John Eckenrode

Self-injurious behaviors in a college population.

OBJECTIVE. The goal was to assess the prevalence, forms, demographic and mental health correlates of self-injurious behaviors in a representative college sample. METHODS. A random sample of undergraduate and graduate students at 2 northeastern US universities were invited to participate in an Internet-based survey in the spring of 2005. Thirty-seven percent of the 8300 invited participants responded. RESULTS. The lifetime prevalence rate of having ≥1 self-injurious behavior incident was 17.0%. Seventy-five percent of those students engaged in self-injurious behaviors more than once. Thirty-six percent reported that no one knew about their self-injurious behaviors and only 3.29% indicated that a physician knew. Compared with non-self-injurers, those with repeat self-injurious behavior incidents were more likely to be female, bisexual or questioning their sexual orientation. They were less likely to be Asian/Asian American and >24 years of age. When controlling for demographic characteristics, those with repeat self-injurious behavior incidents were more likely to report a history of emotional abuse or sexual abuse, ever having considered or attempted suicide, elevated levels of psychological distress, and ≥1 characteristic of an eating disorder. A dose-response gradient was evident in each of these areas when single-incident self-injurious behaviors were compared with repeat-incident self-injurious behaviors. CONCLUSIONS. A substantial number of college students reported self-injurious behaviors in their lifetimes. Many of the behaviors occurred among individuals who had never been in therapy for any reason and who only rarely disclosed their self-injurious behaviors to anyone. Single self-injurious behavior incidents were correlated with a history of abuse and comorbid adverse health conditions but less strongly than were repeat self-injurious behavior incidents. The reticence of these clients to seek help or advice renders it critical that medical and mental health providers find effective strategies for detecting and addressing self-injurious behaviors.

School Performance and Disciplinary Problems among Abused and Neglected Children.

This study investigated the relationship of child abuse and neglect to academic achievement and discipline problems in a school-age population. A representative community sample of 420 maltreated children in kindergarten through Grade 12 were matched with 420 nonmaltreated children in the same community

The virtual cutting edge: the internet and adolescent self-injury

The 2 studies reported here use observational data from message boards to investigate how adolescents solicit and share information related to self-injurious behavior. Study 1 examines the prevalence and nature of these message boards, their users, and most commonly discussed topics. Study 2 was intended to explore the correlations between content areas raised for discussion. Both studies were intended to shed light on the role of message boards in spreading information about self-injurious practices and influencing help-seeking behavior. More than 400 self-injury message boards were identified. Most are populated by females who describe themselves as between 12 and 20 years of age. Findings show that online interactions clearly provide essential social support for otherwise isolated adolescents, but they may also normalize and encourage self-injurious behavior and add potentially lethal behaviors to the repertoire of established adolescent self-injurers and those exploring identity options.

The social context of coping

I am very pleased to have been asked to do abrief foreword to this second CRISP volume, The Social Context o[ Coping. I know most of the participants and their work, and respect them as first-rate and influen- tial research scholars whose research is at the cusp of current concerns in the field of stress and coping. Psychological stress is central to human adaptation. It is difficult to visualize the study of adaptation, health, illness, personal soundness, and psychopathology without recognizing their dependence on how weil people cope with the stresses of living. Since the editor, John Eckenrode, has portrayed the themes of each of the chapters in his introduction, I can limit myself to a few general comments about stress and coping. Stress research began, as unexplored fields often do, with very sim- ple-should I say simplistic?-ideas about how to define the concept. Early approaches were unidimensional and input-output in outlook, modeled implicitly on Hookes late-17th-century engineering analysis in which external load was an environmental stressor, stress was the area over wh ich the load acted, and strain was the deformation of the struc- tu re such as a bridge or building.

Longitudinal Associations Between Teen Dating Violence Victimization and Adverse Health Outcomes

OBJECTIVE: To determine the longitudinal association between teen dating violence victimization and selected adverse health outcomes. METHODS: Secondary analysis of Waves 1 (1994–1995), 2 (1996), and 3 (2001–2002) of the National Longitudinal Study of Adolescent Health, a nationally representative sample of US high schools and middle schools. Participants were 5681 12- to 18-year-old adolescents who reported heterosexual dating experiences at Wave 2. These participants were followed-up ∼5 years later (Wave 3) when they were aged 18 to 25. Physical and psychological dating violence victimization was assessed at Wave 2. Outcome measures were reported at Wave 3, and included depressive symptomatology, self-esteem, antisocial behaviors, sexual risk behaviors, extreme weight control behaviors, suicidal ideation and attempt, substance use (smoking, heavy episodic drinking, marijuana, other drugs), and adult intimate partner violence (IPV) victimization. Data were analyzed by using multivariate linear and logistic regression models. RESULTS: Compared with participants reporting no teen dating violence victimization at Wave 2, female participants experiencing victimization reported increased heavy episodic drinking, depressive symptomatology, suicidal ideation, smoking, and IPV victimization at Wave 3, whereas male participants experiencing victimization reported increased antisocial behaviors, suicidal ideation, marijuana use, and IPV victimization at Wave 3, controlling for sociodemographics, child maltreatment, and pubertal status. CONCLUSIONS: The results from the present analyses suggest that dating violence experienced during adolescence is related to adverse health outcomes in young adulthood. Findings from this study emphasize the importance of screening and offering secondary prevention programs to both male and female victims.

