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Oliver S, Kravitz-Wirtz N. The mediating effect of sleep quality on exposure to community violence and posttraumatic stress symptoms in the United States. Prev Med Rep 2024; 43:102776. [PMID: 38873659 PMCID: PMC11170174 DOI: 10.1016/j.pmedr.2024.102776] [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] [Received: 10/22/2023] [Revised: 03/25/2024] [Accepted: 05/26/2024] [Indexed: 06/15/2024] Open
Abstract
Objectives The role of sleep quality is not yet fully understood in the context of posttraumatic stress disorder (PTSD) following exposure to community violence. Thus, the primary aim of this study is to examine the mediating effect of sleep quality in the relationship between community violence exposure and posttraumatic stress symptoms. Methods Utilizing a cross-sectional survey administered to an online opt-in panel of adults in the United States in 2023 (age ≥ 18 years) (N = 342), respondents reported on their exposure to community violence, sleep quality, and posttraumatic stress symptoms. Covariate-adjusted regressions were used to test these relationships. Results Directly experiencing community violence was associated with poorer sleep quality (β = 0.11, 95 % CI [0.02, 0.20], p = 0.022) and posttraumatic stress symptoms (β = 0.33, 95 % CI [0.17, 0.48], p = < 0.001), and poorer sleep quality predicted greater posttraumatic stress symptoms (β = 0.74, 95 % CI [0.58, 0.91], p = 0<.001). Further, sleep quality was a partial mediator (β = 0.24, 95 % CI [0.04, 0.50], p = 0.028), accounting for 24 % of the relationship. Conclusions Findings from this study help deepen understanding of the processes that contribute to the development of PTSD and provide insights into possible interventions, including treatment for sleep problems in the aftermath of violence exposure as a means for lessening the mental health burdens of community violence.
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Affiliation(s)
- Sophia Oliver
- Department of Psychology, University of California, Davis, CA, United States
| | - Nicole Kravitz-Wirtz
- University of California, Firearm Violence Research Center and Violence Prevention Research Program, Department of Emergency Medicine, Davis School of Medicine, Sacramento, CA, United States
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Pérez-Sastré MA, García-Peña C, Ramos-Lira L, Ortiz-Hernández L. Social capital as a moderator of the relationship between violent community environment and psychological distress. GACETA SANITARIA 2024; 38:102408. [PMID: 38941885 DOI: 10.1016/j.gaceta.2024.102408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 05/02/2024] [Accepted: 05/10/2024] [Indexed: 06/30/2024]
Abstract
OBJECTIVE To evaluate the modifying effect of social capital on the relationship between living in violent communities and the presence of psychological distress in adolescents and youth in Mexico. METHOD The analysis of the Social Cohesion Survey for the Prevention of Violence and Crime (ECOPRED, by its acronym in Spanish) was conducted. The analytic sample consisted of 39,639 participants aged 12 to 29 years. Community violence and social capital were measured at the census tract level using the average answers of a household's head sample. These environmental variables were independent of the experiences of the participants. Social capital variables included structural (social ties, recreational participation, collaborative participation, and social cohesion), and cognitive (trust in neighbors) dimensions. Multilevel structural equation models were used. RESULTS Recreational participation, collaborative participation, and social cohesion modified the relationship between community environments and psychological distress. In females who lived in places with less recreational participation or less social cohesion, the higher the social disorder, the higher the psychological distress. A similar relationship between vandalism and psychological distress was identified, but only in males who lived in places with less collaborative participation, and in females with less social cohesion. CONCLUSIONS Our results suggest that dimensions of the structural social capital (organization and interest in the community and its members) were the ones that had the buffering effect of the exposure to disordered community environments on psychological distress.
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Affiliation(s)
- Miguel A Pérez-Sastré
- Programa de Maestría y Doctorado en Ciencias Médicas, Odontológicas y de la Salud, Universidad Nacional Autónoma de México, Ciudad de México, México
| | | | - Luciana Ramos-Lira
- Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente, Ciudad de México, México
| | - Luis Ortiz-Hernández
- Departamento de Atención a la Salud, Universidad Autónoma Metropolitana Unidad Xochimilco, Ciudad de México, México.
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Mahmood A, Kedia S, Arshad H, Mou X, Dillon PJ. Disparities in Access to Mental Health Services Among Children Diagnosed with Anxiety and Depression in the United States. Community Ment Health J 2024:10.1007/s10597-024-01305-3. [PMID: 38907843 DOI: 10.1007/s10597-024-01305-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 05/24/2024] [Indexed: 06/24/2024]
Abstract
Child and adolescent mental health are major public health concerns in the US. Overall, 20% of US children have a reported mental health condition, while an estimated 40% will be diagnosed with one by age 18. Despite these concerns, little is known about factors associated with access to mental health services among children and adolescents. We analyzed data from a sample of 6655 children (aged 6 to 17 years) with either anxiety and/or depression drawn from the 2020-2021 National Survey of Children's Health (NSCH). A multivariable logistic regression model was fit to investigate predisposing, enabling, and need factors associated with caregiver's (i.e., parent or other guardian) perceived access to mental health services for their children. Approximately 50.8% of caregivers perceived obtaining mental health services for their children to be somewhat difficult, very difficult, or impossible. Children meeting criteria for having a medical home had lower odds of experiencing such difficulties (adjusted [a]OR = 0.38; 95% CI: 0.30-0.49). Further, compared to children who sometimes or never had health insurance coverage for mental or behavioral health needs, children who were always insured (aOR: 0.19; 95% CI 0.14, 0.25) and those who usually had coverage (aOR: 0.38; 95% CI 0.28, 0.51) had lower odds of experiencing perceived difficulties in obtaining care. The results indicate several enabling and need predictors of perceived access to mental health services--highlighting potential structural barriers to care access. Efforts to address access challenges should adopt a multifaceted approach and be tailored to families living in poverty, those with limited health coverage, and minoritized children with less than optimal general health.
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Affiliation(s)
- Asos Mahmood
- Center for Health System Improvement, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA.
- Department of Medicine-General Internal Medicine, College of Medicine, University of Tennessee Health Science Center, 956 Court Ave Avenue, Ste D222A, Memphis, TN, 38103, USA.
| | - Satish Kedia
- Division of Social and Behavioral Sciences, School of Public Health, The University of Memphis, Memphis, TN, USA
| | - Hassan Arshad
- Division of Social and Behavioral Sciences, School of Public Health, The University of Memphis, Memphis, TN, USA
| | - Xichen Mou
- Division of Epidemiology, Biostatistics, Environmental Health, School of Public Health, The University of Memphis, Memphis, TN, USA
| | - Patrick J Dillon
- School of Communication Studies, Kent State University at Stark, North Canton, OH, USA
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Pérez-Sastré MA, García-Peña C, Ramos-Lira L, Ortiz-Hernández L. Beyond direct exposure to violence: effects of living in disordered and violent communities on psychological distress in young Mexican people. CAD SAUDE PUBLICA 2024; 40:e00058123. [PMID: 38324861 PMCID: PMC10841348 DOI: 10.1590/0102-311xen058123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 08/02/2023] [Accepted: 10/26/2023] [Indexed: 02/09/2024] Open
Abstract
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.
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Affiliation(s)
- Miguel A Pérez-Sastré
- Doctorado en Ciencias Médicas, Odontológicas y de Salud, Universidad Nacional Autónoma de México, Ciudad de México, México
| | | | - Luciana Ramos-Lira
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, México
| | - Luis Ortiz-Hernández
- Universidad Autónoma Metropolitana - Unidad Xochimilco, Ciudad de México, México
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Semenza DC, Stansfield R, Silver IA, Savage B. Reciprocal Neighborhood Dynamics in Gun Violence Exposure, Community Health, and Concentrated Disadvantage in One Hundred US Cities. J Urban Health 2023; 100:1128-1139. [PMID: 37843742 PMCID: PMC10728405 DOI: 10.1007/s11524-023-00796-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/13/2023] [Indexed: 10/17/2023]
Abstract
Gun violence imparts a tremendous human and financial toll on local communities. Researchers have documented extensive mental and physical health consequences of generalized violence exposure but few studies have analyzed the particular impacts of gun violence on community well-being using nationally comprehensive data. We leverage a unique database of almost 16,000 neighborhoods in 100 US cities (2014-2019) to examine how year-over-year rates of gun violence correspond to overall neighborhood well-being and three aspects of community health: (1) health behaviors, (2) physical and mental health status, and (3) health prevention efforts. We simultaneously consider the reciprocal influence of neighborhood well-being on subsequent gun violence while accounting for concentrated disadvantage in communities. The results demonstrate that gun violence is associated with poorer community health in subsequent years, particularly health behaviors and mental/physical health status. Furthermore, we find substantial reciprocal effects for both gun violence and community health in their relationship to neighborhood concentrated disadvantage. These findings highlight the consequential role of gun violence in perpetuating cycles of harm in local communities.
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Affiliation(s)
- Daniel C Semenza
- Department of Sociology, Anthropology, and Criminal Justice, Rutgers University, Camden, NJ, USA.
- Department of Urban-Global Public Health, Rutgers University, Newark, NJ, USA.
- New Jersey Gun Violence Research Center, Rutgers University, Newark, NJ, USA.
| | - Richard Stansfield
- Department of Sociology, Anthropology, and Criminal Justice, Rutgers University, Camden, NJ, USA
| | - Ian A Silver
- Research Triangle Institute, Research Triangle Park, Durham, NC, USA
| | - Brielle Savage
- School of Criminal Justice, Rutgers University, Newark, NJ, USA
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Miliauskas CR, Junger W, Hellwig N, Bloch KV, de Souza Lopes C. Community violence in neighborhoods and common mental disorders among Brazilian adolescents. BMC Psychiatry 2023; 23:772. [PMID: 37872524 PMCID: PMC10594681 DOI: 10.1186/s12888-023-05269-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 10/09/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND This study aims to explore the association between exposure to neighborhood violence and the presence of common mental disorders (CMDs) among Brazilian adolescents aged 12 to 17 years. Additionally, we aim to analyze whether sex, age and race are modifiers of the effect of this association. METHODS The study comprised 1,686 adolescents residing in the municipality of Rio de Janeiro, situated in the Southeast region of Brazil. To measure exposure to community violence, we constructed three crime indicators using data from Civil Police of the State of Rio de Janeiro: crimes against property, nonlethal crimes, and lethal crimes. Employing geospatial analysis based on the adolescents' residence location, logistic regression modeling was performed to measure the association between violence and CMDs. RESULTS Adolescents living in regions with higher rates of the three types of violence studied herein were more likely to have CMDs, with odds ratios (ORs) ranging from 2.33 to 2.99. When stratified by sex, age and race, girls, older adolescents and blacks have a greater magnitude of effect on the measure of association, indicating a heightened risk for CMDs. CONCLUSION This study provides important contributions to the public health field, as it reveals new information on the influence of community violence on the mental health of adolescents. Given the elevated rates of violence globally, knowing the effects of such violence on adolescents becomes crucial for the prevention and treatment of CMDs within this population.
