How spousal physical abuse impacts suicidal ideation among community-dwelling older adults: the effects of protective factors.

PURPOSE: The purpose of this study is to examine the impact on suicidal ideation (SI) of having experienced spousal physical abuse and the possible effects of protective factors on the relationship between depressive symptoms and SI among community-dwelling older adults. METHODS: Using Wisconsin Longitudinal Study data (N = 6,125), a path analysis was conducted to examine the impact of spousal physical abuse on SI and test the possible effects of protective factors. RESULTS: First, the experience of spousal physical abuse had a significant impact on both depressive symptoms and SI. Second, problem-focused coping, social support, and having a family confidant reduced depressive symptoms directly and mitigated SI indirectly. Third, emotional-focused coping had both direct and indirect effects on depressive symptoms and SI, leading to increases in both. Fourth, although the practical significance may be small, emotional-focused coping worked as a moderator between depressive symptoms and SI. CONCLUSIONS: Interventions are necessary to increase protective factors and decrease risk factors of depressive symptoms and SI among older adults. In addition, regular screening tests of Intimate Partner Violence, depressive symptoms and SI are recommended.

Protective factors against suicidal ideation among community-dwelling older adults with experience of spousal physical abuse: focusing on direct and indirect protections.

Purpose of the Study: The current research investigated the impact of protective factors - problem-focused coping, emotion-focused coping, having as a confidant either family or friends, and social support from friends - on suicidal ideation among older adults using Wisconsin Longitudinal Study (WLS) data. This study also investigated the indirect effects of protective factors on suicidal ideation (hereafter SI) as mediated by depressive symptoms among older adults who have experienced physical abuse from a spouse or romantic partner.Method: Data from The Wisconsin Longitudinal Study (WLS) were used. The sampled respondents were 475 men and women ages 64 to 65 who reported a history of being physically abused by a spouse or romantic partner. A path analysis using Mplus was employed to identify protective factors against SI.Results: Problem-focused coping and social support had negative indirect effects on SI as mediated by depressive symptoms. Emotion-focused coping had positive direct and indirect effects on SI.Conclusion: Tailored services to boost protective factors and regular screening tests are imperative to reduce depressive symptoms and SI among older adults who have experienced spousal or romantic partner physical abuse.

Student Perceptions of Substance Use Disorder Stigma as a Factor for Health Disparities: A Mixed-Methods Study.

BACKGROUND: The prevalence of substance use disorders (SUDs) is an alarming problem in the United States; however, only a fraction of patients receive treatment. Stigma from both healthcare professionals and society at large negatively impacts SUD treatment. There are limited data regarding the perceptions of healthcare students on SUD stigma as a health disparity. METHODS: We conducted a concurrent mixed-methods study among students enrolled in six health-related colleges at one mid-south health science center in the US over 3 months. Both an electronic survey consisting of 17 close-ended questions and researcher-led focus groups were conducted to understand their perceptions of stigma and SUDs. The research team followed the six steps recommended by Braun and Clarke regarding the data that aimed to capture associations between categories and extract and conceptualize the themes, and thematic analysis was done using Dedoose® (Manhattan Beach, CA, USA) qualitative software, which facilitated all the codes being kept organized and compared the frequency of codes across categories. RESULTS: A total of n = 428 students participated in the survey (response rate = 13%), and n = 31 students took part in five focus groups. Most student respondents, on average, either agreed or strongly agreed that: stigma currently exists in the healthcare field; stigma can lead to patients' not receiving the appropriate care for an SUD; and stigma can lead to lower quality care provided to patients with SUDs. Two themes were identified based on the thematic analysis: (1) additional training is necessary to better equip students for addressing SUDs in practice and (2) suggestions were formed to develop synergy between didactic and clinical rotations to improve SUD training. CONCLUSIONS: It is evident that students perceive the stigma surrounding SUDs as a detriment to patient care. Opportunities may exist in professional training programs to more seamlessly and intentionally weave SUD treatment and management concepts throughout the curriculum, as well as to empower students to operate in the complex regulatory scheme that exists for SUDs in the US.

