Violent crime in America has become a national crisis, and, as a result, America's mental health, health and public safety systems are seriously challenged. Recent surveys have helped create new understanding of the scope of rape and its impact. Data suggest that millions of women have been raped in their lifetime, many when they were still children. The mental health impact of violent crime can be seen in the prevalence of PTSD among women with a history of violent victimization and individuals who have lost a family member to homicide.
The following is an extended text detailing research conducted on behalf of the National Victim Assistance Academy. This is the first in a series of 12 Chapters and supplements.
Editors: Jane N. Burnley, Christine Edmunds, Mario T. Gaboury, and Anne Seymour
"This project was supported by Grant Number 95-MU-GX-K002(S-2) awarded by the Office for Victims of Crime, Office of Justice Programs, U.S. Department of Justice. The Assistant Attorney General, Office of Justice Programs coordinates the activities of the following program offices and bureaus: Bureau of Justice Assistance, Bureau of Justice Statistics, National Institute of Justice, Office of Juvenile Justice and Delinquency Prevention, and the Office for Victims of Crime. Points of view in this document are those of the author and do not necessarily represent the official position or policies of the U.S. Department of Justice."
The Scope of Violent Crime and Victimization
Learning Objectives: Upon completion of this chapter, students will understand the following concepts:
1. The extent to which violent crime is a concern for Americans.
2. The scope of violent crime and the extent to which it has increased in recent years.
3. The extent to which concerns or fears about crime have affected the way Americans live.
4. The broader impact of violence on an individual's view of the world.
There was one violent crime every 16 seconds in 1993. (Federal Bureau of Investigation, 1994, "Crime in the United States, 1993," U.S. Department of Justice, Washington, D.C.)
There were an estimated 43,547,400 criminal victimizations in the United States in 1993, including 10, 848,090 crimes of violence, and 32,182,320 property crimes. (Bureau of Justice Statistics, 1995, "Sourcebook of Criminal Justice Statistics, page 230, U.S. Department of Justice, Washington, D.C.)
Slightly over one-third (35.1 percent) of all crimes were reported to police in 1993, with 41.6 percent of crimes of violence reported to police. (Ibid., page 245)
In 1993, a weapon was used in 27.3 percent of crimes of violence in the United States. (Ibid., page 236)
During 1994, law enforcement agencies made an estimated 14.6 million arrests for all criminal infractions other than traffic violations. The arrest rate was 5,715 arrests per 100,000 population in the United States. Of all persons arrested in 1994, 45 percent were under the age of 25; 80 percent were male; and 67 percent were white. (Federal Bureau of Investigation, 1995, "Crime in the United States, 1994," U.S. Department of Justice, Washington, D.C.)
From 1993 to 1994, violent crimes collectively decreased by three percent. The 1994 total was, however, two percent higher than the 1990 figure and 40 percent above the 1985 level. (Ibid.)
From 1973 to 1991, 36.6 million people were injured as a result of violent crime. Annually, about two million people are injured as a result of violent crime. (Bureau of Justice Statistics, 1993, "Highlights from 20 Years of Surveying Crime Victims," page 15, U.S. Department of Justice, Washington, D.C.)
Of victims of crime who are injured, 51 percent required some type of medical treatment; 19 percent received treatment at a hospital emergency room or were treated at a hospital and released that day, and four percent required hospitalization for at least one night. (Ibid., page 15)
One-third of violent crimes (32 percent) involve a weapon, including 92 percent of aggravated assaults, 55 percent of robberies, and 20 percent of rapes. (Ibid., page 29)
Victims take some type of measure to protect themselves in nearly 71 percent of all violent victimizations; 82 percent of rapes; 58 percent of robberies; and 73 percent of assaults. (Ibid., page 30)
More than 5.1 million Americans -- or almost 2.7 percent of the adult population -- were under some form of correctional supervision in 1994. Almost three-quarters of these men and women were being supervised in the community on probation or parole. The others were confined in jail or prison. (Gilliard, Darrell and Allen Beck, 1995, "The Nation's Correctional Population Tops Five Million," Bureau of Justice Statistics, U.S. Department of Justice, Washington, D.C.)
