Assessing Adult Exposure to Community Violence

Abstract

Objective:

Although experiences of community violence are linked with negative outcomes for adults and children, few standardized measures assessing community violence exist, and available measures lack consistency concerning the definition of community violence. Further, most measures currently utilized to assess adult exposure to community violence were designed for use with children and adolescents. To address these identified concerns and make recommendations for future research, this article reviews contemporary definitions of community violence, identifies the outcomes of exposure to community violence for adults, and evaluates measures of exposure to community violence with published psychometric data employing adult samples.

Method:

A systematic review of the literature was conducted to identify studies that (1) included a self-report of community violence exposure, (2) included primarily adult respondents, and (3) reported psychometric data.

Results:

Seventeen studies met the inclusion criteria. Measures employed in these studies were reviewed and basic psychometric properties discussed. Notably, the Survey of Exposure to Community Violence was the most commonly used measure among these studies.

Conclusions:

Although multiple measures demonstrated limited but acceptable psychometric performance in select studies, few in-depth psychometric analyses exist for measures of adult exposure to community violence. Also, it is difficult to compare studies due to variations in definitions of community violence and multiple versions of each measure. Recommendations for future research include provision of explicit definitions of community violence and reporting psychometric data for measures.

Keywords

community violence exposure adults psychometrics

Approximately 22 of every 1,000 people in America were victimized by violent crime in 2012 (e.g., aggravated and simple assault; Truman, Langton, & Planty, 2012). Thus, violent victimization represents a compelling concern for individuals, families, and communities. Further, there is a strong and extensive literature documenting the link between exposure to violence (ETV) and negative physical and mental health outcomes (e.g., Coker et al., 2002; Garcia-Moreno et al., 2013; Hedtke et al., 2008). However, across studies, exposure to various types of events (e.g., a physical assault with or without a weapon) is frequently assessed either without distinction between the public and private spheres (e.g., Browning & Jackson, 2013) or is focused on specific forms of domestic violence, such as child abuse or partner violence. In contrast, there is a very limited literature that has carefully operationalized and assessed community violence (Aisenberg & Herrenkohl, 2008; Brandt, Ward, Dawes, & Flisher, 2005).

In addition, although literature concerning the measurement of community violence exposure among children and adolescents is growing, comparatively little scholarship exists regarding the measurement of community violence exposure in adult populations. This article aims to address this gap in the literature by reviewing contemporary definitions of community violence and evaluating measures of exposure to community violence with published psychometric data in adults. In addition, the implications for researchers, clinicians, and policy makers in this area are discussed.

Defining Exposure to Community Violence

At this time, there is limited consensus concerning a parsimonious definition of community violence. Previous research regarding exposure to community violence among children and adolescents has noted the importance of defining the key domains of community violence, including the differentiation between “community” and other settings (e.g., domestic, school, and media exposure) and whether “violence” includes direct or indirect exposures, or both (i.e., victimization and/or witnessing; Aisenberg & Herrenkohl, 2008; Brandt et al., 2005; Fowler, Tompsett, Braciszewski, Jacques-Tiura, & Baltes, 2009; McDonald & Richmond, 2008; Trickett, Duran, & Horn, 2003). In 2000, Guterman and colleagues specifically recommended that researchers in this area include clear conceptual and operational definitions of community violence to allow comparisons across studies.

Also more than a decade ago, Rosenthal (2000) specifically defined community violence exposure, as ongoing (i.e., more than one critical incident), public, nonsexual, and personally experienced (i.e., not experienced through media sources). Similarly, Wilson and Rosenthal (2003, p. 242) qualified community violence as that which is a “nondomestic, nonsexual, non-singular-event.” More commonly used measures of community violence exposure (e.g., the Survey of Exposure to Community Violence [SECV]) have broadly characterized community violence exposure as comprising direct (i.e., victimization) and indirect experiences (i.e., witnessing) of public violence (e.g., “being chased;” “drug activity;” “arrests;” “slapping, hitting, punching;” and “shootings”; Richters & Saltzman, 1990; Wilson & Rosenthal, 2003). In this way, there does appear to be some broad agreement concerning the general nature of community violence exposure (i.e., indirect and direct); however, there is no clear consensus concerning the measurement of the specific parameters of direct and indirect exposure nor is there clear agreement on the nature of where and to whom community refers (Guterman, Cameron, & Staller, 2000). Given this lack of consensus, it is difficult to accurately assess risks associated with community violence exposure for adults, but some existing studies suggest important, potential negative outcomes.

