Bystander intervention for problematic alcohol use among graduate and international students: opportunities and challenges.

OBJECTIVES: Bystander intervention (BI) is a prevention approach commonly used for interpersonal violence, but is less studied for problematic alcohol use (PAU). Domestic graduate and international students' life experiences bring a unique context for the potential application of BI to PAU. METHODS AND MEASURES: We conducted a mixed methods study that consisted of a needs assessment and focus groups at a southeastern university in the U.S. The aims of this study were to understand (1) differences in PAU BI opportunities for domestic graduate versus international students, (2) reasons for differences in PAU BI use, and (3) barriers/facilitators in use of PAU BI. RESULTS: Overall, participants had few opportunities to use BI. Domestic graduate students had slightly more opportunities compared to international students. Most prominent reasons for lack of opportunities included not wanting to drive, the cost of drinking, and holding a graduate student identity (e.g. not interested in heavy drinking). Trusting others to be responsible for themselves was a common barrier noted for not using BI for PAU. CONCLUSION: PAU BI programs should contextualize experiences of domestic graduate and international students to provide appropriate skill development that considers unique barriers and facilitators to intervention use.

Attitude Is Everything: Examining Acceptance of Violence Items for Differential Item Functioning Across Heterosexual and Sexual Minority Youth.

Acceptance of dating violence (ADV) is a cognitive risk factor for violence perpetration and a common target of prevention programs. However, frequently used items assessing ADV are characterized by heteronormative item wording, and limited research has evaluated the degree to which ADV items function equivalently for both heterosexual and sexual minority youth (SMY). The current study sought to determine if there are differences in the way heterosexual and SMY respond to ADV survey items. Secondary data from a total of 2,014 adolescents (Mage = 16.78) were used to examine differences in ADV. Results of differential item functioning analysis indicated nonuniform differential item functioning for two of eight ADV items, with heterosexual youth being more likely to express strong levels of agreements with (a) female-perpetrated physical violence in response to male-perpetrated violence and (b) female-perpetrated violence against males broadly, relative to SMY. Although these differences were of negligible magnitude and only resulted in minimal differences in overall expected average scores, heterosexual youth were more likely to strongly accept female-perpetrated dating violence compared to SMY. Findings highlight differences in ADV item response patterns across heterosexual and sexual minority identifying youth and provide preliminary evidence for group differences in acceptance of female-perpetrated dating violence. Implications for prevention programming based on current findings include greater focus on measure adaptation and development as well as more consensus on the necessity of preventing female-perpetrated violence.

Cybervictimization in Relation to Self and Other Protection and Response Behaviors: A Cross-Sectional Look at an Age-Diverse National Sample.

This study considered whether experiencing cybervictimization is associated with increased recognition of cybervictimization intervention opportunities (i.e., witnessing others' cybervictimization), as well as greater engagement in self-protective (e.g., changing usernames and privacy settings) and other-protective cybervictimization bystander response behaviors. We collected cross-sectional self-report data from an age-diverse (M = 46.29 years, SD = 19.14, range = 15-93) national sample (n = 3002). We hypothesized that: (1) personal experiences with cybervictimization would be associated with increased reports of witnessing opportunities to intervene when others are cybervictimized, greater self-reported use of active bystander behaviors in witnessed situations, and greater use of self-protective strategies; (2) We also expected that engagement in self-protective behaviors would be positively associated with engagement in other-protective bystander behaviors in response to witnessed cybervictimization. To test our hypotheses, we estimated a structural equation model wherein four latent variables were constructed: cybervictimization experienced, witnessed opportunities to intervene, engagement in self-protective behaviors, and engagement in other-protective cybervictimization bystander behaviors. As hypothesized, cybervictimization was associated with witnessing more opportunities to intervene in other's cybervictimization, greater self-reported use of active cyber bystander behaviors, and greater engagement in self-protective strategies. However, the strength of two associations was moderated by age, with stronger relationships between cybervictimization and witnessing opportunities to intervene as well as engaging in bystander behavior for older as compared to younger participants. Contrary to hypothesis, there were no significant associations between use of self and other protective behaviors. Furthermore, greater witnessing of cybervictimization was associated with less engagement in bystander behavior in the final model. The implications for existing bystander intervention programs are described. Longitudinal studies of these associations in multiple age groups and among different cultural groups remain necessary.

