Operational Definitions of Poly-Victimization: A Scoping Review

Throughout the last two decades, research on poly-victimization (PV) has evolved from examinations of a core set of past-year victimization types in youth samples to investigations of a broad range of victimization types experienced during variable time intervals in diverse samples of varying ages. As the concept of PV expands, greater clarity regarding the definition and measurement of PV is needed to advance understanding of its risk and protective factors as well as its associated outcomes. This scoping review aimed to (a) identify approaches used to operationally define and measure PV across studies and (b) synthesize empirical findings concerning risk factors and outcomes associated with PV. A systematic search of peer-reviewed research published before 2022 across 12 databases yielded 98 studies that met inclusion criteria. Study characteristics including the research design, sample type, victimization timeframe, operational definition(s) of PV, measurement of PV, analytic methods, and key findings were synthesized across studies. Findings indicated that the majority of reviewed studies were cross-sectional investigations that utilized categorical measures of lifetime PV in samples of youth. Results also demonstrated that PV is robustly associated with a broad range of predictors, including mental health symptoms and diagnoses as well as family- and community-level factors. PV is also associated with numerous adverse outcomes including depression, anxiety, suicidality, substance use, and delinquency across diverse study types and populations. Future research that examines the conditional effects of PV is needed to identify subgroups of individuals at higher risk of adverse outcomes following PV and modifiable targets for interventions.

3-month prevalence of unwanted sexual contact victimization in a national sample of college students: differences by race, gender identity, and sexual identity

IMPORTANCE

Most unwanted sexual contact victimization (USCV) research utilizes predominantly white, cisgender, heterosexual college student samples. Estimates of USCV prevalence and demographic variation can determine the need for dedicated funding and culturally relevant campus services for students in high-risk groups.

OBJECTIVE

To estimate the national prevalence and demographic variation in self-reported USCV within the first three months of college.

DESIGN

Data are from the Sexual Assault Prevention for Undergrads (SAPU) (2020-2021) dataset. SAPU is an online intervention program administered to students on more than 600 college campuses in the United States (N = 250,359). Group differences were assessed by race/ethnicity, gender identity, and sexual identity, and then stratified by gender to assess within-gender group differences.

SETTING

The SAPU dataset includes public and private institutions and 2-year and 4-year colleges with varying sizes of enrollment.

PARTICIPANTS

The sample is demographically diverse, and consists of newly matriculated U.S. college students, most of whom complete the SAPU program within the first three months of enrollment.

MAIN OUTCOMES AND MEASURES

The primary outcome measure is self-reported USCV within the first three months of college enrollment, analyzed for subgroup differences. We hypothesized that USCV would be higher among students from racial/ethnic, gender, and sexual minority populations.

RESULTS

Nearly 8% of transgender men reported USCV, followed by 7.4% of transgender women, 7.4% of genderqueer/gender non-conforming students, 4.5% of women, and 1.5% of men. Several subgroups reported exceedingly high rates of USCV, including Black students who identified as transgender women (35.7%) and American Indian/Alaska Native/Native Hawaiian/Pacific Islander students who identified as trans men (55.6%) or genderqueer/gender non-conforming (41.7%).

CONCLUSIONS AND RELEVANCE

Universal and targeted (selective and indicated) intervention programs are needed to lessen USCV, particularly among gender minority students who also identify as Black, Indigenous, other person of color, or as a sexual minority.

Help-Seeking and Service Utilization Among Survivors of Intimate Partner Violence in Michigan During the COVID-19 Pandemic

This study explores formal and informal intimate partner violence (IPV) service use among women and transgender/nonbinary individuals in the state of Michigan during the COVID-19 pandemic. A total of 14.8% (N = 173) of participants experienced IPV during this period, and 70% utilized at least one formal IPV service (13.3%). Up to 22% of survivors reported wanting to seek formal help but not doing so due to fear of partner reprisal, contracting COVID-19, or COVID-related service reductions. White, pregnant, and part-time-employed survivors were most likely to seek informal help. Older, higher-income, white, part-time-employed, pregnant, and non-essential worker survivors were most likely to seek formal help.

Examining the Association Between Trauma Characteristics and Adult Depression and Anxiety: Analysis of Types, Variety, Repetition, and Timing of Past Trauma

Past research has emphasized the impact of prior trauma on adult depression and anxiety rates. However, few studies have examined the simultaneous connection between various trauma characteristics (e.g., type, variety, repetition, timing) and symptoms of depression and anxiety in adults. Understanding how these different trauma characteristics relate to mental health issues can offer valuable insight into predicting the onset of such problems. We conducted a cross-sectional analysis with 356 adult participants to explore the associations between lifetime trauma history and depression/anxiety scores. Participants retrospectively reported on five different traumatic experiences from birth to the present, including childhood physical abuse, witnessing parental violence, lifetime experiences of rape, witnessing trauma to loved ones, and the unexpected death of loved ones. For each trauma type, participants indicated the timing of their first exposure and the frequency of subsequent occurrences. Depression and anxiety symptoms in the past 2 weeks were also self-reported. Multiple regression analyses with covariates were employed. On average, participants experienced two out of the five trauma types. Regardless of the type, having at least one traumatic experience was linked to higher depression and anxiety scores. Those who experienced all five trauma types reported the highest levels of depression and anxiety. Repeated instances of rape, witnessing trauma to loved ones, and the death of loved ones were significantly associated with elevated depression and anxiety scores. The timing of exposure to the unexpected death of loved ones predicted higher depression scores in childhood compared to adulthood, while no relationship between timing and anxiety scores was observed. Other trauma types did not show significant associations. Our study enhances knowledge of the link between trauma and depression/anxiety by elucidating how various trauma characteristics, such as type, variety, repetition, and timing of trauma, have differential influences on depression and anxiety scores.

Effects of the COVID-19 pandemic on stress, coping, and well-being among adults with histories of child maltreatment

A number of studies now confirm that the COVID-19 pandemic has increased and exacerbated mental health problems in the general population. Previous quantitative studies have found similar effects on mental health symptoms among adults with histories of childhood adversity; however, qualitative research is needed to provide a more in-depth understanding of pandemic-related experiences among this vulnerable population. Using semistructured qualitative interviews, we explored perceptions of adults with histories of child maltreatment and neglect to better understand the overall impact of the pandemic on their mental health, reported changes in stress and alcohol use, and reported coping strategies during the first year of the pandemic (N = 40). Approximately half of participants reported that the pandemic had greatly (negatively) impacted their life, relationships, and well-being. Contributing stressors included being fearful of getting sick, navigating work changes, and experiencing economic and housing hardships, grief and loss, and social isolation. Fewer than half of the sample reported more stress (46%), whereas a third (33%) indicated no changes to stress, and 10% had reduced stress. The majority (80%) indicated no changes in their alcohol use. Most participants reported they used positive coping strategies during the pandemic. Three primary themes emerged related to participants' perceptions of getting through difficult times: seeking outside support, engaging in positive reframing, and drawing on internal strength and resources. Findings can guide prevention strategies that strengthen social support and foster resilience among vulnerable populations of adults with histories of childhood maltreatment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Centering Media Literacy and Cultural Tailoring: A Scoping Review of Interventions Used to Address Black Adolescent Intimate Partner Violence

