Gang members engage in many high-risk activities associated with psychiatric morbidity, particularly violence related ones. The authors investigated associations between gang membership, violent behavior, psychiatric morbidity, and
use of mental health services. The study concluded that gang members show inordinately high levels of psychiatric morbidity,
placing a heavy burden on mental health services. Traumatization and fear of further violence, exceptionally prevalent in gang members, are associated with service use. Gang membership should be routinely assessed in individuals presenting to health care services in areas with high levels of violence and gang activity. Health care professionals may have an important role in promoting desistence from gang activity.
This article co-written by Dr. Robert J. Winn which aims to quantify the number of lesbian, gay, bisexual, and transgender (LGBT) people in Philadelphia who report to be victims of domestic violence.
This article co-written by Dr. Robert J. Winn which aims to quantify the number of lesbian, gay, bisexual, and transgender (LGBT) people in Philadelphia who report to be victims of domestic violence.
Characteristics od Sibling and Nonsibling Sexual Abuse Cases Under Canadian C...BASPCAN
Dr. Delphine Collin-Vezina
Director
Centre for Research on Children and Families
Tier II Canada Research Chair in Child Welfare
Associate Professor, McGill University
Characteristics od Sibling and Nonsibling Sexual Abuse Cases Under Canadian C...BASPCAN
Dr. Delphine Collin-Vezina
Director
Centre for Research on Children and Families
Tier II Canada Research Chair in Child Welfare
Associate Professor, McGill University
Excerpt from the Research Article2 In the Midwest Longitudin.pdfAASTHASTYLETRADITION
Excerpt from the Research Article2
In the Midwest Longitudinal Study of Homeless Adolescents, homeless youth were interviewed
directly
on the streets and in shelters in eight Midwestern cities.
Physical abuse. Physical abuse was an indicator of parental/caretaker abuse. A mean of seven
items
(e.g., thrown something, hit with an object, pushed or shoved, slapped in the face, beaten up,
threatened, and wounded with a weapon) was calculated.
Delinquent behavior. Youth reported on things such as lying, feeling guilty, setting fires, stealing at
home, or other places, using dirty language or swearing, and cutting classes.
Age on own. Age on own was a continuous measure, constructed from the age that adolescents
reported they had first run away.
Deviant peers. Respondents were asked if any of their close friends had ever engaged in
delinquent
activities.
Substance use. Respondents reported how often they had used a list of substances in the past 12
months.
Postrunaway arrest and police harassment. Postrunaway arrest was a dichotomous construct that
measured self-reported arrest after running away from home the first time. Respondents were also
asked if they had been hassled by the police in the past 12 months, but not arrested. Hassled by
the
police was dichotomized (0 = no; 1 = yes).
Age ranged from 16 to 19 years (mean = 17.40). Gender was coded 0 males and 1 = females.
Table 1 Correlation Matrix (n = 354)
*p< 0.05. **p< 0.01.
Please answer the following questions:
1. Which value of r in the table represents the strongest relationship? Would you characterize the
relationship as being strong? Explain.
2. What is the value of the correlation coefficient for the relationship between Hassled by police
and Postrunaway arrest? How would you interpret the result for the health professionals?
3. Which one of the correlation coefficients shown in the table has the largest coefficient of
determination? To two decimal places, what is the value of the coefficient of determination for
the correlation you referred? How would you interpret the result for the health professionals?
4. To two decimal places, what is the value of coefficient of determination for the relationship
between gender and Delinquent behavior? How would you interpret the result for the health
professionals?
5. Would you be willing to generalize the results of this study to all adolescents in the Midwest?
Explain.
Reference
1. Burgess, N. S. (1991). Effect of a very-low-calorie diet on body composition and resting
metabolic rate in obese men and women. Journal of the American Dietetic Association, 91(4),
430-434.
2. Thrane L., Chen X., Johnson K., & Whitebeck L. B. (2008). Predictors of police contact among
Midwestern homeless and runaway youth. Youth Violence Juvenile Justice, 6, 227-239
1 2 3 4 5 6 7 8 9
1.Femal
-
e
2.Age -.22** -
3.
Physical .01 .13* -
Abuse
4.
Delinque
nt -.22** .06 .15** -
Behavio
ur
5. Age
-.09 -.09 .24** .13* -
on own
6.
Deviant -.10 .16** .21** .33** .22** -
peers
7..
Author info Correspondence should be sent to Paul Nicodemu.docxikirkton
Author info: Correspondence should be sent to: Paul Nicodemus, Department of
Psychology, Austin Peay State University, Clarksville, TN 37044
North American Journal of Psychology, 2009, Vol. 11, No. 3, 455-462.
NAJP
The Effects of Maternal Relationships on
Physical and Psychological Dating Violence
Paul Nicodemus
Austin Peay State University
Patricia A. Davenport
Our House, Inc., Greenville, MS
Lynn E. McCutcheon
NAJP
Psychological and physical dating violence patterns were examined to
determine if maternal relationships affected dating violence patterns
differently for male and female adolescents. Participants consisted of 469
ninth grade students from various schools across the Mississippi Delta
region. Participants completed self-report evaluations regarding the
number of experienced and perpetrated violent acts with a dating partner.
A series of two-way ANOVAs were calculated to determine the influence
of maternal relationships on dating violence. These findings indicated
that maternal relationships do not significantly influence the physically
violent behaviors; however, significant interactions were found between
maternal relationships by gender, with males perpetrating greater
numbers of and being victimized more psychologically when the
relationship with the mother was negative. Female participants displayed
completely opposite patterns of psychological violence when
experiencing negative maternal relationships as compared to the males.
The issue of dating violence has received considerable research
attention over the past several years. The social problem created by
adolescents being both physically and psychologically violent toward a
dating partner, and the resulting victimization, is cause for serious
concern. Several factors have emerged from the extant research. First, it
is apparent that both physical and psychological abuse occurs regularly
among adolescents. Secondly, certain individual attributes increase the
likelihood of adolescents becoming abusive toward their dating partners.
Previous research has indicated that dating violence among
adolescents is a prevalent problem. James, West, Deters, and Armijo
(2000) reported that 50% of their adolescent participants perpetrated
physical violence in the form of scratching, pushing, shoving, and hitting
with fist. Yet other studies have indicated that as many as 40% of the
adolescent participants had perpetrated some form of physical violence
456 NORTH AMERICAN JOURNAL OF PSYCHOLOGY
against the dating partner (Malik, Sorenson, & Aneshensel, 1997;
O′Keefe, 1997; O′Keefe & Treister, 1998; O’Leary, Smith Slep, Avery-
Leaf, & Cascardi, 2008; Reuterman & Burcky, 1989). The exhibiting of
violent acts of a more serious nature is also apparent during the
adolescent years. In one such study, James et al. (2000) found that 20%
of the participants reported committing violent behaviors ...
Running Head:
JUVENILE RECIDIVISM
1 1 JUVENILE RECIDIVISM
4
2 Juvenile Recidivism Annotated Bibliography
Ronald S. Dixon Keiser University Dr. Carolyn Dennis MACJ513 October 1, 2017 ANNOTATED BIBLIOGRAPHY Aalsma, M.
2 C., White, L.
M., Lau, K.
L., Perkins, A., Monahan, P., & Grisso, T.
(2015).
2 Behavioral Health Care Needs, Detention-Based Care, and Criminal Recidivism at Community Reentry from Juvenile Detention:
A Multisite Survival Curve Analysis.
American Journal of Public Health, 105(7), 1372-1378.
3 doi:10.2105/AJPH.2014.302529
The authors of the article are researcher-practitioners in contribution to the field of criminology especially in relevance to juvenile delinquency. Matthew Aalsma, Laura White, and Katherine L Lau work with the Division of Pediatrics, Indiana University School of Medicine, and Indianapolis.
2 Anthony Perkins works with Precision Statistical Consulting, LLC, Indianapolis, IN.
Patrick Monahan is with the Division of Biostatistics, Indiana University School of Medicine.