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Affiliation(s)
- Claudia Reis Miliauskas
- Medical Sciences College, Department of Medical Specialties, State University of Rio de Janeiro, Vinte E Oito de Setembro Avenue, 77, 4 Floor, 432. Vila Isabel, Rio de Janeiro, 20.551-030, Brazil.
- Institute of Social Medicine, State University of Rio de Janeiro, São Francisco Xavier Street, 524, Maracanã, 7 Floor, Rio de Janeiro, 20.550-013, Brazil.
| | - Washington Junger
- Institute of Social Medicine, State University of Rio de Janeiro, São Francisco Xavier Street, 524, Maracanã, 7 Floor, Rio de Janeiro, 20.550-013, Brazil
| | - Natalia Hellwig
- Institute of Social Medicine, State University of Rio de Janeiro, São Francisco Xavier Street, 524, Maracanã, 7 Floor, Rio de Janeiro, 20.550-013, Brazil
| | - Katia Vergetti Bloch
- Institute of Studies in Public Health at Universidade Federal Do Rio de Janeiro (IESC), Horácio de Macedo Avenue, no number, Ilha Do Fundão, Rio de Janeiro, 21941-598, Brazil
| | - Claudia de Souza Lopes
- Institute of Social Medicine, State University of Rio de Janeiro, São Francisco Xavier Street, 524, Maracanã, 7 Floor, Rio de Janeiro, 20.550-013, Brazil
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Everett VS, Drabick DAG. Community Violence Exposure and Generalized Anxiety Symptoms: Do Callous-Unemotional Behaviors Moderate this Relation Among Urban Youth? Res Child Adolesc Psychopathol 2023; 51:87-102. [PMID: 36306004 DOI: 10.1007/s10802-022-00973-7] [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: 10/15/2021] [Revised: 04/19/2022] [Accepted: 08/23/2022] [Indexed: 11/07/2022]
Abstract
Community violence exposure (CVE; i.e., direct victimization and witnessed violence) is a major public health concern among youth who reside in low income, urban neighborhoods, who tend to experience CVE chronically and disproportionately. Frequent CVE is associated with generalized anxiety disorder (GAD) symptoms, such as persistent or excessive worry and difficulty concentrating. However, not all youth experiencing CVE exhibit such symptoms. One understudied factor that may moderate this relation is callous-unemotional (CU) behaviors (e.g., behaviors consistent with lack of guilt, low levels of empathy). CU behaviors are associated with lower levels of responsiveness to contextual processes; as such, CU behaviors may be associated with lower levels of GAD symptoms in the context of CVE. However, little research considers CU behaviors and GAD symptoms concurrently. To address this gap, the present study examined associations among witnessed and direct CVE, CU behaviors, and GAD symptoms among low-income, urban youth (N = 104, 50% male, Mage = 9.93 ± 1.22 years old, 95% African-American/Black). Multiple regression analyses indicated teacher-reported CU behaviors moderated the relations between CVE and caregiver-reported GAD symptoms. Post-hoc probing revealed that among youth with higher levels of CVE, higher levels of CU behaviors were associated with elevated GAD symptoms compared to their peers with lower levels of CU behaviors. Youth with lower levels of CU behaviors evidenced moderate levels of GAD symptoms regardless of their levels of CVE. Thus, low-income, urban youth who experience elevated levels of CVE may be at increased risk for co-occurring GAD and CU symptoms.
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Affiliation(s)
- Valerie S Everett
- Department of Psychology, Temple University, Weiss Hall 1701 N 13th Street, 19122-6011, Philadelphia, PA, USA.
| | - Deborah A G Drabick
- Department of Psychology, Temple University, Weiss Hall 1701 N 13th Street, 19122-6011, Philadelphia, PA, USA
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8
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Gibbs A, Chirwa E, Dunkle K. A Prospective Analysis of the Interrelationship between Physical Intimate Partner Violence and Alcohol Use: A Post-Hoc Analysis of Young Women Involved in the Stepping Stones and Creating Futures Trial in South Africa. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:NP750-NP771. [PMID: 35400229 DOI: 10.1177/08862605221084738] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Prospective studies assessing women's experience of intimate partner violence (IPV) and alcohol use have shown mixed results and all are from high-income countries. Using longitudinal data from young women in South Africa we assess whether changes in physical IPV impact alcohol use, and whether changes in alcohol use impact physical IPV experience. Post-hoc analysis of women aged 18-30 living in informal settlements in eThekwini Municipality, South Africa, involved in the Stepping Stones and Creating Futures trial, between September 2015 and October 2019, with data collected at baseline (n = 677) and endline at 24 months (n = 545, 80.5% retention). At both timepoints, women were asked about their past year physical IPV experience and alcohol use. We estimated changes in physical IPV over time and whether this was associated with harmful alcohol use at endline. We then estimated changes in alcohol use over time, and whether this was associated with experience of past year physical IPV at endline. Women who experienced an increase in physical IPV over the study period were more likely to report harmful drinking at 24 months (aOR2.45, 95% CI 1.21-4.97). Similarly, women reporting increased alcohol use over time were more likely to report past year physical IPV at 24 months (aOR2.04, 95% CI 1.21-3.46). Among young women living in urban poverty those who experienced increasing physical violence from intimate partners were more likely to report increased and problematic alcohol use. Similarly, women reporting increasing alcohol use over 24 months were more likely to report physical IPV. However, there was no evidence that decreased alcohol use led to reductions in IPV, or that reduced IPV experience led to decreased alcohol use. Future research and interventions need to consider the reciprocal risks of physical IPV and alcohol use, with a focus on joint underlying drivers.
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Affiliation(s)
- Andrew Gibbs
- Gender and Health Research Unit, 59097South African Medical Research Council, Pretoria, South Africa
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Esnat Chirwa
- Gender and Health Research Unit, 59097South African Medical Research Council, Pretoria, South Africa
| | - Kristin Dunkle
- Gender and Health Research Unit, 59097South African Medical Research Council, Pretoria, South Africa
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A trauma-informed approach to understanding firearm decision-making among Black adolescents: Implications for prevention. Prev Med 2022; 165:107305. [PMID: 36252829 DOI: 10.1016/j.ypmed.2022.107305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 10/07/2022] [Accepted: 10/09/2022] [Indexed: 11/07/2022]
Abstract
Firearm violence remains a public health crisis in marginalized, urban communities, with Black adolescents bearing the burden of firearm homicides and injuries. As such, the prevention of firearm violence among adolescents has moved to a high priority of the U.S. public health agenda. The current paper reviews recent literature to highlight the heterogeneity in firearm behavior among Black adolescents and underscore the need for additional research on decision-making and firearm behavior to better understand how adolescents make decisions to acquire, carry, and use firearms. Through a discussion of the disproportionate levels of trauma exposure and trauma symptoms experienced by Black adolescents, the current paper also proposes a trauma-informed approach to understanding decision-making for risky firearm behavior. We discuss the broader impacts of this approach, including the development of a more comprehensive and contextually relevant understanding of the variability in risky firearm behavior and improvements in risk screening capabilities and preventive intervention strategies.
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Farrell AD, Pittman S, Bettencourt AF, Mehari KR, Dunn C, Sullivan TN. Beliefs as Mediators of Relations Between Exposure to Violence and Physical Aggression During Early Adolescence. THE JOURNAL OF EARLY ADOLESCENCE 2022; 42:297-326. [PMID: 36875347 PMCID: PMC9983758 DOI: 10.1177/02724316211036747] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This study examined beliefs about aggression and self-efficacy for nonviolent responses as mediators of longitudinal relations between exposure to violence and physical aggression. Participants were a predominantly African American (79%) sample of 2,705 early adolescents from three middle schools within urban neighborhoods with high rates of violence. Participants completed measures across four waves (fall, winter, spring, and summer) within a school year. Beliefs supporting proactive aggression, beliefs against fighting, and self-efficacy for nonviolence partially mediated relations between witnessing violence and physical aggression. Indirect effects for beliefs supporting proactive aggression and self-efficacy were maintained after controlling for victimization and negative life events. Beliefs supporting proactive aggression mediated the effects of violent victimization on physical aggression, but these effects were not significant after controlling for witnessing violence and negative life events. The findings underscore the importance of examining the unique pathways from witnessing community violence versus violent victimization to physical aggression.
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Affiliation(s)
| | - Sarah Pittman
- Department of Psychology, Virginia Commonwealth University
| | - Amie F. Bettencourt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine
| | | | - Courtney Dunn
- Department of Psychology, Virginia Commonwealth University
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Bruce MM, Ulrich CM, Webster J, Richmond TS. Injured black men's perceptions of the recovery environment. Soc Sci Med 2022; 292:114608. [PMID: 34861572 PMCID: PMC8748408 DOI: 10.1016/j.socscimed.2021.114608] [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: 12/19/2020] [Revised: 07/23/2021] [Accepted: 11/24/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Black men are disproportionately impacted by injuries in the United States. This disparity is glaring given that injury is one of the top ten causes of death. Injured Black men from disadvantaged neighborhoods experience higher injury mortality, years of life-expectancy loss, and psychological symptoms that persist after initial wounds have been treated. These injured men are typically transported to a hospital where they are medically stabilized and soon after are returned to the community. Black men are less likely to be discharged to comprehensive rehabilitation facilities, magnifying disparities in recovery from injury. While much research has examined individual characteristics that predict poor recovery from injury, fewer studies have focused on social and physical features of the environment and how they may impact the recovery of injury survivors. PURPOSE The purpose of this study was to describe Black men's perceptions of how characteristics of their environment affect their recovery following serious injury. METHODS This was a secondary analysis of an existing data set consisting of semi-structured, qualitative interviews of 43 injured Black men in a northeastern city. The interviews were conducted three months following discharge from a large urban trauma center, and were audiotaped, transcribed verbatim, and de-identified. Thematic analysis consistent with the qualitative paradigm was used to identify themes. RESULTS Four themes were identified in injured men's narratives: challenges to recovery, feeling unsafe, efforts to increase safety, and resources for recovery. CONCLUSIONS Our findings emphasize the importance of the role of community resources that can support injured men's recovery within their neighborhoods. Additional resources should be directed to survivors who return to disadvantaged communities after injury in order to minimize adverse emotional experiences that detract from recovery.
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Affiliation(s)
- Marta M Bruce
- University of Pennsylvania School of Nursing, Claire Fagin Hall, 418 Curie Blvd, Philadelphia, PA, 19104, USA; Hospital of the University of Pennsylvania, Philadelphia, PA, 19104, USA; Penn Injury Science Center, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Connie M Ulrich
- University of Pennsylvania School of Nursing, Claire Fagin Hall, 418 Curie Blvd, Philadelphia, PA, 19104, USA; Department of Medical Ethics and Health Policy, Perelman School of Medicine, Philadelphia, PA, 19104, USA
| | - Jessica Webster
- University of Pennsylvania School of Nursing, Claire Fagin Hall, 418 Curie Blvd, Philadelphia, PA, 19104, USA
| | - Therese S Richmond
- University of Pennsylvania School of Nursing, Claire Fagin Hall, 418 Curie Blvd, Philadelphia, PA, 19104, USA; Penn Injury Science Center, University of Pennsylvania, Philadelphia, PA, 19104, USA.
