Media Coverage of Child Trauma: Implications in Social Framing Research

1. Media Coverage of Child Trauma: Implications in Social Framing Research Anandhi Narasimhan, MD

2. Objectives • Define cognitive frames and understand the relationship to public thinking • Understand how media frames may influence people’s thinking of child trauma • Recognize how frames can affect public policy

3. Outline • Definitions • Historical Background • Description of Framing Research • Our current study- introduction, methods, data, preliminary findings • Future Implications

4. Definitions • Communication-process of sharing information • Mass Media-section of the media designed to reach a very large audience(1920s-newspapers and magazines) • Framing-a method of providing category and structure to thoughts (wikipedia)

5. Frames “The way in which the world is imagined determines a particular moment what men will do” (Lippman, W. 1921. Public Opinion. New York: The Free Press.) - describing the connection between mass communications to public attitudes and policy - Concept of frames based on this connection

7. Composition of Frames • Visuals • Metaphors • Messengers • Narratives • Scripts • Numbers

8. Index • In economics, this is a single number calculated from an array of prices and quantities • In terms of framing, indexing is a process of creating mental shortcuts to make sense of something • This allows us to fill in blanks for missing information, remember certain facts, and forget those that do not support the frame

9. News Frames • Research has shown that types of news frames influence how the public attributes responsibility • Two types- episodic and thematic • “Episodic tends to elicit individualistic rather than societal attributions of responsibility; thematic framing has the opposite effect.” (Iyengar,1991)

10. Examples You believe that the current war was a mistake, so you are drawn to news stories that reinforce this notion, and disregard those that don’t You believe that public schools in Los Angeles do not provide adequate education, so you are drawn to what reinforces this idea

11. Public Health and the Media A systematic review showed that mass media campaigns helped in increasing The use of child car seats( Zaza et al, 2001)

12. Deficits in News Media Coverage • Inaccuracy in the coverage of scientific published papers(Schwartz et al, 1999 and Loo et al, 1998) • Overstating the risks or adverse effects of an intervention(Brown et al, 1996 and Lebow et al, 1999) i.e. suicidality and ssri’s

13. A retrospective analysis of 207 television (n=37) and newspaper (n=180) stories from the period 1994-98 about three drugs (pravastatin, a cholesterol-lowering drug; alendronate, a biphosphonate for the prevention and treatment of osteoporosis; and aspirin, used to prevent cardiovascular disease) showed that: 83 % of 124 stories used a “relative” frame only when quantifying benefits of drug, which can be misleading 53% of 207 stories didn’t mention possible adverse effects 70% of 207 didn’t mention drug costs 60% of 85 stories did not disclose industry relation of expert or study they cited

14. Pharmaceutical Influence • Collective accumulation of information and past experiences about a topic is known as social knowledge. • Social knowledge influences development and transmission of perceptions about prescriptions of medications, including psychoactive medications. • Social knowledge has a component of symbolism meaning of drug described as images, representation, or metaphors.

15. Pharmaceutical Influence • This imagery and symbolism is remembered and transmitted through society. • This is how mass media suggest to patients that a specific medication promises to solve health and life problems in magical ways; i.e. Prozac-happy pill, feel-good pill, “magic bullets”, “like insulin for my mind/mood” (Montagne, 2001, 1996). Eli Lilly launched campaign to condemn media’s exaggeration of the effectiveness of prozac in response (Listening to Eli Lilly, 1994).

16. Strategic Frame Analysis “…Identifies the dominant frame as it exists in public opinion and is reflected in the media, demonstrates its impact on public thinking, and identifies, measures and tests alternative frames that can change decision outcomes.” (Gilliam and Bales, Social Policy Report, 2001)

17. Content Analysis • Identify key concepts, pictures, key words • Decide how above will be recorded as data- coding protocol • From this, recorded communication can be analyzed, i.e. tv news, newspapers, magazines, books • Investigate composition of meaning, and their linguistic, affective, cognitive, social, cultural, and historical significance

18. Examples of Frame Analysis • News exposure to violent youth “superpredators” increased adult support of punitive crime policy (Gilliam and Iyengar, 1998) • Politicians moved to enforce more restrictive youth policies such as lowering the age at which a juvenile can be tried as an adult (Males, 1998), passing youth curfews, gang injunctions, search of children’s lockers and placing metal detectors in schools.