Therefore, it is important that community violence be rigorously assessed based upon a clearly defined construct that represents a meaningful distinction from existing measures of violence and victimization. Indeed, conventional operational definitions do exist for other specific forms of violence, including partner violence (Dutton, Tetreault, Karakanta, & White, 2014), non-partner sexual violence (Abrahams et al., 2014), and family violence (Tolan, Gorman-Smith, & Henry, 2006). The relative clarity with which these forms of violence are measured and operationalized allows researchers to employ accepted measurements and understand specific outcomes associated with each. Furthermore, existing scholarship recognizes the distinct impact of unique forms of violence and victimization. For example, previous research has identified differential posttraumatic outcomes relative to the relationship between victim and perpetrator (e.g., Freyd, 1994). Thus, clear conceptualization of distinct forms of violence offers an important foundation for supporting the recovery and treatment needs of trauma survivors.

However, no such clear operationalization exists for the measurement of community violence. For this reason, it is important that community violence be assessed as a distinct construct concerning one’s public sense of safety and distinct from other forms of violence within the context of specific familial, romantic, or other intimate relationships. The authors propose that community violence refers to the ubiquitous exposure (i.e., witnessing and victimization) to public acts of violence via threatened, witnessed, or completed victimization over time that is not perpetrated by an intimate partner or family member. Specific measurement of community violence would allow for stronger understanding concerning the implications of this form of violence and perhaps yield important outcomes relative to other specific forms of victimization (e.g., non-partner sexual violence, partner violence, and childhood sexual abuse). As noted by Tolan, Gorman-Smith, and Henry (2006) with regard to family violence, it is important to consider ecological and contextual influences within the study of violence and victimization, an aim that would be advanced through specific, valid, and reliable measures of community violence that employ similar operational definitions.

Adult Exposure to Community Violence and Negative Outcomes

While there are comparatively and notably few studies of adults’ experiences of community violence, research conducted by Walling, Ericksson, Putman, and Foy (2011) suggests that rates of adult exposure may be quite high in at-risk communities. Walling and colleagues collected data from an ethnically diverse sample of 284 urban development workers, who ranged in age from 18 to 70 years (M = 35.5, SD = 12). The researchers utilized the SECV(Richters & Saltzman, 1990), a commonly used measure of community violence exposure among children. Notably, 79% of the adults in this sample reported direct exposure to community violence (i.e., victimization) and 99% reported indirect exposure to community violence (i.e., witnessing). Furthermore, these researchers found that after controlling for participants’ exposure to adverse childhood experiences, indirect exposure to community violence significantly predicted current post-traumatic stress disorder (PTSD) symptoms among these urban development workers, although direct exposure did not (Walling, Ericksson, Putman, & Foy, 2011).

However, community violence exposure is not limited to high-risk urban populations (e.g., predominantly male, inner city, ethnic minority, and economically disadvantaged; Scarpa, 2001, p. 38). A series of investigations by Scarpa and Fikretoglu (2000), Scarpa (2001), and Scarpa and Ollendick (2003) noted the high prevalence of lifetime exposure to direct and indirect community violence exposures among a university student sample of 476 primarily European American individuals. Within this group, 95.6% of respondents reported indirect exposure to community violence (i.e., witnessing) and 82% reported direct exposure (i.e., victimization). As Scarpa (2001) noted, these findings are surprising given the expectation that university students (i.e., students at a predominantly European-American rural State University, p. 38) would conventionally be considered at low risk for community violence. Furthermore, secondary data collected from a subsample of these students suggested that respondents with high (i.e., 11 incidents of community violence victimization or 35 incidents of witnessing community violence) community violence exposure evidenced higher levels of depression and aggression when compared to those reporting low levels (i.e., zero incidents of community violence victimization or three or fewer incidents of witnessing community violence) of community violence exposure (Scarpa, 2001).

Another study, conducted by Brady (2006), utilized a sample of 319 university students and found that participants’ exposure to community violence predicted recent and lifetime substance use, risky sexual behavior, and risky driving behavior. Further, these findings were significant after controlling for sociodemographic characteristics and participants’ perceptions of neighborhood efficacy (i.e., overall social cohesiveness among neighbors and their willingness to intervene to help others). Thus, it appears that understanding adults’ experiences and perceptions of community violence offers additional insight above and beyond measurement of social and instrumental support at the neighborhood level (Brady, 2006).

Given these findings, it appears that community violence is a potential concern for adults in both high- and low-risk communities. However, there is very limited existing research examining the prevalence of community violence exposure in adults. Moreover, it appears that community violence exposure in adults is currently being assessed predominantly using measures developed for children and adolescents (Phelps, McCart, & Davies, 2002). Thus, the current literature examining the consequences of community violence exposure in adults may be limited by measurement with questionable validity for adult respondents.