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12
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Patterns of adverse childhood experiences and depressive symptoms: self-esteem as a mediating mechanism. Soc Psychiatry Psychiatr Epidemiol 2022; 57:331-341. [PMID: 34191037 PMCID: PMC8243305 DOI: 10.1007/s00127-021-02129-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 06/22/2021] [Indexed: 11/13/2022]
Abstract
PURPOSE There is a growing interest in the co-occurring natures of adverse childhood experiences (ACEs) and unmeasured types of adversity. The current body of knowledge may also lack plausible mechanisms linking ACEs to mental health in young adulthood. This study aims to identify early adversity patterns using expanded ACEs items and investigate the pathway of ACEs and self-esteem to depressive symptoms in young adulthood. METHODS Data were obtained from the National Longitudinal Study of Adolescent and Adult Health, including a nationally representative sample in the U.S. (N = 10,702). We identified the ACEs patterns and estimated the direct and indirect associations between ACEs and depressive symptoms through self-esteem, using a latent class analysis with a distal outcome. RESULTS This study identified four distinct groups of ACEs that include Child Maltreatment, Household Dysfunction, Violence, and Low Adversity. The Child Maltreatment class showed a significantly higher risk of depressive symptoms compared to other ACEs groups. Self-esteem mediated the negative association of child maltreatment with depressive symptoms. The Violence class presented a significantly higher risk of depressive symptoms than Low Adversity, but no mediation of self-esteem was found. CONCLUSION The study highlights the profound consequence of child abuse/neglect and identifies self-esteem as a plausible mediating mechanism. Researchers and practitioners should increase collaboration efforts to prevent early adversity exposures and detrimental effects on mental health.
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13
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Bordin IA, Handegård BH, Paula CS, Duarte CS, Rønning JA. Home, school, and community violence exposure and emotional and conduct problems among low-income adolescents: the moderating role of age and sex. Soc Psychiatry Psychiatr Epidemiol 2022; 57:95-110. [PMID: 34417860 DOI: 10.1007/s00127-021-02143-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 07/09/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE The purpose of this study is to assess whether violence exposure is associated with emotional/conduct problems, when adjusting for confounders/covariates and controlling for comorbidity, and to investigate interactions between violence exposure and sex and/or age. METHODS This cross-sectional study evaluated a community-based sample of 669 in-school 11-15-year-olds. A three-stage probabilistic sampling plan included a random selection of census units, eligible households, and target child. Multivariable logistic regression investigated the effect of severe physical punishment by parents, peer victimization at school, and community violence on the study outcomes (adolescent-reported emotional/conduct problems identified by the Strengths and Difficulties Questionnaire/SDQ) when controlling for confounders (resilience, parental emotional warmth, maternal education/unemployment/anxiety/depression) and covariates (age, sex, stressful life events, parental rejection). RESULTS Considering interactions, emotional problems were associated with community violence victimization among girls, while conduct problems were associated with severe physical punishment among the younger, suffering peer aggression among the oldest, bullying victimization among girls, and witnessing community violence among boys. Desensitization (less emotional problems with greater violence exposure) was noted among the youngest exposed to severe physical punishment and the oldest who witnessed community violence. CONCLUSION Age and sex are moderators of the association between violence exposure and emotional/conduct problems. Interventions at local health units, schools, and communities could reduce the use of harsh physical punishment as a parental educational method, help adolescents deal with peer aggression at school and keep them out of the streets by increasing the usual five hours in school per day and making free sports and cultural/leisure activities available near their homes.
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Affiliation(s)
- Isabel Altenfelder Bordin
- Department of Psychiatry, Universidade Federal de São Paulo, Rua Botucatu 740, São Paulo, SP, 04038-030, Brazil.
| | | | - Cristiane S Paula
- Department of Psychiatry, Universidade Federal de São Paulo, Rua Botucatu 740, São Paulo, SP, 04038-030, Brazil.,Programa de Pós-Graduação em Distúrbios do Desenvolvimento, Universidade Presbiteriana Mackenzie, Rua da Consolação 896 (Edifício 28 Consolação), São Paulo, SP, 01302-000, Brazil
| | - Cristiane S Duarte
- Department of Psychiatry, Columbia University - New York State Psychiatric Institute, 1051 Riverside Drive Unit #43, New York, NY, 10032, USA
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14
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Shah N, Walker IF, Naik Y, Rajan S, O'Hagan K, Black M, Cartwright C, Tillmann T, Pearce-Smith N, Stansfield J. National or population level interventions addressing the social determinants of mental health - an umbrella review. BMC Public Health 2021; 21:2118. [PMID: 34794401 PMCID: PMC8599417 DOI: 10.1186/s12889-021-12145-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 09/15/2021] [Indexed: 01/08/2023] Open
Abstract
Background Social circumstances in which people live and work impact the population’s mental health. We aimed to synthesise evidence identifying effective interventions and policies that influence the social determinants of mental health at national or scaled population level. We searched five databases (Cochrane Library, Global Health, MEDLINE, EMBASE and PsycINFO) between Jan 1st 2000 and July 23rd 2019 to identify systematic reviews of population-level interventions or policies addressing a recognised social determinant of mental health and collected mental health outcomes. There were no restrictions on country, sub-population or age. A narrative overview of results is provided. Quality assessment was conducted using Assessment of Multiple Systematic Reviews (AMSTAR 2). This study was registered on PROSPERO (CRD42019140198). Results We identified 20 reviews for inclusion. Most reviews were of low or critically low quality. Primary studies were mostly observational and from higher income settings. Higher quality evidence indicates more generous welfare benefits may reduce socioeconomic inequalities in mental health outcomes. Lower quality evidence suggests unemployment insurance, warm housing interventions, neighbourhood renewal, paid parental leave, gender equality policies, community-based parenting programmes, and less restrictive migration policies are associated with improved mental health outcomes. Low quality evidence suggests restriction of access to lethal means and multi-component suicide prevention programmes are associated with reduced suicide risk. Conclusion This umbrella review has identified a small and overall low-quality evidence base for population level interventions addressing the social determinants of mental health. There are significant gaps in the evidence base for key policy areas, which limit ability of national policymakers to understand how to effectively improve population mental health. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12145-1.
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Affiliation(s)
- Neha Shah
- City University London, Northampton Square, EC1V 0HB, London, UK.
| | - Ian F Walker
- Hull York Medical School, University of York, Heslington, York, YO10 5DD, England
| | - Yannish Naik
- Leeds Teaching Hospitals NHS Trust, Great St George Street, Leeds, LS1 3EX, England
| | - Selina Rajan
- Department of Health Services Research and Policy, The London School of Hygiene and Tropical Medicine, London, WC1E 7H, UK
| | - Kate O'Hagan
- Public Health England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK
| | - Michelle Black
- School of Health and Related Research, The University of Sheffield, Regent Court, 30 Regent, Sheffield, S1 4DA, England
| | - Christopher Cartwright
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, Bradford, BD9 6RJ, England
| | - Taavi Tillmann
- Centre for Global Non-Communicable Disease, Institute for Global Health, UCL, 30 Guilford, London, WC1N 1EH, UK
| | - Nicola Pearce-Smith
- Public Health England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK
| | - Jude Stansfield
- School of Health and Community Studies, Leeds Beckett University, Portland Building, PD519, Portland Place, Leeds, LS1 3HE, UK
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15
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Jakubovic RJ, Drabick DAG. Community Violence Exposure and Youth Aggression: The Moderating Role of Working Memory. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2021; 48:1471-1484. [PMID: 32710243 DOI: 10.1007/s10802-020-00683-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Community violence exposure (CVE) is associated with aggression among youth, particularly those who reside in low-income, urban neighborhoods. However, not all youth who experience CVE exhibit aggression. Working memory (WM) difficulties may interfere with attributions or retrieval of nonaggressive responses, suggesting that individual differences in WM may contribute to proactive and/or reactive aggression among youth who experience CVE. Participants were 104 low-income, urban youth (M = 9.92 ± 1.22 years old; 50.5% male; 95% African American). Youth reported on frequency of direct victimization and witnessing of violence in the community and completed two WM tasks. Teachers reported on youth proactive and reactive aggression. WM moderated the relation between direct victimization and proactive and reactive aggression, and between witnessing violence and reactive aggression. Among youth reporting less frequent victimization and witnessing, lower WM was associated with higher levels of proactive and reactive aggression. Among youth reporting more frequent direct victimization, lower WM was associated with higher levels of proactive aggression. Proactive and reactive aggression levels were similar among youth reporting more frequent witnessing regardless of WM levels. WM represents a potential target for early identification and intervention efforts to reduce reactive and proactive aggression among low-income, urban youth who are at elevated risk for CVE.
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Affiliation(s)
- Rafaella J Jakubovic
- Department of Psychology, Temple University, Weiss Hall Floor 6, 1701 North 13th Street, Philadelphia, PA, 19122, USA.
| | - Deborah A G Drabick
- Department of Psychology, Temple University, Weiss Hall Floor 6, 1701 North 13th Street, Philadelphia, PA, 19122, USA
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16
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Mitchell KJ, Jones LM, Turner HA, Beseler CL, Hamby S, Wade R. Understanding the Impact of Seeing Gun Violence and Hearing Gunshots in Public Places: Findings From the Youth Firearm Risk and Safety Study. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:8835-8851. [PMID: 31179801 DOI: 10.1177/0886260519853393] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
There is a current public health emphasis on finding strategies for reducing the risks associated with children's gun violence exposure. This article examines the impact of seeing and hearing gun violence on youth of different ages and living in urban and nonurban areas. Participants were 630 youth, aged 2 to 17. Youth, ages 10 to 17, completed a self-report survey, and caregivers of young children, ages 2 to 9, completed the survey as a proxy for that child. Participants resided in Boston, MA; Philadelphia, PA; and rural areas of eastern TN. Participants were recruited through a variety of techniques including pediatric clinics, housing authorities, youth-serving agencies, festivals, word of mouth, and local e-mail lists for classified advertisements. Data were collected between October 2017 and April 2018 and analyzed in 2019. In total, 41% of youth in this study reported ever seeing or hearing gun violence; 32% had such an experience in the past year. Among exposed youth, 50% took protective action to keep themselves safe, and 58% reported being very or extremely afraid, sad, or upset as a result of the indirect gun violence. More youth living in urban compared with nonurban areas took some protective action. Females and younger children had increased odds of experiencing high fear as a result of the violence. Current gun violence prevention has typically targeted adolescents; however, current findings suggest the need to focus on younger children as well, including the distress resulting from indirect exposure to gun violence.