Intimate partner violence (IPV) among Black adolescents is a critical public health issue, as they report higher levels of IPV perpetration and victimization than their counterparts from other racial groups. Although practitioners frequently implement educational programs to reduce and prevent adolescent relationship violence among adolescents, the extent to which these interventions have been culturally tailored to Black youth is unclear. The purpose of this scoping review is to investigate the nature and effects of cultural tailoring in IPV interventions delivered to Black adolescent populations as well as any critical media literacy (CML) content therein. We conducted searches of three databases for peer-reviewed research published in the United States between 2000 and 2020 that evaluated an IPV-focused educational intervention with a predominantly Black adolescent sample. A total of eight original studies met our inclusion criteria. Findings showed that five of the articles mentioned some level of cultural tailoring for the participants. However, the level and nature of that tailoring ranged widely with regard to curriculum development, staffing, and other program elements. No studies included any elements of CML education. Overall results indicate positive effects of IPV interventions on adolescents and reduced acceptance of violence in romantic relationships. This scoping review highlights a lack of clarity on methods used for cultural tailoring of curriculum based IPV interventions, vague application of social learning theoretical frameworks, and the potential benefits of CML content.

Identification of risk factors and development of a predictive model for bloodstream infection in intensive care unit COVID-19 patients

OBJECTIVES

To identify risk factors for nosocomial bloodstream infections (BSIs) in intensive care unit (ICU) patients with COVID-19 and to build a predictive model for BSIs.

PATIENTS AND METHODS

The retrospective case-control study included 236 ICU COVID-19 patients with BSIs group and 234 patients in the control group. Demographic and laboratory data, comorbidities, drug use, invasive procedures and identified pathogens were recorded separately for patients directly admitted and transferred to ICU. Fine and Gray's multi-variate competing risk model was used to build a predictive model for patients transferred to ICU.

RESULTS

The risk factors were: interleukin inhibitors (HR = 6.1 (95% CI: 2.0-18.5)) and dexamethasone (HR = 3.0 (95% CI: 1.3-7.1)) use in previous hospitalization, glomerular filtration rate <60 mL/min per 1.73 m2 (HR = 4.0 (95% CI: 2.1-7.6)) and blood glucose >9 mmol/L (HR = 2.5 (95% CI: 1.4-4.6)) in patients directly admitted to ICU; and dexamethasone use in previous hospitalization (HR = 4.5 (95% CI: 1.8-11)), the total dexamethasone dose before transfer to ICU (HR = 1.2 (95% CI: 1.06-1.37)), diabetes mellitus (HR = 1.4 (95% CI: 1.1-1.9)), alanine transaminase (ALT) ≥35.5 U/L on hospital admission (HR = 1.5 (95% CI: 1.1-2.1)), and the use of low-flow oxygen versus high-flow oxygen therapy or non-invasive mechanical ventilation on admission to ICU ((HR = 2.7 (95% CI: 5.6-11.1)) in patients transferred to ICU. A predictive model had sensitivity of 63-73% and specificity of 71-83% at different times of ICU stay.

CONCLUSIONS

Our findings may help clinicians detect patients at high risk of developing BSIs.

Dating Abuse and Harassment Among Sexual and Gender Minority U.S. College Students

Purpose: Sexual and relationship violence has devasting effects on the health and well-being of college students. This study assessed the prevalence of dating abuse victimization and harassment among sexual and gender minority (SGM) college students within the first 3 months of college enrollment and identified potential demographic differences in exposure. Methods: Data are from the 2020 to 2021 Sexual Assault Prevention for Undergraduates digital sexual assault prevention program (N = 250,359). Descriptive statistics were used to determine 3-month prevalence of dating abuse victimization and harassment among gender identity and sexual orientation subgroups and to examine within-group differences based on race and ethnicity. Results: Dating abuse victimization during college was reported by 6.5% of transgender women, 5.0% of transgender men, 5.0% of genderqueer/nonconforming students, 2.0% of "women," and 1.0% of "men." Harassment during college was reported by 13.7% of genderqueer/nonconforming students, 11.2% of transgender women, 8.9% of transgender men, 8.7% of "women," and 1.6% of "men." Students who identified with more than one sexual orientation identity reported the highest rates of dating abuse (3.9%) and harassment (14.9%) during college. SGM students with particular racial/ethnic identities (i.e., Indigenous, multiracial) reported disproportionately higher rates, particularly American Indian/Alaska Native/Native Hawaiian/Pacific Islander students who identified as transgender men (42.9%), transgender women (41.7%), genderqueer/nonconforming students (26.1%), queer/pansexual/questioning students (20%), and students with multiple sexual orientation identities (36.4%). Conclusion: Targeted intervention strategies and resources are needed on college campuses to support the needs and experiences of SGM students, including students who identify as Indigenous, multiracial, and other persons of color.

Intimate Partner Violence, Economic Insecurity, and Health Outcomes Among American Indian and Alaska Native Men and Women: Findings From a National Sample

Limited data are available on experiences of intimate partner violence (IPV) and sexual violence (SV) and health outcomes among American Indian and Alaska Native (AIAN) populations. This study explores the relationship between IPV and SV, food insecurity, housing insecurity, healthcare access, and self-reported physical and mental health status in a nationally representative sample of AIAN adults (N = 3,634). IPV and SV were associated with poorer physical and mental health at the bivariate level, but not in multivariate analyses. Economic inequalities are a salient predictor of health and may be compounded by demographic and geographic contexts.

Effects of Neighborhood Disconnection on Psychological Distress and Suicide Risk Associated with Interpersonal Violence Within Racial Groups

Negative mental health outcomes have been associated with adverse childhood experiences (ACEs) and intimate partner violence (IPV); however, few studies have identified risk and protective factors across levels of the social ecology that mitigate the onset of psychological distress and suicide risk associated with trauma. This study examines the relationship between ACEs, IPV, and mental health (i.e., psychological distress, suicidal ideation, and suicide attempts) within racial sub-populations of Black American, Latinx, and White adults. An online, cross-section survey was administered to a general population sample of adults in Baltimore and New York City. ACEs, IPV, and mental health outcomes were assessed within racial sub-populations of Black American (N = 390), Latinx (N = 178), and White (N = 339) adults, while accounting for within-group demographic differences. Moderating effects of social support and neighborhood disconnection on the relationship between ACEs, IPV, and mental health outcomes were also assessed. IPV was associated with psychological distress and suicidal ideation for Black and Latinx adults, but not for White adults. ACEs were associated with increased psychological distress for all three groups, and increased odds for suicidal ideation among Black and Latinx adults.. A significant negative interaction effect for neighborhood disconnection was found in the relationship between ACEs and psychological distress for Black adults. Findings highlight the significant mental health burdens of ACEs and IPV within racial and ethnic groups. Neighborhood disconnection may exacerbate psychological distress associated with ACEs among populations most impacted by interpersonal violence and mental health inequalities.

