Sector connectors, specialists and scrappers: How cities use civic capital to compete in high-technology markets.

This article uses three cities in the same Canadian province (Ontario): Toronto, Ottawa and Waterloo, to examine how regions compete in high-technology markets. We find that regions use civic capital to leverage new, technological windows of opportunity, but they do so in very different ways. Tracing Toronto's evolution from a marketing hub for foreign multinationals into a centre for entrepreneurship, we illustrate how weak ties and cross-sectoral buzz created a 'super connector', scaling high-technology firms in a wide variety of areas. In Ottawa, task-specific cooperation in R&D, education and specialised infrastructure enabled the region to overcome the disadvantages of its small size as a 'specialist' in a single, capital-intensive niche, telecommunications equipment. Finally, entrepreneurs in Waterloo eschewed task-specific cooperation for peer-to-peer mentoring. By diffusing generic knowledge about how to circumvent the liabilities of smallness, mentoring networks enabled this 'scrapper' city to support smaller start-ups in a broad range of niches.

Postpartum Thoughts of Infant-Related Harm and Obsessive-Compulsive Disorder: Relation to Maternal Physical Aggression Toward the Infant.

Objective: Unwanted intrusive thoughts (UITs) of intentional infant-related harm are ubiquitous among new mothers and frequently raise concerns about infant safety. The purpose of this research was to assess the relation of new mothers' UITs of intentional, infant-related harm and obsessive-compulsive disorder (OCD) with maternal aggression toward the infant and to document the prevalence of maternal aggression toward the infant.Methods: From a prospective, province-wide, unselected sample of 763 English-speaking postpartum women, a total of 388 participants provided data for this portion of the research. Participants completed 2 questionnaires and interviews postpartum to assess UITs of infant-related harm, OCD (based on DSM-5 criteria), and maternal aggression toward the infant. Data for this research were collected from February 9, 2014, to February 14, 2017.Results: Overall, few participants (2.9%; 95% CI, 1.5% to 4.7%) reported behaving aggressively toward their infant. Participants who reported UITs of intentional, infant-related harm (44.4%; 95% CI, 39.2% to 49.7%) were not more likely to report aggression toward their newborn compared with women who did not report this ideation (2.6%; 95% CI, 0.9% to 5.8%; and 3.1%; 95% CI, 1.3% to 6.2%, respectively). The same was true for women with and without OCD (1.9%; 95% CI, 0.3% to 6.4%; and 3.5%; 95% CI, 1.8% to 6.0%), respectively.Conclusions: This study found no evidence that the occurrence of either UITs of intentional, infant-related harm or OCD is associated with an increased risk of infant harm. The prevalence of child abuse of infants in this sample (2.9%) is lower than reported in others (4%-9%). Findings provide critical and reassuring information regarding the relation between new mothers' UITs of intentional harm and risk of physical violence toward the infant.

Enhancing prevention and intervention for youth concurrent mental health and substance use disorders: The Research and Action for Teens study.

BACKGROUND: Concurrent mental health and substance use disorders among youth are associated with functional impairment in developmentally salient domains, yet research on prevention and intervention for this vulnerable population is sparse. This paper describes the rationale and design of the Research and Action for Teens study, an initiative designed to strengthen the evidence base for prevention, screening, treatment and service delivery for youth concurrent mental health and substance use concerns. METHODS: Four sub-studies were developed: (1) a cohort study examining the emergence of mental health and substance use concerns from early to mid-adolescence; (2) a screening and diagnosis study validating screening tools with a diagnostic interview; (3) a treatment study examining the feasibility and effectiveness of dialectical behaviour therapy skills training interventions for youth and family members; and (4) a systems study implementing cross-sectoral collaborative networks of youth-serving agencies using a common screening tool. RESULTS: Multiple stakeholders, including service providers from youth-serving agencies across sectors, consumer groups and family members participated in an initial consultation, and in the implementation of 4 sub-studies. CONCLUSIONS: Collaboration with community stakeholders across sectors and disciplines throughout the research process is challenging but feasible, and is important for the production of applicable knowledge across the continuum of care.

Early Adolescent Substance Use and Mental Health Problems and Service Utilisation in a School-based Sample.

