Childhood Maltreatment and Anhedonic Symptoms: Test of a Dual-risk Model in Emerging Adults.

Anhedonia, defined as deficits in positive affect and approach related behaviors, remains an understudied trauma response. As anhedonic responses to interpersonal violence are associated with a more severe course of psychopathology that is more difficult to treat, an increased focus on risk factors for anhedonia is necessary. The present study sought to address this gap in the literature by testing a theoretical model that highlights two transdiagnostic pathways leading to anhedonic responses in emerging adults attending college. Specifically, our study examined how childhood maltreatment subtypes (a) uniquely associate with depressive and post-traumatic stress (PTS) manifestations of anhedonia and (b) how temperament (i.e., anticipatory positive affect) and distress (i.e., negative mood) explain these relations. At baseline, a racially diverse sample of 462 emerging adults (AgeMean = 19.45; 75.5% female; 45.5% White) completed self-report forms on childhood abuse and neglect, anticipatory positive affect, negative mood, and anhedonia. Individuals completed measures of temperament and psychological distress again 6-weeks, and 12-weeks later. Latent growth curve models were utilized to test our model. Consistent with hypotheses, deficits in anticipatory positive affect uniquely explained the relation between neglect and depressive/PTS anhedonic symptoms. Meanwhile, negative mood mediated the relation between abuse and both forms of anhedonia. These findings support the theory that two separate risk pathways lead to anhedonia. Support for our model suggests that distinguishing between pathways for anhedonic responses may be the key to a more targeted, transdiagnostic, trauma-informed approach for treating and preventing these deleterious, treatment-resistant, internalizing symptoms.

Empowering Practices With Domestic Violence Survivors in India.

There is a growing concern about women's safety in India. This study examined a grassroots agency's response to domestic violence in the community by examining their empowerment-focused work with survivors through crisis intervention centers. Multi-informant perspectives examined (a) the organizational process of facilitating or strengthening empowerment of survivors and (b) the mechanisms central to this process. Results highlight various salient mechanisms, namely, the adoption of a survivor-centered approach, collaborative relationships with staff, meeting women where they are, systems advocacy, fostering independence, and building long-term networks with formal and informal supports. Implications for intervention and prevention work are discussed.

Predicting Adolescent Substance Use in a Child Welfare Sample: A Multi-Indicator Algorithm.

Given the risk of substance use (SU) among adolescents in the child welfare system, identification of risk for prospective impairing SU behaviors is a significant public health priority. We sought to quantify the incremental validity of routine multi-informant assessments of adolescent psychological distress (i.e., the Child Behavior Checklist and Youth Self-Report) and a commonly used SU screening protocol (i.e., the CRAFFT) to predict SU at 18 and 36 months after baseline in a nationally representative child welfare sample (N = 1,054; Mage = 13.72). We used receiver operator characteristics and reclassification analyses to develop our algorithms. We found that a battery consisting of baseline CRAFFT scores, self-reported delinquent behavior, and parent-reported rule-breaking behavior provided an incrementally valid prediction model for SU behavior among females, while baseline CRAFFT scores and self-reported delinquent behavior incrementally predicted SU for males. Results suggest that leveraging existing assessments within the child welfare system can improve forecasting of SU risk for this population.

The Association Between PTSD Symptoms and IPV Perpetration Across 6 Years.

A large literature documents that posttraumatic stress disorder (PTSD) symptoms are associated with intimate partner violence (IPV) perpetration among adults. However, research on this relationship among adolescents and young adults has been plagued by methodological flaws (e.g., cross-sectional designs). Thus, the purpose of the present study was to examine the longitudinal and bidirectional associations between PTSD symptoms and psychological and physical IPV perpetration from adolesence to young adulthood. A sample of racially and ethnically diverse high school students (N = 1,042; 56% female) were assessed annually for 6 years (from 2010 to 2015 in Southeastern Texas). At each assessment, participants completed measures of PTSD symptoms and psychological and physical IPV perpetration. The mean age of the sample at the first assessment was 15.09 (SD = .79). Structural equation modeling demonstrated that PTSD symptoms at Years 2, 3, and 4 predicted increases in psychological IPV perpetration in the subsequent year. In turn, psychological IPV perpetration at Years 1 and 4 predicted increases in PTSD symptoms in the subsequent years. In addition, psychological IPV perpetration mediated the association between PTSD symptoms and physical IPV perpetration over time. Results were consistent across gender and race/ethnicity. Findings provide initial evidence that PTSD symptoms are associated with IPV perpetration across time from adolescence to young adulthood. Prevention and intervention programs for adolescent and young adult IPV perpetration may benefit from screening for, and potentially treating, PTSD symptoms.

