Integrating trauma-informed services in out-of-school time programs to mitigate the impact of community gun violence on youth mental health.

Community gun violence disproportionately impacts youth in low-income urban neighborhoods. Integrating trauma-informed mental health care in community-based out-of-school time (OST) programs is an innovative method of service delivery for these youth. This article provides justification for integrating evidence-based, trauma-informed services in OST programs within communities characterized by high rates of violent crime to minimize the impact of violence exposure on youth mental health. We describe the initial feasibility of a model program, the Violence Intervention and Prevention (VIP) Initiative, implemented in a small city in southeastern Pennsylvania. Within the first six months of the VIP Initiative, 95 community residents (90% under age 18; 51% Hispanic) received intervention services, primarily through single-session and short-term weekly group intervention in OST programs, and 80% of OST youth development staff participated in at least one trauma-informed professional development training. Recommendations to enhance and expand the delivery of trauma-informed services in the novel setting of OST programs are provided.

Eating Disorder Examination Questionnaire (EDE-Q): norms for undergraduate women.

OBJECTIVE: This research presents normative data on the Eating Disorder Examination Questionnaire (Fairburn and Beglin, Int J Eat Disorder, 16, 363-370, 1994) (EDE-Q) for samples of undergraduate women in the United States. METHOD: College women (N = 723), ages 18-25, completed the EDE-Q as part of a larger assessment battery. RESULTS: Average scores, standard deviations, and percentile ranks for the raw Restraint, Eating Concern, Shape Concern, and Weight Concern subscales and the Global score are reported. Data on the occurrence of objective and subjective bulimic episodes and compensatory behaviors are presented. CONCLUSION: These results are helpful for clinicians and researchers in the interpretation of the EDE-Q scores of undergraduate women in the United States. Comparisons are drawn between the results for this sample and those of a United Kingdom sample of young adolescent females, an Australian community sample, and an Australian community age-matched sample.

Gender differences in emotional and overt/covert aggressive responses to stress.

We examined the role of stress exposure on gender differences in hostile (emotional and behavioral) reactions within the context of a laboratory paradigm. Aggressive behavior was indexed via the intensity (overt) and the duration (covert) of putative shocks delivered to a confederate. Half of the participants were exposed to a chronic stressor (high stress) and half were not (low stress). Participants' emotional responses were measured via self-report mood ratings before and after the experiment. Men displayed higher aggression in both stress conditions, which corresponded to their ratings of state hostility. On the other hand, women in high stress delivered lower intensity shocks, and this decreased overt aggression was positively correlated with sadness ratings. However, women did not decrease their levels of shock duration (covert aggression) under high stress and showed equivalent shock duration compared with men in high stress. These findings are discussed in terms of differential overt manifestations of distress between men and women.

Borderline personality symptomatology and employment disability: a survey among outpatients in an internal medicine clinic.

OBJECTIVE: The relationship between borderline personality symptomatology and employment disability has undergone limited study. Four previous studies indicate a possible relationship, but each has its own inherent limitations. In the present study, we examined this relationship among 94 internal medicine outpatients. METHOD: Using a sample of convenience, we administered 2 self-report measures for borderline personality (the Personality Diagnostic Questionnaire-4th Edition, which is based on DSM criteria, and the Self-Harm Inventory, which correlates with scores on the Diagnostic Interview for Borderlines) and inquired about the lifetime presence and length of either psychiatric or medical disability. The study was active from February 2003 through January 2005. RESULTS: There was a significant and positive correlation between scores on both borderline personality measures and the length of psychiatric disability for women (r = .33, r = .36, p = .05); however, no significant relationship was found between scores on either measure for borderline personality and the length of either psychiatric or medical disability for men. CONCLUSIONS: These findings suggest that, in contrast to men, there may be a relationship between borderline personality symptomatology and psychiatric disability only among women (i.e., there may be a gender difference). We discuss the possible implications of these results.

Childhood trauma, borderline personality symptomatology, and psychophysiological and pain disorders in adulthood.

In the empirical literature, there is support for the idea of a relationship between childhood trauma and various psychophysiological as well as pain disorders, and between borderline personality symptomatology and somatic preoccupation, as well as chronic pain. However, to date, no single study has examined the relationships between childhood trauma and borderline personality symptomatology, and the number of psychophysiological and pain disorders in adulthood. In this study, the authors examined these relationships and found no significant correlation between borderline personality symptomatology and the number of psychophysiological and pain disorders. However, there were positive and significant correlations between childhood physical abuse, emotional abuse, and witnessing violence and the number of psychophysiological and pain disorders in adulthood. Using hierarchical-regression analyses to determine which specific childhood traumas significantly predicted the number of psychophysiological and pain disorders, only witnessing violence emerged, accounting for 12% of the variance. These data suggest that a general factor associated with various forms of trauma predicts number of psychophysiological and pain disorders and that a specific predictor may be witnessing violence in childhood.

Childhood trauma and employment disability.

INTRODUCTION: While the relationship between childhood trauma and employment disability has undergone very limited study, existing data suggest a possible correlation. METHOD: In this study of 91 outpatients in an internal medicine setting, we surveyed participants and inquired about their childhood histories of sexual, physical, and emotional abuse, of physical neglect, and of witnessing violence. We also asked whether participants had ever been on employment disability, either psychiatric or non-psychiatric, and the length of that disability. RESULTS: Being or having been on disability was significantly related to childhood histories of emotional abuse, physical neglect, and witnessing violence. Being or having been on psychiatric disability was significantly related to childhood emotional abuse and physical neglect while being on non-psychiatric medical disability was significantly related to witnessing violence. The percent of one's lifetime on disability was significantly related to physical and emotional abuse as well as witnessing violence. CONCLUSIONS: Maltreatment in childhood appears to have a relationship to employment disability in adulthood. The authors discuss the implications of these findings.

Body dissatisfaction in married women: the role of spousal influence and marital communication patterns.

Family factors and the media have been established as determinants of body satisfaction, yet little research has looked at the contribution of spousal influence in body dissatisfaction. Marital quality and satisfaction can be a protective factor in the health of women, while high rates of criticism have been associated with poorer health outcomes. The present study investigated the relationship between perceptions of family and spousal factors and body dissatisfaction in married women. Additionally, the impact of marital communication was investigated. Seventy-seven married women completed self-report questionnaires assessing familial body-focused comments, spousal evaluation of a wife's body, marital communication patterns, and body dissatisfaction. After controlling for weight status, women's perceptions of familial body-focused comments and spousal evaluation emerged as significant predictors of body dissatisfaction. It was also found that more destructive communication patterns moderated the effect of perceived spousal evaluation on body dissatisfaction. This study provides some context for understanding the impact of specific influences on women's body dissatisfaction.