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Affiliation(s)
| | | | | | | | - Sherry Hamby
- Life Paths Appalachian Research Center & Univerity of the South, Sewanee, TN, USA
| | - Roy Wade
- Children's Hospital of Philadelphia, PA, USA
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17
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Roy AL, Isaia AR, DaViera AL, Eisenberg Y, Poulos CD. Redefining Exposure: Using Mobile Technology and Geospatial Analysis to Explore When and Where Chicago Adolescents are Exposed to Neighborhood Characteristics. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2021; 68:18-28. [PMID: 33410540 DOI: 10.1002/ajcp.12490] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
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.
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Affiliation(s)
- Amanda L Roy
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
| | - Ashley R Isaia
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Andrea L DaViera
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
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18
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McIntosh D, Tate AD, Berge JM. Exploration of witnessing community violence and recent death on child behavioural outcomes. J Child Adolesc Ment Health 2021; 33:42-54. [PMID: 38041436 DOI: 10.2989/17280583.2023.2270724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
Background: Researchers are increasingly interested in understanding potentially traumatic experiences in children's lives, such as witnessing community violence (WCV) and the recent death of a close family member or friend. These experiences can be distressing and have adverse effects on children's psychological and behavioural adjustment, including externalising behaviours and internalising symptoms.Methodology: This paper reports the results of an exploratory study aimed to address knowledge gaps, particularly among children aged 5-9 years (n = 1 283), by examining the associations between WCV, recent death, and child behavioural outcomes. Additionally, the study explores the potential moderating roles of peer support and family functioning.Findings: The results indicate significant associations between WCV, recent death, and child behaviours.Conclusion: The findings underscore the important need for future research to examine the impact of WCV and recent death on children ages 5-9 years.
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Affiliation(s)
| | | | - Jerica M Berge
- Department of Family Medicine and Community Health, Medical School, University of Minnesota
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19
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O’Connor KE, Sullivan TN, Ross KM, Marshall KJ. "Hurt people hurt people": Relations between adverse experiences and patterns of cyber and in-person aggression and victimization among urban adolescents. Aggress Behav 2021; 47:483-492. [PMID: 33844292 PMCID: PMC8192443 DOI: 10.1002/ab.21966] [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: 09/11/2020] [Revised: 03/11/2021] [Accepted: 03/21/2021] [Indexed: 11/09/2022]
Abstract
This study identified subgroups of adolescents with distinct patterns of involvement with overt and relational in-person and cyber aggression and victimization. We also assessed subgroup similarities and differences in exposure to adverse childhood experiences (ACEs), exposure to community violence, and trauma symptoms. Using latent class analysis, we identified three subgroups among 265 adolescents (Mage = 14.3 years; 57% female; 96% African American) residing in three urban high-burden communities that included youth who reported: (a) combined (cyber and in-person) aggression and victimization (17%), (b) in-person aggression and victimization (51%), and (c) adolescents with limited involvement (32%). Youth in the combined aggressive-victims subgroup had the highest probability of endorsing exposure to community violence, trauma symptoms, and a higher number of ACEs overall as well as higher rates of both verbal and physical abuse compared to the other subgroups. Our results indicated that the adolescents who reported the highest frequencies of aggressive behavior were also the most victimized and traumatized. These findings provide context to aggressive behavior among adolescents living in high-burden, urban communities and underscore the need for trauma-informed prevention interventions.
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Affiliation(s)
- Kelly E. O’Connor
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Terri N. Sullivan
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Katherine M. Ross
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Khiya J. Marshall
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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20
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Foell A, Pitzer KA, Nebbitt V, Lombe M, Yu M, Villodas ML, Newransky C. Exposure to community violence and depressive symptoms: Examining community, family, and peer effects among public housing youth. Health Place 2021; 69:102579. [PMID: 33971570 DOI: 10.1016/j.healthplace.2021.102579] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 03/30/2021] [Accepted: 04/22/2021] [Indexed: 10/21/2022]
Abstract
Exposure to community violence is an epidemic problem that causes debilitating effects on youth mental health. However, the relationships between violence exposure and youth mental health remain unclear when examining co-occurring socioecological risk and protective factors. The purpose of this study is to clarify the observed gaps in knowledge by utilizing structural equation modeling (SEM) to examine the mediating role of community violence exposure on the relationship between perceived neighborhood risk factors, parental behaviors, and peers on depressive symptoms in a sample of urban youth in low-income public housing communities (n = 320). Results indicate that community violence exposure and exposure to delinquent peers mediates the effects of perceived neighborhood risk and parenting behaviors on depressive symptoms. These findings suggest that while interventions that limit exposure to community violence and delinquent peers could reduce depressive symptoms, interventions that reduce community violence are essential to improve youth mental health.
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Affiliation(s)
- Andrew Foell
- Brown School, Washington University in St. Louis, 1 Brookings Dr, St. Louis, MO, 63130, USA.
| | - Kyle A Pitzer
- Brown School, Washington University in St. Louis, 1 Brookings Dr, St. Louis, MO, 63130, USA
| | - Von Nebbitt
- Brown School, Washington University in St. Louis, 1 Brookings Dr, St. Louis, MO, 63130, USA
| | - Margaret Lombe
- School of Social Work, Boston College, 140 Commonwealth Avenue, McGuinn Hall, Chestnut Hill, MA, 02467, USA
| | - Mansoo Yu
- School of Social Work, Department of Public Health, University of Missouri, 720 Clark Hall, Columbia, MO, 65211, USA
| | - Melissa L Villodas
- School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro St #3550, Chapel Hill, NC, 27516, USA
| | - Chrisann Newransky
- School of Social Work, Adelphi University, Social Work Building Room 309, One South Avenue, Garden City, NY, 11530, USA
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21
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Feelemyer J, Duncan DT, Dyer TV, Geller A, Scheidell JD, Young KE, Cleland CM, Turpin RE, Brewer RA, Hucks-Ortiz C, Mazumdar M, Mayer KH, Khan MR. Longitudinal Associations between Police Harassment and Experiences of Violence among Black Men Who Have Sex with Men in Six US Cities: the HPTN 061 Study. J Urban Health 2021; 98:172-182. [PMID: 33821426 PMCID: PMC8079523 DOI: 10.1007/s11524-021-00526-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/02/2021] [Indexed: 10/21/2022]
Abstract
Interactions with the police may result in police brutality, particularly for people of color. Black men who have sex with men (BMSM) face disproportionate risk of police contact and may experience elevated violence risk. We measured longitudinal associations between discriminatory police harassment (DPH) and subsequent risk of a range of interpersonal violence experiences, including intimate partner violence (IPV). In this study, we estimated associations between DPH motivated by racism, homophobia, or both, and subsequent violent experiences (being physically harassed, hit, threatened with weapons, and intimate partner violence) among BMSM. Bivariate and multivariable regression analyses were used to control for demographic and behavioral factors. Among 1160 BMSM included at 12-month follow-up, experiencing DPH motivated by racism and homophobia was associated with over four times the odds of being threatened with violence (AOR 4.85, 95% CI 3.20, 7.33), four times the odds of or experiencing violence defined as being punched, kicked, or beaten, or having an object thrown at them (AOR 4.51, 95% CI 2.82, 7.19), and nearly three times the odds of physical partner abuse (AOR 3.49, 95% CI 1.69, 7.19). Findings suggest that for BMSM, DPH is associated with the threat and experience of violence, with a dose-response relationship between DPH motivated by one or more causes. Given that BMSM are a population particularly vulnerable to both police harassment related to race and sexual orientation and violence coupled with stigma, additional research evaluating mechanisms linking these associations is needed in order to develop additional supportive interventions.
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Affiliation(s)
- Jonathan Feelemyer
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA.
| | - Dustin T Duncan
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Typhanye V Dyer
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD, USA
| | - Amanda Geller
- Department of Criminology, Law, and Society, University of California, Irvine, Irvine, CA, USA
| | - Joy D Scheidell
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Kailyn E Young
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Charles M Cleland
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Rodman E Turpin
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD, USA
| | | | | | - Medha Mazumdar
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Kenneth H Mayer
- The Fenway Institute, Fenway Health and Department of Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA
| | - Maria R Khan
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
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22
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Uršič K, Bucik V, Klemenčič S, Bratina N, Battelino T, Dovč K, Drobnič Radobuljac M. Validation of the Lifetime Incidence of Traumatic Events (LITE-S/P) Questionnaires in Children and Adolescents in Slovenia. Front Psychiatry 2021; 12:665315. [PMID: 34276439 PMCID: PMC8280467 DOI: 10.3389/fpsyt.2021.665315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 06/08/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction: A traumatic event is an extremely threatening and frightening experience in an individual's life. Children who are exposed to traumatic events are twice as likely to develop a mental disorder. Screening can provide insight into the traumatic experience of children, identifying those eligible for further evaluation, and support. With this aim, we evaluated the psychometric properties of the Lifetime Incidence of Traumatic Events questionnaire (LITE) in Slovene by calculating retest reliabilty, construct validity (cross-informant agreement) and external validity, where we calculated the correlation of the number of differenet traumatic events with psychopathological symptoms. Methods: 280 child-parent pairs (children aged 11.3 ± 2.2 years) from various Slovenian primary schools participated in the study. They were divided into two groups: 180 healthy primary school students and 100 children with Type 1 Diabetes (our study was a part of a larger study The Influence of Psychobiological Adversity on Children and Adolescents with Type 1 Diabetes Study). Two versions of the LITE questionnaire were used. Children completed the child report (LITE-S) and parents the parent report (LITE-P) version. After 4 weeks, 117 children, and 114 parents filled out the LITEs again. External validity was assessed using the Youth Self Report and Child Behaviour Checklist syndrome-oriented scales. Results: Retest reliability for individual scales was r = 0.469-0.639 (ρ = 0.443-0.636; p < 0.001), but higher for individual items (κ = 0.263-0.821; p < 0.001). Correlations between reports from parents and children were r = 0.313-0.345 (ρ = 0.317-0.348; p < 0.001). The number of different events experienced by children correlated significantly with the measured depressive-anxiety, and posttraumatic stress disorder symptoms. Conclusions: Based on our results, the LITE-S and LITE-P "All events" scale have acceptable psychometric properties for use in research and in clinical practise screening. We recommend looking at single items, taking into consideration the responses from both the child and the parent for more precise information. To improve the precision of the psychodiagnostic capacity of the questionnaire, further research on various populations should be performed.