Social Reactions to Disclosure of Sexual Violence Experienced by Sexual and Gender Minority Young Adults: Comparisons of Sexual and Gender Minority Recipients Versus Cisgender/Heterosexual Recipients.

Sexual and gender minority (SGM) individuals are at an increased risk of experiencing sexual violence (SV). Social reactions received upon disclosure of SV impact survivors' mental health, and this may be more extreme when social reactions are provided by other SGM individuals. The purpose of the current study was to understand the SV disclosure experiences of SGM young adults, including the identity of disclosure recipients and the quality of the social reactions received by SGM and cisgender/heterosexual disclosure recipients. Additionally, the current study sought to examine how the SGM identity of the disclosure recipient and the quality of the social reactions received were associated with mental health outcomes (depression, post-traumatic stress disorder [PTSD], and alcohol use) among SGM SV survivors. SGM-identifying participants (N = 110) completed a 10-min survey on Qualtrics that was distributed through Prime Panels. Results revealed that 83% of participants (SGM survivors of SV) disclosed their SV experience to other SGM individuals. SGM disclosure recipients provided more positive social reactions and fewer negative social reactions than cisgender/heterosexual disclosure recipients. Regression models indicated that positive social reactions from cisgender/heterosexual recipients were associated with a decrease in depression scores. Negative social reactions from SGM recipients were associated with an increase in depression scores. Unexpectedly, positive social reactions from SGM recipients, while negative social reactions from cisgender/heterosexual recipients, were associated with an increase in PTSD scores. No associations were found between social reactions and alcohol use. Findings highlight the importance of social reactions and disclosure experiences on SGM survivors' mental health and mitigation opportunities to improve these disclosure experiences.

Queering the Conflict in Adolescent Dating Relationships Inventory: An Examination of the Conflict in Adolescent Relationships Inventory Perpetration Scale's Measurement Invariance Across Heterosexual and Sexual Minority Youth.

Teen dating violence (TDV) is a public health concern impacting more than half of U.S. adolescents aged 12 to 18. Sexual minority youth (i.e., adolescents who are not exclusively heterosexual) experience disproportionately high rates of TDV. Yet, measures of TDV such as the Conflict in Adolescent Dating Relationships Inventory (CADRI) have been developed without considering sexual identity with items and instructions frequently anchored in heterosexual romantic relationships. Examination of measurement equivalence across heterosexual and sexual minority youth has only begun recently with existing research examining the CADRI's victimization scale measurement invariance providing empirical support for invariance across heterosexual and sexual minority youth. However, no prior research has examined the measurement invariance of the CADRI perpetration scales across heterosexual and sexual minority youth. The current study fills this gap by examining the CADRI perpetration scale measurement invariance across heterosexual and sexual minority youth. Using multigroup confirmatory factor analysis responses from 1,143 adolescents (Mage = 15.88, SD = 2.49) to the CADRI perpetration items were examined across heterosexual (n = 922) and sexual minority youth (n = 218). Results confirmed the five-factor structure of the CADRI perpetration scales, providing empirical support for the appropriateness of the use of the CADRI perpetration scale's scores across heterosexual and sexual minority youth broadly. However, findings of partial scalar measurement invariance on the emotional/verbal abuse perpetration scale raise questions about the appropriateness of mean-score comparisons on this particular subscale. Areas of potential revisions of the emotional/verbal abuse perpetration scale are discussed to facilitate meaningful comparisons among heterosexual and sexual minority youth and to substantiate program evaluation results by groups.

