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Victimization among African-American adolescents in substance abuse treatment.Victimization victimization Social medicine The abuse of the disenfranchised–eg, those underage, elderly, ♀, mentally retarded, illegal aliens, or other, by coercing them into illegal activities–eg, drug trade, pornography, prostitution. is the experience of direct or threatened harm, including physical violence, sexual violence, psychological or emotional abuse, and neglect (CDC See Control Data, century date change and Back Orifice.
CDC - Control Data Corporation 2007). Victimization among adolescents is a recognized public health concern, which motivated an in-depth report by the Office of the US Surgeon General The U.S. Surgeon General is charged with the protection and advancement of health in the United States. Since the 1960s the surgeon general has become a highly visible federal public health official, speaking out against known health risks such as tobacco use, and promoting disease (US DHHS DHHS Department of Health & Human Services (US government)
DHHS Dana Hills High School (Dana Point, California)
DHHS Deaf and Hard of Hearing Services
DHHS Deaf and Hard of Hearing Services 1999). A national survey found that approximately 17% of adolescents have been physically assaulted and 39% have witnessed violence (NIJ Noun 1. NIJ - the law enforcement agency that is the research and development branch of the Department of Justice
National Institute of Justice
Department of Justice, DoJ, Justice Department, Justice - the United States federal department responsible for 2003). Adolescents are twice as likely as adults to be victims of serious violent crimes (OJJDP OJJDP Office of Juvenile Justice and Delinquency Prevention (federal agency) 2000). Younger adolescents are also more likely to be both violently and nonviolently non·vi·o·lence
1. Lack of violence.
2. The doctrine, policy, or practice of rejecting violence in favor of peaceful tactics as a means of gaining political objectives. victimized than older adolescents (Van Dorn 2004).
Victimization occurs at a high rate among all adolescents, but the rate among African-American adolescents is especially alarming. For example, homicide is the third leading cause of death among White adolescents 15 to 19 years old, but it ranks first among their African-American counterparts (Anderson 2002). When compared to Latino and White adolescents, African-American adolescents are more likely to be involved in fights, to report knowing someone who has been a victim of violence, and to witness violent crimes (Paxton et al. 2004). Howard and colleagues (2002) reported that as many as 75% of urban African-American adolescents have witnessed at least one violent event in the past six months.
The rate of victimization among African-American adolescents can be explained, in part, by their broader social and environmental conditions. Approximately one-third of African-American adolescents live in economically depressed and socially marginalized neighborhoods, resulting in regular exposure to high rates of violence (Paxton et al. 2004). These are key factors that contribute to violence perpetration per·pe·trate
tr.v. per·pe·trat·ed, per·pe·trat·ing, per·pe·trates
To be responsible for; commit: perpetrate a crime; perpetrate a practical joke. and victimization (McCart et al. 2005; Howard et al. 2002). Such conditions also give rise to using violence as a response to the ongoing pressures and threat of violence (Feigelman et al. 2000), which further complicates the problem of responding to and preventing victimization.
The significance of victimization as a public health issue is further supported by its consistent relationships with various psychological and psychosocial problems. It is widely established that victimization can be a traumatic life event, challenging an individual's resources and negatively impacting developmental processes (Kaukinen 2002). A large body of research shows that victimization among adolescents is associated with higher degrees of depressive symptoms, substance use, PTSD PTSD posttraumatic stress disorder.
posttraumatic stress disorder
Post-traumatic stress disorder (PTSD) symptoms, suicidality, physical aggression, and delinquent behavior (Goldstein et al. 2007; Sullivan, Farrell & Kliewer 2006; Champion et al. 2004; Moran, Vuchinich & Hall 2004; Funk et al. 2003; Grella & Joshi 2003; NIJ 2003; Liebschutz et al. 2002; Caviola & Schiff 2000; Cleary 2000; Fitzpatrick & Bolidizar 1993).
Factors related to severity, frequency and context of victimization, commonly referred to as traumagenic factors, can play an important role in how detrimental these experiences are to adolescent development. Traumagenic factors in victimized adolescents have been associated with more comorbid problems, including violence, internal mental distress Mental distress is a term used, both by some mental health practitioners and users of mental health services, to describe a range of symptoms and experiences of a person's internal life that are commonly held to be troubling, confusing or out of the ordinary. , and substance problems (Titus et al. 2003; NIJ 1997). Long-term consequences of victimization have also been described in the literature (Kaukinen 2002). For example, childhood physical abuse and exposure to parental violence is associated with the development of alcohol-related problems in adulthood (Caetano, Field & Nelson 2003).
The causal influences of victimization on mental health functioning and social development are further complicated by various gender differences. For example, early victimization among girls strongly influences the likelihood of delinquency, adult criminality, and violent criminal behavior, as well as entry into the juvenile justice system (Osofsky 2001). Victimization among adolescent males has been associated with increased involvement in violent lifestyles (Hawke, Jainchill & De Leon 2003).
High-risk behaviors, such as multiple sexual partners, substance use, fighting, and other types of violence perpetration, are also associated with victimization. However, the causal associations among these behaviors, especially substance use, are unclear. For example, while substance use may be a mechanism to cope with experiences of victimization (Hawke, Jainchill & De Leon 2000), substance use can also significantly reduce physical competence and decision-making in threatening or violent situations, thereby increasing the risk of victimization (Shepherd, Sutherland & Newcombe 2006). It is plausible that victimization is situated within a complex set of feedback relationships, whereby it influences and is influenced by substance use, mental health functioning, and other high-risk behaviors.
