Psychosocial Interventions for Maltreated and Violence-Exposed Children

Child sexual, physical, and emotional abuse as well as child neglect and domestic violence, community violence, and Childhood Traumatic Grief may result in significant and long-lasting emotional and behavioral difficulties. This article reviews randomized controlled studies that have assessed child mental health outcomes for maltreated and violence-exposed children. Key points of this review include the following: (1) maltreated and violence-exposed children typically experience more than one of these types of traumas; (2) effective psychosocial treatments are available to address Posttraumatic Stress Disorder (PTSD), depression, anxiety, and behavioral problems in these children; (3) it is likely that treatments which effectively reduce mental health symptoms in children exposed to one type of child maltreatment or violence exposure will also be effective for other or multiple types; and (4) mental health outcomes are not the only important outcomes to address in future treatment or intervention efforts. These future directions for treatment intervention research are addressed.     

Young Adult Outcomes of Juvenile Court–Involved Girls

ABSTRACT

The recent increase in the number of girls involved in the juvenile justice system has resulted in increased academic and public attention. Thus far, this attention has focused on entry into the juvenile justice system rather than longer-term consequences. This research helps fill this gap by examining a sample of 700 maltreated and/or impoverished juvenile court–involved females. Competing risks models were used to control for time from juvenile-court entry to adult outcomes: criminal justice system involvement, use of public mental health or substance use services, and income maintenance use. Results indicate that there are distinct predictors associated with the different outcomes, although learning disability and adolescent parenthood were associated with higher risk of both mental health/substance use services and income maintenance. Individualized services for juvenile court–involved girls are suggested. Prospective, longitudinal research is needed to investigate intrapsychic and behavioral dynamics associated with females' young adult outcomes.     

Economic Status,Family Dependence,and Health Outcomes of Older People in Western Rural China

There is a deficiency in empirical knowledge on the physical and mental health of lower-income older people with weak family support in western rural China. To address this research gap, this article uses the data from the 2014 China Longitudinal Aging Social Survey to analyze the disadvantaged situation of older people in western rural China through a regional comparative analysis. Our sample consisted of 7,138 older adults aged 60 or older in eastern and western, rural and urban China. We find that lower personal income is significantly associated with poor physical and mental health. Economic support from families means more for older people when they have a disability related to activities of daily living in western rural China. Fostering stronger family support networks might improve the mental health status of older people in western rural China. Our study suggests a broader scope for the state to play a greater role in economic empowerment and in the development of policies to effectively meet the present and future needs of older people in western rural China or other countries with an imbalance in the distribution of the aging population and welfare resources.     

The negative health effects of external whistleblowing: A study of some key factors

Blowing the whistle is a pro-social behaviour which can be highly effective if wrongdoing could be corrected without any adverse consequences for the person alleging or reporting it. However it is also risky and can cost whistleblowers their jobs and economic security as well as physical health and mental well-being. The purpose of this study was to identify the negative health effects—physical, behavioral, emotional, and mental—of whistleblowing and to examine the impact on these effects of dismissal, number of employees who blew the whistle in a group, income, and the passage of time. We statistically analysed survey data from external whistleblowers who had been identified by the news media in South Korea. This research differs from previous studies that explored the negative health effects of whistleblowing but did not distinguish between internal and external reporting. Our study contributes to the literature on the negative health effects experienced by whistleblowers and has implications for how to better protect them.     

The relationship between adverse childhood experiences,health and life satisfaction in adults with care experience: The mediating role of attachment

Adverse childhood experiences (ACEs) are associated with a plethora of negative outcomes. Research has also found that adults who were separated from parental care and lived in alternative care settings during childhood have high levels of ACEs and are more likely to have poor outcomes. A growing body of research has supported the importance of attachment as a mechanism underlying the relationship between ACEs and adult wellbeing. However, little work has examined the role that attachment may play in the outcomes of adults who resided in residential and foster care during childhood. The current study examined the role of attachment avoidance and anxiety in the associations between ACEs and mental health, physical health, and life satisfaction in a sample of 529 adults with alternative care experience from 11 nations. Attachment avoidance partially mediated the relationship between ACEs and life satisfaction, mental health, and physical health. Attachment anxiety partially mediated the relationship between ACEs and life satisfaction and mental health, but not physical health. Taken together, the present study suggests that both attachment anxiety and avoidance play important, but unique, roles in understanding the relationship between ACEs and health and wellbeing for adults with care experience. Implications and limitations are discussed.     

