The Effect of Classmate Characteristics on Individual Outcomes: Evidence from the Add Health

We use data from the National Longitudinal Study of Adolescent Health (Add Health) to examine the effects of classmate characteristics on economic and social outcomes of students. The unique structure of the Add Health allows us to estimate these effects using comparisons across cohorts within schools, and to examine a wider range of outcomes than other studies that have used this identification strategy. This strategy yields variation in cohort composition that is uncorrelated with student observables suggesting that our estimates are not biased by the selection of students into schools or grades based on classmate characteristics. We find that increases in the percent of classmates whose mother is college educated has significant, desirable effects on educational attainment and substance use. We do not find much evidence that the percent of classmates who are black or Hispanic has significant effects on individual outcomes, on average. Additional analyses suggest, however, that an increase in the percent black or Hispanic may increase dropout rates among black students and post-high school idleness among males.

Prevalence of depressive symptoms in urban middle and high school Hispanic and African American students

This cross-sectional study examined the prevalence of depressive symptoms in urban Hispanic and African American middle and high school students (N=1,292) using data collected from a multi-component, multi-wave violence and substance use intervention program targeted at a large urban school district in Texas. Chi-square analysis was used to examine differences in race/ethnicity, gender, grade level and whether or not a student had been held back/repeated a grade in school. Univariate and multivariate logistic regression were used to analyze the association between depressive symptoms and demographic variables. Being female and being held back/repeating a grade was significantly associated with depressive symptoms in both univariate and multivariate analyses. Overall 16% of the students reported depressive symptoms; Hispanic youth had a higher prevalence of depressive symptoms (16.8%) than the African American youth (14.8%). Minority females and those who had been held back/repeated a grade reported a prevalence of 19.4% and 21.2%, respectively. Further research is needed to understand why Hispanic youth continue to report a higher prevalence of depressive symptoms than other minorities. Additionally research is required to further explore the association between academic performance and depressive symptoms in urban minorities, specifically the effect of being held back/repeating a grade.^

Youth population's health issues in Comal County, Texas

This study assesses adolescent's health issues in Comal County, TX. Adolescents are defined as youth between the ages of 12 to 17 years of age, who resided in Comal County during the time period of 2000 to 2007. The analysis focused on high risk behaviors including use of gateway drugs—tobacco and alcohol; illegal substance use; and reproductive health related indicators, including sexual activity, sexually transmitted diseases, and pregnancy. This study is based on the primary and secondary data collected as part of the 2008 Comal County Community Assessment. It compares findings from the primary data sources to extant data from four secondary data sources including: (1) The Centers for Disease Control & Prevention (national) Healthy People 2010; (2) The Centers for Disease Control & Prevention, Youth Risk Behavior Surveillance Survey, 2007; (3) The Texas Department of State Health Services, 2000 to 2007; and The Pride Survey (Local and Statewide). The methods are drawn from the literature on "rapid epidemiologic appraisal" (Annett H. & Rifkin S. B., 1988). The study focus on corroborating the perceptions, subjective concerns, opinions and beliefs of the Comal County key stakeholders and community participants with qualitative and quantitative indicators of health and well being. The value of this approach is to inform community leaders using a public health perspective and evidence in their decisions about priority setting and resources allocation activities for prevention of high risk behaviors and promotion of adolescent health and well being. ^

Demographics of having a gun in the home in Columbia, SC as reported by women primary care patients

Objectives. To determine demographic correlates of having one or more guns in the household of women primary care patients in the southern USA. ^ Methods. All participants in this cross-sectional study were women aged 18-65 who were insured by either Medicaid or a managed care provider and had ever had an intimate sexual relationship with a male partner that lasted at least three months. Prevalence rate ratios and 95% confidence intervals were calculated using stratified analyses for having a gun in the home and the following demographic factors: age, race, educational attainment, marital status, employment status, and alcohol/drug use. ^ Results. Twenty six percent of households had at least one gun and 6.5% had 3 or more guns. The following demographic characteristics of women were associated with having a gun in the household: age (>40) (prevalence rate ratio [PRR] = 1.4; 95% confidence interval [CI] = 1.1–1.8); White race (PRR = 1.89; 95% CI = 1.61–2.27); currently being employed (PRR = 1.72; 95% CI = 1.22–2.44); higher education; and being insured by an HMO (PRR = 1.92; 95% CI = 1.47–2.50). Neither the partner's unemployment nor his substance use was associated with having a gun. While White households were more likely to have a gun, the same correlates of gun ownership held for both White and African-American households; being married or living as married and higher socio-economic status (i.e. HMO insurance and being employed) were strongly correlated with gun in the household. The following were correlated with having multiple guns in the household: White race (p < 0.0001); increased age (p = 0.005); being currently married or living as married (p < 0.0001); and HMO insured status (p < 0.0001). Among those households with at least one gun, White race and married or currently living as married were associated with having 2 or more guns relative to one gun in the household. ^ Conclusions. Currently living with a man and being of higher socio-economic status were strong correlates of household gun ownership among both Whites and African-Americans. Substance use was not associated with household gun ownership. ^