Community Organizing and Counter Narratives in the Response to Domestic Violence in India.

Domestic violence affects women globally. Domestic violence in India is embedded in structures of patriarchy, cultural norms, and a conservative social structure (Biswas, 2017). Community narratives help to create meaning and impact human behavior and can be tools of empowerment (Rappaport, 1995). They can also provide an important means of detecting changes in norms. Community engagement efforts that focus on empowering communities can play an important role in creating empowering narratives. Organizational settings like grassroots agencies can play a salient role in providing opportunities for community engagement leading to the creation of new community narratives and personal stories. This study sought to examine the work of a grassroots agency in India engaged in community action aimed at social change in the response to domestic violence, with a special focus on understanding shifting community narratives related to the response to domestic violence. Based on data from semi-structured interviews, archival data, and participant-observations, and using a modified-grounded theory approach, our results identified five major themes reflecting counter narratives on domestic violence. These included (a) awareness and discourse on gender related issues, (b) framing domestic violence as a social issue, (c) supporting the empowerment of women, (d) supporting disclosure of violence, and (e) supporting intervening in cases of violence. Implications of our findings for social change work in the response to domestic violence are discussed.

Community Organizing and Transformative Change in the Response to Domestic Violence in India.

Pervasive cultural narratives that normalize domestic violence have made efforts to respond to domestic violence in India challenging. An effective response to domestic violence in India needs to be transformative in nature, supporting the empowerment of survivors of violence and empowering communities to support survivors. Various studies have highlighted the importance of settings like grassroots organizations for promoting empowerment of members through community organizing. This qualitative study builds on this growing body of research using a grassroots agency in India as an exemplar to understand (a) empowering processes at the individual and community level associated with the agency's community organizing efforts; and (b) salient mechanisms associated with social change and action in the response to domestic violence in the community. At the individual level, the agency's organizing efforts provided knowledge, skills and resources, and opportunities for participation and leadership. At the community level, the agency engages in capacity building and increases social capital of members. The mechanisms that emerged as salient were increased critical consciousness of members, an emphasis on breaking the silence around domestic violence, community trust and cohesion, and capacity for informal social control. Implications of our findings for intervention and prevention work are discussed. HIGHLIGHTS: Community organizing is an important avenue for change in the response to domestic violence. Community organizing can facilitate empowering processes like participation and leadership. Building capacity and social capital is central to facilitating empowerment of communities.

Cardiac autonomic functioning and post-traumatic stress: A preliminary study in youth at-risk for PTSD.

The identification of robust, psychophysiological markers of trauma-related distress is critical for developing comprehensive, trauma-informed, mental health assessments for youth. Thus, the present study examined the clinical utility of cardiac autonomic balance (CAB) and cardiac autonomic regulation (CAR), two composite indices of the sympathetic and parasympathetic nervous system. We hypothesized that CAB/CAR would more reliably index post-traumatic stress (PTS) responses compared to measuring the parasympathetic (i.e., respiratory sinus arrhythmia; RSA) and sympathetic (i.e., pre-ejection period; PEP) nervous systems in isolation. Our sample was comprised of 88 diverse, low-income youth (40.9% African-American and 36.4% White; 60.5% girls; Mage = 12.05 years; SDage = 1.57) who are at increased risk for adversity-exposure. RSA and PEP were measured during a 5-minute baseline period and 5-minute parent-child conflict discussion task. Adolescent-caregiver dyads completed a clinician-administered measure of the youth's lifetime trauma-exposure and current PTS. CAB represented the difference between RSA and PEP, while CAR was the summation of RSA and PEP. Analyses revealed that sympathetically-oriented CAB reactivity uniquely (a) indexed PTS, especially in the context of elevated trauma, and (b) distinguished between those with and without PTSD. Findings highlight the translational promise of using physiological markers that account for the balance between the parasympathetic and sympathetic nervous system.

The Formal Systems Response to Violence Against Women in India: A Cultural Lens.

Violence against women (VAW) has become an increasingly salient issue in India, with women at risk for different forms of gendered violence. While there may be universal elements in the international phenomenon of violence against women, it is a complex, multifaceted phenomenon that takes shape in a particular sociocultural context. The current study employs a narrative framework to systematically examine how culture is expressed in the formal systems response and women's help-seeking in two metropolitan cities in India. Specifically, we sought to understand, among formal system responders (a) what characterizes the dominant cultural narratives on violence against women in India; and (b) how these are reflected in community narratives of formal responders. Interviews were conducted with formal responders working in different types of local agencies (e.g., police, health centers, and non-governmental agencies). The paper illustrates the major themes that emerged from participants' narratives describing the multilevel influences that shape the formal system response to violence against women and women's help-seeking efforts. The implications of these findings for effective response and directions for future research are summarized.

