Success of Maternal and Child Health Pipeline Training Programs: Alumni Survey Results

Maternal and Child Health Journal - The Maternal and Child Health (MCH) Pipeline Training Program, promotes development of a diverse health workforce by training undergraduate students from...     

Factors associated with retaliatory attitudes among African American adolescents who have been assaulted

OBJECTIVES: (a) To describe attitudes regarding retaliation among adolescents who have been assaulted. (b) To examine assault/event characteristics, personal, parental, and environmental factors associated with the retaliatory attitudes of adolescents who have been assaulted. METHODS: African American youth aged 10-15 years presenting to two large urban hospitals with peer assault injury and a parent/caregiver completed interviews in their home after their emergency department visit. RESULTS: Multivariate analyses revealed that lower SES, older age, and adolescents' perceptions that their parents support fighting were related to endorsing retaliatory attitudes. Girls who were aggressive were more likely to endorse retaliatory attitudes. However, level of aggression did not impact boys' retaliatory attitudes. Affiliating with aggressive peers influenced the retaliatory attitudes of boys, but did not influence girls' retaliatory attitudes. Overall, youths' perceptions of their parents' attitudes toward fighting had the greatest impact on retaliatory attitudes. CONCLUSIONS: Adolescents' perceptions of their parents' attitudes toward fighting may be a factor in subsequent re-injury among youth. Violence prevention and intervention efforts need to involve components that assess parental attitudes and incorporate strategies to engage parents in violence prevention efforts. In addition, interventions for youth who have been assaulted may need to incorporate some gender-specific components in order to address the unique needs of girls and boys.     

Retaliatory attitudes and violent behaviors among assault-injured youth

ObjectivesTo examine the effect of retaliatory attitudes on subsequent violent behavior and fight-related injuries among youth who presented to the emergency department with assault injuries.DesignAssault-injured youth were interviewed at baseline, 6 months, and 18 months to assess fighting behavior, retaliatory attitudes, weapon carrying, and injury history as part of a larger randomized control trial.SettingTwo emergency departments in urban areas were selected for the study.ParticipantsA total of 129 adolescents aged 10–15 years were included in the study.Outcome measuresFighting behavior, assault injury, weapon carrying, and aggressive behavior.ResultsHigher retaliatory attitudes at baseline were associated with more aggression and a higher frequency of fighting over time.ConclusionsRetaliatory attitudes may fuel cycles of violence among youth. Medical professionals in acute care settings have an opportunity to identify youths at risk of future assault injury by assessing retaliation, providing anticipatory guidance, and referring to intervention programs.     

Burden of unmet mental health needs in assault-injured youths presenting to the emergency department

ObjectivesTo determine if there is a gap between behavioral symptoms and previously recognized mental health conditions in youth victims of peer assault injuries and to describe gender differences in psychological symptoms.MethodsA cross-sectional comparison of rates of previously diagnosed mental health conditions and clinical range behavioral symptoms as measured by the Child Behavior Checklist (CBCL) in 168 youths (range, 10–15 years old) presenting to the emergency department (ED) after an interpersonal assault injury. The Fisher exact test was used for comparisons.ResultsMental health symptoms were common among assault-injured youths. More than half of the youths demonstrating clinical range symptoms on the attention problems or anxious/depressed scales of the CBCL had no prior diagnosis of these conditions. Girls were more likely than boys to exhibit clinical range aggressive behavior symptoms (odds ratio [OR], 3.61; 95% confidence interval [CI], 1.64–7.97). Aggressive behavior was associated with clinical range scores on the other problem scales of the CBCL.ConclusionsAfter an ED visit for an assault-related injury, less than half of 10 to 15 year olds with significant symptoms of common mental conditions reported having a previously diagnosed disorder, reflecting a burden of unmet psychological needs. An ED visit for an assault injury provides an opportunity to screen for emotional/behavioral symptoms and to refer to appropriate follow-up mental health care.     

Longitudinal associations between community violence exposure and suicidality

PURPOSE: To examine longitudinal associations between community violence exposure and suicide ideation and attempt, and whether depressive symptoms and aggressive behavior are intervening variables in this association. METHODS: Participants were 473 urban and predominantly African American adolescents who completed measures of community violence exposure, depressive symptoms, and suicide ideation and attempt in grades 6, 7, and 8; teachers reported about adolescents' aggressive behaviors in grades 6, 7, and 8. Path analysis was used to examine direct and indirect associations between community violence exposure in grade 6 and suicide ideation and attempt in grade 8. Depressive symptoms and aggressive behavior were examined as part of an indirect path from grade 6 community violence exposure to later suicide ideation and attempt. RESULTS: Results revealed an indirect association between community violence exposure and later suicide ideation for males and females; community violence exposure in grade 6 was associated with depressive symptoms in grade 7, which in turn, were positively associated with suicide ideation in grade 8. For males, community violence exposure in grade 6 was associated with increases in aggressive behavior in grade 7, which in turn, were associated with suicide attempts in grade 8.