Given the link between substance use and victimization, it is not surprising that rates of victimization are higher among adolescents in substance abuse treatment than those in the general population (Grella & Joshi 2003; Hawke, Jainchill & De Leon 2003; Titus et al. 2003). Accounting for victimization among adolescents in substance abuse treatment is important for numerous reasons. The existing evidence suggests that adolescents in drug treatment with a history of victimization have higher rates of psychological distress psychological distress The end result of factors–eg, psychogenic pain, internal conflicts, and external stress that prevent a person from self-actualization and connecting with 'significant others'. See Humanistic psychology. (Caviola & Schiff 2000), which may negatively impact treatment engagement (Grella & Joshi 2003; Grella et al. 2001). Titus and colleagues (2003) found that high levels of victimization interact with treatment outcomes and subsequent violence. Consequently, victimization is taking a more prominent role in treatment planning In radiotherapy, Treatment Planning is the process in which a team consisting of radiation oncologists, medical radiation physicists and dosimetrists plan the appropriate external beam radiotherapy treatment technique for a patient with cancer. Typically, medical imaging (i.e. , especially level of care decisions (Funk et al. 2003).
To date, the majority of knowledge on victimization among adolescents is based on school and community samples (Youngstrom, Weist & Albus 2003). Few studies of victimization have been conducted among adolescents in substance abuse treatment (Grella & Joshi 2003). As previously discussed, African-American adolescents tend to experience the highest rates of victimization. However, very little is known about the prevalence and associations of victimization among African-Americans in substance abuse treatment. Additional research in this area is needed to develop effective interventions to address the consequences of victimization (McCart et al. 2005) and prevent future occurrences among this population.
The purpose of this study is to help fill these gaps by pursuing three research objectives: (1) to examine the rate and different types of victimization among a sample of African-American adolescents in an urban substance abuse treatment program; (2) to test whether victimization is associated with increased levels of psychopathology psychopathology /psy·cho·pa·thol·o·gy/ (-pah-thol´ah-je)
1. the branch of medicine dealing with the causes and processes of mental disorders.
2. abnormal, maladaptive behavior or mental activity. and high-risk behaviors; and (3) to compare the rates and associations with those of existing studies of adolescent victimization.
Data for this study were derived from a larger treatment outcome study of 288 adolescents admitted to outpatient or residential substance abuse treatment in a large Mid-western inner city between 2003 and 2006. This initiative was part of the Center for Substance Abuse Treatment The Center for Substance Abuse Treatment (CSAT) is an agency of the United States government. It is a part of the Substance Abuse and Mental Health Services Administration (SAMHSA), within the U.S. Department of Health and Human Services (DHHS). Cooperative Agreement for Strengthening Communities for Youth (SCY SCY Security
SCY Short Course Yards (swimming) ; TI13305). Adolescents completed at least two days of treatment. Following admission, treatment staff introduced the study to the adolescents and invited them to participate. Research staff obtained written informed consent from parents and written assent from interested participants. Adolescents who participated in the study were compensated $20. This study included 259 participants who self-identified as African-American, 90% of the total sample. A university Institutional Review Board approved this study.
All data were collected by treatment staff at intake using a standardized clinical assessment called the Global Appraisal of Individual Needs (GAIN; Dennis et al. 2006). The GAIN contains scales and survey items related to eight domains: demographics, substance use, physical health, risk behaviors, mental health, environment, legal, and vocational issues. Prior research on the psychometric psy·cho·met·rics
n. (used with a sing. verb)
The branch of psychology that deals with the design, administration, and interpretation of quantitative tests for the measurement of psychological variables such as intelligence, aptitude, and properties of the GAIN revealed that it has good reliability and validity for both adolescents and adults (Dennis, Chan & Funk 2006; Dennis et al. 2004; Godley et al. 2002).
Victimization. Victimization was measured using the GAIN's General Victimization Scale (GVS (Global VideoPhone Standard) The technology behind AT&T's VideoPhones. GVS transmits at 10 frames per second, a third the rate of regular TV. The GVS technology is licensed to other manufacturers. ). The GVS is comprised of 15 dichotomously di·chot·o·mous
1. Divided or dividing into two parts or classifications.
2. Characterized by dichotomy.
di·chot scored items. Four items ask whether respondents ever experienced four different types of victimization, including being physically abused, being attacked with a weapon, being forced to participate in sexual acts, and being emotionally abused. Four items reflect concern about future victimization--one item for each type of victimization. Seven items ask about traumagenic factors, which are the circumstances surrounding victimization (e.g., whether victimization occurred before the age of 18, whether victimization was perpetrated by a family member).
Items of the GVS are summed to produce an overall victimization score, ranging from 0 to 15 (Titus et al. 2003). The observed reliability of the GVS for this sample ([alpha] = .65) was consistent with prior research (Funk et al. 2003; Titus et al. 2003). Following the work of Titus and colleagues (2003), a cutoff score of four was used to dichotomize di·chot·o·mize
v. di·chot·o·mized, di·chot·o·miz·ing, di·chot·o·miz·es
To separate into two parts or classifications.
To be or become divided into parts or branches; fork. this variable. Specifically, a score of three or less represented "low victimization," and a score of four or more represented "high victimization."
Participants were queried about their last episode of victimization using the following time frames: past two days, past week, one to four weeks ago, one to three months ago, four to 12 months ago, more than one year ago, or never. These responses were used to create lifetime and past 90-day measures of victimization. Participants were also queried about the age of their first victimization.
Mental health disorders. The GAIN includes items to measure DSM-IV mental health disorders. In this study, participants were classified as having major depressive disorder Major depressive disorder
A mood disorder characterized by profound feelings of sadness or despair.