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Affiliation(s)
- Katarina Uršič
- Department for Haematology and Oncology, University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Valentin Bucik
- Department of Psychology, Faculty of Arts, University of Ljubljana, Ljubljana, Slovenia
| | - Simona Klemenčič
- Department for Endocrinology, Diabetes and Metabolic Disease, University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Nataša Bratina
- Department for Endocrinology, Diabetes and Metabolic Disease, University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Tadej Battelino
- Department for Endocrinology, Diabetes and Metabolic Disease, University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Klemen Dovč
- Department for Endocrinology, Diabetes and Metabolic Disease, University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Maja Drobnič Radobuljac
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.,Unit for Intensive Child and Adolescent Psychiatry, Department for Mental Health, University Psychiatric Hospital Ljubljana, Ljubljana, Slovenia
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23
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Mental Health, Quality of Life and Violence Exposure in Low-Socioeconomic Status Children and Adolescents of Guatemala. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207620. [PMID: 33086701 PMCID: PMC7589969 DOI: 10.3390/ijerph17207620] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 10/15/2020] [Accepted: 10/16/2020] [Indexed: 12/22/2022]
Abstract
Growing up in vulnerable conditions has an impact on children and adolescents’ mental health and well-being outcomes. However, this evidence has rarely been obtained in middle and low-income countries like Guatemala, where food insecurity and exposure to violence frequently threaten childhood development. The aim of this study was to analyse the relations that sociodemographic and socioeconomic factors have with psychological adjustment of low-socioeconomic status (SES) Guatemalan children and adolescents, and how these relations were mediated by food insecurity and exposure to violence. A total of 185 participants (50.8% girls; aged between 6 to 17, M = 11.82, SD = 3.7) from three vulnerable schools located in rural and urban areas of Guatemala were assessed. The results indicated that exposure to violence significantly moderates the effect of sociodemographic and socioeconomic variables in measures of depression, anxiety and health-related quality of life. Adolescents more exposed to violence reported higher levels of depression and anxiety, as well as lower levels of health-related quality of life. In contrast, food insecurity did not seem to influence psychological adjustment outcomes in this low-SES sample. These findings highlight the relevance of exposure to violence for mental health and well-being, and is a factor that should be considered when designing public health policies to promote children and adolescents’ welfare.
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24
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Sherr L, Yakubovich AR, Skeen S, Tomlinson M, Cluver LD, Roberts KJ, Macedo A. Depressive symptoms among children attending community based support in South Africa - pathways for disrupting risk factors. Clin Child Psychol Psychiatry 2020; 25:984-1001. [PMID: 32571077 PMCID: PMC7528548 DOI: 10.1177/1359104520935502] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Children in Southern Africa are exposed to high rates of structural and family adversities. This study tests whether services from Community Based Organisations (CBOs) in South Africa can promote children's resilience against depression exposed to such adversities. Two linked longitudinal studies were conducted, comprising n = 1848 children aged 9 to 13 years. One group received CBO services, whilst the other (quasi-control) did not. Analyses used interaction terms in regression models to test for potential moderation effects of CBO attendance, and marginal effects models to interpret significant interactions. Two interaction effects were shown, demonstrating moderation effects of CBO attendance on common structural disadvantages. First, children exposed to community violence showed increased depression (contrast = 0.62 [95%CI 0.43, 0.82], p < .001), but this association was removed by CBO access (contrast = 0.07 [95%CI -0.28, 0.43], p = .682). Second, children living in informal housing showed increased depression (contrast = 0.63 [95%CI 0.42, 0.85], p < .001), however, this association was removed by CBO access (contrast = 0.01 [95%CI -0.55, 0.56], p = .977). CBO attendance is associated with fewer depressive symptoms, and can buffer against important structural adversities of poor housing and violence that are common in high HIV-prevalence areas. However, CBO attendance was not able to remove the increased psychosocial distress associated with some family-level vulnerabilities such as orphanhood and abuse. These findings highlight the centrality of CBO-provided psychosocial support for children in Southern Africa, and suggest areas for bolstering provision.
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Affiliation(s)
- Lorraine Sherr
- Institute for Global Health, University College London, UK
| | - Alexa R Yakubovich
- Centre for Evidence-Based Intervention, Department of Social Policy & Social Intervention, University of Oxford, UK
| | - Sarah Skeen
- Department of Psychology, Stellenbosch University, South Africa
| | - Mark Tomlinson
- Department of Psychology, Stellenbosch University, South Africa
| | - Lucie D Cluver
- Centre for Evidence-Based Intervention, Department of Social Policy & Social Intervention, University of Oxford, UK.,Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | | | - Ana Macedo
- Institute for Global Health, University College London, UK
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25
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DaViera AL, Roy AL, Uriostegui M, Fiesta D. Safe Spaces Embedded in Dangerous Contexts: How Chicago Youth Navigate Daily Life and Demonstrate Resilience in High-Crime Neighborhoods. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2020; 66:65-80. [PMID: 32557726 PMCID: PMC9127928 DOI: 10.1002/ajcp.12434] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Much is known about how experiences of community violence negatively affect youth, but far less research has explored how youth remain resilient while living in dangerous neighborhoods. This study addresses this need by analyzing in-depth, geo-narrative interviews conducted with 15 youth (60% Black, 27% Latinx, 53% female, 14 to 17 years old) residing in low-income, high-crime Chicago neighborhoods to explore youths' perceptions of safety and strategies for navigating neighborhood space. After carrying geographical positioning system (GPS) trackers for an eight-day period, youths' travel patterns were mapped, and these maps were used as part of an interview with youth that explored daily routines, with special consideration paid to where and when youth felt safe. Drawing on activity settings theory and exploring youth voice, we find that experiences of community violence are commonplace, but youth describe how they have safe spaces that are embedded within these dangerous contexts. Perceptions of safety and danger were related to environmental, social, and temporal cues. Youth reported four overarching safety strategies, including avoidance, hypervigilance, self-defense, and emotional management, but these strategies considerably varied by gender. We discuss implications for practice and future directions of research. HIGHLIGHTS: This study explored Chicago youths' safety strategies and resilience in high-crime neighborhoods. Safe and dangerous spaces are embedded or overlapping settings. All youth practiced safety strategies but they considerably varied by gender. Perceptions are intersubjectively created due to the codes, rules, and norms of community life. Violence is common and extreme in everyday life of this sample of Chicago adolescents.
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Affiliation(s)
- Andrea L DaViera
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
| | - Amanda L Roy
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
| | - Marbella Uriostegui
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
| | - Denise Fiesta
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
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Gaylord-Harden NK, Burnside A, Tinsley D. The Prevalence and Longitudinal Patterns of Continuous Community Violence Exposure and Trauma-Related Symptoms in Adolescent Male Serious Offenders. J Trauma Stress 2020; 33:541-551. [PMID: 32521090 DOI: 10.1002/jts.22535] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 01/10/2020] [Accepted: 01/17/2020] [Indexed: 11/06/2022]
Abstract
The current study examined the longitudinal patterns of continuous exposure to community violence (ECV) and associated symptoms in serious adolescent male offenders. Using data from the Pathways to Desistance Study (Schubert et al., 2004), the current study examined the prevalence of continuous ECV and the stability in exposure over a 3-year period in 1,170 adolescent male offenders (M age at baseline = 16.05 years, SD = 1.15). The results revealed variability in adolescent offenders' ECV and trauma-related symptoms. A latent class analysis identified three classes of participants at each time point: "witnessed with hostility," "dually exposed [i.e., high probability of both witnessing and victimization] with anxiety and hostility," and "no/low exposure with anxiety and hostility." Participants in the witnessed with hostility class reported more baseline ECV than those in the other classes, ds = 0.62-1.37, and more violent offenses than those in the dually exposed with anxiety and hostility class, d = 0.48. In addition, participants in the witnessed with hostility class were older, d = 0.10, and reported more violent offenses at baseline, d = 0.07, than those in the no/low exposure class; however, participants in the no/low exposure class reported spending more time in secure settings with no community access than those in the witnessed with hostility class, d = 0.20. A latent transition analysis over a 3-year period revealed relatively high stability in ECV and trauma-related symptoms over time, with a large proportion of participants remaining in the same violence and trauma class at each transition.
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Affiliation(s)
| | - Amanda Burnside
- Department of Psychology, Loyola University Chicago, Chicago, Illinois, USA
| | - Don'Terius Tinsley
- Department of Psychology, Loyola University Chicago, Chicago, Illinois, USA
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“A Larger System is Placing People in this Predicament”: A Qualitative Exploration of Living Amongst Urban Violence and the Impact on Mental Health and Relationships in the Black Community. CONTEMPORARY FAMILY THERAPY 2020. [DOI: 10.1007/s10591-020-09546-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Davis AN, Carlo G, Taylor LK. The interplay of community and family risk and protective factors on adjustment in young adult immigrants. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2020; 56:208-215. [PMID: 32596848 DOI: 10.1002/ijop.12698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Accepted: 05/23/2020] [Indexed: 11/09/2022]
Abstract
We examined the direct and interactive effects of community violence and both family cohesion and conflict on collective efficacy and aggressive behaviours among immigrant young adults. Participants included 221 young adults (ages 18-26; mean age = 21.36; 45.7% female, 190 born outside the U.S.) who completed self-report measures of their exposure to neighbourhood violence, social cohesion, collective efficacy and prosocial behaviours toward friends and strangers. Results, in general, showed that community violence and family cohesion were positively associated with collective efficacy whereas community violence and family conflict were positively associated with aggressive behaviours. Family cohesion and conflict also moderated the links between community violence and aggressive behaviours. Discussion focuses on the interplay of community and family processes and the relations to adjustment of immigrant young adults.
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Affiliation(s)
- Alexandra N Davis
- Department of Individual, Family, and Community Education, University of New Mexico, Albuquerque, NM, USA
| | - Gustavo Carlo
- School of Education, University of California, Irvine, CA, USA
| | - Laura K Taylor
- School of Psychology, University College Dublin and Centre for Identity and Intergroup Relations in the School of Psychology at Queen's University Belfast, University College Dublin, Dublin, Ireland.,Centre for Identity, Intergroup Relations in the School of Psychology, Queen's University Belfast, Belfast, UK
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DaViera AL, Roy AL. Chicago Youths' Exposure to Community Violence: Contextualizing Spatial Dynamics of Violence and the Relationship With Psychological Functioning. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2020; 65:332-342. [PMID: 31792990 PMCID: PMC8006467 DOI: 10.1002/ajcp.12405] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
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.
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Affiliation(s)
- Andrea L DaViera
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
| | - Amanda L Roy
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
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Zapata Roblyer MI, Betancourth Zambrano S. Crime Victimization and Suicidal Ideation Among Colombian College Students: The Role of Depressive Symptoms, Familism, and Social Support. JOURNAL OF INTERPERSONAL VIOLENCE 2020; 35:1367-1388. [PMID: 29294673 DOI: 10.1177/0886260517696856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Crime victimization is one of the most pressing public health concerns in Latin America. Young people in the region are at particularly high risk of victimization. The present study examined exposure to crime victimization as a risk factor for depressive symptoms and suicidal ideation, and the protective effects of familism and social support in a community sample of Colombian college students. Data (N = 424) came from the Juventud Project (The Emergent Adults Project), a cross-sectional study of college students, 18 to 29 years old (M = 20.8, SD = 2.5; 63% female; 75.5% lived with their families), attending an urban public university in Southern Colombia. Data were collected between March and June of 2014 through anonymous, self-administered surveys. Conditional process analysis was used to test a model in which crime victimization was directly and indirectly associated with suicidal ideation via depressive symptoms, with familism and social support as moderators of this association while controlling for gender, age, and socioeconomic status. Overall, 58.9% of participants reported at least one crime victimization event in the past year. The most common types of victimization were being robbed without the threat of harm (29.8%) and being robbed with a weapon (24.8%). Male participants reported more instances of crime victimization than female participants. Levels of depressive symptoms that could be clinically significant were reported by 30.2% of participants, and suicidal ideation was reported by 31% of participants. The association between crime victimization and suicidal ideation was fully mediated by depressive symptoms. Social support, but not familism, moderated this association; social support weakened the link between depressive symptoms and suicidal ideation. Findings suggest that crime victimization may be a significant risk for depressive symptoms and suicidal ideation among college students in Colombia, and that social support may protect from the harmful mental health effects of crime victimization.
