Images of violence alter children's attitudes toward aggression

A Johns Hopkins team that included a trauma surgeon renowned for his treatment of gunshot victims has found that exposing at-risk children and teenagers to grizzly videos and photos of these patients' wounds can significantly change the youths' beliefs about the value and consequences of aggression.

The study, by researchers with the Johns Hopkins Injury Prevention and Community Outreach Collaborative (HIPCOC), was presented recently at the annual meeting of the Society of Black Academic Surgeons in Washington. HIPCOC is chaired by Edward E. Cornwell III, M.D., trauma chief at The Johns Hopkins Hospital.

Cornwell and colleagues followed 97 boys and girls ages 7 to 17 who participated in activities at two Police Athletic League centers located near the hospital's East Baltimore campus. They assessed the youths' attitudes regarding interpersonal conflict, including their likelihood to act violently, through a survey. Next they conducted sessions with the children, showing explicit photos of actual trauma patients treated for gunshot wounds.

The HIPCOC team compared the photos to rap videos that glamorize violence. For example, one music video shown portrayed a singer getting shot, and in the next scene he continued life as usual, wearing a small Band-Aid on his face. By contrast, the images Cornwell and colleagues offered to the participants included those of a man whose abdomen was torn open by a bullet wound, and a pregnant woman who was shot in the abdomen, killing her 8-month-old fetus.

A follow-up survey completed by 48 youths showed a significant reduction in quantified beliefs supporting aggression. There also was some evidence that the youths would be less likely to resort to violence to settle conflicts.

"Our study suggests that the kind of romanticized version of violence shown on television can be countered by more frank and open discussions and displays of what violence really does to the body," says David C. Chang, Ph.D., M.P.H., M.B.A., a coauthor of the study and a graduate fellow in the Department of Health Policy and Management in the Johns Hopkins Bloomberg School of Public Health, and in the Division of Adult Trauma at The Johns Hopkins Hospital.

"If you give at-risk youth a true picture of violence, it does change their attitudes, beliefs and intentions regarding aggressive behavior," Chang stated in a second presentation of this data to the American Trauma Society.

Adds Erica R.H. Sutton, M.D., a coauthor of the study, postdoctoral fellow at Hopkins and surgery resident at the University of Maryland, "It is important to include girls in violence prevention activities. Although girls themselves may not act violently, as potential mothers they help shape the attitudes of their future sons."

The group has continued to follow the study participants informally, through activities at the Police Athletic League and organized camping trips.

HIPCOC, a group of Baltimore-area clinicians, hospital and community affairs professionals, public health professionals and community members whose work addresses youth violence in the city, was formed in 2000 to address violence prevention and evaluate existing antiviolence programs. The group has received grant support from the American Trauma Society.

Coauthors of the study were Cornwell, and Mike Yonas, M.P.H., of Hopkins; Fred Allen of the Baltimore City Police Athletic League; and Bernard Antkowiak of the National Emergency Medicine Association. https://www.hopkinsmedicine.org/