The Impact of Intimate Partner Violence Exposure in Adolescence and Emerging Adulthood: A Developmental Psychopathology Approach.

Despite increased attention on parental intimate partner violence (IPV) exposure, a relative paucity of research has examined the developmental consequences of this traumatic experience within a life span approach. The aim of the present study was to examine how parental IPV exposure may relate to mental health during the transition from adolescence to emerging adulthood. Furthermore, we examined whether the impact of parental IPV exposure was unique from more commonly studied maltreatment experiences, specifically neglect and physical abuse. A large, racially and ethnically diverse sample (Nbaseline = 1,042; 56% female; Mage = 15.1, SD = 0.79; 31.4% Hispanic, 29.4% White, 27.9% African American, 3.6% Asian, 7.7% biracial or other) of adolescents completed a baseline assessment for parental physical IPV exposure and maltreatment as well as measures for symptoms of depression, posttraumatic stress, and substance use, annually for 6 consecutive years. Mixed-level modeling was used to examine how parental IPV exposure was uniquely associated with different patterns of mental health across developmental epochs. Findings demonstrated a multifaceted relation with mental health. For internalizing symptoms, the effect was pronounced during adolescence, and neglect increased the risk for depression symptomatology. Meanwhile, parental-IPV-exposed adolescents were at increasing risk for substance use as they aged into adulthood. Symptom levels and trajectories were independent and distinct from maltreatment experiences. This study helps illuminate parental IPV exposure's unique influence on well-being during vulnerable developmental periods. It also calls attention to the importance of developing suitable intervention/prevention programs to target this vulnerable population.

Predicting Teen Dating Violence Perpetration.

OBJECTIVES: With our study we aimed to (1) understand what factors uniquely conferred risk for physical and sexual forms of teen dating violence (TDV) perpetration and (2) create a screening algorithm to quantify perpetration risk on the basis of these factors. METHODS: A total of 1031 diverse public high school students living in Southeast Texas participated in our study (56% female; 29% African American, 28% white, and 31% Hispanic). Self-report measures concerning TDV and associated risk factors were completed annually for 6 years. RESULTS: Results suggested that family violence (domestic violence exposure, maltreatment) together with deficits in conflict resolution incrementally improved our forecasts above and beyond lifetime history of physical TDV perpetration (net reclassification improvement = 0.44; 95% confidence interval [CI] = 0.30-0.59). Meanwhile, a violent dating history (TDV sexual perpetration, sexual victimization, and emotional perpetration) and acceptance of TDV incrementally improved our models for forecasting sexual forms of perpetration (net reclassification improvement = 0.41; 95% CI = 0.24-0.58). These models adequately discriminated between future perpetrators and nonoffenders (area under the curve statistic >0.70; 95% CI: 0.69-0.74). Overall, adolescents with positive test results on our algorithms were over twice as likely to perpetrate dating violence over the course of 6 years. CONCLUSIONS: Our study represents one of the first applications of reclassification analyses to psychosocial research in a pediatric population. The result is a theoretically informed, empirically based algorithm that can adequately estimate the likelihood of physical and sexual TDV perpetration during vulnerable developmental periods. These findings can immediately aid emerging preventive initiatives for this increasing public health concern.

Sexual assault victimization and psychopathology: A review and meta-analysis.

Sexual assault (SA) is a common and deleterious form of trauma. Over 40years of research on its impact has suggested that SA has particularly severe effects on a variety of forms of psychopathology, and has highlighted unique aspects of SA as a form of trauma that contribute to these outcomes. The goal of this meta-analytic review was to synthesize the empirical literature from 1970 to 2014 (reflecting 497 effect sizes) to understand the degree to which (a) SA confers general risk for psychological dysfunction rather than specific risk for posttraumatic stress, and (b) differences in studies and samples account for variation in observed effects. Results indicate that people who have been sexually assaulted report significantly worse psychopathology than unassaulted comparisons (average Hedges' g=0.61). SA was associated with increased risk for all forms of psychopathology assessed, and relatively stronger associations were observed for posttraumatic stress and suicidality. Effects endured across differences in sample demographics. The use of broader SA operationalizations (e.g., including incapacitated, coerced, or nonpenetrative SA) was not associated with differences in effects, although including attempted SA in operationalizations resulted in lower effects. Larger effects were observed in samples with more assaults involving stranger perpetrators, weapons, or physical injury. In the context of the broader literature, our findings provide evidence that experiencing SA is major risk factor for multiple forms of psychological dysfunction across populations and assault types.

