Work-Setting Factors and Reasons for Drinking in Japanese Male Workers: A Questionnaire Survey

We conducted a questionnaire survey at a major company in 1989 to explore the relationship between male employees' work-setting features and reasons for drinking. A factor analysis of 20 work-setting items resulted in four main work-setting factors: quality of work, relationships with superiors, work quantity/environment and relationship with colleagues. A multiple regression analysis was carried out to test the relationships between these four work-setting factors and reasons for drinking. The respondents who drank socially in business situations were more satisfied with their relationships with their superiors and colleagues, but this drinking behaviour did not significantly correlate with the quality of work and work quantity/environment factors. Social drinking in business situations appears to promote a friendly relationship with colleagues and superiors in Japanese companies. Those who drank to reduce frustration were less satisfied with all the four work-setting factors. It appears that drinking is more likely to occur to reduce the strain associated with work overload. © 1997 John Wiley & Sons, Ltd.     

Relationships Among Trauma Exposure,Chronic Posttraumatic Stress Disorder Symptoms,and Self-Reported Health in Women: Replication and Extension

Fifty-two women who served during the Vietnam era were assessed for war-zone exposure, traumatic life events, posttraumatic stress disorder (PTSD), and self-reported health status. Symptoms of PTSD were examined as mediators in the relationship between traumatic exposure and subsequent reports of health problems. Results showed that PTSD symptoms accounted significantly for variance in health problems reported by women with prior traumatic stressor exposure. When the cardinal symptom domains of PTSD (reexperiencing, numbing, avoidance, hyperarousal) were analyzed separately, the symptom cluster representing hyperarousal accounted uniquely for the variance associated with health complaints, beyond that contributed by other symptom clusters. Discussion of the results focuses on mechanisms underlying the relationship between specific symptoms of PTSD and self-reported health. Implications for intervention within the medical system are also considered.     

Intoxication, criminal offences and suicide attempts in a group of South African problem drinkers.

BACKGROUND: Incidence rates of crime and alcohol abuse in South Africa are unacceptably high. Research suggests a relationship between alcohol and both crime and suicide. This study aims to add to the information base on this topic in South Africa. METHODS: This is a cross-sectional record study of criminal offences and suicide attempts in 269 admissions to an alcohol rehabilitation unit in the Western Cape. Types of criminal offences and suicide attempts are described. Relationships are sought between crime, violent crime and suicide attempts on the one hand, and demographic and alcohol-related variables on the other. RESULTS: One hundred and four subjects (39%) had criminal convictions, the majority of which were committed while the subjects were intoxicated. The commonest alcohol-related crimes were driving-related (17% of subjects) and crimes of violence (15%). Male gender, younger age at initiation of drinking, and earlier onset of problem drinking were significantly associated with criminal behaviour. Violent crime was associated with earlier onset of initial, regular and problem drinking, and maternal alcohol abuse. Suicide attempts (24% of subjects) were associated with female gender, white racial group, not being in a marital relationship, younger current age and early age of problem drinking. CONCLUSIONS: There was an association between intoxication and both violent crime and suicide attempts. The importance of population studies and the need for intervention programmes aimed at teenagers who are drinking, are emphasised.     

Examining a Dual‐Process Model of Desensitization and Hypersensitization to Community Violence in African American Male Adolescents

The purpose of the current study was to examine a dual‐process model of reactivity to community violence exposure in African American male adolescents from urban communities. The model focused on desensitization and hypersensitization effects as well as desensitization and hypersensitization as predictors of aggressive behavior. Participants were 133 African American male high school students, mean age = 15.17 years, SD = 0.96. Participants completed measures of exposure to community violence, depressive symptoms, hyperarousal symptoms, aggressive beliefs, and aggressive behaviors at two time points. Community violence exposure predicted changes in aggression, β = .25, p = .004, and physiological arousal, β = .22, p = .010, over time, but not aggressive beliefs. The curvilinear association between community violence exposure and changes in depression over time was not significant, β = .42, p = .083, but there was a significant linear association between the exposure to community violence (ECV) and changes in levels of depression over time, β = .21, p = .014. Results indicated a significant mediation effect for hyperarousal on the association between community violence exposure and aggressive behavior, B = 0.20, 95% CI = [0.04, 0.54]. Results showed support for physiological hypersensitization, with hypersensitization increasing the risk for aggressive behavior.     

