Association between intimate partner violence and mental health among Korean married women.

OBJECTIVES: Intimate partner violence (IPV) has only attracted limited attention in Korea despite numerous studies in Western countries that indicate IPV is associated with depressive symptoms. This study examined the association of IPV with depressive symptoms and suicidal ideation as moderated by the perceived gender roles of married women in South Korea. STUDY DESIGN: We analyzed a data set of 4659 married females from the 8th wave of the Korea Welfare Panel Study. Participants were categorized into three groups of non-IPV, non-physical IPV, and physical IPV. The presence of depressive symptoms and suicidal ideation was then used to predict mental health outcomes. METHODS: Logistic regression helped to investigate the association of IPV and mental health. Furthermore, an interactive regression of IPV and perceived gender roles was also done. RESULTS: Each type of IPV (non-physical and physical) was significantly associated with depressive symptoms (Odds ratios [ORs]: 1.65 and 4.34; 95% confidence interval [CIs]: 1.28-2.13 and 2.71-7.28, respectively) and suicidal ideation (ORs: 1.40 and 3.84; 95% CIs: 1.06-1.85 and 2.32-6.36, respectively) after adjusting for covariates. In addition, women who experienced IPV and reported having traditional gender roles were also more likely to report depressive symptoms (OR: 4.59; 95% CI: 2.90-7.28) and suicidal ideation (OR: 7.28; 95% CI: 3.56-14.87). CONCLUSIONS: Research findings indicate an increasingly marked pattern of work-family conflict in regard to the relationship between traditional gender roles and the effect of IPV on the mental health of women. Policy efforts are needed to reduce IPV as a mental health risk factor and address paternalistic traditions deeply rooted in Korean society that place women in an inferior family status.

Post-partum Residential Mobility Among a Statewide Representative Sample of California Women, 2003-2007.

OBJECTIVES: Researchers often examine neighborhood socioeconomic environment and health during the perinatal period using geocoded addresses recorded on birth certificates at the time of delivery. Our objective was to assess the potential for post-partum neighborhood misclassification by examining whether women move neighborhoods during the immediate post-partum period, whether they move to neighborhoods of different socioeconomic status (SES), and whether mobility differs by maternal characteristics. METHODS: We used data from the 2003-2007 California Maternal and Infant Health Assessment (MIHA), an annual, statewide-representative survey of post-partum women, to examine women's neighborhood mobility patterns between giving birth and completing a survey 2-7 months post-partum. We examined whether women changed neighborhoods, whether moves were to neighborhoods of higher, lower, or similar socioeconomic status (SES), and whether these patterns differed by maternal race/ethnicity, maternal SES, or other demographic characteristics. RESULTS: Overall, 93% of women either did not move neighborhoods or moved to a neighborhood of similar SES post-partum. Only 4% of women moved to a neighborhood of lower SES and 3% to an area of higher SES. Mothers who were non-Hispanic black or US-born Hispanic, young, unmarried, primiparous, or lower SES were slightly more likely to move overall and more likely to move to neighborhoods with different SES, compared to other women. CONCLUSIONS: These findings suggest that geocoded addresses from birth certificates can be used to estimate women's neighborhood SES during the early post-partum period with little misclassification, an especially relevant finding for researchers using post-partum surveys.

Beyond the cross-sectional: neighborhood poverty histories and preterm birth.

OBJECTIVES: We examined associations between longitudinal neighborhood poverty trajectories and preterm birth (PTB). METHODS: Using data from the Neighborhood Change Database (1970-2000) and the American Community Survey (2005-2009), we categorized longitudinal trajectories of poverty for California neighborhoods (i.e., census tracts). Birth data included 23 291 singleton California births from the Maternal and Infant Health Assessment (2003-2009). We estimated associations (adjusted for individual-level covariates) between PTB and longitudinal poverty trajectories and compared these to associations using traditional, cross-sectional measures of poverty. RESULTS: Compared to neighborhoods with long-term low poverty, those with long-term high poverty and those that experienced increasing poverty early in the study period had 41% and 37% increased odds of PTB (95% confidence interval [CI] = 1.18, 1.69 and 1.09, 1.72, respectively). High (compared with low) cross-sectional neighborhood poverty was not associated with PTB (odds ratio = 1.08; 95% CI = 0.91, 1.28). CONCLUSIONS: Neighborhood poverty histories may contribute to an understanding of perinatal health and should be considered in future research.

A multisite randomized controlled trial of brief intervention to reduce drinking in the trauma care setting: how brief is brief?

