Taryn Lindhorst

Interpersonal Violence in the Lives of Urban American Indian and Alaska Native Women: Implications for Health, Mental Health, and Help-Seeking

OBJECTIVE We surveyed American Indian/Alaska Native (AIAN) women in New York City to determine the prevalence of 3 types of interpersonal violence among urban AIAN women and the behavioral health and mental health factors associated with this violence. METHODS Using a survey, we questioned 112 adult AIAN women in New York City about their experiences with interpersonal violence, mental health, HIV risk behaviors, and help-seeking. The sampling plan utilized a multiple-wave approach with modified respondent-driven sampling, chain referral, and target sampling. RESULTS Among respondents, over 65% had experienced some form of interpersonal violence, of which 28% reported childhood physical abuse, 48% reported rape, 40% reported a history of domestic violence, and 40% reported multiple victimization experiences. Overwhelmingly, women experienced high levels of emotional trauma related to these events. A history of interpersonal violence was associated with depression, dysphoria, help-seeking behaviors, and an increase in high-HIV risk sexual behaviors. CONCLUSIONS AIAN women experience high rates of interpersonal violence and trauma that are associated with a host of health problems and have important implications for health and mental health professionals.

Toward a Multi-Level, Ecological Approach to the Primary Prevention of Sexual Assault: Prevention in Peer and Community Contexts

Although sexual assault prevention programs have been increasingly successful at improving knowledge about sexual violence and decreasing rape-supportive attitudes and beliefs among participants, reducing sexually assaultive conduct itself remains an elusive outcome. This review considers efforts to support change for individuals by creating prevention strategies that target peer network and community-level factors that support sexual violence. To this end, the article examines successful ecological prevention models from other prevention fields, identifies the components of multilevel prevention that appear critical to efficacy and discusses their application to existing and emerging sexual violence prevention strategies.

Reconceptualizing and Operationalizing Context in Survey Research on Intimate Partner Violence

Survey research in the field of intimate partner violence is notably lacking in its attention to contextual factors. Early measures of intimate partner violence focused on simple counts of behaviors, yet attention to broader contextual factors remains limited. Contextual factors not only shape what behaviors are defined as intimate partner violence but also influence the ways women respond to victimization, the resources available to them, and the environments in which they cope with abuse. This article advances methods for reconceptualizing and operationalizing contextual factors salient to the measurement of intimate partner violence. The analytic focus of the discussion is on five dimensions of the social context: the situational context, the social construction of meaning by the survivor, cultural and historical contexts, and the context of systemic oppression. The authors consider how each dimension matters in the measurement of intimate partner violence and offer recommendations for systematically assessing these contextual factors in future research.

Longitudinal Effects of Domestic Violence on Employment and Welfare Outcomes

This study uses longitudinal data spanning 13 years from a study of 234 adolescent mothers to evaluate the effects of cumulative domestic violence on employment and welfare use before and after welfare reform. Domestic violence increased the odds of unemployment after welfare reform, but not before; domestic violence had no effect on welfare use during any time period. Psychological distress after welfare reform was associated with unemployment, but not with welfare outcomes. Thus, the authors found that the direct effect of domestic violence on unemployment is not mediated by concurrent level of psychological distress. The relationship of psychological distress to unemployment exists only for those with a history of domestic violence. Cumulative domestic violence can have negative effects on economic capacity many years after the violence occurs, suggesting that policymakers recognize the long-term nature of the impact of domestic violence on womens capacity to be economically self-reliant.

Negative and Positive Factors Associated With the Well-Being of Lesbian, Gay, Bisexual, Transgender, Queer, and Questioning (LGBTQ) Youth.

Factors associated with the well-being of lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) youth were qualitatively examined to better understand how these factors are experienced from the youths’ perspectives. Largely recruited from LGBTQ youth groups, 68 youth participated in focus groups (n = 63) or individual interviews (n = 5). The sample included 50% male, 47% female, and 3% transgender participants. Researchers used a consensual methods approach to identify negative and positive factors across 8 domains. Negative factors were associated with families, schools, religious institutions, and community or neighborhood; positive factors were associated with the youth’s own identity development, peer networks, and involvement in the LGBTQ community. These findings suggest a pervasiveness of negative experiences in multiple contexts, and the importance of fostering a positive LGBTQ identity and supportive peer/community networks. Efforts should work towards reducing and eliminating the prejudicial sentiments often present in the institutions and situations that LGBTQ youth encounter.