Effectiveness of a Bystander Intervention Program to Increase Bystander Behaviors Across Latent Risk Groups of High Schoolers.

Bystander intervention programs have established efficacy to increase bystander behaviors to prevent interpersonal violence (IPV). Little research has investigated intervention efficacy among latent risk classes among high school students. Data from a five-year randomized control trial were used to conduct multigroup path analyses to assess the association between type of training received and bystander outcomes moderated by risk groups identified via latent profile analysis (LPA). LPA was used to identify risk based on six indicators related to violence exposure, association with aggressive friends, and alcohol use. Bystander training received was the primary independent variable characterized as: no training, overview speech alone, or skills training. Outcomes included (a) observed bystander behaviors; (b) reactive bystander behaviors; or (c) proactive bystander behaviors. Three risk groups were identified via LPA: low risk, moderate risk witnesses of IPV, and highest risk victims and perpetrators. Of the bystander trainings received, overview speeches only increased reactive bystander behaviors among low risk students. The skills training was effective at increasing most bystander outcomes among all risk groups, with the largest effect sizes observed among the highest risk victims and perpetrators profile. Findings suggest that tailoring or modifying bystander training based on the risk profiles of youth may lead to greater potential to increase bystander behaviors to reduce risk of violence. Specifically, overview speech trainings should be targeted to low risk youth, while skills training primarily delivered to higher risk youth. These skills trainings could incorporate content related to trauma-informed care as well as associations with alcohol use, which may enhance their effectiveness further.

The bystander intervention for problematic alcohol use model (BIPAUM).

Objective: The study aimed to identify phases of bystander intervention (BI) for problematic alcohol use (PAU) among college students. Participants: Twenty focus groups and nine interviews were conducted. Methods: Transcripts were thematically analyzed. Results: The phases of the Bystander Intervention for Problematic Alcohol Use Model (BIPAUM) include: (1) plan in advance, (2) notice and interpret a sign, (3) decide (i.e., assume responsibility, assess support/feasibility to intervene, and identify intervention strategy), (4) intervene, and (5) assess outcomes. Assessing outcomes loops to influence future behavior and each phase is influenced by barriers and facilitators. Conclusions: These unique phases should be considered when designing and evaluating intervention programs for PAU to meet students' needs and better reduce PAU. Future research should empirically test the BIPAUM. The results of the current study demonstrate a promising opportunity for applying BI to PAU, with the goal of reducing risky drinking among college students.

The Holistic Prevention & Intervention Model: A public health approach to college mental health and suicide prevention.

The rate of college student mental health difficulties has been climbing, leading to overburdened college counseling centers. We propose the Holistic Prevention & Intervention Model (HPIM) as one solution in which campus and community resources work collaboratively to support students experiencing psychological distress and alleviate clinical demands. The HPIM moves from autonomous solutions to organizational-based strategies on a continuum of proactive to reactive interventions. We discuss how this model can be tailored and implemented for college campuses across the United States, including examining the resources available to the campus, the overall campus culture, and college demographics that affect risk and protective factors.

Gender, sexual orientation, and mental health in the kink community: an application of coping self-efficacy theory.

OBJECTIVE: This paper advances understanding of the kink community by examining mental health and coping-self efficacy (CSE) variation by gender and sexual orientation. DESIGN: Adult members of the National Coalition for Sexual Freedom (N = 332) completed an online cross-sectional health assessment. MAIN OUTCOME MEASURES: The assessment included the Coping Self-Efficacy (CSE) Scale; Depression and Anxiety Stress Scale-21; and Alcohol Use Disorders Identification Test. RESULTS: Transgender and non-binary persons reported consistently low coping beliefs and poor mental health. Queer sexual minority persons reported low CSE thought stopping and high anxiety. Several CSE thought stopping moderation effects on mental health were observed. CONCLUSIONS: Findings may inform clinical implications, as bolstering coping-related beliefs and skills via cognitive-behavioral therapy may offer mental health benefit to kink practitioners.