Healthcare Professional Students' Perspectives on Substance Use Disorders and Stigma: A Qualitative Study.

BACKGROUND: Access to and quality of care for Substance Use Disorders (SUDs) remain a major public health issue. Stigma associated with SUDs contributes to the gap between the number of patients who need treatment and the much smaller fraction that receive it. Healthcare professional students are future care providers; an opportunity exists to characterize their collective perspectives on patients with SUDs and how that informs the care they provide. METHODS: Healthcare professional students participated in online, semi-structured focus group (FGs) between March and April 2021. The FGs were conducted until thematic saturation was achieved. All verbatim transcripts were analyzed applying Thematic Analysis using Dedoose® qualitative software. Inductive codes were grouped into categories based on similarities that facilitated the emergence of themes. RESULTS: Thematic Analysis revealed one theme (1) Decreasing stigma among healthcare professionals by viewing substance use disorder as a disease; and two sub-themes: Subtheme 1a: Relating with the patients, "It could be me…"; Subtheme 1b: Interactions with patients, "We just don't know exactly how to counsel these patients…" These themes describe how future healthcare professionals might perceive and approach patients with SUDs and highlight the importance of SUD training in the curriculum. CONCLUSION: Medical and pharmacy students are uniquely positioned to apply critical thinking from their didactic training to their real-world clinical experiences, and their collective perspectives inform gaps in training and opportunities to develop best practices for SUD care. An opportunity exists to leverage these findings in order to train future healthcare professionals to ensure access to and quality of SUD care.

Patterns of aggressive behavior and peer victimization from childhood to early adolescence: a latent class analysis.

The developmental period characterized by the transition from childhood and elementary school to early adolescence and middle school has been associated with increases in aggressive behavior and peer victimization. Few longitudinal studies, however, have examined the stability of aggression and victimization during this critical transition. This study uses latent class analysis (LCA) to examine patterns of aggressive behavior and victimization during the transition to middle school among urban, public school students (N = 458; Girls = 53%; Latino/a = 53%; M age at t1 = 10.2 years). Independent LCA models were conducted using self-reported data assessing subjects' involvement in aggressive conduct and victimization during the spring semesters of grades four, five, and six. Elementary school students in the fourth grade initially belonged to one of four groups identified as aggressor, victim, aggressor-victim, and uninvolved latent classes. Contrary to prior research, membership in these classes changed significantly by the time students completed their first year of middle school with most youth participating in episodes of aggression and victimization during the transition. Six common paths that describe patterns of aggressive behavior and victimization from the last two years of elementary school to the first year of middle school were found. Findings are discussed in the context of social dominance theory and prior research that has found greater stability in aggression and victimization among early adolescents.

Predictors of Latinx Youth Health and Emotional Well-being: Social Determinants of Health Perspective.

Latinx youth disproportionately experience numerous negative social determinants of health (SDOH) that can have deleterious impacts on health outcomes. Yet, limited research is available on the role of SDOH on the well-being of Latinx adolescents. Utilizing data from the Fragile Families and Child Wellbeing Study, this study examined the association between variables representing five discrete domains of SDOH and health and emotional well-being outcomes among youth of Latinx mothers (N = 745). The study included 15-year-old youth of Latina mothers who were retained in the most recent wave of data collection (wave 6). Using Mplus8, we performed structural equation modeling to determine whether exogenous indicators of five domains of SDOH (economic stability, education, neighborhood and built environment, social and community context, and health care access) predicted adolescent health status and emotional well-being. SDOH specific to social, educational, and neighborhood factors emerged as significant predictors of health and well-being. Yet, variation existed in regard to which SDOH were most important for each outcome variable. Findings suggest that several SDOH, including economic stability, education, neighborhood and built environment, and social and community context, are particularly important for Latinx adolescent well-being. Implications for social work practice and policy are presented. Future studies should examine the longitudinal impact of SDOH and should examine Latinx youth by nativity.