Relationships Among Caregiving,Income, Gender,and Health: A Cross-Sectional Examination of a Representative Sample of Older Americans

Although there is substantial evidence to support the effect of burden on caregivers, few studies have compared caregivers to their noncaregiving counterparts on the basis of health and well-being outcomes. This study examines the relationship between caregiving and health and whether other factors may have stronger influence on well-being measures. Using a nationally representative sample of older adults in the United States (N = 3,005), this study examines relationships between caregiving status, gender, and income, and 9 outcomes (self-rated physical and mental health, time since seeing a doctor, time since most recent pap smear or prostate-specific antigen [PSA] test, depression, loneliness, stress, anxiety), using logistic and linear regression models. Results support that paradoxically, caregiving was associated with increased likelihood of PSA test in male caregivers, although data also indicated higher levels of anxiety and stress, as might be expected. Income was associated with 8 of 9 outcomes, and gender predicted depression, anxiety, stress, and self-rated mental health. The study highlighted the importance of psychosocial stressors, such as income and gender, on the health outcomes of older adults who may be caregiving. Considering complexity of unique experience is necessary to accurately assess vulnerability to poor mental health or health-related outcomes.     

A Collaboratively Designed Child Mental Health Service Model: Multiple Family Groups for Urban Children with Conduct Difficulties

This paper presents preliminary outcomes associated with an experimental, longitudinal study of a Multiple Family Group (MFG) service delivery approach set within thirteen urban outpatient clinics serving children and their families living in inner-city, primarily African American and Latino communities. Specifically, this paper focuses on parent reports of child oppositional behavior and parenting stress over time. MFG is a flexible, protocol-driven approach designed to address the most common reason for referral to outpatient child mental health clinics, childhood behavioral difficulties. The MFG also aims to enhance family-level engagement and retention in ongoing care. Further, the service delivery model was collaboratively developed with intensive input from parents rearing children with conduct difficulties, parent advocates, community-based child mental health providers and services research staff in order to ultimately expand the number of effective service models that can be situated within "real world," urban child mental health settings.     

Retesting the income inequality hypothesis: Pooled time‐series–cross‐section regression with a new statistical case selection method

The Wilkinson hypothesis, which posits that it is income inequality, rather than economic growth, that determines population health in wealthy societies has been widely debated over decades. This article, with an original case selection process, retests the controversial hypothesis with the time‐series–cross‐section (TSCS) regression model. The main findings are that disposable income inequality is not statistically significantly associated with life expectancy, and its influences on the health of the elderly population are counterintuitively beneficial. Infant mortality rate is the only health indicator that both has the statistically significant association with income inequality and corresponds with the Wilkinson hypothesis. Finally, the relationship between income inequality and population health is not as simple as the hypothesis suggests and found to be dynamic and complex depending on what health indicator is used for the test.     

收入不平等与个体健康——基于2005年中国综合社会调查的实证分析

文章利用2005年中国综合社会调查（CGSS2005）数据与县级社会统计资料,通过拟合多层Logistic回归模型,分析了地区收入不平等程度对个体健康状况的影响,系统检验了绝对收入理论和收入不平等理论。结果表明,即使在控制了个体收入对健康的凹陷效应之后,县级收入不平等程度仍对个体自评健康具有显著的负面影响。对收入不平等影响健康的作用机制的进一步分析表明,社会心理机制仅能部分解释不平等对健康的负面效应,而新唯物主义机制未能得到经验支持。     

Assessing Health Care Needs Among Street Homeless and Transitionally Housed Adults

ABSTRACT

This study examined the health services received and needed among homeless persons in Hillsborough County, FL (N = 823). Lifetime and current need and receipt of health services were assessed with a cross-sectional survey. Participants reported extensive lifetime and current needs for physical and behavioral health care services. Nearly a third of participants reported current unaddressed health problem(s); an inability to obtain needed health care; and feelings of unaddressed mental health issue(s) as well as substance abuse problem(s) in the past year. Future research on homelessness and health should focus on identifying different pathways to health and mental health services for this vulnerable population and the outcomes of these interventions.     

Poverty,Partner Abuse,and Women's Mental Health: New Knowledge for Better Practice

ABSTRACT.

