title: Community violence exposure and severe posttraumatic stress in suburban American youth: risk and protective factors.
abstract: OBJECTIVE
  The psychological effects of community violence exposure among inner-city youth are severe, yet little is known about its prevalence and moderators among suburban middle-class youth. This study aimed to assess the prevalence of community violence exposure among suburban American youth, to examine associated posttraumatic stress and to evaluate factors related to severe vs. less severe posttraumatic stress, such as co-existing internalizing and externalizing problems, as well as the effects of teacher support, parental warmth and support, perceived neighborhood safety and conventional involvement in this context.
  
  
  METHODS
  Data were collected from 780 suburban, predominantly Caucasian middle-class high-school adolescents in the Northeastern US during the Social and Health Assessment (SAHA) study.
  
  
  RESULTS
  A substantial number of suburban youth were exposed to community violence and 24% of those victimized by community violence developed severe posttraumatic stress. Depressive symptoms were strongly associated with higher levels and perceived teacher support with lower levels of posttraumatic stress.
  
  
  CONCLUSIONS
  Similar to urban youth, youth living in suburban areas in North American settings may be affected by community violence. A substantial proportion of these youth reports severe posttraumatic stress and high levels of comorbid depressive symptoms. Teacher support may have a protective effect against severe posttraumatic stress and thus needs to be further assessed as a potential factor that can be used to mitigate the detrimental effects of violence exposure.
authors.affiliation: Child and Adolescent Psychiatry Unit, Department of Neuroscience, Uppsala University, 751 85, Uppsala, Sweden.
authors.forename: Sandra
authors.initials: S
authors.lastname: Löfving-Gupta
authors.forename: Frank
authors.initials: F
authors.lastname: Lindblad
authors.forename: Andrew
authors.initials: A
authors.lastname: Stickley
authors.forename: Mary
authors.initials: M
authors.lastname: Schwab-Stone
authors.forename: Vladislav
authors.initials: V
authors.lastname: Ruchkin
mesh_terms: D000293:Adolescent; D019548:Crime Victims / Q000523:psychology*; D005006:Ethnicity; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D065840:Protective Factors; D012111:Residence Characteristics; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000523:psychology; D014481:United States; D014754:Violence / Q000523:psychology / Q000706:statistics & numerical data*