Psychological Flexibility Mediates Wellbeing for People with Adverse Childhood Experiences during COVID-19.

BACKGROUND: The psychological impact of COVID-19 is multifaceted, both acute and chronic, and has not affected everyone equally. METHOD: This longitudinal study compared those with and without Adverse Childhood Experiences (ACEs) on measures of psychological distress and wellbeing over time. RESULTS: All groups (No ACE, Low ACE, and High ACE) had similar levels of distress at Time 1, with significant increases in psychological distress for those with ACEs over time, but not for those without. Psychological Flexibility was strongly and significantly associated with decreases in psychological distress and improved wellbeing. It significantly mediated the relationship between ACE and wellbeing. CONCLUSIONS: Those with ACEs report significantly increased psychological distress over time, compared to those without ACE during the COVID-19 pandemic. Evidence-based interventions using Psychological Flexibility may improve mental health and wellbeing to help further mediate its effects.

Public Health and Solitary Confinement in the United States.

The history of solitary confinement in the United States stretches from the silent prisons of 200 years ago to today's supermax prisons, mechanized panopticons that isolate tens of thousands, sometimes for decades. We examined the living conditions and characteristics of the populations in solitary confinement. As part of the growing movement for reform, public health agencies have an ethical obligation to help address the excessive use of solitary confinement in jails and prisons in accordance with established public health functions (e.g., violence prevention, health equity, surveillance, and minimizing of occupational and psychological hazards for correctional staff). Public health professionals should lead efforts to replace reliance on this overly punitive correctional policy with models based on rehabilitation and restorative justice.

Alcohol availability and youth homicide in the 91 largest US cities, 1984-2006.

The aggregate relationship between homicide and alcohol availability is well established across a number of national and sub-national settings in North America, Europe and some parts of Asia. However, results linking youth homicide and alcohol availability at the retail level are largely absent from the literature, especially at the city level and across longer time periods. In a multivariate, pooled time series and cross-section study, youth homicide offending rates for two age groups, 13-17 and 18-24, were analysed for the 91 largest cities in the USA between 1984 and 2006. Data for social and economic characteristics, drug use, street gang activity and gun availability were also used as time series measures. Data on the availability of alcohol for each city were gathered from the US Census of Economic Activity, which is conducted every 5 years. These data were used to construct an annual time series for the density of retail alcohol outlets in each city. Results indicated that net of other variables, several of which had significant impacts on youth homicide, the density of alcohol outlets had a significant positive effect on youth homicide for those aged 13-17 and 18-24. Such positive effects have been found for adults in national and neighbourhood level studies, but this is the first study to report such evidence for teenagers and young adults. An important policy implication of these findings is that the reduction of the density of retail alcohol outlets in a city may be an effective tool for violent crime reduction among such youth.

Public health training on the prevention of youth violence and suicide: an overview.

Although injury is the leading cause of death for Americans aged 40 and under, curricula in U.S. Schools of Public Health rarely include training on injury prevention or control. Domestically and internationally, when the topic of injury is addressed, the focus is often on unintentional injuries. Yet intentional injuries from violence and self-harm (apart from acts of war and terrorism) and the acute and chronic health problems associated with them take a large and often hidden toll on individuals, families, and communities worldwide. Adequate education on the prevention of violence and suicide by teenagers remains missing from public health and medical training. Public health and medical practitioners are confronted by violence-related injury but are provided little formal education on youth violence or suicide, effective responses, or prevention. Adolescents' involvement in violence remains a serious public health problem. Involvement in aggression and self-harm by adolescents leaves them at immediate risk of injury and often has ongoing and negative effects on future development, involvement in community and family life, and risk of morbidity and mortality for self and others. Public health practitioners are at the nexus of health care and service provision at local, state, federal, and multinational levels, and are well suited to provide training and technical assistance on youth violence prevention across disciplines and settings. In this article, training resources, opportunities, and strategies for prevention of the high prevalence of youth violence and suicide in the U.S. are discussed and recommendations for a new public health training initiative are outlined.

Violent behavior by girls reporting violent victimization: a prospective study.

OBJECTIVE: To assess the relationships between individual victimization and neighborhood-level violence on subsequent violent perpetration by adolescent girls in a community-based sample. DESIGN: Longitudinal, multilevel analysis of data collected by the Project on Human Development in Chicago Neighborhoods. Three in-home interviews were conducted approximately 24 months apart between November 1995 and January 2002 with youth and their caregivers. Community-level data also were collected in 1995 from a random sample of Chicago residents. Hierarchical regression models and propensity scores were used. SETTING: Families and neighborhoods in Chicago. PARTICIPANTS: Population-based sample of 637 girls, ages 9 to 15 years at baseline, and the neighborhoods in which they resided. This sample is diverse in race/ethnicity, socioeconomic status, family structure, and neighborhood characteristics. MAIN OUTCOME MEASURE: Self-reports of violent behavior in the 12 months before the third interview. RESULTS: At baseline, 38% of the girls reported perpetrating at least 1 violent behavior in the prior 12 months, 28% reported past year violent behavior at the first follow-up interview, and 14% reported past year violent behavior at the third interview. The odds of violent behavior were 2.2 times higher among girls who reported prior violent victimization, after prior confounding factors and baseline violent behavior were controlled (95% confidence interval, 1.3- 4.4). Homicides and concentrated poverty in girls' neighborhoods also were associated with aggression by girls. CONCLUSIONS: Improving safety in communities and homes may reduce rates of violent perpetration by adolescent girls. Study results suggest that, to facilitate identification of and healing among adolescent survivors of violence, practitioners should recognize perpetration of violence as potential sequelae of prior violent victimization.

What girls need: recommendations for preventing violence among urban girls in the US.

The last decade saw increases in arrests of girls for violent behavior and a corresponding concern that girls' involvement in violence was increasing in the USA. However, there are few empirical studies of the dynamics of violence by girls, leaving providers of violence prevention programs and policy-makers without evidence on which to base gender-appropriate prevention strategies. To address this gap, qualitative interviews were conducted with a diverse sample of 61 urban girls aged 11-17. Findings were compared with quantitative interviews from the prospective cohort of 961 girls from whom these respondents were drawn, from the Project on Human Development in Chicago Neighborhoods. Mixed-method techniques were employed. Qualitative data were analyzed for girls' recommendations for preventing involvement in violence. Data from the larger cohort were used to test these recommendations quantitatively. Due to study design, in the qualitative sample, 36 girls (64%) were involved in recent violence, most often with or against other girls. Pro-social behavior was common among both violent and nonviolent girls. In the overall cohort sample, 24.9% of girls reported violent perpetration and 97% reported pro-social activities. Eight themes regarding staying safe and preventing violence emerged from the qualitative interviews: girls stayed safe by staying home, avoiding dangerous people, staying busy with after-school activities, remaining calm when confronted, using escorts, and fighting back if attacked. Girls' protective influences included: empathic parental involvement, positive relationships with peers and older youth, and involvement in safe and constructive activities. These findings emphasize that safety in community, school, and family settings is critical for girls in avoiding violence and other risky behaviors. Violence prevention programs should focus on enhancing girls' relationships with mothers, older girls, and friends their age.

The traumatic impact of child sexual abuse: a conceptualization.

A framework is proposed for a more systematic understanding of the effects of child sexual abuse. Four traumagenic dynamics--traumatic sexualization, betrayal, stigmatization, and powerlessness--are identified as the core of the psychological injury inflicted by abuse. These dynamics can be used to make assessments of victimized children and to anticipate problems to which these children may be vulnerable subsequently. Implications for research are also considered.