In view of these identified issues in the field, an aim of this article is to synthesize the limited literature on assessment of community violence in adults to identify what measures are currently available, describe available psychometric information for these measures, and to make recommendations for future research in this area. In particular, given the lack of conceptual clarity regarding definitions of community violence, it is our goal to highlight the forms of community violence assessed in measures currently utilized with adults.

Method

Literature searches were conducted between June 2013 and May 2014 in Academic Search Premier, ERIC, MEDLINE, PILOTS, PsycARTICLES, PsycINFO, and PubMed databases. Relevant articles were identified with search terms, including “community violence” or “community violence exposure,” in combination with “adults,” “community sample,” “measure,” “outcome,” “psychometrics,” “scale,” and “survey.” Articles selected for this review included those that (1) included a self-report measure of exposure to community violence, (2) utilized a primarily adult sample (mean or median age ≥18), who responded concerning their own exposure to community violence (i.e., not on behalf of a child), and (3) reported some form of psychometric characteristics for the measures employed (e.g., test–retest reliability, intersubscale correlations, and estimates of internal consistency). After scanning the original database search results for articles relevant to the search criteria, 51 empirical studies were identified that included a self-report measure of exposure to community violence.

Of the 51 identified studies, 26 identified in the literature search included child and adolescent samples and thus were not included. Next, 25 studies also utilized primarily adult samples. Eight of the studies with primarily adult samples (Chu, Williams, Harris, Bryant, & Gatt, 2013; Jaycox, Marshall, & Orlando, 2003; Margolin, Vickerman, Oliver, & Gordis, 2010; Margolin et al., 2009; Marshall & Orlando, 2002; Scarpa & Fikretoglu, 2000; Scarpa & Ollendick, 2003; Walling et al., 2011) did not report any psychometric data concerning the measurement of exposure to community violence, and one study (Miller, Grabell, Thomas, Bermann, & Graham-Bermann, 2012) only included mothers’ perceptions of their children’s violence exposure. The remaining 17 studies with primarily adult samples and which included psychometric data were included in the present review of measures.

Findings

The 17 studies examined represented a range of methodological approaches, included a variety of operational definitions of community violence (see Table 1), and utilized several distinct measures of exposure to community violence (see Table 2). In addition, these studies varied in terms of the amount of psychometric data reported to support the reliability and validity of the measures employed. Furthermore, with the exception of the Community Violence Modified Scale employed by Shahar and colleagues (2004), all studies employed measures of community violence exposure that were initially developed for children and adolescents.

Table 1.

Definitions of Community Violence From Identified Studies.

Study	Definition of Community Violence
Aisenberg, Trickett, Mennen, Saltzman, & Zayas (2007)	“The intentional threat or use of force to physically harm, injure, or kill another person or persons that occurs outside the family home, that is, neighborhood, school, or workplace. Community violence exposure stems from direct experience of violence through victimization or witnessing. It does not include hearing gunshots or hearing about violence events from others. It excludes acts of domestic violence that involves family members and usually occurs in the family home … ” (p. 1,233)
Brady (2006)	“Witnessing or being victimized by violence.” (p. 610) Included: “Slapped, hit, or punched,” “attacked with a knife or sharp object.” (p. 611)
Brown, Hill, & Lambert (2005)	“Violence that the participant (a) was aware of occurring in the community, (b) witnessed in the community, and (c) was a victim of in the community.” (pp. 1483–1484)
Fowler, Ahmed, Tompsett, Josefowicz-Simbeni, & Toro (2008)	“Exposure [witnessing and victimization] to community violence represents emerging adults’ appraisals of violence in neighborhoods.” (p. 837)
Mitchel et al. (2009)	“ … how frequently [participants] had directly experienced (e.g., been hit or slapped, sexually assaulted) or witnessed (e.g., heard gunfire while in home, seen others get attacked/stabbed) types of violence ….” (p. 158)
Putnam et al. (2009)	“Exposure to … direct and two forms of indirect exposure (observational and hearing about the event).” (p. 113)
Scarpa (2001); Scarpa et al. (2002)	“ … the frequency of having directly experienced or witnessed the following violence-related events: chased by gangs or individuals, robbed, threatened with serious physical harm, punched or hit by a family member, punched or hit by a non-family member, mugged, sexually assaulted, exposed to a weapon, seriously wounded by violence, stabbed, shot, and exposed to a dead body.” (p. 256)
Scarpa & Haden (2006)	“ … one’s frequency of violent experiences within the community … [including] witnessing, hearing about, and direct victimization exposure.” (p. 506)
Scarpa, Hurley, Shumate, & Haden (2006b)	“ … the frequency of having directly experienced, witnessed, or only heard about the following violence-related event: chased by gangs or individuals, robbed, threatened with serious physical harm, punched or hit by a family member, punched or hit by a non-family member, mugged, sexually assaulted, exposed to a weapon, seriously wounded by violence, stabbed, shot, and exposed to a dead body.” (p. 8)
Scarpa, Haden, & Hurley (2006a)	“ … refers to violence that is experienced in or near homes, schools, and surrounding neighborhoods … encompasses violence that occurs within and outside of the family or home.” (p. 447)
Selner-O’Hagan, Kindlon, Buka, Raudenbush, & Earls (1998)	“exposure to 18 violent events that have either been witnessed or personally experienced.” (p. 217)
Rosenthal (2000)	“Such ‘street’ violence is ongoing, as opposed to isolated incidents … it occurs in public (e.g., a mugging) rather in the home (e.g., child or spouse abuse). It also involves nonsexual violence rather than sexual violence. Further, this study was concerned with real-life exposure to violence, not with exposure through various media … includes being the direct victim … and witnessing such violence against others firsthand.” (p. 273)
Rosenthal & Wilson (2003)	“ … exposure to nondomestic, nonsexual, non-singular-event community violence.” (p. 242)
Rosenthal & Wilson (2006)	“ … violence that is interpersonal; occurs outside the home (non-domestic); is non-sexual; involves “commonplace” events such as shooting, knifings, muggings, beatings, and threats of physical assault, rather than singular events such as sniper attacks or mass bombings; and is experienced firsthand rather than vicariously (reading about, seeing on TV or in the movies, or hearing about from others).” (p. 423)
Shahar et al. (2004)	“direct” and “vicarious” exposure to “community violence.” (p. 37)
Zhang & Anderson (2010)	“ … experiences of witnessing or being victims of the following types of out-of-family violence in the past year: (a) beatings, (b) attacks with a weapon, (c) shootings, and (d) killings.” (p. 891)

