Prevalence of vicarious trauma and related factors as a source of indirect exposure to violence in adolescents

Abstract

In an increasingly turbulent world, individuals are constantly exposed to violent happenings. Pakistan has suffered from natural and man-made catastrophes particularly over the last decade. However, systematic knowledge about the range, exposure or impact on adolescents is scarce. The present research assumed that indirect knowledge of violent events happening to another can cause feelings of chronic anxiety in varying degrees and built upon the concept of vicarious trauma as given by several theorists. It has used a holistic approach by incorporating the symptoms of trauma and the individual’s cognitive world. The present research investigated the prevalence of vicarious trauma in adolescent girls and boys by assessing them for presence of moderate symptoms of Posttraumatic Stress Disorder. Adolescents from private and government schools of Rawalpindi, Islamabad and Karachi were the target group. Purposive sampling method was used. The sample taken consisted of adolescents between 14-16 years with a mean age of 14.9 years. Students studying in classes 8 to first year of intermediate and 0’ level were selected. Focus groups were designed with 40 students. The aim was to explore the topic, develop and refine the Events Exposure Questionnaire. This questionnaire and Impact of Events Scale – Revised (Weiss & Marmar, 1997) with modifications to time frame was administered to 100 students. The scale was translated into Urdu using back method and overall reliability was estimated at .88 using Cronbach’s Alpha. The final study was carried out on 1074 adolescents. Four hypotheses were formulated. It was assumed that there would be prevalence of trauma symptoms among adolescents and girls display more of these symptoms than boys. Physical proximity to the trauma site and emotional proximity to victim were independent variables of the study. These variables were also investigated as third and fourth hypotheses and were assumed to cause vicarious trauma in adolescents. Physical proximity was measured as visiting places which had been targets of bomb blasts. Emotional proximity occurred when the victim of a bomb blast or kidnapping was a family member, relative, friend or known through a friend by the adolescent. Related factors which were considered sources of indirect exposure were also investigated. These were peri-traumatic stressors such as exposure severity, intensity, frequency and duration. The first hypothesis found 54% prevalence of moderate level of trauma symptoms. Girls reported higher intrusion subscale and total IES-R scores. It was found that girls are experiencing vicarious trauma symptoms at p < .01 level. No difference between the two genders was found on hyperarousal and avoidance subscale scores. The third assumption was also supported: physical proximity predicts vicarious trauma and it explains 2% of the variance. Emotional proximity to victims of bomb blast and kidnapping was also found to predict vicarious trauma and explains it 3.3 % of the variance. Thus, all hypotheses were supported. Indirect exposure severity of Pakistani adolescents to violent events is 44%. The intensity of natural and man-made traumatic stressors is 48%, with terrorist attacks being prominent. The frequency of indirect exposures to traumatic events was not found important. Time of occurrence of the traumatic event in present outcome is considered more important as the event had occurred more than a year earlier and lingering symptoms of trauma have manifold implications. Exposure to information through several sources such as media and social interactions was used as a measure of duration of traumatic events. Overall figures indicate high percentage of affirmative responses in all categories and television is found to be the main source of the continuation of the trauma. Gender differences are then observed in their obtaining different information from different sources, with girls relying more on family while boys prefer peers and internet. The research has yielded important information with respect to trauma exposure and prevalence in the Pakistani society. Gender differences are found in the prevalence of vicarious trauma. Usage of media reflects a society where girls and boys follow strict rules of socialization. It also identifies an endemic characteristic of the society which has co-existed with trauma and continues to live with violence. The findings can significantly aid in developing strategies for therapeutic interventions as well as planning educational and mental health policies.