Mentioned in: Conduct Disorder
major depressive disorder (past year) if they reported depressed mood, irritability irritability /ir·ri·ta·bil·i·ty/ (ir?i-tah-bil´i-te) the quality of being irritable.
myotatic irritability the ability of a muscle to contract in response to stretching. , or loss of interest, and reported at least five of 13 symptoms of depression. Participants were classified as having generalized anxiety disorder Generalized Anxiety Disorder Definition
Generalized anxiety disorder is a condition characterized by "free floating" anxiety or apprehension not linked to a specific cause or situation. (past year) if they reported significant problems with anxiety, worry or panic, and problems controlling their worries, and also responded positively to at least two of seven other anxiety symptoms. They were classified as having traumatic stress Traumatic stress is recognized by the Diagnostic and Statistical Manual of Mental Disorders [1] as an acute emotional condition associated with reactive anxiety. disorder (including post-traumatic stress disorder, acute stress disorder Acute Stress Disorder Definition
Acute stress disorder (ASD) is an anxiety disorder characterized by a cluster of dissociative and anxiety symptoms occurring within one month of a traumatic event. and disorder of extreme stress not otherwise specified; past year) if they reported at least five of 13 symptoms. They were classified as having conduct disorder Conduct Disorder Definition
Conduct disorder (CD) is a behavioral and emotional disorder of childhood and adolescence. Children with conduct disorder act inappropriately, infringe on the rights of others, and violate the behavioral expectations of (past 90 days) if they reported engaging in at least three of 15 negative behaviors at least two or more times and had problems due to breaking rules in the past 90 days. Prior research shows GAIN-based mental health diagnoses to match independent staff diagnoses for mood disorders (x = .85) and conduct disorder/oppositional defiant disorder (x = .82) (Shane, Jasiukaitis & Green 2003). Confirmatory factor analysis In statistics, confirmatory factor analysis (CFA) is a special form of factor analysis. It is used to assess the the number of factors and the loadings of variables. of the measure of traumatic stress indicated acceptable factorial factorial
For any whole number, the product of all the counting numbers up to and including itself. It is indicated with an exclamation point: 4! (read "four factorial") is 1 × 2 × 3 × 4 = 24. validity (Dennis, Chan & Funk 2006).
High-risk behaviors. High-risk behaviors in this study included general community behaviors and sex practices. High-risk community behaviors included past 90-day illegal activity and past-year gang involvement. High-risk sex practices included past 90-day unprotected sex Unprotected sex refers to any act of sexual intercourse in which the participants use no form of barrier contraception. Sexually transmitted infections
Specifically, unprotected sex and past 90-day multiple partners (i.e., two or more sex partners).
Analytic Strategy
Data were summarized using descriptive statistics descriptive statistics
see statistics. . Bivariate bi·var·i·ate
Mathematics Having two variables: bivariate binomial distribution.
Adj. 1. associations were tested using chi-square ([chi square chi square (kī),
n a nonparametric statistic used with discrete data in the form of frequency count (nominal data) or percentages or proportions that can be reduced to frequencies. ]) tests and t-tests. To discern the magnitude of the associations, effect sizes were also computed. These included phi-coefficients ([PHI]) and Pearson product-moment correlations (r), derived from the chi-square and t-tests, respectively. Following the rules of thumb proposed by Cohen cohen
or kohen
(Hebrew: "priest") Jewish priest descended from Zadok (a descendant of Aaron), priest at the First Temple of Jerusalem. The biblical priesthood was hereditary and male. (1988), .20 was regarded as a small effect size, .50 a moderate effect size, and .80 a strong effect size. Associations greater than or equal to .20 were considered to have clinical significance.
Very few missing values In statistics, missing values are a common occurrence. Several statistical methods have been developed to deal with this problem. Missing values mean that no data value is stored for the variable in the current observation. were observed in the sample data. Eight variables had one missing value, and two variables had two missing values. Pair-wise deletion was used in the bivariate analyses.
Sample Description
Eighty-four percent (n = 218) of the sample was male, ranging in age from 12 to 17 years (Mean = 14.96, SD = 1.16). Sixty-three percent (n = 163) were admitted to outpatient treatment, and 37% were admitted to residential treatment. The majority of subjects had a marijuana use disorder (83.0%, n = 215) and 27% (n = 69) had an alcohol use disorder.
Approximately half the subjects met criteria for at least one mental health disorder (n = 129), and 30% (n = 77) of the sample met criteria for two or more mental health disorders. Conduct disorder was most prevalent (32%, n = 84), followed by major depressive disorder (20%, n = 56), traumatic stress disorder, 14%, n = 36), and generalized anxiety disorder (5%, n = 12).
About half the sample reported being involved in illegal activity during the past 90 days (n = 142). Twenty percent (n = 53) reported gang membership in the past year. One-fifth of the sample reported having unprotected sex in the past 90 days (n = 56), and approximately half of the sample reported having two or more sexual partners in the past 90 days (n = 126).
Rate and Types of Victimization
Table 1 provides a summary of the rate and types of victimization. Half the subjects reported lifetime victimization, and one-quarter reported victimization during the past 90 days. The age of first victimization ranged from four to 17 years (Mean = 12.3, SD = 2.48). The most common type of victimization was being attacked with a weapon (46%, n = 118). Twenty percent reported being struck or beaten, 15% reported emotional abuse, and 4% reported being forced into sexual acts. Twenty-seven percent (n = 70) reported at least one type of victimization, 20% (n = 51) reported two types, 5% reported three types (n = 12), and 1% (n=3) reported all four types. One percent (n = 3) of respondents did not provide a response to the survey question regarding type of victimization experienced.
Scores on the GVS ranged from 0 to 15 (Mean = 2.90, SD = 3.6). Among participants with a lifetime history of victimization, 77.6% (n = 108) met the criteria for high victimization (GVS score [greater than or equal to] 4). About a third of participants reported being victimized several times or over a long period of time, and about the same percent reported being victimized by more than one person.
