Gun Violence Exposure and Suicide Among Black Adults.

Importance: Black individuals are disproportionately exposed to gun violence in the US. Suicide rates among Black US individuals have increased in recent years. Objective: To evaluate whether gun violence exposures (GVEs) are associated with suicidal ideation and behaviors among Black adults. Design, Setting, and Participants: This cross-sectional study used survey data collected from a nationally representative sample of self-identified Black or African American (hereafter, Black) adults in the US from April 12, 2023, through May 4, 2023. Exposures: Ever being shot, being threatened with a gun, knowing someone who has been shot, and witnessing or hearing about a shooting. Main Outcomes and Measures: Outcome variables were derived from the Self-Injurious Thoughts and Behaviors Interview, including suicidal ideation, suicide attempt preparation, and suicide attempt. A subsample of those exhibiting suicidal ideation was used to assess for suicidal behaviors. Results: The study sample included 3015 Black adults (1646 [55%] female; mean [SD] age, 46.34 [0.44] years [range, 18-94 years]). Most respondents were exposed to at least 1 type of gun violence (1693 [56%]), and 300 (12%) were exposed to at least 3 types of gun violence. Being threatened with a gun (odds ratio [OR], 1.44; 95% CI, 1.01-2.05) or knowing someone who has been shot (OR, 1.44; 95% CI, 1.05-1.97) was associated with reporting lifetime suicidal ideation. Being shot was associated with reporting ever planning a suicide (OR, 3.73; 95% CI, 1.10-12.64). Being threatened (OR, 2.41; 95% CI, 2.41-5.09) or knowing someone who has been shot (OR, 2.86; 95% CI, 1.42-5.74) was associated with reporting lifetime suicide attempts. Cumulative GVE was associated with reporting lifetime suicidal ideation (1 type: OR, 1.69 [95% CI, 1.19-2.39]; 2 types: OR, 1.69 [95% CI, 1.17-2.44]; ≥3 types: OR, 2.27 [95% CI, 1.48-3.48]), suicide attempt preparation (≥3 types; OR, 2.37; 95% CI, 2.37-5.63), and attempting suicide (2 types: OR, 4.78 [95% CI, 1.80-12.71]; ≥3 types: OR, 4.01 [95% CI, 1.41-11.44]). Conclusions and Relevance: In this cross-sectional study, GVE among Black adults in the US was significantly associated with lifetime suicidal ideation and behavior. Public health efforts to substantially reduce interpersonal gun violence may yield additional benefits by decreasing suicide among Black individuals in the US.

Exposure to violence and asthma in Puerto Rican youth with high Th2 immunity.

BACKGROUND: Little is known about the determinants of asthma among youth with high T helper 2 (Th2) immunity. We hypothesized that exposure to violence (ETV) and violence-related distress are associated with asthma in children and adolescents with high Th2 immunity. METHODS: We analyzed data from Puerto Ricans with high Th2 immunity aged 9-20 years in the Puerto Rico Genetics of Asthma and Lifestyle (PR-GOAL) and the Epigenetic Variation of Childhood Asthma in Puerto Ricans (EVA-PR) studies, and in a prospective study (PROPRA). High Th2-immunity was defined as ≥1 positive allergen-specific IgE and/or a total IgE ≥ 100 IU/mL and/or an eosinophil count ≥ 150 cells/µL. Asthma was defined as physician-diagnosed asthma and current wheeze. ETV and violence-related distress were assessed with the validated ETV Scale and Checklist of Children's Distress Symptoms (CCDS) questionnaires, respectively. RESULTS: In multivariable analyses, each 1-point increment in ETV score was significantly associated with 1.13-1.17 times increased odds of asthma in PR-GOAL and in EVA-PR (both at p ≤ 0.01), and each 1-point increment in CCDS score was significantly associated with 1.53-1.54 increased odds of asthma in PR-GOAL and in EVA-PR (both at p ≤ 0.03). Further, a persistently high ETV score was significantly associated with asthma in PROPRA (odds ratio [OR] = 2.83, 95% confidence interval [CI] = 1.10-7.29). Similar results were obtained in a sensitivity analysis using an eosinophil count ≥ 300 cells/µL instead of ≥150 cells/µL to define high Th2 immunity. CONCLUSIONS: ETV during childhood is associated with increased risk of persistent or new-onset asthma in youth with high Th2 immunity.

