Jeffrey E. Hall

Centers for Disease Control and Prevention's Expert Panel on Protective Factors for Youth Violence Perpetration: background and overview.

The CDC Expert Panel on Protective Factors for Youth Violence Perpetration was convened to review and advance the status of etiologic and prevention research on direct protective and buffering protective factors for youth violence perpetration. The current paper introduces Phase One of the panels work, which focuses on direct protective factors and includes the papers in this supplement to the American Journal of Preventive Medicine. This paper provides the context for the panels work, describes its practical and theoretic importance, and summarizes why independently defined direct protective factors and risk factors are important for the advancement of our understanding of youth violence and its prevention. Lastly, this paper briefly describes the organization of the work of the panel as well as the research products that comprise the contents of the supplement.

Intimate Partner Violence Perpetration by Court-Ordered Men: Distinctions and Intersections Among Physical Violence, Sexual Violence, Psychological Abuse, and Stalking

This study continues previous work documenting the structure of violence perpetrated by males against their female intimate partners. It assesses the construct validity of a measurement model depicting associations among eight subtypes of perpetration: moderate physical violence, severe physical violence, forced or coerced sexual violence, sexual violence where consent was not possible, emotional/verbal psychological abuse, dominance/isolation psychological abuse, interactional contacts/surveillance related stalking, and stalking involving mediated contacts. Data were obtained from a sample of 340 men arrested for physical assault of a female spouse or partner, and court ordered into batterer intervention programs. Men were surveyed before starting the intervention. Confirmatory factor analyses (CFA) supported the validity of model as evidenced by good model to data fit and satisfaction of requirements for fit statistics. In addition, the eight factor solution was characterized by a slightly better model to data fit than a four factor higher order solution described in the author’s previous work. Latent variable correlations across the broader categories of intimate partner violence (IPV) revealed that the violence subtypes were mostly moderately positively correlated and ranged from .381 (emotional/verbal psychological abuse with interactional contacts/surveillance related stalking) to .795 (dominance/isolation psychological with abuse with forced sex). Future studies should determine whether there are distinct risk factors and health outcomes associated with each of the eight IPV perpetration subtypes and identify possible patterns of co-occurrence.

Implications of Direct Protective Factors for Public Health Research and Prevention Strategies to Reduce Youth Violence

The development of work on direct protective factors for youth violence has been delayed by conceptual and methodologic problems that have constrained the design, execution, and interpretation of prevention research. These problems are described in detail and actively addressed in review and analytic papers developed by the CDCs Expert Panel on Protective Factors for youth violence. The present paper synthesizes findings from these papers, specifies their implications for public health research and prevention strategies to reduce youth violence, and suggests directions for future research.

Behavioral and Attitudinal Factors Differentiating Male Intimate Partner Violence Perpetrators With and Without a History of Childhood Family Violence

This study utilized a sample of men (N = 340) charged with assault against a female partner to assess differences among IPV perpetrators with and without a history of childhood family violence on factors such as angry, controlling and violent behaviors, substance use related behaviors, and attitudes towards women. Over two-thirds of the sample reported childhood exposure to maltreatment or witnessing IPV. Chi-square analyses and t-tests indicated significant differences between perpetrators with and without a history of family violence on eight of eleven measures. Findings suggest perpetrators with a family violence history more strongly endorse ideas that present women and feminine attributes in a negative light. This research demonstrates that while exposure to family violence during childhood is not necessary for IPV to occur, its presence may be a marker for more severe attitudinal and behavioral problems. Findings highlight the need for primary prevention efforts and can inform secondary prevention strategies.

Expanding Resource Theory and Feminist-Informed Theory to Explain Intimate Partner Violence Perpetration by Court-Ordered Men

This study tested resource and feminist-informed theories to explain physical, sexual, psychological, and stalking intimate partner violence (IPV) perpetrated by court-mandated men. Data were obtained from 340 men arrested for physical assault of a partner before their court-ordered treatment. Using path analysis, findings provided partial support for each model. Ineffective arguing and substance-use problems were moderators of resources and perpetration. Dominance mediated early exposures and perpetration in the feminist-informed model. In both models, predictors of stalking were different than those for other types of perpetration. Future studies should replicate this research and determine the utility of combining models.

Circumstances Preceding Homicide-Suicides Involving Child Victims: A Qualitative Analysis.

Homicide-suicide incidents involving child victims can have a detrimental impact on survivors of the violence, family members and friends of the decedents, and other community members, but the rare occurrence of these acts makes using quantitative data to examine their associated antecedents challenging. Therefore, using qualitative data from the 2003-2011 National Violent Death Reporting System, we examined 175 cases of homicide-suicide involving child victims in an effort to better understand the complex situational factors of these events. Our findings indicate that 98% of homicide-suicides with child victims are perpetrated by adults (mostly parents) and propelled by the perpetrators’ intimate partner problems, mental health problems, and criminal/legal problems. These events are often premeditated, and plans for the violence are sometimes disclosed prior to its occurrence. Findings provide support for several theoretical perspectives, and implications for prevention are discussed.

