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Fielding-Miller R, McDougal L, Frost E, Masuku S, Shabalala F. Association between sexual violence and depression is mediated by perceived social support among female university students in the kingdom of Eswatini. BMC Public Health 2024; 24:2526. [PMID: 39289704 PMCID: PMC11406860 DOI: 10.1186/s12889-024-20040-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 09/10/2024] [Indexed: 09/19/2024] Open
Abstract
BACKGROUND Gender-based violence is a tool that primarily functions to maintain gendered power hierarchies. Manifestations of gender-based violence, sexual assault and street harassment have been shown to have significant effects on mental wellbeing in the global North, however there is little research centering the experiences and consequences of gendered harassment in the Africa region. METHODS We analyzed a cross-sectional random sample of 372 women attending a major university in Eswatini in 2017 to measure the prevalence of street harassment among female university students and assess the relationship between experiences of sexual assault, sexualized street harassment, and mental health outcomes in this population. RESULTS We found that in the previous 12 months, women reported experiencing high levels of sexual assault (20%), street harassment (90%), and depression (38%). Lifetime sexual assault, past 12 months sexual assault, and street harassment were all significantly associated with symptoms of depression. We created a structural model to test hypothesized causal pathways between street harassment, previous experiences of sexual assault, and symptoms of depression, with social support as a potential mediator. We found that a history of sexual violence significantly mediated the association between street harassment and depression, and that social support mediated a large proportion of the association between both forms of gender-based violence and depression. CONCLUSION Sexualized street harassment is associated with increased depressive symptomology for nearly all women, however the effects are especially pronounced for women who have previous experiences of sexual violence. Sexualized street harassment functions as a tool to maintain gendered power hierarchies by reminding women of ongoing threat of sexual violence even in public spaces. Social support and solidarity among women is a potentially important source of resiliency against the physical and mental harms of all forms of gender based violence.
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Affiliation(s)
- Rebecca Fielding-Miller
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, USA.
- Center on Gender Equity and Health, Division of Infectious Disease and Global Public Health, School of Medicine, University of California, San Diego, USA.
| | - Lotus McDougal
- Center on Gender Equity and Health, Division of Infectious Disease and Global Public Health, School of Medicine, University of California, San Diego, USA
| | - Elizabeth Frost
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, USA
| | - Sakhile Masuku
- Department of Community Health Nursing, University of Eswatini, Kwaluseni, Eswatini
| | - Fortunate Shabalala
- Department of Community Health Nursing, University of Eswatini, Kwaluseni, Eswatini
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Smith RL, Dick DM, Amstadter A, Thomas N, Salvatore JE. A longitudinal study examining the associations between interpersonal trauma and romantic relationships among college students. Dev Psychopathol 2023; 35:1346-1357. [PMID: 34903311 PMCID: PMC9192832 DOI: 10.1017/s0954579421001243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We examined the associations between the developmental timing of interpersonal trauma exposure (IPT) and three indicators of involvement in and quality of romantic relationships in emerging adulthood: relationship status, relationship satisfaction, and partner alcohol use. We further examined whether these associations varied in a sex-specific manner. In a sample of emerging adult college students (N = 12,358; 61.5% female) assessed longitudinally across the college years, we found precollege IPT increased the likelihood of being in a relationship, while college-onset IPT decreased the likelihood. Precollege and college-onset IPT predicted lower relationship satisfaction, and college-onset IPT predicted higher partner alcohol use. There was no evidence that associations between IPT and relationship characteristics varied in a sex-specific manner. Findings indicate that IPT exposure, and the developmental timing of IPT, may affect college students' relationship status. Findings also suggest that IPT affects their ability to form satisfying relationships with prosocial partners.