Longitudinal Associations Between Community Violence Exposure and Mental Health Problems in Inner-City Youth: Ethnicity and Gender Perspectives.

There is a lack of agreement on whether children and adolescents with different cultural/ethnic backgrounds react to trauma in a similar fashion. This study adds to the existing literature by providing ethnicity and gender perspectives on the longitudinal associations between the degree of community violence exposure (CVE) and mental health problems in U.S. inner-city youth. The study was conducted on a representative sample of predominantly ethnic minority youth (N = 2,794; 54.1% female; age 11-16 years old (M [SD] = 12.77 [1.29]); 60.0% African-American, 26.1% Hispanic American, 13.9% White). Self-reported information was obtained on CVE in year 1 and on mental health problems (depressive symptoms, posttraumatic stress, alcohol use, and conduct problems) in year 1 and year 2. Multivariate analyses of covariance (MANCOVA) were used to compare mental health problems in youth from the three ethnic groups in relation to the different degrees of CVE experienced one year prior, while controlling for their baseline mental health problem levels, age, and socio-economic status. Mental health problems in year 2 increased in a similar fashion in relation to the degree of severity of CVE in year 1 in all three ethnic groups. The interaction effects suggested a gender-specific response to CVE, where girls in the three ethnic groups reported higher levels of depression and posttraumatic stress in relation to the same degree of CVE, as compared to boys. Adolescents from different ethnic backgrounds respond similarly to differing degrees of CVE with an increase in mental health problems over time. In response to a similar degree of exposure, girls tend to experience greater levels of internalizing problems than boys. Timely recognition of traumatic exposure and associated mental health problems is important for early prevention and intervention strategies.

Development, construct validity, and measurement invariance of the Modified Classes of Racism Frequency of Racial Experiences Measure (M-CRFRE) to capture direct and indirect exposure to perceived racism-based police use of force for Black emerging adults.

OBJECTIVES: To utilize focus groups, cognitive interviews, content expert panel, and computer-assisted surveys to develop and pilot survey items assessing exposure to perceived racism-based police violence to enhance the Classes of Racism Frequency of Racial Experiences (CRFRE). METHOD: Focus groups and cognitive interviews were conducted with Black emerging adults (n = 44) in St. Louis, Missouri. Utilizing a grounded theory approach, a thematic analysis of the focus group and cognitive interview transcripts was conducted to identify key items to be added to the CRFRE. Three content experts assessed the face and content validity of survey items. Computer-assisted surveys were conducted to pilot the modified CRFRE with a sample of Black emerging adults (n = 300). Confirmatory factor analyses and structural paths were used to examine the construct validity of the modified CRFRE. RESULTS: Participant's qualitative data and suggestions from content experts resulted in the development of 16 additional survey items regarding exposure to perceived racism-based police violence across three domains (victim, witness in person, and seen in media). The modified CRFRE measure showed construct validity, internal reliability, and measurement invariance between men and women. CONCLUSIONS: This study advances our epidemiological methodology for quantifying exposure to perceived racism-based police violence. Future research is necessary to assess the prevalence of exposure to perceived racism-based police violence and associated mental and behavioral outcomes for Black emerging adults in the U.S. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Lethal Police Encounters and Cardiovascular Health among Black Americans.

This study uses insights from social stress theory to examine associations between exposure to police killings of Black Americans and cardiovascular health among Black women and men. Data on lethal police encounters come from the Mapping Police Violence (MPV) database, which allows for examination of total exposures to police killings of Black people and exposures to events when decedents were unarmed. MPV data are merged with the Behavioral Risk Factor Surveillance System (n = 26,086) and state-level information from multiple federal databases. Four cardiovascular health outcomes are examined-hypertension, diabetes, heart attack, and stroke. After adjusting for important risk factors, results from gender-stratified multilevel logistic regressions reveal a positive association between exposures to police killings of unarmed Black people and odds of hypertension among Black women and stroke among Black men. Total exposures to police killings of Black people are also associated with greater likelihood of stroke for Black men. Findings from this study demonstrate that stress exposures generated by the quantity and injustice of police killings have important implications for cardiovascular health among Black Americans. Furthermore, adverse cardiovascular health associated with exposure to police violence tends to manifest differently for Black men and women.

Safe Pregnancy intervention for intimate partner violence: a randomised controlled trial in Norway among culturally diverse pregnant women.