Almost one-fifth reported victimization by a family member or trusted person. Of the total sample, about one-fifth reported they were currently worried about being victimized in the future. Among subjects who reported victimization, only 40% reported receiving help related to the experience of victimization.
Associations with Victimization
Table 2 presents cross-tabulations of victimization and the other study variables. The percentages reported in this table are column percentages. For example, the table shows that 84.9% (n = 118) of persons with lifetime victimization were male, and 83.3% (n = 100) of persons without lifetime victimization were male. To obtain percentages for females, each value is subtracted from 100. Thus, the cell percentages for females would be 15.1% (n = 21) and 16.7% (n = 20), respectively. As previously discussed, chi-square ([chi square]) tests were used to determine whether the observed differences were statistically significant, and phi-coefficients ([PHI]) were used to determine clinical significance (> .20). Thus, in the foregoing example, lifetime victimization did not exhibit either statistically or clinically significant associations with gender. It should also be noted that all clinically significant associations were also statistically significant.
Lifetime victimization. Lifetime victimization exhibited a small but clinically significant association with major depressive disorder ([PHI] = .21) and conduct disorder ({PHI] = .33). Generalized anxiety disorder and traumatic stress disorder were statistically associated with lifetime victimization. However, contrary to prior research, these relationships were not clinically significant ([PHI] = .13).
Lifetime victimization was also associated with past 90-day high-risk sex practices, although the effect sizes were small: unprotected sex ([PHI] = .26) and multiple sex partners ([PHI] = .20). Illegal activity (past 90-days) and gang involvement (past-year) exhibited larger effects sizes with respect to lifetime victimization ([PHI] = .29 and .32, respectively).
Past 90-day victimization. Recency of victimization, as indicated by a past 90-day episode, had clinically significant associations with three study variables: conduct disorder ([PHI] = .21), past 90-day illegal activity ([PHI] = .28), and past-year gang involvement ([PHI] = .20). Although some of the other study variables exhibited a statistically significant association with past 90-day victimization, these associations were not clinically significant.
Victimization severity. Victimization severity was associated with having a mental health disorder. Of these disorders, conduct disorder exhibited the strongest association ([PHI] = .37), followed by major depressive disorder ([PHI] = .26), traumatic stress disorder ([PHI] = .23), and generalized anxiety disorder ([PHI] = .22). Past 90-day illegal activity and past year gang involvement exhibited clinically significant associations with victimization severity ([PHI] = .25 and .27, respectively). Past 90-day unprotected sex also reached the threshold of clinical significance ([PHI] = .20).
This study presents findings on victimization prevalence and its association with mental health disorders and high-risk behaviors. The African-American adolescent sample provided an opportunity to report on an underrepresented un·der·rep·re·sent·ed
Insufficiently or inadequately represented: the underrepresented minority groups, ignored by the government. population in the service research literature. The rate of victimization for this substance abuse treatment sample (54%) was significantly higher than the national average, consistent with prior research showing a link between substance use and victimization (Shepherd, Sutherland & Newcombe 2006; Weiner et al. 2005). Approximately 43% of the overall sample and 85% of persons who reported victimization indicated a history of assault with a weapon. This suggests that the environment in which these adolescents live contains a high level of violence, and the use of substances creates further risks for being victimized.
Victimization and Mental Health
This study also revealed a high rate of comorbid mental health disorders. Severity of victimization was associated with having a psychiatric disorder, but associations with 90-day and lifetime victimization were inconsistent. These differential associations may be due to the time-based measures accounting for only the occurrence of victimization, whereas the measure of severity was based on traumagenic factors. Again, this is consistent with prior research suggesting that the severity and context of victimization have important consequences on mental health functioning (Titus et al. 2003). Treatment providers need to pay closer attention to traumagenic factors rather than recency of victimization. However, further research is needed regarding the stability of the effects of traumagenic factors over time.
While a link was observed between victimization and mental health functioning, all statistically significant relationships exhibited either small or small-to-moderate effect sizes. Generally speaking, prior research has not characterized the associations in terms of effect sizes, but the description of the associations suggests they are moderate to large. For example, Brown and colleagues (1999: 94) stated that exposure to trauma has been linked with "deleterious deleterious adj. harmful. mental health outcomes," and Paxton and colleagues (2004: 283) stated that "exposure to violence makes significant contributions to the presence of post-traumatic stress symptomatology symptomatology /symp·to·ma·tol·o·gy/ (simp?to-mah-tol´ah-je)
1. the branch of medicine dealing with symptoms.
2. the combined symptoms of a disease.
n. " [italics in both quotes added for emphasis]. In light of these examples and others (Lambert et al. 2005), the effect sizes observed in this study were smaller than expected. Three possible explanations for this unexpected finding are offered. First, victimization and mental health functioning are associated, but the strength of the association has not been clear as prior studies only focused on tests of statistical significance and p-values.
A second explanation is that the association between victimization and mental health functioning was attenuated Attenuated
Alive but weakened; an attenuated microorganism can no longer produce disease.
Mentioned in: Tuberculin Skin Test
having undergone a process of attenuation. in this sample by an unmeasured mediating factor. Several studies examining the effects of exposure to crime or community violence on children and adolescents have found that protective factors inhibit the development of psychological difficulties, including post-traumatic stress disorder (e.g., Jones 2007; Youngstrom, Weist & Albus 2003; White et al. 1998). Moreover, it appears that protective factors interact with risk factors in their effects on adolescent well-being (Li, Nussbaum & Richards 2007; Ostaszewski & Zimmerman 2007). Even more specific to this study, unmeasured protective factors specific to African Americans including formal and extended kinship, spirituality, and collective coping may have been at play (e.g., Jones 2007; Utsey et al. 2007; Taylor, Casten & Flickinger 1993).