Long-term Effects of Prenatal and Infancy Nurse Home Visitation on the Life Course of Youths: 19-Year Follow-up of a Randomized Trial

OBJECTIVE To examine the effect of prenatal and infancy nurse home visitation on the life course development of 19-year-old youths whose mothers participated in the program. DESIGN Randomized trial. SETTING Semirural community in New York. PARTICIPANTS Three hundred ten youths from the 400 families enrolled in the Elmira Nurse-Family Partnership program. Intervention Families received a mean of 9 home visits (range, 0-16) during pregnancy and 23 (range, 0-59) from birth through the childs second birthday. MAIN OUTCOME MEASURES Youth self-reports of educational achievement, reproductive behaviors, welfare use, and criminal involvement. RESULTS Relative to the comparison group, girls in the pregnancy and infancy nurse-visited group were less likely to have been arrested (10% vs 30%; relative risk [RR], 0.33; 95% confidence interval [CI], 0.13-0.82) and convicted (4% vs 20%; 0.20; 0.05-0.85) and had fewer lifetime arrests (mean: 0.10 vs 0.54; incidence RR [IRR], 0.18; 95% CI, 0.06-0.54) and convictions (0.04 vs 0.37; 0.11; 0.02-0.51). Nurse-visited girls born to unmarried and low-income mothers had fewer children (11% vs 30%; RR, 0.35; 95% CI, 0.12-1.02) and less Medicaid use (18% vs 45%; 0.40; 0.18-0.87) than their comparison group counterparts. CONCLUSIONS Prenatal and infancy home visitation reduced the proportion of girls entering the criminal justice system. For girls born to high-risk mothers, there were additional positive program effects consistent with results from earlier phases of this trial. There were few program effects for boys.

The effects of neglect on academic achievement and disciplinary problems: a developmental perspective.

The present study examines the effect of child neglect, alone and in combination with abuse, on academic achievement and school disciplinary problems for elementary, junior high, and senior high students. The sample included 324 neglected children and adolescents, and a matched nonmaltreated sample of 420 children and adolescents. All subjects were in grades K through 12 in a small city in New York state. The results revealed that neglected children did perform more poorly than their nonmaltreated counterparts, having lower grades, more suspensions, more disciplinary referrals, and more grade repetitions, even when controlling for gender of child and SES. Neglect alone and neglect in combination with physical or sexual abuse was related to lower grades and more suspensions. The combination of abuse and neglect had a particularly strong effect on the number of disciplinary referrals and grade repetitions. Abused/neglected students in junior high had the highest number of grade repetitions. The number of disciplinary referrals continued to increase through senior high for both neglected and abused/neglected students. Interestingly, the academic performance of all subjects dropped during junior high. Neglect and neglect in combination with abuse appeared to exacerbate a decline in academic performance that occurs as children enter junior high school.

Stress between Work and Family

The contributors of this book have presented data from a variety of research projects that show the many and dynamic ways in which the worlds or work and family are intricately connected. This interconnectedness becomes even more apparent when stressful experiences in the workplace or the family upset the homeostasis that may otherwise have been achieved between these domains. As such, the investigation of chronic stress in the workplace and disruptions such as job loss becomes a potential window investigators can use to explore normative family processes, just as chronic stress and change in the family informs our understanding of the meaning of work roles.

Social Relationships, Personality, and Anxiety During a Major Stressful Event

Although it is commonly believed that social relationships buffer the effects of stress on mental health, these apparent buffering effects may be spurious reflections of personality or prior mental health. This possibility was investigated in a prospective study of a medical school entrance examination. Five weeks before the examination, Ss (N = 56) rated their personality (extraversion and neuroticism) and social relationships (number of social contacts and perceived support). They then rated their anxiety for 35 days surrounding the examination. Controlling for personality and prior anxiety, social contacts buffered against increases in anxiety, whereas perceived support did not. Further analyses revealed that discretionary social contacts were beneficial whereas obligatory contacts were not.

The mobilization of social supports: Some individual constraints

The effects of two dispositional variables, locus of control and help-seeking beliefs, as well as sociodemographic variables, on the mobilization of social supports were examined in this study. With a sample of 308 women users of a neighborhood health center, information was gathered regarding social support contacts following stressful events occurring within the previous year. Results confirmed the importance of the two dispositional variables, with internal locus of control and positive beliefs in the benefits of help-seeking each being associated with more support mobilization, independent of the number of potential supporters available. In addition, the educational level of the respondents showed a direct, positive relationship to support mobilization. Tests for interactions revealed several interactions between sociodemographic variables and the dispositional variables or potential support. These interactions generally showed that the dispositional variables and levels of potential support had a greater impact on support mobilization for persons with higher educational achievement, higher incomes, or coming from English-speaking (vs. Spanish-speaking) backgrounds. Results are discussed in relation to current research on social support and differential vulnerability of individuals to the effects of stress.