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An Effective Approach to Violence Prevention: Traditional Martial Arts in Middle School.

ABSTRACT

This study replicated and extended the design and outcome measures of several small studies. In these studies, juveniles at high risk for violence and delinquency showed decreased violence and positive changes in psychological risk factors after being required to take a school-linked course in traditional martial arts. In the present study, 60 boys in a large urban middle school were required to take a traditional martial arts course in their school. They were paired on problematic behavior profiles and assigned to a treatment group or to a wait-list control group. Thirty classes, three per week (45 minutes each), were taught by a master of Koga Ha Kosho Shorei Ryu Kempo and his assistant (neither was a public school teacher). Results are reported here for 14 variables from the following measures: four teacher rating scales from the Sutter-Eyberg Student Behavior Inventory, five self-report scales of the Piers-Harris Self-Concept Scale, four computerized measures of attentional self-control from the Intermedi ate Visual and Auditory Continuous Performance Test, and a count of permanent expulsions from school. The treatment students improved over baseline on 12 variables, while the controls improved on 5 by small amounts and deteriorated from baseline on 8, including teacher-rated violence. There were significant differences between the groups on self-reported happiness and schoolwork and on one measure of attention. After controls took the course, their scores resembled the postcourse scores of the treatment group. Importantly, the control group's increase in teacher-rated violence was reversed. Both groups were then pooled to compare baseline and postcourse teacher ratings. Their scores improved significantly in the areas of resistance to rules, impulsiveness, and inappropriate social behavior. There was also improvement in regard to violence, but the change in scores was not statistically significant. Follow-up on teachers' ratings showed that improvement remained, and in some cases increased, four months after completion of the course. Interestingly, all 6 permanent expulsions were among the control group students who had not yet taken, or had only begun taking, the martial arts course.

Concern has increased about youth violence, both in and out of schools, both in and out of cities. Unfortunately, violence-prevention programs in schools have shown limited success (Howard, Flora, & Griffin, 1999). Recently, however, traditional martial arts have been proposed for violence prevention in several independently conceived programs for juveniles at high risk for violence and delinquency. Several studies have examined this promising approach. These studies placed a traditional martial arts course in middle or elementary school, where it was required for youths known to be at high risk for violence and delinquency (Delva-Tauiliili, 1995; Edelman, 1994; Glanz, 1994; Smith, Twemlow, & Hoover, 1999). Combined with studies of non-school programs for detained juveniles (Demoulin, 1987; Trulson, 1986), there is strong evidence that requiring traditional martial arts training for high-risk youths is effective in reducing violent behaviors and personal characteristics associated with violence and delinquenc y.

It has been argued that traditional martial arts provide exactly the experience that will engage young people who are at clear risk for delinquent acts or impulsive violence, and even start them on positive life paths (Cannold, 1982; Fuller, 1988; Penrod, 1983; Weiser, Kutz, Kutz, & Weiser, 1995). Twemlow and Sacco (1998) stated: "Martial arts ... can be an extraordinarily helpful, ego-building form of psychotherapy ... particularly [for] control of aggressive impulses" (p. 517). According to Trulson, ". . . data suggest that training in the traditional martial arts ... is effective in reducing juvenile delinquent tendencies" (p. 1131).

Furthermore, researchers have presented descriptive, cross-sectional data showing lower scores on hostility and aggression and/or higher scores on self-esteem and positive outlook for traditional martial arts students when compared to students of nontraditional martial arts or other sports. These positive characteristics increased with greater length of traditional martial arts training (Daniels & Thornton, 1990; Kurian, Verdi, Caterino, & Kulhavey, 1994; Lamarre & Nosanchuk, 1999; Nosanchuk 1981; Trulson, 1986); the improvements were not due to attrition of more aggressive students (Nosanchuk & MacNeil, 1989). It should be noted that two studies found aggression to increase with greater length of nontraditional training (Nosanchuk & MacNeil, 1989; Trulson, 1986), but no studies found increased aggression or hostility to correlate with length of traditional training.

