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Substance use disparities among sexual and gender minority (SGM) people are attributed to minority stress, but few studies have examined minority stress and cannabis use over time or investigated differences in cannabis use trajectories by less-studied gender subgroups. We examined if longitudinal cannabis use trajectories are related to baseline minority stressors and if gender differences persisted after accounting for minority stress. Cannabis use risk was measured annually over four years (2017-2021) within a longitudinal cohort study of SGM adults in the United States (N = 11,813). Discrimination and victimization, internalized stigma, disclosure and concealment, and safety and acceptance comprised minority stress (n = 5,673). Latent class growth curve mixture models identified five cannabis use trajectories: 'low or no risk', 'low moderate risk', 'high moderate risk', 'steep risk increase', and 'highest risk'. Participants who reported past-year discrimination and/or victimization at baseline had greater odds of membership in any cannabis risk category compared to the 'low risk' category (odds ratios [OR] 1.17-1.33). Internalized stigma was related to 'high moderate' and 'highest risk' cannabis use (ORs 1.27-1.38). After accounting for minority stress, compared to cisgender men, gender expansive people and transgender men had higher odds of 'low moderate risk' (ORs 1.61, 1.67) or 'high moderate risk' (ORs 2.09, 1.99), and transgender men had higher odds of 'highest risk' (OR 2.36) cannabis use. This study indicates minority stress is related to prospective cannabis use risk trajectories among SGM people, and transgender men and gender expansive people have greater odds of trajectories reflecting cannabis use risk.

The gun assault case fatality rate measures the fraction of shooting victims who die from their wounds. Considerable debate has surrounded whether gun assault case fatality rates have changed over time and what factors may be involved. We use crime event data from Los Angeles to examine the victim and situational correlates of gun assault case fatality rates over time. We estimated log binomial regression models for the probability of death in each year from 2005 to 2021, conditioned on situational and victim characteristics of the crime. Case fatality rates increased by around 1.3% per year between 2005 and 2021 from around 15.9 to 19.7%. Baseline case fatality rates differed systematically by most situational and victim but followed similar temporal trends. Only victim age significantly covaried with the temporal trend in case fatality rates. An individual shot in Los Angeles in 2021 was 23.7% more likely to die than the equivalent victim in 2005. The steady increase in case fatality rates suggests that there were around 394 excess fatalities over what would have occurred if case fatality rates remained at the 2005 level. Increases in the average age of victims over time may contribute to the general temporal trend. We hypothesize that older victims are more likely to be shot indoors where lethal close-range wounds are more likely.

Both adverse childhood experiences (ACEs) and bullying victimization are linked with mental health problems in adolescents. However, little is known about the overlap between the two factors and how this impacts adolescent mental health problems (i.e., internalizing and externalizing problems). The current study analyzed data from 8,085 participants (47.7% female; 44.1% racial/ethnic minority) in the Adolescent Brain Cognitive Development (ABCD) study, baseline (2016-2018, ages 9-10 years) to Year 2. Regression analyses were used to estimate associations between ACEs, bullying victimization and mental health problems, respectively, adjusting for sex, race/ethnicity, country of birth, household income, parental education, and study site. The findings showed that both ACEs and bullying victimization were independently associated with higher internalizing and higher externalizing problems. However, no significant interaction was found between ACEs and bullying victimization. Overall, the results align with the cumulative risk model of adversity, linking cumulative ACEs and bullying victimization to internalizing and externalizing problems in early adolescents.

ObjectiveTo determine the association between cyberbullying (victimization and perpetration) and sleep disturbance among a demographically diverse sample of 10-14-year-old early adolescents.MethodsWe analyzed cross-sectional data from the Adolescent Brain Cognitive Development (ABCD) Study (Year 2, 2018-2020) of early adolescents (10-14 years) in the US. Modified Poisson regression analyses examined the association between cyberbullying and self-reported and caregiver-reported sleep disturbance measures.ResultsIn a sample of 9,443 adolescents (mean age 12.0 years, 47.9% female, 47.8% white), 5.1% reported cyberbullying victimization, and 0.5% reported cyberbullying perpetration in the past 12 months. Cyberbullying victimization in the past 12 months was associated with adolescent-reported trouble falling/staying asleep (risk ratio [RR] 1.87, 95% confidence interval [CI] 1.57, 2.21) and caregiver-reported overall sleep disturbance of the adolescent (RR: 1.16 95% CI 1.00, 1.33), in models adjusting for sociodemographic factors and screen time. Cyberbullying perpetration in the past 12 months was associated with trouble falling/staying asleep (RR 1.95, 95% CI 1.21, 3.15) and caregiver-reported overall sleep disturbance of the adolescent (RR: 1.49, 95% CI 1.00, 2.22).ConclusionsCyberbullying victimization and perpetration are associated with sleep disturbance in early adolescence. Digital media education and counseling for adolescents, parents, teachers, and clinicians could focus on guidance to prevent cyberbullying and support healthy sleep behavior for early adolescents.

Despite increased awareness of sex trafficking of minors in the U.S., prosecution of traffickers remains difficult, in part because of victim uncooperativeness. There are questions about how that uncooperativeness is expressed, whether it is evident in successfully prosecuted cases, and whether it is unique to trafficked minors or it emerges in similar age victims of sexual abuse. To provide insight relevant to these questions, we compared appellate opinions in two types of successfully prosecuted criminal cases: sex trafficking and sexual abuse of adolescent victims. In the trafficking opinions, victims were rarely described as disclosing on their own or as knowing their trafficker before the victimization. The opinions also often alluded to the trafficking victims uncooperativeness and delinquency history, and frequently mentioned electronic evidence and prosecution experts. The sexual abuse opinions, in contrast, tended to suggest that victims own disclosures initiated the case, perpetrators were known and trusted adults, and caregiver support during the case was common. Finally, the sexual abuse opinions never explicitly mentioned victim uncooperativeness or electronic evidence and rarely mentioned expert testimony or delinquency. The different characterizations of the two case types highlight the need for improved education concerning effective prosecution of sex crimes against minors.

The objective was to examine the associations of socioecological connectedness with bullying victimization and depressive symptoms in early adolescence and with non-suicidal self-injury (NSSI) in mid-adolescence, and how these might differ between genders. Diverse adolescents (N = 4115; 49.1% girls) in the 7th grade reported on connections with parents/family, peers, school, and neighborhood, as well as bullying victimization and depressive symptoms, and NSSI in 10th grade (Me = 16.1 years). Structural equation modeling with WSLMV indicated that the lower likelihood of NSSI in 10th grade was associated with higher perceptions of connections between adolescents and their families, both directly as well as indirectly through reduced bully victimization and depressive symptoms three years earlier. Higher school connectedness was indirectly associated with the lower likelihood of NSSI through bullying victimization and depressive symptoms. Paths to NSSI varied for girls and boys. Results advance the understanding of developmental pathways leading to NSSI in adolescent girls and boys.

ObjectiveTo investigate child-parent concordance in reporting social victimization experiences and whether concordance was associated with child behavioral symptoms.MethodsThis was an observational study with data from the Adolescent Brain Cognitive Development study. The analytic sample was 11,235 9- or 10-year-old children from the United States. Exposure variables were demographic and protective factors (child perceptions of parental relationships, school protective factors, neighborhood safety). The outcome was parent-child concordance on 6 domains of child social victimization: conventional crime, peer victimization, witnessing violence, internet victimization, school victimization, and gun violence. Child behavior symptoms were measured using the Child Behavior Checklist.ResultsExposure to social victimization was low (9% of the sample). Concordance ranged from 18% to 50%. The highest levels of concordance were observed for conventional crime (k = 0.48, P < .001) and witnessing violence (k = 0.48, P < .001). Parents' perceptions of greater neighborhood safety was associated with lower odds of concordant conventional crime (odds ratio [OR] = 0.92, 95% confidence interval [CI] 0.86-0.99) and witnessing violence (OR = 0.92, 95% CI0.84-0.99). Concordance was associated with more internalizing/externalizing behaviors.ConclusionsParents under-report social victimization in relation to children. Concordance in reporting social victimization may be an indicator of the severity of experiences, underscoring the need to consider child reports when screening for adversity.

