Invisible Wounds: Exploring the Coping Strategies of Black Survivors of Homicide Victims in Canada.

Canada has experienced a steady increase in homicide. Specifically, out of the 10 provinces and 3 territories, Ontario has consistently experienced the highest number of homicides, the majority concentrated within predominantly African, Caribbean, and Black (ACB) communities in the Greater Toronto Area (GTA). Despite this disproportionate reality, there is limited research on the ways in which survivors of homicide victims cope with the murder of their loved ones. This article explores the identification and characterization of coping strategies for ACB survivors of homicide victims residing in five neighbourhoods in the GTA. Participants in this study provided their insights and experiences, highlighting the coping mechanisms employed, the influence of cultural identity, and the challenges they experienced in accessing adequate care following the death of their loved ones. Implications for future research, policy and practice are discussed.

Effectiveness of man therapy to reduce suicidal ideation and depression among working-age men: A randomized controlled trial.

OBJECTIVE: This randomized controlled trial of the online intervention, man therapy (MT), evaluated efficacy to reduce suicidal ideation (SI) and depression among working-aged men. METHOD: Five-hundred and fifty-four men enrolled and 421 completed all surveys. Control Condition men explored the Healthy Men Michigan (HMM) website and Intervention Condition men explored HMM and MT. Hypotheses included men who used MT would report decreased SI and depression over time compared to Control Condition men. RESULTS: Latent growth curve modeling revealed improvements in SI (slope = -0.23, p < 0.001, 95% CI: -0.29, -0.16) and depression (slope = -0.21, p < 0.001, 95% CI: -0.23, -0.18) over time for men in both groups; however, there was no difference in slope based on group assignment. Depression, lifetime suicide attempts, and interpersonal needs were associated with SI. Interpersonal needs and poor mental health were associated with depression. No group differences in change in risk and protective factors over time were observed. MT sub-group analyses revealed significant improvements in risk and protective factors. CONCLUSION: While a direct effect of MT versus HMM on SI or depression was not observed, men in both groups improved. Results suggest online screening might play a role in reducing SI and depression among men and there are potential benefits to MT related to mental health, social support, and treatment motivation.

Development and validation of the Inventory of Stress and Coping for African American Survivors of Homicide Victims.

OBJECTIVE: African Americans disproportionately experience homicide. However, validated measures designed to assess the traumatic impact of coping with murder for surviving family members and friends of homicide victims are absent from research. This article describes four studies that contributed to the development and preliminary validation of the Inventory of Stress and Coping for African American Survivors of Homicide Victims (ISCASHV). The ISCASHV is a measure that assesses multicomponents (e.g., stress, appraisals, stigma, coping) of the sociocultural and psychological processes in which African Americans cope with homicide. METHOD AND RESULTS: Studies 2-4 provide strong support for the multicomponent 42-item scale consisting of five factors: cultural trauma, reactions to homicide, culture of homicide, racial appraisal, and coping. The ISCASHV demonstrates strong construct validity evidence and good internal consistency estimates. Each of the five measures demonstrated a high test-retest estimate for a 2-week period, suggesting the temporal stability of the factors. CONCLUSIONS: Results suggest that the ISCASHV is a promising multicomponent measure that assesses the racial- and sociocultural-bound manifestation of homicide-related grief for African American survivors of homicide victims. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Psychosocial aspects of coping that predict post-traumatic stress disorder for African American survivors of homicide victims.

African Americans disproportionately experience homicide, and the psychological consequence of experiencing this traumatic event interferes with daily function, often in the form of post-traumatic stress disorder (PTSD). According to the Model of Coping for African American Survivors of Homicide Victims (MCAASHV), African Americans coping with the traumatic impact of homicide are influenced by: the violent nature of the death itself, racial- and cultural-bound experiences (e.g., cultural trauma, the culture of homicide including stigma, blame, shame, and lack of justice) and psychological processes including racial appraisal and coping strategies (e.g., spiritual, collective, meaning making). This study examined the direct and indirect effects racial- and cultural-bound experiences have on PTSD through coping strategies among 304 African American survivors of homicide victims across the United States using Qualtrics Panel collected in March-May 2018. The path analysis model demonstrated strong model fit, and the variables in the model accounted for 34% variance in PTSD. Coping (ß = -0.38, p < .001) and culture of homicide (ß = -0.27, p < .001) were negatively related to PTSD. Cultural trauma (ß = 0.11, p < .014), culture of homicide (ß = 0.43, p < .001), reactions to homicide (ß = 0.11, p < .006) and racial appraisal (ß = 0.32, p < .001) were positively associated with coping (R2 = 52%), and all were indirectly associated with PTSD through coping. Findings provide strong support for the MCAASHV and highlight the direct and indirect effects of racial and cultural experiences of coping that explain PTSD among African Americans chronically exposed to homicide.