Thomas Grisso collaborates with the Division of Psychiatry, University of Massachusetts Medical School, and Worcester.
The examination was chiefly routed to fulfill the discoveries of past comparative looks into to the Indiana Criminal Justice Institute and the US Division of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Research Curriculum. The exploration question in the examination looks to address the effect of behavioral wellbeing administrations to adolescents on recidivism. Particularly the exploration inspected the effect of policy on the young people of the province of Indiana. The approach included two key components. Information about behavioral prosperity needs, behavioral well-being treatment got, and recidivism was found inside a year after release for 8363 adolescents (developed 12-18 years; 79.4% male). After the investigation, the examination group watched that discoveries reinforce past research showing that restorative behavioral issues are related to recidivism and that Black teenagers are unnecessarily rearrested after containment.
Barrett, D.
2 E., & Katsiyannis, A.
(2015).
2 Juvenile Delinquency Recidivism:
Are Black and White Youth Vulnerable to the Same Risk Factors?
Behavioral Disorders, 40(3), 184-195.
The article is a research study carried out by using archived data from the state of South Carolina's juvenile justice agency in contribution to examining the risk level associated with both blacks and white teens in the state of Carolina, in the USA. The research addresses the judicial system of South Carolina as well as future researchers and practitioners in the field of juvenile delinquency. The authors have proficient knowledge in education studies and other specialties. David Barrett is a licensed psychologist and has previously worked in the National Institute of mental health's laboratory of development phycology. He has extensive knowledge ...
AGGRESSIVE BEHAVIOR
Volume 29, pages 366—380 (2003)
Perpetrators of Alcohol-Involved Sexual Assaults: How Do They Differ From Other Sexual Assault Perpetrators and Nonperpetrators?Tina Zawacki, l Antonia Abbey, 1 Philip O. Buck, 1 Pamela McAusIan,2 and A. Monique Clinton-SherrodI
Wayne State University, Detroit, Michigan
2University of Michigan—Dearbom, Dearborn, Michigan
Approximotely 50% of sexual assaults involve alcohol. Researchers have documented situationul characteristics that distinguish between sexual assaults that do and do not involve alcohol, but little attention has been paid to differences bctwcen the perpetrators of these two types of assault. In this study, discriminant function analysis was used to distinguish between college men (N = 356) who reported perpetrating sexual assault that involved alcohol, sexual assault that did not involve alcohol, or no scxuul assault. Predictors of sexual assault perpetration thut have been documented in pust research differentiated nonperpctrators from both types of perpetrators. Pcrpctrators of scxuol assaults that involved alcohol were in most wuys similar to perpetrutors of sexual assautts that did not, although they did differ on impulsivity, alcohol consumption in sexual situations, and beliers about alcohol. These findings suggest mechanisms through which alcohol is involved in sexual assault thut are relevant to theory and prevention. Aggr. Behav. 29:366—380, 2003. 2003 Wiley-Liss, Inc.
Key words: sexual assault; alcohol; antisocial behavior
The problems of rape and sexual assault have been studied intensely for the past 30 years. Rape is typically defined as vaginal, anal, or oral intercourse that is physically forced or occurs when consent could not be given because of the victim's age or mental impairment, which may be due to intoxication [Bureau of Justice Statistics, 1995; Koss, 19921. Sexual assault includes rape as well as other types of physically forced sexual contact and verbally
Tina Zawacki is now at the Department or Psychology. Addictive Behaviors Research Center. University of Washington.
A. Monique Clinton-Sherrod is no'.,v at RTl international. North Carolina.
Grant support: National Institute on Alcohol Abuse and Alcoholism to AA.
*Correspondence to: Tina Zawacki. Department of Psychology-ABRC. Box 351525, University of Washington. Seattle, WA 98195. E-mail: [email protected] u.washington.edu or Antonia Abbey, Department or Community Medicine. Wayne State University. 4201 St. Antoine, Delroil. MI 48201.
Published online in Wiley Jnterscience (wuw.intcrscience.wiley.com). DOI: 10.100>ab.10076
0 2003 Wiley-Liss, Inc.
coerced sexual intercourse [Koss, 19921. In a watershed study, Koss et al. [19871 surveyed a nationally representative sample of approximately 6,000 college men and women and found thal 25% or the men reported perpetrating some level of sexual assault since the age or 14; 54% of the women reported experiencing some level of sexual assault since the agc of.
ArticlePTSD Symptoms Mediate the RelationshipBetween Sex.docxrossskuddershamus
Article
PTSD Symptoms Mediate the Relationship
Between Sexual Abuse and Substance Use
Risk in Juvenile Justice–Involved Youth
Jasmyn Sanders
1
, Alexandra R. Hershberger
2
, Haley M. Kolp
3
, Miji Um
2
,
Matthew Aalsma
4
, and Melissa A. Cyders
2
Abstract
Juvenile justice–involved youth face disproportionate rates of sexual abuse, which increases the risk of post-traumatic stress
disorder (PTSD) and substance use disorders (SUDs), both of which are associated with poor long-term outcomes. The present
study tested two mediation and moderation models, controlling for age, race, and history of physical abuse, with gender as a
moderator, to determine whether PTSD symptoms serve as a risk factor and/or mechanism in the relationship between sexual
abuse and substance use. Data were examined for 197 juvenile justice–involved youth (mean age ¼ 15.45, 68.9% non-White,
78.4% male) that completed court-ordered psychological assessments. Results indicated that PTSD symptoms significantly
mediated the relationship between sexual abuse and drug (b ¼ 3.44, confidence interval [CI] [0.26, 7.41]; test for indirect
effect z ¼ 2.41, p ¼ .02) and alcohol use (b ¼ 1.42, CI [0.20, 3.46]; test for indirect effect z ¼ 2.23, p ¼ .03). PTSD
symptoms and gender were not significant moderators. Overall, PTSD symptoms mediate the relationship between sexual
abuse and SUDs in juvenile justice–involved youth, which suggests viability of targeting PTSD symptoms as a modifiable risk
factor to reduce the effects of sexual abuse on substance use in this high-risk population.
Keywords
sexual abuse, substance use, PTSD, youth, juvenile justice
Substance use disorders (SUDs) occur in approximately 60% of
juvenile justice–involved youth (Substance Abuse and Mental
Health Services Administration, 2016; Teplin et al., 2005).
This is particularly problematic, as juvenile justice–involved
youth with SUDs face a host of negative outcomes, some of
which include increased likelihood of having a co-occurring
severe mental illness (e.g., manic episode and psychosis;
Teplin, Abram, McClelland, Dulcan, & Mericle, 2002),
increased likelihood of recidivism (Conrad, Tolou-Shams,
Rizzo, Placella, & Brown, 2014), and increased likelihood of
engagement in sexual risk-taking behaviors, compared to youth
in the general population (Teplin et al., 2005). Although there
are multiple potential explanations for the high prevalence of
SUDs in this population, such as genetic risk or social norms in
line with substance use (Kendler, Prescott, Myers, & Neale,
2003), emerging research suggests sexual abuse victimization
may be one risk factor for the development of SUDs in juvenile
justice–involved youth.
The prevalence of sexual abuse victimization in juvenile
justice–involved youth is high, with 31% of girls and 15% of
boys (Baglivio et al., 2014; Dierkhising et al., 2013) in the
juvenile justice system reporting a history of sexual abuse.
Extensive research on adolescent and .
Illegal Drug Problem in the City of Ormoc As Perceived By User and Non-User R...inventionjournals
The study was conducted primarily to: describe the socio-demographic characteristics of user and non-user respondents; determine the reasons for engaging in illegal drugs among user respondents; document local and national ordinances enacted against illegal drug users; and identify the programs implemented by government and non-government organizations to make the City of Ormoc a drug-free community. The results of the study revealed that the mean age of the illegal drug users was 22 years old. Majority of them were males whose income fell below P10,000.00 in the form of allowance. They were aware of the illegality of the drugs used. Marijuana was the dominant drug abused. Influence of Peers and Curiosity were the topmost reasons why they got into drugs due to misinformation and assurance from friends who claim to have enjoyed the experience as perceived by the respondents. Among the National and Local Ordinances enacted against illegal drugs users in the City of Ormoc were: the implementation of RA 9165 – Dangerous Drugs Act of 2002; LOI 36/97: ALPHA BANAT (Barangay Against Narcotics Abusers and Traffickers) and Information dissemination of the ill effects of drugs through the Barangay Anti-Drug Abuse Counsel (BADAC).