Table 2.

Studies That Measured Exposure to Community Violence in Adults.

Study	Sample	Measure Used	Psychometrics
Aisenberg, Trickett, Mennen, Saltzman, & Zayas (2007)	47 Mother–child dyads	SAVE-P (40 items)	Vic: α = .67 Wit: α = .57
Brady (2006)	319 College students, aged 18–20 years, 56% male	CEQ	Full scale: α = .88
Brown, Hill, & Lambert (2005)	90 African-American adults, aged 18–65 years (M = 36.43, SD = 11.38)	Mod. Interview on Exposure to Interpersonal and Sexual Violence (31 items)	Full scale: α = .67
Fowler, Ahmed, Tompsett, Josefowicz-Simbeni, & Toro (2008)	341 Emerging adults, aged 17.5–20 years	Mod. TSH (11 items)	Full scale: α = .86
Mitchel et al. (2009)	230 African-American single mothers	Mod. SECV (27 items)	Full scale: α = .74
Putnam et al. (2009)	135 Guatemalan aid workers, aged 19–65 years (M = 33)	Mod. SECV (37 items)	Full scale: α = .85
Rosenthal (2000)	455 urban college students, med = 18 y/o	Mod. SECV (18 items)	Vic: α = .69 Wit: α = .91
Rosenthal & Wilson (2003)	385 NYC residents, aged 16–20 years	Mod. SECV (18 items)	Full scale: α = .88
Rosenthal & Wilson (2006)	617 first year undergrads	Mod. SECV (18 items)	Full scale: α = .88
Scarpa (2001)	476 Psychology students, 17–46 y/o (M = 20.3)	Mod. SECV (25 items)	Vic: α = .65 Wit: α = .81
Scarpa et al. (2002)	518 Psychology students, 92% were 17–22 y/o	Mod. SECV (26 items)	Vic: α = .55 Wit: α = .72
Scarpa & Haden (2006); Scarpa, Hurley, Shumate, & Haden (2006b)	515 Psychology students, 18–22 y/o (M = 19.5)	SECV	Correlation between Vic and Wit subscales, r = .57
Scarpa et al. (2006b)	372 Psychology students, 18–22 y/o (M = 19.5)	Mod. SECV (9 items, Vic. only)	Vic: α = .54
Selner-O’Hagan, Kindlon, Buka, Raudenbush, & Earls (1998)	80 Chicago residents, aged 9–24 y/o, 55% (n = 44) ≥ 18 y/o, retest sample, n = 23	My ETV (18 types of violence—structured interview)	Lifetime^a: Wit: α = .92 (r = .85) Vic: α = .79 (r = .75) Full: α = .93 (r = .88)	Past year^a: Wit: α = .91 (r = .75) Vic: α = .68 (r = .94) Full: α = .89 (r = .81)
Shahar et al. (2004)	109 People with serious mental illness, aged 20–64 years (M = 39.90, SD = 9.74)	Community Violence Mod. Scale (29 items)	Vic (“Been”): α = .85 and Wit (“Seen”): α = .90 Two-factor model supported via measurement model (CFA)
Zhang & Anderson (2010)	346 Low-income single mothers, aged 18–50 years, 73% African American	Untitled Scale (7 items)	Full scale: α = .70