OBJECTIVE: This paper reports on substance use, mental health problems, and mental health service utilisation in an early adolescent school-based sample. METHOD: Participants were 1,360 grade 7 and 8 students from 4 regions of Ontario, Canada. Students completed an in-class survey on mental health and substance use. The sampling strategy and survey items on demographics, substance use, service utilisation, and distress were adapted from the Ontario Student Drug Use and Health Survey. Internalising and externalising mental health problems were assessed using the Global Assessment of Individual Needs - Short Screener. Distress was defined as fair or poor self-rated mental health. RESULTS: Rates of internalising and/or externalising problems above the threshold exceeded 30%; yet, fewer than half had received mental health services in the past 12 mo. Substance use was associated with increased odds of internalising and externalising problems above the threshold and distress. Youth using cannabis had 10-times the odds of exceeding the threshold for internalising or externalising problems. The use of substances other than alcohol or cannabis was associated with increased odds of fair or poor self-rated mental health among grade 8 students. Of the youth who confirmed at least a substance use problem, most also reported mental health problems; this association was stronger among girls than boys. CONCLUSIONS: Early adolescent substance use was associated with concurrent self-reported mental health problems in a non-clinical sample. The low levels of service utilisation reported highlight the need for improved access to early identification and intervention to prevent the development of concurrent disorders.

Why Polyvictimization Matters.

The five important papers in this series reflect the evolving state of research on violence and victimization. Their findings and methods underscore the importance of studying poly-victimization as the more encompassing genesis of harm across stages of development, rather than singular, isolated events. That is, children and youth who experience one type of violence are more likely than not to have experienced (or will experience) many others. Poly-victimized children become victims of further abuse and trauma and, in turn, are at increased risk of becoming perpetrators toward peers and future partners. These five papers incorporate a wider lens that is more inclusive of gender minority and ethnic minority youth, as well as underserved populations such as youth served by the juvenile justice systems (especially girls). Important developments were described in terms of recruiting difficult-to-reach populations, and ways to screen for psychological maltreatment in the background of youths. These papers demonstrate how the field is moving away from narrowly focused studies of violence/victimization, toward a more integrative, person-centered strategy. Such a strategy looks for common elements, such as healthy relationship development, that move us closer to common causes and solutions. These solutions should involve universal prevention via our education system that promotes well-being, enhances resilience, and reduces poly-victimization for all youth.

Bullying Predicts Reported Dating Violence and Observed Qualities in Adolescent Dating Relationships.

The relationship between reported bullying, reported dating violence, and dating relationship quality measured through couple observations was examined. Given past research demonstrating similarity between peer and dating contexts, we expected that bullying would predict negative dating experiences. Participants with dating experience (n = 585; 238 males, M(age) = 15.06) completed self-report assessments of bullying and dating violence perpetration and victimization. One month later, 44 opposite-sex dyads (M(age) = 15.19) participated in behavioral observations. In 10-min sessions, couples were asked to rank and discuss areas of relationship conflict while being video-recorded. Qualities of the relationship were later coded by trained observers. Regression analysis revealed that bullying positively predicted dating violence perpetration and victimization. Self-reported bullying also predicted observations of lower relationship support and higher withdrawal. Age and gender interactions further qualified these findings. The bullying of boys, but not girls, was significantly related to dating violence perpetration. Age interactions showed that bullying was positively predictive of dating violence perpetration and victimization for older, but not younger adolescents. Positive affect was also negatively predicted by bullying, but only for girls. These findings add to the growing body of evidence that adolescents carry forward strategies learned in the peer context to their dating relationships.

Importance of gender and attitudes about violence in the relationship between exposure to interparental violence and the perpetration of teen dating violence.

OBJECTIVE: Mounting evidence has demonstrated a link between exposure to family of origin violence and the perpetration of teen dating violence (TDV). However, only recently have mechanisms underlying this relationship been investigated and very few studies have differentiated between exposure to father-to-mother and mother-to-father violence. METHODS: The current study used structural equation modeling on a large ethnically diverse school-based sample of male and female adolescents (n=917) to address these gaps in the literature. RESULTS: For adolescent girls, there was an association between exposure to interparental violence (father-to-mother and mother-to-father) and TDV perpetration (physical violence and psychological abuse). For adolescent boys, only an association between mother-to-father violence was related to their TDV perpetration. Further, for both girls and boys, the relationship between mother-to-father violence and perpetration of TDV was fully mediated by attitudes accepting of violence. CONCLUSION: These results suggest that attending to gender and targeting adolescents' attitudes about violence may be viable approaches to preventing TDV.

Identity development as a buffer of adolescent risk behaviors in the context of peer group pressure and control.