Conduct problems are increasingly prevalent in girls and they uniquely predict negative outcomes. Yet, few reliable risk factors for aggression and violence in girls and women have been identified. Although preliminary evidence suggests peer relationships may be central to the development of youth conduct problems, especially in girls, rigorous interactive models of peer risk and protective factors for conduct problems are lacking. Based on 3104 10-13-year-old girls in the Adolescent Brain and Cognitive Development study, we tested the independent associations of separate peer risk factors (i.e., relational aggression victimization, physical aggression victimization, and deviant peer affiliation) with multidimensional conduct problems, including their moderation by peer support. Being the victim of relational aggression, being the victim of physical aggression, and deviant peer affiliation were each positively associated with conduct problems and perpetration of aggression whereas peer support was negatively associated with youth report conduct problems and perpetration of physical aggression. Further, elevated peer support significantly attenuated the association of being the victim of relational aggression with teacher-rated conduct problems. These results highlight the sensitivity of conduct problems to peer risk factors and suggest that peer support designates important configurations of risk that differentially relate to conduct problems in girls.

AIM: The aim of this study was to describe psychosocial health factors in a community sample of men who sought care for sexual assault in the previous 3 months and who were recruited using Internet-based methods. METHODS: The cross-sectional survey assessed factors related to HIV postexposure prophylaxis (PEP) uptake and adherence postsexual assault: HIV risk perception, HIV PEP self-efficacy, mental health symptoms, social responses to sexual assault disclosure, PEP costs, negative health habits, and social support. RESULTS: There were 69 men in the sample. Participants reported high levels of perceived social support. A high proportion reported symptoms of depression ( n = 44, 64%) and posttraumatic stress disorder ( n = 48, 70%) consistent with cutoffs for clinical diagnoses. Just over a quarter of participants reported past 30-day illicit substance use ( n = 20, 29%), and 45 people (65%) reported weekly binge drinking (six or more drinks on one occasion). POTENTIAL IMPACT OF THIS WORK ON HEALTH EQUITY AND FORENSIC NURSING: Men are underrepresented in sexual assault research and clinical care. We highlight similarities and differences between our sample and prior clinical samples and also outline needs for future research and interventions. CONCLUSIONS: Men in our sample were highly fearful of acquiring HIV, initiated HIV PEP, and completed or were actively taking HIV PEP at the time of data collection despite high rates of mental health symptoms and physical side effects. These findings suggest that forensic nurses need not only to be prepared to provide comprehensive counseling and care to patients about HIV risk and prevention options but also to address the unique follow-up needs of this population.

Peer victimization during high school is a common experience associated with engagement in risky health behaviors and elevated depressive symptoms. Mechanisms linking peer victimization to health outcomes remain inadequately understood. In the current study, latent class analysis was used to identify latent subclasses of college students who display similar patterns of responses to frequent peer victimization experiences during high school. We also examined moderating and mediating effects of coping (approach/avoidance) on relationships between victimization class and health outcomes (i.e., binge drinking, current smoking, depressive symptoms). College students completed questionnaire measures of peer victimization, approach and avoidance coping, binge drinking, smoking, and depressive symptoms. Four distinct patterns of peer victimization were identified among college students (Low, High, Moderate, and Social/Verbal). Moderation models revealed significant interactions of moderate victimization x approach coping on depressive symptoms and high victimization x avoidance coping on binge drinking. Mediation models revealed a significant indirect effect of avoidance coping on depressive symptoms for those in the high victimization class. Findings provide a greater understanding of the complex patterns of peer victimization. Coping efforts among varying peer victimization classes had different relationships with health outcomes during the college years. Interventions aimed at reducing health-risk and depressive symptoms among college student might benefit from increased attention to high school victimization experiences and current coping processes.Supplemental data for this article is available online at https://doi.org/10.1080/08964289.2021.1946468 .

BackgroundThe consequences of the COVID-19 pandemic have been far-reaching, disproportionately impacting vulnerable populations. Of particular concern is the impact on individuals experiencing domestic violence (DV), an urgent public health issue. There have been numerous reports of pandemic-related surges in DV, and it has been speculated that prolonged periods of state-mandated isolation may be the source of these surges. The current study utilized publicly available records to examine fluctuations in DV coinciding with COVID-19 lockdown restrictions in a diverse metropolitan county.MethodsData were extracted from local police blotters and mapping engines in Orange County, California (United States), documenting police-reported DV assault. All incidents were coded for time to examine the time course of DV among other types of assault, allowing for a longitudinal view of incidents over a 66-week window. Changepoint analyses were used to determine whether and when DV assaults changed when mapped with coinciding tightening or loosening of restrictions county-wide. Piecewise regression analyses evaluated whether any detected fluctuations were statistically meaningful.ResultsIn Santa Ana, rates saw a small but significant spike in the week following the first major lockdown in March 2020 (b = .04, SE = .02, t = 2.37, p = .01), remaining stable at this higher level thereafter (b = -.003, SE = .003, t = -1.29, p = .20). In Anaheim, no meaningful change in DV assault rates was observed at any time interval.ConclusionResults suggest that surges in DV vary between communities and that systemic issues may set the stage for the surge of an already endemic problem.

IntroductionPrior research has found that experiences with violence in the U.S. differ across individual demographic characteristics, including race, gender, and sexual orientation. However, peer reviewed studies have yet to examine the relationship between the intersections of race, gender, and sexual orientation, victimization risk, and characteristics of victimization.MethodsWe use data from three years (2017-2019) of the National Crime Victimization Survey, the primary source of information on criminal victimization in the United States, to examine victimization at the intersection of sexual orientation, gender, and race/ethnicity. We test whether non-Hispanic Black, Hispanic, and non-Hispanic White sexual and gender minority (SGM) persons aged 16 or over are victimized at greater rates than their non-SGM counterparts and assess whether there are differences between sexual minority females and males of each racial group. We further document characteristics of victimization such as reporting to the police by SGM status and race or ethnicity.ResultsWe find that SGMs are disproportionately more likely to be victims of violent crime than non-SGM people, and these disparities are present across the assessed racial and ethnic groups (non-Hispanic Black odds ratio [OR] = 3.3, 90% CI [CI] = 1.36, 5.16; Hispanic OR = 4.5, CI = 2.25, 6.71; non-Hispanic White OR = 4.8, CI = 2.25, 6.71). However, sexual orientation disparities are statistically distinguishable for lesbian or bisexual (LB) non-Hispanic White and Hispanic females but not for non-Hispanic Black LB females. Among LB females, the overall differences in victimization were primarily driven by bisexual respondents. We further find racial and ethnic differences among SGM victims in the likelihood of having the victimization reported to the police, in the utilization of community (non-police) resources, and in other aspects of victimization experiences, such as whether arrests occurred or in the suspicion that the violent incident was a hate crime.ConclusionsOur findings raise indicate a complex picture of how sexual orientation, gender identity, sex, and race and ethnicity interact in victimizations and their characteristics that should be further explored.