Running head THE PSYCHOLOGICAL EFFECTS OF DOMESTIC VIOLENCE .docxagnesdcarey33086
Running head: THE PSYCHOLOGICAL EFFECTS OF DOMESTIC VIOLENCE 1
The Psychological Effects of Domestic Violence
Janet Goris
GEN499: General Education Capstone (GSV1514B)
Instructor: Lance Bernard
April 20, 2015
- 1 -
[no notes on this page]
THE PSYCHOLOGICAL EFFECTS OF DOMESTIC VIOLENCE 2
The Psychological Effects of Domestic Violence
Children who have witnessed violence between their parents have become visibly the
center of public attention. Domestic violence is a continuing experience of psychological,
physical, and sexual abuse in some homes. It is used to establish control and power over one
another. Major research has focused on the implications of domestic violence on some key
victims. Witnessing domestic violence has major effects on “secondary victims including
children who live in houses where the partners fight. In America, for instance, 3.2 million
children witness incidents of violence annually.” (Bowland, 2012) It is important to understand
that there are secondary impacts of domestic violence. Witnessing violence can cause children to
develop negative including psychological ones. Women whose rights were violated may also be
affected by these events. They are at a risk of internalized behavior including depression and
anxiety, while children are at a risk of externalized behavior, including bullying, fighting, lying,
and cheating. The results of these are disobedience in school and at home and social competence
problems including difficulty in relationships with others and poor school performance. This
paper reviews literature on the primary and secondary psychological impacts of domestic
violence, and how it changes the victims.
Bowland, S., Edmond, T., & Fallot, R. D. (2012). Evaluation of a spiritually focused
intervention with older trauma survivors. Social Work, 57(1), 73-82.
The study by Bowland et al. (2012) was used to evaluate the efficiency of an eleven-
session focus group involving older women who had endured domestic violence. It sought
information from women aged fifty-five and above and who survived personal trauma including
sexual assault, child abuse or domestic violence. The intention was to help reduce trauma-related
- 2 -
1
1. victims.
the thesis statement isn't
quite clear here [Lance
Bernard]
THE PSYCHOLOGICAL EFFECTS OF DOMESTIC VIOLENCE 3
depression symptoms ranging from anxiety, post-traumatic stress, and trauma-related depressive
symptoms. Forty three women were randomly picked for treatment. They discussed spiritual
struggles that come as a result of abuse and the spiritual resources the group developed for
handling. The group had low depressive symptoms and anxiety than the control group. In
another analysis, the symptoms of post-traumatic stress also dropped considerably. The results
were supported with a three month.
A research report on root causes, risk factors and preventive strategies. Research by Midrift Hurinet and the Danish Institute Against Torture (DIGNITY).
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
For Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #Girls
Gang Membership, Violence, and Psychiatric Morbidity
1. Article
Gang Membership, Violence, and
Psychiatric Morbidity
Jeremy W. Coid, M.D.
Simone Ullrich, Ph.D.
Robert Keers, Ph.D.
Paul Bebbington, M.D.
Bianca L. DeStavola, Ph.D.
Constantinos Kallis, Ph.D.
Min Yang, M.D.
David Reiss, M.D.
Rachel Jenkins, M.D.
Peter Donnelly, M.D.
Objective: Gang members engage in
many high-risk activities associated with
psychiatric morbidity, particularly violence-
related ones. The authors investigated
associations between gang membership,
violent behavior, psychiatric morbidity, and
use of mental health services.
Method: The authors conducted a cross-
sectional survey of 4,664 men 18–34 years
of age in Great Britain using random
location sampling. The survey oversampled
men from areas with high levels of violence
and gang activities. Participants completed
questionnaires covering gang membership,
violence, use of mental health services, and
psychiatric diagnoses measured using stan-
dardized screening instruments.
Results: Violent men and gang members
had higher prevalences of mental disor-
ders and use of psychiatric services than
nonviolent men, but a lower prevalence of
depression. Violent ruminative thinking,
violent victimization, and fear of further
victimization accounted for the high levels
of psychosis and anxiety disorders in gang
members, and with service use in gang
members and other violent men. Associa-
tions with antisocial personality disorder,
substance misuse, and suicide attempts
were explained by factors other than
violence.
Conclusions: Gang members show inor-
dinately high levels of psychiatric morbid-
ity, placing a heavy burden on mental
health services. Traumatization and fear of
further violence, exceptionally prevalent
in gang members, are associated with
service use. Gang membership should be
routinely assessed in individuals present-
ing to health care services in areas with
high levels of violence and gang activity.
Health care professionals may have an
important role in promoting desistence
from gang activity.
(Am J Psychiatry 2013; 170:985–993)
Violence is a defining characteristic of gang member-
ship (1, 2), together with extensive criminality and sub-
stance misuse (3). Street gangs are increasingly evident in
U.K. cities (1, 4), with similarities to gangs in the United
States, where fluctuations in gang activity correspond to
changes in homicide rates (5), youth violence, and vic-
timization (6, 7). Gun control has resulted in low rates
of homicides involving firearms in the United Kingdom,
but gang members are estimated to carry out half of all
shootings and 22% of serious violent crimes in London (1).
The spread of gang-related violence is held to resemble an
epidemiological “core infection” model (8) through a pro-
cess of social contagion (9) in which gangs evaluate and
respond to the highly visible violent actions of other gangs,
retaliate, and attempt to achieve dominance through
violent retribution (10). Violence is necessary for building
and maintaining personal status and enforcing group
cohesion, is instrumental in obtaining sexual access and
money through robbery and intimidation, and may be
a source of excitement. It is essential to the regulation of
local drugs markets by organized gangs (11). Gang violence
represents a major public health problem. Gang members
engage not only with criminal justice agencies (1) but also
with the health care system, by multiple entry points,
particularly trauma services (2). To our knowledge, no
previous research has investigated whether gang violence
is related to psychiatric morbidity (other than substance
misuse) or places burdens on mental health services.
Epidemiological studies have shown that psychiatric
morbidity is associated with violent behavior (12–15),
although the mechanisms involved are complex and are
not fully understood. In addition to violence toward
others, gang violence can result in high levels of traumatic
victimization and fear of violence (16).
Through their violence, gang members are potentially
exposed to multiple risk factors for psychiatric morbidity.
Our aim in this study was to investigate associations
between gang membership, violent behavior, and psy-
chiatric morbidity in a nationally representative sample
of young men and to identify explanatory factors. We
examined associations between violent behaviors, atti-
tudes toward and experiences of violence, a range of
mental disorders, and use of mental health services. To
identify the specific effects of gang membership, we
compared gang members with young men who were
violent but not in gangs.
This article is featured in this month’s AJP Audio and is discussed in an Editorial by Dr. Monahan (p. 942)
Am J Psychiatry 170:9, September 2013 ajp.psychiatryonline.org 985
2. Method
Data Collection
We carried out the survey in 2011. It was based on random
location sampling, an advanced form of quota sampling shown
to reduce the biases introduced when interviewers choose
a location to sample from. Individual sampling units (census
areas of 150 households each) were randomly selected within
British regions, in proportion to their population. The basic
survey derived a representative sample of young men (18–34
years of age) from England, Scotland, and Wales. In addition,
there were four boost surveys. First, young black and minority
ethnic men were selected from output areas with a minimum of
5% black and minority ethnic inhabitants. Second, young men
from the lower social grades (grades D and E, as defined by the
Market Research Society, based on head of household: semi-
skilled, unskilled, and occasional manual workers; and pen-
sioners and welfare recipients) were selected from output areas
in which there were a minimum of 30 men 18–64 years of age in
these social grades. The final boost surveys were based on output
areas in two locations characterized by high gang membership,
the London borough of Hackney and Glasgow East, Scotland.
