Stressful Life Events,Culture, and Violence

This study explored the contributions of stressful life events and their interactions with social support and cultural factors in predicting serious violence among American adolescent immigrants of Chinese and Southeast Asian origins. Youth differed in their exposure to stressors and how they responded to them. Cambodian and Laotian youth reported the highest levels of stressors, except for emotional abuse. Only physical abuse was an independent predictor of serious violence for all groups, except Chinese. Perceived social support buffered the effects of some stressors, whereas increased levels of acculturation, intergenerational/intercultural conflict, and individualism placed youth at increased risk for serious violence. The results suggest that the moderating effects of culture and social support need to be considered when examining the association between life stressors and serious violence for Chinese and Southeast Asian youth.     

Characterization of Stress in Low-Income,Inner-City Mothers of Children with Poorly Controlled Asthma

The goal of this longitudinal analysis was to characterize factors associated with the experience of life stress in low-income, inner-city mothers of minority children with high-risk asthma.Participants (n = 276) reported on family demographics, child asthma control and healthcare utilization, social support, contemporary life difficulties (housing, finances, violence exposure) measured by the validated Crisis in Family Systems scale, and daily stress. Latent growth curve modeling examined predictors of life stress across 12 months as a function of home and community difficulties, asthma-specific factors, and social support. Mothers were primarily single (73%), unemployed (55%), and living in extreme poverty with most (73%) reporting an annual family income <$20,000 (73%). The children were young (mean age = 5.59, SD = 2.17), African-American (96%), and had poorly controlled asthma (94%) at study enrollment. Higher daily stress was associated with financial difficulties, safety concerns in the home and community, and housing problems. Access to social support was consistently related to reduced stress. The only asthma-specific factor associated with life stress was healthcare utilization, with more emergency services for asthma related to higher daily stress. Findings underscore the clinical significance of assessing diverse home and community stressors and social support in low-income, inner-city caregivers of children with poorly controlled asthma.     

Associations among risk factors, individual resources, and indices of school-related asthma morbidity in urban, school-aged children: a pilot study

This paper presents a conceptual model including examples of risk and resource factors associated with indices of school-related asthma morbidity (eg, missed sleep, participation in activities, school absences) in a group of urban, school-aged children with asthma from ethnic minority backgrounds. Specifically, the current longitudinal study examines relations between a contextual risk factor (ie, family life stressors), an asthma-related risk factor (ie, asthma symptoms), individual resources (ie, attention, children's problem-solving beliefs, and self-esteem), and aspects of asthma morbidity that have been shown to have an impact on children's academic performance. Participants of the study included 31 mother-child dyads from low-income, inner-city neighborhoods. Results of hierarchical regression analyses revealed that after controlling for risk factors (ie, asthma symptoms and family life stressors) at baseline, children's individual characteristics (ie, children's problem-solving beliefs and self-esteem) functioned as resource factors for some indices of asthma-related functioning (school absences, participation in activities, and missed sleep) at follow-up (1 year later). Results suggest that contextual and individual risk and resource factors should be further explored in studies including larger samples of urban children with asthma in order to help guide the development of preventive interventions in school-based and health care settings.     

Daily hassles and chronic strains: a hierarchy of stressors?

Among 105 poor, male heads of household in an urban center of India, common daily hassles were similar to those experienced by individuals from economically advantaged, western countries. However, we did not replicate the correlation between hassle frequency and mental health problems that has been previously found in a middle-class, western sample. In contrast to daily hassles, which include low-intensity, relatively discrete stressors (e.g. disagreement with spouse, missing a bus), chronic strains include ongoing social and environmental conditions that represent high-intensity stressors (e.g. substandard housing, inadequate access to water) that threaten survival. We found that chronic strains were associated with greater levels of psychosomatic symptomatology, as well as lower perceived social support. Furthermore, the correlation between chronic strains and psychosomatic symptoms increased when the effects of income were statistically controlled, suggesting that income attenuates the effects of chronic strains and that chronic strains affect symptoms independent of income. In sum, chronic strains may be a more valid and potent stressor than daily hassles in poor, urban populations in developing countries.     

