The Latent Threat of Community Violence: Indirect Exposure to Local Homicides and Adolescents' Mental Health in Colombia

Community violence and early childhood language development: The moderating role of maternal efficacy and satisfaction

This paper estimates the acute effect of community-level homicides on early childhood language development and explores the moderating role of maternal efficacy and satisfaction in Chile. It uses data from the 2017 wave of the Early Childhood Longitudinal Survey of Chilean Children (N = 1194, Mage: 52.8 months, 52% girls). Children in municipalities with homicides 1 month before the Peabody Picture Vocabulary assessment scored between 0.18 and 0.41 SDs lower compared to children in the same municipality but for whom homicides happened after the assessment. On average, higher maternal satisfaction appears to have a protective effect, though it dissipates in the most violent municipalities. Evidence that higher maternal efficacy protects children from the negative effects of violence is inconclusive.

Beyond direct exposure to violence: effects of living in disordered and violent communities on psychological distress in young Mexican people

The association between community violence and mental health has been studied by reports of individual experiences, particularly in adolescents and youths, but little is known about the effect of living in disordered and violent communities. This study aims to determine the possible relation between living in disordered and violent community environments and psychological distress in Mexican adolescents and youths regardless of their individual experience of victimization and to assess the potential modifying effect of sex and age on this association. Data come from a cross-sectional survey with a representative sample of adolescents and youths living in Mexican municipalities, including 39,639 participants aged from 12 to 29 years. Disordered and violent community environments were assessed using reports from a secondary sample of adults who lived in the same communities as participants. Using exploratory factor analysis, three contextual variables related to disordered and violent community environment were created: social disorder, vandalism, and criminality. Multilevel linear regression models with random intercept were estimated. Adolescents and youths who lived in environments with higher social disorder had more psychological distress. Men in environments with greater vandalism had a higher level of psychological distress. Unexpectedly, women from communities with higher levels of crime had fewer symptoms. It is necessary to address the violence that exists in these communities, creating strategies that reduce not only crime, but also the social disorder and vandalism that could contribute to developing negative effects on mental health.

Coping in the Face of Violence - a Qualitative Study on the Impacts of Stressful Life Events on the Mental Health of Older Adults in Colombia

BACKGROUND

Many older adults in Colombia have lived through violent and stressful life events, particularly in areas of poverty. The aim of this qualitative study was to understand the impact of stressful life events on the mental health and wellbeing of older Colombians living in areas of relative poverty.

METHODS

Older adults (aged 60+) living in the Turbo region in Colombia were interviewed face-to-face between August and December 2021. Transcripts were coded in Spanish and English by at least two researchers, using inductive thematic analysis.

RESULTS

Twenty-six older adults participated in the study. Four overarching themes were generated: Living in violent and dangerous communities; Disturbing gender violence and gender roles; Lack of mental health awareness; Coping mechanisms. Older adults experienced a long narrative of stressful life events. Younger generations appeared to disrespect older members of Society. Without any mental health support, older adults coped by accepting the extreme situations or seeking solace in their faith.

CONCLUSIONS

The health system and Government need to build up trust and generate an awareness of mental health, as older Colombians will not approach psychological support otherwise. Intergenerational community-based interventions may provide a first avenue of mental health support.

PROTOCOL: Group-based interventions for posttraumatic stress disorder: A systematic review and meta-analysis of the role of trauma type

This is the protocol for a Campbell systematic review. The primary objective is to assess the effects of group-based treatments on posttraumatic stress disorder (PTSD) symptomology in people diagnosed with PTSD (by a clinician or screening instrument) or referred to a PTSD treatment group for their symptoms by a medical professional. We will also examine a range of moderators that may affect the efficacy of group-based treatments, including the nature of the trauma (interpersonal, stigmatized) and the group fit (in terms of gender and shared vs. unshared trauma). Further, we will also explore what, if any, group-based and social identity factors are recorded and how they relate to PTSD outcomes.