The same sampling principles applied to each survey type.
A self-administered questionnaire piloted in a previous survey
was adapted for this one. Informed consent was obtained from all
survey respondents. Respondents completed the pencil-and-paper
questionnaire in privacy and were paid £5 for their participation.
Survey Measures
The Psychosis Screening Questionnaire (17) was used to
screen participants for psychosis; a positive screening was one in
which three or more criteria were met. Questions from the
Structured Clinical Interview for DSM-IV Personality Disorders
Screening Questionnaire (18) identified antisocial personality
disorder.
The Hospital Anxiety and Depression Scale (19) was used to define
anxiety and depression, based on a score $11 in the past week.
Scores $20 on the Alcohol Use Disorders Identification Test (20) and
scores $25 on the the Drug Use Disorders Identification Test (21)
were used to identify alcohol or drug dependence, respectively.
Participants were asked if they had ever deliberately attempted
to kill themselves. They were also asked whether they were
currently taking any prescribed psychotropic medications, had
consulted a medical practitioner over the past 12 months for
mental health problems, had ever seen a psychiatrist or psychol-
ogist, or had ever been admitted to a psychiatric hospital.
Gang Membership and Violence
All participants were questioned about violent behavior,
including whether they had been “in a physical fight, assaulted
or deliberately hit anyone in the past 5 years,” as used in previous
surveys of violence (13, 15). Information was sought about the
number of violent incidents they had been involved in and their
attitudes toward and experiences of violence. They were ad-
ditionally asked, “Are you currently a member of a gang?” For
inclusion in the study, gang members had to endorse gang
membership and one or more of the following: serious criminal
activities or convictions, involvement with friends in criminal
activities, or involvement in gang fights during the past 5 years.
Participants were divided into three mutually exclusive groups
according to participation in violence and gang membership: 1)
nonviolent men—participants reporting no violent behavior over
the past 5 years and no gang membership; 2) violent men—
participants reporting violence over the past 5 years but no
gang membership or involvement in gang fights; and 3) gang
members.
Statistical Analysis
Initially, we compared the demographic characteristics of non-
violent men, violent men, and gang members using logistic re-
gressions to identify potential confounders. Three analyses were
performed, comparing nonviolent men and violent men, nonviolent
men and gang members, and violent men and gang members.
Differences between the nonviolent men, the violent men, and
the gang members with respect to psychopathology and service
use were established by performing logistic regression analyses
in the three comparison groups. Linear trends were established
by entering group membership as an ordinal variable. As above,
three analyses were conducted, comparing nonviolent men and
violent men, nonviolent men and gang members, and violent
men and gang members.
Finally, we investigated whether associations between 1) gang
membership, 2) violence, and 3) psychopathology or service
use were explained by attitudes toward violence, victimiza-
tion experiences, and characteristics of violent behaviors. Po-
tential explanatory variables were first identified by testing
their association with 1) gang membership or violence and 2)
psychopathology or service use. Only if both associations were
significant at an alpha level of 0.05 were variables selected and
then entered in an adjusted model, with group membership as
the independent variable and psychopathology or service use as
the dependent variable. We examined the percentage reduction
in the baseline odds of each mental disorder and type of service
use after adding each of the potentially explanatory variables into
the following equation: (bunadjusted 2 badjusted) / bunadjusted 3
100. In a final model, all explanatory variables were entered
simultaneously. Comparisons between baseline-adjusted and
fully adjusted coefficients were used to estimate the extent to
which the association between group membership and psycho-
pathology or service use was accounted for by the explanatory
variable.
To control for differences between samples, survey type was
included as a covariate in all analyses. We also used robust
standard errors to account for correlations within survey areas
because of clustering within postal codes. An alpha level of 0.05
was adopted throughout. All analyses were performed in Stata,
version 12 (StataCorp, College Station, Tex.).
Results
Demography and Sampling
The weighted sample included 4,664 men 18–34 years of
age: 1,822 (39.1%) from the main survey; 969 (20.8%) from
the ethnic minority sample; 555 (11.9%) from the sample
of men from lower social classes; 624 (13.4%) from Hackney;
and 694 (14.9%) from Glasgow East. Of the total sample,
3,285 (70.4%) reported no violence over the past 5 years,
1,272 (27.3%) reported assaulting another person or in-
volvement in a fight, and 108 (2.1%) reported current gang
membership.
Violent men were younger on average than nonviolent
men, more were U.K. born and unemployed, and fewer
were black or from the Indian subcontinent. Gang
members were also younger than nonviolent men, less
likely to be single and non-U.K. born, and more likely to
be unemployed, black, and from the Indian subcontinent.
Compared with violent nonmembers, fewer gang mem-
bers were single and non-U.K. born, while more were of
minority ethnic origin (Table 1).
986 ajp.psychiatryonline.org Am J Psychiatry 170:9, September 2013
GANG MEMBERSHIP, VIOLENCE, AND PSYCHIATRIC MORBIDITY
3. Psychiatric Morbidity and Service Use
Table 2 summarizes the psychiatric morbidity and
service use of nonviolent men, violent men, and gang
members. The data show a marked gradient: psychiatric
morbidity and service use were infrequent among non-
violent men but increased progressively from violent
nonmembers to gang members. This gradient was con-
firmed for all outcomes (p,0.001) except depression.
The three pairwise sets of analyses were used to explore
the relationships in more detail (Table 2). Violent men
differed significantly from nonviolent men on all mea-
sures of psychopathology except drug dependence, and
on all service use variables. The differences between
gang members and nonviolent men in relation to psy-
chopathology and service use were considerably greater
(Figure 1). After adjustment, depression was signifi-
cantly less prevalent among gang members and violent
men. Gang members were significantly less likely than
violent men to be depressed but demonstrated higher
levels of other mental disorders, except psychosis and
anxiety disorders. They were also significantly more
likely than violent men to report use of all forms of service
(Table 2).
Attitudes Toward Violence and Victimization and
Characteristics of Violent Behavior
As shown in Table 2, violent men differed from the
nonviolent reference group in their attitudes toward
violence and violent victimization. However, greater dif-
ferences were observed between gang members and
nonviolent men. Gang members were significantly more
likely than nonviolent men to have been victims of vi-
olence and to fear further violent victimization. They
were also more likely to experience violent ruminations
and more prepared to act violently if disrespected. These
attitudes and experiences were also significantly higher in
gang members than in violent men. The characteristics of
violence among gang members also differed considerably
from those in violent men who were not gang members.
Gang members reported significantly more violent inci-
dents and were more likely to have previous convictions
for violence, to report using instrumental violence, and to
be excited by violence (Table 2).
Explaining Links Between Psychopathology, Service
Use, and Violence/Gang Membership
Violent men and gang members were significantly more
likely to acknowledge positive attitudes toward violence,
increased violent victimization, and more severe charac-
teristics of violence (Table 2). Many of these same variables
were significantly associated with psychopathology and
service use (see Table S1 in the data supplement that
accompanies the online edition of this article). We therefore
investigated whether violence variables explained the
elevated rates of psychopathology and service use among
violent men and gang members.