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Affiliation(s)
- Rebecca L. Smith
- Department of Psychology, Virginia Commonwealth University, Box 842018, Richmond, VA 23284-2018
| | - Danielle M. Dick
- Department of Psychology, Virginia Commonwealth University, Box 842018, Richmond, VA 23284-2018
- Department of Human and Molecular Genetics, Virginia Commonwealth University, Box 980033, Richmond, Virginia 23298
| | - Ananda Amstadter
- Department of Psychology, Virginia Commonwealth University, Box 842018, Richmond, VA 23284-2018
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Box 980126, Richmond, VA 23298
| | - Nathaniel Thomas
- Department of Psychology, Virginia Commonwealth University, Box 842018, Richmond, VA 23284-2018
| | | | - Jessica E. Salvatore
- Department of Psychology, Virginia Commonwealth University, Box 842018, Richmond, VA 23284-2018
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Box 980126, Richmond, VA 23298
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Caravaca-Sánchez F, Aizpurua E, Taliaferro LA, Stephenson A. Substance use and victimization experiences among college students in Spain. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:607-615. [PMID: 33830894 DOI: 10.1080/07448481.2021.1900196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 10/26/2020] [Accepted: 03/02/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE We examined relationships between different types and patterns of substance use and victimization experiences. PARTICIPANTS College students from two universities in Spain completed an online, cross-sectional survey. METHOD A series of tetrachoric correlations were estimated to examine the bivariate associations between different types of substances and victimization experiences. Regression analyses then examined relationships between patterns of substance use (non-users, mono-users, and poly-users), and victimization. RESULTS Slightly over half (57.7%) of students reported any form of victimization during the previous year, and most students (87.0%) reported using substances during the last three months. Polysubstance users were more likely than non-users to experience any victimization, as well as multiple forms of victimization. CONCLUSIONS Findings highlight the importance of differentiating types and patterns of substance use when developing prevention and intervention programs. Implementing intervention strategies that target polysubstance users and decrease substance use could reduce rates of victimization among college students.
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Affiliation(s)
| | - Eva Aizpurua
- School of Law, Trinity College Dublin, The University of Dublin, Dublin, Ireland
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DeLaney EN, Williams CD, Jones SCT, Hood KB, Cage J, Coston BE, Hawn SE, Santana A, Dick DM. Sexual Victimization and Mental Health Among LGBQ + College Students: Examining Social Support and Trauma-Related Drinking as Mediators. Int J Ment Health Addict 2023. [DOI: 10.1007/s11469-022-00997-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
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Xie Y, Wu J, Zhang C, Zhu L. Cumulative childhood trauma and cybervictimization among Chinese college students: Internet addiction as a mediator and roommate relationships as a moderator. Front Psychol 2022; 13:791291. [PMID: 36092086 PMCID: PMC9450690 DOI: 10.3389/fpsyg.2022.791291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 07/12/2022] [Indexed: 01/09/2023] Open
Abstract
Existing studies have found that childhood trauma is a risk predictor of cybervictimization, but few studies have explored the relationship between cumulative childhood trauma and college students' cybervictimization. This study explored the relationship and the roles of Internet addiction and Internet victimization between them. A total of 854 college students (568 females, M age = 18.92 years, SD = 0.86) completed a survey including the Short Form of Childhood Trauma Questionnaire, the Cyberbullying Inventory, the Young's Internet Addiction Scale, and the revised Roommate Relationships Questionnaire. The results showed that: (1) cumulative childhood trauma was significantly positively associated with cybervictimization; (2) Internet addiction played a mediating role between cumulative childhood trauma and cybervictimization; and (3) roommate relationships played a moderating role between cumulative childhood trauma and cybervictimization, as well as Internet addiction and cybervictimization. The research findings provide a theoretical and practical basis for the prevention and intervention of college students' cybervictimization.
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Affiliation(s)
- Yunzi Xie
- Department of Psychology, School of Education, Soochow University, Suzhou, China
| | - Jixia Wu
- Department of Psychology, School of Education, Soochow University, Suzhou, China
| | - Chen Zhang
- School of Educational Sciences, Xuzhou University of Technology, Xuzhou, China
| | - Lingyi Zhu
- Graduate School of Education and Human Development, George Washington University, Washington, DC, United States
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DeLaney EN, Williams CD, Mosley DV, Hawn SE, Dick DM. The Associations Between Sexual Victimization and Health Outcomes Among LGBQA College Students: Examining the Moderating Role of Social Support. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP10393-NP10417. [PMID: 33289453 DOI: 10.1177/0886260520978179] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Prior studies have demonstrated that sexual minority college students are two to four times more likely to experience sexual victimization (e.g., sexual assault and/or unwanted or uncomfortable sexual experiences) compared to their heterosexual counterparts. However, research that has focused on the detrimental effects of sexual victimization on health outcomes has paid more attention to heterosexual college samples and community-based adults. Understanding how sexual victimization influences mental health and substance use outcomes among lesbian, gay, bisexual, queer, and asexual (LGBQA) emerging adults in college is warranted given that this developmental period represents a critical risk period for trauma exposure, risk behavior, and psychological distress. Thus, the current study tested how sexual victimization was associated with depressive symptoms, post-traumatic stress disorder (PTSD) symptoms, and alcohol use disorder (AUD) symptoms among 234 diverse college students who self-identified as LGBQA. Additionally, social support was tested as a moderator. Findings indicated that sexual victimization was related to greater depressive symptoms, PTSD symptoms, and AUD symptoms. In addition, perceived social support moderated the relation between sexual victimization and depressive symptoms, however, in a direction contrary to hypotheses. In particular, higher sexual victimization was associated with greater depressive symptoms among LGBQA students with higher levels of social support (b = .29, p = .00), and was not significant among LGBQA students with lower levels of social support (b = .13, p = .26). The current study highlights the need to consider the detrimental effects of sexual victimization on health outcomes among LGBQA college students, as well as the mechanisms through which social support may be influencing these relations.
