Time from COVID-19 shutdown, gender-based violence exposure, and mental health outcomes among a state representative sample of California residents.
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ABSTRACT: Background
There is increasing evidence of the negative impact of the COVID-19 pandemic and resultant shutdowns on mental health. This issue may be of particular concern to those affected by intimate partner violence (IPV) and sexual violence.Methods
We conducted a cross-sectional analysis using data from a California state-representative online survey conducted in the two weeks following the state stay-at-home order, enacted March 19, 2020 (unweighted N = 2081). We conducted a series of multivariate multinomial logistic regressions to assess the associations between a) time since stay-at-home order and b) partner and sexual violence exposure ever with our outcomes of interest: depression and/or anxiety symptoms in the past two weeks. Covariates included demographics and social support.Findings
Nearly one in five (19•7%) respondents reported moderate or severe mental health symptoms in the past two weeks; 15•5% had a history of IPV and 10•1% had a history of sexual violence. In models adjusting for gender, partner and sexual violence history, and other demographics, time was significantly associated with greater mental health symptom severity, as were IPV and sexual violence. When we additionally adjusted for current social support, effects of time were lost and effects related to violence were slightly attenuated.Interpretation
Time under shutdown is associated with higher odds of depression and anxiety symptoms, and may be worse for those with a history of IPV. However, those with greater social support appear to have better capacity to withstand the mental health impacts of the pandemic. Social support programs, inclusive of those available virtually, may offer an important opportunity to help address increased mental health concerns we are seeing under the pandemic.Funding
Blue Shield Foundation of California Grant RP-1907-137. Bill and Melinda Gates Foundation OPP1179208.
SUBMITTER: Raj A
PROVIDER: S-EPMC7444602 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:ImportanceDuring the past century, more than 100 catastrophic hurricanes have impacted the Florida coast; climate change will likely be associated with increases in the intensity of future storms. Despite these annual threats to residents, to our knowledge, no longitudinal studies of representative samples at risk of hurricane exposure have examined psychological outcomes associated with repeated exposure.ObjectiveTo assess psychosocial and mental health outcomes and functional impairment associated with repeated hurricane exposure.Design, setting, and participantsIn this survey study, a demographically representative sample of Florida residents was assessed in the 60 hours prior to Hurricane Irma (wave 1: September 8-11, 2017). A second survey was administered 1 month after Hurricane Irma (wave 2: October 12-29, 2017), and a third survey was administered after Hurricane Michael (wave 3: October 22 to November 6, 2018). Data were analyzed from July 19 to 23, 2021.ExposureHurricanes Irma and Michael.Main outcomes and measuresThe main outcomes were posttraumatic stress symptoms (PTSS), global distress, worry about future events (generalized worries), and functional impairment. Path models were used to assess associations of individual-level factors (prior mental health, recent adversity), prior storm exposures (loss and/or injury, evacuation), and direct, indirect, and media-based exposures to hurricanes Irma and Michael with those outcomes. Poststratification weights were applied to facilitate population-based inferences.ResultsOf 2873 individuals administered the survey in wave 1, 1637 responded (57.0% completion rate) (894 [54.6%, weighted] women; mean [SD] age, 51.31 [17.50] years); 1478 in wave 2 (90.3% retention from wave 1) and 1113 in wave 3 (75.3% retention from wave 2) responded. Prior mental health ailments (b, 0.18; 95% CI, 0.07-0.28), prior hurricane-related loss and/or injury (b, 0.09; 95% CI, 0.02-0.17), hours of Hurricane Irma-related media exposure (b, 0.03; 95% CI, 0.02-0.04), being in an evacuation zone during Hurricane Irma and not evacuating (b, 0.14; 95% CI, 0.02-0.27), and loss and/or injury in Hurricane Irma (b, 0.35; 95% CI, 0.25-0.44) were positively associated with PTSS after Hurricane Irma; most associations persisted and were associated with responses to Hurricane Michael. Prior mental health ailments (b, 0.10; 95% CI, 0.03-0.17), hours of Hurricane Michael-related media exposure (b, 0.01; 95% CI, 0.003-0.02), hurricane Irma-related PTSS (b, 0.42; 95% CI, 0.34-0.50), recent individual-level adversity (b, 0.03; 95% CI, 0.005-0.05), being in an evacuation zone during Hurricane Irma and evacuating (b, 0.10; 95% CI, 0.002-0.19), and direct (b, 0.36; 95% CI, 0.16-0.55) and indirect (b, 0.12; 95% CI, 0.05-0.18) Hurricane Michael-related exposures were directly associated with Hurricane Michael-related PTSS. After Hurricane Michael, prior mental health ailments (b, 0.17; 95% CI, 0.06-0.28), and PTSS related to hurricanes Irma (b, 0.11; 95% CI, 0.001-0.22) and Michael (b, 0.58; 95% CI, 0.47-0.69) were associated with respondents' functional impairment. Analogous analyses using global distress and generalized worries as mediators of functional impairment yielded a similar pattern of results.Conclusions and relevanceIn this survey study, repeated direct, indirect, and media-based exposures to hurricanes were associated with increased mental health symptoms among Florida residents who experienced hurricanes Irma and Michael, suggesting that people were sensitized to respond with more psychological symptoms over time. These results may inform targeted public health intervention efforts for natural disasters.