Beyond Systems of Oppression: The Syndemic Affecting Black Youth in the US.

Adolescence is a challenging time fraught with developmental changes that influence sociocultural identity, psychosocial and biological development. Integrating a sense of ethnic identity into one's personal identity is an important task for Black youth during this developmental stage as it impacts aspirations, ideology, and interpersonal identity. Black youth are not only navigating this critical stage but doing so while traversing issues related to a syndemic of injustice rooted in anti-Black racism that permeates the very fabric of our society. This manuscript describes the syndemic of injustice framework as it relates to the ways in which anti-Black racism contributes to experiences of structural, symbolic and interpersonal violence for Black youth and how these experiences of violent oppression ultimately influence the developmental processes involved in identity formation for Black youth. Implications for social work practice are discussed.

Exploring research on the coping strategies of black survivors of homicide victims: a scoping review protocol.

INTRODUCTION: Black people are disproportionately impacted by homicide. However, despite this over-representation, research is limited relevant to how black individuals, families and communities cope with the chronic traumatic devastation of homicide. This scoping review will provide an amalgamation of the current literature regarding the coping strategies of black survivors of homicide victims to inform future health and social work practice. METHODS AND ANALYSIS: In this scoping review, Arksey and O'Malley's five-stage framework will be used to succinctly gather and synthesise previous literature and identify gaps in research relevant to black survivors of homicide victims. This method will allow for a focused process of chosen pertinent databases. The seven databases include OVID (MEDLINE and PsycINFO), ProQuest (Sociological Abstracts, Social Services Abstracts, International Bibliography of Social Sciences), EBSCO (Africa Wide, The Cumulative Index to Nursing and Allied Health Literature). The seven databases were chosen for their relevance to the topic of coping with homicide for black individuals, families and communities. All members of the research team will screen the abstracts and full texts of the literature based on the inclusion criteria. The findings will be charted and synthesised using a qualitative thematic analysis. ETHICS AND DISSEMINATION: The articles chosen for this review will be gathered from peer-reviewed journals and scholarly search engines. Due to this research project's nature, ethics approval is not warranted. The results of this scoping review will inform culturally responsive approaches to research, policy and practice for first responders (eg, law enforcement, emergency medical technicians) and providers (eg, mental health clinicians, physicians and faith-based communities) who frequently render services to black survivors of homicide victims. The results will be shared through journal article publications, academic and community conferences, as well as professional training opportunities for practitioners who support Black individuals, families and communities.

The impact of exposure to gun violence fatality on mental health outcomes in four urban U.S. settings.

RATIONALE: Given the widespread availability of firearms, high prevalence of gun violence in the U.S., and the intersection of race, cumulative violence and adverse mental health outcomes, it is important to understand the mental health consequences of exposure to gun violence fatality on racially/ethnically diverse secondary victims. OBJECTIVE: The aims of this study were to examine 1) the prevalence and demographic differences in exposure to gun violence fatality; 2) the associations between exposure and depression, psychological distress, suicidal ideation and psychosis-like experiences; and 3) the interaction between race and exposure in relation to depression, psychological distress, suicidal ideation and psychotic experiences. METHODS: Participants (n=1615) were adult community residents from Baltimore, New York, Philadelphia, and Washington, D.C, who participated in the online Survey of Police-Public Encounters. Chi-square, linear, and logistic regression were used to test study aims. RESULTS: Twenty-four percent of respondents reported exposure to gun violence fatality. Black, Latinx, younger, and those of lower income and education were disproportionately exposed. Exposed respondents had significantly higher levels of psychological distress, depression, suicidal ideation and/or psychotic experiences compared to those not exposed. There was a significantly stronger association between exposure and depression among Latinxs and "other" races relative to Whites. CONCLUSIONS: Findings suggest that vicarious exposure to gun violence fatality is widespread, disproportionately experienced by racial/ethnic minorities, and related to a higher prevalence of mental health symptoms. Implications of these findings are that clinicians should attend to the mental health needs of people vicariously exposed to gun violence fatality, and that gun violence reduction interventions may positively impact community-level mental health. Given that Blacks and Latinxs are disproportionately exposed to gun violence, a more extensive examination of exposure to gun violence fatality as a social determinant of mental health is warranted using longitudinal and nationally representative data.