Traditional martial arts training is not to be confused with the competitive fighting skills that are glorified in action movies and taught in many martial arts studios. Traditional martial arts have ancient Buddhist/Taoist origins and philosophy, as well as specific training methods and goals. This philosophy is deeply pacifistic (i.e., it abhors initiation of conflict and teaches protection of one's assailants). The aim is to develop a centered, calm, discriminating mind (do in Japanese) that is applied in all areas of life--the antithesis of a mind set for aggression, whether impulsive or not. (The word do in the name of a martial arts program is a clue that it may be traditional, but absence of the word does not necessarily indicate a nontraditional approach.) The aim is also to develop a respectful attitude, physical skill, spiritual clarity, and an understanding of the body and of the physics of action. Some forms, such as the specific Kempo used in the present study, were designed to train prepubertal and adolescent boys who entered ancient monasteries.

The present study expanded on previous studies that evaluated school-linked programs requiring traditional martial arts for boys at risk for violence and delinquency (Delva-Tauiliili, 1995; Edelman, 1994; Glanz, 1994; Smith, Twemlow, & Hoover, 1999). These studies examined changes from baseline to completion of the program; none did postprogram follow-up. Only Delva-Tauiliili (1995) used a waitlist control group (nonrandom) drawn from the same population. The present study used a proffle-matched, randomly assigned, wait-list control group. Our study generally replicated the other studies' dependent variables (aggressive behavior and self-esteem) and added several others. It also included a four-month follow-up on negative behaviors. Specifically, the following variables were investigated: teachers' ratings of disruptive classroom behavior (including impulsivity), self-concept, attention control, and number of permanent school expulsions.

METHOD

Subjects

Subjects were drawn from one large (870 students) urban public middle school. The school was located in a working-class and welfare-receiving neighborhood that had the third highest juvenile arrest rate in the city during the time of this study. Administrative staff and/or teachers selected 64 boys who they deemed to be at high risk for violence and delinquency. Sixty returned parental permission slips. The final sample consisted of 22 sixth graders (mean age = 12.11 years, SD = .46), 28 seventh graders (mean age = 13.11 years, SD = .43), and 10 eighth graders (mean age = 14.30 years, SD = .52).

Procedure

Homeroom teachers filled out the Sutter-Eyberg Inventory of Student Behavior (Eyberg, 1992) for each boy. Pairs of boys, regardless of school grade, were then matched on violence and inappropriate social behavior according to their Sutter-Eyberg profiles. One was then placed into Group A, which took the martial arts course first, and the other into Group B, which waited to take the course the following semester. All eighth graders were assigned to Group A to ensure that they took the course before graduation. At the start of the program, 4 boys were shifted from Group B to Group A (because of parental request and impending school change), and the boys with whom they were matched were shifted to Group B. Two boys assigned to Group B dropped out. After six classes, 2 boys new to the school were placed in Group A at the principal's request. Thus, the final assignment of boys was as follows: 32 in Group A and 28 in Group B (4 boys in Group A were unpaired).

All measures were administered to all boys twice--at the start of the first semester course (baseline, or Time 1) and at the end of the first semester course (Time 2). Some measures also were administered at the end of the second semester course (Time 3), in order to collect four-month follow-up data for Group A and data on postcourse changes from baseline for Group B (see Figure 1).

Measures

Sutter-Eyberg Student Behavior Inventory. This well-respected inventory (Eyberg, 1992; Eyberg & Colvin, 1994) presents a 36-item list of negative behaviors that the teacher rates for frequency on a 7-point Likert scale. We modified the inventory by removing items that were too childish or redundant or too extreme to show variation. The remaining items were grouped by face validity into 4 scales: Violent (9 items), Impulsive (8 items), Inappropriate Social Behavior (4 items), and Resists Rules (4 items). Scale items were not noticeably grouped on the answer forms, which teachers filled out in private.

Piers-Harris Children's Self Concept Scale. This is a well-known, well-standardized, long-used instrument (Piers & Harris, 1964, 1969). The present study used 5 of the 6 factors that compose the full scale: Behavior (18 conduct items), Work (18 schoolwork items), Calm (13 anxiety items), Popular (12 popularity items), and Happy (9 happiness items). The scale was administered as part of an interview battery of seven instruments (totaling about 35 minutes), which was conducted by a psychiatrist or psychologist.

Intermediate Visual and Auditory Continuous Performance Test (IVA). This well-respected, well-standardized computerized test (Sanford & Turner, 1995) measures aspects of attentional self-control through a 15-minute presentation of auditory and visual targets sequenced to lull and to distract. This study used standardized scores generated by the test program: Prudence (delaying reaction to check target meaning and respond accordingly) and Vigilance (staying alert to target changes despite lulling repetition). Both Prudence and Vigilance were measured for auditory and visual stimuli, yielding four scores. Low Prudence is a characteristic of impulsivity. Low Vigilance is a characteristic of "tuning-out" or "spacing-out." A psychologist administered this test.