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Project description:ObjectivesRecent violent attacks on college campuses in the United States have sparked discussions regarding the prevalence of psychiatric disorders and the perpetration of violence among college students. While previous studies have examined the potential association between mental health problems and violent behavior, the overall pattern of findings flowing from this literature remain mixed and no previous studies have examined such associations among college students.MethodsThe current study makes use of a nationally representative sample of 3,929 college students from the National Epidemiologic Study on Alcohol and Related Conditions (NESARC) to examine the prevalence of seven violent behaviors and 19 psychiatric disorder diagnoses tapping mood, anxiety, personality, and substance use disorders. Associations between individual and composite psychiatric disorder diagnoses and violent behaviors were also examined. Additional analyses were adjusted for the comorbidity of multiple psychiatric diagnoses.ResultsThe results revealed that college students were less likely to have engaged in violent behavior relative to the non-student sample, but a substantial portion of college students had engaged in violent behavior. Age- and sex-standardized prevalence rates indicated that more than 21% of college students reported at least one violent act. In addition, more than 36% of college students had at least one diagnosable psychiatric disorder. Finally, the prevalence of one or more psychiatric disorders significantly increased the odds of violent behavior within the college student sample.ConclusionsThese findings indicate that violence and psychiatric disorders are prevalent on college campuses in the United States, though perhaps less so than in the general population. In addition, college students who have diagnosable psychiatric disorders are significantly more likely to engage in various forms of violent behavior.
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Project description:Background: School violence is widely acknowledged as a public health problem with considerable consequences on student learning and social development. There are also a wide range of health consequences. A large share of previous research on school violence has focused on populations in the global north, with significant gaps in the state of knowledge in the world's emerging economies. To this end, the present study provides an examination of correlates for school-based violence in Chile using a nationally representative cohort. Methods: Six independent variables were considered (age, sex, physical activity, sedentary life style, bullying victimization, food insecurity) within a logistic regression model to ascertain the strength and direction of associations with physical fighting. Results: Among the surveyed students, ~13.08% reported being involved in two or more physical fights during the twelve month recall period. Males were significantly over represented among those reporting being involved in a fight OR 2.91 (CI = 1.98-4.27). Those who reported experiencing food insecurity were 5.29 (CI = 1.43-19.50) times more likely to have been involved in a physical fight. Students who reported being bullied were 2.41 (CI = 1.67-3.47) times more likely to have been involved in physical fights. While age provided protection from involvement in physical fights with an adjusted odds ratio of 0.91 (CI = 0.84-0.98). Conclusion: Consistent with previous research, our results suggest that the use of school-based interventions that target multiple risk behaviors may be helpful in reducing rates of physical fighting.