Note. CEQ = Community Experiences Questionnaire; Vic. = victimization; Wit. = witnessing; SAVE-P = Self-Assessment of Community Violence–Parent Version; NYC = New York city; TSH = Things I Have Seen and Heard; SECV = Survey of Exposure to Community Violence; ETV = exposure to violence; CFA = confirmatory factor analysis; y/o = years old.

^aTest–retest correlations shown in parentheses.

Community Violence Exposure Measures With Adults

SECV–self-report

As demonstrated in Table 2, the measure with psychometric data most commonly employed to assess community violence in adults (n = 10) was the SECV–Self-Report (Richters & Saltzman, 1990). The SECV is a 54-item measure (Full scale) that assesses one’s direct (i.e., victimization) and indirect (i.e., witnessed or heard of) ETV at home, school, and in the community (Richters & Saltzman, 1990). The SECV was originally developed for use with children, however it has been used in several studies with adult and adolescent populations.

In the identified studies with adults, the SECV evidenced acceptable to excellent (Nunnally, 1978) internal consistency for the diverse groups within these studies including African American single mothers (Full-scale score, α = .74; Mitchel et al., 2009), Guatemalan aid workers (Full-scale score, α = .85; Putnam et al., 2009) and an ethnically diverse sample of urban university students (victimization subscale, α = .89 and witnessing subscale, α = .91; Rosenthal, 2000). In addition, Rosenthal and Wilson (2003) utilized a modified version of the SECV among an ethnically diverse sample of 385 college students in New York city (aged 16–20 years). Their modified 18-item version of the SECV, which also demonstrated good internal consistency (α = .88), specifically focused on respondents’ exposure to community violence in the 3 years prior to completing the survey and included items concerning respondents’ personal victimization, or firsthand witnessing, of nondomestic violence (e.g., “chased,” “threatened,” “stabbed,” and “shot”; Rosenthal & Wilson, 2003). A similarly modified version of the SECV (Rosenthal & Wilson, 2001) also demonstrated good internal consistency (α = .88) among a sample of 617 African American, Jamaican American, and Jamaican undergraduates (Rosenthal & Wilson, 2006).

Scarpa and Fikretoglu (2000); Scarpa (2001); Scarpa (2003); Scarpa and Colleagues (2002); Scarpa and Ollendick (2003); Scarpa and Haden (2006); Scarpa, Haden, and Hurley (2006a); Scarpa, Hurley, Shumate, and Haden (2006b); and Haden & Scarpa, 2008 have conducted several studies that utilized modified versions of the SECV among American undergraduates. Notably, Scarpa and colleagues (2002) conducted an analysis of the concurrent validity of the SECV relative to a measure of lifetime trauma exposure. The authors reported that undergraduates with histories of trauma exposure scored higher on the SECV, suggesting that the SECV had utility to distinguish among participants with and without a history of trauma exposure and establishing some concurrent validity for this measure (Scarpa et al., 2002).

In summary, the SECV appears to be the most commonly used measure of community violence exposure with adults at this time and has evidenced acceptable estimates of internal consistency with diverse samples. However, the SECV appears to have been modified for use in all except one of the identified studies, with the total number of items ranging from 18 (Rosenthal, 2000, 2003, 2006) to 54 (Scarpa & Haden, 2006; Scarpa, Haden, & Hurley, 2006a). Given this variability, it is difficult to compare findings across samples and studies or to characterize the overall utility of the SECV with adult populations.

Additional adult community violence measures

Other measures utilized to assess adult community violence exposure that reported psychometric data include the Self-Assessment of Community Violence–Parent Version (SAVE-P; Aisenberg, 1998a), the Community Experiences Questionnaire (CEQ; Schwartz & Proctor, 2000), a modified version of the Things I have Seen and Heard (TSH) interview protocol (Richters & Martinez, 1990), a modified version of the Interview on Interpersonal and Sexual Violence (Brown, Hill, & Lambert, 2005), the Community Violence Modified Scale (Shahar et al., 2004), and the My ETV structured interview (Buka, Selner-O’Hagan, Kindlon, & Earls, 1996).