Homeless mortality in Harris County in 2008

Little research has been on homeless mortality, but what has been done indicates that homeless people have higher mortality rates than the general population. Homeless decedents in Harris County in 2008 who were referred to the Harris County Medical Examiner's Office (HCMEO) were described by age, race/ethnicity, sex, and marital status and compared to the homeless population as enumerated by the Coalition of the Homeless (COH) in 2007. Of the 47 decedents, eight (17%) were female and 39 (83%) were male, 24 (51.1%) were non-Hispanic white, 11 (23.4%) were black, and 12 (25.5%) were Hispanic, none of the decedents were listed as married, however, a large number (29, 61.5%) were listed as “unknown,” and the average age of decedents was 50 years, six years older than the average of 44 years in the general homeless population. Most common causes of death were injuries, which included motor vehicle accidents, homicides and suicides and poisonings, (acute overdose and chronic substance use). Homeless decedents were representative to the larger Harris County homeless population. ^

A cross-sectional study of disparities in suicide ideation between Hispanic and non-Hispanic white female adolescents

Suicide is recognized as a major public health and clinical problem in the United States. One fifth of adolescents in the United States seriously consider suicide each year, and about 8% of high school students attempt suicide at least once. Hispanic ethnicity constitutes a risk factor for suicidal ideation and suicide attempts, with Hispanic females at highest risk. Nevertheless, published studies on suicidal behavior in Hispanic female adolescents are extremely limited and focus on suicidal ideation in school samples. Given the severity of the problem and the paucity of information on this topic, more research on ethnic differences in suicidal ideation in community samples of high-risk children is urgently needed. This cross-sectional study delineated differences in suicide ideation between Hispanic female adolescents and non-Hispanic white female adolescents attending a mental health clinic and examined the association of ethnicity with suicide ideation independent of other known risk factors. Data were accrued between June 2004 and December 2008 in a Harris County Mental Health and Mental Retardation Association (MHMRA) clinic. Data were limited to adolescents who were Harris County Residents between the ages of 10 to 17 years when they were admitted to the clinic. The objective of this study was to determine whether differences in socio-demographic and clinical variables play a significant role in ethnic disparities in suicide ideation. A series of logistic regressions were performed to estimate the association between ethnicity and suicide ideation after controlling for potentially confounding factors. ^ Results showed an interaction between Hispanic ethnicity and having a history of treatment: Hispanic girls having history of treatment had lower odds of having suicide ideation than Hispanic girls without such a history. After adjusting for treatment history, family problems, substance use, juvenile justice involvement, current treatment, and age, Hispanic girls had 1.86 times the odds of having suicide ideation than non Hispanic girls (OR=1.86, 95% CI=0.88-1.46). Although additional studies on community samples of high risk adolescents are needed to verify these findings, our study highlights the fact that Hispanic girls are at significantly higher risk and need to be targeted for prevention and treatment efforts. ^

An examination of the cross-cultural reliability and construct validity of a measure of loneliness