Association between Loneliness, Mental Health Symptoms, and Treatment Use among Emerging Adults

Loneliness research has focused primarily on older adult populations. There is limited research on how loneliness and social support impact young people's mental health and mental health services use. This article reports an assessment of whether loneliness and social support are associated with mental health services use and mental health symptoms (psychological distress and suicidal ideation) among emerging adults. A subsample of emerging adults ages 18 to 29 (N = 307) was drawn from the 2017 Survey of Police-Public Encounters, a cross-sectional, general population survey administered to residents of New York City and Baltimore. Ordinary least squares and binary logistic regression analyses were performed to model associations between loneliness and mental health symptoms and services use outcomes. Emerging adults with higher levels of loneliness reported higher levels of distress and suicidal ideation. Having more social support, experiencing higher levels of distress, and suicidal ideation were associated with increased odds for using services. First-generation American emerging adults and Black emerging adults were less likely to use services than their U.S.-born and non-Black counterparts. The significant impact of loneliness on mental health symptoms and the effect of social support on service use highlight the importance of developing interventions to prevent and reduce loneliness over the life course.

Associations of self-isolation, social support and coping strategies with depression and suicidal ideation in U.S. young adults during the COVID-19 pandemic

There have been concerns about the psychological impact of COVID-19-related stressors on young adults. However, there remains limited information regarding how psychosocial factors and coping strategies correlate with suicidal ideation in young adults during the pandemic. We studied a cross-sectional, observational online survey using a probability-based, nationally representative sample of U.S. young adults aged 18 to 29 (N = 1077). We performed weighted logistic regression to evaluate how self-isolation, social support and coping strategies (exposures) were associated with depression and suicidal ideation (outcomes), adjusting for age, gender, race, educational level and sexual orientation. The method of multiple imputations for addressing missing data was executed through chained equations. A total of 296 participants had depression, while 323 had suicidal ideation. Individuals who consistently self-isolated exhibited nearly threefold higher odds of depression compared to those without self-isolation. Social support was consistently protective against depression and suicidal ideation. Coping through positive reframing was protective against depression and suicidal ideation, whereas substance use, self-blame and behavioural disengagement had the opposite impact. Providing social support may help prevent suicidal ideation among young adults during the pandemic. Interventions that focus on developing young adults' coping strategies, such as through positive reframing, are recommended to develop positive and healthy relationships. Healthcare providers should advise against substance use, self-blame and behavioural disengagement.

Ethnoracial Variation in Risk for Psychotic Experiences

BACKGROUND & HYPOTHESIS

Psychotic disorders are inequitably distributed by race in the United States, although it is not known whether this is due to assessment biases or inequitable distributions of risk factors. Psychotic experiences are subclinical hallucinations and delusions used to study the etiology of psychosis, which are based on self-report and therefore not subject to potential clinician biases. In this study, we test whether the prevalence of psychotic experiences (PE) varies by race and if this variance is explained by socioenvironmental risk factors.

STUDY DESIGN

Data on demographics, PE, and socioenvironmental risk factors were collected through the National Survey of Poly-victimization and Mental Health, a national probability sample of US young adults. Logistic regression analyses were used to determine whether PE prevalence varied by race/ethnicity and, if so, whether this was attenuated with inclusion of indicators of income, education, urban/rural living, discrimination, and trauma exposure.

STUDY RESULTS

Black and Hispanic respondents reported PE at significantly greater rates than White or "other" ethnoracial groups, with hallucinations more commonly reported by Hispanic respondents. PE were significantly associated with police violence exposure, discrimination, adverse childhood experiences, and educational attainment. These factors statistically explained ethnoracial differences in the likelihood of overall PE occurrence and of nearly all PE subtypes.

CONCLUSIONS

Previously observed racial differences in psychosis extend beyond clinical schizophrenia, and therefore, are unlikely to be explained entirely by clinician biases. Instead, racial disparities in PE appear to be driven by features of structural racism, trauma, and discrimination.

Intimate Partner Violence Training and Readiness to Respond among Students, Staff, and Faculty in Three Institutions in the United States

Intimate partner violence (IPV) is a significant public health concern; however, limited studies have explored perceptions and experiences towards IPV among students, staff, administrators, and faculty across diverse disciplines at institutions of higher education. The purposes of this study were to (1) assess experiences of IPV among a sample of students, staff/administrators, and faculty and (2) examine the relationship among attitudes, actual and perceived knowledge, awareness, training, readiness, and personal experiences with IPV in this sample. Participants were recruited from an urban university and two university-affiliated medical institutions to participate in an online survey. Bivariate and multivariate associations were assessed. Structural Equation Modeling (SEM) was used to examine direct and indirect effects of perceived and actual knowledge and personal experiences with IPV. Of the 216 respondents, 42.6% reported personally experiencing IPV and 34.3% reported having witnessed IPV. Over 34% of participants never received training on IPV. The sub-sample with training received between one and more than 15 hours of training. Standardized total effect of training on attitudes and awareness was β = 0.42 (95% confidence interval [CI] = 0.30-0.51), the combined indirect effects was β = 0.18 (95% CI = 0.10-0.27) and the direct effects of β=0.23 (95% CI = 0.12-0.34), indicating that hours of training was highly associated with the participants' perceived knowledge and actual knowledge, which improved their attitudes and awareness towards IPV survivors. Our findings suggest the need for campus-wide formal training on IPV to better prepare members in higher education to accurately identify, assess, and intervene to protect victims of abuse. Interprofessional approaches are needed that focus on the multiple and intersecting needs of victims of violence and should also enhance professional self-efficacy and increase readiness to respond to IPV survivors.

Distinct profiles of violence victimization and suicide risk: Findings from a national survey of emerging adults

Victims of bullying, dating violence, and child maltreatment are all more likely than their peers to contemplate and attempt suicide in adolescence and young adulthood. However, knowledge of the relationship between violence and suicide risk is primarily limited to studies that isolate certain forms of victimization or examine several forms in additive risk models. We aim to move beyond the findings of basic descriptive studies by investigating whether multiple types of victimization elevate risk for suicide and whether latent profiles of victimization are more strongly related to suicide-related outcomes than are others. Primary data are from the first National Survey on Polyvictimization and Suicide Risk, a cross-sectional, nationally representative survey of emerging adults 18-29 in the United States (N = 1,077). A total of 50.2% of participants identified as cisgender female, followed by 47.4% cisgender male, and 2.3% transgender or nonbinary. Latent class analysis (LCA) was used to establish profiles. Suicide-related variables were regressed onto victimization profiles. A four-class solution was determined to be the best fitting model: Interpersonal Violence (IV; 22%), Interpersonal + Structural Violence (I + STV; 7%), Emotional Victimization (EV; 28%), and Low/No Victimization (LV; 43%). Participants in I + STV had increased odds for high suicide risk (odds ratio = 42.05, 95% CI [15.45, 114.42]) compared to those in LV, followed by IV (odds ratio = 8.52, 95% CI [3.47, 20.94]) and EV (odds ratio = 5.17, 95% CI [2.08, 12.87]). Participants in I + STV reported significantly higher odds for nonsuicidal self-injury and suicide attempts compared to most classes. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Racial and Gender Inequalities in Food, Housing, and Healthcare Insecurity Associated with Intimate Partner and Sexual Violence