A third explanation may be bias in the sample due to service pathways. This was a substance abuse treatment sample, and adolescents with more severe co-occurring psychiatric disorders may have been diverted through the psychiatric or foster care systems. In the community from which this sample was drawn, adolescents with serious emotional disturbance This article requires authentication or verification by an expert.
Please assist in recruiting an expert or [ improve this article] yourself. See the talk page for details. are not necessarily referred to community substance abuse treatment. Depending on the history of victimization among these adolescents, the effect size between mental health and victimization may be larger than was observed in this study.
The foregoing interpretations on the association between victimization and mental health should be considered in the context of the study design. That is, because this was a cross-sectional study, the temporal relationship of victimization and mental health is unclear. Additional research is needed to determine how victimization and the onset or exacerbation of mental health problems are related. In addition to longitudinal studies that can help untangle the causal associations (e.g., Koenen et al. 2007; Giaconia et al. 2000), carefully designed retrospective accounts may also be important. Retrospective studies might involve a qualitative analysis Qualitative Analysis
Securities analysis that uses subjective judgment based on nonquantifiable information, such as management expertise, industry cycles, strength of research and development, and labor relations. to document the experiences of victimization, which could facilitate an understanding of how victims see their experiences to be related to mental health functioning. These results can generate new hypotheses, including other possible mediating factors.
Victimization and High-Risk Behaviors
Unlike associations with mental health disorders, victimization exhibited consistent relations with the lifetime measure of victimization. Gang membership and illegal activity exhibited the strongest associations. This is consistent with prior research that shows a high degree of overlap between victimization and violence perpetration (Hawke, Janichill & De Leon 2003; Howard et al. 2002; Feigelman et al. 2000). The effect size among victimization and high-risk sex behaviors reached the threshold of clinical significance. Engagement in these high-risk behaviors is most likely due to the lack of meaningful opportunities afforded to these adolescents.
The temporal ordering of victimization and high-risk behaviors is unclear; however, gaining knowledge on the temporal ordering of these relationships may not be as important as improving the conditions in which these adolescents live. That is, their decisions must be considered within the context of an environment with severely restricted social and economic opportunities, as well as a failing educational system. An effective treatment and prevention strategy will require a multifaceted effort that targets individuals and their broader social conditions.
Treatment and Prevention
Overall, this study documents a need for services related to treatment and prevention of victimization among African-American adolescents in substance abuse treatment. Sixty percent of subjects who were victimized reported that they had not received help for their experience of victimization, and 20% of the overall sample worried about future victimization.
A necessary step is improved access to and integration with the mental health service system. This can allow adolescents to be treated for the distress of mental disorders that may be due, in part, to victimization. Prior research has suggested that supportive relationships can help buffer against the effects of victimization (Youngstrom, Weist & Albus 2003). Treatment providers can explore the social network of the individuals and help identify ways of enhancing existing relationships.
Lambert and colleagues (2005: 44) stated that prevention efforts targeting urban adolescents "should attempt to increase youth vigilance of surroundings or awareness of danger as a means of reducing their risk for exposure to community violence by helping them avoid violent situations and involvement in violent activity." Nadel (1995) considered the modification of beliefs, attitudes and norms as fundamental to developing behaviors that can help prevent violence and victimization. Such prevention efforts can be included in substance abuse treatment through psychoeducation and cognitive behavioral groups. Service providers should assist adolescents in seeking out opportunities in the community that provide safe environments for structured activities and role models that discourage the use of substances.
Finally, it is unlikely that the problem of violence and victimization can be effectively addressed without improving the social and economic conditions of African-American adolescents living in urban settings. Thus, it is necessary to heighten the awareness of policy makers to promote meaningful social change.
Limitations and Future Directions
This study contributes to a developing area of research, focusing on an underrepresented group in services research. The contributions must be considered in the context of study limitations. First, as previously discussed, the cross-sectional design prevented any inferences regarding the temporal ordering of variables.
Second, the psychometrics psychometrics
Science of psychological measurement. Psychometricians design and administer psychological tests (see psychological testing), both to generate empirical data on mental processes and to refine their understanding of measurement techniques and the of the GAIN have not been thoroughly examined with African-American adolescents. African-American adolescents, especially those in urban environments, may have different conceptualizations of victimization due to their chronic exposure. Additional research is needed to understand how victimization can be effectively measured across different populations. Qualitative approaches can be an important method of research to help clarify these differences.
Third, the measure of victimization is based on assumptions that need to be validated. A summary score is derived by adding different experiences of victimization. This assumes that the items are additive and contribute equally to the final score. Future research should consider whether there are multiplicative effects of victimization and possible nonlinear associations with other variables.
Finally, the GAIN was administered at intake to substance abuse treatment. Clinical staff may not have had enough time to develop rapport with clients, which is a necessary condition for discussing sensitive topics such as victimization. It is possible that the true rate of victimization may be underestimated.
This study revealed a high rate of victimization in a sample of African-American adolescents in substance abuse treatment. The results contribute to existing evidence on the link between substance use and victimization. Severity of victimization was associated with having a mental disorder mental disorder
Any illness with a psychological origin, manifested either in symptoms of emotional distress or in abnormal behaviour. Most mental disorders can be broadly classified as either psychoses or neuroses (see neurosis; psychosis). Psychoses (e.g. (i.e., depression, generalized anxiety disorder, traumatic stress disorder, and conduct disorder). Lifetime victimization was associated with various high-risk behaviors (i.e., multiple sex partners, unprotected sex, gang membership, and illegal activity). Treatment and prevention of victimization will require strategies that address problems of the individual in addition to targeting broader social and economic conditions.