BACKGROUND: Intimate partner violence (IPV) during pregnancy is a global health problem with adverse consequences for mothers, infants and families. We hypothesise that information about IPV and safety behaviours during pregnancy has the potential to increase quality of life and the use of safety behaviours and prevent IPV. METHODS: A multicentre randomised controlled trial among culturally diverse pregnant women in Norway, to test the effect of a tablet-based video intervention about IPV and safety behaviours. Women attending routine antenatal check-ups alone (baseline) were screened for violence (Abuse Assessment Screen) by responding to questions on a tablet, and randomised (1:1) by computer to receive an intervention or a control video. The intervention video presented information about IPV and safety behaviours. The controls viewed a video promoting healthy pregnancy in general. Outcome measures were assessed three months post-partum: The World Health Organization Quality of Life-BREF, the Composite Abuse Scale on violence during the last 12 months and use of safety behaviours based on a 15-item checklist. A general linear model for repeated measures was used to examine the intervention's effect. The analyses were conducted by intention to treat. RESULTS: Among 1818 eligible women, 317 reported IPV and were randomised to an intervention (157) or a control group (160). A total of 251 (79.2%) women completed the follow-up questionnaire: 120 (76.4%) in the intervention group and 131 (81.9%) in the control group. At follow-up, 115 (45.8%) women reported a history of IPV. Few women (n = 39) reported IPV during the last 12 months. No differences in quality-of-life domains and overall quality of life and health were found between the intervention and the control groups. We detected no differences between the use of safety behaviours or IPV frequency and severity during the last 12 months. CONCLUSION: Our intervention did not improve women's quality of life, use of safety behaviours or exposure to violence. Nevertheless, a tablet-based tool may motivate women experiencing IPV to seek help and support. More research is needed regarding tablet-based interventions for women experiencing IPV, particularly culturally sensitive interventions. TRIAL REGISTRATION: NCT03397277 registered in clinicaltrials.gov on 11/01/2018.

Passagens adolescentes em afrodiáspora: do estado-coisa ao estado de sujeito / Pasajes adolescentes en aphrodiaspora: del estado-cosa al estado de sujeto / Adolescent passages in aphrodiaspora: from the state-thing to the state-subject / Passages adolescents en l'aphrodiaspora: de l'état-chose à l'état-sujet

Propomos uma reflexão sobre o acolhimento da urgência subjetiva e a orientação de jovens originários da África subsaariana nos serviços da rede de proteção da infância francesa. A partir do acompanhamento clínico de uma adolescente de origem senegalesa, realizado durante um ano em um centro de acolhimento de jovens menores não acompanhados da família e em situação de migração, apresentaremos os pilares de uma práxis psicanalítica realizada nestas condições. Em um segundo momento, abordaremos um caso clínico no qual a urgência subjetiva se apresenta pelo viés da perplexidade como resposta a violações sexuais, errância e exílio vividos em um percurso migratório. Finalmente, refletiremos sobre a apropriação do estrangeiro-íntimo como potencialidade de reedição narrativa e produção de ancoragens diante do trauma

Proponemos una reflexión sobre la acogida de la urgencia subjetiva y la orientación de los jóvenes del África subsahariana en los servicios de la red francesa de protección a la infancia. A partir del seguimiento clínico de una adolescente de origen senegalés, realizado durante unaño en un centro de acogida de menores no acompañados en situación migratoria, presentaremos los pilares de una práctica psicoanalítica realizada en estas condiciones. En un segundo momento, abordaremos un caso clínico en el que la urgencia subjetiva se presenta a través del sesgo de la perplejidad como respuesta a las violaciones sexuales, vagabundeos y exilios vividos en un trayecto migratorio. Finalmente, reflexionaremos sobre la apropiación del íntimo-extraño como potencial de reedición narrativa y producción de anclas ante el trauma

We propose a reflection on the reception of subjective urgency and the orientation of young people from sub-Saharan Africa in the services of the French child protection network. Based on the clinical follow-up of an adolescent of Senegalese origin, carried out for one year in a reception center for young minors unaccompanied by their family and in a migration situation, we will present the pillars of a psychoanalytic practice carried out in these conditions. In a second moment, we will approach a clinical case in which the subjective urgency presents itself through the bias of perplexity as a response to sexual violations, wandering and exile experienced in a migratory path. Finally, we will reflect on the appropriation of the foreign-intimate as a potential for narrative re-editing and production of anchors in the face of trauma