Loneliness is a pervasive, rather common experience in American culture, particularly notable among adolescents. However, the phenomenon is not well documented in the cross-cultural psychiatric literature. For psychiatric epidemiology to encompass a wide array of psychopathologic phenomena, it is important to develop useful measures to characterize and classify both non-clinical and clinical dysfunction in diverse subgroups and cultures.^ The goal of this research was to examine the cross-cultural reliability and construct validity of a scale designed to measure loneliness. The Roberts Loneliness Scale (RLS-8) was administered to 4,060 adolescents ages 10-19 years enrolled in high schools along either side of the Texas-Tamaulipas border region between the U.S. and Mexico. Data collected in 1988 from a study focusing on substance use and psychological distress among adolescents in these regions were used to examine the operating characteristics of the RLS-8. A sample stratified by nationality and language, age, gender, and grade was used for analysis.^ Results indicated that in general the RLS-8 has moderate reliability in the U.S. sample, but not in the Mexican sample. Validity analyses demonstrated that there was evidence for convergent validity of the RLS-8 in the U.S. sample, but none in the Mexican sample. Discriminant validity of the measures in neither sample could be established. Based on the factor structure of the RLS-8, two subscales were created and analyzed for construct validity. Evidence for convergent validity was established for both subscales in both national samples. However, the discriminant validity of the measure remains unsubstantiated in both national samples. Also, the dimensionality of the scale is unresolved.^ One primary goal for future cross-cultural research would be to develop and test better defined culture-specific models of loneliness within the two cultures. From such scientific endeavor, measures of loneliness can be developed or reconstructed to classify the phenomenon in the same manner across cultures. Since estimates of prevalence and incidence are contingent upon reliable and valid screening or diagnostic measures, this objective would serve as an important foundation for future psychiatric epidemiologic inquiry into loneliness. ^

Stressful life events and their contributions to symptoms of anxiety and depression in adolescents

There are several innovative aspects to this thesis that extend our current knowledge of the relations between stress and psychiatric symptoms in adolescents. First, distal and proximal stressors are differentiated. This approach allows one to specifically examine the role of early childhood stressors as well as stressors experienced more recently as they impact the expression of depression and anxiety during adolescence. Second, a state-of-the-art assessment instrument was used to examine proximal stressors, helping to distinguish several aspects of stress, including objective stress and subjective stress. Third, the parent study from which these data were derived was designed to examine the role of familial risk for depression and related risk factors for the initial development of depression and alcohol use disorders. This allowed for a very thorough collection of demographic characteristics of the study population. Accordingly, this thesis examines the initial prodromal expression of anxiety and depressive symptoms as they are originally expressed prior to the development, if any, of a full-blown psychiatric disorder.^

PERCEPÇÃO DE SUPORTE SOCIAL E CONSUMO DE ÁLCOOL EM DESEMPREGADOS

O desemprego tem sido objeto de preocupação no contexto político, econômico e social, uma vez que a população de trabalhadores desempregados enfrenta dificuldades diárias para a obtenção de trabalho/ou emprego, situação que gera intenso sofrimento psíquico e pode repercutir de modo negativo na saúde do trabalhador. Este estudo teve por objetivo investigar a percepção de suporte social e o consumo de álcool em desempregados. Por meio de estudo epidemiológico, quantitativo e transversal constituímos uma amostra de 300 indivíduos, recrutados em uma agência pública em São Bernardo do Campo SP, que capta vagas no mercado e encaminha trabalhadores para recolocação profissional. A amostra resultou em 54,3% pessoas do gênero masculino, com idade média de 29,30, com mínimo de 18 anos e máximo de 56 anos; 67% tinham ensino médio, sendo 50% solteiros, 52% encontravam-se desempregados de um a seis meses, 37% residiam em imóvel próprio, e 37% possuíam renda familiar de um a dois salários mínimos. Foram utilizados três instrumentos auto-aplicáveis para coleta dos dados: a) Questionário de características sócio-demográficas; b) Escala de Percepção de Suporte Social (EPSS); c) Teste para Identificação de Problemas Relacionados ao Uso de Álcool (AUDIT). Os dados coletados foram submetidos ao programa estatístico SPSS, versão 15.0 para Windows que permitiu fazer as correlações entre as variáveis. Os resultados indicaram correlações significativas entre as variáveis: suporte prático e renda; suporte prático e suporte emocional, com idade. Estas correlações sugeriram que os sujeitos apresentavam melhor percepção de suporte prático na medida em que aumentava a renda familiar, e que quanto maior a idade, menor é a percepção do suporte prático e emocional recebido pela rede social. O AUDIT não apontou correlações significativas entre as variáveis estudadas, e 76% da amostra se situou na zona 1 consumo de baixo risco ou abstinência. Não verificamos correlação entre consumo de álcool e desemprego.(AU)