Pharmaceutical Perspectives of Spices and Condiments as Alternative Antimicrobial Remedy.

Medicinal values of spices and condiments are being revived by biologists through in vitro and in vivo trials providing evidence for its antimicrobial activities. The essential oils and extracts of spices like black pepper, cloves, cinnamon, and nutmeg contain active compounds like piperine, eugenol, cinnamaldehyde, and lignans. Similarly, condiments like coriander, black cumin, turmeric, garlic, and ginger are recognized for constituents like linalool, thymoquinones, curcumin, allicin, and geranial respectively. These act as natural preventive components of several diseases and represent as antioxidants in body cells. Scientists have to investigate the biochemical nature, mode of action, and minimum concentration of administrating active ingredients effectively. This review reports findings of recent research carried out across South Asia and Middle East countries where spices and condiments form chief flavoring components of traditional foods. It narrates the history, myths, and facts people believe in these regions. There may not be scientific explanation but has evidence of cure for centuries.

The distal consequences of physical and emotional neglect in emerging adults: A person-centered, multi-wave, longitudinal study.

Despite being the most prevalent form of child maltreatment, the correlates and consequences of neglect are poorly understood, particularly during early adulthood. The present multi-wave, longitudinal study sought to address this gap in this literature by examining physical and emotional neglect in emerging adults in a diverse community sample. 580 adolescents (AgeMean=18.25; AgeSD=0.59; 58.3% female; 31% Hispanic, 28.9% Caucasian; 26.2% African-American; 13.9% other) completed self-report measures for child maltreatment at baseline, and measures for depression, posttraumatic stress disorder, generalized anxiety disorder, and substance use every year for three years. For our analyses, we used both variable-centered (mixed-level modeling) and person-centered (latent profile analysis) analyses to best understand a) how physical and emotional neglect relate to other forms of maltreatment and b) to determine physical and emotional neglect's unique impact on prospective mental health functioning. Our person-centered analyses revealed that a three-profile model provided the best solution for our data ("No Trauma," "Abuse", and "Neglect"). In longitudinal analyses, the "the neglect" group had significantly elevated scores compared to the "no trauma" group on all outcomes except alcohol use (p<0.01). Results from our variable-centered analyses showed comparable findings between physical and emotional neglect, with higher scores corresponding to elevated symptoms of depression, PTSD, illicit substance use, and cigarette use over time (p<0.01). In conclusion, our results suggest that early neglect-exposure poses a risk for the subsequent development of internalizing symptoms and substance use behaviors among emerging adults.

How should we screen for depression following a natural disaster? An ROC approach to post-disaster screening in adolescents and adults.

BACKGROUND: The present study's aim was to provide the foundation for an efficient, empirically based protocol for depression screening following a natural disaster. Utilizing a Receiver Operating Characteristic (ROC) analytic approach, the study tested a) what specific disaster-related stressors (i.e., property damage, loss of basic services) and individual-related constructs (i.e., PTSD symptoms, trauma history, social support) conveyed the greatest risk for post-natural disaster depression, b) specific cutoff scores across these measures, and c) whether the significance or cutoff scores for each construct varied between adolescents and adults. METHODS: Structured phone-based clinical interviews were conducted with 2000 adolescents who lived through a tornado and 1543 adults who survived a hurricane. RESULTS: Findings suggested that in both adolescents and adults, individual-related constructs forecasted greater risk for depressive symptoms following a natural disaster compared to disaster-related stressors. Furthermore, trauma history and PTSD symptoms were particularly strong indicators for adolescent depressive symptoms compared to adult depressive symptoms. Adolescents and adults who reported vulnerable scores for social support, trauma history, and lifetime PTSD symptoms were approximately twice as likely to present as depressed following the natural disaster. LIMITATIONS: Findings from the present study were limited to post-disaster assessments and based on self-reported functioning 6-12 months following the natural disaster. CONCLUSIONS: The present study synthesizes the extensive body of research on post-disaster functioning by providing a clear framework for which questions may be most important to ask when screening for depression following a natural disaster.

Priapism - A Rare Presentation in Chronic Myeloid Leukemia: Case Report.