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([dagger]) Financial assistance for this study was provided by SAMHSA's Center for Substance Abuse Treatment (CSAT CSAT Center for Substance Abuse Treatment
CSAT Customer Satisfaction
CSAT Client Satisfaction
CSAT Certified Sexual Addiction Therapist
CSAT Combined Systems Acceptance Test
CSAT Civil Service Arbitration Tribunal (United Kingdom) ) Grant No. TI13305.
Brian E. Perron Per´ron
n. 1. (Arch.) An out-of-door flight of steps, as in a garden, leading to a terrace or to an upper story; - usually applied to mediævel or later structures of some architectural pretensions. , Ph.D., Assistant Professor, University of Michigan (body, education) University of Michigan - A large cosmopolitan university in the Midwest USA. Over 50000 students are enrolled at the University of Michigan's three campuses. The students come from 50 states and over 100 foreign countries. School of Social Work, Ann Arbor Ann Arbor, city (1990 pop. 109,592), seat of Washtenaw co., S Mich., on the Huron River; inc. 1851. It is a research and educational center, with a large number of government and industrial research and development firms, many in high-technology fields such as , MI.
Heather J. Gotham, Senior Manager of Evaluation, Mid-America Addiction Technology Transfer Center, University of Missouri-Kansas City, Kansas City, Missouri Kansas City is the largest city in the state of Missouri. It encompasses parts of Jackson, Clay, Cass, and Platte counties and is the anchor city of the Kansas City Metropolitan Area, the second largest in Missouri, which includes counties in both Missouri and Kansas. .
Dong Cho, Associate Professor, Department of Psychiatry at Missouri Institute of Mental Health, School of Medicine, University of Missouri at Columbia.
Please address correspondence and reprint requests to Brian E. Perron, Ph.D., University of Michigan, School of Social Work, 1080 S. University Avenue, Ann Arbor MI 48109; email: email@example.com.
TABLE 1 Summary of Rate and Type of Victimization among Overall Study Sample Study Variables N (Range) % or Mean (SD) Lifetime Victimization 139 53.7 Past 90 Days Victimization 60 23.2 Days Victimized (if Any) in Past 90 Days (1-90) 6.88 (17.25) Age of First Victimization (4-17) 12.3 (2.48) Received Needed Help for Victimization (if Victimized) * 55 39.6 Currently Worried About Being Victimized 56 21.6 Type of Victimization Attacked with Weapon 118 45.6 Hurt by Striking/Beating 51 19.7 Forced into Sexual Acts 11 4.2 Abused Emotionally 40 15.4 Traumagenic Factors Victimized Several Times or for a Long Time 85 32.8 With More Than One Person Involved 92 35.5 Was Person Family Member/Trusted One 43 16.6 Where You Afraid for Life or Injury 36 14.0 Result in Oral, Vaginal, or Anal Sex 11 4.2 People You Told did not Believe or Help You 28 10.8 High Victimization ** 108 41.7 * Among subjects who reported a history of victimization (N = 139). ** Score of 4 or greater on GVS. TABLE 2 Summary of Associations Among Victimization and Study Variables Lifetime Victimization Study Yes No [chi square] [PHI] Variable (n = 139) (n = 120) Male 84.9% 83.3% .12 .02 Clinical Disorders Major Depressive 29.5% 12.5% 10.98 *** .21 Generalized Anxiety 7.9% 0.8% 7.31 ** .17 Traumatic Stress 18.0% 9.2% 4.18 * .13 Conduct 46.8% 15.8% 28.11 *** .33 High-Risk Behaviors Illegal Activity 68.3% 39.2% 22.14 *** .29 Gang Membership 32.4% 6.7% 26.15 *** .32 Unprotected Sex 31.9% 10.1% 17.82 *** .26 Multiple Sex Partners 58.3% 37.8% 10.74 *** .20 Past 90-day Victimization Study Yes No [chi square] [PHI] Variable n = 60) (n = 199) Male 85.0 83.9 .04 .01 Clinical Disorders Major Depressive 33.3% 18.1% 6.32 .16 Generalized Anxiety 6.7% 4.0% .48 ([dagger]) .00 Traumatic Stress 15.0% 13.6% .08 .02 Conduct 50.0% 27.1% 11.00 *** .21 High-Risk Behaviors Illegal Activity 80.0% 47.2% 19.98 *** .28 Gang Membership 35.0% 16.1% 10.14 *** .20 Unprotected Sex 33.3% 18.3% 6.12 * .15 Multiple Sex Partners 58.3% 46.9% 2.82 .10 High Severity Victimization Study Yes No [chi square] [PHI] Variable (n = 108) (n = 151) Male 81.5 86.1 1.00 .06 Clinical Disorders Major Depressive 34.3% 12.6% 17.46 *** .26 Generalized Anxiety 10.2% 0.7% 12.92 *** .22 Traumatic Stress 23.1% 7.3% 13.24 *** .23 Conduct 52.8% 17.9% 35.00 *** .37 High-Risk Behaviors Illegal Activity 69.4% 44.4% 15.98 *** .25 Gang Membership 33.3% 11.3% 18.85 *** .27 Unprotected Sex 31.8% 14.7% 10.73 *** .20 Multiple Sex Partners 54.6% 44.7% 2.94 .10 Note: * p < .05, ** p < .01, *** p < .001. Phi-coefficients ([PHI]) [greater than or equal to] .20 are in bold, indicating a clinically significant association. ([dagger]) Cross-tabulation did not meet assumption of chi-square ([chi square]) test due to low cell counts; thus, Fisher's exact test was used and reported.
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Some Tips To Make SSH/SCP Usage More Convenient
Submitted by tony2 (Contact Author) (Forums) on Thu, 2008-05-29 13:02. :: Linux | Other
Some Tips To Make SSH/SCP Usage More Convenient
I guess many of us rely heavily on ssh/scp to access/maintain remote hosts. In this short article I would like to share some experiences I find useful for ssh/scp usage.