Exposure to community violence and depressive symptoms: Examining community,family, and peer effects among public housing youth

Exposure to community violence is an epidemic problem that causes debilitating effects on youth mental health. However, the relationships between violence exposure and youth mental health remain unclear when examining co-occurring socioecological risk and protective factors. The purpose of this study is to clarify the observed gaps in knowledge by utilizing structural equation modeling (SEM) to examine the mediating role of community violence exposure on the relationship between perceived neighborhood risk factors, parental behaviors, and peers on depressive symptoms in a sample of urban youth in low-income public housing communities (n = 320). Results indicate that community violence exposure and exposure to delinquent peers mediates the effects of perceived neighborhood risk and parenting behaviors on depressive symptoms. These findings suggest that while interventions that limit exposure to community violence and delinquent peers could reduce depressive symptoms, interventions that reduce community violence are essential to improve youth mental health.     

Examining Youth Hopelessness as an Independent Risk Correlate for Adolescent Delinquency and Violence

Prior research has identified a relationship between youth hopelessness and violence perpetration within specific groups of young people. The purpose of this study was to evaluate the relationship between youth hopelessness and violence perpetration in a population-based sample of adolescents. This study is a cross-sectional analysis of data from 136,549 students in the 6th, 9th, and 12th grades responding to the 2007 Minnesota Student Survey. Logistic regression models were used to evaluate the relationship between hopelessness and youth violence perpetration, including comparison analyses for gender and race/ethnic subgroups as well as adjustment for a measure of poor-low affect. One in four youth (25.1%) reported levels of hopelessness at least enough to bother them in the previous month. Moderate-high levels of hopelessness exhibited a statistically significant independent relationship with a range of violence-related outcomes for youth subgroups: delinquent behavior, weapon carrying on school property, and all forms of self-directed violence. Relationships between hopelessness and interpersonal and intimate partner violence suggest a greater contribution by poor affective functioning for some groups. Interventions designed to reduce youth violence perpetration may benefit from increased strategies to address youth hopelessness as well as youth mental health in general.     

Life events and daily hassles and uplifts as predictors of hospitalization and outpatient visitation.

Increased occurrence of major life events and daily "hassles" and "uplifts" have been shown to be associated with several measures of health status and health care utilization. In order to test for such an association with hospital admission, a prospective study was designed. Navajo Indians presenting for either inpatient or outpatient health care at a U.S. Indian Health Service facility were questioned regarding the occurrence of major life events in the preceding six months and of hassles and uplifts in the preceding week. Two years later the subsequent numbers of outpatient visits and of hospital admissions were determined for each subject. An increased number of either major life events (relative risk 1.66) or daily hassles and uplifts (relative risk 1.87) was found to be associated with an increased risk of hospital admission. The effects of major and daily life events were additive on the risk of admission. In addition, hassles were predictive of subsequent outpatient utilization. While further demonstrating the influence of major and daily life occurrences on health care utilization, this study also shows their importance in an additional cultural setting.     

Associations of poverty, substance use, and HIV transmission risk behaviors in three South African communities

The majority of the world's HIV infections occur in communities ravished by poverty. Although HIV/AIDS and poverty are inextricably linked, there are few studies of how poverty-related stressors contribute to HIV risk behavior practices. In this study, surveys were conducted in three South African communities that varied by race and socio-economic conditions: people living in an impoverished African township (N = 499); an economically impoverished but well infrastructured racially integrating township (N = 995); and urban non-impoverished neighborhoods (N = 678). Results showed that HIV/AIDS risks were closely related to experiences of poor education, unemployment, discrimination, violence, and crime. Although poverty-related stressors were associated with a history of alcohol and drug use, substance use did not moderate the association between poverty-related stressors and HIV risk behaviors. The findings suggest that HIV prevention strategies should not treat AIDS as a singled out social problem independent of other social ills.     