The My ETV is a structured interview that assesses lifetime and past year exposure to 18 types of community violence. The measure consists of both witnessing and victimization subscales similar to the SECV and other measures of community violence exposure. However, it does not distinguish between acts committed in public or at home nor does it exclude sexual victimization. Importantly, My ETV appears to be one of few measures for which there are rigorous psychometric data, with ongoing efforts to further develop and validate the instrument (Selner-O’Hagan, Kindlon, Buka, Raudenbush, & Earls, 1998). Selner-Ohagan and colleagues (1998) evaluated My ETV among an ethnically diverse, stratified (by age and neighborhood crime level) sample of 80 Chicago residents. Although the sample for this study included children under the age of 18 years, the majority (55%) of participants were older than 18 years, and thus the investigation was included in the present review. The measure demonstrated acceptable to excellent estimates of internal consistency for lifetime community violence exposure (Full scale, α = .93; witnessing subscale, α = .92; and victimization subscale, α = .79) and marginal to excellent estimates of internal consistency for past year exposure to community violence as well (Full scale, α = .89; witnessing subscale, α = .91; and victimization subscale, α = .68). A subsample of 23 participants completed a second interview 2–4 weeks after their initial assessment to evaluate test–retest reliability. Test–retest correlations supported the temporal stability of My ETV for lifetime (total, r = .88) and past year exposure (total, r = .81) to community violence. My ETV scores were also found to differ significantly among neighborhoods classified as having high, medium, or low crime according to police crime statistics (Selner-O’Hagan et al., 1998). Thus, My ETV scores appear to be associated with objective indicators of criminal activity and perhaps support the inclusion of witnessing and victimization subscales within the operationalization of community violence exposure. However, the measure includes violence that occurs both in public and private spheres.

Another measure employed among the identified studies was the Self-Assessment of Exposure to Community Violence–Parent Version (SAVE-P), which is a 54-item questionnaire used to assess parents’ personal exposure to violent acts (Aisendberg, 1998b). The SAVE-P identifies respondents’ exposure to community violence across several time periods (i.e., past 6 months, past year, prior to past year, and lifetime). The SAVE-P includes additional details not consistently present in other measures, including respondents’ relationship to the perpetrator, the setting in which the violence occurred, and whether their children witnessed the violence. Similar to other scales identified in this review, the SAVE-P includes subscales that measure direct and indirect community violence exposures. Aisenberg, Trickett, Mennen, Saltzman, and Zayas (2007) examined survey data from 47 Latina mothers and found marginal estimates of internal consistency (witnessing subscale, α = .57 and victimization subscale, α = .67).

The modified Interview on Exposure to Interpersonal and Sexual Violence (Hill, 1991) includes 31 self-report items that assess the frequency of one’s witnessing and/or victimization by violence at home or in the community. Brown, Hill, and Lambert (2005) utilized a modified version of this scale that only assessed violence that occurred in the community and specifically excluded violence that occurred in the home, among a sample of 90 African American women living in a large Eastern city. These researchers found the internal consistency of this measure to be marginal (total score, α = .67).

The CEQ is a 25-item self-report measure comprised of two subscales (i.e., victimization and witnessing), which was designed to assess children’s exposure to community violence (Schwartz & Proctor, 2000). The CEQ includes events that occur in public, at work, and at school, and excludes violent acts at home or involving family members (Schwartz & Proctor, 2000; Brady, 2006). Research by Brady (2006) utilized the CEQ to examine the association between community violence exposure and health risk behaviors among a predominantly European American sample of 319 college students (56% male, aged 18–20 years). They found the estimated internal consistency of the CEQ to be good (total score, α = .88).

The Community Violence Modified Scale is a modified version of a scale developed by Dailey and colleagues (2000), which was originally designed as a clinician rating scale and modified by Shahar and colleagues (2004) to serve as a self-report measure in their study of 109 participants with serious mental illness. Confirmatory factor analysis (CFA) supported a two-factor model of community violence comprised of witnessing and direct victimization. Although the researchers did not include individual types of violence exposure as observed indicators of community violence, it is important to note the contribution of their measurement model with regard to the assessment of community violence among adults (Shahar et al., 2004). In addition to the identified measurement model that supported witnessed violence and violence victimization as indicators of community violence, Shahar and colleagues (2004) observed strong internal consistency within their modified measure of community violence (witnessing, α = .90 and victimization, α = .85).

The final study represented in Table 2, by Zhang and Anderson (2010), included a sample of 346 African American, low-income, single mothers, aged 18–50 years (M = 27.3). These researchers developed an untitled 7-item survey specifically for their study, which demonstrated acceptable internal consistency (α = .70) to assess participants’ direct and indirect exposure to four types of community violence (i.e., beatings, attacks with weapons, shootings, and killings; Zhang & Anderson, 2010).