Nous proposons une réflexion sur l'accueil de l'urgence subjective et l'orientation des jeunes d'Afrique subsaharienne dans les services du réseau français de protection de l'enfance. A partir du suivi clinique d'une adolescente d'origine sénégalaise, réalisé pendant un an dans un centre d'accueil pour mineurs non accompagnés en situation migratoire, nous présenterons les piliers d'une pratique psychanalytique menée dans ces conditions. Dans un second temps, nous aborderons un cas clinique dans lequel l'urgence subjective se présente à travers le biais de la perplexité comme réponse aux violations sexuelles, errances et exils vécus dans une trajectoire migratoire. Enfin, nous réfléchirons à l'appropriation de l'intime-inconnu comme potentiel de réédition narrative et de production d'ancres face au trauma

Exposure to Violence and Posttraumatic Stress Among Youth in Public Housing: Do Community, Family, and Peers Matter?

This study examines the mediating roles of neighborhood risk factors, parental behaviors, and peers on the relationship between community violence exposure and posttraumatic stress in a sample of urban youth in low-income public housing communities. Data are from 320 African-American youth living in public housing in a northeastern city in the USA. Structural equation modeling was utilized to examine the stated relationships. Study results point to significant effects of violence exposure on posttraumatic stress in urban youth. While findings indicated indirect effects of neighborhood risk, parenting practices, and exposure to delinquent peers on posttraumatic stress, each of these paths operates through their relationship with violence exposure, with exposure to delinquent peers having the strongest mediating effect. Exposure to delinquent peers mediates the effects of neighborhood risks and parental behaviors on exposure to community violence, representing one potential intervention point to disrupt the deleterious effects of exposure to violence among youth. Our findings suggest interventions that address peer influence, and group norms may serve as protective factors against the risk of youth violence exposure. Overall, results highlight the co-occurring socioecological context of community violence exposure for youth living in public housing.

Posttraumatic Stress, Academic Performance, and Future Orientation as Pathways to Community Violence Exposure and Sexual Risk among African American Youth in Chicago's Southside.

Posttraumatic stress, low academic performance, and future orientation as pathways from community violence exposure to sexual risk-taking behavior were examined among 753 African American youth in a large urban school district, ranging from ages of 13 to 24 years. Youth completed a self-report instrument. Youth completed a self-report instrument of Exposure to Violence Probe, University of California at Los Angeles' PTSD Reaction Index Adolescent Version, and Coopersmith's Self-Esteem Scale. Structural equation modeling was performed to examine relationships among the major study variables. Results indicated that community violence exposure was not directly associated with sexual risk behavior. However, community violence exposure had a significantly positive impact on posttraumatic stress, which was associated with low future orientation and sexual risk behavior. Findings suggest that targeted interventions need to consider variables that mediate the association between violence exposure and sexual risk behavior, which can reduce poor sexual health outcomes among urban youth who are exposed to violence in their community.

A legacy of fear: Physiological evidence for intergenerational effects of trauma exposure on fear and safety signal learning among African Americans.

OBJECTIVE: To determine the influence of maternal trauma and posttraumatic stress disorder (PTSD) symptoms on children's physiological response to threat and safety signals during a fear conditioning task in trauma-exposed mothers and children. METHOD: Participants were African American mother-child dyads (N = 137; children aged 8-13 years). Mothers' trauma history and PTSD symptoms were assessed; Latent Class Analysis (LCA) was conducted from these measures to identify distinct classes. Children reported violence exposure and completed a differential fear conditioning task using fear-potentiated startle (FPS) responses to conditioned danger (CS+) and safety (CS-) signals. RESULTS: Four classes of maternal trauma history and PTSD symptoms emerged: 1) Lower Trauma, 2) Moderate Trauma, 3) High Sexual Abuse, and 4) High Trauma and PTSD Symptoms. Children's FPS to CS + and CS- were tested with maternal class as the between-subjects factor. FPS to the danger signal was not significantly different across maternal classes, but FPS to safety (CS-) was significantly higher for the Lower Trauma and High Trauma and PTSD Symptoms classes than either the Moderate Trauma or the High Sexual Abuse classes. CONCLUSIONS: Results indicate that maternal trauma impacts children's ability to modulate fear responses in the presence of a safety signal, independent of the children's own trauma exposure. To our knowledge, this is the first study to demonstrate that children's fear inhibition is impacted by maternal trauma exposure. Prior studies have linked fear inhibition to mental health outcomes, highlighting the need to understand intergenerational modulation of fear learning and physiology.

