NDSU Department of Child Development and Family Science
North Dakota Department of Human Services
June 1998
Harriett Light, Ph.D. Professor, Child Development and Family Science, College of Human Development and Education
North Dakota State University
Fargo, ND 58105
Fax:701-231-7174
Phone:701-231-7099
e-mail:light@badlands.nodak.edu
Appreciation is expressed to Jim Deal, Ph.D., Associate Professor and Chair, Department of Family and Consumer Science, for his assistance with the statistical analysis of the data for this article.
The purposes of this study were (1) to examine the extent to which North Dakota youth are exposed to violence as either victims or observers, and (2) to determine the relation of violence exposure to ethical behavior and attitudes.
An anonymous self-report questionnaire was administered to 378 high school students between the ages of 15 and 18 years and 261 college students between the ages of 19 and 25 years. The results indicate a relatively high level of exposure to violence.
Significant correlations between violence exposure and ethical behavior and attitudes were also found. These results provide support for the need to take action to provide safe environments for young people and to encourage services that will lessen or eliminate the negative effects of violence on young people's ethical behaviors and attitudes.
Violence committed by children, adolescents, and young adults against their peers, families, teachers, communities, and themselves has become a national epidemic (Grisso, 1996; Warner & Weist, 1996; Staub, 1996). This violence occurs in schools because that is where children and adolescents are required to be, and in local community centers and businesses because that is where they choose to "hang out." Their families are a significant component of the violence epidemic, often cited as both a cause and recipient of their youth's violence (Crespi, 1996; Hinton-Nelson, Roberts, & Snyder, 1996).
There is evidence that exposure to violence has a lifelong psychological impact on young people. Aggressive behavior and stress-related behaviors are commonly reported consequences. Significant relationships have been found between violence exposure and childhood/teenage depression, dissociation, anger, anxiety, and post-traumatic stress disorder (Friday, 1995; Crespi, 1996; Singer, 1995). Having established these negative effects of violence exposure, it is possible that other areas of young people's lives are also affected. This study explored that possibility.
The first purpose of this project was to explore the extent of exposure to violence (other than viewing violence in the media) in the lives of North Dakota high school and college students. The second purpose was to explore possible relationships between exposure to violence and ethical issues regarding cheating, shoplifting, drug usage, honesty, and the youth's perception of the source of influence in their lives.
Exposure to violence could occur in four ways: (1) the individual was slapped, punched or kicked at home, school, or in his or her neighborhood this past year; (2) the individual observed someone else being slapped, kicked or punched at home, school or in his or her neighborhood; (3) the individual was made to do a sexual act when he or she did not want to; and (4) the individual knew of someone else who was made to do a sexual act against their will.
A total of 639 students between the ages of 15 and 25 years took part in this study by completing a questionnaire to determine their exposure to violence and their views on ethical issues. Two-hundred sixty one of the participants were students (age range of 18 - 25 years) at an eastern North Dakota university at the time they completed the questionnaire. The rest of the participants (378) were high school students enrolled in eastern North Dakota schools. There were 214 males and 425 females in the total sample. In this project, "youth," "young people," "young adults" and "students" are defined as being between the ages of 15 and 25 years of age.
The research instrument was a modified version of the Singer Exposure to Violence Scales (Singer, 1995) and was used with permission. This instrument is a self-report questionnaire containing 30 statements describing violent, ethical, or moral situations and issues. Participants' choices for response were "agree," "uncertain," or "disagree" with the statements.
The questionnaire was administered to 261 university students who were attending introductory human development and education classes on an arbitrarily selected day in the fall of 1997. The questionnaire was also administered to 177 high school students attending the opening session of the fall 1997 Close-Up Conference at North Dakota State University. (Close-Up is sponsored annually by the North Dakota Department of Public Instruction and provides an opportunity for high school students to study civic issues.) Two hundred and one high school students were administered the questionnaire in their classes on the day selected by the teachers in the fall of 1997. All questionnaires were completed in one setting and were distributed and collected by the teachers or adult in charge of the group.