The costs and consequences of intimate partner violence (IPV) and sexual violence (SV) are well-documented; however, little is known about how experiences of violence are connected to specific economic insecurities including food, healthcare, and housing insecurity among both men and women. This study investigates (1) the prevalence of food, healthcare, and housing insecurity across gender and racial groups exposed to IPV and SV and (2) associations between exposure to past-year IPV and SV and past-year food, healthcare, and housing insecurity controlling for confounding factors. A cross-sectional survey design was used in this study. Data from 2010 National Intimate Partner and Sexual Violence Survey (NISVS) were analyzed in a nationally representative sample of men (N = 8079) and women (N = 9970). Logistic regressions were used to model associations between past-year intimate partner and sexual violence and dependent variables of food, healthcare, and housing insecurity. Analyses were stratified by gender and included control variables of age, income, education, and race/ethnicity. Higher rates of food, housing, and healthcare insecurity were found among men and women of color exposed to violence, particularly among respondents who identified as Black/African American, Latinx, American Indian/Alaska Native, and other racial/ethnic minority groups. For men, IPV and SV was associated with higher odds for experiencing food (AOR = 2.40, p <.001), housing (AOR = 2.06, p <.001), and healthcare insecurity (AOR = 2.39, p <.001). For women, IPV and SV was also associated with higher odds for experiencing food (AOR = 2.16, p <.001), housing (AOR = 1.94, p <.001), and healthcare insecurity (AOR = 2.38, p <.001). Findings identify specific economic needs among survivors and suggest that the burdens of IPV and SV are not equitably shared across racial/ethnic populations. Findings can inform policy that aims to reduce inequalities in food, housing, and healthcare associated with IPV and SV.

Increases in Intimate Partner Violence During COVID-19: Prevalence and Correlates

Measures to contain the global COVID-19 pandemic led to stay-at-home orders across the world, accompanied by fears of a global surge in intimate partner violence (IPV). We administered an online general-population survey to 1169 women and transgender/nonbinary individuals throughout the state of Michigan in June-August 2020 to assess changes in the prevalence, severity, and correlates of IPV during the COVID-19 pandemic. Quota sampling was used to match the racial/ethnic and urban/rural distribution of the state. More than one in seven (15.1%) participants reported physical, sexual, psychological, or technology-facilitated IPV since COVID, similar to the prevalence in the 3 months before COVID (16.2%). However, there were indications that IPV severity increased and that novel cases of IPV are occurring in relationships that previously had no abuse. A majority (64.2%) of individuals who experienced IPV since COVID reported that the IPV was new to the relationship (34.1%) or of increased severity during COVID-19 (26.6%), representing 9.7% of the overall sample. New or increased IPV was significantly more prevalent among those who were essential workers, pregnant, unable to afford rent, unemployed/underemployed or had recent changes to their job, had partners with recent changes to employment, and those who had gotten tested or tested positive for COVID-19. Urban residence, trans/nonbinary identity, and having a toddler were more strongly associated with IPV during COVID as compared to before COVID. While findings do not support significant changes in the overall prevalence of IPV, the majority of survivors reported incident IPV in relationships that had not previously been abusive, or IPV that became more severe since the start of the pandemic. Cases of new or increased IPV were more concentrated in marginalized groups. Potential touchpoints for outreach and services during future lockdowns include prenatal and pediatric settings, daycares, employers of essential workers, and COVID-19 testing centers. Policies providing rental, childcare, and unemployment support may mitigate increases in IPV during COVID-19.

Perceptions of Partner Decarceration among Survivors of Intimate Partner Violence during the COVID-19 Pandemic

The COVID-19 pandemic prompted the early release of thousands of incarcerated individuals, including those with histories of intimate partner violence (IPV) perpetration. Survivor advocates stress the importance of adequate supports for decarcerated individuals during re-entry, and notification and supports for their partners or ex-partners if there is a history of IPV. This survey assessed IPV survivors' expectations of and experiences with decarceration in the state of Michigan. Findings highlight that out of 42 survivors with recently decarcerated (ex-)partners, 64.3% reported helpful behavior on the part of their released partner. By contrast, out of 72 survivors with still-incarcerated (ex-)partners, the same percentage - 64.3% - expected harmful behavior from their partner if released. Decarceration efforts may distinguish between individuals who are likely to harm versus help (ex-)partners upon release. Nonetheless, survivors reported several unmet needs, indicating the need for better re-integration services for decarcerated individuals and their families.

Polyvictimization Risk Among North Korean Refugee Women in South Korea

North Korean (NK) refugee women living in South Korea are known to be vulnerable to interpersonal violence, but little is known about the possible link between or co-occurrence of acts of sexual violence (SV) and intimate partner violence (IPV) perpetrated against NK refugee women. This study examined the prevalence of polyvictimization and explored the association between SV in different settings (i.e., North Korea, intermediate countries, and South Korea) and various types of IPV. A convenience sample of 140 adult NK refugee women was analyzed, and logistic regression analyses were conducted to examine the link between SV and polyvictimization in IPV. NK refugee women with a history of SV reported a significantly higher rate of IPV over the previous 12 months (51.2%) compared to those without a history of SV (20.4%). NK refugee women with a history of SV are significantly more likely to become victims of most forms of IPV. SV victimization in intermediate countries significantly increased the odds of being physically victimized by their male partners in South Korea (OR = 3.31, p =.05). An SV victimization history in North Korea (OR = 4.50, p =.04) and SV victimization experienced outside their intimate relationship in South Korea significantly increased the odds of sexual IPV from their current intimate partner (OR = 4.74, p =.03). This study showed that victims of human trafficking and sexual assault during their journey to South Korea were at a greater risk of IPV in South Korea. Male partners of NK refugee women with a history of SV may shame and physically sanction NK refugee women for "breaching honor." Therefore, screening for potential risk of physical and sexual IPV among NK refugee women with a prior exposure to SV is needed to develop programs in safety planning for NK refugee women experiencing SV and IPV.

Associations Between Interpersonal Violence, Psychological Distress, and Suicidal Ideation Among Formerly Incarcerated Men and Women

Survivors of interpersonal violence are at increased risk of negative mental health outcomes; however, scant research has explored the relationship between violence exposure and mental health symptoms among formerly incarcerated individuals. This cross-sectional survey study investigates the demographic characteristics and mental health symptoms (i.e., psychological distress and suicidal ideation) associated with interpersonal violence exposure, including physical and sexual intimate partner violence, non-partner sexual violence, and sexual violence perpetrated by prison employees in a sample of formerly incarcerated men and women, with the aim that the findings both deepen the understanding of the effects of sexual violence exposure and help inform prison and jail policies. Surveys were administered to English-speaking adults ages 18 and older to recruit a sample of adults who were formerly incarcerated (N = 201). Questions on the survey included questions regarding demographic details, sexual violence exposure, mental health symptoms, and time incarcerated. Findings show that higher levels of sexual violence exposure were significantly associated with higher levels of psychological distress and reporting of suicidal ideation. Results also suggest that higher levels of income and education and younger age were significantly associated with sexual violence perpetrated by prison employees. In addition, most forms of interpersonal violence were independently associated with psychological distress and suicidal ideation in this population. The findings make recommendations for prison and jail policies to include targeted treatment for individuals with sexual victimization histories, to mitigate the risk of revictimization and appropriately treat adverse mental health outcomes from sexual victimization within and outside the confines of incarceration.

