Book Review

Guns and Violence

Understanding and Preventing Violence

N Engl J Med 1994; 330:373-374February 3, 1994

Article

Understanding and Preventing Violence
Edited by Albert Reiss, Jr., and Jeffrey A. Roth. 464 pp. Washington, D.C., National Academy Press, 1993. $49.95. ISBN: 0-309-04594-0

Understanding and Preventing Violence contains much useful information on a wide range of topics. The chief value of this book is its encyclopedic nature. The discipline of violence prevention outside criminal-justice pursuits is young, and the book's contribution to that discipline is substantial. The book is less successful in accomplishing two of its stated objectives: integrating various disciplinary approaches and setting forth a model to guide an interdisciplinary understanding of violent behavior and its control. Instead, the book presents a comprehensive description of selected approaches to the study of violence.

Understanding and Preventing Violence was assembled by the Panel on the Understanding and Control of Violent Behavior and Social Sciences and Education, which in turn is part of the National Research Council. The book's preface, written by Albert J. Reiss, Jr., chairman of the panel, explains how the panel narrowed its work to focus on “the understanding and control of violent behavior that was, at law, criminal behavior and the ways that biobehavioral, social, and psychological scientific research provided theoretical and empirical work relevant to its understanding and control.” The panel has excluded from consideration self-inflicted and collective forms of violence and provides “limited treatment” of violence between wards and custodians and between police and citizens. The decision to concentrate more on an understanding of violence and less on prevention or intervention is explained in the summary that follows the preface:

We were frustrated to realize that it was still not possible to link these fields of knowledge together in a manner that would provide a strong theoretical base on which to build prevention, intervention programs. For that reason, our recommendations primarily concern the research needed to improve our understanding of mechanisms at the individual, group, community level and evaluations of the interventions that appear most promising.

The panel makes four recommendations. The first is for “sustained scientific problem-solving initiatives” in the following areas: the biological and psychosocial factors that can lead to a potential for violent behavior; the “places, routine activities, and situations that promote violence”; efforts by the police to reduce violence in illegal markets (drugs and firearms); the role of firearms, alcohol, and drugs in violence; the role of “bias crimes, gang activities, and community transitions” in violence; and domestic assault. The second recommendation is to improve the statistical information on violence. The third recommendation calls for new research on the impact of weapons on episodes of violence, the role of overcrowding, “how developmental processes in ethnically and socioeconomically diverse communities alter the probabilities of developmental sequences that promote or inhibit violent behavior,” neurobiologic markers, medications that reduce violence, sexual violence, and violence by custodians against wards. The final recommendation is for a large-scale, multicommunity cohort study “to improve both causal understanding and preventive interventions at the biological, individual, and social levels.”

The book's eight chapters are divided into three parts. The first, “Violent Human Behavior,” provides a wealth of descriptive data on various areas of violence. The panel makes a compelling case for collecting more accurate and thorough data through sources other than the criminal-justice system. The second part, “Understanding Violence,” details the current criminal-justice and public health approaches to violence prevention. This generally thoughtful and well-documented section describes the link between violence and alcohol and drugs, explores family violence, and discusses guns and violence. The book's third part, “Harnessing Understanding to Improve Control,” presents a complex overview of the factors that make up a violent act. This section accurately assesses the difficulties that arise in identifying risk factors and applying interventions to curb violence:

A major problem in understanding violence is to describe the probability distributions of predisposing factors, situational elements, triggering events at the biological, psychosocial, microsocial,, macrosocial levels. The problem in controlling violence is to choose among possible interventions.

Although it offers valuable information from several disciplines, Understanding and Preventing Violence is weak in its theoretical framework. Discussions of various public agencies and institutions fail to mention the importance of collaborations with other potential players, such as the departments of Education, Housing and Urban Development, and Health and Human Services. A multidisciplinary approach to the problem of violence demands partnerships involving a multitude of institutions and communities. The policy and resource recommendations offered in this book should be considered with the caveat that the bias of the authors is toward criminal-justice strategies.

Reiss applauds the diversity in the professional backgrounds of the panel members. Chaired by a sociologist, the panel consisted of seven criminologists, three psychologists, three physicians (two of whom are psychiatrists), a political scientist, a human-services professional, a geneticist, an economist, and a community activist. Women and ethnic minorities were not well represented, however, with 17 men, 2 of whom are African Americans, and 2 women. The dominant perspective was that of criminal justice, with an emphasis on biologic and biobehavioral research.

The book suffers from a glaring lack of attention to the impact of racism on violent behavior and a notable absence of any critique of the writings of such prominent African and African American scholars as Kawanza Kunjufu, A. Leon Higginbotham, Jr., Ronald L. Braithwaite, Cornel West, Ron Walters, and Gloria Johnson Powell. Theories based on an understanding of violence as learned behavior are given minimal attention. The book also lacks a consideration of violence as a social and cultural problem. Instead, the authors embrace a more traditional and limited view of violence -- that there are violent criminals who exist because of genetic, biobehavioral, or psychological disorders and who ought be identified and controlled early. Reluctant to confront traditional institutional barriers to social change, the authors give only lip service to promising strategies for the control of violence that require a shift in public attitudes. For instance, in the discussion of weapons control, strategies to sway public opinion and promote a change in public policy are neglected.

Despite its slant toward traditional approaches to the study of violence, this is a valuable book. It is a useful reference for those devoted to the science and practice of violence prevention.

Deborah Prothrow-Stith, M.D.
Harvard School of Public Health, Boston, MA 02115