Rosalyn D. Lee

The Impact of Parental Incarceration on the Physical and Mental Health of Young Adults

OBJECTIVES: We investigated the relationship between parental incarceration history and young adult physical and mental health outcomes using Wave 1 and Wave 4 data from the National Longitudinal Study of Adolescent Health. METHODS: Dependent variables included self-reported fair/poor health and health diagnoses. The independent variable was parental incarceration history. Cross-tabulations and logistic regression models were run. RESULTS: Positive, significant associations were found between parental incarceration and 8 of 16 health problems (depression, posttraumatic stress disorder, anxiety, cholesterol, asthma, migraines, HIV/AIDS, and fair/poor health) in adjusted logistic regression models. Those who reported paternal incarceration had increased odds of 8 mental and physical health problems, whereas those who reported maternal incarceration had increased odds of depression. For paternal incarceration, with the exception of HIV/AIDS, larger associations were found for mental health (odds ratios range 1.43–1.72) as compared with physical health (odds ratios range 1.26–1.31) problems. The association between paternal incarceration and HIV/AIDs should be interpreted with caution because of the low sample prevalence of HIV/AIDs. CONCLUSIONS: This study suggests exposure to parental incarceration in childhood is associated with health problems in young adulthood. Extant literature suggests underlying mechanisms that link parental incarceration history to poor outcomes in offspring may include the lack of safe, stable, nurturing relationships and exposure to violence. To prevent poor health in offspring of the incarcerated, additional studies are needed to (1) confirm the aforementioned associations and (2) assess whether adverse experiences and violence exposure in childhood mediate the relationship between parental incarceration history and offspring health problems.

Safe, Stable, Nurturing Relationships as a Moderator of Intergenerational Continuity of Child Maltreatment: A Meta-Analysis

PURPOSE The present paper summarizes findings of the special issue papers on the intergenerational continuity of child maltreatment and through meta-analysis explores the potential moderating effects of safe, stable, nurturing relationships (SSNRs). METHODS Studies were selected for inclusion in this meta-analysis if they (1) were published in peer-reviewed journals; (2) tested for intergenerational continuity in any form of child maltreatment, using prospective, longitudinal data; and (3) tested for moderating effects of any variable of SSNRs on intergenerational continuity of child maltreatment. The search revealed only one additional study beyond the four reports written for this special issue that met inclusion criteria for the meta-analysis. RESULTS Estimates of intergenerational stability of child maltreatment from the studies included in this special issue are consistent with several other studies, which find that child maltreatment in one generation is positively related to child maltreatment in the next generation. Furthermore, meta-analytic results from the five studies that met the inclusion criteria suggest a protective, moderating effect of SSNRs on intergenerational continuity of child maltreatment. The calculated fail-safe index indicated that 49 unpublished intergenerational studies with an average null effect would be required to render nonsignificant the overall moderation effect of SSNRs on child maltreatment. CONCLUSIONS This special issue expanded the examination of SSNRs beyond the caregiver-child dyad. That is, these studies considered SSNRs in adult relationships as well as parent-child relationships. Results suggest that certain types of SSNRs between parents and other adults (e.g., romantic partner, co-parent, or adult social support resource) may decrease maltreatment continuity.

Breaking the cycle of maltreatment: The role of safe, stable, and nurturing relationships

PURPOSE We examine two research questions. First, does a history of child maltreatment victimization significantly increase the likelihood of maltreatment perpetration during adulthood? Second, do safe, stable, and nurturing relationships (SSNRs) during early adulthood serve as direct protective factors, buffering protective factors, or both to interrupt intergenerational continuity in maltreating behaviors? METHODS Data come from the Rochester Youth Development Study that followed a community sample from age 14 to 31 with 14 assessments. Maltreatment victimization records covering birth through age 17 were collected from Child Protective Services records as were maltreatment perpetration records from age 21 to 30. Data on five SSNRs were measured during three interviews from ages 21 to 23. RESULTS There is a significant relationship between maltreatment victimization and maltreatment perpetration (odds ratio = 2.57; 95% confidence interval = 1.47-4.50). Three of the five SSNRs investigated-relationship satisfaction, parental satisfaction, and attachment to child-served as direct protective factors, significantly reducing risk for those who had been maltreated. However, none of the interaction terms--between maltreatment victimization and the SSNR--was statistically significant, indicating that the SSNRs did not serve as buffering protective factors CONCLUSIONS Although a history of maltreatment significantly increases the risk of subsequent perpetration of maltreatment, enhancing SSNRs with intimate partners and with children during early adulthood can decrease the odds that a victim of maltreatment will become a perpetrator. Mandated reporters and service providers should be aware of the risk posed by earlier maltreatment and be prepared to ameliorate that risk, in part by strengthening supportive social relationships.

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.

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.

