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Peer violence and violence prevention

Robert D Sege, MD, PhD
Section Editors
Teresa K Duryea, MD
Marilyn Augustyn, MD
Amy B Middleman, MD, MPH, MS Ed
Deputy Editor
Mary M Torchia, MD


An overview of peer violence and prevention of violence is reviewed here. Violence in the media, domestic violence, and child abuse are discussed separately. (See appropriate topic reviews.)


Violence is a major cause of death and disability for American children. Violence or witnessing violence has both physical and psychiatric sequelae, including posttraumatic stress disorder, adjustment reactions, severe grief reactions, and depression [1].

Pediatric care providers play an important role in prevention of violence. Universal (primary) prevention centers on screening and anticipatory guidance for the promotion of resilience and the avoidance of risk. Secondary prevention involves treatment, counseling, and referral for children and adolescents who have experienced violence-related injury. In addition, pediatric care providers can advocate for school policies and state and federal legislation to reduce the risk of violence for children. The newer view of violence prevention, discussed below, puts violence squarely in the context of improving individual and family resilience, and positively engaging adolescents.


The United States has the highest youth homicide rate among the 26 wealthiest nations [2]. Homicide is the second leading cause of death among 15- to 19-year-olds and the leading cause of death among black youth [3,4].

Data describing nonfatal violence come from national surveillance systems and emergency departments. State and national data are available from the Web-based Injury Statistics Query and Reporting System. These statistics underestimate the prevalence of nonfatal violence because many victims do not seek medical treatment, or because the cause of injury is not coded completely or correctly. Other government agencies track relevant data through surveys:


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Literature review current through: Sep 2016. | This topic last updated: Jul 5, 2016.
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