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Diffusion theory posits that information is disseminated throughout a social network by the persuasion of key opinion leaders (KOLs). This study examined the relative and combined influence of peer-identified KOL teachers (n = 12) and mental health providers (n = 21) on classroom teachers' (n = 61) self-reported use of commonly recommended classroom practices for children with attention-deficit/hyperactivity disorder in 6 low-income urban African American communities, relative to teachers (n = 54) at 4 matched schools who received mental health provider consultation only. Mixed-effects regression models showed that KOLs in collaboration with mental health providers promoted higher rates of teachers' serf-reported use of recommended strategies than mental health providers alone, and that these effects were mediated by KOL support but not by mental health provider support. The results suggest an expanded role for KOL teachers as indigenous and natural supports for the dissemination and implementation of school-based mental health programs. Keywords: key opinion leaders, urban schools, diffusion, ADHD, community mental health consultation

Given the devastation caused by disasters and mass violence, it is critical that intervention policy be based on the most updated research findings. However, to date, no evidence--based consensus has been reached supporting a clear set of recommendations for intervention during the immediate and the mid-term post mass trauma phases. Because it is unlikely that there will be evidence in the near or mid-term future from clinical trials that cover the diversity of disaster and mass violence circumstances, we assembled a worldwide panel of experts on the study and treatment of those exposed to disaster and mass violence to extrapolate from related fields of research, and to gain consensus on intervention principles. We identified five empirically supported intervention principles that should be used to guide and inform intervention and prevention efforts at the early to mid--term stages. These are promoting: 1) a sense of safety, 2) calming, 3) a sense of self--and community efficacy, 4) connectedness, and 5) hope.

Managing violent patients is a dilemma that every clinician faces. This article reviews the current literature and assesses the evidence on the management of violent patients in the clinical setting. Risk factors (dispositional, historical, contextual and clinical) and early warning signs of violence will be outlined. Understanding these issues will facilitate the short-term prediction and prevention of violence in clinical settings. Interventions have been categorized for use according to the urgency of the situation. This degree of urgency has been designated as either potential, imminent or emergent violence. Special considerations that may alter the management of violence will be delineated. Specifically, we will highlight issues related to gender, age and mental retardation. Aspects of professional training in regards to the management of the violent patient will be underscored as well. Finally, the review of the literature has led to a decision tree that can inform the reader in the evidence-based management of the violent patient. This decision tree is offered to the busy practitioner as a practical clinical tool for using evidence based practices in managing violent patients. KEY WORDS: violence; aggression; prediction; management.

Managing violent patients is a dilemma that every clinician faces. This article reviews the current literature and assesses the evidence on the management of violent patients in the clinical setting. Risk factors (dispositional, historical, contextual and clinical) and early warning signs of violence will be outlined. Understanding these issues will facilitate the short-term prediction and prevention of violence in clinical settings. Interventions have been categorized for use according to the urgency of the situation. This degree of urgency has been designated as either potential, imminent or emergent violence. Special considerations that may alter the management of violence will be delineated. Specifically, we will highlight issues related to gender, age and mental retardation. Aspects of professional training in regards to the management of the violent patient will be underscored as well. Finally, the review of the literature has led to a decision tree that can inform the reader in the evidence-based management of the violent patient. This decision tree is offered to the busy practitioner as a practical clinical tool for using evidence based practices in managing violent patients. KEY WORDS: violence; aggression; prediction; management.

Byline: Paula Smith (1), Brian R. Flay (2), Carl C. Bell (2), Roger P. Weissberg (2) Keywords: parental closeness; prosocial peers; violence Abstract: Objectives: This study attempted to provide further insight into the roles of parents and peers as they influence youth involvement with violence. Specifically, this paper considers whether parents who are close to their children have children who affiliate with prosocial friends who may in turn serve as a buffer against violence. This study also considers how parent and peer influences may change as youth transition to adolescence. Methods: A cross-sectional health behavior survey was administered to 384 low-income, African-American youth aged 10--15 from three Chicago area schools. Structural equation models (SEM) were developed to assess the impact of youth reported prosocial friends and parental closeness on violence involvement. The overall model was tested to examine equivalence across preadolescent and adolescent age-groupings. Results: Results from the overall model indicated that parental closeness did not have a direct influence on youth violence involvement, but having a close parent--child relationship improved the youth's ability to select prosocial friends, which was directly related to decreased involvement with violence. Differences in the model by age-grouping suggested the presence of prosocial friends was a stronger factor for adolescent violence avoidance when compared to preadolescents. Conclusions: Parents can make a difference in the way in which their children choose their friends and therefore get involved with violence by maintaining a closely bonded relationship throughout preadolescence and adolescence. The importance of this closely bonded relationship has even greater effects for decreasing violence involvement for adolescents than preadolescents. Author Affiliation: (1) Department of Family and Consumer Studies, The University of Utah, Salt Lake City, Utah, 84112 (2) The University of Illinois at Chicago, Chicago, Illinois Article History: Registration Date: 07/10/2004

Culturally-based messages of African American women as domineering, castrating, pathological figures requiring control are significant factors in making them vulnerable to domestic violence. Heterosexual African American men often regard their enforcing domestic dominance through violence as necessary.

THIS report summarizes a program of study on African-American children and violence conducted by a comprehensive community mental health center on the southside of Chicago. The research, which looked at exposure to violence, self-reports of aggression, and possible interventions, grew out of: (1) an awareness of the enormous amount of familial and extrafamilial violence in the black community; (2) clinical experiences that indicated that victimization and covictimization (i.e., victimization of close others) were often significant factors in the lives of the mentally ill; (3) a growing uneasiness, and indeed curiosity, over the extent to which children were witnessing these events and the impact of this witnessing, particularly on their own levels of aggression; and (4) a belief that the integrity of the black community was being threatened by the violence and that solutions must be sought.

Most psychiatrists are trained to diagnose symptoms and treat patients with medication, psychotherapy, or a combination of both. Unfortunately, while we may have an appreciation of family, social, and cultural [...]

As the United States becomes more culturally, racially, and ethnically diverse, psychiatry will be faced with the need to treat more diverse populations. This article focuses on challenges and obstacles [...]