar studies (e.g., Haj-Yahia et al., 2011). Although it can be reasonably assumed that the trauma of experiencing a violent incident is greater than the trauma of witnessing it, the frequency of overall witnessing CV among youth is considerably higher than the frequency of experiencing such violence. The findings of the current study highlight the importance of considering the frequency of witnessing CV as an important component of exposure to such violence.

Overall, the findings indicate that among Palestinian youth, the frequency of exposure to incidents of mild CV is greater than the frequency of exposure to severe CV. This trend has also been found in previous studies conducted among other populations of youth (e.g., Cooley-Quille et al., 2001; Scarpa, 2001, 2003; Scarpa et al., 2002). For example, it has been found that youth who live in communities that are not defined as being at risk were exposed to less severe incidents of CV, but the frequencies of their exposure were similar to those found among youth living in communities at risk (Scarpa, 2001, 2003; Scarpa et al., 2002; Scarpa, Haden et al., 2006).

In contrast to the findings of several studies conducted in countries throughout the world, which have revealed a higher frequency of ECV among youth in large urban localities than in small rural localities (e.g., Groves, 1997; Margolin & Gordis, 2000), the findings of the present study indicated that ECV among Palestinian youth from small localities was greater than among their counterparts from large localities. In this study, the small localities (with up to 15,000 residents) were villages, refugee camps, and Bedouin areas. Although there is a lack of research on the characteristics of these localities, it is known that they have a very poor infrastructure of educational and welfare services, and that disputes and feuds between hamulot (clans of extended families) in those localities are frequent. Moreover, these localities were characterized by high rates of poverty and unemployment as well as poor housing conditions (especially in Bedouin areas and refugee camps). The relationship of these characteristics of localities to dimensions of CV was not examined in this study. Hence, there is a need to conduct more comprehensive research on the quality and conditions of life in different types of localities (i.e., cities, villages, Bedouin areas, and refugee camps) in the Palestinian Authority and throughout the Arab world, and the relationship of those characteristics to different dimensions of CV (including rates and characteristics). In particular, examining the socioeconomic characteristics of the community, at the collective level, rather than just the socioeconomic situation of individuals and families in the community—including rates of poverty and unemployment, the quality and accessibility of various services and infrastructures, and different characteristics of the community such as weak social and professional capital—could enrich our knowledge and understanding of CV in the region. It is also important to note that each of the four types of localities has unique sociopolitical, sociocultural, and even religious characteristics. Therefore, an examination of the relationship of those characteristics to CV in each of the four types of localities would further enhance our understanding of this problem in the region. For example, rural and Bedouin areas in the Palestinian Authority are within the civil jurisdiction of the Palestinian Authority—but in terms of security, they are under Israeli control. According to the agreement between Israel and the Palestinian Authority, the Palestinian police force is forbidden to enter the rural and Bedouin areas. However, the Israeli police force usually deals only with political affairs that they view as a security threat to Israel. In contrast, there is usually a presence of the Palestinian police in urban areas of the Palestinian Authority. Is the lack of police control in rural and Bedouin areas a risk factor and catalyst for the proliferation of CV in those areas? Conversely, is the presence of Palestinian police in urban areas a deterrent against the proliferation of CV in cities? To cite another example, although rural and Bedouin areas are characterized by high social solidarity, this solidarity is among clan and tribe members (i.e., intraclan and intratribe solidarity), and less based on concern for the interests of the whole community per se (i.e., less intertribes solidarity). Is this type of solidarity a risk factor for more CV in these areas than in urban areas? Future studies on these characteristics and their relationships to CV can enhance our understanding of the characteristics and risk factors for the problem in the region.

Examination of the extent of familiarity of Palestinian youth with the parties involved in violent incidents (perpetrators and victims) revealed that most of the youth who have experienced CV were attacked both in their neighborhood and outside of their neighborhood. Nonetheless, their experience with beating was more in the school and in the neighborhood than in the home of a stranger, in the home of a relative acquaintance, or outside of the neighborhood. However, more youth had witnessed an incident of CV in the neighborhood and outside of the neighborhood in comparison with the percentage of youth who had witnessed violence in the school, in the home of a stranger, and in the home of a nonrelative acquaintance. These differences might derive from the different mechanisms of exposure. Witnessing violence is a random occurrence, and witnesses are not personally involved in the violent incidents. In contrast, experiencing of violence is often an interactive process, in which the participant is actively involved. As such, it can be assumed that in adolescence, there are usually interactive processes that culminate in violent incidents between youth who are acquainted with one another.