Predictors of Emotional Numbing in Posttraumatic Stress Disorder

Little is known about the mechanisms underlying emotional numbing (EN). The functional relationship between other classes of posttraumatic stress disorder (PTSD) symptoms and EN is also not well understood. In the present study, we examined the statistical predictors of EN. We hypothesized that the severity of EN would be most strongly associated with the hyperarousal symptoms rather than the avoidance symptoms of PTSD, or comorbid depression or substance abuse. This prediction was derived from psychological and biological models that posit EN to be a product of the depletion of emotional resources subsequent to chronic hyperarousal. Using hierarchical multiple regression in two separate samples of Vietnam combat veterans, we found hyperarousal symptoms to be the most robust predictor of EN. These data suggest that there is a substantive relationship between hyperarousal symptoms and EN in PTSD.     

Childhood abuse and intake severity in alcohol disorder patients

In a sample of 336 patients with an alcohol use disorder, this study examined, whether patients with histories of childhood sexual abuse (CSA) and childhood physical abuse (CPA) compared to those without such histories have a greater severity of alcohol and other clinical difficulties. Whether lifetime posttraumatic stress disorder (PTSD) mediates the relationship between childhood abuse and clinical outcomes was explored. Results were that CSA was associated with earlier age of onset for alcohol disorder, greater Axis I comorbidity as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; American Psychiatric Association, 1994), more social and psychiatric problems, but lower drinking frequency. Childhood physical abuse was related to greater drinking consequences, social and psychiatric dysfunction, and Axis I comorbidity, but also lower drinking frequency. Posttraumatic stress disorder partially mediated the effect of both CSA and CPA on severity of psychiatric problems.     

PTSD Severity and Health Perceptions in Female Victims of Sexual Assault

In women with chronic posttraumatic stress disorder (PTSD), poor physical health may be related to their PTSD symptoms through an underlying negative affect or distress that accompanies the disorder, through the PTSD symptoms in general, or specifically through the chronic hyperarousal present in the disorder. The current study examined the relative contribution of these factors to reported physical symptoms in female victims of sexual assault. Seventy-six women with chronic PTSD were assessed, using measures of stressful life events, psychological difficulties, and perceived health. Negative life events, anger, depression, and PTSD severity were all related to self-reported physical symptoms; however, PTSD severity predicted self-reported physical symptoms beyond these other variables. Contrary to our hypothesis, the reexperiencing cluster of PTSD, and not the hyperarousal cluster, was related to self-reported physical symptoms.     

PTSD as a mediator of sexual revictimization: the role of reexperiencing, avoidance, and arousal symptoms

Theory and research suggest that posttraumatic stress disorder (PTSD) may mediate the relationship between child sexual abuse and adult sexual assault. However, little empirical research has examined the mediational role of PTSD. In the present study, the authors use structural equation modeling to examine the degree to which the three symptom clusters that define PTSD (reexperiencing, avoidance, and hyperarousal) contribute to sexual revictimization. To assess PTSD symptomatology, undergraduate women completed questionnaires (N = 1,449), which detailed the history and severity of childhood and adult sexual assault experiences. Results indicated that PTSD mediated sexual revictimization. When PTSD symptom clusters were examined individually, only the hyperarousal cluster was a significant mediator. Results are discussed in terms of information-processing mechanisms that may underlie sexual revictimization.     

The Relationship Between Violence Dimensions and Symptom Severity Among Homeless, Mentally Ill Women

Little is known about the relationship between violence and symptomatology in the lives of homeless, mentally ill women. This study investigates the possibility that specific dimensions of violence—frequency, recentness and type—may be associated with severity of psychiatric symptomatology in this population. Results indicate that each of the abuse dimensions is associated with a broad range of psychiatric symptoms and, in combination with substance abuse, account for almost one third of the variance in overall distress. These findings suggest the possibility that intensity of exposure to violence contributes to the severity of psychiatric symptoms even in women who already suffer an overwhelming number of intrapsychic and social difficulties; and that multiply traumatized women do not become desensitized to the impact of new violence. This article discusses the clinical and policy implications of these conclusions.     