Understanding the link between child maltreatment and adolescent future expectations in Northern Uganda: A serial mediation analysis.

BACKGROUND: Recent research has identified high levels of child maltreatment and harsh parenting in post-war societies which have had detrimental effects on children's development. Future expectations are an important aspect of adolescents' development particularly in the challenging contexts of post-war societies where social instabilities and violence are prevalent. To date, however, the link between child maltreatment and adolescent future expectations remains understudied. OBJECTIVE: By applying a socio-ecological perspective, this study aimed to investigate risk (internalizing symptoms) and protective factors (community integration) linking experiences of harsh parenting with adolescents' future expectations. PARTICIPANTS AND SETTING: Data was collected from N = 199 northern Ugandan adolescents (40.2 % females, Mage = 14.56 years) with structured interviews. METHODS: Serial mediation analyses were calculated with child maltreatment as the predictor, future expectations as the outcome, and internalizing symptoms as well as community integration as mediating variables. RESULTS: Results of the mediation model (R2 = .22, F(5193) = 10.54, p <  .001, total effect (b = -0.28, p < .005) revealed a direct effect of child maltreatment on future expectations (effect size: -.20, 95 % bootstrap CI = -0.40, -.01) as well as an indirect effect of child maltreatment via internalizing symptoms and community integration on future expectations (effect size of -.07 (95 % bootstrap CI = -0.14, -0.01). CONCLUSION: Child maltreatment was found to be linked to negative future expectations among Northern Ugandan adolescents, and both internalizing symptoms as well as community integration played mediating roles in the associations. Interventions should take psychopathology and community factors into account.

Exploring parent-child agreement on reports of exposure to community violence: Utilizing a latent profile approach.

Exposure to community violence (ECV) has a number of implications for children including poor mental health functioning, impaired cognition, memory, learning, and school performance (Edlynn et al, 2008 Am. J. Orthopsychiat., 78, 249-258; Gardner et al., 1996, J. Consult. Clin. Psychol., 64, 602-609). Discrepancies in child and parent reports of the child's ECV may exacerbate these adverse effects (Hill & Jones, 1997 J. Natl Med. Assoc., 89, 270-276). This study aimed to categorize dyads based on the agreement in reports of ECV. Furthermore, this study aimed to identify ethnic differences within these groups in addition to mental health issues. Four profiles, based on average exposure to violence, emerged: Low exposure (LE), moderate exposure, high exposure, and severe exposure. Ethnic differences among these profiles indicate ethnic minorities are less likely to belong to the LE profile and more likely to represent the other profiles. There were differences among profiles based on mental health functioning.

Sociodemographic and Environmental Factors are Associated with Adolescents' Pain and Longitudinal Health Outcomes.

Research in adult populations indicates that several sociodemographic and environmental variables increase risk for pain and poor outcomes. There is little research exploring the impact of household income, health insurance coverage, barriers to health care, neighborhood and school safety, violence experienced, and neighborhood isolation on pediatric chronic pain. Data from the Add Health Study, a longitudinal examination of a nationally-representative adolescent sample were analyzed. The relationships between demographic variables, risk factors, chronic pain, and long-term health outcomes were examined. Adolescents with chronic pain had lower income, more health care barriers, greater safety concerns, and experienced more violence compared to those without pain. In a model together, female sex, White race/ethnicity, and greater health care barriers, safety concerns, and violence exposure conferred significant risk for chronic pain. Additional analyses revealed nuances in the strength of risk factors between racial/ethnic groups. Systemic health care barriers were significantly associated with chronic pain and may delay symptom alleviation and return to functioning. Considering access to care is necessary in prevention efforts. Among adolescents with chronic pain, greater safety concerns predicted poor mental health outcomes, particularly for White females. The cumulative stress of environmental concerns, such as safety, and managing chronic pain may worsen functioning. PERSPECTIVE: Adolescents with chronic pain had lower income, and more health care barriers, safety concerns, and violence exposure compared to those without chronic pain. Access to care is a significant problem in youth with chronic pain. The relationships between race/ethnicity, risk factors, and health outcomes are complex and require additional research.