The relatively low levels of experiencing violence in the home of a nonrelative acquaintance, in the home of a stranger, and at schools are noteworthy, although more youth experienced violence at school than in the other two locations. This finding can be attributed to the high level of control and supervision in these contexts and to the presence of a responsible adult, as well as to the discipline that is expected of youth in traditional contexts such as Palestinian society when they are at school and when they are visiting the home of friends. In light of the high levels of ECV that were found in the neighborhood and outside of the neighborhood, it would be worthwhile to conduct more comprehensive studies that examine where exposure occurs, when it occurs, who are involved, and the various causes of exposure in those two locations.

The findings also revealed that exposure to all of the types and characteristics of CV examined in the study were significantly higher among boys than girls. These findings are consistent with the results of previous research (Brookmeyer, Fanti, & Henrich, 2006; Haj-Yahia et al., 2011; Scarpa, Haden et al., 2006). The gender gap in levels of ECV might be explained by routine activities theory and by the lifestyle model of victimization. Routine activities theory maintains that changes in the lives of the adolescents, which include moving the focus of their activity outside of the home, provide greater opportunities for exposure to violent elements. It can also be assumed that among youth who regularly participate in activities outside of the home, where they encounter strangers without supervision by a parent or responsible adult, there is a greater risk of experiencing violence and being exposed to crime (Cohen & Felson, 1979). The lifestyle model of victimization maintains that the extent of personally experiencing violence is influenced by lifestyle—including routines related to work, school, and recreational activities. Lifestyle develops in light of functional expectations, cultural norms, and status aspirations related to demographic variables (Hindelang, Gottfredson, & Garofalo, 1978). As children grow older, they are expected to draw away from parental control and the family environment, spend more time at school, and become more involved in peer group activities. Girls are expected to spend more time at home under the close supervision of their parents (Hindelang et al., 1978). This situation applies all the more to girls in Arab societies, including Palestinian society (Haj-Yahia, 1995). Gender differences in types of activity also derive from differences in patterns of communication among boys and girls. Girls form a tighter array of bonds with a limited number of girls, whereas boys build loose connections with a larger number of boys (Gilligan, 1982; Haj-Yahia et al., 2011).

The group activities of boys are usually more physical, take place in larger groups that include outsiders, very often occur outside of the home, without the supervision of a responsible adult, and are characterized by less social commitment. In contrast, girls gather in smaller, more intimate groups, their activities are less physical, and usually occur at home or in a controlled, protected environment. Therefore, the routine activities and lifestyle of boys cause them to be exposed to more violence than girls. Based on both of these theories, it can be argued that exposure to violence in itself is a risk factor for further exposure, because it generates antisocial behavior that can lead individuals to situations in which the chance of exposure to violence increases (Haj-Yahia et al., 2011; Halliday-Boykins & Graham, 2001; Nofziger & Kurtz, 2005). Undoubtedly, based on these theories, there is a need for a comprehensive conceptualization of the potential risk factors for ECV, which should be accompanied by an empirical examination of the rates and characteristics of ECV among youth in general, and among youth in traditional and transitional contexts such as Palestinian society in particular.

Limitations of the Study and Recommendations for Future Research

Notwithstanding the potential theoretical, empirical, and practical contributions of this study, its limitations should not be ignored. Even though the My ETV has well established psychometric properties as a measure of ECV, and even though it was expanded and revised for the purpose of this study, there are several issues that need to be addressed. In particular, the My ETV was used in this study to measure ECV among Palestinian youth during their lifetime (besides asking them about their ECV during the last year), without measuring the extent of ECV during different periods or years of childhood and adolescence. Moreover, participants were not asked how their interpretations of exposure to each of the violent acts in childhood and adolescence as reported in the measure compared with their interpretations of these experiences at the time of their participation in the study. In addition, questions about exposure to violence during the entire lifetime may result in recall bias, forgetting, or the repression of some of the violence they witnessed and/or experienced during their childhood and/or adolescence. As such, the participants’ reports could have been partial or distorted. Moreover, this result (i.e., partial and distorted reporting) might be intensified by a tendency toward social desirability, taking into consideration that the participants were asked to report about a very sensitive problem. These limitations can be addressed in future research on the topic by inquiring about the contexts in which the participants were exposed to CV, and by asking them about their past and present interpretations of exposure to CV. In addition, it would be worthwhile to incorporate a measure of social desirability in the questionnaire. This measure would facilitate the examination of the extent to which the participants’ responses were influenced by their tendency toward social desirability. Furthermore, if data on the participants’ ECV are obtained from more than one source in their families (e.g., one of their parents) and even from their teachers, this might help overcome or mitigate the abovementioned limitations.