吸烟、饮酒、喝绿茶等生活习惯对老年人骨质疏松的影响

目的 分析吸烟、饮酒、喝绿茶等生活习惯对老年人骨质疏松的影响。方法 选取2012年9月到2013年5月在天津武警后勤学院附属医院老年门诊就诊的老年人群728例,使用双能骨密度仪进行骨密度测定，同时，自行设计调查表收集资料，有效问卷703例,其中将确诊的303例骨质疏松老年人群作为病例组,未发生骨质疏松400例的老年人群作为对照组进行研究。结果 吸烟、饮酒、喝绿茶等生活习惯对老年人骨质疏松的影响：1单因素分析结果显示：吸烟、吸烟年数、饮酒、饮酒量、喝绿茶、喝咖啡与老年人骨质疏松的发生有关，差异有统计学意义（P＜0.05），饮酒类型与饮酒年数与老年人骨质疏松的发生无关，差异无统计学意义（P＞0.05）；2多因素Logistic回归分析结果显示：吸烟、喝绿茶与老年骨质疏松发生有关（P＜0.05）。结论 老年人骨质疏松的发生情况与吸烟与否、喝茶与否有关，吸烟是老年人骨质疏松的危险因素，喝绿茶是老年人骨质疏松的保护因素。     

Musculoskeletal manifestations of physical abuse after intimate partner violence

BACKGROUND: Domestic violence is the most common cause of nonfatal injury to women in the United States, with an estimated cost of $50 billion annually. Little is known about the spectrum of musculoskeletal injuries in victims of domestic violence. We examined the characteristics of abused women, the prevalence of musculoskeletal injuries, and the variables associated with increasing frequency of physical violence against women. METHODS: We identified all female survivors of intimate partner violence who were referred to the Minnesota Domestic Abuse Program from January 1, 2002, through December 31, 2003. Characteristics of each woman's background, abuse history, and injuries were obtained by a trained program therapist in an in-depth, 2-hour intake interview. Specific data forms were completed for each interview. Five forms of experienced abuse were explored (physical, emotional, psychological, sexual, and financial). Injuries were subcategorized as (1) head and neck, (2) musculoskeletal, (3) chest, (4) abdomen, and (5) skin (integumentary system). We conducted regression analyses to determine factors associated with the frequency of physical abuse. RESULTS: Of 270 potentially eligible women, 263 (97%) with complete records were included. Women were commonly Caucasian (62%) in their third decade of life with one or more children (87%). A history of abuse was recalled by over half of the women (54%). The most prevalent forms of abuse were emotional (84%), psychological (68%), physical (43%), sexual (41%), and financial (38%). Child protective services were concomitantly involved in half of the women living in abusive relationships. Among those women who reported physical abuse, 36% sought medical attention. We identified 144 injuries in 218 physically abused women. Head and neck injuries were the most prevalent after intimate partner violence (40%). Musculoskeletal injuries were the second most common manifestation of intimate partner violence (28%). The spectrum of injuries included sprains (n = 21 injuries), fracture/dislocations (n = 17 injuries), and foot injuries (n = 2 injuries). Our analysis identified seven variables associated with increasing physical abuse frequency. These included (1) younger age (p = 0.04); (2) shorter length of relationship (p = 0.049); (3) emotional abuse (p = 0.02); (4) psychological abuse (p = 0.003); (5) sexual abuse (p = 0.004); (6) drug dependency (p = 0.05); and (7) alcohol dependency (p = 0.045). CONCLUSIONS: Among women presenting to a domestic violence therapy program seeking counseling, head and neck and musculoskeletal injuries were most common. Frequency of physical abuse was most likely to be associated with younger women who are in short-term relationships, have chemical and alcohol dependency, and concomitant emotional, psychological, and sexual abuse. Recognizing musculoskeletal injuries in women as a potential result of intimate partner violence is warranted. Identifying children exposed to abusive situations may further alert treating surgeons to the potential for intimate partner violence in the mother.     