The Development of a Culturally Adapted Pilot Intervention for African American Family Members of Homicide Victims: A Preliminary Report.

African Americans are disproportionately impacted by homicide in the United States. Individuals who have lost a relative to homicide often experience symptoms of complicated grief. The objective of this study was to explore the impact of a culturally tailored psychoeducational pilot intervention whose development was informed by a conceptual model of coping for African American survivors of homicide victims and was designed to (a) educate participants about the manifestation of complicated grief and symptoms and (b) help participants develop ways to cope with their grief. Pre- and post-test results indicate preliminary support for this encouraging intervention in achieving its intended outcomes to help participants identify complicated grief symptoms, supports, and services to help them manage their grief. Implications for posthomicide research and practice are discussed.

Elevated Prevalence of Suicide Attempts among Victims of Police Violence in the USA.

Recent evidence suggests that police victimization is widespread in the USA and psychologically impactful. We hypothesized that civilian-reported police victimization, particularly assaultive victimization (i.e., physical/sexual), would be associated with a greater prevalence of suicide attempts and suicidal ideation. Data were drawn from the Survey of Police-Public Encounters, a population-based survey of adults (N = 1615) residing in four US cities. Surveys assessed lifetime exposure to police victimization based on the World Health Organization domains of violence (i.e., physical, sexual, psychological, and neglect), using the Police Practices Inventory. Logistic regression models tested for associations between police victimization and (1) past 12-month suicide attempts and (2) past 12-month suicidal ideation, adjusted for demographic factors (i.e., gender, sexual orientation, race/ethnicity, income), crime involvement, past intimate partner and sexual victimization exposure, and lifetime mental illness. Police victimization was associated with suicide attempts but not suicidal ideation in adjusted analyses. Specifically, odds of attempts were greatly increased for respondents reporting assaultive forms of victimization, including physical victimization (odds ratio = 4.5), physical victimization with a weapon (odds ratio = 10.7), and sexual victimization (odds ratio = 10.2). Assessing for police victimization and other violence exposures may be a useful component of suicide risk screening in urban US settings. Further, community-based efforts should be made to reduce the prevalence of exposure to police victimization.

Psychotic Experiences in the Context of Police Victimization: Data From the Survey of Police-Public Encounters.

Social defeat has been proposed as the common mechanism underlying several well-replicated risk factors for sub-threshold psychotic experiences (PEs) identified in epidemiological research. Victimization by the police may likewise be socially defeating among vulnerable individuals and, therefore, may be associated with elevated risk for PEs. However, no prior studies have examined the relation between police victimization and PEs. We tested the hypothesis that exposure to police victimization (ie, physical, sexual, psychological, and neglect) would be associated with increased odds for PEs in the Survey of Police-Public Encounters data (N = 1615), a general population sample of adults from 4 US cities. Respondents who reported each type of police victimization were more likely to report PEs in logistic regression analyses (all P < .01), most of which were significant even when adjusting for demographic variables, psychological distress, and self-reported crime involvement (adjusted OR range: 1.30 to 7.16). Furthermore, the prevalence of PEs increased with greater exposure to police victimization in a linear dose-response relation, OR (95% CI) = 1.44 (1.24-1.66). These findings suggest that police victimization is a clinically important and previously unreported risk factor for PEs in the urban US population. These findings support the need for community-based outreach efforts and greater police training to reduce the prevalence of this exposure, particularly in socially disadvantaged urban communities.

Risk factors for recurrent violent injury among black men.

BACKGROUND: Black men are disproportionately overrepresented among victims of repeat violent injury. However, little is known about the risk factors that influence violent trauma recidivism among black men. We hypothesize that the following risk factors would be significant among black male victims of repeat violent injury: disrespect; being under the influence; being in a fight and using a weapon in the past year; and previous incarceration when comparing trauma recidivists versus nonrecidivists. METHODS: Using secondary data analysis, we identified a sample of 191 (n = 191) urban low-income black men treated by a level I trauma unit in Baltimore for violent injury (e.g., gunshot wound, stabbing, or assault) who participated in a hospital-based violence intervention program from 1998 to 2011. Participants in the program completed a risk factor for violent injury questionnaire to assess: exposure to chronic violence, criminal justice involvement, substance abuse, and disrespect (code of the street). RESULTS: We found that 58% of the sample is characterized as trauma recidivists (defined as hospitalization two or more times for violent injury). Black male patients of violent injury who engage in the following: substance abuse; had previously been in a fight or used a weapon in the past year; perceived disrespect as a precursor to violence; and experienced a previous incarceration were more likely to have multiple hospitalizations for violent injury. CONCLUSIONS: Trauma recidivism among urban black male victims of violent injury is a major public health issue. Hospital-based violence intervention programs should be engaged in reducing trauma recidivism among this population.