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Pathways from witnessing community violence to mental health problems among South African adolescents. S Afr Med J 2020; 110:145-153. [PMID: 32657687 PMCID: PMC9327528 DOI: 10.7196/samj.2020.v110i2.13929] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND The intersection of violence exposure and mental health problems is a public health crisis for South African (SA) adolescents. Understanding the impact of community violence on adolescent mental health can inform future interventions. OBJECTIVES To assess pathways between community violence exposure and internalising and externalising problems in SA adolescents receiving mental healthcare, and the roles of parent and peer relationships in these associations. METHODS Participants (N=120 parent-adolescent pairs) were recruited from four mental health clinics in Western Cape Province to participate in a pilot test of a family-based HIV prevention study. Adolescents reported on their exposure to community violence, parental attachment, peer support of risk behaviour, and mental health. Parents reported on adolescents' internalising and externalising mental health problems. Participants received transport money (ZAR30 = USD3) and a shopping voucher or cash (ZAR50 = USD5) for their time. RESULTS Adolescents were 12 - 18 years old (mean (standard deviation) 14.39 (1.82) years), 53% were male, and 67% and 33% reported black African and mixed-race ethnicity, respectively. Parents were 94% female and reported an average monthly income of ZAR3 973 (USD397). Boys reported significantly higher rates of witnessing community violence than girls. Among boys, significant paths emerged from community violence and low parent attachment to externalising symptoms and from community violence to peer support of risky behaviour. For girls, the only significant path was from low parent attachment to peer support of risky behaviour. CONCLUSIONS This cross-sectional study sheds new light on the possible pathways from witnessing community violence to mental health problems among SA adolescents. Identifying factors that drive and mitigate psychological distress in the context of persistent community violence is critical to SA's future and can inform the selection and delivery of appropriate and targeted evidence-based interventions.
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Exposure to community violence and Children's mental Health: A quasi-experimental examination. Soc Sci Med 2019; 246:112740. [PMID: 31864176 DOI: 10.1016/j.socscimed.2019.112740] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 11/24/2019] [Accepted: 12/14/2019] [Indexed: 11/21/2022]
Abstract
RATIONALE Community violence and mental health problems are global health concerns. Yet, assessing the causal links between community violent crime and mental health is challenging due to problems of selection bias. OBJECTIVE This study examines the link between community violent crime and children's mental health problems, as well as the moderating role of parents' mental health. METHOD The study employs a representative sample of 404 children (Mage=8.99, range=7-11) from Bogotá, Colombia, as well as longitudinal geocoded data on violent crimes from the national police. To account for problems of selection bias, the empirical strategy exploits naturalistic exogenous variation in the timing and location of an incident of violent crime relative to assessment of children's mental health problems, combined with matching techniques. RESULTS Findings suggest an incident of violent crime in close proximity to children's homes is associated, on average, with increases in children's mental health problems by 0.28-0.38 SD; having parents with worse mental health exacerbates children's problems. Results from sensitivity checks and falsification tests further support the internal validity of the findings. CONCLUSIONS Collectively, the results from the present study and those of previous research suggest that community violent crime has the potential to affect local residents negatively beyond direct victims, placing a heavy burden on individuals and society.
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Turner HA, Mitchell KJ, Jones LM, Hamby S, Wade R, Beseler CL. Gun Violence Exposure and Posttraumatic Symptoms Among Children and Youth. J Trauma Stress 2019; 32:881-889. [PMID: 31833114 DOI: 10.1002/jts.22466] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 06/28/2019] [Accepted: 06/30/2019] [Indexed: 01/15/2023]
Abstract
Although statistics on youth homicide and injury from gun violence are available, little research has focused on how gun violence overlaps with other victimizations or on the psychological impact of gun violence on children. Pilot survey data were collected on the experiences of 630 U.S. children (age range: 2-17 years) from Boston, Philadelphia, and rural areas of eastern Tennessee. Youth aged 10-17 years completed a self-report survey on a wide range of gun violence exposures, and parents of younger children (aged 2-9 years) completed the survey as a proxy for that child. Direct gun violence exposure, witnessing gun violence, and hearing gunshots were all significantly associated with other forms of victimization, rs = .10-.38, p < .001. The findings suggest that youth who experience direct gun violence are often exposed to multiple violent contexts. For older youth (ages 10-17 years) polyvictimization was most strongly associated with posttraumatic symptoms, β = .35, p < .001, although witnessing gun violence still uniquely predicted a higher level of symptoms, β = .18, p < .01. For younger children (ages 2-9 years), hearing and witnessing gun violence were both related to posttraumatic symptoms, β = .15, p < .01 for both, even after controlling for polyvictimization. Mental health professionals and trauma-informed services should be mindful that the traumatic impact of gun violence for children may not necessarily be attached to direct victimization experiences but may also result from simply seeing or hearing it in their neighborhoods.
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Affiliation(s)
- Heather A Turner
- Crimes Against Children Research Center, University of New Hampshire, Durham, New Hampshire, USA
| | - Kimberly J Mitchell
- Crimes Against Children Research Center, University of New Hampshire, Durham, New Hampshire, USA
| | - Lisa M Jones
- Crimes Against Children Research Center, University of New Hampshire, Durham, New Hampshire, USA
| | - Sherry Hamby
- Life Paths Appalachian Research Center and University of the South, Monteagle, Tennessee, USA
| | - Roy Wade
- Roberts Center for Pediatric Research, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Cheryl L Beseler
- Departmet of Psychology, Colorado State University, Fort Collins, Colorado, USA
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Gollub EL, Green J, Richardson L, Kaplan I, Shervington D. Indirect violence exposure and mental health symptoms among an urban public-school population: Prevalence and correlates. PLoS One 2019; 14:e0224499. [PMID: 31774835 PMCID: PMC6881142 DOI: 10.1371/journal.pone.0224499] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 10/15/2019] [Indexed: 11/29/2022] Open
Abstract
Available literature identifies the need for a deeper understanding of the role of gender, age and socioeconomic status in children's exposure to violence and associations with mental health (MH) outcomes. The 1548 participants for this study were enrolled from 28 public charter schools and 9 community-based settings; youth were administered a screener that assessed exposure to traumatic events and symptoms of post-traumatic stress disorder (PTSD) and depression. Respondents reported extremely high levels of exposure to indirect violence: 41.7% witnessed shooting/stabbing/beating; 18.3% witnessed murder; and 53.8% experienced the murder of someone close. Frequency of adverse MH outcomes was high: 21.2% screened positive for depression; 45.7% for lifetime PTSD; and 26.9% for current PTSD. More males than females reported witnessing shooting/stabbing/beating (p = .04); females more often reported experiencing the murder of someone close (p = .001). Indirect violence exposure generally increased with age. Youth attending schools with ≥90% free/reduced lunch participation (FRLP) showed significantly higher levels of violence exposure compared to youth in schools with <90% FRLP. Females endorsed significantly higher levels of depression (21.4% vs. 9.7%), and lifetime (53.9% vs. 34.9%) and current (32.5% vs. 19.6%) PTSD, compared with males (p < .0001, all comparisons). Female sex (aOR = 2.6), FRLP (aOR = 1.4 for ≥90% vs. <90%) and the number of different indirect violence exposures (aORs from 1.3 to 10.4), were significantly associated with a positive screen for any adverse MH outcome. Our data add important insights into gender heterogeneity of viewed violence, mental health symptoms, and their association-all of which are critical to guiding effective intervention efforts.
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Affiliation(s)
- Erica L. Gollub
- Health Science Program, College of Health Professions, Pace University, Pleasantville, NY, United States of America
| | - Jakevia Green
- Institute of Women & Ethnic Studies, New Orleans, LA, United States of America
| | - Lisa Richardson
- Institute of Women & Ethnic Studies, New Orleans, LA, United States of America
| | - Ilyssa Kaplan
- Department of Psychology, Pace University, New York, NY, United States of America
| | - Denese Shervington
- Institute of Women & Ethnic Studies, New Orleans, LA, United States of America
- Charles R. Drew School of Medicine and Science, Psychiatry and Behavioral Sciences, Los Angeles, CA, United States of America
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Cuartas J, Roy AL. The Latent Threat of Community Violence: Indirect Exposure to Local Homicides and Adolescents' Mental Health in Colombia. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2019; 64:218-230. [PMID: 31087369 PMCID: PMC7318774 DOI: 10.1002/ajcp.12335] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
This study examines the relation between adolescents' indirect exposure to local homicides and mental health disorders and post-traumatic stress disorder (PTSD) symptoms. We employ a sample of 300 adolescents ( Mage=14.52,range=12-17) representative for Bogotá, Colombia, and geocoded data on violent crimes recorded by the national police. Findings show that one SD increment in local homicides is associated with increments by 0.17 SD in the mental health disorder index and a 0.14 SD increase in the PTSD score index, even after accounting for adolescents' direct exposure to violence. The estimated effect for PTSD was larger for adolescents' who were directly exposed to violence and for those living in multidimensionally poor households, whereas no detectable effects were found for adolescents who perceived their residential neighborhood as relatively safe.
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Affiliation(s)
- Jorge Cuartas
- Harvard Graduate School of Education, Harvard University, Cambridge, MA, USA
| | - Amanda L Roy
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
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Violence Exposure, Drug Use and HIV/AIDS Risk Taking Behaviors: The Role of Gender. J Natl Med Assoc 2019; 112:484-502. [PMID: 31202486 DOI: 10.1016/j.jnma.2019.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 04/17/2019] [Accepted: 05/10/2019] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To examine gender differences among African American young adults in their exposure to violence (ETV) before age 18 and community violence as an adult, and the relationship of these exposures to drug use and HIV risk taking behaviors (HIVRTB). METHOD We detail these experiences in 440 self-identified African Americans, ages 18 to 25, from socio-economically disadvantaged wards in Washington, DC. Factor analysis was used to identify the types of violence experienced before age 18 and as adults. Regression was used to identify which types of violence had the greatest impact on subsequent drug use and HIVRTB. RESULTS We found gender differences in the types of violence experienced and their effects on drug use and HIVRTB. For women, the strongest ETV factors were direct personal violence, and exposure to drug sales or physical violence as adults. For men, the strongest factors were feeling unsafe in different situations as adults and exposure to violence among adults before age 18. CONCLUSIONS We identified the specific kinds of violence that are most likely to impact drug use and risky sexual behaviors that can leave one vulnerable to HIV and how these differ between women and men exposed to both childhood violence and community violence as an adult. Our findings point toward the need for trauma-informed programs that are tailored to gender.