First let's have a look how things started:
I use a simple trick to get out of this mess: I have a simple script named ssh-generic that looks as follows:
#!/bin/bash port="22" case "$0" in *-host1) account="email@example.com" ;; *-host2) account="email@example.com" ;; *-host3) account="email@example.com" port="222" ;; *) echo "unsupported name: $0" exit 1 ;; esac case "$0" in */ssh-*) echo running ssh -p $port $account "$@" ssh -p $port $account "$@" ;; */scp-to-*) echo running scp -P $port "$@" $account: scp -P $port "$@" $account:$scpdir ;; */scp-from-*) echo scp -P $port $account:$1 . scp -P $port $account:$1 . ;;
Then I make ssh-host1, scp-to-host1 and scp-from-host1 as symlink to the above script (ie ssh-generic). Usage is trivial:
Similar for host2 and host3. When we get another host, it's easy to edit ssh-generic, add the relevant entry and make needed symlinks. For example, let's add another host with ip 192.168.0.4, port for ssh 2222 and user id admin2. We want to access this host by simply saying ssh-host4. This turns out to be easy:
*-host4) account="email@example.com" port="2222" ;;
A bonus is that we can say in the command line eg ssh-host<Tab> to free ourselves from remembering the hostnames, connection details and hence from making mistakes. There are some cosmetic details that I left out from the script for clarity, like automatically setting the title of current xshell before running ssh/scp, or a dryrun option for the script.
I also have a companion script that can be used to ease uploading ssh keys. I named it "enable-ssh" (a bit poor chosen name, should be renamed to something better) and it looks as follows:
if test -z "$1"; then echo Usage: $0 '[-p <port>] <host>' exit 1 fi if ! test -s $HOME/.ssh/id_rsa.pub; then ssh-keygen -t rsa fi cd cat $HOME/.ssh/id_rsa.pub | \ ssh "$@" "mkdir -p .ssh; touch .ssh/authorized_keys; cat >> .ssh/authorized_keys"
That's it. I hope you find this useful.


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Watch These Dogs Dragging People Around — Daily Distraction
This looks like it could actually be quite a bit of fun.
This looks like it could actually be quite a bit of fun.
Sometimes a dog just doesn't feel like it. Feel like what, exactly? Anything. So he just lies there, on the ground, and if you want him to move, well, good luck with that.
As creatures designed to walk on land, humans have always encountered trouble on the high seas. Or, in some cases, lakes or even a small pond.
We can't remember the first time we ever tried a lemon, but we bet our face looked just like this.
There's something about golf carts that just brings out the bad driver in all of us.
Seems like a waste of perfectly good eggs, doesn't it?
Being flower girl can be tough. You have a very important job, everyone's looking at you, and you're probably only a few years old.
Cats vs. mirrors: the battle rages on.
What's the thing that everyone knows about llamas? That they spit, right? So why are these people caught off-guard?
We don't know what's gotten into these guys. Maybe some of them just aren't cut out for life on the farm.
It's the kind of present you never forget seeing the first time.
Sure, they could swim, but why not take a ride if it's there?


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Just received some interesting info from my father on SATA cables and what not to do with them.
This all came about because I had a server at home with "tidied" sata cables amongst others and Dads lecture mode went into full effect.
Apparently you should avoid the following:
- right angle bends or sharp bends in the cable (folding is waaay out!)
- looping cables (long ones obviously) into coils
- running cables close to each others for more than an inch or so (so no strapping them together in bundles)
It may seem obviously but apparently the above can cause the interference and results in data loss which, needless to say, you'd want to avoid.
Either way, I've just unbundled a bunch of cables and replaced a couple which I'd pretty much folder up and nylon strapped into a nice tidy bundle and lo' the server lockups I was experiencing have disappeared.
Anyways, thought I'd share as it'd never occurred to me before and might be a useful troubleshooting tip.


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There are 43 results - Show results on a map Print this page
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This is a delightful terraced property overlooking the Clifton Suspension Bridge. It offers bedrooms of varying shapes and sizes with either views across the river or of Clifton Village. Meals can be ...More about The Avon Gorge Hotel
In a prime position on the river this handsome, purpose-built hotel is designed and finished with care. The shopping centre and theatres are within easy walking distance. The stylish bedrooms are extr...More about Mercure Brigstow Bristol
In a pleasant setting, just a couple of miles from the delightful village of Castle Combe, this well-established country inn is run personally by the resident proprietors and their family. Six purpose...More about The Old House at Home
This attractive country house has a quiet parkland setting in the heart of the city, on the edge of Durdham Downs. It stands in glorious gardens and is furnished with period pieces and paintings. The ...More about Downs Edge
This delightful building was built in the late 1890s as a private manor house and is surrounded by rose and woodland gardens. The five-year renovation project has now been completed to provide very hi...More about Berwick Lodge
With easy access from the M5, this attractive, listed building in Clifton is conveniently close to the city centre. The individually decorated bedrooms provide a useful range of extra facilities for t...More about Rodney Hotel
History fans may be interested to learn that Henry VIII ordered the first owner of this castle to be beheaded! Guests today have the opportunity of sleeping in historical surroundings fitted out with ...More about Thornbury Castle
On the edge of Durdham Downs, this detached guest house is ideally located for many of Bristol's attractions. Breakfast is served in the spacious dining room overlooking the front garden. Bedrooms and...More about Westbury Park Guest House
This welcoming hotel offers high quality, individual bedrooms and bathrooms in a variety of shapes and sizes. The hotel is just one mile from the city centre and a two-minute stroll from the heart of ...More about BEST WESTERN Victoria Square Hotel
Modern, budget hotel offering comfortable accommodation in bright and practical bedrooms. Breakfast is self-service and dinner is available in the restaurant. ...More about Ibis Bristol Temple Meads


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Unbiased Reviews by Real People
Summary: My family (two kids, 3yrs and 10mos) went to Beaches Turks & Caicos for March 2-9, 2002. My husband has repeatedly called it the "best vacation of his life," mostly due to scuba diving, childcare, and friendly service.