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Affiliation(s)
| | | | | | - Sage E Hawn
- Virginia Commonwealth University, Richmond, VA, USA
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Smith RL, Dick DM, Amstadter A, Thomas N, Salvatore JE. A longitudinal study of the moderating effects of romantic relationships on the associations between alcohol use and trauma in college students. Addiction 2021; 116:3008-3018. [PMID: 33886135 PMCID: PMC8492481 DOI: 10.1111/add.15490] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/01/2020] [Accepted: 03/10/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS College students report high levels of alcohol use, which can be exacerbated by interpersonal trauma exposure (IPT). Romantic relationships may represent salient contexts for moderating associations between IPT and alcohol use. We examined whether relationship status, partner alcohol use and relationship satisfaction moderated associations between IPT and alcohol use, and whether these associations varied in a sex-specific manner. DESIGN University-wide longitudinal survey of college students. SETTING Large, urban public university in mid-Atlantic United States. PARTICIPANTS We used two subsets of participants (n = 5673 and 3195) from the Spit for Science project, a longitudinal study of college students. Participants completed baseline assessments during the autumn of their freshman year and were invited to complete follow-up assessments every spring thereafter. Participants were included in the present study if they completed surveys at baseline and at least one follow-up assessment (meanfollow-ups = 1.70, range = 1-4). MEASUREMENTS Predictors included precollege and college-onset IPT, relationship status, partner alcohol use, relationship satisfaction and sex. Alcohol consumption was the primary outcome of interest. Pre-college IPT was measured at baseline and all other measures were assessed at each follow-up. FINDINGS Individuals with pre-college IPT consumed more alcohol than those without IPT, but this was mitigated for those in relationships (β = -0.15, P = 0.046, 95% confidence interval (CI) = -0.29, 0.00). Individuals with college-onset IPT consumed more alcohol than those without IPT, and this was more pronounced for those with higher partner alcohol use (β = -0.18, P = 0.001, 95% CI = -0.29, -0.07). Relationship satisfaction was not a significant moderator of the associations between IPT and alcohol use (Ps > 0.05 and 95% CIs include 0). CONCLUSIONS Involvement in relationships, but not relationship satisfaction, appears to reduce the effects of interpersonal trauma exposure (IPT) on alcohol use among US college students, while high partner alcohol use appears to exacerbate it. The moderating effects of relationship characteristics depend on the developmental timing of IPT.