Discussion

Taken together, the measures described in this article raise important concerns and challenges for the state of measurement of community violence exposure. First, the absence of carefully operationalized and explicitly stated definitions of community violence underpins the fragmentation that exists within the measurement of this construct. It is important to note that this issue has been raised previously by multiple reviews concerning the state of community violence exposure measurement among children and adolescents (e.g., Brandt et al., 2005). Similarly, the present review has identified several distinct definitions of community violence exposure within the relatively small corpus of studies that have examined adult exposure to community violence (see Table 1).

Notably, Rosenthal (2000; Rosenthal &Wilson, 2003; 2006) offered a precise definition that distinguishes community violence exposure from childhood sexual abuse, adult sexual violence, intimate partner violence (IPV), and family violence. Although community violence exposure has not always been operationalized in this way, existing measurement of exposure to community violence suggests some consensus regarding a contemporary definition comprised of victimization (direct exposure), witnessing (indirect exposure), and occurrence in public (i.e., nondomestic) settings. Furthermore, it is critical that community violence exposure be clearly defined so as not to be conflated with other forms of traumatic exposure, symptomatology, or abuse and neglect (Mablango, 2002). The authors note the following definition from Wallen and Rubin (1997):

The term community violence … denote[s] violence that occurs in the [individual’s] environment but outside the home and between or among individuals who are not members of the [individual’s] family … This is not an absolute distinction, of course, since neighborhood violence may intrude into the home and violent acts between family members may occur outside the home. (p. 33)

Consistent with this definition, the authors assert that measures of community violence should rigorously assess ubiquitous public experiences of completed, witnessed, and threatened acts of violence over time, not perpetrated by a family member or intimate partner. In this way, clearly operationalized community violence measurements might offer a robust assessment of adults’ perceptions of public safety within the context of their communities that is distinct from specific dyadic and familial experiences of violence and victimization. Regardless of the specific definition employed, a meaningful definition of community violence exposure must address “where” and “who” is community and “what” is violence (Guterman et al., 2000). Further, refinement of existing scales or development of new measures for use with adults should address issues of timeline and clearly evaluate the utility of considering both recent and lifetime histories of community violence exposure.

Of particular relevance for the development of community violence measures for adults is the issue of whether or not to include public acts of non-partner sexual violence within the definition of community violence. Existing community violence scales developed for children do not consistently assess this specific form of violence exposure. As estimated by Abrahams and colleagues (2014), approximately 7% of women worldwide suffer some form of non-partner sexual violence, often within the context of multiple perpetrators and in public settings. Thus, non-partner sexual violence, including sexual violence perpetrated in public, represents a compelling concern with regard to one’s public sense of safety. Indeed, the original version of the SECV assesses for acts of sexual violence (Richters & Saltzman, 1990). However, 3 of the 10 studies in the present review that utilized the SECV, or a modified version of the SECV (Rosenthal, 2000; Rosenthal & Wilson, 2003, 2006), did not administer the sexual violence items from the SECV. Moreover, other measures of community violence included in this review (i.e., SAVE-P, CEQ, and TSH) did not include items to assess sexual violence. In sum, of the 17 studies identified in this review, 8 (47%) did not assess exposure to acts of sexual violence. Therefore, it is important that future research considers the extent to which non-partner sexual violence represents a dimension of community violence exposure or is better conceptualized as a distinct form of victimization. Nascent evidence among children and adolescents has addressed this to an extent via factor analytic methods. Specifically, a recent study by Martin, Revington, and Seedat (2013) found support for including acts of non-consensual sexual abuse in a three-factor model of community violence among children using the Child Exposure to Community Violence measure (i.e., modified version of TSH). Similar psychometric validation studies are needed to determine the extent to which public acts of sexual violence should be included within an empirically supported definition of adult exposure to and experiences of community violence.

Second, the present review evidences the absence of standard psychometric data in the description of community violence exposure measures. Specifically, of the 25 studies found to have reported findings from measures of community violence exposure in adults, only 17 included any psychometric properties of the measures employed. Notably, Cronbach’s coefficient α was the only psychometric characteristic reported by most (n = 13, 76%) of the articles identified within the present review. It is important to note the well-established limitations of Cronbach’s α (see Brown, 2006; Raykov, 2010) and the importance of evaluating and reporting estimates of reliability and validity across multiple domains (e.g., test–retest reliability, convergent/discriminant validity, and criterion validity). Given that only four identified studies included estimates of reliability and/or validity other than Cronbach’s α (i.e., test–retest reliability, intersubscale correlations, and CFA), the present review is unable to address the overall temporal stability of extant measures of community violence exposure in adults. In addition, measures were often modified and sample sizes ranged from very small (<40) to large (>500). As a result, it is difficult to interpret and compare the findings across studies.