Colombian Adolescents’ Perceptions of Violence and Opportunities for Safe Spaces Across Community Settings

During adolescence, access to safe environments is critical for healthy development. This study analyzed adolescents’ perceptions of safety in personal and public spaces in the semi-rural community of Santa Ana, Colombia on the Island of Barú (95.8% of inhabitants live in poverty). We used thematic analysis to explore adolescents’ experiences and reflections to identify the factors influencing their perception of safety across different community spaces. Four gender-segregated focus group discussions were held with 40 adolescents (20 male and 20 female) from ages 13 to 17 ( M = 14.4, SD = 1.2). Most of them self-identified as Black (86%). The more recurrent spaces in the adolescents’ conversations were the streets, the school, the local sports field, individual homes, and commercial sound system parties known as “Picos.” Adolescents perceived the school as the safest space, while the “Picos” were the most unsafe. The other spaces were considered mixed, meaning that their perceived safety shifts and depends on the presence of certain factors. These factors were risky behaviors, group affiliation, designated authority roles and the relevance of time. The authors discuss the importance of addressing the factors that inform adolescents’ safety perception, particularly within low resource settings cross-culturally.

Deadly gun violence, neighborhood collective efficacy, and adolescent neurobehavioral outcomes

Gun violence is a major public health problem and costs the United States $280 billion annually (1). Although adolescents are disproportionately impacted (e.g. premature death), we know little about how close adolescents live to deadly gun violence incidents and whether such proximity impacts their socioemotional development (2, 3). Moreover, gun violence is likely to shape youth developmental outcomes through biological processes-including functional connectivity within regions of the brain that support emotion processing, salience detection, and physiological stress responses-though little work has examined this hypothesis. Lastly, it is unclear if strong neighborhood social ties can buffer youth from the neurobehavioral effects of gun violence. Within a nationwide birth cohort of 3,444 youth (56% Black, 24% Hispanic) born in large US cities, every additional deadly gun violence incident that occurred within 500 meters of home in the prior year was associated with an increase in behavioral problems by 9.6%, even after accounting for area-level crime and socioeconomic resources. Incidents that occurred closer to a child's home exerted larger effects, and stronger neighborhood social ties offset these associations. In a neuroimaging subsample (N = 164) of the larger cohort, living near more incidents of gun violence and reporting weaker neighborhood social ties were associated with weaker amygdala-prefrontal functional connectivity during socioemotional processing, a pattern previously linked to less effective emotion regulation. Results provide spatially sensitive evidence for gun violence effects on adolescent behavior, a potential mechanism through which risk is biologically embedded, and ways in which positive community factors offset ecological risk.

Social determinants of depression among mid-to-older aged Australians: A prospective study of the effects of neighbourhood disadvantage and crime

Background

Few studies examining social determinants of depression have incorporated area level objectively measured crime combined with self-report measures of perceived crime. How these factors may interrelate with neighbourhood disadvantage is not well understood, particularly in Australia, where mental health disorders are of major concern. This study examined relationships between area-level objective crime, self-reported perceptions of crime, neighbourhood disadvantage and depression, and potential mechanisms by which these variables indirectly lead to depression.

Methods

This study used data from the HABITAT Project, a representative longitudinal study of persons aged 40–65 years residing in 200 neighbourhoods in Brisbane, Australia, during 2007–2016. A prospective sample of residentially stable persons who reported depression at two years (n =3120) and five years (n=2249) post-follow-up was developed. Area level objective crimes were categorised as either crimes against the person, social incivilities or unlawful entry. Logistic regression was used to establish relationships with depression, followed by a decomposition analysis to establish potential mechanisms.

Results

Neighbourhoods in the highest quartile of crimes against the person had an increased risk of individuals reporting depression at all periods of follow-up. Associations were also found between unlawful entry and depression. Decomposition analysis indicated a positive and significant total effect of crime against the person on depression for all periods of follow-up, while an indirect effect of perceived crime was found to partially explain this relationship at 2-years after baseline (prop. Mediated = 46.5%), and at either or both periods of follow-up (prop. Mediated = 53.7%), but not at 5-years follow-up.

Discussion

Neighbourhoods with the highest levels of crime against the person may influence depression over time through a pathway of perceived crime. Perceived crime, particularly in areas of high crime against the person should be considered as part of a multi-faceted strategy aimed at improving population mental health.

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Prospective study of depression amongst mid to older aged Australians.

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Objective and perceived crime are rarely included together in one study.

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Area level crime against the person associated with the incidence of depression.

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Neighbourhood disadvantage associated with depression.

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Perceived crime partly mediates association between crime against the person and depression.