Participation was voluntary. No students refused to participate; 639 questionnaires were handed out and 639 were returned with usable data. Confidentiality and anonymity was assured. The methodology of the entire project was approved by the human subject review committee of the university where the researcher of this project is a faculty member.
Response choices were coded:
agree = 3; uncertain = 2; disagree = 1.
The frequency and percentage of responses to each statement was calculated to determine the extent of exposure to violence. Pearson correlations (two-tailed) tests were performed to determine if there was a relationship between exposure to violence and reported ethical behavior and attitudes. A significant correlation in a negative direction indicates that the variables move in opposite directions; as one increases the other decreases. A significant correlation in a positive direction indicates that the variables move in the same direction; as one increases or decreases the other variable does likewise.
Twenty-two percent (N=140) of the total sample reported they had been slapped, punched, or kicked at home, school or in their neighborhood during the past year. Almost half of the subjects (47%, N=300) said they had seen someone else slapped, punched, or kicked at home, school, or in their neighborhood during the past year (not including media portrayals of violence).
Five percent (N=32) of all the respondents said they were made to do a sexual act against their will during the past year. Eighteen percent (N= 1 15) said they knew of someone else who was made to do a sexual act against their will. Twenty-six percent (N=68) of the college students said they knew of someone else who was made to do a sexual act when they did not want to.
One fourth (24.3%) of the total sample said they did not feel physically safe at their school. Three percent (N= 18) did not feel safe in their homes, and 7% did not feel safe in their neighborhood. However, 53% of the college students (N=137) said they did not feel safe on campus after dark and 23% (N=59) were uncertain if they felt safe.
Is it morally wrong to use drugs of any kind, including marijuana? Sixty-five percent (N=415) of all participants agreed it was morally wrong. However, when alcohol replaced marijuana in the same statement only 26% of all respondents (N= 166) agreed it was morally wrong. Just 10% (N=26) of all college students thought it was morally wrong to use drugs, including alcohol; 61% (N=159) thought it was wrong to use drugs including marijuana.
Seventy-four percent (N=409) of the total sample said cheating on tests and other assignments was wrong. But over half (53%, N=339) said they would cheat if they knew they would not get caught or were uncertain if they would cheat.
Ninety-four percent (N=600) of the respondents agreed that it is wrong to shoplift. However, 19% (N= 120) said they would shoplift if they knew they would not get caught or were uncertain if they would shoplift.
Almost half (47%, N=301) said that honesty depended on the circumstances in which they find themselves. About one-fourth (21%, N=134) were uncertain if honesty depended on the circumstances. Among the college students, 38% (N=243) said honesty depended on the situation and 18% (N= 1 15) were uncertain.
Twenty-three percent (N= 146) of the entire sample said their attitudes about what is right or wrong are influenced by their friends. A much higher percentage, 74% (N=475), agreed their families influenced their attitudes about right or wrong. Fifty eight percent (N=339) said their attitudes were influenced by their religious beliefs. Surprisingly, 84% (N=219) of the college students said their families influenced their attitudes about right and wrong, and 70% (N= 183) said they were influenced by their religious beliefs.
This study cannot establish causes of ethical behavior, but Pearson correlations tests revealed strong statistically significant relationships in several areas. With this statistical test, a correlation in a negative direction means that the variables go in opposite directions; as one increases, the other decreases or vice versa. A correlation in a positive direction means that both variables go in the same direction; as one increases or decreases, the other does likewise.
Being slapped, punched or kicked at home, school or in the neighborhood was significantly correlated in a negative direction with the family influence on attitudes about what is right or wrong (r = -. 1515, p <. 0 1) and with influence from religion (r = -. 1589, p <. 05). In contrast, being slapped, kicked or punched was not significantly correlated with influence from friends. Observing someone else being violently treated was not significantly correlated with influence from family or friends, but it was related in a negative direction with religion's influence on attitudes about what is right and wrong (r = -.1133, p <.01).