At the end of June 1995, there were 1,104,074 men and women incarcerated in the nation's prisons. (Gilliard, Darrell and Allen Beck, 1995, "Prisoners at Midyear, 1995," Bureau of Justice Statistics, U.S. Department of Justice, Washington, D.C.)
According to Webster's New World Dictionary, "disaster" is defined as "any happening that causes great harm or damage, serious or sudden misfortune, or calamity." Using this definition, violence in America is clearly a health, public safety, and mental health disaster. Violence affects not only individuals, children, and adults; it also affects America's families, America's communities, and our nation at large.
Violence is a major concern of all Americans:
In a 1991 survey of a national probability sample of 1,000 adult Americans, more than four out of five Americans (82%) said they were personally very concerned about violent crime (Kilpatrick, Seymour, and Boyle, 1991).
More Americans were concerned about violent crime and drug abuse than about unemployment, pollution, the deficit, or educational quality (Kilpatrick, et al., 1991).
This survey, sponsored by the National Victim Center, also found that a majority of Americans (54%) think that violent crime is more of a problem now than it was ten years ago.
Information about the magnitude of the violent crime problem suggests that Americans' concerns about crime are not misplaced. Data from The National Women's Study, a National Institute of Drug Abuse-funded survey of a national probability sample of 4,008 adult American women, indicated that 3.5% of the sample, or an estimated 3.7 million adult women, were victims of some type of sexual or aggravated assault during a one year period; 2.5%, or an estimated 2.4 million American women, were victims of rape or aggravated assault; 1.8%, or approximately 1.7 million American women, were victims of aggravated assault; and 0.71%, or an estimated 683,000 American women, were victims of completed rape (Kilpatrick, Edmunds, & Seymour, 1992; Resnick, Kilpatrick, Dansky, Saunders, & Best, in press). These estimates of rape are much higher than those obtained in the National Crime Survey because The National Women's Study used screening questions that were specifically designed to measure rape and other types of sexual assault (Kilpatrick, et al., 1992).
Thus, millions of American men, women and children are victims of criminal violence each year. Particularly for rape and sexual assault, official statistics substantially underestimate the extent of the problem. Information from non-retrospective studies is particularly poor about violence directed at children under 12, adolescents and/or men.
Americans are vulnerable to criminal victimizations throughout the lifespan. For example, The National Women's Study found that:
22.6% of sample members, or an estimated 21.7 million women in America, had been victims of some type of sexual assault throughout their lifetime.
12.9% of the sample, or an estimated 12.1 million people in America, had been victims of one or more completed rapes.
10.3%, or an estimated 9.8 million women, had been victims of aggravated assault.
13.4%, or an estimated 12.8 million women, had lost a family member or close friend to criminal homicide or alcohol-related vehicular homicide.
Over a third of the sample members (35.6%), or an estimated 34.1 million adult women in America, had been victims of forcible sexual assault, aggravated assault, or had suffered the homicide death of a relative or close friend (Resnick, et al., in press).
For many women, rape is a tragedy of youth. The National Women's Study obtained information about up to three forcible rapes per person; her first, most recent, and "worst" rape if other than the first or most recent.
Almost 40% of women who had been raped had been raped more than once. Twenty-nine percent of all rapes happened before the victim was age 11, and an additional 32.3% happened between the ages of 11 and 17 (Kilpatrick, et al., 1992). Thus, almost two thirds (62.6%) of all rapes happened during childhood or adolescence.
A National Institute of Justice-funded national study of the indirect effects of criminal homicide (The National Homicide Study) found that 1.58% of the sample, or an estimated 2.8 million adults in America, had lost an immediate family member to criminal homicide (Amick-McMullan, Kilpatrick, & Resnick, 1991).
Another 1.48% of the sample, or an estimated 2.6 million adults, had lost another relative to homicide.
An additional .75% of the sample, or an estimated 1.3 million adults in America, had lost a close friend to criminal homicide.
