Suicide ideation among US college students. Associations with other injury risk behaviors

Suicide, the endpoint of a continuum that begins with suicide ideation, is the third leading cause of death among the US college-aged population. The first and second leading causes of death among this age group, unintentional injury and homicide, may also be linked to suicide ideation. We used data from the National College Health Risk Behavior Survey to examine the association between suicide ideation and injury-related behaviors among 18- to 24-year-old college students. Students who reported suicide ideation were significantly more likely than students who did not report considering suicide to carry a weapon, engage in a physical fight, boat or swim after drinking alcohol, ride with a driver who had been drinking alcohol, drive after drinking alcohol, and rarely or never used seat belts. Given this clustering of injury-related risk behaviors, college prevention programs should aim to reduce risks for injuries comprehensively, rather than addressing each risk behavior separately.     

Gambling and other risk behaviors on university campuses

To examine the prevalence of problem gambling and its relationship to other risk-taking behaviors, the authors surveyed 1,350 undergraduates at the 4 campuses of Connecticut State University (CSU) during fall 2000. On the basis of a modified version of the South Oaks Gambling Screen, a widely used screening instrument, they found that 18% of the men and 4% of the women reported that gambling had led to at least 3 negative life consequences (eg, felt guilty, gambled more than intended), commonly defined as problem gambling. Students identified as problem gamblers, compared with other students, were significantly more likely to be heavy drinkers, report negative consequences of alcohol consumption, and be regular tobacco and marijuana users. Problem gambling was related to binge eating and greater use of weight-control efforts. University athletes were also found to have significantly greater problem gambling rates than nonathletes. The majority of students gambled but experienced few of the negative consequences reported by problem gamblers.     

The natural history and risk factors of musculoskeletal conditions resulting in disability among US Army personnel

We describe the natural history of 13 musculoskeletal conditions requiring hospitalization and identify demographic, behavioral, psychosocial, occupational, and clinical characteristics most strongly associated with disability discharge from the Army. Subjects included 15,268 active-duty personnel hospitalized for a common musculoskeletal condition between the years 1989-1996 who were retrospectively followed through 1997. Back conditions had the greatest 5-year cumulative risk of disability (21%, 19%, and 17% for intervertebral disc displacement, intervertebral disc degeneration, and nonspecific low back pain, respectively). Cox proportional hazards models identified the following risk factors for disability among males: lower pay grade, musculoskeletal diagnosis, shorter length of service, older age, occupational category, lower job satisfaction, recurrent musculoskeletal hospitalizations, more cigarette smoking, greater work stress, and heavier physical demands. Among females, fewer covariates reached statistical significance, although lower education level was significant in more than one model. Modifiable risk factors related to work (job satisfaction, work stress, physical demands, occupation) and health behaviors (smoking) suggest possible targets for intervention.     

Intimate partner violence among married male U.S. Army soldiers: ethnicity as a factor in self-reported perpetration and victimization

Correlates of self-reported intimate partner violence (IPV) were examined among 488 married male U.S. Army soldiers. Study results were examined within the framework of Johnson's (1995) typology, which proposes that there are two main types of IPV, common couple violence and intimate terrorism. We predicted that poor marital adjustment would be associated with minor violence, hypothesized to be indicative of common couple violence. We also predicted that psychological and behavioral characteristics associated with perpetrators of IPV would be more strongly correlated with severe inflicted aggression--a pattern hypothesized to be indicative of intimate terrorism. The results, based on a multivariate analysis of covariance, generally supported our hypotheses. Furthermore, the higher levels of IPV reported by Black respondents in this study were associated with the pattern hypothesized to be characteristic of common couple violence.     

Sexual risk behaviors among youth in the child welfare system

This study uses data from the National Survey of Child and Adolescent Well-Being (NSCAW) to provide estimates of sexual risk behaviors for 877 youth, age 11–14 at baseline, in the child welfare system. It examines the association between baseline psychosocial risk and protective factors on engagement in sexual risk behaviors after 36 months. It further compares rates of sexual risk behaviors between youth placed in out-of-home care and those who remained with their biological family. Key findings include a high rate of pregnancy, a high percentage of youth who initiated sexual activity at or before age 13 as well as a limited role of protective factors in moderating sexual risk behaviors. A history of placement into out-of-home care is not significantly associated with greater engagement in sexual risk behaviors. Implications for intervention development and child welfare policy for this population are discussed.     

Childhood exposure to the Second World War and financial risk taking in adult life

Adverse childhood experiences might have long-lasting effects on decisions under uncertainty in adult life. Merging the European Survey on Health, Ageing and Retirement with data on conflict events during the Second World War, and relying on region-by-cohort variation in war exposure, we show that warfare exposure during childhood is associated with lower financial risk taking in later life. Individuals who experienced war episodes as children hold less – and are less likely to hold – stocks, but are more likely to hold life insurance, compared to non-exposed individuals. Effects are robust to the inclusion of potential mediating factors, and are tested for nonlinearity and heterogeneity. Moreover, we provide evidence of hedonic adaptation to war, as high and low intensity of war exposure have comparable long-term effects. We also document that war exposure in childhood increases sensitivity to financial uncertainty since exposed-to-war individuals are less likely to hold stocks after periods of high volatility. Finally, we shed light on the most likely mechanism in the relationship between war exposure and financial risk taking – i.e., enhanced sensitivity to uncertainty – and we show that preferences, and not beliefs, channel this relationship.     