Thinking that cheating is wrong was significantly correlated in a negative direction with being violently treated (r = -. 1686, p < .01) and also with observing the violent treatment of someone else (r = -.2221, p <.01). Likewise, viewing shoplifting as wrong was negatively correlated with personal experience of violence (r = -. 1325, p <.01) and also with seeing the violent treatment of others (r = -.0821, p <.05). Moreover, there was a significant positive correlation between being slapped, kicked or punched and agreement that they would cheat (r = .1553, p <. 01) and with shoplifting if they knew they would not get caught (r =. 1188, p <.01).
Does being honest depend on the circumstances in which one finds oneself? There was a significant positive correlation between agreement with this statement and being treated violently (r = .1053, p <.01). There was also a significant positive correlation between observing the violent treatment of others and agreeing that honesty is dependent on the circumstances (r = . 1550, p <. 01).
There was a significant correlation in a negative direction between receiving violent treatment and thinking it is morally wrong to use drugs of any kind, including marijuana (r = -. 1008, p <.05). Likewise, there was a significant negative correlation between being forced to do a sexual act and thinking drug usage, including marijuana, is morally wrong (r = -. 1525, p < .01); there was also a significant relationship between knowing of someone who was forced into sexual acts and thinking drugs, including marijuana, are morally wrong (r = -. 1529, p <.01). However, there was no significant correlation between exposure to violence and thinking drug usage including alcohol was morally wrong.
On the other hand, experiencing unwanted sexual acts was negatively correlated with thinking drug usage, including alcohol, was morally wrong (r = -. 1050, p <.01), as was knowing someone who was made to perform sexual acts against their will (r = -.0899, p <.01). Could the reason for this be that alcohol is involved in most unwanted sexual acts?
The results of this study cannot be generalized to all North Dakota youth. However, based on the results of this study the following conclusions are offered.
It is a generally accepted fact that violence is epidemic in large urban areas. However, young adults attending high school or college in eastern North Dakota apparently experience violence as well. A majority of the college students do not feel safe on their campus. It is important that parents and professionals in the helping professions acknowledge the students' perceptions and act to provide a safe environment. Safety and security from physical harm is a basic need; our young people have a right to learn and develop in safe environments.
Formal and informal education for moral development needs to be addressed. While most of the youth in this study agreed that cheating and shoplifting were wrong, a sizable number were not sure about being able to follow through when tempted to cheat and steal.
Likewise, it is disappointing that so many young people think honesty depends on the situation. Moreover, serious attention must be paid to the prevailing notion that alcohol is not as "wrong" as marijuana, an idea that can be discounted by the alarming research on Fetal Alcohol Syndrome and other alcohol-related health issues.
Finally, it is important for helping professionals, educators, and parents to take seriously the strong relationships that emerged in this study between exposure to violence and the young persons' attitudes toward ethics and moral behavior. Indeed, while the results of this study cannot be generalized to all young people, the message is a clarion call to action to eliminate violence in the lives of young people.
This study was exploratory; the results warrant additional research with other samples of young people to determine if youth in general are experiencing the same levels and consequences of violence on their ethical and moral attitudes and behavior.
Crespi, T. (1996). Violent children and adolescents: Facing the treatment crisis in child and family interaction. Family Therapy, 23(l), 43-50.
Friday, J. (1995). The psychological impact of violence in underserved communities. Journal of Health Care, 6(4):403-409.
Grisso, T. (1996). Society's retributive response to juvenile violence: A developmental perspective. Law and Human Behavior, 20(3):229-247.
Hinton-Nelson, M., Roberts, M., & Synder, C. (1996). Early adolescents exposed to violence. American Journal of Orthopychia!, 66(3):346-353.
Singer, M., Anglin, T., & Song, L. (1995). Adolescents' exposure to violence and associated symptoms of psychological trauma. Journal of American Medical Association, 273(6):477-482.
Warner, B. & Weist, M. (1996). Urban youth as witness to violence. Journal of Youth and Adolescence, 25(3):361-377.