High school students' posttraumatic symptoms, substance abuse and involvement in violence in the aftermath of war

This study examined one-year after effects of exposure to war events on adolescents' Posttraumatic Stress Symptoms (PTS) and risk behaviors (substance use and involvement in school violence). In addition, it addressed two potential vulnerability factors: at the micro level, it examined whether childhood trauma raised the vulnerability of Israeli adolescents to PTS and risk behaviors when exposed to war events. At the macro level, we explored whether ethnicity, i.e., being an Israeli Arab, is a vulnerability factor to PTS and risk behaviors. We used a representative sample of 7th to 11th grade students from the north of Israel that included 4151 students: 1800 Jewish (54.4% boys) and 2351 Arab (41.5% boys). We assessed exposure to war events and childhood traumatic events, PTS and PTSD, substance use (alcohol, cannabis, Ecstasy) and involvement in school violence. The findings revealed extensive exposure to war events among both Jewish and Arab students. A year after the war, its effects on adolescents were still manifested in PTS, and involvement in school violence and substance use. Exposure to child physical abuse was associated with higher levels of PTS symptoms, substance use and involvement in violence. Exposure to other traumatic events was also associated with greater PTS symptoms and involvement in violence but not with greater substance use. Arab students were a more vulnerable population. They reported higher PTS symptoms, more cannabis use and greater involvement in school violence than Jewish students. However, exposure to war events had similar effects on both Arab and Jewish students. We conclude that war effects include a broad range of psychological distress and risk behaviors that last long after the war ends, especially among youth who have experienced childhood trauma and high exposure to war-related stressors.     

A Longitudinal Study of Predictors of Suicide Attempts Among Lesbian, Gay, Bisexual, and Transgender Youth

This short-term prospective study examined general and lesbian, gay, bisexual, and transgender (LGBT)-specific risk and protective factors for suicide attempts in an ethnically diverse sample of LGBT youth (N = 237, 47.7 % male). A structured psychiatric interview assessed clinical depression and conduct disorder symptoms, as well as past and prospective suicide attempts over a 1-year follow-up period (91 % retention). Participants completed questionnaires measuring general risk factors for suicide attempts, including hopelessness, impulsiveness, and perceived social support. They also completed measures of LGBT-specific suicide risk factors, including gender nonconformity, age of first same-sex attraction, and LGBT victimization. Correlation and multivariate regression analyses were conducted to examine the relations between predictors and suicide attempt, and to identify mediators. Of nine variables examined, seven were related to lifetime history of attempted suicide: hopelessness, depression symptoms, conduct disorder symptoms, impulsivity, victimization, age of first same-sex attraction, and low family support. Depressive symptoms and hopelessness mediated the relation between multiple risk and resilience factors and suicide attempts. Suicide attempt history was the strongest predictor of prospective suicide attempts. Participants who previously attempted suicide (31.6 % of the sample) had more than 10 times greater odds of making another attempt in the 1-year follow-up period than were those who had made no previous attempt. These results highlight the need for suicide prevention programs for LGBT youth and suggest the importance of addressing depression and hopelessness as proximal determinants and family support and victimization, which have more distal effects.     

Recognition of stress in workers (report 1)--relationship between recognitions of causes of stress and stress reaction

Three aspects of the recognition of stress in 665 workers were investigated; namely, causes of stress, stress reactions and modifying factors. We examined the relationship among these aspects, in order to determine some different types of recognition. Several characteristics of the different recognition groups were also examined. 1) The workers who recognized that the causes of their stress were mainly "daily hassles" or "minor events which happened occasionally" accounted for 82.5% of all subjects, and the workers who recognized that their stress was caused mainly by "major life events" accounted for the remaining 17.5%. 2) The subjective stress of the workers in the "major life events" group was significantly larger than that of the workers in "daily hassles". 3) The group with stress due to "daily hassles or minor events" recognized the stress reaction mainly as "irritability", and their actual stressor was "busyness in work". In contrast, the recognition of a stress reaction due to a "major life event" group was represented by "depression/anxiety", and their actual stressors were not only major events such as "promotion or transfer" but also psychological factors such as "low emotional support of family members". 4) The mean age and rank of the "major life event" group were significantly higher than those of the other group.     

The association between childhood asthma and community violence, Los Angeles County, 2000

OBJECTIVE: This study's objective is to determine if there is an association between rates of violence and rates of childhood asthma in Los Angeles County communities. METHODS: Rates of hospitalization for assault and for asthma were calculated for each ZIP Code and city in Los Angeles County. Linear regression was used to determine the effect of assault rates on asthma rates while controlling for potential confounders such as poverty and racial/ethnic distribution. At the city level, crime rates were included in the model as additional measures of community violence. RESULTS: Hospitalization rates for childhood asthma and assaults were significantly correlated at both the city (r = 0.80) and the ZIP Code (r = 0.54) levels. The association remained significant when controlling for poverty and racial/ethnic distribution with linear regression (p < 0.0001). At the city level, the variables measuring the crime rate were not significant predictors of asthma hospitalizations. CONCLUSIONS: Community violence as measured by the rate of assault hospi; talizations is associated with childhood asthma in Los Angeles County. Health care providers should consider their asthmatic patients' social environments when devising treatment plans.     