Perceiving fairness in an unfair world: System justification and the mental health of girls in detention facilities

Psychologists in the helping professions have long accepted the idea that cognitions have implications for mental health and wellbeing. Community psychologists have further established the importance of context and systems in the etiology of mental health problems. In this paper, we argue that as a discipline that prioritizes social justice, community psychology should consider associations between cognitions about structural and systemic inequality and individual mental health, particularly in marginalized populations. As one illustration of this argument and its complexities, we asked if and to what degree mental health was concurrently associated with adolescents' beliefs in societal fairness (i.e., system-justifying beliefs), attending to gender differences. Our findings were informed by a sample of 196 adolescents residing in detention facilities (49.50% girls; 51.75% Black/Caribbean, 21.68% multiracial; 15.38% Hispanic/Latine; 27.98% LGBTQ+). These youth represent an understudied group in the research literature addressing fairness beliefs and their influence on wellness. Results suggested that boys were more likely to endorse societal fairness compared to girls, but these beliefs were unrelated to their mental health. However, we found a significant gender moderation such that girls who perceived society to be fair reported lower levels of internalizing and externalizing mental health problems. We discuss implications for theory, research, and intervention.

Community violence and internalizing mental health symptoms in adolescents: A systematic review

PURPOSES

Mental disorders are responsible for 16% of the global burden of disease in adolescents. This review focuses on one contextual factor called community violence that can contribute to the development of mental disorders OBJECTIVE: To evaluate the impact of community violence on internalizing mental health symptoms in adolescents, to investigate whether different proximity to community violence (witness or victim) is associated with different risks and to identify whether gender, age, and race moderate this association.

METHODS

systematic review of observational studies. The population includes adolescents (10-24 years), exposition involves individuals exposed to community violence and outcomes consist of internalizing mental health symptoms. Selection, extraction and quality assessment were performed independently by two researchers.

RESULTS

A total of 2987 works were identified; after selection and extraction, 42 works remained. Higher exposure to community violence was positively associated with internalizing mental health symptoms. Being a witnessing is less harmful for mental health than being a victim. Age and race did not appear in the results as modifiers, but male gender and family support appear to be protective factors in some studies.

CONCLUSION

This review confirms the positive relationship between community violence and internalizing mental health symptoms in adolescents and provides relevant information that can direct public efforts to build policies in the prevention of both problems.

Exploring exposure to intertwined community violence among Uruguayan adolescents using a mixed-method approach

Building on the case of adolescents (aged 12-16 years) from underprivileged neighborhoods in Montevideo, two studies explore patterns of exposure to community violence among understudied South American youth. Applying a mixed-methods approach, the first study (n = 117) used principal component analysis to examine response patterns on a self-reported exposure to community violence scale. The second study examined subjective experience, drawing from focus group discussions with adolescents (n = 27) and their teachers (n = 22). Events were clustered into three components: indirect violence, traumatic violence, physical/verbal abuse, and robbery. Participants described the severity of violence in relation to chronic exposure, processes of naturalization, and permeable boundaries among the neighborhood, school, family, and social media networks. Violence chronicity and potential threats to life appear to be central dimensions in community violence reporting. Delimitating the study of community violence based on the setting or perceptual closeness has limited socioecological relevance.

Experience of neighbourhood violence and mental distress in Brazilian favelas: a cross-sectional household survey

Background

Living in informal settlements with extensive neighbourhood violence has been shown to be linked with poorer mental health. However, there is little evidence as to whether different levels of personal experiences and fears of neighbourhood violence within such settlements affect mental health. This study assessed such personal experiences and fears of residents in favelas in Brazil. We tested whether variations predict mental health symptoms and quality of life, and whether this is independent of the influence of sociodemographic characteristics and poverty.

Methods

In a population-based survey of adults living in a group of favelas in Rio de Janeiro, Brazil, we assessed: sociodemographic characteristics; extent of personal experiences and fear of neighbourhood violence; mental health symptoms on the Brief Symptom Inventory; and quality of life on the Manchester Short Assessment of Quality of Life. Univariate and multivariate regressions were fit to predict mental health symptoms and quality of life.

Findings

We interviewed 1,211 residents. Both more experiences of neighbourhood violence and more fear of violence predicted higher levels of mental health symptoms and poorer quality of life. In multivariate regression analyses, the associations remained significant after adjusting for the influence of other factors, in particular female gender, younger age, and marked poverty.