A Phenomenological Study on the Experience of Syrian Asylum-Seekers and Refugees in the United States.

Violence in Syria has displaced an unprecedented number of people from their homes. While couple/family therapy (C/MFT) scholars have explored migration experiences, particularly among refugees, there is still limited research using a bioecological framework. This exploratory study examined the experiences of Syrian asylum-seekers and refugees living in the United States using a qualitative phenomenological approach. Twelve Syrians (n = 8 men, n = 4 women) between 20 and 52 years of age (M = 35.8, SD = 10.7) were interviewed about their experiences across three stages of resettlement: (1) pre-resettlement, (2) resettlement/migration, and (3) post-resettlement. Findings suggest that the effects of conflict-induced displacement and resettlement permeate across multiple ecologies. These range from the individual and his or her interpersonal relationships to their larger community and society. C/MFTs should account for contextual factors while becoming familiar with the sociopolitical impact of displacement and resettlement in their clinical work with this population.

La violencia en Siria ha desplazado a un número de personas sin precedentes de sus hogares. Si bien los especialistas en terapia de pareja, conyugal y familiar han analizado las experiencias de migración; particularmente entre los refugiados, aun hay escasas investigaciones que usan un marco bioecológico. Este estudio exploratorio analizó las experiencias de los solicitantes de asilo y los refugiados sirios que viven en Estados Unidos utilizando un enfoque fenomenológico cualitativo. Se entrevistó a doce sirios (n = 8 hombres, n = 4 mujeres) de entre 20 y 52 años (M = 35.8, SD = 10.7) con respecto a sus experiencias en tres etapas del reasentamiento: (1) prereasentamiento, (2) reasentamiento/migración, y (3) posreasentamiento. Los resultados sugieren que los efectos del desplazamiento inducido por el conflicto, junto con el reasentamiento, penetran en las ecologías. Estos pueden variar desde la persona y sus relaciones interpersonales hasta su comunidad y sociedad más amplias. Por lo tanto, la terapia de pareja, conyugal y familiar debería justificar los factores contextuales y a la vez familiarizarse con el efecto sociopolítico del desplazamiento y el reasentamiento en su trabajo clínico con esta población.

Exposure to gangs in low-income urban communities and substance use among Hispanic youth.

A third of Hispanic youth live below the poverty line, making them vulnerable for exposure to gangs, substances, and violence, all of which have been associated with substance use. The aim of the present study was to test the link between these variables, using a multiple mediation model. Results suggest that the relationship between gang exposure and adolescent substance use was mediated by both access to substances and exposure to violence. Findings provide insight into how gang exposure impacts outcomes for low-income youth. Implications for prevention and policy are discussed.

Social Isolation, Loneliness, And Violence Exposure In Urban Adults.

Social isolation is a key predictor of mortality in the US and may be heightened in communities affected by violence. Qualitative studies have documented that people living in high-crime neighborhoods often report being confined to their homes because of safety concerns. However, few quantitative studies have empirically assessed relationships between violence exposure and social isolation. In 2018 we conducted hour-long, in-person surveys with 504 adults in Chicago, Illinois. Prior exposure to community violence was associated with a 3.3-point reduction (on a 100-point scale) in the frequency of interaction with network confidantes, a 7.3-point reduction in perceived social support from friends, and a 7.8-point increase in loneliness. At a time when public health and policy leaders are calling for solutions to the "epidemic of loneliness," identifying populations at higher risk because of violence could help target interventions and ensure equitable access to social and medical support.

Mitigating Negative Consequences Of Community Violence Exposure: Perspectives From African American Youth.

The burden of community violence on young African Americans includes disproportionate rates of physical and mental health consequences. To develop appropriate and sustainable interventions that mitigate the negative consequences after violence exposure, it is critical to incorporate the lived experiences and perspectives of African American youth. We conducted five focus groups that collectively included thirty-nine African American youth living in income-disadvantaged urban neighborhoods in Kansas City, Missouri, to examine their experiences and perceptions of community violence and identify priorities to reduce the negative consequences of community violence. Youth-identified priorities included increasing proactive responses from multiple community sectors; reducing racial discrimination; and creating safe environments, including access to mental health care and other supportive services. Incorporating these findings into current policy and cross-sector initiatives offers a promising opportunity to improve the health and well-being of African American youth exposed to community violence.