To better understand how poverty and poor mental health impact women who are abused by intimate partners, a convenience sample of 300 abused women using shelters or justice services for the 1st time were interviewed. The 300 women were categorized as having no income, being above poverty, and being below poverty according to U.S. Poverty Guidelines. Results indicated that no direct effect of income on poor mental health was noted; however, an interaction between type and severity of abuse and income level had an impact on poor mental health. Abused women who were above poverty with the highest incomes reported the highest levels of depression in the presence of high physical and sexual abuse. In contrast, women reporting no income reported no significant effect of severity or type of abuse on depression scores. Women just above the poverty level who experienced severe abuse were at highest risk for mental health problems. Poverty impacts the mental health of abused women according to the degree of poverty and type and severity of abuse. More research is needed to specify programs to maximize the mental health functioning and economic solvency of abused women.     

How parents' income,time and job quality affect children's health and development

The advent of the Global Financial Crisis reminds us that modern epidemiological research has consistently demonstrated links between the socio‐economic circumstances of families and children's health and development. Drawing on data from the Longitudinal Study of Australian Children, this article firstly examines the evidence for intergenerational transmission of socio‐economic disadvantage from parents to young children. It then examines parents' jobs as another source of social inequality. Results confirm that children's healthy development is affected by family income, by parents' hours of work and by the quality of parents' jobs. Job combinations that include long work hours of mothers and fathers and poorer quality jobs are associated with elevated rates of parental mental health problems, less time spent in developmentally important activities with children, and socio‐emotional developmental difficulties for children. The evidence suggests that these effects are greater within low income families. These findings highlight the need for social and economic policies to move beyond simplistic notions of promoting parental workforce participation as a way of reducing the adverse effects of social disadvantage. A more nuanced approach is required that considers the additional impacts of the quality and characteristics of jobs, especially for the parents of young children.     

Income and Power Inequality as Determinants of Environmental and Health Outcomes: Some Findings*

Objective. The article corrects for two main shortcomings in conventional economic analyses of environmental change. First is the overemphasis placed on income growth, and general disregard for other socioeconomic factors. Second is economists' often oversimplified view of the environment, where distinctions between environmental necessities such as potable water and so‐called environmental luxuries are ignored. I test for the effectiveness of power inequality in explaining access to sanitation and safe water as well as their health consequences. Methods. I develop a two‐stage model seeking first to explain changes in the environmental variables and then population health. I employ ordinary least squares regressions on international cross‐sectional data. Results. Some dimensions of power inequality outperform per‐capita income as possible determinants of population health. Neither power inequality nor income is clearly superior at explaining environmental quality. Conclusion. The study casts further doubt on the importance of per‐capita income in explaining environmental and health outcomes.     

Economic distress and health: A fixed effects analysis of low‐income persons in Singapore

Using fixed effects regressions, this study examined the transactional effects of different types of economic status on the physical and mental health of low‐income persons in Singapore. Among the economic variables considered, unemployment and arrears had the most significant effects. This signals the physical and psychological distress of being out of work and possessing arrears while income is low. The insignificant effects of poor health on household earnings suggest possible earnings supplementation by other household members. The findings imply the fruitfulness of dually improving employment prospects and health, work activation that takes into consideration mental health effects, increasing affordability of health services in liberal welfare systems, improving mental bandwidth through reducing arrears accounts, and short lag time from application to receipt of assistance. These implications point to a larger question on health and welfare systems in an increasingly uncertain economic environment for households in poverty. Key Practitioner Message: ? Employment and health are inter‐related: employment assistance incorporating physical and mental health interventions and vice versa can be more effective than either alone; ? Compared with decreasing arrears amounts, reducing the number of arrears can more effectively relieve mental distress; ? Effects between economic distress and health materialise quickly; minimising the lag time between application and receipt of assistance will provide great relief.     

Socio‐Economic Factors and Mental Health of Young People in India and China: An Elusive Link with Globalization

Globalization and its related social, cultural, and economic changes have significant mental health outcomes for young people. However, mental health disorders among youth are seldom included in the range of problems linked to globalization. It is imperative that these multifaceted associations are considered in light of the substantial and increasing burden of disease caused by mental illness, particularly in Asian countries, which are comparatively young and in next few decades will be the major sources of the growth of world’s young population. The evidence reviewed in this study makes an argument that globalization has increased [relative] poverty and deprivation, social and income inequality, migration, occupational stress, educational competition, and educated unemployment in India and China. Simultaneously there is evidence which shows that these variables are causally linked with mental health of young people. Altogether, these phenomena are accompanied by higher rates of suicide among lower class, migrant, and student youth. This substantiates the proposition that globalization has significant consequences for the mental health of young people. Some interventions for debate and discussion are considered.     