Child Maltreatment, Youth Violence, Intimate Partner Violence, and Elder Mistreatment: A Review and Theoretical Analysis of Research on Violence Across the Life Course

This article reports the results of a scoping review of the literature on life-course patterns of violence that span the developmental periods of childhood, adolescence, and early and middle adulthood. We also assess the evidence on elder mistreatment and its relation to earlier forms of violence. Additionally, we draw on theories and empirical studies to help explain the transmission of violence over time and relational contexts and the factors that appear to mitigate risks and promote resilience in individuals exposed to violence. Results suggest that encounters with violence beginning in childhood elevate the risk for violence in subsequent developmental periods. The strongest connections are between child maltreatment (physical abuse, emotional abuse, sexual abuse, and neglect) and violence in adolescence and between violence in adolescence and violence in early and middle adulthood. Persistence of violence into older adulthood leading to elder mistreatment is less well-documented, but probable, based on available research. We conclude that more attention should be paid to studying developmental patterns and intersecting forms of violence that extend into old age. To eradicate violence in all its forms, considerably more must be done to increase awareness of the repetition of violence; to connect research to actionable steps for prevention and intervention across the life course; and to better integrate systems that serve vulnerable children, youth, and adults. Primary prevention is essential to breaking the cycle of violence within families and to alleviating the risks to children caused by poverty and other external factors such as social disconnection within communities.

Police Violence and Public Health

Despite their enormous potential impact on population health and health inequities, police violence and use of excessive force have only recently been addressed from a public health perspective. Moving to change this state of affairs, this article considers police violence in the USA within a social determinants and health disparities framework, highlighting recent literature linking this exposure to mental health symptoms, physical health conditions, and premature mortality. The review demonstrates that police violence is common in the USA; is disproportionately directed toward Black, Latinx, and other marginalized communities; and exerts a significant and adverse effect on a broad range of health outcomes. The state-sponsored nature of police violence, its embedding within a historical and contemporary context of structural racism, and the unique circumstances of the exposure itself make it an especially salient and impactful form of violence exposure, both overlapping with and distinct from other forms of violence. We conclude by noting potential solutions that clinicaly psychology and allied fields may offer to alleviate the impact of police violence, while simultaneously recognizing that a true solution to this issue requires a drastic reformation or replacement of the criminal justice system, as well as addressing the broader context of structural and systemic racism in the USA. Expected final online publication date for the Annual Review of Clinical Psychology, Volume 18 is May 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Moderating Effects of Perceived Neighborhood Factors on Intimate Partner Violence, Psychological Distress, and Suicide Risk

Neighborhood factors such as instability and weakened social ties have been linked to both intimate partner violence (IPV) and poor mental health outcomes; however, research has not yet investigated the relationship between IPV and gentrification-specific change, including whether gentrification-related neighborhood factors affect mental health symptoms commonly associated with IPV. This study aims to determine if (a) perceptions of neighborhood connectedness and recent compositional changes (e.g., residential mobility, crime, and infrastructure) are associated with IPV exposure and (b) perceived neighborhood connectedness and compositional change moderates the relationship between IPV and mental health symptoms (i.e., psychological distress, suicidal ideation, suicide attempts). Data from the 2017 Survey of Police-Public Encounters were used, which is an online, cross-sectional, general population survey administered to male and female adults residing in New York City and Baltimore (N = 1,000). Findings suggest that higher levels of neighborhood disconnectedness were associated with higher levels of IPV, whereas higher levels of neighborhood compositional change were associated with lower levels of IPV. Neighborhood disconnectedness and compositional change worsened psychological distress symptoms and suicide risk most strongly among individuals exposed to IPV. Violence prevention and intervention approaches should consider the extent to which neighborhood instability, related to community connectedness and recent compositional change, impacts the safety and mental health of victims of IPV.

Associations between prospective and retrospective measures of child abuse and self-reported adult health at midlife

BACKGROUND

The long-term health effects of physical child abuse are well documented in self-report, retrospective studies. However, there have been few longitudinal, multimethod studies on physiological responses to stress and the onset of chronic disease, thereby slowing the advancement of prevention and intervention programs.

OBJECTIVES

This study used survey data from an extended longitudinal study to examine prospective and retrospective associations between measures of physical child abuse and adult health in the 40s.

PARTICIPANTS AND SETTING

Data are from an ongoing longitudinal study of the correlates and consequences of child maltreatment that began in the 1970s with a sample of 457 children.

METHODS

Bivariate correlations and multiple regression models with covariates were used to assess associations between measures of physical child abuse and outcomes of self-reported health in adulthood.

RESULTS

Physical child abuse, measured retrospectively, was moderately related to reports of overall health, as well as a number of adult health problems and conditions, such as back and chest pain, hypertension, and certain forms of cancer. Associations were also observed for lifetime alcohol problems and past-year doctor and emergency room visits. Fewer associations between prospective parent self-report measures of physical child abuse and adult health were identified, although child welfare (official record) reports performed similarly to retrospective measures.

CONCLUSIONS

This study adds important information on the long-term health effects of child physical abuse, as well as measurement differences in the prediction of adult health outcomes. Conclusions drawn from prospective and retrospective studies of abuse are at best inconsistent, and possibly incompatible.

A Prospective Study on Child Abuse and Elder Mistreatment: Assessing Direct Effects and Associations With Depression and Substance Use Problems During Adolescence and Middle Adulthood

BACKGROUND AND OBJECTIVES

We examined the prospective association between 2 measures of child abuse, one based on official child welfare records and the other based on parent self-reports, and the perpetration of elder mistreatment by an adult child. We also examined measures of adolescent and adult depression and substance use problems as predictors of elder mistreatment.

RESEARCH DESIGN AND METHODS

Data are from a prospective study that began in the 1970s with a sample of children aged 18 months to 6 years of age. Analyses draw on data collected when child participants were in preschool and elementary school, when they were adolescents, and as adults at midlife (at ages 36 and 46, on average). Results are from bivariate correlations and multivariable path models in which variables from different life stages were entered in steps to assess their prediction of elder mistreatment.

RESULTS

All variables were significantly correlated with elder mistreatment. In a final path model, parent self-reports of physical child abuse remained a significant, unique predictor of elder mistreatment. Adolescent and adult substance use problems were also statistically significant.

DISCUSSION AND IMPLICATIONS

Few longitudinal studies have tracked patterns of abuse over time and relationships. Findings suggest that child abuse is a risk factor for the perpetration of elder mistreatment by an adult child. Substance use problems may also increase the risk for the perpetration of elder mistreatment. Further longitudinal research is needed to replicate and extend these findings in order to advance prevention and intervention programs and policies.

College student perceptions of institutional responses to sexual assault reporting and general help-seeking intentions

College students are a high-risk population for sexual assault exposure. This study examines 1) sociodemographic differences in student perceptions of institutions of higher education (IHEs) responses to sexual assault reporting and 2) the relationship between student perceptions, knowledge of campus sexual assault (CSA) services, and general help-seeking intentions. Participants: A sample of 1,648 college students completing an online survey during the 2016-2017 academic year. Methods: A secondary analysis of data from the Healthy Minds Study. Results: Transgender/nonconforming, sexual minority, and domestic students held more negative perceptions of IHEs. Positive perceptions were significantly associated with increased odds for both formal (odds ratio [OR] = 1.09, p < .05) and informal help-seeking intentions (OR = 1.05, p < .05). Knowledge of CSA services did not significantly moderate the relationship between perceptions of IHEs' responses and help-seeking intentions. Conclusions: Student perceptions of their IHEs vary based on aspects of identity and may contribute to general help-seeking.