We examined identity development as a moderator of the relation between peer group pressure and control and adolescents' engagement in risk behaviors. Participants (n=1070; M(age)=15.45 years) completed a self-report measure of identity exploration, the degree to which they have explored a variety of self-relevant values, beliefs and goals, and identity commitment, the degree to which they have secured a personal identity. Participants further reported on their frequency of risk behaviors (substance use and general deviancy) and experienced peer group pressure and control. Results confirmed that identity commitment was a buffer of substance use and identity exploration was a buffer of general deviancy in more pressuring peer groups. In more controlling peer groups, teens with greater identity commitment engaged in less risk behavior than teens with low-identity commitment. Thus, identity development may be a suitable target to deter negative effects of peer pressure in high-risk adolescents.

Observations of adolescent peer resistance skills following a classroom-based healthy relationship program: a post-intervention comparison.

This study examines peer resistance skills following a 21-lesson classroom-based intervention to build healthy relationships and decrease abusive and health-risk behaviors among adolescents. The Fourth R instructs students in positive relationship skills, such as negotiation and delay, for navigating challenging peer and dating scenarios. Observational data from 196 grade 9 students participating in a larger cluster randomized controlled trial were used to evaluate post-intervention acquisition of peer resistance skills. Pairs of students engaged in a role play paradigm with older student actors, where they were subjected to increasing pressure to comply with peer requests related to drugs and alcohol, bullying, and sexual behavior. Specific and global measures of change in peer resistance responses were obtained from two independent sets of observers, blinded to condition. Specific peer resistance responses (negotiation, delay, yielding to pressure, refusal, and compliance) were coded by research assistants; global peer resistance responses were rated by teachers from other schools (thinking / inquiry, application, communication, and perceived efficacy). Students who received the intervention were more likely to demonstrate negotiation skills and less likely to yield to negative pressure relative to controls. Intervention students were also more likely to use delay than controls; control girls were more likely to use refusal responses; the number of times students complied with peer requests did not differ. Teacher ratings demonstrated significant main effects favoring intervention youth on all measures. Program and research implications are highlighted.

Longitudinal prediction and concurrent functioning of adolescent girls demonstrating various profiles of dating violence and victimization.

Adolescent girls are involved in physical dating violence as both perpetrators and victims, and there are negative consequences associated with each of these behaviors. This article used a prospective design with 519 girls dating in grade 9 to predict profiles of dating violence in grade 11 based on relationships with families of origin (child maltreatment experiences, harsh parenting), and peers (harassment, delinquency, relational aggression). In addition, dating violence profiles were compared on numerous indices of adjustment (school connectedness, grades, self-efficacy and community connectedness) and maladjustment (suicide attempts, distress, delinquency, sexual behavior) for descriptive purposes. The most common profile was no dating violence (n = 367) followed by mutual violence (n = 81). Smaller numbers of girls reported victimization or perpetration only (ns = 39 and 32, respectively). Predicting grade 11 dating violence profile membership from grade 9 relationships was limited, although delinquency, parental rejection, and sexual harassment perpetration predicted membership to the mutually violent group, and delinquency predicted the perpetrator-only group. Compared to the non-violent group, the mutually violent girls in grade 11 had lower grades, poorer self-efficacy, and lower school connectedness and community involvement. Furthermore, they had higher rates of peer aggression and delinquency, were less likely to use condoms and were much more likely to have considered suicide. There were fewer differences among the profiles for girls involved with dating violence. In addition, the victims-only group reported higher rates of sexual intercourse, comparable to the mutually violent group and those involved in nonviolent relationships. Implications for prevention and intervention are highlighted.

Distinguishing between poor/dysfunctional parenting and child emotional maltreatment.

OBJECTIVE: This paper was intended to distinguish between poor parenting and child emotional maltreatment (CEM), to inform child welfare and public health policymakers of the need for differentiated responses. METHODS: Scientific literature was integrated with current practice and assumptions relating to poor/dysfunctional parenting and child emotional maltreatment, with a primary focus on the parent-child relationship context (rather than abnormal parent behavior alone). Numerous factors that impinge on the distinction between these acts were considered, such as the child's age, the frequency, and severity of behavior shown by caregivers, cultural norms, and parental beliefs and goals in childrearing. RESULTS: The literature on child emotional maltreatment has advanced beyond the descriptive phase of scientific understanding, and principles and practical criteria for distinguishing such behavior from poor parenting are presented. CONCLUSIONS: Recommendations focus on practical guidelines for assessing risk and activating appropriate prevention and intervention: (1) parental actions and relative risk of harm to the child are both important ingredients in defining and distinguishing child emotional maltreatment from other forms of poor parenting; (2) poor parenting methods fall along a broad continuum and fit within a population health mandate aimed at reducing incidence of all forms of negative parenting methods; (3) child emotional maltreatment can be defined categorically based on qualitatively more extreme and potentially more harmful behaviors (than poor parenting), which requires a focused intervention response. Additional recommendations for training, research, and community-based public health initiatives are presented.