Child welfare outcomes for youth in care as a result of parental death or parental incarceration.

Every day, in the United States, children are removed from their homes and placed into state supervised out-of-home care because of concerns around their safety. These children enter care as a result of child abuse, child neglect, abandonment or some other reasons. Lost in most discussions of out-of-home care is the role that parental incarceration and parental death have on the trajectory of children through the child welfare system. In order to address this gap in the literature, the present study aims to compare youth in foster care as a result of parental death or youth in foster care as a result of parental incarceration with youth in care because of child maltreatment in terms of the length of time to achieve permanency. Holding all other variables constant, entering care as a result of parental death more than doubled the average time to exit (HR=2.32, SE=0.22), and these youth were significantly less likely to exit to permanency when compared to children entering care for other maltreatment reasons (OR=0.35, SE=0.24). Entering care as a result of parental incarceration led to a 24% longer time to exit (HR=1.24, SE=0.09) compared to children entering care for other maltreatment reasons. Findings suggest that a one-size-fits-all approach to policy and practice may not be useful to identifying permanent placements for children entering care as a result of parental death or incarceration.

Understanding the sociocultural context of coping for African American family members of homicide victims: a conceptual model.

The disproportionate representation of African American survivors of homicide victims places them at greater risk for compromised mental health. However, an examination of factors that influence how this population copes with this traumatic event is absent from the literature. This article elucidates the importance of sociocultural factors that influence coping resources and strategies for African Americans surviving the homicide of a loved one. A socioculturally responsive model of coping is presented that can be utilized in furthering the development of research and practice that is culturally responsive to the needs of African American survivors of homicide victims.

Coping with grief responses among African American family members of homicide victims.

Research relevant to coping with grief for African American family members of homicide victims is limited. This retrospective study was conducted to determine the effects of gender, length of time since death, the traumatic impact of experiencing the homicide of a loved one, and the use of coping strategies to current grief reactions of African American family members of homicide victims (N = 44). Multiple regression analysis results suggest that gender and level of traumatic stress, related to posttraumatic stress symptomatology, predict current symptoms of grief. Women reported higher levels of current grief symptoms than men. Family members of homicide victims who reported higher levels of posttraumatic stress symptomology reported higher levels of current grief. Implications for research and recommendations for practitioners are discussed.

Suicide and homicide bereavement among African Americans: implications for survivor research and practice.

Suicide and homicide are among the leading causes of death for young African-American men; however, little is known about how family members cope with these types of deaths. This exploratory phenomenological study examines the traumatic loss and coping experiences of a purposive convenience sample of 12 immediate African-American surviving family members with a combined experience of 13 deaths, 8 suicides and 5 homicides. Novel aspects of suicide and homicide survivor phenomenon were identified, including Survivor Responses and Reactions, Coping Strategies, and Survivor Service Needs. The implications for research and for those providing services to surviving African-American families are discussed.

Social determinants of HIV/AIDS and sexually transmitted diseases among black women: implications for health equity.

Recent epidemiologic reports show that black women are at risk for HIV infection and other sexually transmitted diseases (STDs). In this report, we go beyond race and consider a number of social and economic trends that have changed the way many black women experience life. We discuss poverty, loss of status and support linked to declining marriage participation, and female-headed single-parent household structure-all of which influence sexual risks. We also discuss the Centers for Disease Control and Prevention-led national efforts to advance consideration of social determinants of health (SDH) and promotion of health equity in public health activities that may have impact on black and other women.

We fall down: the African American experience of coping with the homicide of a loved one.