Warzone violence in Vietnam: An examination of premilitary,military, and postmilitary factors in PTSD in-patients

The impact of childhood victimization and other premilitary factors on warzone abusive violence was examined with 177 Vietnam combat veteran inpatients. Premilitary and military variables were also examined in relationship to postmilitary variables, including violence and PTSD. Statistical analyses showed that none of the premilitary variables predicted warzone violence. High combat exposure did, however, predict warzone abusive violence and PTSD. In addition, participation in warzone violence predicted postmilitary violence to self, spouse, and others. Although high rates of childhood victimization and high levels of combat exposure were found, neither predicted postmilitary violence, criminal activities, drug/alcohol problems, or suicide attempts. Low childhood adjustment ratings and school suspensions predicted adult alcohol abuse and drug abuse, respectively. These findings and their implication for treatment are discussed.     

Hospital-based violence intervention programs work

BACKGROUND: Hospital-based violence prevention programs have emerged at trauma centers nationwide; however, none has been thoroughly evaluated for effectiveness. Our Violence Intervention Program (VIP) conducted a prospective randomized control study to evaluate the effectiveness of intervention for repeat victims of violence. METHOD: Patients admitted between 1999 and 2001 for treatment of injuries inflicted by a violent act were identified. Repeat victims of violence on parole/probation were invited to join the study. Participants were given a history-gathering questionnaire and randomized into two groups. Cases (intervention [n = 56]) received intensive psychosocial follow-up services, family or group therapy, and assisted with substance abuse treatment. Controls (nonintervention [n = 44]) received standard medical treatment and follow-through in accordance with standard parole or probation procedures. RESULTS: There was no significant difference in the number of arrests in the two groups. The control group was three times more likely to be arrested for a violent crime, two times more likely to be convicted of any crime, and four times more likely to be convicted of a violent crime. The projected time of incarceration is significantly longer for the control group. Repeat violent criminal activity was significantly more evident in the control group. CONCLUSION: Significant differences exist between the VIP intervention and nonintervention groups in terms of the quantity and severity of criminal activity.     

Relationships of Dissociation and Childhood Abuse and Neglect with Heart Rate in Delinquent Adolescents

This study examined the relationship of dissociative symptoms, abuse and neglect, and gender to mean heart rate (HR) in two types of interviews. Participants were 25 female and 16 male delinquent adolescents. Dissociative symptoms and abuse and neglect were assessed by structured interviews. Participants were randomized to one of two conditions, to describe either their most stressful life experience or their free association thoughts. Greater dissociative symptoms were associated with lower mean HR, whereas abuse and neglect, being a girl, and participating in the free association task were associated with higher mean HR. The finding that high levels of dissociative symptoms may be related to a suppression of autonomic physiological responses to stress support Bremner's conceptualization (J. D. Bremner, 1999) that dissociative symptoms comprise one of two subtypes of the acute stress response, differing physiologically as well as subjectively from a predominantly hyperarousal or intrusive symptom response.     

Maladaptive Dependency Schemas,Posttraumatic Stress Hyperarousal Symptoms,and Intimate Partner Aggression Perpetration

This study examined the associations between maladaptive dependency‐related schemas, posttraumatic stress disorder (PTSD) hyperarousal symptoms, and intimate‐partner psychological and physical aggression in a sample of court‐referred men (N = 174) participating in a domestic‐abuser‐intervention program. The men were largely African American; average age was 33.5 years. The extent to which hyperarousal symptoms moderated the association between dependency schemas and aggression was also examined. Maladaptive dependency‐related schemas were positively associated with severe psychological, and mild and severe physical aggression perpetration. Hyperarousal symptoms were positively associated with mild and severe psychological aggression, and mild physical aggression perpetration. Multiple regression analyses showed a significant interaction for mild physical aggression: For those with high levels of hyperarousal symptoms, greater endorsement of maladaptive dependency schemas was associated with the perpetration of aggression (B = 0.98, p = .001). For those with low levels of hyperarousal symptoms, there was no association between dependency schemas and aggression (B = 0.04, ns). These findings suggest that focusing on problematic dependency and PTSD‐hyperarousal symptoms in domestic‐abuser‐intervention programs may be helpful, and that examining related variables as possible moderators between dependency schemas and intimate aggression would be a fruitful area for future research.     

Domestic violence: effect on pregnancy outcome.