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Abstract
UNLABELLED AimsAlthough violence is a vital public health problem, no prospective studies have tested for subsequent vulnerability to violence, as a victim or witness, in members of the general population with a range of psychiatric symptoms, or evaluated the importance of higher symptom burden on this vulnerability. METHODS We used successive waves of a household survey of Southeast London, taken 2 years apart, to test if association exists between psychiatric symptoms (symptoms of psychosis, common mental disorders, post-traumatic stress disorder and personality disorder) and later victimisation, in the form of either witnessing violence or being physically victimised, in weighted logistic regression models. Statistical adjustment was made for prior violence exposure, sociodemographic confounders, substance/alcohol use and violence perpetration. Sensitivity analyses were stratified by violence perpetration, sex and history of mental health service use. RESULTS After adjustments, psychiatric symptoms were prospectively associated with reporting any subsequent victimisation (odds ratio (OR) 1.88, 95% confidence interval (CI) 1.25-2.83), a two times greater odds of reporting witnessed violence (OR 2.24, 95% CI 1.33-3.76) and reporting physical victimisation (OR 1.76, 95% CI 1.01-3.06). One more symptom endorsed was accompanied by 47% greater odds of subsequent victimisation (OR 1.47, 95% CI 1.16-1.86). In stratified analyses, statistical associations remained evident in non-perpetrators, and among those without a history of using mental health services, and were similar in magnitude in both men and women. CONCLUSIONS Psychiatric symptoms increase liability to victimisation compared with those without psychiatric symptoms, independently of a prior history of violence exposure and irrespective of whether they themselves are perpetrators of violence. Clinicians should be mindful of the impact of psychiatric symptoms on vulnerability to victimisation, including among those with common psychiatric symptoms and among those who are not considered at risk of perpetrating violence.
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Musci RJ, Bettencourt AF, Sisto D, Maher B, Masyn K, Ialongo NS. Violence exposure in an urban city: A GxE interaction with aggressive and impulsive behaviors. J Child Psychol Psychiatry 2019; 60:72-81. [PMID: 30159911 PMCID: PMC6392042 DOI: 10.1111/jcpp.12966] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/23/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Previous research has demonstrated a reciprocal relationship between community violence exposure and disruptive behavior problems among youth. No study to date, however, has explored the potential interaction between violence exposure in early adolescence and genetics. METHODS We explore the gene x environment interaction's impact on teacher-rated aggressive and impulsive behaviors. Violence exposure during the middle school years was assessed using self-report. Genetic data collection occurred in emerging adulthood. A polygenic score was created using findings from a conduct disorder symptomatology genome-wide association study. RESULTS Three longitudinal classes of teacher reported aggressive and impulsive behavior were identified. We found a significant relationship between violence exposure and class membership. There was a significant GxE interaction, such that those with below average levels of the polygenic score and who were exposed to violence were more likely to be in the moderately high aggressive and impulsive class as compared to the no to low class. CONCLUSIONS These findings highlight the influence of genetic risk together with violence exposure on adolescent problem behavior. Although youth may have little control over the environments in which they live, interventions can and should focus on helping all youth.
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Affiliation(s)
- Rashelle J. Musci
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Amie F. Bettencourt
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD,Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD
| | - Danielle Sisto
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Brion Maher
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Katherine Masyn
- Division of Epidemiology & Biostatistics, Georgia State University School of Public Health, Atlanta, GA, USA
| | - Nicholas S. Ialongo
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
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Cancino R. Primary Care Issues in Inner-City America and Internationally. PHYSICIAN ASSISTANT CLINICS 2019. [DOI: 10.1016/j.cpha.2018.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lai BS, Osborne MC, Lee N, Self-Brown S, Esnard AM, Kelley ML. Trauma-informed schools: Child disaster exposure, community violence and somatic symptoms. J Affect Disord 2018; 238:586-592. [PMID: 29945077 PMCID: PMC7482407 DOI: 10.1016/j.jad.2018.05.062] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 05/03/2018] [Accepted: 05/28/2018] [Indexed: 12/28/2022]
Abstract
BACKGROUND Given the increasing prevalence of natural disasters, trauma-informed school settings should include efficient methods for assessing child health and mental health in post-disaster environments. To develop such methods, factors that contribute to children's vulnerability and key signs of distress reactions after disasters need to be understood. To address these issues, we evaluated pre-disaster community violence exposure as a vulnerability factor for children's post-disaster reactions and somatic symptoms as a key post-disaster outcome. METHODS We evaluated 426 children exposed to Hurricane Katrina at two timepoints (3-7 months and 13-17 months post-disaster). Structural equation models evaluated community violence exposure, hurricane exposure, and posttraumatic stress and somatic symptoms. RESULTS Community violence exposure was associated with increased levels of posttraumatic stress symptoms among disaster-impacted youth, and did not moderate the relationship between disaster exposure and posttraumatic stress symptoms. Posttraumatic stress symptoms were associated with somatic symptoms in the short-term recovery period (3-7 months), but not associated with somatic symptoms during the longer-term recovery period (13-17 months). LIMITATIONS This study did not include school-level factors, and somatic symptoms were based on parent reports. The study did not include parent functioning information or distinguish between whether somatic symptoms were medical or functional in nature. CONCLUSIONS Post-disaster school-based screeners may need to incorporate questions related to children's past exposure to community violence and their somatic symptoms to provide trauma-informed care for children.
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Affiliation(s)
- Betty S. Lai
- Department of Counseling, Developmental, and Educational Psychology, Boston College, United States,Corresponding author. (B.S. Lai)
| | | | - NaeHyung Lee
- School of Public Health, Georgia State University, United States
| | | | - Ann-Margaret Esnard
- Andrew Young School of Policy Studies, Georgia State University, United States
| | - Mary Lou Kelley
- Department of Psychology, Louisiana State University, United States
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Weber HM, Petermann F. Gruppentherapie bei Kindern und Jugendlichen mit aggressivem Verhalten. KINDHEIT UND ENTWICKLUNG 2018. [DOI: 10.1026/0942-5403/a000260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Gruppentherapeutische Maßnahmen stellen einen wesentlichen Bestandteil der kognitiven Verhaltenstherapie von Kindern und Jugendlichen dar. Der Vorteil einer Gruppentherapie besteht darin, dass sie Probleme dort behandelt, wo sie entstehen – in den sozialen Beziehungen der Patienten. Kinder und Jugendliche mit aggressivem Verhalten weisen Defizite in ihren sozialen Kompetenzen auf, sodass zur Behandlung ein gruppentherapeutisches Vorgehen indiziert ist. In der vorliegenden Übersichtsarbeit werden unterschiedliche nationale und internationale Programme zur Behandlung von Kindern und Jugendlichen mit aggressivem Verhalten vorgestellt. Es wird der Frage nachgegangen, inwieweit es diesen Programmen gelingt, die wesentlichen Therapieziele bei aggressivem Verhalten umzusetzen. Dabei werden Erkenntnisse über die Wirksamkeit der einzelnen Programme diskutiert. Schließlich werden Gelingensbedingungen aufgezeigt, die die Wirksamkeit einer Gruppentherapie zur Behandlung aggressiven Verhaltens noch einmal steigern können.
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Affiliation(s)
- Hanna M. Weber
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
| | - Franz Petermann
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
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Donnelly R, Holzer K. The moderating effect of parental support: internalizing symptoms of emerging adults exposed to community violence. JOURNAL OF EVIDENCE-INFORMED SOCIAL WORK 2018; 15:564-578. [PMID: 29995587 DOI: 10.1080/23761407.2018.1495139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Evidence suggests parental support mitigates the association between community violence exposure and internalizing symptoms in adolescents. This study investigates this moderation of parental support for emerging adults and compares it with that for adolescents. Data were drawn from the Pathways to Desistence Study using community violence, parental support, and their interaction to predict internalizing symptoms in a series of regression models for adolescents and emerging adults. Results suggest that exposure to community violence during adolescence and emerging adulthood had a significant association with internalizing symptoms. Mother support during adolescence moderated this relationship. Emerging adulthood was marked by an increase in parental support; however, this support did not moderate the relationship between community violence and internalizing symptoms. Interventions, programs, and policies that leverage the parental support of emerging adults may be a useful strategy to mitigate the negative impacts of community violence.
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Affiliation(s)
- Robert Donnelly
- a School of Social Work, College for Public Health and Social Justice , Saint Louis University , St. Louis , MO , USA
| | - Katherine Holzer
- a School of Social Work, College for Public Health and Social Justice , Saint Louis University , St. Louis , MO , USA
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43
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Affrunti NW, Suárez L, Simpson D. Community violence and posttraumatic stress disorder symptoms in urban youth: The moderating influence of friend and parent support. JOURNAL OF COMMUNITY PSYCHOLOGY 2018; 46:636-650. [PMID: 31682288 DOI: 10.1002/jcop.21963] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 01/22/2018] [Accepted: 01/23/2018] [Indexed: 06/10/2023]
Abstract
Separate lines of research have demonstrated that community violence predicts posttraumatic stress disorder (PTSD) symptoms in youth and that social support is one protective factor against the development of PTSD symptoms. The current study sought to examine the associations between primary and secondary exposure to community violence and the moderating role of parent and friend support on these relations. Participants were 96 urban youths (aged 6-17 years; 58.4% racial/ethnic minority; 51% female) and a caregiver recruited from a university mental health clinic. Results indicated that both primary and secondary exposure to community violence predicted PTSD symptoms. Friend support, but not parent support, moderated the association between primary, but not secondary, exposure to community violence and PTSD symptoms. The findings suggest that friend support is a salient protective factor for urban youth who may be at risk of PTSD symptoms due to exposure to community violence.
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Dubé C, Gagné MH, Clément MÈ, Chamberland C. Community Violence and Associated Psychological Problems Among Adolescents in the General Population. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2018; 11:411-420. [PMID: 30546818 PMCID: PMC6267123 DOI: 10.1007/s40653-018-0218-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Based on a populational survey conducted among 1400 adolescents aged between 12 and 17 years old, the aim of this study is to assess the relationships between their community violence experiences and their psychological health (anger, depressive symptoms, and post-traumatic stress disorder symptoms). One MANOVA confirms that both boys and girls who report at least one incident of physical community violence present more psychological difficulties, especially anger. Subsequent MANOVAs show that anger intensity varies depending on whether the youth was a direct victim or a witness only, as well as on the diversity of the types of violent manifestations and on acquaintance with the perpetrator, whereas the presence of injuries has no significant effect. This study highlights the importance of considering the context of the community violence incident, to clearly understand its relationships with the youth's psychological difficulties.