Moderating Effects of Resilience on Depression, Psychological Distress, and Suicidal Ideation Associated With Interpersonal Violence

Resilience has been found to attenuate the effects of negative mental health symptomology associated with interpersonal victimization; however, existing research has largely focused on resilience traits, such as individual cognitive and environmental factors that promote resilience. In addition, empirical knowledge on the extent to which resilience mitigates suicidal symptomology associated with interpersonal violence victimization is particularly limited. This study assesses whether the relationship between interpersonal violence (i.e., IPV and nonpartner sexual violence) and mental health symptomology (i.e., depression, psychological distress, and suicidal ideation) is moderated by resilience using a general population sample of women (N = 932). A cross-sectional, observational survey was administered in four U.S. cities (Baltimore, New York City, Philadelphia, and Washington, D.C.). Bivariate results indicated that women exposed to interpersonal violence reported significantly higher rates of suicidal ideation, depression, and psychological distress compared with women without exposure to interpersonal violence. Regression models revealed significant positive associations between interpersonal violence and depression, distress, and suicidal ideation, adjusting for sociodemographics. Resilience did not significantly moderate the relationship between interpersonal violence victimization and any associated mental health outcomes. However, subgroup analyses reveal significant interaction effects between resilience and IPV within specific racial and ethnic minority subgroups, suggesting that attenuating effects of resilience on mental health symptoms (i.e., depression and psychological distress) associated with IPV likely vary across race and ethnicity. Implications for future research and clinical interventions focused on resilience among survivors of interpersonal violence are discussed.

Impact of Police Violence on Mental Health: A Theoretical Framework

Police violence has increasingly been recognized as a public health concern in the United States, and accumulating evidence has shown police violence exposure to be linked to a broad range of health and mental health outcomes. These associations appear to extend beyond the typical associations between violence and mental health, and to be independent of the effects of co-occurring forms of trauma and violence exposure. However, there is no existing theoretical framework within which we may understand the unique contributions of police violence to mental health and illness.This article aims to identify potential factors that may distinguish police violence from other forms of violence and trauma exposure, and to explore the possibility that this unique combination of factors distinguishes police violence from related risk exposures. We identify 8 factors that may alter this relationship, including those that increase the likelihood of overall exposure, increase the psychological impact of police violence, and impede the possibility of coping or recovery from such exposures.On the basis of these factors, we propose a theoretical framework for the further study of police violence from a public mental health perspective.

Prevalence and sociodemographic factors associated with stalking victimization among college students

Objective: This study's purpose was to examine the prevalence and sociodemographic factors associated with stalking victimization among a diverse sample of college students. Participants: Data were collected through a cross-sectional survey administered in November 2015 to students 18 and older on 8 academic universities in a Southwestern university system (N = 26,417). Methods: Descriptive statistics were used to assess the prevalence of stalking experiences across student populations. Multivariate logistic regression was used to examine associations between sociodemographic factors and stalking victimization. Results: A total of 17.4% of students reported stalking victimization since entering college. Cisgender females, transgender/gender-nonconforming, and sexual minority students had higher odds of stalking victimization than their counterparts, whereas Latino/a students had lower odds of stalking victimization compared to White nonHispanic students. Conclusions: A notable proportion of college students have experienced stalking. Disparities found among student populations are concerning and warrant further investigation.

Neighborhood change and psychotic experiences in a general population sample

Social stress caused by the neighborhood environment may be a risk factor for psychotic experiences (PEs). However, little information is available on the effect of the perception of the neighborhood in relation to PEs. In a general population study in the United States (N = 974), we examined the relationship between PEs and neighborhood disruption/gentrification. When adjusted for age, sex, race, income, nativity, city, marital status, and common mental disorders, higher disruption scores were significantly associated with higher odds for any PE (odds ratio = 1.09, 95% CI = 1.05-1.12). The same pattern of associations was observed for individual PEs including delusional mood, delusion of reference and persecution, delusion of control, and hallucination. This study suggests that subjectively perceived neighborhood change may be a factor contributing to the occurrence of PEs. There was no significant relationship between PE and gentrification. Having a low income and racial minority status did not modify this association. Future studies can employ comparative longitudinal analyses of individuals/neighborhoods/cities, geographical information systems, and ethnography, to examine the impact of neighborhood change on mental health.

Risk Factors for Domestic Child Sex Trafficking in the United States

Despite increased effort to respond to human trafficking at national and state levels, very little empirical research has been conducted on domestic child sex trafficking. This study retrospectively examines associations between multiple risk factors and domestic child sex trafficking (i.e., entry into the commercial sex industry under the age of 18) in a sample of individuals aged 16 and older currently involved in the commercial sex industry ( N = 273). Two primary research questions are addressed: (1) What set of risk factors, prior to entering the commercial sex industry, are associated with domestic child sex trafficking and (2) what group differences, if any, exist in risk factors between current or former domestic child sex-trafficking victims and non-trafficked adults engaged in the commercial sex industry? A cross-sectional survey was administered using Respondent-Driven Sampling (RDS) in five cities in one Midwestern state. Overall, 115 participants (48.3%) were identified as current or former domestic child sex-trafficking victims. Bivariate results suggest that childhood emotional and sexual abuse, rape, ever running away from home, having family members in sex work, and having friends who purchased sex were significantly associated with domestic child sex trafficking. Multivariate results indicate that domestic child sex trafficking victims were significantly more likely to have ever run away and to be a racial/ethnic minority than non-trafficked adults engaged in the commercial sex industry. Findings can inform state-level policies on human trafficking and assist child protection and juvenile justice agencies in developing prevention and intervention responses to commercial sexual exploitation.

An Ecological Analysis of Risk Factors for Runaway Behavior among Individuals Exposed to Commercial Sexual Exploitation

Running away from home is a known risk factor for commercial sexual exploitation among youth; however, research has not fully investigated the process by which multiple factors at individual, familial, and extra-familial levels increase youths' risk for runaway behavior. This study applies an ecological risk factor framework to assess risk for runaway behavior among individuals exposed to commercial sexual exploitation and examines mediating relationships between salient risk factors (i.e. substance abuse, insufficient basic needs, having a much older boyfriend/girlfriend) and runaway behavior. A cross-sectional, retrospective survey was administered to individuals involved in the commercial sex industry using Respondent Driven Sampling methods (N = 273). Bivariate results suggested associations between runaway behavior and childhood emotional and physical abuse, having friends who sold sex, having a much older boyfriend/girlfriend, dropping out of school, being worried about where to eat/sleep, homelessness, and frequent alcohol and drug use prior to entering the commercial sex industry. Hierarchical logistic regression revealed that individuals with runaway behavior histories were more likely to have frequently used alcohol and/or drugs and to have insufficient basic needs compared to those did not run away; however, these factors were no longer significant after accounting for having a much older boyfriend/girlfriend. Having an older boyfriend/girlfriend fully mediated the relationship between frequent alcohol and/or drug use and runaway behavior. Findings support the need for community and school-based prevention programs that target these risk factors with a specific focus on healthy dating relationships, which may reduce risk for runaway behavior and subsequent commercial sexual exploitation.