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Affiliation(s)
- Rebecca L. Smith
- Department of Psychology, Virginia Commonwealth University, Box 842018, Richmond, VA 23284-2018
| | - Danielle M. Dick
- Department of Psychology, Virginia Commonwealth University, Box 842018, Richmond, VA 23284-2018
- Department of Human and Molecular Genetics, Virginia Commonwealth University, Box, 980033, Richmond, Virginia 23298
| | - Ananda Amstadter
- Department of Psychology, Virginia Commonwealth University, Box 842018, Richmond, VA 23284-2018
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth, University, Box 980126, Richmond, VA 23298
| | - Nathaniel Thomas
- Department of Psychology, Virginia Commonwealth University, Box 842018, Richmond, VA 23284-2018
| | | | - Jessica E. Salvatore
- Department of Psychology, Virginia Commonwealth University, Box 842018, Richmond, VA 23284-2018
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth, University, Box 980126, Richmond, VA 23298
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Guggisberg M, Bottino S, Doran CM. Women's Contexts and Circumstances of Posttraumatic Growth After Sexual Victimization: A Systematic Review. Front Psychol 2021; 12:699288. [PMID: 34512456 PMCID: PMC8427813 DOI: 10.3389/fpsyg.2021.699288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 07/30/2021] [Indexed: 11/13/2022] Open
Abstract
Sexual violence is a concerning public health and criminal justice problem. Even though extensive literature has linked sexual victimization to a multitude of mental and physical problems, some victim/survivors recover and are able to lead lives without notable negative impacts. Little is known about women who experienced posttraumatic growth following sexual victimization. This review brings together knowledge accumulated in the academic literature in the past decade. It was informed by the PRISMA-P guidelines. Databases were searched using a combination of keywords to locate original peer-reviewed research articles published between January 2010 and October 2020 focusing on posttraumatic growth following sexual victimization. The initial search identified 6,187 articles with 265 articles being read in full, identifying 41 articles that were included in the analysis. The results suggest that recovery from sexual victimization is possible with the healing process being idiosyncratic. Victim/survivors employed various strategies resulting in higher degrees of functioning, which were termed growth. Following a synthesis of themes that emerged from the thematic analysis, a higher order abstraction, using creative insight through reflexivity, discussions among the research team and consistent interpretation and re-interpretation of the identified themes as a second stage analysis, resulted in the identification of two superordinate topics "relationship to self" and "relationship to others." Findings indicated that women engaged in deliberate introspection to connect with themselves and utilized altruistic actions and activism in an attempt to prevent further sexual victimization Helping victim/survivors deal with the sexual violence facilitated growth as a collective. We concluded that helping others may be a therapeutic vehicle for PTG. Given research in this area remains in its infancy, further investigation is urgently needed.
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Affiliation(s)
- Marika Guggisberg
- Queensland Centre for Domestic and Family Violence Research, School of Nursing Midwifery and Social Sciences, CQUniversity Australia, Perth, WA, Australia.,Cluster for Resilience and Wellbeing, Appleton Institute, CQUniversity Australia, Brisbane, QLD, Australia
| | - Simone Bottino
- School of Nursing Midwifery and Social Sciences, CQUniversity Australia, Brisbane, QLD, Australia
| | - Christopher M Doran
- Cluster for Resilience and Wellbeing, Appleton Institute, CQUniversity Australia, Brisbane, QLD, Australia
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Caceres BA, Wardecker BM, Anderson J, Hughes TL. Revictimization Is Associated With Higher Cardiometabolic Risk in Sexual Minority Women. Womens Health Issues 2021; 31:341-352. [PMID: 33766475 PMCID: PMC8260453 DOI: 10.1016/j.whi.2021.02.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 02/09/2021] [Accepted: 02/12/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Although there is evidence that interpersonal trauma is associated with cardiometabolic risk in women, previous studies have not assessed the potential role of revictimization (victimization in both childhood and adulthood) among sexual minority women. METHODS We used data from the Chicago Health and Life Experiences of Women study to examine the associations of revictimization (including physical, sexual, and any revictimization) with self-reported psychosocial factors, health behaviors, and cardiometabolic risk factors (e.g., obesity, hypertension, and diabetes). We tested multiple logistic regression models, adjusted for covariates, to estimate odds ratios of the associations between revictimization and cardiometabolic risk. RESULTS The sample included 615 sexual minority women with a mean age of 40.0 years; 38.7% White. Eighty-three (13.5%) and 101 (16.4%) participants reported experiencing sexual revictimization and physical revictimization, respectively. Each form of revictimization was associated with higher odds of reporting lifetime depression and recent binge eating, but lower odds of having high social support. Physical revictimization was associated with higher odds of obesity (adjusted odds ratio [AOR], 2.38; 95% confidence interval [CI], 1.38-4.10) and hypertension (AOR, 3.31; 95% CI, 1.70-6.46). Similarly, participants who reported any revictimization were more likely to have obesity (AOR, 2.36; 95% CI, 1.42-3.92) and hypertension (AOR, 2.60; 95% CI, 1.31-5.26). No form of revictimization was associated with a higher odds of diabetes. CONCLUSIONS The higher odds of obesity and hypertension observed among sexual minority women who reported revictimization reinforce the need for early interventions to reduce cardiometabolic risk in this vulnerable population.