In total, an estimated 3.82% of the sample, or an estimated 6.7 million adults, had suffered a homicide death of an immediate family member, other relative or close friend (Amick-McMullen, et al., 1991).
The National Homicide Study was conducted in 1987, preceding an increase in the homicide rate. Therefore, these estimates are extremely conservative as to the number of Americans indirectly affected by homicide.
The Mental Health Impact of Violence
The mental health impact of criminal violence is substantial. For example:
The National Women's Study found that 12.8% of the adult women in the sample, or an estimated 12.3 million adult women in America, had Post-traumatic Stress Disorder (PTSD) at some time (Kilpatrick, et al., 1992; Resnick, et al., in press).
Also 5.3%, or an estimated 5 million adult women, met DSM-III-R diagnostic criteria for PTSD within the past six months (see Table 6).
Other findings from The National Women's Study suggest that PTSD was much more likely to develop after violent crime experiences than other types of potentially traumatic events such as accidents or natural disasters. Data from The National Homicide Study indicated that 19.1% of all sample members who had lost a family member due to criminal homicide had developed PTSD and that 5.2% still had PTSD (Amick-McMullen, et al., 1991).
Preliminary data from the National Comorbidity Study conducted by Kessler, Bromet and Nelson found that 11% of adult women and 5.5% of adult men had PTSD at some time, and that 3.1% of adult women and 1.6% of adult men had PTSD within the past month.
These data indicate that violence-related PTSD is endemic among Americans.
The mental health impact of violence is not limited to PTSD. A history of violence substantially increases the risk for a host of other mental health disorders and problems including depression, suicide attempts, anxiety disorders, alcohol and other drug abuse problems (Burnam, et al, 1988; Kilpatrick, et al, 1985; Kilpatrick, et al, 1992; Kilpatrick & Resnick, 1993; Saunders, et al., 1992). Illustrative are these data from The National Women's Study comparing the rates of PTSD, major depression, suicidal ideation and suicide attempts among rape victims and nonvictims of crime (Kilpatrick, et al., 1992; see Figure 6):
Compared to their non-crime victim counterparts, rape victims were 6.2 percent more likely to develop PTSD (31% vs. 5%), three times more likely to develop major depression (30% vs. 10%), 4.1 times more likely to have seriously contemplated suicide (33% vs 8%), and 13 times more likely to have actually made a suicide attempt (13% vs. 1%).
There is also evidence that violence affects the longer-term physical health as well as the mental health of its victims. At least one study found that health care utilization and health problems increased following violent attacks (Koss, Woodruff, & Koss, 1990).
The Broader Impact of Violence
Not only does being a victim of violence affect physical and mental health; it also influences how one views the world. Many violence victims are no longer able to see the world as a safe place, as a just place, or as a place with meaning. Violence often breeds a cynicism and distrust that unravel the very fabric of social life.
Violence and fear of violence have taken away Americans' freedom. A majority of adult respondents interviewed in America Speaks Out reported that they were at least "a little fearful" of being attacked or robbed (Kilpatrick, Seymour, and Boyle, 1991):
When traveling on vacation or business (72%).
Out alone at night in their own neighborhoods (61%).
At home in their own house or apartment (60%).
Fear of crime restricts freedom of people to go where they want, when they want. Because of the threat of crime, many people in our nation restrict their behavior and/or have purchased some manner of protective device.
In America Speaks Out:
Sixty percent limited the places they will go by themselves.
Almost a third limited the places or times they go shopping.
More than one person in five limited the types of places he or she will work.
More than one person in four has installed a home security system.
Perhaps more dramatically, nearly one out of every five adults (18%) reports that the fear of crime has caused them to purchase a weapon for self protection. Fear of crime and fear of crime-related restrictions on lifestyle and behavior take a much heavier toll on women than on men.
Crime and fear of crime also place a heavy burden on the lives of racial and ethnic minorities. The America Speaks Out survey of 1,000 adults asked if respondents had ever been a victim of a violent crime involving the use or threat of force:
Three out of ten Hispanics (30%) and almost three out of ten African-Americans (28%) but slightly less than two out of ten whites (19%) had been victims of violent crime (Kilpatrick, et al.,1991). Note: These crime prevalence rates are almost certainly an underestimate because only one screening question was used.