Student absenteeism affects students' engagement in school and academic and professional success. While research documents a significant association between school bullying/fighting and student absenteeism due to fear of being at school or getting to school, little research has examined the association of adolescent dating violence (ADV) victimization with this type of absenteeism. This study examined the relationship between physical and/or sexual ADV victimization in the past year (dichotomized as yes or no), and number of days of student absenteeism due to feeling unsafe at school or on the way to school in the past month (dichotomized as any vs. none). We analyzed cross-sectional data from the 2019 Youth Risk Behavior Survey (YRBS), a nationally representative survey of U.S. high school students (n = 9507). We conducted crude and multivariate regression models for the total sample and stratified by sex to assess our hypothesized association of ADV victimization and absenteeism; sex, grade, race/ethnicity, and sexual identity were included as covariates in adjusted models. Findings demonstrate that students reporting past year ADV victimization had 3.69 times the odds of student absenteeism due to feeling unsafe, when compared to students who did not report ADV victimization (95% CI: 3.06-4.45, p < 0.001). Sex-stratified models reveal that this effect is significantly stronger for males than for females, as indicated by non-overlapping confidence intervals (male AOR: 5.67, 95% CI: 4.18-7.68; female AOR: 2.95, 95% CI: 2.32-3.74). The multivariate models also show that Black and Latinx compared with White students, and lesbian/gay/bisexual/unsure compared with heterosexual students, had higher odds of student absenteeism due to feeling unsafe. Findings indicate the need to address ADV victimization and student absenteeism with integrated and gender-tailored responses, and with consideration of greater vulnerabilities for queer students and students of color.

Background: Transgender and gender diverse (TGD) people are disproportionately incarcerated in the United States relative to the general population. A dearth of quantitative research has explored victimization as a risk factor for incarceration as well as the victimization experiences of formerly incarcerated TGD populations. Methods: In 2019, 574 TGD adults completed an online survey assessing sociodemographics, victimization across settings, and incarceration history. Latent class analysis was used to identify two sets of latent subgroups based on respondent's victimization experiences: 1) lifetime victimization (low; moderate; and high) and 2) classes of victimization while incarcerated (low; moderate; and high). Bivariate and multivariable logistic regression analyses examined sociodemographic, mental health, and lifetime victimization experiences associated with lifetime incarceration (Outcome 1). Among those with incarceration histories, bivariate hierarchical logistic regression analyses also explored the association between gender identity, race/ethnicity, HIV status, visual gender non-conformity, and class of victimization during incarceration (Outcome 2) . Results: Participants' mean age was 31.4 (SD = 11.2), 43.4% had a non-binary gender identity, 81.5% were White, non-Hispanic, 2.1% were living with HIV, and 13.2% had been incarcerated. In the multivariable model for Outcome 1, high levels of victimization, age, being a racial/ethnic minority, being a trans woman, living with HIV, and past-12-month polysubstance use were all associated with increased odds of lifetime incarceration (p-values < 0.05). In the bivariate hierarchical logistic regression analyses for Outcome 2, living with HIV and having a visually gender non-conforming expression were significantly associated with elevated odds of experiencing high levels of victimization while incarcerated (p-values < 0.05). Conclusion: Findings document the relationships between victimization and incarceration among TGD people as well as identify the subpopulations at greater risk for incarceration and experiencing victimization while incarcerated. Efforts are needed to prevent victimization across the life course, including while incarcerated and support TGD individuals in coping with the negative sequelae of victimization and incarceration experiences.

BackgroundAutistic children report higher levels of bullying victimization than their non-autistic peers. However, autistic children with fewer social difficulties, as measured on the Autism Diagnostic Observation Schedule (ADOS), are more likely to report being bullied. Autistic children with stronger social skills may not only be more likely to identify and report incidents of bullying, but they may also be more likely to interact with their non-autistic peers, increasing their likelihood of being victimized. Autistic girls may be especially at-risk of experiencing bullying victimization, as a growing body of research suggests that autistic girls demonstrate fewer social difficulties and are more socially motivated than autistic boys. Here, we explored reported problems with peers and bullying victimization among a carefully matched sample of autistic and non-autistic boys and girls. Qualitative methods were further implemented to gain a more holistic understanding of the social experiences of autistic boys and girls.MethodsThis mixed-methods study analyzed the transcribed clinical evaluations of 58 autistic children (29 girls) matched to 42 non-autistic children (21 girls) on age and IQ. Within each diagnostic group, boys and girls were matched on ADOS severity score. We compared reported problems with peers and bullying victimization across sex and diagnosis. Among autistic children, we further examined whether ADOS social affect (SA), restricted repetitive behaviors, and severity scores predicted problems with peers and bullying victimization. We then identified themes related to personal experiences of victimization.ResultsAutistic children were more likely than non-autistic children to have experienced bullying victimization, and autistic children with lower ADOS severity and SA scores were more likely to report having been bullied. While autistic boys and girls reported similar levels of bullying victimization, qualitative analyses revealed sex differences in the underlying causes of peer conflict.LimitationsThis study was a secondary data analysis. The standardized set of questions on the ADOS limited the amount of information that children provided about their peer relationships, and variations in follow-up questions may have influenced children's responses.ConclusionsAlthough autism symptomatology places autistic children at greater risk for bullying victimization compared to their non-autistic peers, greater social challenges among autistic children are associated with lower rates of victimization. This study further highlights the importance of using mixed-methods approaches to discover nuances in the social experiences of autistic girls and boys that may become opportunities for support.

PurposeA quarter of women and nearly 1 in 10 men in the United States have reported experiencing intimate partner violence (IPV) that had lasting negative impacts at least once during their lifetime. To prevent IPV over the lifecourse, adolescence has been identified as an ideal period for healthy relationship education that addresses the various IPV risk factors. One of those risk factors is believing in traditional gender roles, but the behavioral aspect of gender performance has been understudied. This study explores the relationship between adolescent gender performance and adult IPV perpetration and victimization/survival.MethodsWe used logistic regression to estimate associations of adolescent gender performance and adult IPV perpetration and victimization/survival in a sample of 2,197 males and 2,587 females from The National Longitudinal Study of Adolescent to Adult Health (Add Health) between 1994 and 2008.ResultsMale adolescent gender performance was associated with increased adult IPV perpetration (adjusted odds ratio [AOR] = 1.11; 95% confidence interval [CI], 1.05-1.18 per 10% increase in gender performance) and victimization/survival (AOR = 1.07; 95% CI, 1.03-1.11 per 10% increase in gender performance). Female adolescent gender performance was not associated with adult IPV perpetration or victimization/survival.DiscussionThe more similarly adolescent males behave to their adolescent male peers, the more likely they are to perpetrate and experience IPV in adulthood. This study supports the implementation of gender transformative education during adolescence and the specific need to address how the behaviors associated with male gender performance are risk factors for adult IPV.

ObjectiveTo determine the prevalence and sociodemographic correlates of cyberbullying victimization and perpetration among a racially, ethnically and socioeconomically diverse population-based sample of 11-12-year-old early adolescents.MethodsWe analyzed cross-sectional data from the Adolescent Brain Cognitive Development (ABCD) Study (Year 2; N = 9429). Multiple logistic regression analyses were used to estimate associations between sociodemographic factors (sex, race/ethnicity, sexual orientation, country of birth, household income, parental education) and adolescent-reported cyberbullying victimization and perpetration.ResultsIn the overall sample, lifetime prevalence of cyberbullying victimization was 9.6%, with 65.8% occurring in the past 12 months, while lifetime prevalence of cyberbullying perpetration was 1.1%, with 59.8% occurring in the past 12 months. Boys reported higher odds of cyberbullying perpetration (AOR 1.71, 95% CI 1.01-2.92) but lower odds of cyberbullying victimization (AOR 0.80, 95% CI 0.68-0.94) than girls. Sexual minorities reported 2.83 higher odds of cyberbullying victimization (95% CI 1.69-4.75) than nonsexual minorities. Lower household income was associated with 1.64 (95% CI 1.34-2.00) higher odds of cyberbullying victimization than higher household income, however household income was not associated with cyberbullying perpetration. Total screen time, particularly on the internet and social media, was associated with both cyberbullying victimization and perpetration.ConclusionsNearly one in 10 early adolescents reported cyberbullying victimization. Pediatricians, parents, teachers, and online platforms can provide education to support victims and prevent perpetration for early adolescents at the highest risk of cyberbullying.