The operationalization of violence in this study focused on exposure to physical violence, whereas other types of exposure such as sexual abuse, verbal and psychological abuse, social abuse, economic exploitation and extortion, and political violence were not examined. It can be assumed that if the operationalization of violence in this study had included other types of exposure as specified above, the results would have yielded a more comprehensive perspective on the rates and characteristics of CV in the lives of Palestinian children and youth. This kind of comprehensive study can also enhance understanding of the relationships among different variables that have relevance to CV, including the correlations among different types of abuse and violence that Palestinian children and youth are exposed to (e.g., political violence, school violence, family violence, and violence between clans and tribes).

Notably, although the participants in the study were told that they are not being asked about political violence—particularly violence occurring in the context of the Arab–Israeli conflict—the relationship between political violence and other types of violence such as child abuse (Haj-Yahia & Abdo-Kaloti, 2003) and violence against women (Clark et al., 2010) cannot be ignored. Therefore, it would be worthwhile to examine exposure to political violence as well as the extent to which political violence is a risk factor for various patterns and types of CV in future studies on the exposure of Palestinian youth to this problem. In addition, although the youth participating in this study were asked about where the violence took place and whether the people involved in the violent incident were acquaintances or strangers, there are unique patterns of violence in traditional contexts, such as Palestinian society, that were not examined in this study, such as violence among clans and tribes. Therefore, future studies on these patterns of violence can enhance knowledge about the sociocultural and sociopolitical context of different types of CV.

It should be noted that this study was conducted among a sample of students enrolled in school, and did not include youth who had dropped out of school. It can be assumed that the dropouts spend time in the community more than their counterparts who attend school, and that they have greater ECV as a result—whether they are witnesses, victims, or perpetrators of such violence. This could bias the frequency of ECV as well as the characteristics and risk factors for such violence. Against that background, future research on the topic should include youth who have dropped out of school. These studies should examine not only the extent of their ECV, but also the specific factors that characterize them (e.g., their employment status, the socioeconomic status of their families, and their involvement in antisocial behavior), as well as the relevance of those factors to the extent of their exposure to different patterns and types of CV (as witness, victims, or perpetrators).

In sum, to expand our knowledge and understanding of youth ECV, we recommend that future research examine the rates and characteristics of children’s and adolescents’ exposure to different types of violence that were not examined in this study (i.e., political violence, violence among clans and tribes, and criminal violence) and their relevance to CV. In addition, future studies should examine more in-depth the relevance of the socioeconomic, professional, and organizational characteristics of the localities in which the research is conducted to the extent and characteristics of CV that children and youth are exposed to. Furthermore, comparisons should be made between youth in the school system versus those who have dropped out of school, as well as comparisons among children and youth from different types of localities (e.g., urban areas, rural areas, refugee camps, and Bedouin areas) as with regard to their ECV. We hope that this study as well as the abovementioned recommendations for future studies will pave the way for further comprehensive research on the mental health consequences of ECV among Palestinian youth and on risk factors, protective factors, and resiliency factors that mediate and moderate these consequences.

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 by grants from the CRB Bronfman Foundation, the Sara Moses Fund, the Sondra and Chen Feldman Fund, and the Milton Rosenbaum Fund.

Author Biographies

Muhammad M. Haj-Yahia earned his doctoral degree in social work from the University of Minnesota, and is currently a professor and Gordon Brown chair in social work at the Paul Baerwald School of Social Work and Social Welfare, the Hebrew University of Jerusalem, Israel. His research areas include family violence, political violence, community violence, and the sociocultural and sociopolitical contexts of child abuse and wife abuse. He has served on the editorial board of Child Abuse & Neglect: The International Journal and is currently an associate editor of that journal, in addition to serving on the editorial boards of Psychology of Violence, Violence Against Women, and several other journals. He has trained and supervised numerous groups of mental health practitioners for work with battered women and maltreated children. In addition, he serves on the boards of several human rights organizations and on the academic counsels of several colleges and research centers.

Becky Leshem is a faculty member at the School of Special Education, Achva College, Israel, and a teacher of special education in several colleges. She represents the Special Education Division of the Ministry of Education on several committees regarding the families of children with special needs. She earned her doctoral degree from the School of Social Work and Social Welfare, the Hebrew University of Jerusalem, Israel, and her research areas include community violence among youth and adolescents and social support contexts.

Neil B. Guterman is the dean and Mose & Sylvia Firestone Professor at the School of Social Service Administration at the University of Chicago. He has served as the principal or coprincipal investigator for a number of federally and privately funded studies concerning child abuse and children’s victimization. He is the founding director of the Beatrice Cummings Mayer Program in Violence Prevention at the University of Chicago, and has served on national and local advisory boards, and has provided collaborative expertise and consultation to federal, state, and local governmental bodies, foundations, national and international advocacy organizations on child maltreatment and children’s exposure to violence.

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