Conventional and expanded adverse childhood experiences (ACEs) and maternal functioning among low-income Black mothers

A paucity of research has examined the individual and cumulative effects of conventional and expanded adverse childhood experiences (ACEs) on maternal functioning, especially among low-income Black mothers. Using self-report data from a subsample of Black mothers (N = 157) who participated in a larger study to evaluate the effectiveness of an urban public prekindergarten program in the mid-Atlantic region of the United States, we examined the prevalence of ACEs and the individual and cumulative effects of conventional (i.e., family trauma and dysfunction) and expanded (i.e., community stressors) ACEs on depression and health among low-income Black mothers. Findings indicated that Black mothers had more exposure to expanded than conventional ACEs. Hierarchical regression analyses revealed that experience of physical neglect was significantly associated with depression and physical abuse with compromised health, and perceived experience of racism was a predictor of depression and compromised health. More conventional and expanded ACEs were associated with clinical levels of depression and compromised health. Findings highlight the need for more research related to the impact of ACEs, especially expanded ACEs, on mental and behavioural health outcomes. Additionally, our findings indicate the need for more trauma-informed care to reduce and address the impact of individual and community-level adversities on low-income Black mothers.     

Six-Month Follow-Up Changes for TANF-Eligible Clients Involved in Kentucky's Targeted Assessment Program

ABSTRACT

Welfare reform has been successful in helping clients achieve self-sufficiency. However, some individuals experience problems associated with basic needs, physical health, mental health, substance abuse, and intimate partner violence (IPV) that can impede transitioning from welfare to work and/or interfere with parental responsibilities. The Targeted Assessment Program (TAP) was created more than a decade ago to identify and address these problems and help clients move off the welfare rolls in Kentucky. Self-reported interview data were used to examine changes and effect sizes between baseline assessment and 6-month follow-up from a sample (n = 322) of Temporary Assistance for Needy Families-eligible clients participating in Kentucky's TAP. Using McNemar's test for correlated proportions, paired-sample t-tests, and measures of effect size, significant changes with varied effect sizes were found for selected basic needs, as well as physical health, mental health, substance use, and IPV barriers. Findings suggest that social service practitioners could incorporate strengths-based case management and motivational interviewing into their practice. Further research is suggested utilizing longitudinal and controlled studies on evidence-based practice that address pretreatment and assessment strategies involving case management and motivational interviewing.     

Dementia Caregiving Outcomes: The Impact of Caregiving Onset,Cognitive Impairment and Behavioral Problems

With a projected increase in the prevalence of Alzheimer’s disease (AD) and related dementias, family caregiving is steadily increasing. Caring for an individual with AD is characterized as a “career,” and within this career are a number of key transitions, including the onset of caregiving. Research reveals a number of negative emotional health outcomes for AD caregivers, including depression and role overload, but less research has examined the influence of key transitions on the emotional adaptation of caregivers. The purpose of this study is to examine how different patterns of caregiving onset (gradual and abrupt) impact emotional health outcomes for AD caregivers. This study also explores how care-recipient cognitive impairment and behavioral problems moderate these relationships. Cross-sectional, quantitative data from 100 caregivers completing self-administered surveys were used. A series of one-way ANOVAs and multiple regression analyses were conducted to address study aims. Results indicate that care-recipient cognition and behavioral problems moderated the relationship between caregiving onset and emotional health outcomes for caregivers who experienced a more abrupt entry into the caregiving role. Results suggest the importance of considering different onset transitions and moderating factors within the caregiving career to target clinical interventions. Implications for social work practice are discussed.     

Density zoning and class segregation in U.S. metropolitan areas

Objectives:Socioeconomic segregation rose substantially in U.S. cities during the final decades of the 20th century, and we argue that zoning regulations are an important cause of this increase.Methods. We measure neighborhood economic segregation using the Gini coefficient for neighborhood income inequality and the poor-affluent exposure index. These outcomes are regressed on an index of density zoning developed from the work of Pendall for 50 U.S. metropolitan areas, while controlling for other metropolitan characteristics likely to affect urban housing markets and class segregation.Results. For both 2000 and changes from 1990 to 2000, OLS estimates reveal a strong relationship between density zoning and income segregation, and replication using 2SLS suggests that the relationship is causal. We also show that zoning is associated with higher interjurisdictional inequality.Conclusions. Metropolitan areas with suburbs that restrict the density of residential construction are more segregated on the basis of income than those with more permissive density zoning regimes. This arrangement perpetuates and exacerbates racial and class inequality in the United States.