We were actually ... read more
Summary: This February, I used Vacation Rental By Owner to rent a house next to Sapodilla Bay, known locally as Baby Beach for it's calm water and powder soft sand. You are also minutes from Taylor Bay on this side of the ... read more
Summary: I know that everyone's always looking for a new and amazing Caribbean resort, so I thought I would share a review of my recent stay at Nikki Beach in Turks and Caicos. The Nikki Beach resort will ensure that you stay in the lap of luxury while ... read more
Summary: Way too expensive for what it was!!! Room stunk, food was just buffet cafeteria food, too crowded, outdated kids pool with unsafe slide and bridge. The resort did not clean the regulators when husband and son took dive class. They just pass them on to ... read more
Summary: The Turks and Caicos Islands are made up of 8 inhabited islands with Grand Turk, the political capital and Providenciales, the island with the nicest beaches, where most resorts are located. The islands are located south of the Bahamas and north of ... read more
Summary: Going to Turks and Caicos was one of if not the best vacation I've ever been on. For a little travel credibility let me name a few sun vacations I've been on. I've been to Key West, Cancun, St. Maartin, Barbados, and San Diego. Turks and Caicos was ... read more
Summary: Below is a general description of Providenciales, Turks & Caicos Islands, BWI - along with descriptions of my experiences from July 29 - August 6th, 2004. Hope you have as wonderful a time as I did. GENERAL I went to the island of Providenciales in ... read more
Summary: We�ve previously stayed at three different Sandals resorts in St. Lucia and Jamaica, and had high expectations for our family trip to Beaches Turks and Caicos. We were in for a crushing disappointment. I�m not normally a negative person, but the ... read more
Summary: THE ISLAND Breathtakingly beautiful turquoise water. Miles and miles of soft white beach to walk. Wonderful food and drinks. No rushing, even if you want to, strictly island time here! Once you get used to the service [or lack of], it's ok. Relax and ... read more
Summary: My fianc� and I visited Providenciales in late June / early July 2003. We had high hopes for the Tur ... read more
Summary: My family was really excited to go to Turks and Caicos at Beaches but once we got there it wasn't wh ... read more
Summary: One week in Club Med Turkoise was certainly action packed. It was our first time to a Club Med, so it took a day or two to become accustomed to the "camp" style atmosphere.
The resort itself was acceptable, it's rated as a 3 out of 4 star ... read more
Summary: My husband and I just returned from a week at Beaches Turks and Caicos. We were there from May 5-12. The weather was partly sunny most days, but very windy. We have also stayed at Sandals Montego Bay and found Beaches T & C to be much nicer in several ... read more
Summary: This resort offers a beautiful beach, delectable cuisine, exciting activities, and comfortable accommodations.
My husband and I traveled in August '00 for a one week stay. The "All-Inclusive" package started from the moment we stepped onto ... read more
Summary: Last January, my family and I visited the Beaches resort in Turks & Caicos. We have 2 small children, who were 5 1/2 and 2 at the time, so decided on Beaches because of their family reputation. We were pleased with our choice.
The Beaches ... read more
Summary: Club Med � Turks and Caicos
There are few vacation destinations where adult travelers can relax in peace with no children around, singles can feel free to travel solo and make new friends in the process, and couples can spend time alone or ... read more
Review Topic: Sights & AttractionsIn June of 2000 I planned a vacation for my husbands family to celebrate his folk's 50th anniversary. It had to be perfect! After lots and lots of research I decided on the Provo in the ... read more
Review Topic: OverviewReport on Beaches at Turks and Caicos Island
Our family spent 2 weeks at Beaches, Turks/Caicos, from Aug.15-Aug.29. We even experienced the media frenzy of Hurricane Debbie. The news was more ... read more
Summary: With limited knowledge of being an adult and never having to actually PAY for such an expensive trip, all summed up, Turks and Caicos (Turquoise for short) is absolutely breathtaking. I am 15 years of age and have been to the Caribbean twice and to ... read more
Summary: Just got back from a May trip to Grand Turk. Traveling from Houston, it's difficult to get to - through Miami, Providenciales and then to Grand Turk. The diving is worth the trip. We stayed at the Arawak Resort. It's near the south end of the island. ... read more


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|a softer world
"We gladly feast on those who would subdue us."
here is a picture that makes me feel like the world isn't so bad.
party vest embroidered with the logo from one of our mutual favourite kids' books! aaaaaaaaaah it's the best thing!
ASW has an RSS FEED, LJ FEED, tumblr and a Facebook group.


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Why do you like or dislike this movie?
These bitches look trashy and I like the cargo pants on that brunette and seeing the wrinkles and creases in the front and bahind the knees from long wear. I had trailer trash sluts and crack whores abuse me fully clothed in dirty pants and leather jackets forced to lick their sweat and tortured with my balls beaten with their belts while laying on the floor jerking and looking up at the crotches of their pants
Both them skanks are crazy over mistress dressed in them satin cargo pants and clouse tie with that clasy blond hair, the slave getting kicks probably is in mistresses closet smelling her pant crotch and rubbing her cunt with them and would love to hump mistesses pant leg while mistress wears them and cum all over them


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Special Assets Officer
Overview: The position of Special Assets Officer follows the direction of the Special Assets Manager and assists in rewriting and negotiating adversely graded loans. Tracks the progress of the loan workout process and prepares reports for the Credit Administrator. Meets ...
Nov 19 -
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