Sex, Race/Ethnicity, and Context in School-Associated Student Homicides:

This study assessed the importance of sex, race/ethnicity, and geographic context for incidents of school-associated student homicides between July 1, 1994 and June 30, 1999, covering 5 academic years. Using data from the Centers for Disease Control and Prevention School Associated Violent Deaths Study (n = 125 incidents), we compared percentages and medians of victim, offender, motive, and school characteristics for incidents by geographic context and race/ethnicity of the offenders. Most incidents involved urban areas (53.6%), Black and Latino offenders and victims, moderately high youth poverty, and male on male violence (77.6%) driven by disputes and gang-related motives. Suburban area incidents (31.2%) often involved offenders and victims of a different race/ethnicity (51.3%). Multiple victims and White offenders were more common in rural areas (15.2%). More than 50% of the rural incidents involved male offenders and female victims. White offender incidents more often included multiple victims and female victims while Black and Latino offenders more often included single victims of the same sex. These results emphasize the utility of an incident-based analysis of school-associated student homicides in highlighting important variations by intersections of sex, race/ethnicity, and geographic context.

Youth violence and connectedness in adolescence: what are the implications for later sexually transmitted infections?

PURPOSE To examine associations between (1) youth violence victimization and perpetration and later sexually transmitted infections (STI) and (2) parent-family and school connectedness and later STI, and to explore the moderating role of connectedness on the associations between youth violence victimization and perpetration and later STI. METHODS We used data from Waves I and IV of the National Longitudinal Study of Adolescent Health, which provided a baseline weighted sample of 14,800 respondents. We used logistic regression to examine associations between youth violence and connectedness with self-reported ever STI diagnosis, including gonorrhea, chlamydia, syphilis, genital herpes, genital warts or human papillomavirus, or human immunodeficiency virus. If participants reported having an STI at Wave I they were excluded from the analysis. RESULTS Controlling for biological sex, race/ethnicity, age, parents highest education level, and parents marital status, both youth violence victimization and perpetration were associated with an increased risk of later STI (adjusted odds ratio [AOR], 1.27, 95% confidence interval [CI], 1.07-1.52; and AOR, 1.21, 95% CI, 1.04-1.41, respectively). Parent-family and school connectedness in adolescence were associated with a decreased risk for later STI (AOR, .96, 95% CI, .95-.98; and AOR, .97, 95% CI, .95-.99, respectively); however, connectedness did not moderate the associations between nonsexual violence involvement and later STI. CONCLUSIONS These results indicate that youth violence victimization and perpetration may be risk factors for STI later in life. Conversely, parent-family and school connectedness in adolescence appear to protect against subsequent STI. The findings suggest that provider efforts to address youth violence and connectedness in adolescence can promote positive sexual health outcomes in adulthood.

Centers for Disease Control and Prevention: An Overview of Elder Abuse Prevention Initiatives

Elder Abuse (EA) is a threat to population health that is addressable using public health approaches and expertise. This chapter presents a rationale for why elder abuse is considered a public health problem from the perspective of the Centers for Disease Control and Prevention (CDC) and provides an overview of how this federal public health focused agency has acted to advance surveillance, practices, and policy relating to elder abuse. The overview is provided using a narrative approach to first outline CDC’s history of work in preventing injury and violence and establish how its accomplishments created demands and space for the application of public health approaches to the prevention of elder abuse. The narrative approach is then used to describe past and presently active CDC initiatives implemented to assist the field focused on EA in obtaining data that may allow elder abuse to be identified, measured, monitored and documented over time. The chapter concludes with summary statements and a brief glimpse of possible next steps that could be taken by the CDC in light of recommendations in the comprehensive agenda that has guided the agency’s work on elder abuse for over a decade.

Examining the Prevalence and Predictors of Injury from Adolescent Dating Violence

ABSTRACT Medical needs of youth who experience dating violence are not well understood because of limited past research examining the prevalence and predictors of injuries and medical help seeking. To address these gaps, the current study described the prevalence and predictors of injuries from dating violence from grades 8 through 12 in a large sample of youth. Results indicate that one third to one half of youth who experienced any physical and/or sexual dating violence also sustained an injury. Prevalence of injury was highest in the 8th grade and was significantly higher for females than for males across grades 8 through 11. Youth who experienced greater amounts of violent victimization in their relationships (physical, sexual, and psychological) were at the highest risk for injury. Results also suggest that victims at highest risk for injury are girls, White youth, those experiencing multiple types of violence, and those who also engage in perpetration. Given the high prevalence of injury among youth who report dating violence, healthcare professionals may be in a unique position to screen and counsel youth about dating violence. Because the highest prevalence of injury occurred before high school, prevention programs should start early and selected prevention may be used for youth at highest risk for injury.