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Affiliation(s)
- Christine Dubé
- School of Psychology, Université Laval, 2325 rue des Bibliothèques, Pavillon Félix-Antoine-Savard 11ème étage, Québec, Québec G1V 0A6 Canada
- Present Address: Centre Hospitalier de l’Université Laval, Québec City, Canada
| | - Marie-Hélène Gagné
- School of Psychology, Université Laval, 2325 rue des Bibliothèques, Pavillon Félix-Antoine-Savard 11ème étage, Québec, Québec G1V 0A6 Canada
| | - Marie-Ève Clément
- Psychology and Psychoeducation Department, Université du Québec en Outaouais, Saint-Jérôme, Canada
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Lund C, Brooke-Sumner C, Baingana F, Baron EC, Breuer E, Chandra P, Haushofer J, Herrman H, Jordans M, Kieling C, Medina-Mora ME, Morgan E, Omigbodun O, Tol W, Patel V, Saxena S. Social determinants of mental disorders and the Sustainable Development Goals: a systematic review of reviews. Lancet Psychiatry 2018; 5:357-369. [PMID: 29580610 DOI: 10.1016/s2215-0366(18)30060-9] [Citation(s) in RCA: 431] [Impact Index Per Article: 71.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 10/12/2017] [Accepted: 10/13/2017] [Indexed: 01/08/2023]
Abstract
Mental health has been included in the UN Sustainable Development Goals. However, uncertainty exists about the extent to which the major social determinants of mental disorders are addressed by these goals. The aim of this study was to develop a conceptual framework for the social determinants of mental disorders that is aligned with the Sustainable Development Goals, to use this framework to systematically review evidence regarding these social determinants, and to identify potential mechanisms and targets for interventions. We did a systematic review of reviews using a conceptual framework comprising demographic, economic, neighbourhood, environmental events, and social and culture domains. We included 289 articles in the final Review. This study sheds new light on how the Sustainable Development Goals are relevant for addressing the social determinants of mental disorders, and how these goals could be optimised to prevent mental disorders.
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Affiliation(s)
- Crick Lund
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Carrie Brooke-Sumner
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; Alcohol, Tobacco and Other Drug Research Unit, Medical Research Council of South Africa, Cape Town, South Africa
| | - Florence Baingana
- World Health Organization Sierra Leone Country Office, Freetown, Sierra Leone
| | - Emily Claire Baron
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Erica Breuer
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Prabha Chandra
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Johannes Haushofer
- Princeton University, Princeton, NJ, USA; Busara Center for Behavioral Economics, Nairobi, Kenya
| | - Helen Herrman
- Orygen, The National Centre of Excellence in Youth Mental Health, and Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Mark Jordans
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Research and Development Department, War Child, Amsterdam, Netherlands
| | - Christian Kieling
- Department of Psychiatry, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Child & Adolescent Psychiatry Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | | | | | - Olayinka Omigbodun
- Centre for Child and Adolescent Mental Health and Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Wietse Tol
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Peter C Alderman Foundation, Bedford, NY, USA
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Cambridge, MA, USA; London School of Hygiene & Tropical Medicine, London, UK; Sangath, Porvorim, Goa, India; Centre for Chronic Conditions and Injuries, Public Health Foundation of India, Delhi, India
| | - Shekhar Saxena
- Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
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Butler O, Yang XF, Laube C, Kühn S, Immordino-Yang MH. Community violence exposure correlates with smaller gray matter volume and lower IQ in urban adolescents. Hum Brain Mapp 2018; 39:2088-2097. [PMID: 29450935 DOI: 10.1002/hbm.23988] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 01/13/2018] [Accepted: 01/22/2018] [Indexed: 01/16/2023] Open
Abstract
Adolescents' exposure to community violence is a significant public health issue in urban settings and has been associated with poorer cognitive performance and increased risk for psychiatric illnesses, including PTSD. However, no study to date has investigated the neural correlates of community violence exposure in adolescents. Sixty-five healthy adolescents (age = 14-18 years; 36 females, 29 males) from moderate- to high-crime neighborhoods in Los Angeles reported their violence exposure, parents' education level, and free/reduced school lunch status (socio-economic status, SES), and underwent structural neuroimaging and intelligence testing. Violence exposure negatively correlated with measures of SES, IQ, and gray matter volume. Above and beyond the effect of SES, violence exposure negatively correlated with IQ and with gray matter volume in the left inferior frontal gyrus and anterior cingulate cortex, regions involved in high-level cognitive functions and autonomic modulation, and previously shown to be reduced in PTSD and combat-exposed military populations. The current results provide first evidence that frontal brain regions involved in cognition and affect appear to be selectively affected by exposure to community violence, even in healthy nondelinquent adolescents who are not the direct victims or perpetrators of violence.
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Affiliation(s)
- Oisin Butler
- Center for Lifespan Psychology, Max Planck Institute for Human Development, Lentzeallee 94, Berlin, 14195, Germany
| | - Xiao-Fei Yang
- Brain and Creativity Institute, University of Southern California, 3620A McClintock Ave, Los Angeles, CA, 90089, USA.,Department of Psychology, University of Southern California, 3620 McClintock Ave, Los Angeles, CA, 90089, USA.,Rossier School of Education, University of Southern California, 3470 Trousdale Parkway, Los Angeles, CA, 90089, USA
| | - Corinna Laube
- Center for Adaptive Rationality, Max Planck Institute for Human Development, Lentzeallee 94, Berlin, 14195, Germany
| | - Simone Kühn
- Center for Lifespan Psychology, Max Planck Institute for Human Development, Lentzeallee 94, Berlin, 14195, Germany.,Clinic and Policlinic for Psychiatry and Psychotherapy, University Clinic Hamburg-Eppendorf, Martinistrasse 52, Hamburg, 20246, Germany
| | - Mary Helen Immordino-Yang
- Brain and Creativity Institute, University of Southern California, 3620A McClintock Ave, Los Angeles, CA, 90089, USA.,Department of Psychology, University of Southern California, 3620 McClintock Ave, Los Angeles, CA, 90089, USA.,Rossier School of Education, University of Southern California, 3470 Trousdale Parkway, Los Angeles, CA, 90089, USA
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Larson S, Chapman S, Spetz J, Brindis CD. Chronic Childhood Trauma, Mental Health, Academic Achievement, and School-Based Health Center Mental Health Services. THE JOURNAL OF SCHOOL HEALTH 2017; 87:675-686. [PMID: 28766317 DOI: 10.1111/josh.12541] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 12/28/2016] [Accepted: 04/22/2017] [Indexed: 05/27/2023]
Abstract
BACKGROUND Children and adolescents exposed to chronic trauma have a greater risk for mental health disorders and school failure. Children and adolescents of minority racial/ethnic groups and those living in poverty are at greater risk of exposure to trauma and less likely to have access to mental health services. School-based health centers (SBHCs) may be one strategy to decrease health disparities. METHODS Empirical studies between 2003 and 2013 of US pediatric populations and of US SBHCs were included if research was related to childhood trauma's effects, mental health care disparities, SBHC mental health services, or SBHC impact on academic achievement. RESULTS Eight studies show a significant risk of mental health disorders and poor academic achievement when exposed to childhood trauma. Seven studies found significant disparities in pediatric mental health care in the US. Nine studies reviewed SBHC mental health service access, utilization, quality, funding, and impact on school achievement. CONCLUSION Exposure to chronic childhood trauma negatively impacts school achievement when mediated by mental health disorders. Disparities are common in pediatric mental health care in the United States. SBHC mental health services have some showed evidence of their ability to reduce, though not eradicate, mental health care disparities.
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Affiliation(s)
- Satu Larson
- San José State University, The Valley Foundation School of Nursing, One Washington Square, San José, CA 95192
| | - Susan Chapman
- University of California San Francisco, School of Nursing, Department of Social and Behavioral Sciences, Nurse Health Policy Program, 3333 California St., Ste. 265, San Francisco, CA 94118
- University of California San Francisco, Philip R. Lee Institute for Health Policy Studies, 3333 California St., Ste. 265, San Francisco, CA 94118
- University of California San Francisco, Healthforce Center, 3333 California St., Ste. 265, San Francisco, CA 94118
| | - Joanne Spetz
- University of California San Francisco, Philip R. Lee Institute for Health Policy Studies, 3333 California St., Ste. 265, San Francisco, CA 94118
- University of California San Francisco, Healthforce Center, 3333 California St., Ste. 265, San Francisco, CA 94118
- University of California San Francisco, School of Medicine, Department of Family and Community Medicine, 3333 California St., Ste. 265, San Francisco, CA 94118
- University of California San Francisco, School of Nursing, Department of Social and Behavioral Sciences; 3333 California St., Ste. 265, San Francisco, CA 94118
| | - Claire D Brindis
- University of California San Francisco, Philip R. Lee Institute of Health Policy Studies, 3333 California St., Ste. 265, San Francisco, CA 94118
- University of California San Francisco, School of Medicine, Department of Pediatrics and Department of Obstetrics, Gynecology, and Reproductive Health Services, 3333 California St., Ste. 265, San Francisco, CA 94118
- Adolescent and Young Adult Health National Resource Center, 3333 California St., Ste. 265, San Francisco, CA 94118
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Saadatmand F, Harrison R, Bronson J, Crouse D, Jackson M. Gender Differences and the Impact of Exposure to Violence on Depressive Symptoms and Sleep Habits among Young African American Adults. JOURNAL OF FAMILY STRENGTHS 2017; 17:5. [PMID: 30288367 PMCID: PMC6168193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Abstract
Inner-city patient populations are high-risk for poor outcomes, including increased risk of mortality. Barriers to delivering high-quality primary care to inner-city patients include lack of access, poor distribution of primary care providers (PCPs), competing demands, and financial restraints. Health care issues prevalent in this population include obesity, diabetes, cancer screening, asthma, infectious diseases, and obstetric and prenatal care. Population health management and quality improvement (QI) activities must target disparities in care. Partnering with patients and focusing on social determinants of health andmedical care are key areas inwhich to focus toimprove overall healthoutcomes inthispopulation.
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50
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Quiroga A, López-Rodríguez L, Willis GB. Parental Support Buffering the Effect of Violence on Adolescents' Depression: Gender Differences. JOURNAL OF INTERPERSONAL VIOLENCE 2017; 32:1068-1086. [PMID: 26002877 DOI: 10.1177/0886260515587664] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
In Mexico violence across the country has increased in recent years and has become a social problem of great importance. The continuous exposure to all types of interpersonal violence leads adolescents to cope with experiences and challenges of great risk of development deviations. Trying to find a more comprehensive understanding of violence outcomes on Mexican adolescents and its moderators, the present quantitative, non-experimental, cross-sectional correlation study was performed. Parental support ( vs. other sort of social support) was proposed to be a relevant moderator factor for decreasing the negative outcomes of violence exposure on depression, and gender was predicted to play a role in this process. A two-way interaction between violence exposure and parental support was only significant in the case of adolescent girls, whereas there was no evidence of such moderation for adolescent boys. The effect of exposure to violence on girls' depression was stronger when their parental support was relatively low than when their parental support was relatively high. Parental support may serve as a protective factor of depression after violence exposure especially for girls, whereas more research should be conducted in order to detect an efficient protective mechanism for boys who are exposed to violence.
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