A higher proportion of African-Americans and Hispanics than whites say they are either very or somewhat afraid of being attacked or robbed at home (44% vs. 35% vs. 27%), on the streets of their neighborhood in the daytime (30% vs. 25% vs. 16%), alone at night in their neighborhood (48% vs. 50% vs. 31%) and with others at night in their neighborhood (28% vs. 23% vs. 13%). Fears of being attacked or robbed while traveling were more similar across racial/ethnic groups.
With the exception of limiting places they go by themselves, which was high for all racial/ethnic groups, a higher percentage of African-Americans and Hispanics than whites say fear of crime has caused them to limit times or places they will work (33% ve. 37% vs. 19%), purchase a weapon for protection (27% vs. 25% vs. 16%), and purchase a home security system (34% vs. 41% vs. 22%).
Racial/ethnic minorities are more likely than whites to have been violent crime victims. Their fear of crime is higher than whites, and their fear of crime causes them to place more restrictions on their lifestyles than whites.
Several unescapable conclusions emerge from this brief review of violent crime and its effects:
Violence is endemic in America.
The mental health consequences of violence are substantial for individuals, families, communities, and for our nation as a whole.
The economic cost of violence is enormous.
Americans are extremely concerned about violence, thereby providing a large potential base of support for addressing the problem of violence and its consequences.
The scope of the problem of violence and its mental health impact is so great that it will require a comprehensive approach to address the problem.
Violence and fear of crime are problems for all people in our nation.
Self-Examination Chapter 1
1) To what extent are people who live in America concerned about violent crime in the U.S.?
2) How has a concern about violent crime affected the way people in America view the world and live their lives?
3) What is the likelihood that a female friend of yours, aged 35, was raped at some point in her life?
4) What are the mental health consequences of rape or the homicide of a family member?
Amick-McMullen, A., Kilpatrick, D. G., & Resnick, H. S. (1991). Homicide as a risk factor for PTSD among surviving family members. Behavioral Modification, 15 (4), 545-559.
Burnam, M. A., Stein, J. A., Golding, J. M., Siegel, J. M., Sorenson, S. B., Forsythe, A. B., & Telles, C. A. (1988). Sexual assault and mental disorders in a community population. Journal of Consulting and Clinical Psychology, 56, 843-850.
Kilpatrick, D. G., Best, C. L., Veronen, L. J., Amick, A. E., Villeponteaux, L. A., & Ruff, G. A. (1985). Mental health correlates of criminal victimization: A random community survey. Journal of Counseling and Clinical Psychology, 53 (6), 866-873.
Kilpatrick, D. G., Edmunds, C. N., & Seymour, A. K. (1992). Rape in America: A report to the nation. Arlington, VA: National Victim Center and Charleston, SC: Medical University of South Carolina.
Kilpatrick, D. G., Resnick, H. S. (1993). PTSD associated with exposure to criminal victimization in clinical and community populations. In J. R. T. Davidson and E. B. Foa (Eds.), PTSD in review: Recent research and future directions, 113-143.
Kilpatrick, D. G., Seymour, A., & Boyle, J. (1991). America speaks out: Citizens' attitudes about victims' rights and violence. Arlington, VA: National Victim Center.
Koss, M. P., Woodruff, W. J., Koss, P. G. (1990). Relation of criminal victimization to health perceptions among women medical patients. Journal of Counseling and Clinical Psychology, 58 (2), 147-152.
Resnick, H. S., Kilpatrick, D. G., Dansky, B. S., Saunders, B. E., & Best, C. L. (In press). Prevalence of civilian trauma and post-traumatic stress disorder in a representative national sample of women. Journal of Counseling and Clinical Psychology.
Saunders, B. E., Villeponteaux, L. A., Lipovsky, J. A., Kilpatrick, D. G., & Veronen, L. J. (1992). Child sexual assault as a risk factor for mental disorders among women: A community survey. Journal of Interpersonal Violence, 7, 189-204.