Mental health services for all: Factors influencing desire for mental health services among underresourced adults during COVID-19.

The coronavirus disease (COVID-19) pandemic has substantially impacted psychological health in the U.S and has disproportionately impacted underresourced individuals. Despite the higher need for mental health services during this time, service availability and access were disrupted due to increased demand, social distancing recommendations, and stay-at-home orders. Thus, it is crucial to understand factors that predict the desire for psychological services for underresourced individuals. The present study examined factors at multiple levels of Bronfenbrenner's socioecological model (Bronfenbrenner, 1994) to determine which factors best predicted the desire for mental health services including individual, group, in-person, and online services. The sample consisted of 155 underresourced adults in North Carolina. Participants completed an online survey of mental health symptoms, coping strategies, COVID-19 related stressors, and provided demographic information including ZIP code, which was used to classify urban-central and urban-outlying dwellers. Results from univariate general linear models demonstrated that depression symptoms, venting as a coping strategy, COVID-related stress, and living in more rural regions were all significant predictors of the desire for psychological services. Venting as a predictor of the desire for services may signify a general misunderstanding regarding the purpose of psychotherapy as well as the need for individuals to gain social support and connectedness during a pandemic. This study helps to clarify individual-level and contextual factors that impact the desire for psychological services during a global pandemic. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A Systematic Review of Validated Measures of U.S.-Based Bystander Intervention-Related Constructs.

This review aimed to identify U.S.-based, construct-validated measures of bystander intervention. Following PRISMA-P guidelines, electronic databases were searched, and emails were solicited identifying 8,559 articles for title screening. Abstracts and full texts were double screened, resulting in 24 scales meeting inclusion criteria: (a) measured a bystander-related construct in a situation where there was a potential for actual or perceived imminent physical or emotional harm, (b) written in English, and (c) statistically validated on U.S. samples. Most scales addressed the domain of interpersonal violence (67%), with fewer relating to bias/bullying (8.2%), mental health crises (12.5%), and substance use (12.5%). Most scales (71%) assessed the "take action" step of the situational model. The modal construct represented was intent/willingness/likelihood to intervene (50%). The average number of items on a scale was 14, and most (79%) provided Likert-style response options. None of the validated scales assessing behavior first accounted for an opportunity. Sample sizes ranged from 163 to 3,397, with the modal setting from colleges. Overall, samples were young (21.8 years old), White (75%), women (64%), and heterosexual (89%). Results indicate the need to validate additional measures that capture the "interpreting the situation as problematic" step of the situational model. Scales also need to be validated using diverse samples, particularly within the mental health crisis domain. Across all domains, validated measures need to be developed that first account for an opportunity when measuring actual bystander behavior. The information gleaned can be used to assist researchers in selecting measures and guide future measure development.

Coming together in a digital age: Community twitter responses in the wake of a campus shooting.

Campus mass shootings have become a pressing policy and public health matter. Twitter is a platform used for processing events among interested community members. Examining the responses of invested community members to a mass shooting on a college campus provides evidence for how this type of violence affects the immediate community and the larger public. These responses may reflect either content (e.g. context-specific) or emotions (e.g. humor). Aims Using Twitter data, we analyzed the emotional responses as well as the nature of non-affective short-term reactions, in response to the April 2019 shooting at UNC Charlotte. Methods Drawn from a pool of tweets between 4/30/19-5/7/19, we analyzed 16,749 tweets using keywords related to the mass shooting (e.g. "shooting," "gun violence," "UNC Charlotte"). A coding team manually coded the tweets using content and sentiment analyses. Results Overall, 7,148 (42.67%) tweets contained negative emotions (e.g. anger, sadness, disgust, anxiety), 5,088 (30.38%) contained positive emotions (e.g. humor, hope, appreciation), 14,892 (88.91%) were communal responses to the shooting (e.g. prayers, healing, victim remembrance), 8,329 (49.73%) were action-oriented (e.g. action taken, policy advocacy), and 15,498 (92.53%) included information (e.g. death/injury, news). All tweets except positive emotions peaked one day following the incident. Conclusions Our findings point to peaks in most emotions in the 24 hours following the event, with the exception of positive emotions which peaked one day later. Social media responses to a campus shooting suggest college preparedness for immediate deployment of supportive responses in the case of campus violence is needed.