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Affiliation(s)
- Billy A Caceres
- Program for the Study of LGBT Health, Columbia University School of Nursing, New York, New York.
| | | | - Jocelyn Anderson
- Pennsylvania State College of Nursing, University Park, Pennsylvania
| | - Tonda L Hughes
- Program for the Study of LGBT Health, Columbia University School of Nursing, New York, New York
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Guggisberg M, Haldane HJ, Lowik V, Taylor A, Mackay B, Signal T. Silencing by design: Lessons learned about child sexual abuse from a university sexual assault survey. ACTA ACUST UNITED AC 2021; 17:17455065211017062. [PMID: 34105431 PMCID: PMC8193663 DOI: 10.1177/17455065211017062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: University students have been recognized as particularly being vulnerable to sexual victimization. Purpose: With little research to date, and acknowledgement for the need of a better understanding of sexual violence, our study analysed the CQUniversity Sexual Assault Survey’s qualitative responses. An open-ended qualitative question allowed students to provide information anonymously. Methods: A total of 109 participants contributed responses with 17 respondents commenting on the fact that the survey omitted to ask about child sexual abuse prior to the cut-off age of 12 years. Results: University students revealed unexpected disclosures of prepubescent child sexual abuse victimization and ongoing sexual victimization into adulthood. Furthermore, students’ comments indicated negative impacts including distress, mental health and substance use problems, distrust, and interpersonal difficulties. Strong feelings about ‘silencing’ prepubescent child sexual abuse in university surveys were expressed with a request that questions about child sexual abuse prior to the age of 12 years be included. Conclusion: Our study found that child sexual abuse victimization is important to students. Recommendations indicate the need for future research about sexual violence among university students without age restrictions to gain a better understanding about the impact of trauma including revictimization experiences.
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Affiliation(s)
- Marika Guggisberg
- CQUniversity Australia, Perth, WA, Australia.,Queensland Centre for Domestic and Family Violence Research, Mackay, QLD, Australia
| | | | - Vicki Lowik
- CQUniversity Australia, Brisbane, QLD, Australia
| | - Annabel Taylor
- Queensland Centre for Domestic and Family Violence Research, Mackay, QLD, Australia.,CQUniversity Australia, Brisbane, QLD, Australia
| | | | - Tania Signal
- Department of Psychology, Medical & Applied Sciences, CQUniversity Australia, Rockhampton, QLD, Australia
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Woerner J, Schleider JL, Overstreet C, Foster DW, Amstadter AB, Sartor CE. The role of drinking motives and perceived controllability of events in the association between college women's sexual assault victimization and binge drinking. Addict Behav 2019; 90:210-216. [PMID: 30445414 PMCID: PMC6324951 DOI: 10.1016/j.addbeh.2018.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 10/02/2018] [Accepted: 11/05/2018] [Indexed: 11/16/2022]
Abstract
Women with a history of sexual assault are at elevated risk for engaging in binge drinking. The aims of the current study are to investigate two types of drinking motives (coping and social) that potentially underlie the sexual assault-binge drinking link in a sample of female college drinkers (N = 691; 37.6% sexual assault prevalence), and to determine the extent to which the relationships between sexual assault history and each type of drinking motive depend on women's assumptions about the controllability of events. Conditional process analysis results indicated that women who experienced sexual assault (vs. those who did not) were more likely to report both coping and social drinking motives, which in turn, were both positively associated with increased binge drinking. Consistent with our hypothesis, results showed the relationship between sexual assault history and coping drinking motives was moderated by perceived controllability of events. Specifically, sexual assault victims reported high coping motives regardless of controllability of events. Nonvictims only reported high coping motives when their perceived controllability of events was low - comparable to coping motives of victims. This integrative approach affords a more comprehensive understanding of the context in which college women's binge drinking occurs, and offers insight into processes that could be targeted in interventions.
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Affiliation(s)
- Jacqueline Woerner
- Yale University School of Medicine, 389 Whitney Ave, New Haven, CT, United States.
| | - Jessica L Schleider
- Stony Brook University, Psychology B Building, Stony Brook, NY, United States
| | - Cassie Overstreet
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, 800 E Leigh, Richmond, VA, United States
| | - Dawn W Foster
- Yale University School of Medicine, 34 Park St, New Haven, CT, United States
| | - Ananda B Amstadter
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, 800 E Leigh, Richmond, VA, United States
| | - Carolyn E Sartor
- Yale University School of Medicine, 389 Whitney Ave, New Haven, CT, United States
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