Interpretation

Even within a context in which the whole population can be exposed to violence and economic disadvantage, individual variations in the experiences of violence still make a significant difference for mental distress and quality of life. Policies to improve mental health and quality of life of residents in informal settlements need to address risk factors separately, most importantly the personal experiences of violence and poverty.

Funding

Economic and Social Research Council and Arts and Humanities Research Council in the United Kingdom.

Antecedentes

Viver em assentamentos informais, com ampla violência na vizinhança, parece estar associado a piores condições de saúde mental. No entanto, há poucas evidências de que, nestes locais, os diferentes níveis de experiências pessoais e o medo da violência na vizinhança afetem a saúde mental. Este estudo avaliou experiências pessoais e medos de moradores de favelas no Brasil. Testamos se tais variações predizem sintomas de saúde mental e qualidade de vida, e se isso é independente da influência das características sociodemográficas e da pobreza.

Métodos

Com base em um inquérito domiciliar de base populacional, realizado com adultos residentes em um grupo de favelas do Complexo da Maré, Rio de Janeiro, Brasil, foram observadas: características sociodemográficas; a extensão das experiências pessoais de exposição à violência e o medo da violência na vizinhança; sintomas de saúde mental, a partir do Inventário de Sintomas Psicopatológicos (BSI); e qualidade de vida, a partir da escala Manchester Short Assessment of Quality of Life (MANSA). Regressões univariadas e multivariadas foram ajustadas para explicar variações nos sintomas de saúde mental e qualidade de vida.

Resultados

Entrevistamos 1.211 pessoa adultas residentes na Maré. Tanto maiores níveis de exposição a experiências de violência na vizinhança quanto mais medo dessa violência estiveram relacionados a piores níveis de saúde mental (maior número e intensidade de sintomas no BSI) e pior qualidade de vida. Nas análises de regressão multivariada, tais associações permaneceram significativas mesmo após controlarmos pela influência de outros fatores, em particular sexo (feminino), idade (mais jovem) e pobreza acentuada.

Interpretação

Mesmo em um contexto no qual toda a população pode estar exposta à violência e a desvantagens materiais e econômicas, as variações individuais nas experiências de violência ainda assim fazem diferença significativa nas condições de sofrimento mental e qualidade de vida. Políticas para melhorar a saúde mental e a qualidade de vida dos residentes de assentamentos informais, como as favelas, precisam abordar fatores de risco separadamente focando, principalmente, na redução da exposição a experiências pessoais de violência e da pobreza.

Financiamento

Economic and Social Research Council (ESRC) e Arts and Humanities Research Council (AHRC), ambos do Reino Unido.

Redefining Exposure: Using Mobile Technology and Geospatial Analysis to Explore When and Where Chicago Adolescents are Exposed to Neighborhood Characteristics

Differences in how individuals navigate and interact with physical space have clear implications for when and where they are exposed to environmental characteristics. To address this reality, we propose and test a novel method with a sample of Chicago adolescents that links individual GPS coordinates with locations of environmental characteristics as a strategy to increase precision in the measurement of environmental exposures. We use exposure to violent crime as an example and link the GPS coordinates of 51 youth collected over a one-week period during the summer of 2016 to locations and times of violent crime. We explore different spatial and temporal parameters to determine whether an exposure occurred. Using the 660-foot (201 m), 24-hour operationalization, we found that youth were exposed to a total of 126 violent crimes, with an average of 3.82 (SD = 3.24) per respondent. This was higher than the 12 that were identified when exposure was calculated as the number of violent crimes occurring within 660 feet (201 m) of youths' residential addresses during the week-long assessment period. Examining correlations between the different exposure variables and measures of youths' psychological functioning, we found the largest relationships when using the GPS-based indices. We present a strategy for measuring exposure to environmental characteristics using GPS data. Higher rates of crime exposure are found based on GPS coordinates than with residential address. GPS-based exposure measures are related to youths' psychological functioning.

The impact of neighbourhood crime on mental health: A systematic review and meta-analysis

BACKGROUND

Growing evidence indicates that the residential neighbourhood contributes to the complex aetiology of mental disorders. Although local crime and violence, key neighbourhood stressors, may be linked to mental health through direct and indirect pathways, studies are inconclusive. This systematic review and meta-analysis aimed to synthetize the evidence on the association between neighbourhood crime and individual-level mental health problems.