OBJECTIVE: Determine the efficacy of 3 brief intervention strategies that address heavy drinking among injured patients. BACKGROUND: The content or structure of brief interventions most effective at reducing alcohol misuse after traumatic injury is not known. METHODS: Injured patients from 3 trauma centers were screened for heavy drinking and randomly assigned to brief advice (n = 200), brief motivational intervention (BMI) (n = 203), or BMI plus a telephone booster using personalized feedback or BMI + B (n = 193). Among those randomly assigned, 57% met criteria for moderate to severe alcohol problems. The primary drinking outcomes were assessed at 3, 6, and 12 months. RESULTS: Compared with brief advice and BMI, BMI + B showed significant reductions in the number of standard drinks consumed per week at 3 (Δ adjusted means: -1.22, 95% confidence interval [CI]: -0.99, approximately -1.49, P = 0.01) and 6 months (Δ adjusted means: -1.42, 95% CI: -1.14, approximately -1.76, P = 0.02), percent days of heavy drinking at 6 months (Δ adjusted means: -5.90, 95% CI: -11.40, approximately -0.40, P = 0.04), maximum number of standard drinks consumed in 1 day at 3 (Δ adjusted means: -1.38, 95% CI: -1.18, approximately -1.62, P = 0.003) and 12 months (Δ adjusted means: -1.71, 95% CI: -1.47, approximately -1.99, P = 0.02), and number of standard drinks consumed per drinking day at 3 (Δ adjusted means: -1.49, 95% CI: -1.35, approximately -1.65, P = 0.002) and 6 months (Δ adjusted means: -1.28, 95% CI: -1.17, approximately -1.40, P = 0.01). CONCLUSIONS: Brief interventions based on motivational interviewing with a telephone booster using personalized feedback were most effective at achieving reductions in alcohol intake across the 3 trauma centers.

An examination of the path between recent sexual violence and sexually transmitted infections.

PURPOSE: Sexually transmitted infections (STIs) are among the most common infections in the United States and are particularly prevalent in survivors of sexual violence. The purpose of this study is to examine co-occurring risk factors for sexual violence and STIs including mental health, alcohol use, drug use, and multiple partners as intersecting pathways to STIs for women who experienced sexual abuse in the past year. METHODS: Secondary analyses were conducted on cross-sectional data from women originally recruited as respondents for an epidemiologic survey funded by the Centers for Disease Control and Prevention (CDC): Project CHOICES. The survey was administered to 2,672 women in six settings: A large, urban jail and residential alcohol and drug treatment facilities (Texas); a gynecology clinic (Virginia); two primary care clinics (Virginia and Florida); and media solicitation (Florida). Women were included in the current study if they were fertile, sexually active, and not pregnant or trying to get pregnant (n = 1,183). Structural equation modeling (SEM) was used to test the conceptual path model between sexual violence and STI occurrence. RESULTS: In the SEM, there were no significant paths from mental health, alcohol severity, or drug use to STI occurrence contrary to the results of the initial bivariate analyses. Multiple sexual partners significantly mediated the relationship between sexual violence and STIs and between mental health and drug use and STIs. CONCLUSION: This study highlights the importance of providing effective treatment to survivors of sexual violence, which includes addressing risky sexual behaviors to reduce STI occurrence.

Estrangement factors associated with addiction to alcohol and drugs among homeless youth in three U.S. cities.

Substance use is highly prevalent among homeless, street-involved young people. Societal estrangement is often associated with substance use, particularly among this population. The current study sought to identify four domains of social estrangement (disaffiliation, human capital, identification with homeless culture, and psychological dysfunction) in relation to alcohol and drug addiction. Homeless young adults were recruited from three disparate urban areas: Los Angeles, CA (n=50), Austin, TX (n=50) and St. Louis, MO (n=46) using comparable research methods and measurement instruments. Findings demonstrated that variables measuring psychological dysfunction and homeless culture predicted alcohol addiction, while institutional disaffiliation and homeless culture predicted drug addiction. Findings affirm distinct patterns of estrangement related to alcohol compared to drug addiction. Understanding these features and the heterogeneity of this population has strong potential for assisting development of programs targeting substance use among this underserved population.

A comparison of addiction and transience among street youth: Los Angeles, California, Austin, Texas, and St. Louis, Missouri.

The purpose of this study was to compare measures of addiction and transience among street youth in three disparate urban areas: Los Angeles, California; Austin, Texas; and St. Louis, Missouri. Street youth from Los Angeles (n = 50), Austin (n = 50) and St. Louis (n = 46) were recruited using comparable engagement strategies. Youth were interviewed concerning use of alcohol and other substances and their level of transience. Youth from each city were compared using chi-squares and multinomial logistic regression. Results reveal that youth in each city differed in ethnicity, age, educational status, length of time homeless, and substance abuse and dependence. Comparisons across youth in three cities suggest that length of homelessness and drug dependence/abuse significantly differentiate between low, moderate and high transience. Understanding the heterogeneity of this population as well as the relationship between addiction and transience has implications for providing national substance abuse responses.

Life regrets and pride among low-income older adults: relationships with depressive symptoms, current life stressors and coping resources.

We examined the contents and intensities of both life regrets and pride among a convenience sample of 213 low-income older adults and the associations between the contents and intensities of life regrets and pride, on the one hand, and the older adults' current life stressors, coping resources and depressive symptoms, on the other. Regrets about education, career and marriage were common, but intensities of regrets were higher for issues related to finance/money, family conflict and children's problems, loss and grief, and health. Common sources of pride were related to children and parenting, career, volunteering/informal caregiving, long/strong marriage and personal growth/self. Controlling for current life stressors of disability, money worries, loneliness and overdependence on others for management of daily life, and coping resources of social support and religiosity, the intensities of loss-and-grief related regrets and the pride in long/strong marriage were significant predictors of the Geriatric Depression Scale (GDS) scores. However, the regrets and pride explained a small amount of the variance in the GDS scores, while the current life stressors explained a large portion of the variance.