Rates of homicide among African Americans are much higher than those of other racial or ethnic groups. Research has demonstrated that homicide can be psychologically debilitating for surviving family members. Yet, exploring the experiences of homicide victims' surviving loved ones has received little attention. This study examined the coping strategies of African American survivors of homicide. Qualitative interviews were conducted with 8 African American family members (ages 18-82) of homicide victims. Survivors were recruited from the Massachusetts Office of Victim Services and from homicide survivor support, school, and community groups throughout the New England area. Interviews were conducted using open-ended questions derived from coping, support network, grief, and bereavement literatures. Results indicate that the primary coping strategies utilized by African American survivors of homicide victims are spiritual coping and meaning making, maintaining a connection to the deceased, collective coping and caring for others, and concealment. Implications for research and practice are discussed.

Identifying the impact of social determinants of health on disease rates using correlation analysis of area-based summary information.

OBJECTIVES: We developed a statistical tool that brings together standard, accessible, and well-understood analytic approaches and uses area-based information and other publicly available data to identify social determinants of health (SDH) that significantly affect the morbidity of a specific disease. METHODS: We specified AIDS as the disease of interest and used data from the American Community Survey and the National HIV Surveillance System. Morbidity and socioeconomic variables in the two data systems were linked through geographic areas that can be identified in both systems. Correlation and partial correlation coefficients were used to measure the impact of socioeconomic factors on AIDS diagnosis rates in certain geographic areas. RESULTS: We developed an easily explained approach that can be used by a data analyst with access to publicly available datasets and standard statistical software to identify the impact of SDH. We found that the AIDS diagnosis rate was highly correlated with the distribution of race/ethnicity, population density, and marital status in an area. The impact of poverty, education level, and unemployment depended on other SDH variables. CONCLUSIONS: Area-based measures of socioeconomic variables can be used to identify risk factors associated with a disease of interest. When correlation analysis is used to identify risk factors, potential confounding from other variables must be taken into account.

Summary of CDC consultation to address social determinants of health for prevention of disparities in HIV/AIDS, viral hepatitis, sexually transmitted diseases, and tuberculosis. December 9-10, 2008.

In December 2008, the Centers for Disease Control and Prevention (CDC) convened a meeting of national public health partners to identify priorities for addressing social determinants of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), viral hepatitis, sexually transmitted diseases (STDs), and tuberculosis (TB). The consultants were divided into four working groups: (1) public health policy, (2) data systems, (3) agency partnerships and prevention capacity building, and (4) prevention research and evaluation. Groups focused on identifying top priorities; describing activities, methods, and metrics to implement priorities; and identifying partnerships and resources required to implement priorities. The meeting resulted in priorities for public health policy, improving data collection methods, enhancing existing and expanding future partnerships, and improving selection criteria and evaluation of evidence-based interventions. CDC is developing a national communications plan to guide and inspire action for keeping social determinants of HIV/AIDS, viral hepatitis, STDs, and TB in the forefront of public health activities.

Risk of alcohol-exposed pregnancies among low-income, illicit drug-using women.

OBJECTIVES: Poor women of childbearing age who use crack, cocaine, marijuana, and heroin may be at risk for having an alcohol-exposed pregnancy because of concurrent alcohol use. Women who use illicit drugs may not know the harmful effects of fetal alcohol exposure. Fetal alcohol exposure is a leading cause of developmental disabilities and mental retardation. METHODS: We report findings of a survey administered to 2672 women 18-44 years of age in settings serving low-income women, including an urban jail, a drug treatment facility, and healthcare facilities in Florida, Virginia, and Texas. We compared women who reported using more than one illicit drug (drug users) and women who reported never using illicit drugs (nonusers) for frequent alcohol consumption, binge drinking, failure to use contraception, unplanned pregnancies, and drinking during pregnancy. RESULTS: Of women interviewed, 75% (2000) reported using more than one illicit drug. Drug users were more likely to report frequent drinking (33%, relative risk [RR] 12.73, 95% confidence interval [CI] 7.9-20.4, binge drinking (39%, RR 5.7, 95% CI 4.9-7.6), and drinking during pregnancy (37%, RR 2.10, 95% CI 1.75-2.53) compared with nonusers (3%, 7%, 17%, respectively, p < 0.0001). Greater proportions of drug users (27%, RR 2.20, 95% CI 1.75-2.53) also failed to used contraception compared with nonusers (19%, p < 0.05). Notable proportions of both groups, drug users (91%) and nonusers (82%), reported unplanned pregnancies. CONCLUSIONS: The findings suggest that poor women who reported ever using more than one illicit drug were at greater risk for having an alcohol-exposed pregnancy. Unplanned pregnancies in both groups surpassed national averages. Poor women likely require enhanced education about the hazards of drinking during pregnancy and methods to reduce unplanned pregnancies.