METHOD

We searched 11 electronic databases, grey literature and reference lists to identify relevant studies published before September 14, 2020. Studies were included if they reported confounder-adjusted associations between objective or perceived area-level crime and anxiety, depression, psychosis or psychological distress/internalising symptoms in non-clinical samples. Effect measures were first converted into Fisher's z-s, pooled with three-level random-effects meta-analyses, and then transformed into Pearson's correlation coefficients. Univariate and multivariate mixed-effects models were used to explore between-study heterogeneity.

RESULTS

We identified 63 studies reporting associations between neighbourhood crime and residents' mental health. Pooled associations were significant for depression (r = 0.04, 95% CI 0.03-0.06), psychological distress (r = 0.04, 95% CI 0.02-0.06), anxiety (r = 0.05, 95% CI 0.01-0.10), and psychosis (r = 0.04, 95% CI 0.01-0.07). Moderator analysis for depression and psychological distress identified stronger associations with perceived crime measurement and weaker in studies adjusted for area-level deprivation. Importantly, even after accounting for study characteristics, neighbourhood crime remained significantly linked to depression and psychological distress. Findings on anxiety and psychosis were limited due to low number of included studies.

CONCLUSIONS

Neighbourhood crime is an important contextual predictor of mental health with implications for prevention and policy. Area-based crime interventions targeting the determinants of crime, prevention and service allocation to high crime neighbourhoods may have public mental health benefits. Future research should investigate the causal pathways between crime exposure and mental health, identify vulnerably groups and explore policy opportunities for buffering against the detrimental effect of neighbourhood stressors.

Association between psychological factors and temporomandibular disorders in adolescents of rural and urban zones

Background

Temporomandibular disorders (TMD) are related to psychological factors. Adolescence is one of the stages in life with more psychosocial vulnerability, which is dissimilar in rural and urban zones. Thus, the aim of this investigation was to evaluate the association between psychological factors (symptoms of anxiety, depression and somatization) and TMD in adolescents between 12 and 15 years, belonging to urban and rural zones of Colombia.

Methods

180 subjects aged 12–15 years (mean 13.8, SD 1.2), enrolled in public schools in the rural (n = 90) and urban (n = 90) zones were included. All subjects were evaluated using the DC/TMD instrument; the Axis I was applied for the clinical examination and the Axis II for the psychological evaluation. Data were analyzed by means of T-student, Mann–Whitney, Kruskall–Wallis tests, Pearson Chi square and multiple-variable analysis with logistic regression.

Results

Forty percent of the included subjects presented some type of TMD. TMD related to pain were the most common (25.5% of the studied adolescents), being myalgia the most common (20% of the adolescents in urban zone and 31.1% of the adolescents in the rural zone). There was no difference between the TMD present in males and females, but there were differences in the symptoms of Anxiety, and Somatization (p < 0.05). TMD and psychological factors were more prevalent in children with 13 years of age. A statistically significant association between TMD and symptoms of Anxiety (Pearson Chi squared 25.57, p = 0.04), depression (Pearson Chi squared 33.28, p = 0.03) and somatization (Pearson Chi squared 25.79, p = 0.04) was found in subjects from rural zones. No associations between psychological aspects and TMD were found in subjects from urban zones, but overall all psychological factors significantly influenced TMD.

Conclusion

This study indicates Myalgia to be the most prevalent TMD in studied Colombian adolescents. Pain-related TMDs are associated with psychological factors in the adolescent population of rural Colombia. Symptoms of anxiety, depression and somatization were found to be associated to TMD, even when the frequency was not necessarily severe.

Exposure to Armed Conflict in Childhood vs Older Ages and Subsequent Onset of Major Depressive Disorder

Importance

This study offers a rare opportunity to evaluate life-course differences in the likelihood of developing major depressive disorder (MDD) after exposure to georeferenced neighborhood-level violence during an armed conflict.

Objective

To examine age cohort (age <11 vs ≥11 years) differences in associations of neighborhood-level violence with subsequent depression onset, independently of individual exposure and other key characteristics.

Design, Setting, and Participants

The Chitwan Valley Family Study is a population-representative panel study (1995 to present) conducted in Western Chitwan in Nepal, a low-income country that experienced a medium-intensity armed conflict from 2000 to 2006. Data for violent events were collected during the armed conflict and were linked to lifetime histories of MDD (collected in 2016-2018). The present cohort study analyzes 10 623 participants within 151 neighborhoods, systematically selected and representative of Western Chitwan. All residents aged 15 to 59 years at MDD assessment were eligible (response rate, 93%). Data analysis was performed from May 2019 to July 2020.