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Project description:BackgroundResearch on violence exposure emphasizes discrete acute events such as direct and witnessed victimization. Little is known about the broad range of experiences of violence (EVs) in daily life. This study assesses the prevalence and patterns of distribution of 6 EVs in an adult general population.MethodsCalifornia state-representative survey administered online (English and Spanish), July 14-27, 2020. Adult (age ≥ 18 years) California resident members of the Ipsos KnowledgePanel were eligible to participate. Two EVs concerned community environments: (1) the occurrence of gunshots and shootings in the neighborhood and (2) encounters with sidewalk memorials where violent deaths occurred. Four concerned social networks: direct personal knowledge of individuals who (1) had purposefully been shot by someone else or (2) had purposefully shot themselves, and direct personal knowledge of individuals whom respondents perceived to be at risk of violence, either (3) to another person or (4) to themselves. Main outcome measures, expressed as weighted percentages with 95% confidence intervals (CIs), were the prevalence and extent (or dose) of each EV and of EVs in combination and associations between EVs and respondents' sociodemographic characteristics and firearm ownership status.ResultsOf 2870 respondents (57% completion rate), 52.3% (95% CI 49.5-55.0%) were female; mean [SD] age was 47.9 [16.9] years. Nearly two-thirds (64.6%, 95% CI 61.9-67.3%) reported at least 1 EV; 11.4% (95% CI 9.7-13.2%) reported 3 or more. Gender was not associated with the prevalence of any experience. Non-owners of firearms who lived with owners reported more extensive EVs through social networks than did firearm owners or non-owners in households without firearms. Knowledge of people who had been shot by others was most common among Black respondents, 31.0% (95% CI 20.9-43.3%) of whom knew 2 or more such persons. Knowledge of people who had shot themselves was greatest among respondents aged ≥ 60 years, but knowledge of persons perceived to be at risk of violence to themselves was greatest among respondents aged 18-29 years.Conclusions and relevanceExperiences of violence in daily life are widespread. They occur in sociodemographic patterns that differ from those for direct victimization and suggest new opportunities for research and intervention.
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Project description:A large body of research has linked disaster exposure to adverse mental and physical health outcomes. Few studies, however, have explored the cumulative impact of exposure to multiple disasters. Participants (N = 8,366) from the National Institute of Environmental Health Sciences Gulf Long-Term Follow-Up Study were classified as having been exposed to both, either, or neither Hurricane Katrina and the Deepwater Horizon oil spill (DHOS). Participants also reported on a range of mental and physical health symptoms. Logistic regression models found that participants who were exposed to both disasters had significantly higher odds of probable generalized anxiety disorder, odds ratio (OR) = 1.72, 95% CI [1.52, 1.96]; major depression, OR = 1.53, 95% CI [1.32, 1.77]; and posttraumatic stress disorder, OR = 2.51, 95% CI [2.03, 3.10], than participants who were exposed to only one disaster, ps < .001. Additionally, a linear regression model found that participants who were exposed to both disasters had significantly more physical health symptoms at the time of the spill than those who were exposed to only one disaster, B = 0.99, SE = .20, p < .001. The results indicate that cumulative disaster exposure confers enhanced risk for adverse mental and physical health outcomes. The findings demonstrate that screening for prior exposure among disaster-affected individuals might identify those at greatest risk for adverse health outcomes.
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| S-EPMC6324385 | biostudies-literature
Project description:OBJECTIVES:Person-centered care (PCC), which considers nursing home resident preferences in care delivery, has been linked to important outcomes such as improved quality of life, resident satisfaction with care, and mood and reduced behavioral symptoms for residents with dementia. Delivery of PCC fundamentally relies on knowledge of resident preferences. The Minimum Data Set (MDS) 3.0 Preference Assessment Tool (PAT) is a standardized, abbreviated assessment that facilitates systematic examination of preferences from a population of nursing home residents. However, it is unknown how well the PAT discriminates preferences across residents or items. The purpose of this study was to use MDS 3.0 PAT data to describe (1) overall resident preferences, (2) variation in preferences across items, and (3) variation in preferences across residents. DATA:Data from admission MDS assessments between October 1, 2011 and December 31, 2011 were used for this study. SAMPLE:A nationally representative sample of 244,718 residents over the age of 65 years who were able to complete the resident interview version of preference, cognition, and depression assessments were included. MEASUREMENTS:Importance ratings of 16 daily care and activity preferences were the primary outcome measures. Resident factors including function (MDS Activities of Daily Living-Long Form), depression (Patient Health Questionnaire-9), cognitive impairment (Brief Interview for Mental Status), and sociodemographics (age, race, sex, and marital status) were used as predictors of important preferences. ANALYSIS:Overall preferences were examined using descriptive statistics. Proportional differences tests were used to describe variation across items. Logistic regression was used to describe variation in preferences across residents. RESULTS:The majority of residents rated all 16 preferences important. However, there was variation across items and residents. Involvement of family in care and individualizing daily care and activities were rated important by the largest proportion of residents. Several resident factors including cognitive impairment, depression, sex, and race were significant predictors of preferences. CONCLUSIONS:Findings demonstrate the PAT captures variation in preferences across items and residents. Residents with possible depression and cognitive impairment were less likely to rate preferences important than residents without those conditions. Non-Caucasian and male residents reported some preferences differently than Caucasian and female residents. Additional assessment and care planning may be important for these residents. More research is needed to determine the factors that influence preferences and the ways to incorporate them into care.