Permanent expulsion from school. Certain behaviors or behavior repetitions were sufficiently extreme to result in permanent expulsion from school. Relative rates of permanent expulsion enabled a real-world comparison of intolerable behavior between boys who had taken the course and those who were waiting.

Treatment

Traditional (meditative) martial arts course. The treatment condition was a course in Koga Ha Kosho Shorei Ryu Kempo, an 800-year-old form of martial arts training designed for the full life education of young Buddhist monks. As with other traditional martial arts, it emphasizes nonviolent self-defense and respect for all living things. The course met three times a week for 30 sessions, during the last period (45 minutes) of the school day, in a large classroom with moveable seats. The martial arts master and his adult assistant wore traditional attire and gently but firmly insisted on respectful language and behavior. There was a focusing, moving meditation at the beginning of class ("The Energy Gathering Meditation") and a pattern (kata) composed of 35 movements. The kata was the major activity for developing concentration, for learning graceful, strong movement execution, and for experiencing mastery. When executed continuously, a kata can promote a meditative state. The boys mostly achieved strong concent ration, a requisite for meditation, during kata practice.

RESULTS

Most statistical analyses used t tests to compare the difference-from-baseline scores of Groups A and B for Semester 1. Several of these comparisons reached statistical significance. However, it must be emphasized that there was a consistent pattern of improvement for the boys who had taken the course. This pattern is shown in a series of bar graphs comparing Group A ("students") and Group B ("controls") at the end of the first semester (see Figures 2-4). The comparison was of the "difference scores" created by subtracting baseline scores (Time 1) from scores at the end of the first semester (Time 2).

Teacher ratings at end of Semester 1: controls vs. students. Figure 2 shows that, according to teacher ratings on the Sutter-Eyberg Student Behavior Inventory, controls (Group B at the end of Semester 1) increased over baseline in terms of violence and inappropriate social behavior in the classroom. Students (Group A at the end of Semester 1) consistently decreased across all four types of troublesome behavior. The results of t tests for uncorrelated samples were not significant.

Self-report at end of Semester 1: controls vs. students. On the happiness and schoolwork dimensions of the Piers-Harris Self-Concept Scale, Figure 3 shows consistent improvement over baseline self-reports for students (Group A at the end of the Semester 1). Simultaneously, there was definite deterioration from baseline for controls (Group B at the end of Semester 1). The t tests (one-tail, alpha = .05, Bonferroni alpha = .012) for uncorrelated samples indicated significant differences on how happy the boys had become and how good they reported their schoolwork to be. On Happy, t(50) = 1.83, p = .04; for controls (n = 22), M = - .05 (SD = .20), and for students (n = 30), M = .04 (SD = .14). On Work, t(50) = 3.00, p = .002; for controls, M = .06 (SD = .11), and for students, M = .03 (SD .11).

Attention at end of Semester 1: controls vs. students. Figure 4 shows consistent improvement from baseline for students (Group A at the end of Semester 1) on three of four measures of the IVA computerized test of attentional self-control. Meanwhile, controls (Group B at the end of Semester 1) deteriorated on three of the four measures. The t test (one-tail, alpha = .05, Bonferroni alpha = .013) for uncorrelated samples indicated a significant difference on Auditory Vigilance: t(46) = 1.75, p = .04; for controls (n = 22), M = -1.7 (SD = .15), and for students (n = 26), M = 7.7 (SD = .21).

Semesters 1 and 2: teacher ratings, pooled groups. Both groups were pooled and the improvements in teacher-rated behaviors were further examined with a larger sample size (n = 48), providing greater statistical power. Comparing both groups' baseline scores with their postcourse scores, using correlated t tests, revealed that the boys' scores improved (i.e., decreased) significantly (p < .05) on three of the four scales: Resists Rules, Impulsive, and Inappropriate Social Behavior (see Table 1).

Semesters 1 and 2: teacher ratings compared across groups. The postcourse raw scores (not difference scores) for the two groups were notably similar. Three of the four scale means differed by only about 0.1; the fourth differed by 0.25, which was not statistically significant (see Table 1).