In order to continue pushing college campuses to the forefront of survivor-centered practice and student-centered care, it is imperative that the barriers students experience in accessing campus sexual violence resource centers be documented and addressed. This research evaluates student and staff perceptions of barriers to accessing the Campus Assault Resources and Education (CARE) offices on three University of California (UC) campuses. Data were collected by researchers from UC Speaks Up, a cross-campus research initiative at UC Los Angeles (UCLA), UC Santa Barbara (UCSB), and UC San Diego (UCSD) aimed at understanding factors that both contribute to and prevent sexual violence among college students. This analysis only included data that yielded insights into CARE's accessibility. Thematic analysis of 63 interviews and 27 focus group discussions was conducted using Dedoose. The following six thematic codes emerged from the data: (1) awareness of office, (2) confidentiality of services, (3) physical accessibility, (4) accessibility for vulnerable and marginalized groups, (5) utilization experiences, and (6) limited institutional support. To increase the accessibility of sexual violence resource centers in higher education, this study indicates that universities and campus sexual violence resource centers should (1) encourage survivor-centered cross-campus collaborations between sexual violence resource centers and other campus entries, (2) add more trainings that are tailored to the needs of vulnerable and marginalized communities, (3) increase the resource's campus-wide office exposure through multiple prevention education opportunities, and (4) better fund sexual violence resource centers. Implications for future research are discussed to maximize this study's public health impact.

Bullying victimization is a prevalent and harmful experience for adolescents and is positively associated with risky behaviors, including tobacco use. We investigated a potential moderator for the associations between bullying victimization and tobacco use, namely time perspective, which refers to thoughts about time. Bullied adolescents may focus on past events more than present or future events, which could lead to less adaptive coping mechanisms in response to stress, such as tobacco use. Multiple time perspective dimensions and time periods (past, present, and future) were examined. Time orientation refers to the relative emphasis placed on a time period. Time relation refers to the perceived relationship among the time periods. Bullying victimization and tobacco use were self-reported. Participants included 758 adolescents (Mage = 15.81, SDage = 1.22; 54% female). Multiple linear regression analysis indicated that bullying victimization was positively associated with tobacco use. Moderated regression analyses indicated that perceiving all time periods as important (time orientation) and interrelated (time relation) buffered the positive association between bullying victimization and tobacco use in adolescents. Analyses controlled for demographics, sensation seeking, and stress. Results suggest that future research should examine the viability of time perspective-based interventions for bullying victimization and tobacco use in adolescents.

Adolescents involved in the juvenile justice system face a variety of risk factors that are associated with more frequent and severe experiences of aggression within romantic relationships as compared to community samples. The current study examines the nature and characteristics of adolescent dating violence (ADV) among first-time offense court-involved non-incarcerated (CINI) adolescents. A sample of 199 male and female CINI adolescents (58% male; M age = 15.05) who had a first-time, open status (e.g., truancy, curfew violation) and/or delinquent petition (e.g., assault, breaking, and entering). Overall, CINI adolescents reported prevalence rates of ADV consistent with community samples of adolescents. Females reported higher perpetration than did males in the sample of physical abuse and social networking abuse, as well as higher victimization of social networking abuse. Only one difference was found by offense type. CINI females report an increased risk for dating violence, though the cause of these gender differences is unclear. Findings also highlight that risk for ADV does not differ by offense type, suggesting that prevention efforts targeting ADV at the earliest possible intervention point, regardless of first-time offense type or severity, may be especially impactful.

Although authoritative school climate-strict, yet fair enforcement of rules alongside strong adult support-is associated with lower rates of bullying victimization, less is known about whether it influences how negatively adolescents feel after being victimized at school. Further, it is unclear whether boys and girls respond differently to an authoritative climate. Identifying ways that schools can reduce negative feelings after being bullied is important given the long term psychological ramifications of bullying that, if left unaddressed, can extend into adulthood. To address these gaps, this study examined whether authoritative school climate related to how negatively adolescents felt about their schoolwork, relationships, physical health and self-perception after being bullied. Differences between boys and girls were also investigated. Analyses were conducting using national data from the 2017 School Crime Supplement on a sample of 1,331 adolescents aged 12 to 18 years (Mage = 14.3 years; 59% girls). Findings from a set of ordinal regression models with a robust set of student, parent and school controls demonstrated that adolescents in more supportive schools were less likely to report that bullying victimization negatively impacted their schoolwork and feelings about themselves. Similar results were found for girls but not boys. By investing in supportive school climates, schools can be potentially transformative places where adolescents, especially girls, can feel more positively about themselves despite being bullied.

Latinx early adolescents within the United States are particularly vulnerable to dating violence; yet, little research has examined early dating experiences and violence outside large urban settings. Latinxs, in particular, may experience a unique window of opportunity for dating violence (DV) prevention during early adolescence, based on their trends in risk behavior over the adolescent period. This study extends the current research on dating violence by examining a highly understudied population, Latinx early adolescent girls and boys residing in an agricultural community, by assessing victimization and perpetration, and examining interpersonal-level factors as potential risk and protective factors for violence. Using data from a prospective cohort study of Latinx adolescents with relationship experience (past six months) (N = 296; girls: n = 147; boys: n = 149; mean age: 13.8), we assessed the association between dating relationship characteristics and dating violence victimization and perpetration using modified-Poisson regression models with robust standard errors stratified by gender. In multivariable analyses, we found that girls with gang-affiliated partners, partner-related withdrawal from friends, and girls who had used drugs or alcohol with a partner experienced greater risk for dating violence. Additionally, holding beliefs supportive of female sexual naivete and engaging in and communicating about sexual activity were associated with victimization among girls. No significant associations were found among boys. Findings affirm the need for multilevel DV prevention programming that starts in middle school and addresses social isolation, gang exposure, and traditional Latinx gender-norm beliefs regarding marianismo. These findings underscore the imperative to coordinate dating and gang violence prevention efforts by addressing common co-occurring interpersonal and environmental risk factors, including social isolation and culturally-specific traditional beliefs. Such factors could also assist providers, families, and peers in early identification of Latinx early adolescents at risk for DV, especially in rural contexts where resources are often limited.

IntroductionFirearms and motor vehicle collisions (MVC) are leading causes of mortality in children. We hypothesized that firearm injuries would have a higher mortality than MVCs in children and a higher level of resource utilization METHODS: Trauma patients

Outpatient civil commitment (OCC) requires the provision of needed-treatment, as a less restrictive alternative (LRA) to psychiatric-hospitalization in order to protect against imminent-threats to health and safety associated with severe mental illness (SMI). OCC-reviews aggregating all studies report inconsistent outcomes and interpret such as intervention failure. This review, considering those studies whose outcome criteria are consistent with the provisions of OCC-law, seeks to determine OCC-effectiveness in meeting its legislated objectives. This review incorporated studies from previous systematic-reviews, used their search methodology, and added investigations through August 2020. Selected OCC-studies evaluated samples of all eligible patients in a jurisdiction. Their outcome-measures were threats to health or safety or the receipt of needed-treatment exclusive of post-OCC-assignment- hospitalization, the latter being the OCC-default for providing needed-treatment in the absence of an LRA and dependent on bed-availability. A study's evidence-quality was evaluated with the Berkeley Evidence Ranking and the New Castle Ottawa systems. Thirty-nine OCC-outcome-studies in six-outcome-areas directly addressed OCC-statute objectives: 21 considered imminent threats to health and safety, 10 compliance with providing needed-treatment, and 8 conformity to the LRA-standard. With the top evidence-rank equal to one, the studies M = 2.55. OCC-assignment was associated with reducing mortality-risk, increasing access to acute-medical-care, and reducing risks of violence and victimization. It enabled reaching these objectives as a LRA to hospitalization and facilitated the use of community-services by individuals refusing such assistance when outside of OCC-supervision. OCC's appears to enable recovery by reducing potentially life-altering health and safety risks associated with SMI.