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Project description:BACKGROUND:Most research on the prevalence, distribution, and psychiatric comorbidity of intellectual disability (ID) relies on clinical samples, limiting the generalizability and utility of ID assessment in a legal context. This study assessed ID prevalence in a population-representative sample of US adolescents and examined associations of ID with socio-demographic factors and mental disorders. METHODS:Data were drawn from the National Comorbidity Survey Adolescent Supplement (N = 6256). ID was defined as: (1) IQ ? 76, measured using the Kaufman Brief Intelligence Test; (2) an adaptive behavior score ?76, and (3) age of onset ?18 measured using a validated scale. The Composite International Diagnostic Interview assessed 15 lifetime mental disorders. The Sheehan disability scale assessed disorder severity. We used logistic regression models to estimate differences in lifetime disorders for adolescents with and without ID. RESULTS:ID prevalence was 3.2%. Among adolescents with ID, 65.1% met lifetime criteria for a mental disorder. ID status was associated with specific phobia, agoraphobia, and bipolar disorder, but not behavior disorders after adjustment for socio-demographics. Adolescents with ID and mental disorders were significantly more likely to exhibit severe impairment than those without ID. CONCLUSIONS:These findings highlight how sample selection and overlap between ID and psychopathology symptoms might bias understanding of the mental health consequences of ID. For example, associations between ID and behavior disorders widely reported in clinical samples were not observed in a population-representative sample after adjustment for socio-demographic confounders. Valid assessment and understanding of these constructs may prove influential in the legal system by influencing treatment referrals and capital punishment decisions.General Scientific SummaryCurrent definitions of intellectual disability (ID) are based on three criteria: formal designation of low intelligence through artificial problem-solving tasks, impairment in one's ability to function in his/her social environment, and early age of onset. In a national population sample of adolescents, the majority of those with ID met criteria for a lifetime mental disorder. Phobias and bipolar disorder, but not behavior disorders, were elevated in adolescents with ID. Findings highlight the need to consider how behavioral problems are conceptualized and classified in people with ID.
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Project description:Laboratory studies have shown that nickel exposure may adversely affect glucose metabolism. However, studies about the effects of environmental nickel exposure on diabetes pathogenesis in humans are sparse. We aimed to evaluate the association of urinary nickel concentrations, as a biomarker of environmental nickel exposure, and diabetes in a nationally representative sample of US adults. The data from a nationally representative population (n = 1585) in the National Health and Nutrition Examination Survey 2017-18 were used. Diabetes (n = 330) was defined as self-reported physician's diagnosis, HbA1c ≥ 6.5%, fasting plasma glucose ≥ 126 mg/dL, or 2-h plasma glucose ≥ 200 mg/dL. Urinary nickel concentrations were determined by inductively coupled plasma mass spectrometry. Logistic regression with sample weights was used to estimate the odds ratios (ORs) of diabetes and 95% confidence intervals (CIs). Urinary nickel concentrations were higher in individuals with diabetes (weighted median 1.23 μg/L) than those without diabetes (1.01 μg/L). After adjustment for urinary creatinine and other risk factors for diabetes, the OR of diabetes comparing the highest with lowest quartile of urinary nickel concentrations was 2.70 (95% CI 1.39-5.24; Ptrend = 0.03). Environmental nickel exposure is positively and significantly associated with diabetes in U.S. adults.
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