Philip S. Hall
Annette M. Kost
Kim M. Fretty
Paul D. Markel
Department of Psychology
College of Education and Human Services
Minot State University
500 University Ave. W
Minot, ND 58707
Oppositional Defiant Disorder (ODD) was first identified as a childhood pathology with the publication of the Diagnostic and Statistical Manual in 1980. Since then, ODD has been diagnosed with increasing frequency. Today, approximately one-third of all children referred to mental health clinics are diagnosed with ODD.
Research suggests that ODD has tripartite etiology: the newborn child has a fussy, demanding temperament; there is parental dysfunction; and the parents do not have parenting skills commensurate with the child's challenging behaviors. Patterson was among the first to develop effective treatment for children with ODD. The treatment largely consisted of improving parenting skills. In succession, Forehand and McMahon, and Webster-Stratton refined parent training.
This paper explains the treatment we provide at our clinic for children with ODD and their parents. Whereas our treatment follows the evolved model, we expand parent training to include an opportunity for catharsis for the parents and some modifications in parenting skills.
Our clinic places more emphasis on ignoring, and we think the skills of developing a routine, using logical consequences, and avoiding punishment are useful.
Finally, our treatment differs from previous work in that children with ODD are specifically taught how to develop equitable, nurturing relationships.
Children who have Oppositional Defiant Disorder (ODD) are characterized by a pattern of negative, oppositional behavior of over six month duration. These children have frequent and severe temper tantrums; they argue with adults; they defy requests; and they often are angry, resentful, spiteful, and vindictive. However, a degree of oppositional behavior is common among children. Learning to resist and even to oppose the will of others is part of normal development (Rey, 1993). In the course of normal development, temper tantrums reach their peak when children are two to three years old (Goodenough, 1931; and Shepherd, Oppenheim, & Mitchell, 1971). The common occurrence of oppositional behavior in normal children makes it difficult to distinguish between normal and abnormal oppositional behavior. Therefore, the diagnosis of ODD should be made only when symptoms are severe, when they persist past ages that most other children have outgrown, or when they cause distress and dysfunction.
Oppositional Defiant Disorder was first listed as a diagnostic category in the Diagnostic and Statistical Manual III in 1980. Since then, ODD has been diagnosed with increasing frequency. Prevalence of ODD in children ranges, depending on the study, from 1.7% (Bird et. al., 1988) to 9.9% (McGee et al., 1990). Approximately one-third of all children referred to mental health clinics are diagnosed with ODD (Rey, 1993).
Children do not "outgrow" ODD (Lahey, B. et al., 1992). In clinical samples, youth diagnosed with Conduct Disorder (CD) first met the criteria for ODD. As symptoms of CD emerge in children, symptoms of ODD are retained (Loeber et al., 1993). Moreover, many children with ODD progress to having Conduct Disorder and develop Antisocial Personality Disorder as adults.
Our understanding of the etiology of ODD is best described as evolving. Patterson (1976) formulated the "coercive hypothesis" to explain the development of oppositional behavior. According to the coercive hypothesis, the parent makes a request, the child acts out in defiance of the request, and the parent subsequently withdraws the request. Withdrawing the request negatively reinforces the child's defiant behavior. In essence, the coercive hypothesis maintains that ODD is the result of poor parenting (Patterson 1976; and Schroder & Gordon, 1991).
Whereas inadequate parenting skills are components of ODD, other, more systemic factors appear to be involved. Researchers have determined that most parents of children with ODD exhibit a degree of family dysfunction. Depressed parents, particularly mothers, are more likely to have children with ODD (Biederman, Munir & Knee, 1987; and Beardslee et al., 1983). Substance abuse (Frick et al., 1992 ) and marital dysfunction (Emery, 1982) are commonly found in parents of children with ODD. Having a parent, particularly a father, with Antisocial Personality Disorder places the child at greater risk for ODD (Biederman et al., 1987).
The correlation between maternal depression, marital stress, and parental substance abuse makes it tempting to conclude that parental dysfunction is causal to ODD. However, parent-child relationships are reciprocal (Bronfenbrenner, 1979). Whereas the parent's behavior affects the child, the child's behavior also affects the parent. It is possible that a mother becomes depressed and marital stress escalates in the face of raising an oppositional, whining, demanding child. In short, it is not known whether parental dysfunction causes the development of ODD or whether the child with ODD causes parental dysfunction. Most likely, each exacerbates the other into a downward spiral.
