Violence Exposure, A Chronic Psychosocial Stressor, and Childhood Lung Function

Objective: Chronic psychosocial stressors, including violence, and neuropsychological and behavioral development in children as well as physiologic alterations that may lead to broader health effects. Methods: We studied the relationship between violence and childhood lung function in a prospective birth cohort of 313 urban children (age range = 6–7 years). Mothers reported on their child’s lifetime exposure to community violence (ETV) and interparental conflict in the home (Conflict Tactics Scale (CTS)) within 1 year of the lung function assessment. Results: In linear regression analyses, adjusting for maternal education, child’s age, race, birthweight, tobacco smoke exposure, and medical history, girls in the highest CTS verbal aggression tertile had a 5.5% (95% confidence interval (CI) = −9.6, −1.5) decrease in percent predicted forced expiratory volume (FEV1) and a 5.4% (95% CI = −9.7, −1.1) decrease in forced vital capacity (FVC) compared with girls in the lowest tertile. The CTS verbal aggression subscale was associated with lung function among boys in the same direction, albeit this was not statistically significant. Boys in the highest ETV tertile had a 3.4% (95% CI = −8.0, 1.1) lower FEV1 and 5.3% lower FVC (95% CI = −10.2, −0.4) compared with boys in the lowest tertile. The ETV score was not a significant predictor of girls’ lung function. Conclusions: Interparental conflict, specifically verbal aggression, and ETV were associated with decreased childhood lung function independent of socioeconomic status, tobacco smoke exposure, birthweight, and respiratory illness history. Gender differences were noted based on the type of violence exposure, which may warrant further exploration. ETV = exposure to violence; CTS = Conflict Tactic Scale; FEV1 = forced expiratory volume; FVC = forced vital capacity; FEF25%–75% = forced mid-expiratory flow rate; UTS = in utero tobacco smoke; SHS = second hand smoke.

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