4 results
The emergence of co-occurring adolescent polysubstance use and depressive symptoms: A latent growth modeling approach
- Julia W. Felton, Michael J. Kofler, Cristina M. Lopez, Benjamin E. Saunders, Dean G. Kilpatrick
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- Journal:
- Development and Psychopathology / Volume 27 / Issue 4pt1 / November 2015
- Published online by Cambridge University Press:
- 09 January 2015, pp. 1367-1383
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This study tests competing models of the relation between depression and polysubstance use over the course of adolescence. Participants included a nationwide sample of adolescents (N = 3,604), ages 12 to 17 at study Wave 1, assessed annually for 3 years. Models were tested using cohort-sequential latent growth curve modeling to determine whether depressive symptoms at baseline predicted concurrent and age-related changes in drug use, whether drug use at baseline predicted concurrent and age-related changes in depressive symptoms, and whether initial levels of depression predicted changes in substance use significantly better than vice versa. The results suggest a transactional model such that early polysubstance use promotes early depressive symptoms, which in turn convey elevated risk for increasing polysubstance use over time, which in turn conveys additional risk for future depressive symptoms, even after accounting for gender, ethnicity, and household income. In contrast, early drug use did not portend risk for future depressive symptoms. These findings suggest a complicated pattern of interrelations over time and indicate that many current models of co-occurring polysubstance use and depressive symptoms may not fully account for these associations. Instead, the results suggest a developmental cascade, in which symptoms of one disorder promote symptoms of the other across intrapersonal domains.
Mental Health Outcomes Among Adults in Galveston and Chambers Counties After Hurricane Ike
- Kenneth J. Ruggiero, Kirstin Gros, Jenna L. McCauley, Heidi S. Resnick, Mark Morgan, Dean G. Kilpatrick, Wendy Muzzy, Ron Acierno
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- Journal:
- Disaster Medicine and Public Health Preparedness / Volume 6 / Issue 1 / March 2012
- Published online by Cambridge University Press:
- 08 April 2013, pp. 26-32
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Objective: To examine the mental health effects of Hurricane Ike, the third costliest hurricane in US history, which devastated the upper Texas coast in September 2008.
Method: Structured telephone interviews assessing immediate effects of Hurricane Ike (damage, loss, displacement) and mental health diagnoses were administered via random digit-dial methods to a household probability sample of 255 Hurricane Ike–affected adults in Galveston and Chambers counties.
Results: Three-fourths of respondents evacuated the area because of Hurricane Ike and nearly 40% were displaced for at least one week. Postdisaster mental health prevalence estimates were 5.9% for posttraumatic stress disorder, 4.5% for major depressive episode, and 9.3% for generalized anxiety disorder. Bivariate analyses suggested that peritraumatic indicators of hurricane exposure severity—such as lack of adequate clean clothing, electricity, food, money, transportation, or water for at least one week—were most consistently associated with mental health problems.
Conclusions: The significant contribution of factors such as loss of housing, financial means, clothing, food, and water to the development and/or maintenance of negative mental health consequences highlights the importance of systemic postdisaster intervention resources targeted to meet basic needs in the postdisaster period.
(Disaster Med Public Health Preparedness. 2012;6:26–32)
15 - Rape and other sexual assault
- from Section 4 - Specific challenges
- Edited by Steven M. Southwick, Brett T. Litz, Boston University, Dennis Charney, Matthew J. Friedman
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- Book:
- Resilience and Mental Health
- Published online:
- 07 September 2011
- Print publication:
- 18 August 2011, pp 218-237
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Summary
Introduction
This chapter describes the prevalence of rape and the risk of associated mental health problems, including definition of key terms such as rape. The particular focus of the chapter is on post-traumatic stress disorder (PTSD) as a primary mental health problem associated with rape. Major methodological approaches to the study of rape, related risk, resilience, and associated mental health problems are described, and advantages and disadvantages and implications of the major approaches are discussed. Findings from the literature related to risk and protective factors for PTSD are reviewed in general, as well as what is known specifically about risk and protective factors for PTSD given exposure to rape. The discussion is concluded by considering the implications for future research related to etiology and/or intervention in relation to the study of resilience.