ODD is often comorbid with other conditions. Estimates of comorbidity with Attention Deficit Hyperactivity Disorder (ADHD) range from 20% (Barkley, 1990) to 60% (Biederman et al., 1987). One study found that 50% of children with ODD had dysthymia (Wenning, Nathan, & King, 1993). Ten percent of the children with ODD had a concurrent diagnoses of anxiety disorder (Shaffer et al., 1988).
Patterson, Cobb, & Ray (1973) were among the first to develop treatment for children with ODD. Patterson's treatment consisted of an analysis of the parent-child interaction followed by parent training. Forehand and McMahon (1981) improved upon Patterson's parent training model by using simulation practice to give parents feedback about their ability to modify their children's behavior through the use of five specific skills. The skills taught by Forehand and McMahon, and used extensively in most successful ODD treatment programs, are giving attends, giving rewards, ignoring, issuing commands, and implementing time-out.
In phase one, Forehand & McMahon teach the skills of attending, using positive reinforcement, and ignoring. Attends, which are commentaries on the child's behavior, are employed to provide a more consistent source of attention. Attends are used to describe the child's behavior ("You're putting a puzzle together.") or to emphasize desired behavior ("You're reading a book."). Positive reinforcement employs three types of rewards. "Physical rewards" include hugs, kisses, pats on the back, etc. A second kind of reward is the "unlabeled verbal reward." These are nonspecific praise statements such as, "Good job," "I like that," and "Nice work." The third type of reward is the "labeled verbal reward." These rewards are praise statements that describe the particular behavior the parent wishes to reinforce: "Thank you for putting your coat away;" "I like how well you are listening to what Dad says;" and "Thank you for helping me with the trash."
The second phase of Forehand and McMahon's model is compliance training. Compliance training uses commands and time-out (TO). The two types of commands are alpha commands (clear, concise commands) and beta commands (inadequate commands). Beta commands are not behaviorally specific (e.g., "Look out."). A chain of commands (e.g., "Pick up the toys, make your bed, turn off the TV, brush your teeth, and get your coat on") are beta commands. Question commands (e.g., "Would you like to put your pajamas on now?"), "Let's..." commands (e.g., "Let's clean up your room.) or commands accompanied with a rationale or other verbalizations (e.g., "Clean up your room, it is messy. I don't like a mess in the house.") are also beta commands. Command training focuses on teaching parents to use alpha commands.
Compliance is achieved through the use of time-out (TO). After receiving an alpha command, the child has five seconds to initiate compliance. After five seconds the command is repeated with a warning. If the child fails to comply after an additional five seconds, the child is taken to the time-out area and told, "Since you didn't _____, you have to stay here until I say you can leave." Arguing and rationalizing are discouraged. The parent ignores tantrums, shouts, protests, or promises to behave. TO lasts a minimum of three minutes. Release from TO is contingent upon 15 seconds of quietly sitting on a chair. After TO, the parent removes the child from the chair and repeats the original command. Refusal to comply results in another session of TO.
In Forehand and McMahon's model, the procedures and rationale for each skill are explained to the parents. The therapist demonstrates the skill through role playing. Parents practice the technique as the therapist plays the part of the child. The procedure is explained to the child, and the child verbalizes his understanding. While the clinician watches behind a one-way mirror, the parent practices the skill. Parents are required to reach criteria on each of the skills. Homework generalizes the use of the skills to home.
Carol Webster-Stratton, operating a clinic at the University of Washington, effected the most recent advancements in the treatment of ODD (Webster-Stratton, 1981a, 1981b, and 1982). She demonstrated that video tapes of effective parenting techniques achieved results comparable to therapist-facilitated programming. Video tapes have several advantages. They augment research by bringing consistency from one parent training group to another. Additionally, video tapes make parent training less clinician dependent, thereby increasing the efficiency of the clinic.
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The North Dakota Journal of Human Services, June 1998