Bullying of sexual minorities in the United States is common and often begins in middle and high school, yet research that examines sexual harassment of sexual minorities is limited. This study examines whether sexual minorities are more likely than straight people to (a) report sexual harassment and (b) report sexual harassment as adolescents at middle or high school. We analyzed survey data from a cross-sectional study of sexual harassment and assault, conducted with nationally representative samples of adults in 2019 (N = 2,205). Sexual harassment was categorized as non-physically aggressive sexual harassment only (NPSH; e.g., verbal or cyber harassment), physically aggressive sexual harassment (PSH; e.g., stalking, rubbing up against you; with or without NPSH), sexual assault (SA; i.e., forced sex; with or without NPSH or PSH), or no sexual harassment (none). In total, 6% of female and male respondents identified as a sexual minority. A history of sexual harassment or assault was reported by 95.0% of sexual minority women and 80.3% of straight women (p = .001), and by 77.3% of sexual minority men and 41.3% of straight men (p = .001). Multivariable multinomial models demonstrate that sexual minorities were more likely than straight individuals to report NPSH (Adjusted Odds Ratio [AOR] = 2.88, 95% [Confidence Interval] CI = [1.33, 6.20]), PSH (AOR = 4.15, 95% CI: [1.77, 9.77]), and SA (AOR = 5.48, 95% CI = [2.56, 11.73]; reference group: no harassment), as well as to report PSH (AOR = 2.67, 95% CI = [1.30, 5.47]) at school in middle or high school. These abuses demonstrate increased risk for sexual harassment among sexual minorities, including increased risk for physically aggressive sexual harassment when in middle and high school.

Legislation has been passed in some states to reduce discrimination and victimization toward sexual and gender minority people (SGM; people who are not solely heterosexual and/or whose gender identity is not equal to what is socially associated with sex assigned at birth). The purpose of these analyses is to test whether state-level policy environments are associated with past-year discrimination and victimization among SGM people. Cross-sectional data from The Population Research in Identity and Disparities for Equality (PRIDE) Study annual questionnaire (collected 2018−2019), a national study of the health of SGM adults in the USA, were used for these analyses. Measures included related to discrimination, victimization, and demographic characteristics. State-level policy environments were measured using data from the Movement Advancement Project. Logistic regression analyses evaluated state-level policy environment scores and past-year discrimination and victimization among gender identity categories. In this sample, 7044 people (gender minority n = 2530) were included. Cisgender sexual minority (odds ratio [OR] = 1.007, p = 0.041) and the gender expansive subgroup of gender minority people (OR = 1.010, p = 0.047) in states with more protective policy environments had greater odds of discrimination. The gender expansive subgroup was found to have greater odds of victimization in states with more protective policy environments (OR = 1.003, p < 0.05). There was no relationship between state-level policy environments and victimization among any other study groups. SGM people may experience increased risk for discrimination and victimization despite legislative protections, posing continued risks for poor health outcomes and marginalization. Evaluation of factors (e.g., implementation strategies, systems of accountability) that influence the effectiveness of state-level polices on the reported experiences of discrimination and victimization among SGM people is needed.

We estimate the prevalence and characteristics of violent hate crime victimization of lesbian, gay, bisexual, and transgender (LGBT) people in the United States, and we compare them to non-LGBT hate crime victims and to LGBT victims of violent non-hate crime. We analyze pooled 2017-2019 data from the National Crime Victimization Survey (n persons = 553, 925;n incidents = 32, 470), the first nationally representative and comprehensive survey on crime that allows identification of LGBT persons aged 16 or older. Descriptive and bivariate analysis show that LGBT people experienced 6.6 violent hate crime victimizations per 1,000 persons compared with non-LGBT people's 0.6 per 1,000 persons (odds ratio = 8.30, 95% confidence interval = 1.94, 14.65). LGBT people were more likely to be hate crime victims of sexual orientation or gender bias crime and less likely to be victims of race or ethnicity bias crimes compared to non-LGBT hate crime victims. Compared to non-LGBT victims, LGBT victims of hate crime were more likely to be younger, have a relationship with their assailant, and have an assailant who is white. Compared to LGBT victims of non-hate violence, more LGBT hate crime victims reported experiencing problems in their social lives, negative emotional responses, and physical symptoms of distress. Our findings affirm claims that hate crimes have adverse physical and psychological effects on victims and highlight the need to ensure that LGBT persons who experience hate crime get necessary support and services in the aftermath of the crime.

BackgroundResidential youth care (RYC) institutions aim to provide care and stability for vulnerable adolescents with several previous and present challenges, such as disrupted attachments, wide-ranging adverse childhood experiences, mental health problems, and poor quality of life (QoL). To the best of our knowledge, the present study is the first to provide knowledge of the associations between perceived social support and QoL and to explore the potential moderating effect of perceived social support on QoL for adolescents who have experienced maltreatment and polyvictimization.MethodsAll RYC institutions with adolescents between the ages 12-23 in Norway were asked to participate in the study. A total of 86 institutions housing 601 adolescents accepted the invitation, from which 400 adolescents volunteered to participate. The Child and Adolescent Psychiatric Interview was used to gather information on maltreatment histories and degree of victimization; the Kinder Lebensqualität Fragebogen was used to measure QoL through several domains (overall QoL, physical well-being, emotional well-being, and self-esteem); and the Social Support Questionnaire was used to measure perceived social support. Linear regression and independent samples t-test were used to study the associations between perceived social support and QoL as well as the potential moderating effect of perceived social support in the association between maltreatment history and QoL.ResultsPerceived social support was positively associated with QoL for both girls and boys, with domain-specific findings. A higher number of different types of support persons was associated with overall QoL, emotional well-being, and self-esteem for boys, but only with self-esteem for girls. Individual social support from RYC staff and friends was associated with higher QoL for girls. However, perceived social support did not moderate the association between maltreatment history and reduced QoL for either sex.ConclusionsThis study emphasizes the importance of maintaining social support networks for adolescents living in RYC, the crucial contribution of RYC staff in facilitating social support, and the potential value of social skills training for these vulnerable adolescents. Furthermore, a wider range of initiatives beyond social support must be carried out to increase QoL among adolescents with major maltreatment and polyvictimization experiences.

Sexual assault on university campuses has attracted growing attention, but there is little data available on the scope of the problem in Southern Africa. We sought to measure the prevalence of campus sexual assault among female university students at the University of Eswatini and describe the experience of survivors using a mixed-methods study design. Women were randomly sampled from a list of all full-time female university students provided by the office of the registrar, and participants completed a brief behavioral survey in a private study office using a tablet with computer-assisted self-interview software. Women who indicated experiences of sexual violence during the survey were invited to self-identify themselves to study staff to participate in a follow-up qualitative interview. We measured sexual assault using the Sexual Experiences Survey-Short Form Version (SES-SFV). We found that women in University were over 6 times more likely to report forced or coerced sex in the previous 12 months than has been previously reported in the general population. Sixty percent of participants reported experiencing an attempted or completed sexual assault in their lifetime, and a total of 38% reported an assault in the past 12 months. The vast majority (93%) of assailants were known to their victim, and the majority (56%) of perpetrators were romantic partners. The majority of participants had never disclosed their assault, and victim blaming and stigma emerged as highly salient themes during in-depth qualitative interviews. Food insecurity, losing a parent before age 21, and hazardous drinking were all significantly associated with experiencing sexual assault in the previous 12 months, as was experiencing a previous assault before the age of 18. To our knowledge, this is the first generalizable study of campus sexual assault prevalence conducted in the Southern African region.