Semesters 1 and 2: follow-up for Group A on teacher ratings. Teacher ratings at the end of Semester 2 were available for 19 of the original 32 boys who took the course during the first semester. These ratings constituted a follow-up measure a semester after having taken the course (see Figure 1). At 4-month follow-up, the boys in Group A were rated even better on three of the four scales of troublesome behavior (Violent, Resists Rules, and Impulsive). On Inappropriate Social Behavior, their mean rating remained better than baseline, but their improvement declined from that immediately following the course (see Figure 2).

Permanent expulsions. All six of the permanent school expulsions were among the boys in Group B. This difference between groups was significant (p = .012 by Fisher exact test). Five boys were expelled during the semester in which they did not take the course and one was expelled at the beginning of the semester in which he was taking the course (that boy had attended only two sessions).

DISCUSSION

The current research clearly duplicated and extended the positive findings of the three studies of traditional martial arts in schools and the two studies of delinquents referred to nonschool programs. It demonstrated a martial arts program's effectiveness in reducing violent behavior and psychological characteristics that correlate with violence and delinquency. It also showed that it is feasible to involve school personnel in supporting a required martial arts course, taught by a martial arts master from the outside, on school property and coordinated with the school schedule.

Feasibility

One aim of the study was to demonstrate that it is possible to institute such a course during the school day in an urban public school. Although resources for a formal assessment of school staff satisfaction were not available, there were several anecdotal findings. The self-evident point is that the program, with its unusual approach, was conducted with the cooperation of school staff for over a year. All teachers were willing to fill out the Student Behavior Inventory for at least one student (or as many as eight) twice or three times. Furthermore, the principal and schedule administrator moved the course from immediately after dismissal to the last period of the day. The program was deemed so successful by the principal that she invited the martial arts master to run a course for the school's most difficult girls. During the second semester, several teachers asked if it were possible to reenroll some of their students in the course because the great improvement that had been seen was falling off. The only negative staff reaction noted was the reluctance of some teachers to "reward" their most difficult boys with special treatment (i.e., attendance in the class). The intricacies of actually instituting the program in this setting are a topic for a separate, application-oriented report.

Effectiveness

The other aim of this study was to test whether a traditional martial arts course for involuntarily enrolled, high-risk boys would effectively reduce psychological risk factors for violence and delinquency. Fourteen variables were examined, including six that are often reported as correlated with violence and delinquency (Farrington & West, 1993; Hawkins, Catalino, & Miller, 1992; Rowe & Flannery, 1994): impulsivity, attention difficulties, unhappiness with oneself, poor schoolwork, resistance to rules, and escalating trouble with authorities. The study found a clear pattern of improvement: boys who had taken the course did consistently better than those who had not yet taken it. Very notably, on the measure of permanent expulsions among program boys, none of the six expulsions of that year came from the boys who had taken the full course.

The boys who took the course in the first semester improved over baseline on 12 variables. The waiting boys improved over baseline on only 5 variables, and to a comparatively lower degree. The waiting boys deteriorated from baseline on teacher-rated violence and inappropriate social behavior, on self-reported positive behavior, happiness, and schoolwork, and on three of four attention measures. At minimum, it might be that the martial arts course prevented, for the boys who took the course first, a common trend toward deterioration shown by the waiting boys at the end of the first semester.

Deterioration of the boys on the waiting list appears to have been halted by their taking the martial arts course in the second semester. In terms of teacher-rated conduct, Group B improved greatly over their baselines: they showed postcourse ratings that were remarkably similar to those of Group A. When both groups were pooled after having taken the course, statistically significant improvements were seen on teacher-rated resistance to rules, inappropriate social behavior, and impulsivity--although not on violence (apparently, the primary effect was the reversal of Group B's increased violence from baseline to end of the first semester). Thus, according to teachers' ratings, the two groups appear comparably improved from baseline after the same treatment. Group B's improvement might be seen as a small internal replication of Group A's success.

Design

Because of the low power of the t tests and the low representativeness of our small ns, it would be premature to emphasize those variables showing statistically significant results over those that did not. It is worth noting, however, that on the six psychological risk factors often found correlated with violence, there were modest (p < .012) to strong (p < .002) significant results (but only four had ps below their Bonferroni alpha). Most confidence can be placed in the more general finding: many risk factors improved among these high-risk middle school boys after as few as 30 classes in martial arts training that emphasizes nonaggression, respect, peaceful philosophy, and meditation.