TABLE 1. Demographic Characteristics of Nonviolent and Violent Men and Gang Members
Violent Men Compared
With Nonviolent Men
Gang Members
Compared With
Nonviolent Men
Gang Members
Compared With Violent
Men
Characteristic
Nonviolent
Men
Violent
Men
Gang
Members
Adjusted
Odds Ratio 95% CI
Adjusted
Odds Ratio 95% CI
Adjusted
Odds Ratio 95% CI
N % N % N %
Non-U.K. born 520 16.1 102 8.1 5 4.6 0.76* 0.58, 0.99 0.15*** 0.06, 0.38 0.19** 0.07, 0.51
Single 1,944 59.9 862 68.1 70 57.7 1.16 0.97, 1.39 0.45** 0.27, 0.74 0.38*** 0.23, 0.65
Unemployed 1,128 35.1 542 43.8 51 50.4 1.23* 1.04, 1.45 1.96** 1.21, 3.16 1.59 0.97, 2.61
Ethnicity
White
(reference)
1,961 59.8 980 77.1 37 34.1
Black 473 14.4 135 10.6 53 49.3 0.62** 0.45, 0.85 9.81*** 5.50, 17.48 15.9*** 8.57, 29.50
Indian
subcontinent
788 24.0 143 11.2 16 15.3 0.41*** 0.29, 0.57 2.36* 1.15, 4.87 5.78*** 2.71, 12.30
Other 57 1.7 13 1.0 1 1.2 0.62 0.30, 1.28 2.3 0.52, 10.29 3.74 0.75, 18.75
Survey type
Main
(reference)
1,228 37.4 575 45.2 19 17.8
Ethnic
minorities
786 23.9 175 13.8 8 7.9 0.85 0.58, 1.24 0.27* 0.10, 0.74 0.32* 0.11, 0.89
Lower social
classes
350 10.7 190 14.9 16 14.6 1.06 0.84, 1.33 2.41* 1.09, 5.33 2.28* 1.04, 5.01
London,
Hackney
459 14.0 111 8.7 54 49.9 0.66* 0.48, 0.90 4.04** 1.83, 8.92 6.16*** 2.86, 13.26
Glasgow East 462 14.1 221 17.4 11 9.8 0.83 0.63, 1.08 2.39 0.84, 6.82 2.89* 1.01, 8.25
Mean SD Mean SD Mean SD
Age (years) 26.6 4.9 25.4 5.0 25.1 5.3 0.96*** 0.94, 0.97 0.93** 0.88, 0.98 0.97 0.92, 1.02
*p,0.05. **p,0.01. ***p,0.001.
Am J Psychiatry 170:9, September 2013 ajp.psychiatryonline.org 987
COID, ULLRICH, KEERS, ET AL.
4. Table 3 presents the change in odds of psychopathol-
ogy and service use among violent men after accounting
for their attitudes toward violence and their violent
victimization experiences (percentage of change in odds
explained by these variables). Once violent ruminations,
fear of victimization, and violent victimization were taken
into account, some of the previously observed associations
between violent men and psychosis were considerably
reduced in size and no longer significant. These same
variables also explained the elevated likelihood in this
TABLE 2. Independent Associations of Violence and Gang Membership With Psychiatric Morbidity and Service Usea
Nonviolent
Men
Violent
Men
Gang
Members
Violent Men Compared
With Nonviolent Men
Gang Members Compared
With Nonviolent Men
Gang Members
Compared With
Violent Men
Measure N % N % N %
Adjusted
Odds Ratio 95% CI
Adjusted
Odds Ratio 95% CI
Adjusted
Odds Ratio 95% CI
Psychiatric
morbidity
Psychosisb
25 0.8 61 4.9 26 25.1 2.94** 1.49, 5.78 4.16** 1.50, 11.59 1.42 0.54, 3.68
Anxietyb
343 10.6 242 19.2 63 58.9 1.83*** 1.39, 2.42 2.25* 1.09, 4.65 1.23 0.61, 2.45
Depressionb
303 9.4 107 8.5 21 19.7 0.65* 0.44, 0.97 0.18** 0.05, 0.63 0.27* 0.08, 0.89
Alcohol
dependenceb
191 6.0 174 14.2 68 66.6 1.63** 1.14, 2.34 6.49*** 3.04, 13.87 3.97*** 1.90, 8.30
Drug dependenceb
26 0.8 61 5.0 59 57.4 1.40 0.59, 3.33 12.71*** 3.64, 44.37 9.06*** 3.60, 22.83
Antisocial
personality
disorderb
117 3.6 359 29.2 86 85.8 8.84*** 6.75, 11.58 57.39*** 23.94, 137.62 6.49*** 2.73, 15.43
Suicide attemptc
94 2.9 121 9.7 35 34.2 3.32*** 2.40, 4.60 13.09*** 7.74, 22.16 3.94*** 2.34, 6.63
Psychiatric
service usec
Consulted medical
practitioner
213 6.6 144 11.4 28 27.1 1.91*** 1.48, 2.48 4.31*** 2.33, 7.96 2.25** 1.21, 4.18
Consulted
psychiatrist or
psychologist
40 1.2 45 3.6 13 12.1 2.71*** 1.65, 4.47 7.75*** 3.51, 17.10 2.86** 1.29, 6.32
Psychiatric
admission
76 2.4 63 5.0 21 20.7 2.21*** 1.48, 3.29 7.80*** 3.66, 16.62 3.53*** 1.67, 7.46
Psychotropic
medication
95 3.0 77 6.3 16 15.9 2.04*** 1.44, 2.89 5.00*** 2.23, 11.22 2.45* 1.11, 5.41
Attitudes toward
violencec
Violent if
disrespected
272 9.3 513 46.7 87 87.3 8.84*** 7.18, 10.89 68.27*** 29.81, 156.34 8.10*** 3.65, 17.97
Violent ruminations 98 3.1 202 17.0 68 70.1 5.49*** 4.10, 7.36 61.76*** 34.71, 109.88 12.63*** 7.33, 21.75
Violent
victimizationc
Fear violent
victimization
510 16.3 236 19.5 67 65.4 1.32** 1.08, 1.62 8.84*** 5.00, 15.62 6.69*** 3.78, 11.86
Violent victimization 281 8.6 410 32.2 41 38.6 4.96*** 4.03, 6.10 10.37*** 6.17, 17.45 2.09** 1.25, 3.50
Characteristics of
violencec
Number of violent
incidents
0 0 0 10 10.0 4.70*** 2.21, 20.00
1 238 23.1 1 0.9
2 336 32.6 10 9.9
$3 456 44.3 80 79.1
Previous conviction
for violence
208 16.4 37 34.6 7.54*** 3.99, 14.23
Excited by violence 203 16.4 58 62.8 7.87*** 4.39, 14.13
Instrumental
violence
122 9.7 77 72.7 21.80*** 12.20, 38.96
a
All 95% confidence intervals are computed using robust standard errors to account for correlations within survey areas due to clustering
within postal codes.
b
Adjusted for all other psychiatric morbidity outcomes, non-U.K. birth, being single, unemployment, ethnicity, age, Index of Multiple
Deprivation (a relative measure of deprivation at small-area level across the United Kingdom), and survey type.
c
Adjusted for non-U.K. birth, being single, unemployment, ethnicity, age, Index of Multiple Deprivation, and survey type.
*p,0.05. **p,0.01. ***p,0.001.
988 ajp.psychiatryonline.org Am J Psychiatry 170:9, September 2013
GANG MEMBERSHIP, VIOLENCE, AND PSYCHIATRIC MORBIDITY
5. group of having consulted a psychiatrist or psychologist
and of psychiatric admission. However, these reductions
were not seen for some of the outcomes: anxiety disorders,
alcohol dependence, antisocial personality disorder, sui-
cide attempt, general practitioner consultation, and use of
psychotropic medication were reduced in size but still
significant.
A similar pattern was observed when gang members
were compared with nonviolent men (Table 4), with the
addition that the discrepant prevalence of anxiety disor-
ders was also explained by violent ruminations, fear of
victimization, and being a victim of violence.
Comparison of gang members and violent men (see
Tables S2 and S3 in the online data supplement) showed
that their higher rates of antisocial personality disorder,
suicide attempt, consultation with a psychiatrist or psy-
chologist, and psychiatric admission were substantially
explained by their positive attitudes toward violence, their
greater victimization experiences, and the characteristics of
their violent behavior.
Discussion
We found inordinately high levels of psychiatric mor-
bidity and associated health service use among young
British men who are gang members. Street gangs are
concentrated in inner urban areas characterized by
socioeconomic deprivation, high crime rates, and multiple
social problems (1). One percent of men 18–34 years of
age in Great Britain are gang members, compared with
8.6% in the London borough of Hackney, where 1 in 5
black men in that age group reported gang membership.