Exposures

Georeferenced number of armed conflict-related physical beatings within 1 km of residential neighborhood.

Main Outcomes and Measures

The main outcome was onset of MDD, as defined by Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition), during or after the conflict, stratified by children (aged <11 years) and older individuals (aged ≥11 years), assessed by the Nepal-specific World Mental Health-Composite International Diagnostic Instrument 3.0 with a life history calendar.

Results

In total, 10 623 participants (5745 female [54.08%]; 4074 [38.35%] aged <11 years at the conflict start) contributed 171 899 person-years of exposure to the risk of MDD. Two or more beatings occurred within 1 km of 15 neighborhoods (9.9%). Discrete-time survival models showed that children (but not older individuals) living in neighborhoods with 2 or more beatings had a higher likelihood of developing MDD than those who lived in a community with no beatings (odds ratio, 1.82; 95% CI, 1.17-2.84; P = .008); there was also a significant interaction between age group and neighborhood beatings (odds ratio, 1.85; 95% CI, 1.27-2.70; P = .001). A confirmatory, multivariable, multilevel matching analysis showed a neighborhood association for children (z = -2.66; P = .008), but not older individuals (z = -0.454; P = .65). The mean (SE) incidence of MDD among children living in neighborhoods with 2 or more beatings nearby was 12.69% (2.37%) vs 5.08% (1.56%) in the matched unexposed sample.

Conclusions and Relevance

The youngest individuals may be the most at risk during times of violence, with mental health consequences lasting long after conflicts have subsided and should be a priority for population-level interventions. Future research should consider other disorders, other types of violence, and elderly individuals.

Chicago Youths' Exposure to Community Violence: Contextualizing Spatial Dynamics of Violence and the Relationship With Psychological Functioning

This study explores where and when community violence exposure (CVE) matters for psychological functioning in a sample of low-income, racial/ethnic minority youth (M) age = 16.17, 55% female, 69% Black, and 31% Non-Black/Latinx) living in Chicago. CVE was measured with violent crime data that were geocoded in terms of distance from youths' home and school addresses, and then calculated in terms of three distinct spatial dynamics: chronicity, pervasiveness, and spatial proximity. These measures reflect indirect/objective CVE across different conceptualizations of time, space, and neighborhood context. We tested the relationship between each CVE measure and trait anxiety and behavioral and cognitive dysregulation while controlling for youth-reported, direct violent victimization (e.g., being attacked) to examine how indirect/objective CVE occurring within youths' neighborhood contexts matters beyond direct/subjective violence exposure. Results revealed that long-term chronic, pervasive, and spatially proximal CVE was related to higher levels of behavioral dysfunction. In contrast, CVE within home- and school-based neighborhoods interacted to predict trait anxiety; youth living in low-crime neighborhoods and attending schools in high-crime neighborhoods had the highest rates of trait anxiety. Measuring CVE within both home and school neighborhoods at specific spatial measurements and time frames is critical to understand and prevent the consequences of CVE.

Associations between neighborhood-level violence and individual mental disorders: Results from the World Mental Health surveys in five Latin American cities

Rapidly urbanizing areas of Latin America experience elevated but unevenly distributed levels of violence. Extensive research suggests that individual exposure to violence is associated with higher odds of both internalizing (anxiety and mood) and externalizing (substance and intermittent explosive) mental disorders. Less research, however, has focused on how neighborhood-level violence, as an indicator of broader neighborhood contexts, might relate to the mental health of residents, independently of an individual's personal exposure. We used multilevel analyses to examine associations of neighborhood-level violence with individual-level past-year mental disorders, controlling for individual-level violence exposure. We used data from 7,251 adults nested in 83 neighborhoods within five large Latin American cities as part of the WHO World Mental Health Surveys. Accounting for individual-level violence exposure, living in neighborhoods with more violence was associated with significantly elevated odds of individual-level internalizing disorders, but not externalizing disorders. Caution should be exercised when making causal inferences regarding the effects of neighborhood-level violence in the absence of experimental interventions. Nevertheless, neighborhood context, including violence, should be considered in the study of mental disorders. These findings are particularly relevant for rapidly urbanizing areas with high levels of violence, such as Latin America.