The effects of avoidance coping and coping self-efficacy on eating disorder attitudes and behaviors: A stress-diathesis model

The present study employed a series of stress-diathesis models to examine whether avoidance coping and poor coping self-efficacy contribute to disordered eating attitudes and behaviors in a sample of college students. The sample included one hundred fifteen undergraduate students (28.7% male; 71.3% female). Participants completed self-report measures to assess daily stressors, coping style, coping self-efficacy, and eating disorder attitudes and behaviors. As predicted, among students with an avoidance coping style, those who reported more daily stressors exhibited higher eating disorder attitudes and behaviors than those with less daily hassles. Contrary to study hypothesis, number of daily hassles did not moderate the association between coping self-efficacy and eating disorder attitudes and behaviors. However, there was a significant main effect for coping self-efficacy, suggesting that students who lack confidence in their coping abilities are more likely to have problematic eating attitudes and behaviors, regardless of their level of daily stress. Clinically, results suggest that students who enter college with an avoidance coping style and poor coping self-efficacy may be at risk for disordered eating, particularly with the onset of associated stress. Teaching students active problem-focused coping skills to deal with daily hassles associated with college life, and providing opportunities for repeated practice to bolster self-efficacy, may help prevent and/or reduce disordered eating attitudes and behaviors.     

Who Should Transition? Defining a Target Population of Youth with Depression and Anxiety That Will Require Adult Mental Health Care

The process of transitioning youth from child to adult mental health services is poorly managed, and many adolescents disengage from services during transfer. The waxing and waning of symptoms over time means that some youth who are asymptomatic prior to transfer (15–17 years) will be at high risk for recurrence during the transition period. There are no clear, evidence-based guidelines about who should transfer to adult care. Objectives were to propose: (1) criteria to define anxious or depressed youth (16–21 years) that should transfer and (2) levels of service needed in young adulthood. Natural history of psychopathology and treatment response for depression and anxiety was reviewed. Risk factors for recurrence and persistence, such as initial severity, comorbidity, and family functioning, can help to identify youth requiring transfer. Few controlled treatment studies have examined predictors of long-term course. Recommendations for follow-up care and ongoing monitoring during young adulthood are discussed.     

Predictors of Aggressive Behaviors among Rural Middle School Youth

This study determined multivariate sets of predictors for verbal and physical aggression among rural middle school youth. Surveys were obtained from 1,440 7th and 8th grade youth from six middle schools in five geographically dispersed states. Multivariate logistic regression identified final predictive models. Similar, but varying sets of predictors were identified across types of aggression. The most consistent set of predictors was gender, family actions against violence, peer violence, anger, academic performance, and alcohol use. These results suggest that in comparison with past studies of non-rural youth, similar factors predict aggressive behavior among urban and non-urban youth.  Editors’ Strategic Implications: This paper makes two contributions to our understanding of the contextual factors influencing youth violence. First, it indicates that the predictive factors for rural and non-rural youth violence are similar. Second, it confirms the role of both family and peers in influencing such violence. Those who design and implement programs and polices addressing youth violence must look beyond individual variables in order to create comprehensive strategies.     

Psychosocial correlates of depressive symptoms among 12–14-year-old Norwegian adolescents