Although prior studies have identified several risk factors for gun carrying, no prior longitudinal studies have examined a comprehensive set of explanatory factors together in within-individual change models or examined whether the predictors of gun carrying change across adolescence and early young adulthood. The present study fills these gaps by examining the predictive utility of several risk factors for gun carrying, and by examining whether any of the associations vary by age. The sample included 1216 young men who were arrested for the first time during adolescence (approximately 15 years old) and interviewed regularly for 5 years (until approximately 20 years old) after the first arrest. The outcome was youth-self-reported gun carrying and the risk factors included several variables consistent with various explanations for gun carrying (psychosocial maturity deficits; antisocial behavioral style; socialization; victimization). Research questions were addressed with fixed effects dynamic panel models (within-individual change models). Results showed that the most robust predictors of gun carrying were increased exposure to guns and gun-related violence and increased engagement in other antisocial and illegal behavior. The results emphasize the specific etiology of gun carrying and the potential social contagion effect of gun-related events. Overall, the study points to the need for prevention and intervention programs to specifically target the reduction of the real and perceived prevalence of gun-related events in young men's lives.

The homeless population is aging; older homeless adults may be at high risk of experiencing violent victimization. To examine whether homelessness is independently associated with experiencing physical and sexual abuse, we recruited 350 adults, aged 50 and older in Oakland, California, who met criteria for homelessness between July 2013 and June 2014. We interviewed participants at 6-month intervals for 3 years in Oakland about key variables, including housing status. Using generalized estimating equations, we examined whether persistent homelessness in each follow-up period was independently associated with having experienced physical or sexual victimization, after adjusting for known risk factors. The majority of the cohort was men (77.4%) and Black American (79.7%). At baseline, 10.6% had experienced either physical or sexual victimization in the prior 6 months. At 18-month follow-up, 42% of the cohort remained homeless. In adjusted models, persistent homelessness was associated with twice the odds of victimization (adjusted odds ratio [AOR] = 2.01; 95% confidence interval [CI]: [1.41, 2.87]). Older homeless adults experience high rates of victimization. Re-entering housing reduces this risk. Policymakers should recognize exposure to victimization as a negative consequence of homelessness that may be preventable by housing.

BackgroundIn September 2018, Dr. Christine Blasey Ford accused then-nominee to the U.S. Supreme Court Brett Kavanaugh of sexual assault. When then-U.S. President Donald Trump questioned her credibility on Twitter, sexual assault survivors began tweeting their reasons for not reporting using the hashtag #WhyIDidntReport. This study examined how these posts were discussed on Twitter and to what extent the tweets fit within levels of the Social Ecological Model (SEM).MethodThis study used quantitative content analysis to code 1,000 tweets with #WhyIDidntReport for violence type, reasons for not reporting, and SEM levels.ResultsOverall, 68.7% of posts mentioned a specific reason for not reporting; of these, 24.1% referred to the perpetrator being in a position of power, 36.3% feared not being believed, and 20.6% mentioned that others invalidated the assault. In addition, 47.6% mentioned a specific form of violence. Within the SEM, 47.6% referred to individual, 52.6% to relational, 43.2% to community, and 21.7% to societal reasons for not reporting.ConclusionReading social media content allows healthcare providers to directly discover how survivors talk about their experiences, priorities in the care environment, and how to support a patient-centered and trauma-informed approach.ImplicationsUnderstanding reasons people do not report sexual assault is critical for healthcare professionals to engage patients in open, honest screening and intervention efforts.

BACKGROUND: Trans women experience high rates of gender-based violence (GBV)-a risk factor for adverse health outcomes. Transphobic hate crimes are one such form of GBV that affect trans women. However, little is understood about factors that shape transphobic hate crimes and racial/ethnic variation in these experiences. To contextualize GBV risk and police reporting, we examined self-reported types and correlates of transphobic hate crimes by racial/ethnic group of trans women in the San Francisco Bay Area. METHODS: From 2016 to 2018, trans women participated in a longitudinal cohort study of HIV. Secondary data analyses (N = 629) examined self-reported experiences of transphobic hate crimes (i.e., robbery, physical assault, sexual assault, and battery with weapon) by race/ethnicity, and whether hate crimes were reported to the police. Chi-square tests and simple logistic regression examined demographic, sociocultural, and gender identity factors associated with transphobic violence experiences and police reporting. RESULTS: About half (45.8%) of participants reported ever experiencing a transphobic hate crime; only 51.1% of these were reported to the police. Among those who reported a hate crime experience, Black (47.9%) and Latina (49.0%) trans women reported a higher prevalence of battery with a weapon; White (26.7%) and trans women of other race/ethnicities (25.0%) reported a higher prevalence of sexual assault (p = 0.001). Having ones gender questioned, history of sex work, homelessness as a child and adult, and a history incarceration were associated with higher odds of experiencing a transphobic hate crime. Trans women who felt their gender identity questioned had lower odds of reporting a hate crime to the police compared to those did not feel questioned. CONCLUSIONS: A high proportion of trans women experienced a transphobic hate crime, with significant socio-structural risk factors and racial differences by crime type. However, crimes were underreported to the police. Interventions that address structural factors, especially among trans women of color, can yield violence prevention benefits.

BackgroundSubstantial research gaps exist regarding the relationship between transgender-related discrimination and substance use outcomes for transgender adults, with few studies accounting for other experiences of victimization.MethodsTransgender adults (N = 600) from Massachusetts and Rhode Island completed a survey online or in-person. Multivariable linear and logistic regression models examined the association between lifetime experiences of transgender-related discrimination using the validated 11-item Everyday Discrimination Scale (theoretical range = 0-44) and substance use outcomes: past 12-month substance use frequency, lifetime substance use disorder (SUD) diagnosis, and substance use treatment (SUTx) history. All models were adjusted for age, gender identity, race, survey modality, childhood physical/sexual abuse, intimate partner violence, and discrimination attributable to other reasons than being transgender.ResultsThe mean transgender-related discrimination score was 20.8 (SD = 9.6, range = 0-44). Overall, 11.8 % of the sample had a SUD diagnosis and 11.0 % had received SUTx. In separate multivariable models adjusted for sociodemographic and victimization experiences, the highest quartile of transgender-related discrimination was significantly associated with higher past 12-month substance use (B = 1.44; aR2 = 0.13; p = .009), SUD diagnosis (aOR = 3.64; 95 % CI = 1.46-9.07; p = .006), and lifetime treatment history (aOR = 3.93; 95 % CI = 1.50-10.21; p = .005).ConclusionsThere was a significant positive association between experiencing high levels of transgender-related discrimination and substance use outcomes among the transgender adults sampled. Longitudinal research is needed to understand the specific mediators driving these relationships and to address the implications of transgender-related discrimination on SUD treatment utilization.

IntroductionBullying victimization is detrimental to psychosocial wellbeing in adolescents. It is paramount that factors that mitigate the harmful effects of bullying victimization be identified. Time perspective may be a potential mechanism. Thus, we examined the moderating effect of time perspective on the associations between traditional and cyberbullying victimization (being bullied in person and on electronic media) and self-esteem in adolescents. Time perspective refers to feelings and thoughts about the past, present, and future. We examined time feelings (positive and negative feelings about the time periods), time frequency (frequency of thoughts about the time periods), and time relation (the perceived relationship among the time periods).MethodsTwo cross-sectional survey studies were conducted. Study 1 examined traditional bullying victimization in 721 American adolescents (Mage = 15.84, SD = 1.20; 57% female). Study 2 examined cyberbullying victimization in 190 American adolescents (Mage = 15.83, SD = 1.28; 59% female).ResultsHierarchical linear regression analyses indicated that time perspective dimensions moderated the associations between high levels of traditional and cyberbullying victimization and self-esteem in adolescents who (a) had strong positive and weak negative feelings about the present and future (time feelings); (b) thought a little about the past (time frequency); or (c) perceived all time periods as interrelated (time relation).ConclusionsTime perspective dimensions (feelings, frequency, and relation) moderated the associations between traditional and cyberbullying victimization and self-esteem in adolescents. Findings have implications for bullying victimization prevention efforts. Findings also demonstrate the multidimensional and multi-temporal qualities of time perspective.