Our findings imply that gang members make a large
contribution to mental health disability and burden on
mental health services in these areas. This represents an
important public health problem, previously unreported.
We found a marked gradient in level of psychopathol-
ogy across the three groups. In general, mental disorders
were more prevalent among violent men and gang mem-
bers than among nonviolent men, and both groups re-
ported significantly higher use of psychiatric services.
However, depression was less prevalent among violent
men and gang members. Violence can be construed as one
of several displacement activities and mechanisms for en-
hancing self-esteem that are used to reduce the deleterious
effects of negative environment, including childhood mal-
treatment and educational failure (22). However, since we
cannot determine the direction of association, it is equally
possible that higher levels of depression resulted in a re-
duction of violence because depressed individuals are less
inclined or able to behave violently.
Violent men did not differ from the nonviolent reference
group with respect to their relatively low prevalence of
drug dependence. In contrast, over half of gang members
had drug dependence. This is unsurprising given the large
proportion of gang members actively involved in the
underground drug economy.
The associations with antisocial personality disorder
were unsurprising, as violence before age 15 persisting into
adulthood is a criterion for this diagnosis. Criminality and
violence both demonstrate escalation in frequency during
gang membership (23). Associations with lifetime suicide
attempts may partly reflect other psychiatric morbidity,
including anxiety disorders and depression. However, they
also correspond to the notion that impulsive violence may
be directed both outward and inward (24). The relationship
FIGURE 1. Adjusted Odds Ratios of Psychiatric Morbidity and Service Use for Violent Men and Gang Members Compared With
Nonviolent Men as Reference Groupa
0.01 0.1 1 10 100 1000
Psychosis
Anxiety disorders
Depression
Antisocial personality disorder
Alcohol dependence
Drug dependence
Suicide attempt
Consulted medical practitioner
Consulted psychiatrist or psychologist
Psychiatric admission
Psychotropic medication
Adjusted Odds Radio
Violent men
Gang members
a
Error bars indicate 95% confidence intervals.
Am J Psychiatry 170:9, September 2013 ajp.psychiatryonline.org 989
COID, ULLRICH, KEERS, ET AL.
6. between alcohol misuse and violence is highly complex (25).
However, heavy alcohol use is a well-documented aspect of
gang life (26) and a well-established risk factor for violent
behavior.
The high prevalences of anxiety disorders and positive
screening for psychosis among gang members were un-
expected. Although psychotic illness and psychiatric
admissions are more common in inner urban areas,
including those characterized by gang violence, these
factors could have provided only a partial explanation.
This issue warrants further investigation.
Characteristics of Violence
Violence is commonly reported by young men, and 1 in
3 of our nationally representative sample reported getting
into a fight or assaulting someone in the past 5 years.
Correspondingly, fear of violent victimization was rela-
tively high even among young British men who did not
report violence. Nevertheless, rates of violent victimization
and fear of violent victimization were significantly higher
among violent men and greater still among gang mem-
bers. Frequent violent ruminations and the propensity
to react violently to perceived disrespect differentiated
violent and nonviolent men but were highest in gang
members.
There were quantitative and qualitative differences in
the violence of gang members and other violent men.
Instrumental (purposeful) violence was a defining char-
acteristic of gang activity, as was repetitive violence.
Gang members were also more likely to report violent
TABLE 3. Testing Explanations for the Links Between Gang Membership, Violence, and Psychopathology and Service Use:
Violent Compared With Nonviolent Mena
Baseline Violent If Disrespected Violent Ruminations
Measure Odds Ratio 95% CI Odds Ratio 95% CI %b
Odds Ratio 95% CI %b
Psychosis 2.94** 1.49–5.78 — 2.43* 1.19–4.98 18
Anxiety 1.83*** 1.39–2.42 — 1.79*** 1.34–2.39 4
Depression 0.65* 0.44–0.97 — —
Alcohol dependence 1.63** 1.14–2.34 — 1.56* 1.07–2.28 9
Antisocial personality disorder 8.84*** 6.75–11.58 5.47*** 4.01–7.45 22 7.50*** 5.63–10.00 8
Suicide attempt 3.32*** 2.40–4.60 2.93*** 1.94–4.43 10 2.74*** 1.91–3.94 16
Consulted medical practitioner 1.91*** 1.48–2.48 — —
Consulted psychiatrist or psychologist 2.71*** 1.65–4.47 — —
Psychiatric admission 2.21*** 1.48–3.29 — 1.81** 1.20–2.74 25
Psychotropic medication 2.04*** 1.44–2.89 — —
a
All 95% confidence intervals are computed using robust standard errors to account for correlations within survey areas resulting from
clustering within postal codes.
b
Percentage change in beta coefficient (beta=log[odds ratio]) from baseline model to final adjusted model.
*p,0.05. **p,0.01. ***p,0.001.
TABLE 4. Testing Explanations for the Link Between Gang Membership, Violence, and Psychopathology and Service Use:
Gang Members Compared With Nonviolent Mena
Baseline Violent If Disrespected Violent Ruminations
Measure Odds Ratio 95% CI Odds Ratio 95% CI %b
Odds Ratio 95% CI %b
Psychosis 4.16** 1.50–11.59 — 3.46* 1.06–11.25 13
Anxiety 2.25* 1.09–4.65 — 2.00 0.88–4.54 14
Depression 0.18** 0.05–0.63 — —
Alcohol dependence 6.49*** 3.04–13.87 — 5.05*** 2.06–12.37 13
Drug dependence 12.71*** 3.64–44.37 6.51** 1.81–23.38 26 10.76** 2.53–45.79 7
Antisocial personality
disorder
57.39*** 23.94–137.62 33.60*** 11.98–94.28 13 45.26*** 15.66–130.83 6
Suicide attempt 13.09*** 7.74–22.16 9.57*** 5.10–17.98 12 5.92*** 3.12–11.24 31
Consulted medical
practitioner
4.31*** 2.33–7.96 — —
Consulted psychiatrist
or psychologist
7.75*** 3.51–17.10 — —
Psychiatric admission 7.80*** 3.66–16.62 — 5.60*** 2.48–12.64 16
Psychotropic medication 5.00*** 2.23–11.22 — —
a
All 95% confidence intervals are computed using robust standard errors to account for correlations within survey areas resulting from
clustering within postal codes.
b
Percentage change in beta coefficient (beta=log[odds ratio]) from baseline model to final adjusted model.
*p,0.05. **p,0.01. ***p,0.001.
990 ajp.psychiatryonline.org Am J Psychiatry 170:9, September 2013
GANG MEMBERSHIP, VIOLENCE, AND PSYCHIATRIC MORBIDITY
7. ruminations, excitement from violence, and being pre-
pared to be violent if disrespected. They were corre-
spondingly more likely to have criminal convictions for
violence.
Can the Associations With Psychopathology and
Service Use Be Explained by Characteristics of
Violence?
Given that violent men and gang members were
significantly more likely to have positive attitudes toward
violence, more experiences of violence, and fear of violent
victimization and that violence among gang members was
qualitatively different than among violent men, we in-
vestigated whether these factors explained the increased
psychiatric morbidity and service use in these groups. We
found that none of these variables explained the high
levels of alcohol and drug dependence, antisocial person-
ality disorder, and suicide attempts or the lower rates of
depression, suggesting that they were accounted for by
other, unmeasured, variables. However, the combination
of violent ruminations, experiences of being violently
victimized, and fear of future victimization explained
associations of gang membership with both anxiety dis-
orders and psychosis. Violent men who were not gang
members also reported significantly higher levels of anx-
iety disorders. However, in contrast to gang members,
their anxiety was not explained by violent characteristics
as demonstrated for gang members, suggesting that the
causes of anxiety in gang members differ from those of
other violent young men.