Some limitations of the study dictate that even the findings in regard to consistent improvement patterns be considered tentative. The control group (Group B during Semester 1) was imperfect in three ways. First, it was not given placebo attention during the first semester (when waiting to take the martial arts course). Second, being placed in the control group may have been perceived as a negative experience. Although they had been told that it was due to random drawing, they may have resented the wait, which detracted from their second measurement scores. Third, while the groups were matched for problem types and intensities, the same was not true for age and grade. The 10 eighth graders and their matched controls were not randomly assigned--all eighth graders were placed in Group A to ensure that they took the course before graduation. Recall that the significant differences that were found depended on the poor performance of the controls as well as on the course takers' improvement. Perhaps if an equal nu mber of eighth graders had been wait-listed (i.e., placed in Group B), the two groups might have performed more similarly.

Furthermore, the comparability of teacher ratings at the end of the second semester and at baseline may be problematic, since most boys had different teachers at the two measurement times. It is certain that one set of teachers cannot subjectively rate students exactly the same as another set of teachers. It is unknown how much disparity there was or whether the disparity simply increased measurement error without introducing bias. Perhaps this incomparability leaves each boy's individual second semester score globally meaningful (high or low), but inappropriate for obtaining a difference score. However, there is one indication that the second set of teachers rated these boys much as the prior teachers had: postcourse means and standard deviations were similar for both groups.

Implications

So many factors were bundled in the experience of this martial arts course that it is unwise to speculate as to which were most important for its positive effects. Nevertheless, three factors deserve mention as potent and unique components of the experience: (1) Self-respect and respect for others, regardless of status or skill, was embodied in the discussed philosophy, exemplified by the teacher, and required of the students. (2) The moving meditation gave three-times-weekly practice in calming. This begins to retrain the boys' nervous system away from impulsive reaction. Boys reported using breathing techniques for stress control in daily life. (3) The instructor showed genuine interest in and concern for each student. Perhaps his positive influence was augmented by his strength of character and his being a respected member of the local community.

The first two factors are unique to training in traditional martial arts. The third aspect (a truly concerned and inspiring teacher) is not unique to such training, but is typical of it. There are many teachers of traditional martial arts. By subscribing to this pacifistic, respectful philosophy and by being interested in teaching youth, they could bring a core program for at-risk youngsters into their local schools.

The need for this course is not limited to boys. A similar course was instituted in the same middle school for its highest risk girls. Although we did not investigate its effects, the martial arts instructor reported similar attitude change among the girls as among the boys.

The positive effects on the boys were evident even though the course was held in an ordinary classroom, without uniforms, and for only 30 class meetings. It is unknown whether these effects, with or without follow-up courses, would be long lasting. Studies have shown that the psychological benefits of martial arts are correlated with length of participation (Nosanchuk & MacNeil, 1989; Trulson, 1986). That such a clear and broad pattern of psychological improvement appeared after only 30 classes surely is worth noting. Also noteworthy is that these effects occurred without the multimodal, holistic approach sometimes considered necessary for violence-prevention programs. It is hoped that these findings can be replicated and that long-term follow-up effects will be studied.

Conclusion

The difficult question is: What do the present study's findings imply for policy? It seems obvious that schools are the single most efficient location for programs for at-risk children: teachers and staff get a sense of who may be heading for trouble, and participation of unwilling students can be overseen. However, the problem of detecting less overtly troubled children remains, as well as how already overburdened teachers can monitor and encourage program attendance.

The findings of this study are encouraging; they did replicate those of other studies. However, a larger replication may never be done. The cost of one 30-class course, without a research component, is roughly $20,000, the salary of one martial arts master and an assistant. Should schools wait for further replication or explore their own martial arts courses for indications of benefits? Local assessment of small programs might not reliably increase our knowledge base, but those programs, if successful and ongoing, might prove crucial in preventing violence among at-risk youths.

REFERENCES

Cannold, S. A. (1982). Using karate to build a positive mental attitude. Thrust, May-June, 34-35.

Daniels, K., & Thornton, E. W. (1990). An analysis of the relationship between hostility and training in the martial arts. Journal of Sports Sciences, 8, 95-101.