BackgroundInterpersonal violence, such as intimate partner violence, sexual assault, and adverse childhood experiences, is a significant global health concern. A major challenge to nurses and others working in the field of interpersonal violence deals with the complexity involved in measuring interpersonal violence. Numerous validated instruments exist; however, there is no standard approach for scoring these instruments. There is also a tendency to examine different forms of violence separately, not accounting for the known co-occurrence of violence. This has led to confusion as the interpretation of results often differs depending on the specific method used.ObjectivesThe purpose of this article is to summarize the major methods for scoring interpersonal violence measures and implications of each approach with a specific focus on co-occurrence.MethodsThe article begins with a summary of the primary goals of measuring interpersonal violence, major methods for scoring interpersonal violence measures, along with scoring challenges. We then provide a case exemplar examining the relationship between interpersonal violence and posttraumatic stress disorder symptoms to illustrate how scoring methods can affect study results and interpretation of findings.ResultsOur article shows that each scoring method provides a different picture of the distribution of interpersonal violence experiences and varies regarding the ease of interpretation. Scoring methods also affect interpretation of associations between interpersonal violence and other factors, such as having statistical power to detect significant associations. Accounting for the co-occurrence is critical for making accurate inferences by identifying potential confounding interactions between different types of violence.DiscussionThe application of different scoring methods leading to varying interpretations highlights the need for researchers to be purposeful when selecting a method and even applying multiple methods when possible. Recommendations are provided to assist researchers and providers when making decisions about the use of scoring methods in different contexts.

Through this meta-analysis, we sought to examine the prevalence of, risks for, and factors associated with bullying involvement (victimization, perpetration, perpetration-victimization) among students with autism spectrum disorder (ASD). Additionally, we attempted to examine sources of variance in the prevalence and effect sizes of bullying in students with ASD across studies. Systematic database and literature review identified 34 relevant studies (31 for Western countries, three for Eastern countries). Pooled prevalence estimates for victimization, perpetration, and perpetration-victimization in general were 67%, 29%, and 14%, respectively. The risk of victimization in students with ASD was significantly higher than that in typically developing students and students with other disabilities. Further, deficits in social interaction and communication, externalizing symptoms, internalizing symptoms, and integrated inclusive school settings were related to higher victimization, and externalizing symptoms were related to higher perpetration. Finally, moderation analyses revealed significant variations in the pooled prevalences thereof depending on culture, age, school settings, and methodological quality and in the pooled effect sizes according to publication year and methodological quality. Our results highlight needs for bullying intervention for students with ASD, especially those who are younger, are in an inclusive school setting, and have higher social difficulties and externalizing/internalizing symptoms; for intensive research of bullying experiences among students with ASD in Eastern countries; and for efforts to improve the methodological quality of such research.

Do sexual and gender minorities (SGMs) in the United States encounter disproportionate rates of victimization as compared with their cisgender, heterosexual counterparts? Answering this question has proved elusive because nationally representative victimization data have not included victims' sexual orientation or gender identity. The National Crime Victimization Survey, the nation's primary source of representative information on criminal victimization, began documenting sexual orientation and gender identity in 2016 and released data publicly for the first time in 2019. We find SGMs disproportionately are victims across a variety of crimes. The rate of violent victimization for SGMs is 71.1 victimizations per 1000 people compared with 19.2 victimizations per 1000 people for those who are not SGMs. SGMs are 2.7 times more likely to be a victim of violent crime than non-SGMs. These findings raise the importance of further considering sexual orientation and gender identity in victimization and interventions.

BackgroundOutpatient civil commitment (OCC), community treatment orders (CTOs) in European and Commonwealth nations, require the provision of needed-treatment to protect against imminent threats to health and safety. OCC-reviews aggregating all studies report inconsistent outcomes. This review, searches for consistency in OCC-outcomes by evaluating studies based on mental health system characteristics, measurement, and design principles.MethodsAll previously reviewed OCC-studies and more recent investigations were grouped by their outcome-measures' relationship to OCC statute objectives. A study's evidence-quality ranking was assessed. Hospital and service-utilization outcomes were grouped by whether they represented treatment provision, patient outcome, or the conflation of both.ResultsOCC-studies including direct health and safety outcomes found OCC associated with reduced mortality-risk, increased access to acute medical care, and reduced violence and victimization risks. Studies considering treatment-provision, found OCC associated with improved medication and service compliance. If coupled with assertive community treatment (ACT) or aggressive case management OCC was associated with enhanced ACT success in reducing hospitalization need. When outpatient-services were limited, OCC facilitated rapid return to hospital for needed-treatment and increased hospital utilization in the absence of a less restrictive alternative. OCC-studies measuring "total hospital days", "prevention of hospitalization", and "readmissions" report negative and/or no difference findings because they erroneously conflate their intervention (provision of needed treatment) and outcome.ConclusionsThis investigation finds replicated beneficial associations between OCC and direct measures of imminent harm indicating reductions in threats to health and safety. It also finds support for OCC as a less restrictive alternative to inpatient care.

Suicidal ideation increases in adolescence, especially for anxious youth, and is a frequent precursor to suicide. This study examined whether neural processing of social rejection interacted with negative social experiences to predict suicidal ideation. Thus, to our knowledge this is the first study to examine how brain function may interact with the environment to contribute to suicidal ideation in youth, consistent with a developmental psychopathology perspective. Thirty-six anxious youth (ages 11 to 16) completed diagnostic interviews and questionnaires, an ecological momentary assessment (EMA) protocol, and a functional magnetic resonance imaging paradigm. Results showed that youth experienced greater severity of suicidal ideation when they exhibited heightened activation to social rejection in the right anterior insula and also experienced high levels of peer victimization or EMA-measured daily negative social experiences. Findings provide preliminary evidence that alterations in neural processing of social rejection interacts with exposure to negative social experiences to contribute to suicidal ideation.

BackgroundLittle is known about how victimization and discrimination relate to suicide risk among sexual and gender minority (SGM) college students, or what is protective for these students. The current study will: 1.) determine the extent to which interpersonal victimization, discrimination, identity affirmation, and social connectedness are associated with suicide risk characteristics, and if race and/or ethnicity moderates this association; 2.) examine whether identity affirmation and social connectedness are protective against associations between victimization or discrimination and suicide risk characteristics.MethodParticipants were 868 students (63.6% female) from four United States universities who completed an online screening survey and met the following study inclusion criteria: self-identification as gender and/or sexual minority, endorsement of at least one suicide risk characteristic and no current use of mental health services. Participants also completed measures that assessed demographics, non-suicidal self-injury (NSSI), victimization, discrimination, connectedness, and LGBTQ identity affirmation.ResultsVictimization was positively associated with depression severity, suicidal ideation, alcohol misuse, suicide attempt history, and NSSI. Discrimination was positively associated with depression severity, suicide attempt history, and NSSI. Connectedness was inversely associated with depression severity, suicidal ideation severity, suicide attempt history, and NSSI, and moderated the association between victimization and suicide attempt history. LGBTQ identity affirmation moderated the link between victimization and depression.ConclusionsResults suggest efforts to decrease victimization and discrimination and increase connectedness may decrease depressive morbidity and risks for self-harm among SGM college students. Further, increasing LGBTQ identity affirmation may buffer the impact of victimization on depression.