The high levels of consultations with psychiatrists or
psychologists among violent men and gang members were
accounted for by their fear of, and actual experiences
of, violent victimization. These variables, together with
violent ruminations, also explained their high rates of
Fear of Victimization Victim of Violence Final Model
Odds Ratio 95% CI %b
Odds Ratio 95% CI %b
Odds Ratio 95% CI %b
2.91** 1.48–5.74 1 2.67** 1.34–5.32 9 2.04 0.99–4.21 34
1.76*** 1.32–2.33 7 1.70*** 1.28–2.26 12 1.58** 1.15–2.16 25
— — 0.65* 0.44–0.97 0
— — 1.56* 1.07–2.28 9
— 7.46*** 5.65–9.85 8 4.43*** 3.19–6.15 32
3.26*** 2.33–4.55 2 2.47*** 1.74–3.50 25 2.08** 1.34–3.23 39
1.56** 1.18–2.06 32 1.56** 1.18–2.06 32
2.44*** 1.45–4.12 10 1.84* 1.08–3.16 39 1.70 0.98–2.97 47
1.95** 1.30–2.91 16 1.65* 1.05–2.58 37 1.28 0.80–2.07 69
1.81** 1.24–2.65 16 — 1.81** 1.24–2.65 16
Fear of Victimization Victim of Violence Final Model
Odds Ratio 95% CI %b
Odds Ratio 95% CI %b
Odds Ratio 95% CI %b
3.83* 1.29–11.35 6 3.75* 1.29–10.85 7 2.77 0.76–10.14 28
1.66 0.76–3.62 38 2.15* 1.03–4.46 6 1.04 0.40–2.75 95
— — 0.18** 0.05–0.63 0
— — 5.05*** 2.06–12.37 13
14.28*** 4.24–48.13 –5 11.00*** 3.24–37.36 6 5.46* 1.41–21.07 33
— 52.13*** 21.80–124.64 2 22.64*** 7.62–67.28 23
8.65*** 4.97–15.04 16 8.90*** 5.09–15.54 15 2.82* 1.25–6.34 60
3.25*** 1.71–6.19 19 3.25*** 1.71–6.19 19
3.61** 1.50–8.70 37 4.53*** 1.96–10.51 26 2.26 0.92–5.52 60
3.42** 1.57–7.44 40 5.30*** 2.38–11.80 19 1.96 0.78–4.92 67
2.73* 1.18–6.29 38 — 2.73* 1.18–6.29 38
Am J Psychiatry 170:9, September 2013 ajp.psychiatryonline.org 991
COID, ULLRICH, KEERS, ET AL.
8. admission to psychiatric hospitals, suggesting the impor-
tance of violent traumatization in determining service use.
Posttraumatic stress disorder (PTSD) is the most frequent
psychiatric outcome of exposure to violence. Epidemio-
logical surveys suggest that 15%224% of those exposed
will develop PTSD, with the highest risk following violent
assault (27). Psychotic symptoms frequently occur in PTSD
(28) and have been reported as particularly frequent
among military combat veterans (29). Additional symp-
toms include anxiety and misuse of alcohol. It has been
suggested that gang membership increases the risk of
posttraumatic stress (30). Furthermore, a combination of
PTSD and psychotic illness is associated with high levels
of cognitive, emotional, and behavioral disturbance, in-
cluding violent ruminations and behaviors (31). It is prob-
able that among gang members, high levels of anxiety
disorders and psychosis were explained by PTSD. How-
ever, this would only partly explain the high prevalence
of positive screens for psychosis in gang members.
Psychosis is more likely than PTSD to lead to psychiatric
hospitalization in the United Kingdom. Further research
should determine whether the high prevalence of posi-
tive screens for psychosis among gang members was
explained by psychotic illness or severe PTSD with psy-
chotic symptoms.
Limitations
Our survey had several limitations, including the def-
inition used to determine gang membership. However,
there is no consensus about definition because gang
structures have considerable heterogeneity. Nevertheless,
we included three of the five U.K. criminal justice agency
criteria (1) that could be captured using self-report, cov-
ering predominantly street-based individuals who see
themselves as a discernible group, engage in criminal
activity or violence, and are in conflict with similar gangs.
However, because participants were 18–34 years of age
and the mean age for gang membership in the United
Kingdom is 15 years, gang members in this study should be
considered “core” members who have not desisted by
early adulthood. Longitudinal study is needed to in-
vestigate whether age and remaining in the gang were
key factors determining our findings (32). Furthermore,
U.S. national surveillance studies of gangs have observed
longitudinal trends of increased prevalence of gang
members 18 years and above.
Violent behavior within the past 5 years was also
assessed by self-report and did not include objective
information, such as data on arrests or convictions. Self-
report may have underestimated the true prevalence
because socially undesirable behaviors tend to be less
frequently reported. Diagnoses were also derived from
self-report questionnaires and not confirmed by clinical
interview, although self-report instruments can compare
favorably with clinicians’ assessments (33). Furthermore,
prevalences of mental disorders among young men in two
previous surveys in Great Britain (34, 35) were similar to
those of nonviolent men in this survey.
Dating of episodes of mental disorders proved difficult,
and we did not identify whether violent incidents related
to times when symptoms were present. However, the
community-based design and large sample size allowed us
to examine associations between different categories of
mental disorders and violent behavior, thus avoiding the
selection bias associated with clinical samples. Further-
more, the sample size provided sufficient statistical power
to test complex models and to control for confounding
from demographic characteristics and comorbidity.
Implications
Our study highlights a complex public health problem at
the intersection of violence, substance misuse, and mental
health problems among young men. Gang membership
and involvement in gang violence should be routinely
assessed in young men presenting to health care services
with psychiatric morbidity in inner urban areas with high
levels of gang activity. Risk of relapse and failed in-
tervention are elevated among those who return to gang
activities, and gang members should be helped to un-
derstand the risks to their mental health. Readiness to
retaliate violently if disrespected, excitement from vio-
lence, and short-term benefits from instrumental violence
lead to further cycles of violence and risk of violent
victimization (36). Our study suggests that these factors
can increase anxiety to a level that requires treatment and
can increase the risk of psychotic symptoms. Substance
misuse, while temporarily increasing excitement and
reducing the associated anxiety, may increase anxiety
and paranoid thinking in the long term and be accompa-
nied by additional addictive behaviors (37).
Further research is needed on effective interventions for
gang members with psychiatric morbidity. Other risk
factors that were not measured here but to which gang
members are more frequently exposed are likely to
contribute to a high prevalence of psychiatric morbidity
and use of health care services—for example, involvement
in the underground drug economy and drug dependence,
which may increase risk for other psychiatric disorders
irrespective of involvement in violence. Nevertheless,
violent victimization and fear of further violence were
predominant explanations for high levels of service use.
Violent victimization is an important motivator for leaving
the gang (38), suggesting that health care professionals
may have a key role in helping gang members disassociate
from gang activities.
Received Sept. 10, 2012; revision received March 19, 2013;
accepted April 25, 2013 (doi: 10.1176/appi.ajp.2013.12091188).
From the Forensic Psychiatry Research Unit, Queen Mary University
of London. Address correspondence to Dr. Coid (j.w.coid@qmul.ac.
uk).
All authors report no financial relationships with commercial
interests.
992 ajp.psychiatryonline.org Am J Psychiatry 170:9, September 2013
GANG MEMBERSHIP, VIOLENCE, AND PSYCHIATRIC MORBIDITY
9. The survey was funded by the Maurice and Jacqueline Bennett
Charitable Trust and the U.K. National Institute for Health Research
(NIHR). Drs. Coid, Kallis, Keers, and Ullrich were supported by a Program
Grant for Applied Research, program RP-PG-0407-10500, from NIHR.