Prevalence of rape
Rape is a common problem in many countries, including America. Carefully conducted epidemiological studies estimate the proportion of women who have been raped is between 12.6% and 16.1% in the USA (Kilpatrick et al., 1992, 2007a; Tjaden & Thoennes, 2000). Based on the most recent estimates and the 2005 US Census data, an estimated 20.2 million women have been raped, with an estimated 1.1 million women who have been raped within a given year (Kilpatrick et al., 2007b). Furthermore, the incidence of rape is likely to be increasing, with recent lifetime prevalence estimates of rape being higher than those obtained in the early 1990s. There is substantial evidence to support significant untoward consequences of rape. Women who are victims of rape are at a significantly increased risk for mental health problems, substance abuse, and poor physical health compared with non-victims (Steketee & Foa, 1987; Resick, 1993; Resnick et al., 1993, 1997; Kessler et al., 1995; Kilpatrick et al., 1997, 2003). In particular, findings from epidemiological studies indicate that rape or completed sexual assault, compared with other traumatic events, is associated with greatest risk of PTSD (Kilpatrick et al., 1989; Norris, 1992; Resnick et al., 1993; Kessler et al., 1995). While estimates vary, approximately half of rape victims develop PTSD (Breslau et al., 1998); so not all women who experience rape develop emotional problems, but, given the high prevalence of rape and the substantial cost associated with this adverse event, it is not surprising that researchers have focused on predictors of PTSD among rape victims. A significant consequence of this focus is that little is understood about the characteristics of those who appear to endure rape with minimal adverse sequelae. A better understanding of the human capacity to maintain healthy, symptom-free functioning or resilience in the face of significant adversity is of great importance to the study of PTSD. It is useful to identify protective factors as well as risk factors for psychopathology, both to understand resilience in the face of known risk factors and to identify potentially modifiable risk factors that might be targeted in interventions promoting resilience (e.g., providing secondary prevention once a woman has been sexually assaulted). For example, knowing characteristics of rape that elevate risk may help to identify those who are resilient even under high-risk conditions and to identify individual, system response, or social response factors that produce more positive outcomes under those conditions. Consequently, the major objective of this chapter is to review what is known about risk and protective factors for PTSD after exposure to rape, with particular emphasis on factors related to resilience. Prior to this review, important terms will be defined and key methodological issues identified that should be considered in a review of rape and resilience and how well extant research is capable of providing information on resilience. Our review will draw on what existing reviews of the literature tell us about risk and protective factors for PTSD in general, as well as what we know about risk and protective factors for PTSD given exposure to rape specifically.
Interpersonal Violence and Public Policy: What about the Victims?
- Dean G. Kilpatrick
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- Journal:
- Journal of Law, Medicine & Ethics / Volume 32 / Issue 1 / Spring 2004
- Published online by Cambridge University Press:
- 01 January 2021, pp. 73-81
- Print publication:
- Spring 2004
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Violence is an extremely prevalent problem in the United States and throughout the world, and it is a major contributing factor to increased mortality and mortalityty. These facts are well documented in the recent Report on violence and Health published by the World Health Organization. This report, which is likely to become a landmark document in the public health community, defines violence broadly as: The intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community, that either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment or deprivation. This World Health Organization definition encompasses three types of violence: 1) suicide and selfharm, 2) collective violence, and 3) interpersonal violence.
Interpersonal violence is defined asviolence inflicted by an individual or small group of individuals and includes youth violence, violence between intimate partners, other forms of family violence such as abuse of children and the elderly, rape and sexual assault by strangers, and violence in institutional settings such as schools, workplaces, nursing homes and prisons.