La Cuarta R: Un programa escolar de prevención de la violencia en las relaciones de pareja en la adolescencia / The Fourth R: A school-based adolescent dating violence prevention program

En este trabajo se presenta un programa de prevención creado para su aplicación en el entorno escolar (La Cuarta R), que tiene como objetivo la prevención de la violencia contra la pareja en la adolescencia y conductas de riesgo relacionadas. El elemento central de La Cuarta R es un programa de 21 temas curriculares, implementado por profesores que reciben una formación especializada, que trata de promoverlas relaciones saludables, y cuyo principal objetivo es la violencia, el comportamiento sexual de alto riesgo y el uso de sustancias entre los adolescentes. La Cuarta R se evaluó en 20 escuelas mediante un diseño con asignación aleatoria a la condición experimental o control. Los resultados de la evaluación de este programa de intervención señalan que la inclusión de contenidos curriculares sobre relaciones sociales saludables, así como habilidades para evitar situaciones de violencia física en las relaciones de pareja entre adolescentes, permitía reducir este tipo de violencia, así como incrementaba el uso del condón 2.5 años después (AU)

This paper presents a school-based primary prevention program (The Fourth R) to prevent adolescent dating violence, and related risk behaviors. The cornerstone of The Fourth R is a 21-lesson skillbased curriculum delivered by teachers who receive specialized training, that promotes healthy relationships, and targets violence, high-risk sexual behavior, and substance use among adolescents. The Fourth R was evaluated in a cluster randomized trial in 20 schools. Results indicated that teaching youth healthy relationships and skills as part of their curriculum reduced physical dating violence, and increased condom use 2.5 years later (AU)

Impact of a universal school-based violence prevention program on violent delinquency: distinctive benefits for youth with maltreatment histories.

OBJECTIVE: Child maltreatment constitutes a strong risk factor for violent delinquency in adolescence, with cumulative experiences of maltreatment creating increasingly greater risk. Our previous work demonstrated that a universal school-based violence prevention program could provide a protective impact for youth at risk for violent delinquency due to child maltreatment history. In this study we conducted a follow-up to determine if participation in a school-based violence prevention program in grade 9 continued to provide a buffering effect on engaging in acts of violent delinquency for maltreated youth, 2 years post-intervention. METHODS: Secondary analyses were conducted using data from a cluster randomized controlled trial of a comprehensive school-based violence prevention program. Students (N=1,722; 52.8% female) from 20 schools participated in 21 75-min lessons in grade 9 health classes. Individual data (i.e., gender, child maltreatment experiences, and violent delinquency in grade 9) and school-level data (i.e., student perception of safety averaged across students in each school) were entered in a multilevel model to predict violent delinquency at the end of grade 11. RESULTS: Individual- and school-level factors predicting violent delinquency in grade 11 replicated previous findings from grade 9: being male, experiencing child maltreatment, being violent in grade 9, and attending a school with a lower perceived sense of safety among the entire student body increased violent delinquency. The cross-level interaction of individual maltreatment history and school-level intervention was also replicated: in non-intervention schools, youth with more maltreatment in their background were increasingly likely to engage in violent delinquency. The strength of this relationship was significantly attenuated in intervention schools. CONCLUSIONS: Follow-up findings are consistent with the buffering effect of the prevention program previously found post-intervention for the subsample of youth with maltreatment histories. PRACTICE IMPLICATIONS: A relative inexpensive school-based violence prevention program that has been shown to reduce dating violence among the whole student body also creates a protective effect for maltreated youth with respect to lowering their likelihood of engaging in violent delinquency.

Assessing historical abuse allegations and damages.

Practitioners may be called upon to assess adults who have alleged child abuse as a minor and are seeking reparations. Such assessments may be used by the courts to determine harm and assess damages related to their claim or testimony. Our clinical/research team has conducted many such evaluations and reported the findings pertaining to the psychological harm stemming from historical abuse in published studies. We use the opportunity provided by this new section on Practical Strategies to describe the role of the assessor, and to provide details concerning our methods for preparing these assessments and reporting the findings for the purpose of civil or criminal actions. Specific recommendations for wording of written reports are provided.

Impact of sexual harassment victimization by peers on subsequent adolescent victimization and adjustment: a longitudinal study.

