Original article
Retaliatory Attitudes and Violent Behaviors Among Assault-Injured Youth

https://doi.org/10.1016/j.jadohealth.2011.04.005Get rights and content

Abstract

Objectives

To examine the effect of retaliatory attitudes on subsequent violent behavior and fight-related injuries among youth who presented to the emergency department with assault injuries.

Design

Assault-injured youth were interviewed at baseline, 6 months, and 18 months to assess fighting behavior, retaliatory attitudes, weapon carrying, and injury history as part of a larger randomized control trial.

Setting

Two emergency departments in urban areas were selected for the study.

Participants

A total of 129 adolescents aged 10–15 years were included in the study.

Outcome measures

Fighting behavior, assault injury, weapon carrying, and aggressive behavior.

Results

Higher retaliatory attitudes at baseline were associated with more aggression and a higher frequency of fighting over time.

Conclusions

Retaliatory attitudes may fuel cycles of violence among youth. Medical professionals in acute care settings have an opportunity to identify youths at risk of future assault injury by assessing retaliation, providing anticipatory guidance, and referring to intervention programs.

Section snippets

Subjects

A consecutive sample of youth presenting to two urban EDs for assault injury was identified for a randomized trial of a community-based intervention with methods previously published in detail [16]. Eligibility criteria included adolescents aged 10–15 years presenting to either a large urban children's hospital or urban university hospital; residence in the Washington, DC-Baltimore metropolitan area; presentation with interpersonal assault injuries (E960, 961–966, 968–969), excluding sexual

Recruitment and participation

Figure 1 presents the study recruitment yield and follow-up at 6 and 18 months. Of the 227 eligible patients in whom consent was attempted, 23% refused. Of those consenting, 166 patients completed parent and youth baseline interviews, with 4% completing partial interviews. At 6- and 18-month follow-up, 68% and 63% were interviewed, respectively. Five participants were excluded either because of multiple extreme outlier responses on outcome variables or partial interviews.

There was no difference

Discussion

Little research has explored youth retaliatory attitudes in relation to future aggressive behavior. Our study found that assault-injured youth who endorsed retaliatory attitudes at baseline reported more aggression and fighting over time. There were significant relationships between retaliatory attitudes and subsequent aggression and fighting. This suggests that retaliatory attitudes may lead youth to be vigilant or “on guard,” resulting in further aggressive behavior. Our findings are

Acknowledgments

This project was supported by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (to D.L.H.), 1K24HD052559 (T.L.C.), the Maternal and Child Health Bureau (Title V Social Security Act), Health Resources and Services Administration, Department of Health and Human Services, R40MC00174, 4H34MC00025 (T.L.C.), the DC-Baltimore Research Center on Child Health Disparities grant number P20 MD00165 and 00198 from the National Center on

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      Further, among the baseline sample, almost half of those seeking care for assault indicated that they did not feel that the altercation prompting their visit was over, and almost a quarter indicated that they, or their friends or family would likely retaliate (Carter et al., 2017; Cunningham et al., 2014), increasing risk for involvement in the criminal justice system. This is consistent with prior research identifying the immediate post-ED time period as a high-risk time for retaliatory violence, as well as literature noting that retaliation is a key motivation for adolescent fighting behaviors (Carter et al., 2015; Copeland-Linder et al., 2012; Rich and Stone, 1996; Wiebe et al., 2011). Future research analyzing daily data could aid in clarifying if later violent events are related to retaliation for the assault that prompted the ED visit for assault at baseline.

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    Present address: Nikeea Copeland-Linder is now at the University of Maryland School of Social Work and the Kennedy Krieger Family Center, Baltimore, MD.

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