The shadow of the past: Financial risk taking and negative life events

Based on data from the four 2004–2010 waves of the US Health and Retirement Study (HRS), we show that financial risk taking is significantly related to life-history negative events out of an individual’s control. Using observed portfolio decisions to proxy for risk taking, we find correlation with two of such individual-specific events: having been victim of a physical attack and (especially) the loss of a child are associated with lower and less frequent investments in risky assets, with an intensity similar to that of the beginning, in 2008, of a collectively experienced event such as the recent financial crisis. We also find evidence that the correlation of risk taking with a child loss is long-lasting, as opposed to the correlation with a physical attack that disappears after few years. Our analysis is more in favor of a preference-based – rather than a belief-based – explanation of the observed change in risk taking. Overall our findings indicate that the past, especially through the loss of a child, casts a long shadow that extends over individuals’ current decisions also within unrelated domains.     

An examination of sexual risk behaviors in adolescent substance users

ABSTRACT. Objectives: This study examined the risk for engaging in high-risk sexual behavior associated with substance use in a sample of U.S. adolescents. Methods: The sample (N = 15,425) was obtained via the Youth Risk Behavior Surveillance System, a survey of public high school students. Results: Substance use was associated with sexual risk behaviors, with odds ratios being greatest for adolescents who used cigarettes and illicit substances, as well as those who engaged in injection drug use. Conclusions: Results highlight the need for prevention and intervention programs targeting sexual risk behaviors in substance-using adolescents as a means to decrease the spread of sexually transmitted infections.     

Trauma and health risk behaviors in people with severe mental illness

The current study tests the association between a composite measure of unsafe sex and sharing syringes for drug use with six of the more common lifetime traumatic/stressful events in 421 community mental health clients with severe mental illness (SMI) while controlling for psychiatric symptoms and related problems. A small but significant proportion of respondents said they had injected drugs with a shared needle in their lifetime (30, 7.2%), and a much larger proportion of respondents had engaged in unprotected sex (165, 39.2%). Unprotected sex and needle sharing were significantly correlated (Spearman’s rho = .20, p < .01). Frequency of lifetime traumatic events that occurred at least once was reported by one third to three quarters of clients depending on type of trauma. Regression analysis revealed that substance abuse and lifetime homelessness were significantly correlated with health risk behaviors. Practitioners need to be continuously vigilant to comorbid substance use and the housing needs of people with SMI. Limitations of the study include its cross-sectional design.     

The same and the other: male childcare workers managing identity dissonance

As childcare workers, men are in a contested position. On the one hand, they are in danger of being depicted as the pedophile; on the other hand, they are expected to bring something new and innovative to the thus-far female-dominated field. These men are experiencing ‘identity dissonance’ and have to find ways to manage and facilitate legitimate subject positions as both childcare workers and as men. Applying a perspective of discursive positioning, this article discusses men's positioning practices in nine qualitative interviews conducted with male childcare workers in German-speaking Switzerland. We identified a total of six discursive practices that men engage in to manage identity dissonance and construct a legitimate subject position. We found that men are engaging in a greater variety of practices than have been discussed so far. Unlike findings from other studies of men in female-dominated occupations, ours do not point to a clear-cut typology with regards to hegemonic and alternative masculinities; instead they show a variety of practices that are mobilized throughout all interviews.     

Measuring risk and protective factors for substance use,delinquency, and other adolescent problem behaviors. The Communities That Care Youth Survey

Risk and protective factors predictive of adolescent problem behaviors such as substance abuse and delinquency are promising targets for preventive intervention. Community planners should assess and target risk and protective factors when designing prevention programs. This study describes the development, reliability, and validity of a self-report survey instrument for adolescents ages 11 to 18 that measures an array of risk and protective factors across multiple ecological domains as well as adolescent problem behaviors. The instrument can be used to assess the epidemiology of risk and protection in youth populations and to prioritize specific risk and protective factors in specific populations as targets for preventive intervention.     

The economy of risk and respect: Accounts by Puerto Rican sex workers of HIV risk taking

Three‐hundred eleven female drug‐using sex workers in urban Puerto Rico were asked to describe their last negotiation with a client. They described efforts to protect themselves from many hazards of sex work, including violence, illness, and drug withdrawal. They also described efforts to minimize the stigma and marginalization of sex work by cultivating relationships with clients, distinguishing between types of clients, and prioritizing their role as mothers. Sex workers adopted alternating gender roles to leverage autonomy and respect from clients. Their narratives suggest that sex workers negotiate a world in which HIV is relative to other risks, and in which sexual practices which are incomprehensible from an HIV‐prevention perspective are actually rooted in a local cultural logic. Future HIV prevention efforts should frame condom use and other self‐protective acts in terms that build upon sex workers' own strategies for understanding their options and modifying their risks.     