A predominantly white, suburban, indigent population of pregnancy women were followed up to determine the incidence of domestic violence and its effect on preterm delivery, low birth weight, and outcome of pregnancy (infant admission to the neonatal intensive care unit. A total of 489 gravidas were screened for domestic violence and drug and alcohol abuse. Patients were assigned to the control group if they had no substance abuse and no domestic violence and to the study group if they had no substance abuse but were victims of domestic violence. Of the total study population, 20% were victims of domestic violence. Among patients suffering domestic violence, 22% had preterm deliveries as compared with 9% of patients without domestic violence (P = .002). Sixteen percent of patients in the study group had low-birth-weight babies compared with 6% of women in the control group (P = .002). No significant relationship was found between domestic violence and admission to the neonatal intensive care unit. Therefore, domestic violence is a risk factor for preterm delivery and low-birth-weight infants.     

Associations between psychological stress and smoking,drinking, obesity,and high blood pressure in an upper middle‐income country in the African region

The direction and magnitude of the associations between cardiovascular risk factors (CVRFs) and psychological stress continue to be debated, and no data are available from surveys in the African region. In this study, we examine the associations between CVRFs and psychological stress in the Seychelles, a rapidly developing small island state in the African region. A survey was conducted in 1,240 adults aged 25–64 years representative of the Seychelles. Participants were asked to rank psychological stress that they had experienced during the past 12 months in four domains: work, social life, financial situation, and environment around home. CVRFs (high blood pressure, tobacco use, alcohol drinking, and obesity) were assessed using standard procedures. Psychological stress was associated with age, sex, and socioeconomic status. Overall, there were only few consistent associations between psychological stress and CVRFs, adjusting for age, sex, and socioeconomic status. Social stress was associated with smoking, drinking, and obesity, and there were marginal associations between stress at work and drinking, and between financial stress, and smoking and drinking. Psychological stress was not associated with high blood pressure. These findings suggest that psychological stress should be considered in cardiovascular disease prevention and control strategies.     

The association between caregiver substance abuse and self-reported violence exposure among young urban children

This study examined the relative importance of caregiver substance abuse as a correlate of child-reported exposure to violence. A total of 407 female African-American primary caregivers and their children age 6 to 7 were evaluated. The association between child report of violence and exposure to substance abuse by others (both within and outside the home) was considered after controlling for variance accounted for by child characteristics, caregiver characteristics, home environment, and neighborhood environment (including neighborhood crime). Caregiver alcohol abuse, children's witnessing of drug use in the home, and children's witnessing of drug deals all explained significant additional variance in violence exposure. These findings suggest that for early elementary-age children, meaningful prevention of violence exposure may be possible via addressing their exposure to substance abuse in their home and community.     

Physical and sexual abuse in patients with overactive bladder: is there an association?

The known sequelae of sexual abuse include acute and chronic injury. The purpose of this study was to evaluate the association of overactive bladder symptoms (OABs) with a history of physical or sexual abuse. Two hundred and forty-three women who attended the gynaecological out-patient clinic or the urogynaecological clinic were recruited for our study. Based on their clinical examination, they were assigned to three groups of patients with either OAB or with stress urinary incontinence (SUI) without concomitant urgency symptoms (SUI), or without history of incontinence (control group). Afterwards, they completed an anonymous questionnaire about bladder function and physical/sexual violence. Significantly more women (30.6%, 26/85) with OAB had previously been physically or sexually abused than women with SUI (17.8%, 18/101) and of the control group (17.5%, 10/57). Our study showed that significantly more women with OAB report physical and sexual abuse than subjects with stress incontinence or no urinary complaints. Women with stress incontinence had the same rate of self-reported physical/sexual abuse as continent controls.     

Coping with Domestic Violence: Control Attributions,Dysphoria, and Hopelessness

We investigated the influence of control judgments and coping style on emotional reactions to domestic violence utilizing the framework of hopelessness theory. We assessed abuse severity, control attributions, coping, dysphoric symptoms, and hopelessness in 70 battered women recruited from 12 domestic violence agencies. Respondents reported dysphoria but not hopelessness. Increased reports of dysphoria were associated with higher levels of self-blame and avoidance coping and lower levels of problem-focused coping. Increased problem-focused coping was associated with decreased hopelessness. Perceived control over current abuse was not related to dysphoria. High expectations for control over future events were associated with decreased dysphoria. We discuss our results in terms of their application to attributional accounts of emotional reactions to battering.