Finally, relative to the scholarship available concerning children and adolescents, there is a scarcity of findings regarding the measurement of adults’ exposure to community violence. Notably, the SECV, which was observed to be the most commonly used measure of community violence exposure for adult populations in this review, was developed for use with children and older youth (Richters & Saltzman, 1990). Although it is imperative that community violence exposure be understood among children and adolescents, scientists and clinicians must also be able to accurately measure the experiences of community violence that are likely to persist across one’s lifespan.

Limitations

The present review is tempered by multiple limitations. First, although this article aimed to identify all recent studies concerning the measurement of community violence exposure in adults, it is possible that relevant studies were not identified and thus not included in this review. In addition, the construct of “neighborhood violence,” which is often discussed within the sociology and criminology literature (e.g., Browning & Jackson, 2013; Cooper et al., 2013), was excluded from the present review, given the absence of studies that included robust scales of individuals’ perceptions of community violence that also included psychometric data (i.e., estimates of validity and reliability). Thus, the development of reliable and valid scales to measure adults’ exposure to community violence may serve to strengthen multimodal approaches to the measurement of neighborhood violence. Second, many of the studies examined in this review modified and adapted measures of community violence exposure from their original versions (e.g., Kennedy, Bybee, Sullivan, & Greeson, 2010; Rosenthal & Wilson, 2001; Thompson et al., 2007), and thus there may be limited correspondence among different forms of the same original measure.

The present review was also limited by the relatively narrow age range of adults included in the identified studies. Indeed, most (n = 13) studies included in the present review focused on emerging adults, and thus it is difficult to assert the applicability of existing measurements across generational cohorts. Future studies should consider community violence exposure across the lifespan and more directly address the implications of community violence that may unfold over time. The current limitations that exist within the measurement of community violence exposure in adults offer implications and future directions for researchers, clinicians, and policy makers.

Research Implications

Researchers should work toward a consensus and parsimonious operationalization of community violence exposure and embrace standardized measures of this important variable. In addition, to further advance the understanding of the utility of various measures, it will be necessary for researchers to report at least basic psychometric properties for all measures utilized, including estimates of internal consistency (i.e., Cronbach’s coefficient α) as appropriate. In addition, future research should evaluate the temporal stability (i.e., test–retest reliability) of existing measures of community violence. This is a task for researchers and the broader research community who serve as peer reviewers and evaluators of publications. Furthermore, additional application of factor analytic methods (e.g., Shahar et al., 2004; Martin, Revington, & Seedat, 2013) to existing models of community violence exposure may assist in the development of theory-driven, parsimonious scales. It is also important for researchers to consider the generalizability of empirically derived definitions of community violence across varied cultural and community contexts, and perceived needs and experiences of affected stakeholders, which may in turn support more effective efforts toward translational research aimed at violence prevention and recovery.

Clinical and Policy Implications

The present review offers important implications for researchers, mental health workers, and policy makers, in that community violence represents a critical intersection between psychological distress, environmental factors, and social institutions (Salzinger, Feldman, Stockhammer, & Hood, 2002). In addition, clinicians and policy makers should consider the role of cultural and ethnic influences within the context of community violence. Indeed, the present review highlights the salience of community violence exposure across diverse social, cultural, and geographic contexts. Given the emerging literature on the relationship between exposure to community violence and psychological distress, clinicians should embrace an evidence-driven approach to the assessment of community violence within the context of multimodal assessment. Accurate assessment of community violence may better facilitate targeted prevention and intervention efforts with at-risk community members. Further given that community violence often co-occurs with IPV, PTSD, and substance abuse, it is critical that mental health providers accurately assess individuals’ exposure and risk and protective factors to inform treatment selection (Brandt et al., 2005; Lynch & Cicchetti, 1998; Ward, Flisher, Zissis, Muller, & Lombard, 2001). In addition, the overlap between community violence and criminal acts (Wilkinson & Carr, 2008), as well as the association between community violence exposure and socioeconomic status, warrants further investigation and the concerted effort of policy makers toward addressing the experiences of affected stakeholders.

Conclusion

The present review sought to characterize the state of the measurement of community violence exposure in adults. Although there is a growing literature examining the impact of community violence exposure on psychological functioning, relatively few have examined this in adult samples. In addition, there are few measures that have been rigorously evaluated or developed for use with adult populations. Therefore, it is important that researchers continue to advance the measurement of community violence exposure through careful operationalization of the construct itself, reporting of psychometric properties of measures employed, and continued expansion of research designs to include adult populations, for whom the effects of community violence are felt beyond childhood and adolescence.

Footnotes

Declaration of Conflicting Interests

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

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

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