PERCEPÇÃO DE SUPORTE SOCIAL E CONSUMO DE ÁLCOOL EM DESEMPREGADOS

O desemprego tem sido objeto de preocupação no contexto político, econômico e social, uma vez que a população de trabalhadores desempregados enfrenta dificuldades diárias para a obtenção de trabalho/ou emprego, situação que gera intenso sofrimento psíquico e pode repercutir de modo negativo na saúde do trabalhador. Este estudo teve por objetivo investigar a percepção de suporte social e o consumo de álcool em desempregados. Por meio de estudo epidemiológico, quantitativo e transversal constituímos uma amostra de 300 indivíduos, recrutados em uma agência pública em São Bernardo do Campo SP, que capta vagas no mercado e encaminha trabalhadores para recolocação profissional. A amostra resultou em 54,3% pessoas do gênero masculino, com idade média de 29,30, com mínimo de 18 anos e máximo de 56 anos; 67% tinham ensino médio, sendo 50% solteiros, 52% encontravam-se desempregados de um a seis meses, 37% residiam em imóvel próprio, e 37% possuíam renda familiar de um a dois salários mínimos. Foram utilizados três instrumentos auto-aplicáveis para coleta dos dados: a) Questionário de características sócio-demográficas; b) Escala de Percepção de Suporte Social (EPSS); c) Teste para Identificação de Problemas Relacionados ao Uso de Álcool (AUDIT). Os dados coletados foram submetidos ao programa estatístico SPSS, versão 15.0 para Windows que permitiu fazer as correlações entre as variáveis. Os resultados indicaram correlações significativas entre as variáveis: suporte prático e renda; suporte prático e suporte emocional, com idade. Estas correlações sugeriram que os sujeitos apresentavam melhor percepção de suporte prático na medida em que aumentava a renda familiar, e que quanto maior a idade, menor é a percepção do suporte prático e emocional recebido pela rede social. O AUDIT não apontou correlações significativas entre as variáveis estudadas, e 76% da amostra se situou na zona 1 consumo de baixo risco ou abstinência. Não verificamos correlação entre consumo de álcool e desemprego.(AU)

The Perpetration of Spousal Abuse by Male Combat Veterans: Recommendations for Individualized Group Domestic Violence Treatment for Veterans

Recent estimates suggest that spousal abuse is, in fact, on the rise in the U.S. military (The Miles Foundation, 2005). As research specific to the impact of posttraumatic stress disorder (PTSD) on U.S. soldiers has grown since the Vietnam War, clinicians and researchers have begun to investigate how combat-related trauma affects veterans in terms of aggression, hostility and social/emotional functioning. The training and stressors experienced by soldiers in the military are unique and affect all aspects of the veteran's functioning. This paper discusses questions related to why combat veterans may be at increased risk to commit spousal abuse (verbal, psychological, and physical), the relationship between PTSD, substance use, and violence, and the advantages to individualizing group domestic violence (DV) treatment programs for combat veterans. Recommendations will be made for a DV treatment program specifically for combat veterans who also suffer from PTSD.

Description des relations familiales : la perspective d’hommes en situation d’itinérance atteints de troubles concomitants

Les personnes en situation d’itinérance, principalement des hommes, représentent pour certains une culture au sein de laquelle on identifie des personnes atteintes de troubles concomitants de santé mentale et d’abus de substances. Déjà vulnérables de par leur statut domiciliaire précaire, les personnes atteintes de cette concomitance le sont davantage et tendent à être plus isolées de leur famille que celles ne rencontrant pas cette double problématique. Le soutien familial est toutefois reconnu comme un élément favorisant l’engagement de comportements de santé et réduisant l’itinérance. Le but de cette étude était alors de décrire, du point de vue des hommes en situation d’itinérance atteints de troubles concomitants de santé mentale et d’abus de substances, les relations qu’ils entretiennent avec leur famille. Pour ce faire, le devis choisi fût une ethnographie ciblée. Différents degrés d’observation participante au sein de la Mission Old Brewery et des entrevues avec neuf informateurs-clés ont été les principales méthodes de collecte des données. L’analyse des données qualitative était soutenue par le guide proposé par Roper et Shapira (2000) ainsi que l’épistémologie constructiviste et l’approche systémique familiale de Calgary (Wright & Leahey, 2013) qui furent les cadres de référence de cette étude. Les résultats font ressortir trois thèmes explicitant 1) l’influence du contexte de vie dans les relations familiales, 2) la teneur conflictuelle de ces relations ainsi que 3) le soutien familial perçu. Finalement, des recommandations pour la pratique infirmière ainsi que des pistes pour de futures recherches sont suggérées.