Priapism is a complication rarely seen in leukemia. We report a 19-year-old man presented with persistent painful erection of penis for over 24 hours at home. The patient had underwent immediate irrigation and decompression of priapism by urologist at emergency services of the hospital. This approach resulted in a flaccid penis later. During hospitalization, peripheral blood smear and bone marrow aspiration confirmed the diagnosis of chronic myeloid leukemia.

Assessment of knowledge and attitude about basic life support among dental interns and postgraduate students in Bangalore city, India.

BACKGROUND: Life-threatening emergencies can occur at anytime, at anywhere and in anyone. Effective management of an emergency situation in the dental office is ultimately the dentist's responsibility. The lack of training and inability to cope with medical emergencies can lead to tragic consequences and sometimes legal complications. Therefore, health professionals including dentists must be well prepared to deal with medical emergencies. This study was undertaken to assess the knowledge about and attitude towards basic life support (BLS) among dental interns and postgraduate students in Bangalore city, India. METHODS: A cross sectional survey was conducted among dental interns and postgraduate students from May 2014 to June 2014 since few studies have been conducted in Bangalore city. A questionnaire with 17 questions regarding the knowledge about and attitude towards BLS was distributed to 202 study participants. RESULTS: The data analyzed using the Chi-square test showed that dental interns and postgraduate students had average knowledge about BLS. In the 201 participants, 121 (59.9%) had a positive attitude and 81 (40.1%) had a negative attitude towards BLS. CONCLUSIONS: Cardiopulmonary resuscitation should be considered as part of the dental curriculum. Workshops on a regular basis should be focused on skills of cardiopulmonary resuscitation for dental students.

Risk factors for prostate cancer: An hospital-based case-control study from Mumbai, India.

BACKGROUND: In India, prostate cancer is one of the five leading sites of cancers among males in all the registries. Very little is known about risk factors for prostate cancer among the Indian population. OBJECTIVES: The present study aims to study the association of lifestyle factors like chewing (betel leaf with or without tobacco, pan masala, gutka), smoking (bidi, cigarette), comorbid conditions, diet, body mass index (BMI), family history, vasectomy with prostate cancer. MATERIALS AND METHODS: This an unmatched hospital-based case-control study, comprised of 123 histologically proven prostate 'cancer cases' and 167 'normal controls. Univariate and regression analysis were applied for obtaining the odds ratio for risk factors. RESULTS: The study revealed that there was no significant excess risk for chewers, alcohol drinkers, tea and coffee drinkers, family history of cancer, diabetes, vasectomy and dietary factors. However, patients with BMI >25 (OR = 2.1), those with hypertension history (OR = 2.5) and age >55 years (OR = 19.3) had enhanced risk for prostate cancer. CONCLUSIONS: In the present study age, BMI and hypertension emerged as risk factors for prostate cancer. The findings of this study could be useful to conduct larger studies in a more detailed manner which in turn can be useful for public interest domain.

Translation and validation of brief patient health questionnaire against DSM IV as a tool to diagnose major depressive disorder in Indian patients.

CONTEXT: Depression is frequently encountered in the primary care setting but is often unrecognized and hence untreated. There is a need for a uniform user-friendly screening instrument for depression for primary healthcare personnel in India. AIMS: Translation and validation of the brief patient health questionnaire (BPHQ) as a screening tool for depression in major Indian languages. MATERIALS AND METHODS: This was a prospective study conducted at 18 sites, in psychiatric and general clinics. The English version of the BPHQ was translated into 11 Indian languages. The translations were reviewed by experts and volunteers and proofread for the final translated BPHQ. The validation exercise included more than 3000 subjects. A psychiatrist and a psychiatry social worker / coordinator conducted the study under the supervision of the principal investigator. For each language, the presence or absence of major depressive disorder (MDD) as diagnosed with the help of a patient-completed BPHQ and the psychiatrist DSM-IV diagnosis was matched. The kappa coefficient was used as a measure of inter-observer agreement between the two diagnostic methods. RESULTS: Seven languages failed the primary validation exercise. These translations were reviewed and the updated versions, after proofreading were re-run for validation. The self-administered BPHQ was successfully translated and validated for diagnosis of MDD against DSM-IV diagnosis made by a psychiatrist, in English, Hindi, Marathi oriya, Malayalam, Assamese, Gujarati, Kannada, Telugu, Bengali and Tamil. CONCLUSIONS: BPHQ is a simple, quick and reliable instrument, which facilitates rapid and accurate diagnosis of depression in the primary care setting in our country.