Psychological Well-Being, Risk, and Resilience of Youth in Out-Of-Home Care and Former Foster Youth

This study assesses psychological well-being, risk, and resilience of youth currently in-care and former foster youth and how preparation for independent living affects these factors. Findings suggest significant psychosocial distress for former foster youth. Youth currently in-care fared better but demonstrated high scores on measures suggesting risk and potential for future mental health challenges. For former foster youth, independent living preparation positively impacted well-being. The more preparation for independence a youth received, the lower the psychological challenges. Findings suggest the need for mental health support for transitioning youth as well as preparation for independent living as a way to improve the well-being of former foster youth.

Association of Exposure to Police Violence With Prevalence of Mental Health Symptoms Among Urban Residents in the United States

IMPORTANCE

Police violence is reportedly widespread in the United States and may pose a significant risk to public mental health.

OBJECTIVE

To examine the association between 12-month exposure to police violence and concurrent mental health symptoms independent of trauma history, crime involvement, and other forms of interpersonal violence exposure.

DESIGN, SETTING, AND PARTICIPANTS

This cross-sectional, general population survey study of 1221 eligible adults was conducted in Baltimore, Maryland, and New York City, New York, from October through December 2017. Participants were identified through Qualtrics panels, an internet-based survey administration service using quota sampling.

EXPOSURES

Past 12-month exposure to police violence, assessed using the Police Practices Inventory. Subtypes of violence exposure were coded according to the World Health Organization domains of violence (ie, physical, sexual, psychological, and neglectful).

MAIN OUTCOMES AND MEASURES

Current Kessler Screening Scale for Psychological Distress (K6) score, past 12-month psychotic experiences (World Health Organization Composite International Diagnostic Interview), and past 12-month suicidal ideation and attempts.

RESULTS

Of 1221 eligible participants, there were 1000 respondents (81.9% participation rate). The sample matched the adult population of included cities on race/ethnicity (non-Hispanic white, 339 [33.9%]; non-Hispanic black/African American, 390 [39.0%]; Hispanic/Latino, 178 [17.8%]; other, 93 [9.3%]), age (mean [SD], 39.8 [15.2] years), and gender (women, 600 [60.0%]; men, 394 [39.4%]; transgender, 6 [0.6%]) within 10% above or beyond 2010 census distributions. Twelve-month prevalence of police violence was 3.2% for sexual violence, 7.5% for physical violence without a weapon, 4.6% for physical violence with a weapon, 13.2% for psychological violence, and 14.9% for neglect. Police violence exposures were higher among men, people of color, and those identified as homosexual or transgender. Respondents reported suicidal ideation (9.1%), suicide attempts (3.1%), and psychotic experiences (20.6%). The mean (SD) K6 score was 5.8 (6.1). All mental health outcomes were associated with police violence exposure in adjusted logistic regression analyses. Physical violence with a weapon and sexual violence were associated with greater odds of psychotic experiences (odds ratio [95% CI]: 4.34 [2.05-9.18] for physical violence with a weapon; 6.61 [2.52-17.36] for sexual violence), suicide attempts (odds ratio [95% CI]: 7.30 [2.94-18.14] for physical violence with a weapon; 6.63 [2.64-16.64] for sexual violence), and suicidal ideation (odds ratio [95% CI]: 2.72 [1.30-5.68] for physical violence with a weapon; 3.76 [1.72-8.20] for sexual violence).

CONCLUSIONS AND RELEVANCE

Police violence was commonly reported, especially among racial/ethnic and sexual minorities. Associations between violence and mental health outcomes did not appear to be explained by confounding factors and appeared to be especially pronounced for assaultive forms of violence.

Campus Sexual Assault: A Systematic Review of Prevalence Research From 2000 to 2015

Sexual assault is a pervasive problem on university and college campuses in the United States that has garnered growing national attention, particularly in the past year. This is the first study to systematically review and synthesize prevalence findings from studies on campus sexual assault (CSA) published since 2000 ( n = 34). The range of prevalence findings for specific forms of sexual victimization on college campuses (i.e., forcible rape, unwanted sexual contact, incapacitated rape, sexual coercion, and studies' broad definitions of CSA/rape) is provided, and methodological strengths and limitations in the empirical body of research on CSA are discussed. Prevalence findings, research design, methodology, sampling techniques, and measures, including the forms of sexual victimization measured, are presented and evaluated across studies. Findings suggest that unwanted sexual contact appears to be most prevalent on college campuses, including sexual coercion, followed by incapacitated rape, and completed or attempted forcible rape. Additionally, several studies measured broad constructs of sexual assault that typically include combined forms of college-based sexual victimization (i.e., forcible completed or attempted rape, unwanted sexual contact, and/or sexual coercion). Extensive variability exists within findings for each type of sexual victimization measured, including those that broadly measure sexual assault, which is largely explained by differences in sampling strategies and overall study designs as well as measures of sexual assault used in studies. Implications for findings and recommendations for future research on the prevalence of college-based sexual victimization are provided.

Teen Dating Violence Victimization, Perpetration, and Sexual Health Correlates Among Urban, Low-Income, Ethnic, and Racial Minority Youth

This study explores the associations between teen dating violence (TDV) perpetration, victimization, sexual risk behaviors, and pregnancy among a sample of low-income, urban, and predominately African–American and Latino youth age 15 to 21 years ( N = 513). Findings suggest that youth who experienced TDV victimization were more likely to report inconsistent condom use in the past 12 months ( OR = 1.6) and pregnancy ( OR = 2.2) compared with nonvictimized youth. Youth who reported perpetrating dating violence were more likely to be female ( OR = 3.8) and to report multiple sex partners ( OR = 2.0), inconsistent condom use ( OR = 2.6), and prostitution in the past 12 months ( OR = 6.7). TDV perpetration and victimization were highly associated (χ2 = 127.00, p < .001); that is, 30% of the sample reported both victimization and perpetration in their previous or current romantic relationships. Findings from this study highlight the need to integrate culturally informed TDV prevention and intervention strategies into existing adolescent sexual and reproductive health education programs.

Use and misuse of research in books on sex trafficking: implications for interdisciplinary researchers, practitioners, and advocates

Recent articles have raised important questions about the validity of prevalence data on human trafficking, exposing flawed methodologies behind frequently cited statistics. While considerable evidence points to the fact that human trafficking does exist in the United States and abroad, many sources of literature continue to cite flawed data and some misuse research in ways that seemingly inflate the problem, which can have serious implications for anti-trafficking efforts, including victim services and anti-trafficking legislation and policy. This systematic review reports on the prevalence data used in 42 recently published books on sex trafficking to determine the extent to which published books rely on data estimates and just how they use or misuse existing data. The findings from this review reveal that the vast majority of published books do rely on existing data that were not rigorously produced and therefore may be misleading or at minimum, inaccurate. Implications for practice, research, and policy are discussed, as well as recommendations for future prevalence studies on human trafficking.