Background The aim of the study was to examine the relationships between various psychosocial factors and depressive symptoms in early adolescence. Methods A representative sample of 2465 12–14‐year‐old adolescents comprising 50.8% girls and 49.2% boys, with a mean age of 13.7 years, was recruited in two counties in Norway. The participation rate was 88.3%. Depressive symptoms were measured by the Mood and Feelings Questionnaire (MFQ). Results Correlations between the total sum of stressful events/daily hassles and the total sum of MFQ were moderately high, r_s = 0.49 and r_s = 0.53, respectively. Depressive symptoms were more strongly correlated with school‐related stress among boys than girls, whereas the correlation between daily hassles and depressive symptoms was higher for girls than boys. The results of univariate analyses showed significantly higher mean total MFQ scores among adolescents not living with both natural parents, those who had moved more than twice and those with more than 3 siblings or having fewer than 2 close friends. Further, adolescents from Third World societies and adopted adolescents, those from lower socio‐economic status (SES) groups, having unemployed parents or living in coastal areas had higher mean depressive symptom scores. The results of multiple regression analyses yielded the following six significant predictors of total MFQ scores in order of importance: Sum of daily hassles and sum of stressful life events, gender, number of friends, ethnicity and mother's employment status. Altogether, these variables accounted for 43% of the total variance in MFQ scores. Conclusions It is concluded that these psychosocial predictors should be addressed when assessing depressive symptoms in early adolescence. The findings of the study are discussed in view of previous research in the field and their clinical significance.     

Community violence and childhood asthma prevalence in peripheral neighborhoods in Salvador, Bahia State, Brazil

This study aimed to identify degrees of exposure to community violence reported by parents and guardians of children from four to 12 years of age and the association with childhood asthma symptoms. A cross-sectional study was conducted with 1,232 parents/guardians in 24 peripheral neighborhoods in Salvador, the capital of Bahia State, Brazil. The authors investigated asthma symptoms in children and acts of violence in the community. More than 75% of parents/guardians had been exposed to community violence in the previous year, with 20% reporting high levels of exposure. Children that were more exposed to violence showed higher asthma prevalence (28.4%) as compared to non-exposed children (16.4%). Children exposed to maximum levels of violence were nearly twice as likely to present asthma symptoms (adjusted OR = 1.94; 95%CI: 1.12-3.36). The study highlighted the relevance of community violence as a risk factor for asthma and the need for further research to elucidate methodological issues.     

Hopelessness and Violence Among Inner-City Youths

Objectives: Ethnographic literature on inner-city life argues that adolescents react to their uncertain (and objectively bleak) future by abandoning hope; this, in turn, leads them to engage in risk behaviors, including violence, with considerable frequency. This study empirically measures the pervasiveness of hopelessness and uncertainty about the future among inner-city adolescents and documents the link between hopelessness, uncertainty, and risk behavior. Methods: We surveyed a sample of 583 adolescents (aged 9–19) living in public housing in Huntsville, AL; this constitutes 80% of the eligible population. Each participant in the survey received $10. Their responses yielded empirical distributions for hopelessness, uncertainty about the future, and four violent behaviors. Using OLS regression, we examined the effect of hopelessness on these violent behaviors. Results: Hopelessness about the future was relatively rare, affecting only 20–30% of the respondents. However, it was a strong predictor of fighting and carrying a knife for females, and of carrying a knife, carrying a gun, and pulling a knife or gun on someone else for males. Uncertainty about the future was more prevalent, but unrelated to the violent behaviors. Conclusions: These results suggest that the conclusions of the ethnographic literature are only partially valid: While hopelessness is, in fact, strongly related to risk behavior, it is not nearly so prevalent as is generally assumed.     

Angry wives, abusive husbands: relationship between domestic violence and psychosocial variables

BACKGROUND: A small number of studies conducted in Pakistan have shown high rates of domestic violence. None of the studies, however, discussed associated psychosocial factors. We interviewed a group of women to look at violence and associated psychosocial factors. We wanted to see if self-esteem, quality of relationships, social support, stressful life events, psychiatric symptoms, and different measures of anger were associated with domestic violence. METHODOLOGY: In a cross-sectional survey of women presenting to primary care physicians, we used Women's Experience with Battering and Domestic Abuse Checklist to measure domestic violence. The Relationship Assessment Scale, Oslo Social Support Scale, State Trait Anger Inventory, and Evaluative Belief Scale were used to look at the correlates of violence. We used the information in a regression model to identify independent predictors of violence in this sample. RESULTS: More than half of the women reported experiencing battering and/or violence. Women in abusive relationships reported unhappiness with their intimate relationships and had high scores on 1 subscale of anger. Living in extended families was protective against violence. CONCLUSIONS: We were able to replicate findings that women in abusive relationships are not satisfied with the relationships with their partners. Living in extended families was protective against violence. Community studies may provide a better design to look at the association between abuse and poverty, literacy, self-esteem, and social support.