PURPOSE: To examine gender differences in prevalence and types of sexual harassment victimization experienced in grade 9 and how it contributes to relationship victimization and psychological adjustment 2.5 years later. METHODS: A total of 1734 students from 23 schools completed self-report surveys at entry to grade 9 and end of grade 11. Self-report data were collected on victimization experiences (sexual harassment, physical dating violence, peer violence, and relational victimization) and adjustment (emotional distress, problem substance use, self-harm, suicidal thoughts, maladaptive dieting, feeling unsafe at school, and perpetration of violent delinquency). Separate analyses by sex were prespecified. RESULTS: Sexual harassment victimization was common among boys (42.4%) and girls (44.1%) in grade 9, with girls reporting more sexual jokes, comments, and unwanted touch than among boys, and with boys reporting more homosexual slurs or receiving unwanted sexual content. For girls, sexual harassment victimization in grade 9 was associated with elevated risk of self-harm, suicidal thoughts, maladaptive dieting, early dating, substance use, and feeling unsafe at school. A similar pattern of risk was found for boys, with the exception of dieting and self-harm behaviors. Adjusted odds ratios (AOR) indicated these students were significantly more likely than nonharassed students to report victimization by peers and dating partners 2.5 years later (AOR for boys and girls, respectively; all p < .01), including sexual harassment (AOR: 2.45; 2.9), physical dating violence (AOR: 2.02; 3.73), and physical peer violence (AOR: 2.75; 2.79). Gr 9 sexual harassment also contributed significantly to emotional distress (AOR: 2.09; 2.24), problem substance use (AOR: 1.79; 2.04), and violent delinquency perpetration (AOR: 2.1; 3.34) 2.5 years later (boys and girls, respectively; all p < .01). CONCLUSIONS: Sexual harassment at the beginning of high school is a strong predictor of future victimization by peers and dating partners for both girls and boys, and warrants greater prevention and intervention efforts.

Understanding the association between maltreatment history and adolescent risk behavior by examining popularity motivations and peer group control.

The purpose of the present study was to examine how peer group processes of pressure and control and individual motivations for popularity would add to, and moderate the relationship between, childhood maltreatment and risky behavior in adolescence. A total of 1558 youth (804 girls) from three high schools in Ontario, Canada (M age = 15.02 years, SD = .86) reported on their alcohol use, delinquent behavior, childhood experiences of physical and emotional maltreatment and neglect, peer group processes involving control and individual popularity motivations. Regression analyses showed that, beyond the significant contributions of childhood maltreatment, peer group control predicted risky alcohol use and delinquent behavior. Peer group control and popularity motivations exacerbated the negative effect of physical maltreatment on delinquent behavior. Boys' experiences of peer group control were more strongly linked to alcohol use and delinquent behavior than girls'. These results suggest that there is a significant window of opportunity during adolescence where the peer group context can exacerbate or buffer childhood experiences.

A school-based program to prevent adolescent dating violence: a cluster randomized trial.

OBJECTIVE: To determine whether an interactive curriculum that integrates dating violence prevention with lessons on healthy relationships, sexual health, and substance use reduces physical dating violence (PDV). DESIGN: Cluster randomized trial with 2.5-year follow-up; prespecified subgroup analyses by sex. SETTING: Grade 9 health classes. PARTICIPANTS: A total of 1722 students aged 14-15 from 20 public schools (52.8% girls). Intervention A 21-lesson curriculum delivered during 28 hours by teachers with additional training in the dynamics of dating violence and healthy relationships. Dating violence prevention was integrated with core lessons about healthy relationships, sexual health, and substance use prevention using interactive exercises. Relationship skills to promote safer decision making with peers and dating partners were emphasized. Control schools targeted similar objectives without training or materials. MAIN OUTCOME MEASURES: The primary outcome at 2.5 years was self-reported PDV during the previous year. Secondary outcomes were physical peer violence, substance use, and condom use. Analysis was by intention-to-treat. RESULTS: The PDV was greater in control vs intervention students (9.8% vs 7.4%; adjusted odds ratio, 2.42; 95% confidence interval, 1.00-6.02; P = .05). A significant group x sex interaction effect indicated that the intervention effect was greater in boys (PDV: 7.1% in controls vs 2.7% in intervention students) than in girls (12.1% vs 11.9%). Main effects for secondary outcomes were not statistically significant; however, sex x group analyses showed a significant difference in condom use in sexually active boys who received the intervention (114 of 168; 67.9%) vs controls (65 of 111 [58.6%]) (P < .01). The cost of training and materials averaged CA$16 per student. CONCLUSION: The teaching of youths about healthy relationships as part of their required health curriculum reduced PDV and increased condom use 2.5 years later at a low per-student cost.