The economy of risk and respect: accounts by Puerto Rican sex workers of HIV risk taking

Three-hundred-eleven female drug-using sex workers in urban Puerto Rico were asked to describe their last negotiation with a client. They described efforts to protect themselves from many hazards of sex work, including violence, illness, and drug withdrawal. They also described efforts to minimize the stigma and marginalization of sex work by cultivating relationships with clients, distinguishing between types of clients, and prioritizing their role as mothers. Sex workers adopted alternating gender roles to leverage autonomy and respect from clients. Their narratives suggest that sex workers negotiate a world in which HIV is relative to other risks, and in which sexual practices which are incomprehensible from an HIV-prevention perspective are actually rooted in a local cultural logic. Future HIV prevention efforts should frame condom use and other self-protective acts in terms that build upon sex workers own strategies for understanding their options and modifying their risks.     

Prevalence and correlates of interpersonal violence victimization in a junior enlisted Navy cohort

This study assesses the prevalence and correlates of interpersonal violence victimization in a cohort of 493 male and 220 female junior Navy personnel who participated in a cross-sectional follow-up study on health-related behaviors. Survey data were obtained during 2000 about past-year prevalence of physical violence and sexual victimization. Chi-square tests of independence and multivariable logistic regression analyses were employed to estimate prevalence rates and to assess correlates of interpersonal violence. No gender differences were found for rates of violence victimization (16.4%) or sexual victimization (4.5%). Significant correlates of interpersonal violence victimization among males were depression and tobacco use; among females, significant correlates were depression and frequent heavy drinking. Findings suggest that large numbers of young enlisted adults serving in the military may be victims of interpersonal violence.     

Race and risk behaviors: The mediating role of school bonding

This study tests the hypotheses that school bonding mediates the relationship between adolescents' racial background and key risk behaviors (substance use, failing grades, and fighting). Data sources include an epidemiological survey administered at 50 urban schools to 16,169 students, linked to information about school context (socioeconomic composition, attendance rate, and grade-level). Results indicate that school bonding partially mediates the relationship between race and risk behavior. Findings suggest that culturally responsive efforts to strengthen educational attachment, connection, commitment, and involvement among youth of color may reduce gaps in outcomes that are perceived to be distal from schooling. Further development and testing of multi-level interventions that increase school bonding among youth from non-dominant racial groups are needed.     

Non-parental adults in the social and risk behavior networks of sexual minority male youth

The presence of non-parental adults (NPAs), or adults outside of caregivers (e.g., extended family and natural mentors), in the lives of adolescents and emerging adults has received a rapidly expanding amount of empirical attention in the last decade. Compared to their heterosexual counterparts, sexual minority male youth (SMMY) experience disproportionate rates of abuse and victimization from parents and peers. Yet, despite the fact that this group, therefore, may be potentially vulnerable to negative interpersonal influences but also poised to benefit from additional relationships, NPA involvement in the lives of SMMY is currently not well understood in the extant literature. This study sought to examine and characterize the involvement of NPAs in the social and risk networks of SMMY (n = 175; 54% African American, 21% Hispanic/Latino, 14% Caucasian; ages: 17–23). Most SMMY identified at least one NPA, such as friends and grandparents, in their networks. Three categories of relationships were identified, Strictly Social, which only involved social interactions; Complex, which were both social and involved substance use and/or sexual activity; and Risky, which purely consisted of substance use or sexual activity. Relationships were rated as emotionally “closer” among ethnic minority SMMY, although, racial/ethnic similarity between SMMY and NPAs was not associated with relationship closeness. In addition, relationships involving female and heterosexual NPAs were also rated as stronger. These findings suggest the potential usefulness of considering multiple types of relationships between SMMY and NPAs when designing intervention and prevention efforts. Moreover, African American and Latino SMMY, who represent the most vulnerable sub-groups of SMMY in terms of HIV-risk, may be particularly poised to benefit from positive NPA relationships.     

An examination of sheltered battered women's perpetration of stalking and other unwanted pursuit behaviors

In the current study, sheltered battered women (n = 105) self-reported whether they had perpetrated stalking or other unwanted pursuit behaviors (e.g., harassment, threat) during relationship separations from their abuser. Results indicated that sheltered battered women who admitted perpetrating stalking behavior (about 25% of the sample) had more self-blame, depression, and a greater tendency to leave the shelter within the first week (45%) than did battered women who did not report perpetrating stalking behaviors. The majority of battered women who reported perpetrating stalking behavior also reported being victimized by stalking behaviors (bidirectional stalking). Although these women reported similarly high levels of fear toward their abuser as did unidirectionally stalked women, bidirectionally stalking women were less likely to perceive that their abuser was using his violence to obtain control over them and were more depressed and self-blaming. Directions for future research, recommendations for shelter staff, and the potential treatment implications of these findings are discussed.