Disclosing and Reporting of Consent Violations Among Kink Practitioners in the United States.

Kink practitioners are marginalized and experience adverse health and social outcomes, which are exacerbated by consent violations. This study aims to understand experiences of reporting consent violations within a kink context. Kink practitioners (N = 2,888) completed a survey focused on consent violations, reporting, and recommendations, with 767 (25.56%) of them reporting consent violations in the kink context. The type of consent violation (sexual assault or kink-related behaviors), disclosure, and reporting significantly differed based on gender, sexual orientation, and injury status, but not age. Additionally, recommended steps included avoidance of police and others in positions of power and increased accountability.

Couple Conflict and Intimate Partner Violence during the Early Lockdown of the Pandemic: The Good, the Bad, or Is It Just the Same in a North Carolina, Low-Resource Population?

The COVID-19 pandemic has forced couples to navigate illness-related stressors and unique public health responses, including extended lockdowns. This study focused on under-resourced North Carolina residents (n = 107) who self-reported changes in relationship conflict (Increased, Decreased, Stayed the Same) and intimate partner violence (IPV) during the pandemic. We expected high rates of increased conflict and IPV since the start of the pandemic. We then sought to determine the associations between dyadic changes in conflict and reports of IPV and pandemic-related experiences and responses. Participants completed a brief online survey assessing their demographics, COVID-19 exposure/stressors, and pandemic responses. As expected, reports of increased couple conflict were related to difficulties getting needed social support, loss of health insurance, more fear and worry, stress, pain, and greater use of alcohol and/or illicit drugs, related to the coronavirus. Participants reporting increased conflict were also more likely to be unemployed. Conversely, reports of decreased conflict were associated with being ill from the virus (48.9%), having health insurance, and working part time. Substantial amounts of IPV were reported (62.2% of the sample); however, increased conflict and IPV were unrelated. Those reporting No IPV were less likely to be receiving public assistance but more likely to have home responsibilities due to the virus. They also reported increased social interactions and less use of alcohol than those reporting IPV perpetration. Findings highlight key associations among pandemic experiences and responses, IPV, and couple functioning in an under-resourced sample. Efforts to facilitate coping, resilience, and tolerating uncertainty may facilitate cooperative and safe couple functioning throughout the pandemic.

Bystander Program to Reduce Sexual Violence by Witnessing Parental Intimate Partner Violence Status.

INTRODUCTION: Youth who witness parental intimate partner violence are at increased risk for sexual violence. Existing data from a cluster RCT were used to determine the effectiveness of Green Dot bystander intervention to reduce sexual violence among high-school students who did and did not witness parental intimate partner violence. STUDY DESIGN: A secondary analysis was conducted in 2021 of extant data from a 5-year cluster RCT. SETTING/PARTICIPANTS: A total of 26 high schools in Kentucky were randomized to intervention or control condition in 2010. A total of 15,863 surveys were analyzed from baseline, 30,014 from partial intervention implementation (Years 1 and 2), and 25,907 from full implementation (Years 3 and 4). The sample was stratified to include students who witnessed or did not witness parental intimate partner violence. INTERVENTION: The bystander intervention program was delivered in 2 stages. During partial implementation, a persuasive speech describing rates, risk factors, and bystander-based approaches to violence prevention was provided to most students in schools randomized to the intervention. During full implementation, an in-depth 5-hour skill-based bystander training was provided to popular opinion leaders among the students in intervention schools (10%-15%). MAIN OUTCOME MEASURES: The primary outcome was sexual assault measured as perpetration and victimization. Secondary outcomes included sexual harassment and stalking, measured as victimization and perpetration. RESULTS: During full implementation, among students who witnessed parental intimate partner violence, the intervention was associated with significant reductions in sexual assault perpetration (ß= -0.21, p<0.01), sexual harassment perpetration (ß= -0.29, p<0.001), sexual assault victimization (ß= -0.25, p<0.01), and sexual harassment victimization (ß= -0.45, p<0.001). For students who did not witness parental intimate partner violence, the intervention was only associated with reductions in sexual harassment (ß= -0.19, p<0.001) and stalking (ß= -0.09, p<0.01) victimization. CONCLUSIONS: As implemented in the parent RCT, the bystander training was more effective at reducing violent outcomes among those who witnessed parental intimate partner violence than in those who did not witness parental intimate partner violence. TRIAL REGISTRATION: This study is registered at www. CLINICALTRIALS: gov, under identifier NCT01878097.