Predictors of sexually coercive behavior in a nationally representative sample of adolescent males

Data from male participants in the National Longitudinal Study of Adolescent Health are used to examine childhood predictors of late adolescent and early adulthood sexually coercive behavior and adolescent mediators of these relationships. A path analysis shows that experiencing sexual abuse as a child has a direct effect on perpetrating subsequent coercion that is partially mediated by early sexual initiation. Involvement in delinquent activities in adolescence was the only additional significant predictor of sexually coercive behavior and completely mediated the relationship between physical abuse in childhood and later sexual coercion. Of note, more than half of men reporting sexually aggressive acts had no history of childhood victimization, so pathways to sexually coercive behavior for this group remain unidentified. In addition to the universal prevention approaches currently in use in the field, these findings suggest that targeted prevention programs need to be formulated for youth with histories of childhood sexual or physical abuse.

Disjunctures for Women and Frontline Workers: Implementation of the Family Violence Option

This research uses analysis of qualitative interviews with 10 battered welfare clients and 15 frontline welfare workers to examine the implementation of the Family Violence Option (FVO) under welfare reform. States adopting the FVO agree to screen for domestic violence, refer identified victims to community resources, and waive program requirements that would endanger the women or with which they are unable to comply. The analyses find that none of the 10 clients in this study received these services. This lack of services reflects four critical disjunctures between the formal policy and the policy experienced by the clients. It also reveals several more basic structural factors that provide conflicting mandates to frontline workers. Frontline workers’ discretionary behaviors enforce core rules related to welfare eligibility and reduce welfare caseloads but do not provide violence‐related services to victims.

CONTEXTUALIZED ASSESSMENT WITH BATTERED WOMEN: STRATEGIC SAFETY PLANNING TO COPE WITH MULTIPLE HARMS

Given the prevalence of domestic violence and the likelihood that many victims will not receive services from specialized domestic violence providers, this article provides a framework for contextualized assessment that can be used by generalist practitioners. Drawing from stress and coping theory, the authors discuss the relevance of assessing appraisals and emotional responses within the context of environmental and individual risk and protective factors. Through an illustrative case assessment, the authors describe the contextualized assessment process and its ramifications for strategic safety planning.

The Prevalence and Correlates of Depressive Symptoms Among Adolescent Mothers: Results from a 17-Year Longitudinal Study

The objective of the authors in this study was to examine the prevalence and correlates of elevated depressive symptoms in a 17-year cohort study of 173 women who were unmarried, pregnant adolescents between June 1988 and January 1990. Multiple logistic regression was used to estimate the associations between correlates and elevated depressive symptoms during five distinct developmental periods of the life course. Depressive symptoms were measured by the Brief Symptom Inventory depression subscale. The prevalence of elevated depressive symptoms in adolescent mothers significantly increased over the 17 years of the study from 19.8% to 35.2%. In adjusted analyses, antenatal depressive symptoms were positively and significantly associated with elevated depressive symptoms at every developmental period. Intimate partner violence was positively and significantly associated with elevated depressive symptoms during all but one developmental period. Other significant correlates of elevated depressive symptoms included welfare receipt, smoking, and parity, all of which were significant at some, but not other, developmental periods. Antenatal depressive symptoms and intimate partner violence were positively and significantly associated with elevated depressive symptoms. Given the public health consequences associated with maternal depression, clinical and community-based interventions should be developed to identify and to treat adolescent mothers at-risk for antenatal depression and intimate partner violence.

A blueprint of pain curriculum across prelicensure health sciences programs: one NIH Pain Consortium Center of Excellence in Pain Education (CoEPE) experience.

UNLABELLED To improve U.S. pain education and promote interinstitutional and interprofessional collaborations, the National Institutes of Health Pain Consortium has funded 12 sites to develop Centers of Excellence in Pain Education (CoEPEs). Each site was given the tasks of development, evaluation, integration, and promotion of pain management curriculum resources, including case studies that will be shared nationally. Collaborations among schools of medicine, dentistry, nursing, pharmacy, and others were encouraged. The John D. Loeser CoEPE is unique in that it represents extensive regionalization of health science education, in this case in the region covering the states of Washington, Wyoming, Alaska, Montana, and Idaho. This paper describes a blueprint of pain content and teaching methods across the University of Washingtons 6 health sciences schools and provides recommendations for improvement in pain education at the prelicensure level. The Schools of Dentistry and Physician Assistant provide the highest percentage of total required curriculum hours devoted to pain compared with the Schools of Medicine, Nursing, Pharmacy, and Social Work. The findings confirm the paucity of pain content in health sciences curricula, missing International Association for the Study of Pain curriculum topics, and limited use of innovative teaching methods such as problem-based and team-based learning. PERSPECTIVE Findings confirm the paucity of pain education across the health sciences curriculum in a CoEPE that serves a large region in the United States. The data provide a pain curriculum blueprint that can be used to recommend added pain content in health sciences programs across the country.