Mental Health Consequences and Costs

People differentially respond to trauma, including victimization. Some people may cope by internalizing their feelings and emotions, whereas others may experience externalizing responses. It is likely that the way people deal with victimization is tied to their biological makeup, their interactional style, their coping style and resources, and the context in which the incident occurs and in which they operate thereafter. Some of the responses can be quite serious and long- term, whereas others may be more transitory.

Three affective responses that are common among crime victims are depression, reductions in self-esteem, and anxiety. The way in which depression manifests itself varies greatly across individuals. It can include symptoms such as sleep disturbances, changes in eating habits, feelings of guilt and worthlessness, and irritability. Generally, depressed persons will experience a decline in interest in activities they once enjoyed, a depressed mood, or both. For youth, depression is a common outcome for those who are victimized by peers, such as in bullying (Sweeting, Young, West, & Der, 2006). With the advent of technology and the widespread use of the Internet, recent research has explored online victimization and its effects. Online victimization is related to depressive responses in victims (Tynes & Giang, 2009).

Victimization may be powerful enough to alter the way in which a crime victim views himself or herself. Self-esteem and self-worth both have been found to be reduced in some crime victims, particularly female victims. In one study of youths in Virginia, Amie Grills and Thomas Ollendick (2002) found that, for girls, being victimized by peers was associated with a reduction in global self-worth and that their self-worth was related to elevated levels of anxiety. There may also be a difference in crime’s impact on self-appraisals based on the type of victimization experienced. For example, victims of childhood sexual abuse are likely to suffer long-term negative impacts to their self-esteem (Beitchman et al., 1992). Sexual victimization also has been linked to reductions in self-esteem (Turner, Finkelhor, & Ormrod, 2010). Beyond victimization of females, research has also found that victimization among older Americans (those 50 years of age and older) is also related to reductions in self-esteem and self-efficacy for African Americans (DeLisi, Jones-Johnson, Johnson, & Hochstetler, 2014).

Anxiety is another consequence linked to victimization. Persons who suffer from anxiety are likely to experience a range of emotional and physical symptoms. Much like depression, however, anxiety affects people differently. Most notably, anxiety is often experienced as irrational and excessive fear and worry, which may be coupled with feelings of tension and restlessness, vigilance, irritability, and difficulty concentrating. In addition, because anxiety is a product of the body’s fight-or-flight response, it also has physical symptoms. These include a racing and pounding heart, sweating, stomach upset, headaches, difficulty sleeping and breathing, tremors, and muscle tension (Dryden-Edwards, 2007).

Although anxiety that crime victims experience may not escalate to a point where they are diagnosed with an anxiety disorder by a mental health clinician, victimization does appear to be linked to anxiety symptoms. For example, adolescents who experience victimization by their peers experience anxiety at higher levels than nonvictimized adolescents (Storch, Brassard, & Masia-Warner, 2003). The relationship between anxiety and victimization is likely complex in that victimization can lead to anxiety, but anxiety and distress are also precursors to victimization (R. S. Siegel, La Greca, & Harrison, 2009). Some victims do experience mental health consequences tied to anxiety that lead to mental health diagnoses.

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