Bystander Intervention Opportunities and Prosocial Behaviors Among Gender and Sexual Minority College Students.

Bystander intervention education has proliferated as a popular strategy to address campus interpersonal violence, including intimate partner and sexual violence, which remain major public health concerns. Much of the work on bystander engagement, however, is cis- and heteronormative (i.e., centered on those individuals whose gender identity aligns with their biological sex at birth and/or who identify as heterosexual), thus failing to capture the experiences of students who identify as gender or sexual minorities (GSM), a population at increased risk for interpersonal violence. Research has demonstrated that cisgender females face an increased likelihood of victimization, which is related to greater awareness of intimate partner and sexual violence and results in more prosocial intentions and prosocial behaviors. The question remains whether this extends beyond cisgender females. The current study is a secondary analysis of data collected in a web-based sexual assault prevention course designed for undergraduate students and implemented at their respective institutions. Data from 474,395 undergraduate students, aged 18-23 years, were used to answer the research question. Results indicate that students' bystander intervention opportunities and prosocial behaviors differ based on GSM status. For example, although cisgender bisexual women, transwomen, and genderqueer/gender nonconforming (GNC) students were more likely to report having the opportunity to intervene in sexual assault situations, relative to cisgender heterosexual women, the latter two groups were less likely to intervene. Further, cisgender gay and bisexual men, as well as transmen and genderqueer/GNC students were more likely to report having the opportunity to intervene in dating abuse situations, relative to cisgender heterosexual men, and cisgender gay men were more likely to report having intervened. Given the call for centering research on minoritized student experiences, this research is a vital step toward recognizing the diversity of those experiences for GSM students, a population at risk for victimization.

Disclosure to friends or family and consequences after interpersonal violence: intersections of sexual identity and race.

Objective: This study's purpose was to examine whether disclosures to friends or family post-victimization was associated with emotional and academic consequences (e.g. feeling detached from others, getting worse grades) among students grouped by sexual identity and race intersections. Participants and Methods: We analyzed data from an online survey that was distributed to students (n = 6,331) at a university in the Southeast. Results: Path analyses indicated disclosure to friends and family partially mediated the relationship between victimization and consequences, such that an increase in the number of disclosures was associated with an increase in the number of consequences. These paths were significant among White sexual minority victims, sexual minority victims of color, White heterosexual students, and heterosexual students of color. Conclusions: These findings indicate that disclosure to informal sources is associated with amplified consequences, which may be ameliorated by training friends and family to respond to disclosures in a supportive manner.

Who do They Tell? College Students' Formal and Informal Disclosure of Sexual Violence, Sexual Harassment, Stalking, and Dating Violence by Gender, Sexual Identity, and Race.