Examining the Role of Safe, Stable, and Nurturing Relationships in the Intergenerational Continuity of Child Maltreatment—Introduction to the Special Issue

This special issue is the result of a successful collaboration between the Centers for Disease Control and Prevention (CDC) and researchers leading four important longitudinal studies on intergenerational patterns of violence: The Environmental Risk Longitudinal TwinStudy (E-Risk) [1]; theFamilyTransitionsProject (FTP) [2]; the Lehigh Longitudinal Study [3]; and the Rochester Youth Development Study [4]. The papers that follow investigate the role of safe, stable, and nurturing relationships and social contexts in the lives of children and their caregivers, provide insight into complex relationship factors that influence the intergenerational continuity of child maltreatment, and point to a number of important avenues to improve the lives of children and families by preventing violence and promoting health and well-being. Child maltreatment is a significant public health problem that requires a multifaceted approach to prevention. It is estimated that one out of every ten children in the United States experiences one or more forms of physical, sexual, or emotional abuse or neglect by a parent or other caregiver at some point during their lifetime [5e7]. In 2011, social service workers identified 681,000 children1 in the United States as substantiated victims of maltreatment. This equates to an overall victimization rate of 9.1 per 1,000 children in the U.S. population [8]. It is well-established that experiencing child maltreatment is associated with a variety of negative physical, emotional, and psychological outcomes, including subsequent harsh and/or neglectful parenting in adulthood [9e13]. Yet, it is also clear that not all maltreated children grow up to become maltreating parents [14,15]. Thus, identifying factors that distinguish families in which the cycle of violence is maintained from families in which it is interrupted is critical for violence prevention and optimal child development. The CDC has identified the promotion of safe, stable, nurturing relationships (SSNRs) as a key strategy for the public health approach to child maltreatment prevention [16]. The three dimensions of SSNRs (i.e., safety, stability, and nurturance) each represent significant aspects of the social and physical environments that

The Protective Effects of Intimate Partner Relationships on Depressive Symptomatology Among Adult Parents Maltreated as Children

PURPOSE We examined whether intimate partner relationships in general, and satisfying and stable intimate partner relationships in particular, protect victims of child maltreatment from depressive symptoms during young adulthood. METHODS Prospective, longitudinal data on 485 parents, 99 maltreated during childhood, were used. Longitudinal multilevel models (12 annual interviews, conducted from 1999 to 2010, nested in individuals) were specified to estimate the effects of relationship characteristics on depressive symptomatology by maltreatment status. RESULTS Relationship characteristics operated as direct protective factors for maltreated and not maltreated individuals. Higher relationship satisfaction and stability were prospectively predictive of less depressive symptomatology. Models of inter and intraindividual variability were also consistent with significant direct protective effects. Between persons, a more satisfying and stable relationship was associated with fewer depressive symptoms. Within person, periods when an individual moved into a relationship and periods of enhanced satisfaction and stability were associated with fewer depressive symptoms. Relationship satisfaction and stability operated as significant buffering protective factors for the effect of maltreatment on depressive symptoms in most models, suggesting that positive intimate partner relationships may reduce the risk that childhood maltreatment poses for adult depressive symptoms. CONCLUSIONS The Centers for Disease Control and Prevention identifies safe, stable, and nurturing relationships as key in preventing maltreatment and its consequences. This study adds to the evidence on the protective role of safe, stable, and nurturing relationships by identifying intimate partner relationship factors that may protect parents who were maltreated during childhood from depressive symptoms.

Parental Incarceration and Social Exclusion: Long-term Implications for the Health and Well-being of Vulnerable Children in the United States ☆

Abstract Research suggests social exclusion is linked to violence. To expand what is known about risk factors for violence, this study investigates links between having a parent with a history of incarceration and experiencing social exclusion. Data from waves 1 and 4 of the National Longitudinal Study of Adolescent Health were used to conduct regression analyses to assess associations between parental incarceration and social exclusion adjusting for child, parent, and family factors. Results indicate that compared to individuals whose parents had never been incarcerated, those who reported a parent had been incarcerated were at greater risk of experiencing material exclusion, incarceration, and multiple forms of exclusion. When assessing differences by parent gender, results indicate that those who reported their mother had been incarcerated compared to those who reported their father had been incarcerated had higher risk of being incarcerated themselves and experiencing multiple forms of exclusion. Since research suggests social exclusion increases violence risk, studies are needed (1) to identify mechanisms linking parental incarceration to offspring social exclusion and (2) to increase understanding around differential impact by parent gender. Such studies can inform development of interventions to promote better outcomes in this vulnerable sub-population of children.

Adverse childhood experiences, mental health, and excessive alcohol use: Examination of race/ethnicity and sex differences

Responses from N=60,598 interviews from the 2010 Behavioral Risk Factor Surveillance System (the 10 states and the District of Columbia that included the optional Adverse Childhood Experience (ACE) module) were used to test whether associations between childhood adversity and adult mental health and alcohol behaviors vary by race/ethnicity and sex. ACE items were categorized into two types - household challenges and child abuse. Outcomes were current depression, diagnosed depression, heavy drinking and binge drinking. Logistic regression models found ACEs significantly associated with depression and excessive alcohol use, but sex did not moderate any relationships. Race/ethnicity moderated the relationship between ACEs and heavy drinking. In stratified analyses, compared to those not exposed to ACEs, non-Hispanic blacks who experienced either type of ACE were about 3 times as likely to drink heavily; Non-Hispanic whites who experienced child abuse or both ACE types were 1.5-2 times as likely to drink heavily; and Hispanics who experienced household challenges or both ACE types were 1.2 and 11 times as likely to report heavy drinking. ACEs impact depression and excessive alcohol use similarly across men and women. With the exception of heavy drinking, ACEs appear to have the same association with excessive alcohol use across race/ethnicity. It may be prudent to further investigate why the relationship between ACEs and heavy drinking may differ by race/ethnicity such that prevention strategies can be developed or refined to effectively address the needs of all sub-groups.