BACKGROUND: Outpatient civil commitment (OCC), community treatment orders (CTOs) in European and Commonwealth nations, require the provision of needed-treatment to protect against imminent threats to health and safety. OCC-reviews aggregating all studies report inconsistent outcomes. This review, searches for consistency in OCC-outcomes by evaluating studies based on mental health system characteristics, measurement, and design principles. METHODS: All previously reviewed OCC-studies and more recent investigations were grouped by their outcome-measures relationship to OCC statute objectives. A studys evidence-quality ranking was assessed. Hospital and service-utilization outcomes were grouped by whether they represented treatment provision, patient outcome, or the conflation of both. RESULTS: OCC-studies including direct health and safety outcomes found OCC associated with reduced mortality-risk, increased access to acute medical care, and reduced violence and victimization risks. Studies considering treatment-provision, found OCC associated with improved medication and service compliance. If coupled with assertive community treatment (ACT) or aggressive case management OCC was associated with enhanced ACT success in reducing hospitalization need. When outpatient-services were limited, OCC facilitated rapid return to hospital for needed-treatment and increased hospital utilization in the absence of a less restrictive alternative. OCC-studies measuring total hospital days, prevention of hospitalization, and readmissions report negative and/or no difference findings because they erroneously conflate their intervention (provision of needed treatment) and outcome. CONCLUSIONS: This investigation finds replicated beneficial associations between OCC and direct measures of imminent harm indicating reductions in threats to health and safety. It also finds support for OCC as a less restrictive alternative to inpatient care.

PurposeThe purpose of this study was to estimate the effect of firearm involvement during violent victimization on the level of distress experienced and daily functioning within sociodemographic subgroups.MethodsWe used cross-sectional data from the National Crime Victimization Survey (n = 5698) and Targeted Maximum Likelihood Estimation. Sociodemographic subgroups were defined by age, race, sex, and socioeconomic position. Outcomes included experiencing the victimization as severely distressing and problems in the workplace or at school, or with peers or family.ResultsAmong people victimized with a firearm, nearly 40% experienced the victimization as severely distressing and 28% reported daily functioning problems as a result of the victimization, compared with 25% and 27% of those victimized without a firearm. In most of the subgroups examined, a greater proportion of people described the event as severely distressing when a firearm was involved in the victimization, ranging up to 19 percentage points higher among women and among black respondents (95% CI for women = 10%-28%; for blacks = 6%-31%).ConclusionsOur findings suggest an almost universal negative response to firearm involvement during a violent victimization as compared with violent victimizations involving other or no weapons. These findings highlight the need for efforts by medical and mental health practitioners to address the potential sequelae of experiencing severe distress during a firearm victimization.

IntroductionEarly adolescence is a developmental period in which peer victimization, bullying, relational aggression, and social exclusion are particularly prominent. As these behaviors have long-term implications for children, in this study, we investigated early variations of prosocial behaviors as one of the critical precedents that shape youth's subsequent peer relational outcomes. Specifically, we identified different profiles of prosocial behaviors in middle childhood (Grade 4) and related these profiles to peer relationships in early adolescence (Grade 6).MethodUsing longitudinal data from the NICHD Study of Early Child Care and Youth Development (N = 914; 52% girls), a three-step latent profile analysis was conducted on Grade 4 prosocial behaviors, which were then related to Grade 6 teacher- and student-rated peer relationships (e.g., relational aggression).ResultsFour patterns of prosocial behaviors emerged: low prosocial (18%), high prosocial (67%), primarily friendly (8%), and primarily kind (7%). These four patterns of prosocial behaviors were differentially related to later problematic peer relationships: Low prosocial youth demonstrated the most problematic peer relationships (Mdiff = 0.36-0.93, all p

BackgroundThere is limited evidence regarding the ways in which displacement disrupts social norms, expectations and trajectories for adolescent girls and young women and the resulting impacts on their risks of violence. This knowledge gap is especially marked with regards to Syrian adolescent girls and young women seeking refuge in Turkey. We explored risks of gender-based violence against Syrian adolescent girls and young women in Turkey and examined how these risks were shaped by their displacement.MethodsData were collected in August 2016 in Izmir, Turkey through five sex-specific focus group discussions with Syrian adolescents and young people (aged 15-25 years) and two mixed gender focus group discussions with Syrian adults (18 years and older). Group discussions covered the issues facing Syrian adolescents and young women in Turkey, and how these were influenced by their displacement. Discussions in Arabic were audio-recorded, transcribed and translated into English. Data were coded inductively, and analysed thematically.ResultsSyrian adolescent girls and young women expressed an increased sense of vulnerability to violence since their displacement. Due to financial strains and limited educational opportunities, they were often encouraged by parents to work or marry, both of which they perceived to increase the risks of violence. In contrast, some adults suggested that marriage could protect adolescent girls and young women from risks of violence associated with working. Being alone outside the home was viewed as risky by all participants due to pervasive sexual, verbal and physical harassment, aggression, and even kidnapping attempts. To limit these risks, many parents reported keeping adolescent girls and young women at home, or ensuring that they were accompanied by male relatives when in public.ConclusionsSyrian adolescent girls and young women face multiple risks of violence following displacement related to altered social trajectories. Some family-based strategies to protect young women from violence could reinforce restrictive gender norms and increase risks of violence. Interventions to address violence should include providing safe spaces, access to education and safe transport for young women, and financial support for families as well as community-based interventions to address the daily risks of sexual harassment in public spaces.

Mobile phones can produce detailed and personalized data to help diagnose, treat, prevent or rehabilitate women who are victims of gender violence. We sent automatic text messages, based on cognitive-behavioural therapy, to female victims of gender violence to assess the feasibility of the medium for mental health intervention. During the 28-day intervention period, each woman received four automatic text messages every day on a pre-established schedule. We evaluated symptoms of depression using the Personal Health Questionnaire-9. The Personal Health Questionnaire-9 decreased from an average of 14.8 at the beginning of the intervention, to 6.1 at the end of the text messaging period. All of the women reported that they liked receiving the messages, they found them useful and they felt that the messages had improved their health. Text messages are acceptable to women users who are recipients of public health and social services. Future research should focus more on the evaluation of the results and on how the specific content and aspects of text messaging improve health outcomes.

Relational bullying and victimization are common social experiences during adolescence, but relatively little functional magnetic resonance imaging (fMRI) research has examined the neural correlates of bullying and victimization in adolescents. The aim of the present study was to address this gap by examining the association between amygdala activity to angry and fearful faces and peer relational bullying and victimization in a community-based sample of adolescents. Participants included 49 adolescents, 12-15 years old, who underwent fMRI scanning while completing an emotional face matching task. Results indicated that interactions between amygdala activity to angry and fearful faces predicted self-reported relational bullying and victimization. Specifically, a combination of higher amygdala activity to angry faces and lower amygdala activity to fearful faces predicted more bullying behavior, whereas a combination of lower amygdala activity to angry faces and lower amygdala activity to fearful faces predicted less relational victimization. Exploratory whole-brain analyses also suggested that increased rostral anterior cingulate cortex activity to fearful faces was associated with less bullying. These results suggest that relational bullying and victimization are related to different patterns of neural activity to angry and fearful faces, which may help in understanding how patterns of social information processing predict these experiences.

The practice of trauma-informed care (TIC) allows nurses in any setting to identify and intervene with traumatized individuals and to create a continuum of care when forensic nursing services are needed. The purpose of this article is to suggest ways to incorporate TIC content into baccalaureate nursing programs. We begin with an overview of baccalaureate nursing curricula and common types of traumatic experience important for students to understand. We then propose specific strategies for inclusion of TIC content in baccalaureate nursing education, using the American Association of Colleges of Nursing Essentials of Baccalaureate Education for Professional Nursing Practice. With a solid foundation in TIC, baccalaureate-prepared nursing students can provide effective patient care and better support forensic nursing practice. This will increase the capacity of the nursing profession in general to meet the needs of those affected by trauma, violence, and abuse.