Disclosure of interpersonal violence (i.e., sexual violence, sexual harassment, dating violence, and stalking) is often the first step toward receiving social and systemic support. Research demonstrates that sexual assault and dating violence survivors on college campuses are more likely to disclosure to informal sources (i.e., friends and family) than formal sources (e.g., police, Title IX, counseling centers). However, there is limited research examining disclosure rates after other forms of violence (i.e., stalking, sexual harassment), and little is known about the impact of the survivors' identities on disclosure. Utilizing four academic years (2016-2019) of aggregated campus climate data from a large Southeastern university, the current study examined rates of disclosure across experiences of sexual violence, sexual harassment, dating violence, and stalking while identifying whether the prevalence and type of disclosure (formal versus informal-only) differed by gender, sexual orientation, and/or race/ethnicity. Of 8,017 participants, 4.6% reported sexual violence, 18.9% reported sexual harassment, 12.3% reported dating violence, and 11.3% reported stalking in the past academic year. Results of multinomial logistic regression indicated that, across all four types of violence, men (as compared to women) had lower odds of disclosing both informally-only and formally. Bisexual as compared to heterosexual students had higher odds of formal disclosure of sexual harassment and stalking while gay/lesbian students had higher odds of formally disclosing sexual harassment. Individuals of another race/ethnicity (compared to White students) had lower odds of informal-only disclosure of dating violence. Findings underscore the need to implement programs to improve the social reactions of friends and family members receiving disclosures, and to increase culturally-tailored service provision.

Substance use-related suicide after release from correctional, behavioral health, and healthcare facilities using national violent death reporting system data.

INTRODUCTION: Suicide and substance use are prevalent problems among persons discharged from facilities. This study (1) articulated rates of substance-related suicide deaths among those discharged correctional, behavioral health, and healthcare facilities, and (2) identified factors associated with substance-related suicide deaths unique to, or generalizing across, facility discharge. METHODS: We used data from the National Violent Death Reporting System. Suicide deaths (N = 105,968) were aggregated from 2003 to 2017. Chi-square and independent samples t-tests were used to examine associations between drug/alcohol-related deaths and each correlate. Logistic regression was employed to identify the most robust substance-related suicide death-related factors. RESULTS: Suicide deaths were commonly marked as being substance-related: 69% from correctional institutions, 54% from behavioral health facilities, 45% from those not released from a facility, and 39% from healthcare facilities. Regression models indicated housing interruptions and interpersonal stressors increased odds of the suicide death being marked as substance-related across discharge categories. Each discharge category also had unique predictors, underscoring the need for tailored prevention. CONCLUSIONS: Substance-related suicide deaths are particularly common among adults discharged from correctional and behavioral health facilities. Findings are discussed with respect to community-focused, discharge planning, and clinical care suicide prevention strategies.

Bystander Intervention Efficacy to Reduce Teen Dating Violence Among High School Youth Who Did and Did Not Witness Parental Partner Violence: A Path Analysis of A Cluster RCT.

Youth who witness parental intimate partner violence (IPV) are at increased risk of teen dating violence (DV). This analysis of secondary data investigated whether a bystander intervention program, Green Dot, was effective at reducing physical and psychological DV victimization and perpetration among youth who had and had not previously witnessed parental IPV. The parent RCT assigned 13 schools to control and 13 schools to the Green Dot intervention. Responses from 71,797 individual surveys that were completed by high school students were analyzed across three phases of a 5-year cluster randomized control trial. Multigroup path analyses revealed that students in intervention schools who witnessed parental IPV had a reduction in psychological (p < .001) and physical DV (p < .01) perpetration and psychological DV victimization (p < .01) in Phase 2 of the intervention, while those who did not witness parental IPV had a significant reduction in psychological DV victimization (p < .01). Individuals in the intervention received more training (p < .001), which was associated with lower levels of violence acceptance (p < .001). Violence acceptance was positively associated with DV victimization and perpetration (p < .001), especially for individuals who previously witnessed parental IPV. Green Dot is an effective program at reducing DV victimization and perpetration among the high-risk group of youth who previously witnessed parental IPV, largely operating through violence acceptance norms. This underscores the bystander intervention approach as both a targeted and universal prevention program.