19. Goals of Our Study • Perform a content analysis of media coverage of child trauma • Understand how child trauma is portrayed in the media • Use this information to help develop effective public health campaigns to promote increased willingness to access care for victims of child trauma

20. Methods • We chose 16 major newspapers representing different demographic regions, ethnic and cultural diversity, political and religious affilations, small and large market sizes • New York Times, Chicago Tribune, LA Times, Atlanta Constitution Journal, Christian Science Monitor, El Paso Times, Topeka Capital Journal, Des Moines Register, Boston Globe, Dallas Morning News, Cleveland Plain Dealer, Miami Herald, Washington Post, Pittsburgh Post-Gazette, Salt Lake City Tribune, Minneapolis Star Tribune

21. Trigger Words • Child Abuse, also physical or sexual abuse • Child Trauma • Child Kidnapping • Child Hostages • Youth Violence • War related violence involving children

23. Trigger Words cont’d • Genocide involving children • Dog bite or animal bite involving child • Burns involving child • Shaken baby • Adolescent suicide • Child witnessing suicide • School shootings

24. Trigger Words cont’d • Child Amputation • Child hit by a car • Cancer in child • War orphans • Violence in Darfur involving children • Child Trafficking • Child Prostitution

25. Abd al-Rahman, Age 13“I am looking at the sheep in the wadi [riverbed, or oasis]. I see Janjaweed coming—quickly, on horses and camels, with Kalashnikovs—shooting and yelling, ‘kill the slaves, kill the blacks.’ They killed many of the men with the animals. I saw people falling on the ground and bleeding. They chased after children. Some of us were taken, some we didn’t see again. All our animals were taken: camels, cows, sheep, and goats. Then the planes came and bombed the village.”

27. Methods Cont’d • Articles were divided and distributed to three coders • One coding packet filled out for every article • Coders rated articles for trigger words, attribution of responsibility, recommendations, tone, type- thematic or episodic, government source, education source, industry source, non-profit agency source, primary or secondary topic

28. Methods cont’d • Access World News Bank was the search engine used to locate articles from newspapers • Time frame July 1, 2006 to July 31, 2006 • Trigger words entered into search engine and articles from the sixteen newspapers were identified

29. Methods cont’d • Reliability checked by randomly selecting articles by independent reviewers and comparing coding data • Data Analysis- descriptive study verses prescriptive study such as in clinical trials, so no hypothesis being validated or rejected

30. Results • First Trigger Word- Child Abuse First 60 articles out of 472 cited reviewed 13 removed because they were repeats or unrelated to children Leaving 47 articles

31. Results Cont’d Story Type Code • Episodic- 40% • Thematic- 17% • Episodic/Some Thematic- 28% • Thematic/Some Episodic- 15%

32. Results Cont’d Tone • Problem Frame-30% • Problem Frame/Some Benefit-21% • Benefit Frame-2% • Benefit Frame/Some Problem- 4% • Neutral Frame- 43%

33. Results Cont’d Reccommendations - 36%; 17 out 47 • Mental Health Services- 11% • Medical Care- 18% • Community Programs- 9% • Child Protective Services- 30% • Other Recs included shelters, parents speaking to children, Non-profit agencies, crisis assistance, clergy

34. Results Cont’d Attribution of Responsibility-36% • Family/Parent-59% • Policy and Legislation- 18% • Law Enforcement- 6% • Child Protective Services-6% • Other Attributions-war, resistance to change, racism, drugs, affected population

35. Results Cont’d • Government Source Cited- 66% • Industry Source Cited- 23% • Education Source- 2%

36. Conclusions • Attribution of Responsibility was predominantly linked to parents/family • More of the stories tended to be episodic in nature as opposed to thematic • About one-third of stories had recs, even fewer for Mental Health Services • Education source is not a component of most stories

37. Questions • How much does the public know about the effects of trauma on children? • Do people think that treatment is necessary and are they familiar with available treatment? • How will their knowledge influence their support for public health campaigns to increase willingness to access care?

38. Future Steps • Expand research to include other media outlets, television news, radio • Conduct Focus groups to see how public discourse is influenced by messages from the media regarding child trauma • Simplify Models developed to correct misunderstandings and false beliefs • Conduct Priming Surveys

39. Acknowledgements Mentors Coders Robert Pynoos, MD, MPH Julia Newbold Alessia Gottlieb, MD Eden Fairweather Frank Gilliam, PHD,Vice Chancellor, UCLA Lorena Chavea Department of Communications Bonnie Zima MD, MPH Margaret Stuber, MD Sheryl Katoaka, MD Collaborators Technical Support National Center for Child Traumatic Stress- UCLA Joan R Kaplowitz, PhD And Duke UCLA Library Alan M. Steinberg, PHD, Associate Director Vanderbilt TV NewsArchive

40. “You must be the change you want to see in the world.” (Mahatma Gandhi, (1869-1948)