N THE LAST DECADE, THERE HAS BEEN heightened awareness of the extent to which children personally witness or experience violence. [1][2][3] Public health officials have responded by identifying violence as one of the most significant US public health issues. [4][5][6] Large numbers of US children experience such violence, and an even greater number may experience symptoms of distress after personally witnessing violence directed at others. 2,7-9 For many children, personally experiencing or directly witnessing multiple incidents of violence is the norm. 3,10,11 Violence affects all racial, ethnic, and socioeconomic groups, but its burden falls disproportionately on urban, 5,12 poor, and minority populations. 13,14 Several studies have found that the majority of children exposed to violence, defined as personally witnessing or directly experiencing a violent event, display symptoms of posttraumatic stress disorder (PTSD), 15,16 and a substantial minority develop clinically significant PTSD. [17][18][19] However, the harmful effects of violence extend beyond symptoms of PTSD. Exposure to violence is associated with depression 20 and behav-Author Affilations are listed at the end of this article.