References
1. Government of the United Kingdom: Ending Gang and Youth
Violence: A Cross-Government Report Including Further Evi-
dence and Good Practice Case Studies. London, The Stationery
Office, 2011
2. Decker SH: Youth gangs and violent behaviour, in The Cam-
bridge Handbook of Violent Behavior and Aggression. Edited by
Flannery DJ, Vazsonyi A, Waldman ID. New York, Cambridge
University Press, 2007, pp 388–402
3. Thornberry TP, Freeman-Gallant A, Lizotte AJ, Krohn MD, Smith
CA: Linked lives: the intergenerational transmission of antisocial
behavior. J Abnorm Child Psychol 2003; 31:171–184
4. Bullock K, Tilley N: Understanding and tackling gang violence.
Crime Prev Community Saf 2008; 10:36–47
5. Robinson PL, Boscardin WJ, George SM, Teklehaimanot S, Heslin
KC, Bluthenthal RN: The effect of urban street gang densities on
small area homicide incidence in a large metropolitan county,
1994–2002. J Urban Health 2009; 86:511–523
6. Egley A, Howell J, Major AK: Recent patterns of gang problems
in the United States: results from the 1996–2002 National Youth
Gang Survey, in American Youth Gangs at the Millennium. Edi-
ted by Esbensen F-A, Tibbets SA, Gaines L. Prospect Heights, Ill,
Waveland Press, 2004, pp 90–108
7. Lynch JP: Trends in Juvenile Violence Offending: An Analysis of
Victim Survey Data (Office of Juvenile Justice and Delinquency
Bulletin). Washington, DC, US Department of Justice, Office of
Justice Programs, 2002
8. Laumann EO, Youm Y: Racial/ethnic group differences in the
prevalence of sexually transmitted diseases in the United States:
a network explanation. Sex Transm Dis 1999; 26:250–261
9. Fagan J, Wilkinson DL, Davies G: Social contagion of violence, in
The Cambridge Handbook of Violent Behavior and Aggression.
Edited by Flannery DJ, Vazsonyi A, Waldman ID. New York,
Cambridge University Press, 2007, pp 688–723
10. Papachristos AV: Murder by structure: dominance relations and
the social structure of gang homicide. AJS 2009; 115:74–128
11. Howell JC, Decker SH: The Youth Gangs, Drugs, and Violence
Connection (Juvenile Justice Bulletin). Washington, DC, De-
partment of Justice, Office of Justice Programs, Office of Juvenile
Justice and Delinquency Prevention, 1999
12. Swanson JW, Holzer CE 3rd, Ganju VK, Jono RT: Violence and
psychiatric disorder in the community: evidence from the Epi-
demiologic Catchment Area surveys. Hosp Community Psychi-
atry 1990; 41:761–770
13. Stueve A, Link BG: Violence and psychiatric disorders: results
from an epidemiological study of young adults in Israel. Psy-
chiatr Q 1997; 68:327–342
14. Corrigan PW, Watson AC: Findings from the National Comor-
bidity Survey on the frequency of violent behavior in individuals
with psychiatric disorders. Psychiatry Res 2005; 136:153–162
15. Coid J, Yang M, Roberts A, Ullrich S, Moran P, Bebbington P,
Brugha T, Jenkins R, Farrell M, Lewis G, Singleton N: Violence
and psychiatric morbidity in a national household population:
a report from the British Household Survey. Am J Epidemiol
2006; 164:1199–1208
16. Taylor TJ, Freng A, Esbensen F-A, Peterson D: Youth gang
membership and serious violent victimization: the importance
of lifestyles and routine activities. J Interpers Violence 2008; 23:
1441–1464
17. Bebbington PE, Nayan T: The Psychosis Screening Question-
naire. Int J Methods Psychiatr Res 1995; 5:11–19
18. Ullrich S, Deasy D, Smith J, Johnson B, Clarke M, Broughton N,
Coid J: Detecting personality disorders in the prison population
of England and Wales: comparing case identification using the
SCID-II screen and the SCID-II clinical interview. J Forensic Psy-
chiatry Psychol 2008; 19:301–322
19. Zigmond AS, Snaith RP: The Hospital Anxiety and Depression
Scale. Acta Psychiatr Scand 1983; 67:361–370
20. Babor TF, Higgings-Briddle JC, Saunders JB, Monteiro M: The
Alcohol Use Disorders Identification Test, 2nd ed. Geneva,
World Health Organization, 2001
21. Berman AH, Bergman H, Palmstierna T, Schlyter F: Evaluation
of the Drug Use Disorders Identification Test (DUDIT) in criminal
justice and detoxification settings and in a Swedish population
sample. Eur Addict Res 2005; 11:22–31
22. Heitmeyer W, Anhut R: Disintegration, recognition, and violence:
a theoretical perspective. New Dir Youth Dev 2008; 119:25–37
23. Farrington DP, Loeber R: Epidemiology of juvenile violence.
Child Adolesc Psychiatr Clin N Am 2000; 9:733–748
24. Dawes MA, Mathias CW, Richard DM, Hill-Kapturczak N,
Dougherty DM: Adolescent suicidal behaviour and substance
use: developmental mechanisms. Subst Abuse 2008; 2:13–28
25. White HR: Alcohol, illicit drugs, and violence, in Handbook of
Antisocial Behavior. Edited by Stoff DM, Breiling J, Maser JD.
New York, John Wiley, 1997, pp 511–523
26. Hunt GP, Laidler KJ: Alcohol and violence in the lives of gang
members. Alcohol Res Health 2001; 25:66–71
27. Wilcox HC, Storr CL, Breslau N: Posttraumatic stress disorder and
suicide attempts in a community sample of urban American
young adults. Arch Gen Psychiatry 2009; 66:305–311
28. Braakman MH, Kortmann FA, van den Brink W: Validity of “post-
traumatic stress disorder with secondary psychotic features”:
a review of the evidence. Acta Psychiatr Scand 2009; 119:15–24
29. David D, Kutcher GS, Jackson EI, Mellman TA: Psychotic symp-
toms in combat-related posttraumatic stress disorder. J Clin
Psychiatry 1999; 60:29–32
30. Li X, Stanton B, Pack R, Harris C, Cottrell L, Burns J: Risk and
protective factors associated with gang involvement among ur-
ban African American adolescents. Youth Soc 2002; 34:172–194
31. Sautter FJ, Brailey K, Uddo MM, Hamilton MF, Beard MG, Borges
AH: PTSD and comorbid psychotic disorder: comparison with
veterans diagnosed with PTSD or psychotic disorder. J Trauma
Stress 1999; 12:73–88
32. Silver E: Understanding the relationship between mental dis-
order and violence: the need for a criminological perspective.
Law Hum Behav 2006; 30:685–706
33. Wittchen HU, Ustün TB, Kessler RC: Diagnosing mental disorders
in the community: a difference that matters? Psychol Med
1999; 29:1021–1027
34. Singleton N, Bumpstead R, O’Brien M, Lee A, Multzer H: Psy-
chiatric Morbidity Among Adults Living in Private Households.
London, The Stationery Office, 2001
35. McManus S, Multzer H, Brugha T, Bebbington P, Jenkins R: Adult
Psychiatric Morbidity in England, 2007: Results of a Household
Survey. Leeds, National Centre for Social Research/NHS In-
formation Centre, 2009
36. Curry GD, Decker SH: Confronting Gangs: Crime and Commu-
nities. Los Angeles, Roxbury Press, 2003
37. Schneider S, Peters J, Bromberg U, Brassen S, Miedl SF, Banaschewski
T, Barker GJ, Conrod P, Flor H, Garavan H, Heinz A, Ittermann B,
Lathrop M, Loth E, Mann K, Martinot JL, Nees F, Paus T, Rietschel
M, Robbins TW, Smolka MN, Spanagel R, Ströhle A, Struve M,
Schumann G, Büchel C; IMAGEN Consortium: Risk taking and the
adolescent reward system: a potential common link to substance
abuse. Am J Psychiatry 2012; 169:39–46
38. Decker SH, Lavritsen JL: Leaving the gang, in Gangs in America
III. Edited by Huff CR. Thousand Oaks, Calif, Sage Publications,
2002, pp 51–70
Am J Psychiatry 170:9, September 2013 ajp.psychiatryonline.org 993
COID, ULLRICH, KEERS, ET AL.