Identifying subgroups of refugees from Syria resettled in Sweden based on multiple trauma exposures: A latent class analysis of trauma history and mental health outcomes.

OBJECTIVE: Many refugees have been subjected to pre-migratory trauma. Evidence is needed to address the heterogeneity within refugee populations in regard to patterns of multiple trauma exposures. This study identified subgroups within a refugee population displaying different profiles of multiple trauma exposures and assessed sociodemographic predictors and differences in mental health symptom severity across these classes. METHODS: Study population consisted of 1215 refugees from Syria resettled in Sweden. Latent class analysis 3-step method for modelling predictors and outcomes and a class-specific weighted multigroup approach were used to identify classes of refugees using self-reported data on violent and non-violent trauma exposures, sociodemographic variables and symptom severity scores for depression, anxiety and PTSD. RESULTS: Three classes were identified: class 1 'multiple violent and non-violent trauma' (39.3%, n = 546); class 2 'witnessing violence and multiple non-violent trauma' (40.8%, n = 569); and class 3 'low multiple non-violent trauma' (20.1%, n = 281). Trauma exposure and gender significantly predicted class membership. Male gender and highest severity of mental ill health defined class 1. Female gender predicted higher mental ill health within classes 1 and 2. Across all three classes living with a partner was associated with lower severity of mental ill health regardless of trauma exposure classes. CONCLUSIONS: There are distinct patterns within refugee populations concerning exposure to multiple trauma. Violence is a primary marker for higher likelihood of multiple trauma exposures and severity of mental health. Gender predisposes individuals to trauma exposure and its outcomes differentially.

Negative life experiences contribute to racial differences in the neural response to threat.

Threat-related emotional function is supported by a neural circuit that includes the prefrontal cortex (PFC), hippocampus, and amygdala. The function of this neural circuit is altered by negative life experiences, which can potentially affect threat-related emotional processes. Notably, Black-American individuals disproportionately endure negative life experiences compared to White-American individuals. However, the relationships among negative life experiences, race, and the neural substrates that support threat-related emotional function remains unclear. Therefore, the current study investigated whether the brain function that supports threat-related emotional processes varies with racial differences in negative life experiences. In the present study, adolescent violence exposure, family income, and neighborhood disadvantage were measured prospectively (i.e., at 11-19 years of age) for Black-American and White-American volunteers. Participants then, as young adults (i.e., 18-23 years of age), completed a Pavlovian fear conditioning task during functional magnetic resonance imaging (fMRI). Cued and non-cued threats were presented during the conditioning task and behavioral (threat expectancy) and psychophysiological responses (skin conductance response; SCR) were recorded simultaneously with fMRI. Racial differences were observed in neural (fMRI activity), behavioral (threat expectancy), and psychophysiological (SCR) responses to threat. These threat-elicited responses also varied with negative life experiences (violence exposure, family income, and neighborhood disadvantage). Notably, racial differences in brain activity to threat were smaller after accounting for negative life experiences. The present findings suggest that racial differences in the neural and behavioral response to threat are due, in part, to exposure to negative life experiences and may provide new insight into the mechanisms underlying racial disparities in mental health.

Violence exposure, conflict, and health outcomes in inner-city African American adolescents.

PURPOSE: To examine relationships among community and school violence exposure, parent-adolescent conflict, coping style, and self-reported health in a sample of 432 high-risk, inner-city African American adolescents at age 14 years. DESIGN AND METHODS: Multiple regression and principal component analysis were used to analyze the secondary data. After controlling for multiple covariates (eg, sex, age, blood lead levels, and socioeconomic status), both violence exposure and posttraumatic stress symptoms (PTSS) were related to health outcomes. The survey of exposure to community violence, the safe-school survey, and the conflict tactics scale were used to measure community violence, school violence, and parent-adolescent conflict. Coping was evaluated using the general coping scale. The child health illness profile-adolescent edition was used to obtain self-reported health measures, and the clinician-assisted PTSD scale was used to measure PTSS. RESULTS: Higher exposure to community violence was associated with less emotional comfort, less family involvement, higher individual risk, and poorer academic and work performance. Parent-adolescent conflict predicted less physical and emotional comfort and poorer home safety and health. CONCLUSIONS: Our findings suggest that it is important to evaluate both violence exposure and the responses to the exposure, which can include both PTSS and diverse coping strategies.