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This Week in JAMA
August 4, 2010

This Week in JAMA

JAMA. 2010;304(5):497. doi:10.1001/jama.2010.1095

A JAMA THEME ISSUE

Edited by Annette Flanagin, RN, MA, and Thomas B. Cole, MD, MPH

In a randomized trial that enrolled adolescents who reported past-year episodes of violence or alcohol use during an emergency department visit, Walton and colleagues Article assessed the efficacy of a single-session, brief motivational and conflict-resolution intervention—either computerized or therapist-delivered—on reducing these behaviors. The authors found that compared with controls who were randomly assigned to receive a community resource brochure only, adolescents who received the brochure and the brief intervention reported experiencing less peer violence and alcohol consequences during follow-up. In an editorial, Saitz and Naimi Article discuss the limited evidence that brief counseling interventions can reduce violence and alcohol use among adolescents.

Intimate partner violence against women has been associated with negative mental health among survivors. In a randomized trial that enrolled community-dwelling Chinese women in Hong Kong who screened positive for intimate partner violence, Tiwari and colleagues Article assessed change in depressive symptoms among women who received either a 12-week advocacy intervention involving empowerment and telephone social support components or usual community services that included child care, health care and health promotion services, and recreational programs. The authors found that the advocacy intervention—which focused on problem solving, safety assessment, and planning—did not result in a clinically meaningful improvement in depressive symptoms. In an editorial, Taft and Hegarty Article discuss implications of the study's findings for clinicians, researchers, and survivors of intimate partner violence.

There has been little empirical documentation of physical and mental health consequences associated with decades of violence in the Central African Republic. In a multistage stratified cluster random survey of 1879 adult residents of 5 administrative units of the Central African Republic, Vinck and Pham assessed mortality, morbidity, exposure to traumatic events, and symptoms of depression and anxiety. The authors report that high percentages of respondents were exposed to potentially traumatic events and more than half the respondents met the symptom criteria for both depression and anxiety. Exposure to violence and self-reported physical health were associated with mental health outcomes.

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The Democratic Republic of the Congo has experienced violence and civil conflict for more than a decade. In a March 2010 cross-sectional, population-based cluster survey of 998 adults living in the territories of North and South Kivu provinces and Ituri district in the Eastern Democratic Republic of the Congo, Johnson and colleagues assessed the prevalence of all forms of sexual violence, human rights abuses, circumstances of abuse, characteristics of perpetrators, and the physical and mental health effects on individuals, family, and communities. Among the authors' findings were high rates of sexual violence—reported by both women (39.7%) and men (23.6%)—and human rights abuses—reported by two-thirds of the households—that were associated with adverse physical health and symptoms of major depressive disorder and posttraumatic stress disorder.

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“‘They got my boy by accident. He was the only one who got hit. He was in the wrong place at the wrong time.’” From “The Haircut.”

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This issue's theme is explored in news features on the impact of child marriage on the health and lives of girls and on violence against clinicians and others in health care settings.

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Violence and substance use in mental illness

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Affect regulation and risky behaviors

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Mortality surveys in conflict settings: improving credibility

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CIA physicians, detainee interrogation, and torture

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Paraprofessionals and PTSD treatment

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Violence, condom negotiation, and HIV/STD risk

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Join Patricia Goode, MSN, MD, Wednesday, August 18, from 2 to 3 PM eastern time to discuss caring for aging patients' urinary incontinence. To register, go to http://www.ihi.org/AuthorintheRoom.

For your patients: Information about intimate partner violence.

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