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Edelman, A. J. (1994). The implementation of a video-enhanced aikido-based school violence prevention training program to reduce disruptive and assaultive behaviors among severely emotionally disturbed adolescents (Ed.D. Practicum, Nova Southeastern University, 1994). (ERIC Document Reproduction Service No. EC 304 0227)

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Eyberg, S., & Colvin, A. (1994, August). Restandardization of the Eyberg Child Behavior Inventoy. Paper presented at the annual meeting of the American Psychological Association, Los Angeles.

Farrington, D. P., & West, D. J. (1993). Criminal, penal and life histories of chronic offenders: Risk and protective factors and early identification. Criminal Behavior and Mental Health, 3, 492-523.

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Glanz, J. (1994). A school/curricular intervention martial arts program for at risk students (Speech/conference report, Orlando, Florida, May 15, 1994). (ERIC Document Reproduction Service, No. ED 375 347)

Hawkins, D. J., Catalano, R. F., & Miller, J. Y. (1992). Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood. Psychological Bulletin, 112(1), 64-105.

Howard, K. A., Amman, F. J., & Griffin, M. (1999). Violence-prevention programs in schools: State of the science and implications for future research. Applied and Preventive Psychology, 8(3), 197-215.

Howard, K. A., Flora, J., & Griffin, M. (1999). Violence-prevention programs in schools. Applied and Preventive Psychology, 8(3), 197-215.

Kurian, M., Verdi, M. P., Caterino, C. I., & Kulhavy, R. W. (1994). Relating scales on the Children's Personality Questionnaire to training time and belt rank in ATA taekwondo. Perceptual and Motor Skills, 79(2), 904-906.

Lamarre, B. W., & Nosanchuk, T. A. (1999). Judo -- The gentle way: A replication of studies on martial arts and aggression. Perceptual and Motor Skills, 88(3, Pt. 1), 992-996.

Nosanchuk, T. A. (1981). The way of the warrior: The effects of traditional martial arts training on aggressiveness. Human Relations, 34(6), 435-444.

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Penrod, H. (1983). Social psychology. Englewood Cliffs, NJ: Prentice-Hall.

Piers, E. V., & Harris, D. B. (1964). Age and correlates of self-concept in children. Journal of Educational Psychology, 55, 691-700.

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Powell, K. E., & Hawkins, D. F. (Eds.). (1996). Youth violence prevention: Descriptions and baseline data from 13 evaluation projects. American Journal of Preventive Medicine. Supplement to Vol. 12(5).

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Smith, J., Twemlow, S. W., & Hoover, D. W. (1999). Bullies, victim and by-standers: A method of in-school intervention and possible parental contributions. Child Psychiatry and Human Development, 30(1), 29-37.

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Twemlow, S. W., & Sacco, F. C. (1998). The application of traditional martial arts practice and theory to the treatment of violent adolescents. Adolescence, 33(131), 505-518.

Weiser, M., Kutz, I., Kutz, S. J., & Weiser, D. (1995). Psychotherapeutic aspects of the martial arts. American Journal of Psychotherapy, 49(1), 118-127.

[Graph omitted]

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Table 1

Comparison of Teachers' Ratings of Boys' Negative Behaviors

 Groups A & B Pooled
 (n=48)
Sutter-Eyberg Baseline Postcourse
 Scale (a)
 M (SD) M (SD)

Violent 3.46 (1.20) 3.28 (1.32)
Resists Rules 4.45 (1.48) 3.99 (1.82) (*)
Impulsive 4.63 (1.61) 4.17 (1.47) (*)
Inappropriate
Social Behavior 4.45 (1.61) 3.85 (1.75) (*)

 Groups A & B Compared
 Postcourse
Sutter-Eyberg Group A Group B
 Scale (a) (n = 31) (n = 17)
 M (SD) M (SD)

Violent 3.20 (1.46) 3.34 (1.05)
Resists Rules 3.85 (1.59) 4.10 (1.49)
Impulsive 4.10 (1.64) 4.21 (1.13)
Inappropriate
Social Behavior 3.79 (1.87) 3.87 (1.63)

Note. Postcourse for Group A was Time 2; for Group B it was Time 3.

(a)Seven-point Likert ratings.

(*)p < .05 (correlated t test).
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Article Details
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Author:Zivin, Gail; Hassan, Nimr R.; DePaula, Geraldine F.; Monti, Daniel A.; Harlan, Carmen; Hossain, Kash
Publication:Adolescence
Geographic Code:1USA
Date:Sep 22, 2001
Words:4934
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