[Influence of auxiliary materials on the proportion of effective particle size of metered-dose suspension type aerosols]

The aim of the present study was to formulate suspension type inhalation aerosols by various types of auxiliary materials, and to select the formulation with the highest proportion of the effective particle size. The examined suspension type aerosol contained sodium cromoglycate as an active compound. For the stabilization of the suspension, the applied surface active ingredients were oleic acid and oleyl oleate, and dimethyl siloxane polymer was selected as hydrophobizing agent. Factorial design was used for the optimization of the experimental results. On the basis of our results, the correct types and amounts of auxiliary materials can be selected to obtain the therapeutically effective formulation.

[Usage modeling test in aerosols formulations]

Authors emphasize the importance of "usage-modelling" test concerning the uniformity of doses in the case of aerosol formulations, containing propellants or supplied with atomising devices. Weight measurement was carried out to identify the uniformity of doses per actuation keeping non-use periods in the case of water-based solutions with different density and suspension containing HFC propellants. It can be concluded that uniformity of doses--applying non-use periods during the testing time--significantly depends on the composition, the density of the formulation and the spraying mechanism of the atomising device.

Differential sympathetic reactions during cerebral ischaemia in cats: the role of desynchronized nerve discharge

1. Sympathetic nerve discharge (SND) of three postganglionic nerves with different functions and anatomical locations was simultaneously recorded at rest and during severe cerebral ischaemia (Cushing reaction). The three nerves, controlling the heart (inferior cardiac nerve), visceral (renal nerve) and skeletal muscle circulation (vertebral nerve), were selected with the assumption that their activity pattern will represent the differential central autonomic command to the major players of the circulatory response to cerebral ischaemia. 2. Changes in the power density spectra of the nerve signals, and in the pairwise coherence functions, elicited by the cerebral ischaemia, were evaluated separately for the rhythmic (R-SND, i.e. between 0 and 6 Hz) and high-frequency (HF-SND, i.e. between 12 and 100 Hz) components of the nerve signals. 3. The sympathetic nerve response to cerebral ischaemia developed in two phases. Phase 1 was a massive R-SND reaction and phase 2 was characterized by SND desynchronization and by the emergence of HF-SND. The power of HF-SND occupied a wide band between 12 and 80 Hz with maximum between 20 and 30 Hz. All three nerves were involved in the Cushing response but the magnitude and character of the reactions were specific for each nerve. In the cardiac nerve, the power of the rhythmic component of the discharge increased almost twice the control and remained dominant during the whole reaction, strongly modulating HF-SND during the second phase. In the vasomotor nerves, R-SND was suppressed during phase 2 and HF-SND occupied 65% of the total power of the signal. Near equal R- to HF-SND proportions, however, were reached on different activity levels in renal and vertebral nerves. Whereas total renal SND did not change, the power of the vertebral SND increased more than twice. In addition, desynchronization in the vertebral SND was preceded by a massive R-SND reaction during phase 1, which was missing in the renal nerve. 4. For all possible nerve pairs, R-SND was highly coherent before the reaction and remained so during intracranial pressure elevation, regardless of the direction and magnitude of the changes in absolute and/or relative power of this component in different nerves. On the other hand, HF-SND never correlated between any of the nerve pairs indicating that this component in each nerve originated from specific sources of regional sympathetic activity.(ABSTRACT TRUNCATED AT 400 WORDS)

Effect of preexisting brain ischemia on sympathetic nerve response to intracranial hypertension

The performance of the sympathetic nervous system during sustained moderate cerebral ischemia (CI) was examined in the present study. For this purpose, a Cushing response was elicited repeatedly during incomplete global CI in anesthetized artificially ventilated cats after vagotomy and baroreceptor denervation. In control animals without CI, sympathetic activity in response to brief elevation of intracranial pressure (ICP) showed a well-repeatable two-phase reaction. During CI there was a progressive deterioration of background sympathetic nerve discharge (SND) over a period of 30 min. SND response to repeated elevation of ICP was initially similar to control response but later with progression of CI was seriously changed. 1) Instead of the usual hyperactivation, sympathetic nerve activity was depressed during intracranial hypertension. 2) The characteristic desynchronized activity either appeared later during the reperfusion period or remained absent. The progressive loss of SND response to raised ICP in developed CI was compared with the changes seen in experiments in which repeated ICP elevations were superimposed on asphyxia. These findings suggest that the sympathetic component of the Cushing reaction strongly depends on the actual state of brain stem autonomic circuits and may be seriously altered in pathological situations involving ischemic brain injury.

Comparison of methods eliciting cerebral ischaemic pressor response in the cat

Three methods of intercepting the blood supply to the brain were tested by means of X-ray angiography and by monitoring the pressor response following cerebral ischaemia. The methods were: (1) occlusion of carotid and basilar artery; (2) occlusion of carotids and vertebral arteries in the cervical canal of the third vertebra; (3) occlusion of carotid and subclavian arteries. The X-ray angiographs showed that in most cases we could close the accessory sources of the cerebral circulation and drastically reduce the blood supply to the brain of the cat. With all three methods the cerebral ischaemia evoked strong blood pressor elevation, which was weaker however when the carotid and basilar artery were clamped, in comparison with the other two methods. This may be explained by the existence of small arteries supplying the lower brain stem and originating intracranially from the vertebral artery near to the junction of the vertebral and anterior spinal artery.

Transplantation of cultured embryonic spinal cord grafts into the hemisected spinal cord of adult rabbits

Spinal cord fragments from 20-day-old rabbit embryos cultivated for 1 week were transplanted into the hemisected and intact spinal cord of adult rabbits. The morphological changes at the site of intervention were investigated by light and electron microscopy 3, 12, and 29 weeks following implantation. In 80% of the animals the procedure was successful. The implants grew in volume, the cells matured, and many new neural processes with myelinization and synapse formation appeared. The histological findings indicate the survival, maturation, and integration of transplanted cultured embryonic spinal cord tissue in the lesioned adult spinal cord.

Two-phase change of sympathetic rhythms in brain ischemia, Cushing reaction, and asphyxia

The present study was designed to determine the extent to which the brain stem neural networks, normally capable of synchronizing the sympathetic nerve discharge (SND) into 2- to 6- and 10-Hz rhythmic fluctuations, contribute to the control of autonomic reactions during brain hypoxia and/or hypercapnia. Vertebral, cardiac, and renal nerve discharges were recorded electrophysiologically in 34 anesthetized, curarized, and artificially ventilated cats. The sympathetic nerve responses to cerebral ischemia (elicited by reducing the blood supply to the brain), intracranial pressure elevation (Cushing reaction), and systemic asphyxia were tested with special focus on the rhythmic structure of the SND. It has been found that there are two phases of SND changes during cerebral ischemia differing mainly in the frequency content of the signals and less in the compound action potential amplitude. During the first phase the rhythmic generators controlling the tonic sympathetic outflow are more strongly activated, which is reflected in a stronger, more regular, and more widespread manifestation of these rhythms on the efferent neurograms. After some time the normal SND structure abruptly changes to a desynchronized activity with loss of the three main sympathetic rhythms and responsiveness to baroreceptor reflex activation. The same stereotyped changes can be observed regardless of the way in which the brain hypoxia and/or hypercapnia has been produced. Nor does the denervation of peripheral baro- and chemoreceptors substantially alter the general pattern of the responses.