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1. Military personnel exposed to war-zone trauma are at risk for developing PTSD. Those at greatest risk are those exposed to the highest levels of war-zone stress, those wounded in action, those incarcerated as prisoners of war, and those who manifest acute war-zone reactions, such as CSR. 2. In addition to problems directly attributable to PTSD symptoms per se, individuals with this disorder frequently suffer from other comorbid psychiatric disorders, such as depression, other anxiety disorders, and alcohol or substance abuse/dependence. The resulting constellation of psychiatric symptoms frequently impairs marital, vocational, and social function. 3. The likelihood of developing chronic PTSD depends on premilitary and postmilitary factors in addition to features of the trauma itself. Premilitary factors include negative environmental factors in childhood, economic deprivation, family psychiatric history, age of entry into the military, premilitary educational attainment, and personality characteristics. Postmilitary factors include social support and the veteran's coping skills. 4. Among American military personnel, there are three populations at risk for unique problems that may amplify the psychological impact of war-zone stress. They are women whose war-zone experiences may be complicated by sexual assault and harassment; nonwhite ethnic minority individuals whose premilitary, postmilitary, and military experience is affected by the many manifestations of racism; and those with war-related physical disabilities, whose PTSD and medical problems often exacerbate each other. 5. The longitudinal course of PTSD is quite variable. Some trauma survivors may achieve complete recovery, whereas others may develop a persistent mental disorder in which they are severely and chronically incapacitated. Other patterns include delayed, chronic, and intermittent PTSD. 6. Theoretically primary preventive measures might include prevention of war or screening out vulnerable military recruits. In practice, primary preventive measures have included psychoeducational and inoculation approaches. Secondary prevention has been attempted through critical incident stress debriefing administered according to the principles of proximity, immediacy, expectancy, and simplicity. Tertiary prevention has included psychotherapy, pharmacotherapy, dual diagnosis approaches, peer counseling, and inpatient treatment. Few treatments have been rigorously evaluated. 7. There are both theoretical reasons and empirical findings to suggest that military veterans with PTSD are at greater risk for more physical health problems, poorer health status, and more medical service usage. Much more research is needed on this matter. 8. Despite the potential adverse impact of war-zone exposure on mental and physical health, there is also evidence that trauma can sometimes have salutary effects on personality and overall function.
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PMID:Post-traumatic stress disorder in the military veteran. 793 58

Sexual harassment of women in organizational settings has recently become a topic of interest to researchers and the general public alike. Although numerous studies document its frequency, the development of conceptual models identifying antecedents and consequences of harassment has proceeded at a slower pace. In this article, an empirical test of a recently proposed conceptual model is described. According to the model, organizational climate for sexual harassment and job gender context are critical antecedents of sexual harassment; harassment, in turn, influences work-related variables (e.g., job satisfaction); psychological states (e.g., anxiety and depression); and physical health. On the basis of a sample of women employed at a large, regulated utility company, the model's predictions were generally supported.
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PMID:Antecedents and consequences of sexual harassment in organizations: a test of an integrated model. 937 85

We aimed to determine the major health concerns or problems of women and their personal attributions for the causes of their primary health concerns. We used a survey of women from the Toronto area attending a women's health symposium. Completed questionnaires were returned by 153 (85%) of 180 women attendees. Persistent fatigue was the primary and most commonly cited health concern. Fatigue was ranked first by 42 (27.5%) women and among the top 10 concerns by 123 (80.4%) women. Women attributed their fatigue to a combination of home and outside work (63.4%), poor sleep (38.2%), lack of time for self (34.1%), lack of exercise (32.5%), financial worries (28.5%), relationship problems (22.0%), emotional causes (17.9%), care of ill family members (13.8%), lack of social or individual support (9.8%), poor physical health (8.9%), work in home or child care (3.3%), or gender bias/harassment (2.4%). Our subjects, women from the community, overwhelmingly endorsed social determinants as the cause of their persistent fatigue. Although depression and anxiety form the most robust associations with persistent fatigue in primary care and community studies, women in this sample ranked these factors in seventh place in their attributions. Similarly, although physicians often assume physical causes for fatigue, women rank physical health low in their own attributions. Given the high prevalence of fatigue in women and its impact on quality of life, more attention needs to be given to the social, systemic, and personal factors that women feel contribute to their fatigue to develop more effective interventions.
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PMID:What makes women tired? A community sample. 951 Nov 34

This study tested the hypotheses that gender harassment is related to decreased job satisfaction and increased distress, and that White and minority women differ in their responses to it, in a sample of 385 women office workers. Over 70% reported exposure to gender harassment at work. As predicted, frequency of harassment was negatively correlated with job satisfaction and positively associated with an index of distress, assessed by self-reported somatic complaints, the Center for Epidemiological Studies Depression Scale (L. S. Radloff, 1997), and the reported use of alcohol for palliative coping. Minority status was unrelated to frequency of reported harassment or to responses to it. The tendency to focus on negative aspects of self and environment (negative affectivity) was statistically controlled. Findings indicate that gender harassment is a commonplace workplace stressor that warrants serious attention.
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PMID:Gender harassment, job satisfaction, and distress among employed white and minority women. 955 70

Statistics are seldom recorded on the incidence of HIV-related verbal or physical abuse. The New York Gay and Lesbian Anti-Violence Project (AVP), and San Francisco's Community United Against Violence are the only known programs to recognize and collect data on HIV-related violence. Psychological abuse, physical battery, harassment, and rape are all signs of domestic violence. Reluctance to report bias crimes is thought to stem from fear of discrimination and further violence. In addition, some community members are concerned that partner notification laws may foster more household violence, or discourage people from being tested. The repercussions of violence against people with HIV is evident, often resulting in depression, lack of sleep, and non-adherence to medication. Those victimized by violent situations can seek assistance in New York from AVP, which provides resources, counseling, legal aid and advocacy for victims. AVP also provides guidance and support through the process of criminal prosecution, and formulating a safety plan. A list of organizations that can assist victims of violence is provided, which includes contact information for each.
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PMID:HIV-related violence. 1136 76

This article discusses the extent of child rape in India, case studies of girl children in legal procedures, rape settings and perpetrators, public morality, and the nature of rape laws in India. It is concluded that there is no safe place for children. Currently, rapists are allowed to go free or are acquitted. Prevention and control of child rape must involve punishment of rapists. It is not appropriate that society ostracize the victim and her family. Victims should not remain silent. National Crime Records Bureau statistics reveal increases in rape during 1986-91. State figures are given for 1986-88. Madhya Pradesh had the highest reported incidence of rape in 1988. In 1993, Madhya Pradesh had a total of 2459 rapes. Nationally, 10,425 women were reported as raped in 1991. 51.7% were 16-30 years old. There were 1099 cases of pedophilia in 1991, which was an increase over 1990. Over 50% of the pedophilia cases were reported in Uttar Pradesh. The record of convictions shows very low figures. 1992 trial results of 276 rape cases indicated that only 46 persons were convicted. Victims suffer from psychological effects of embarrassment, disgust, depression, guilt, and even suicidal tendencies. There is police and prosecution indifference as well as social stigma and social ostracism of the victim and her family. Many cases go unreported. The case studies illustrate the difficulties for the victim of experiencing the rape and the social responses: police harassment, shame and fear, and occasionally public outrage. The case studies illustrate rape in familiar settings, such as schools, family homes, and neighbors and friends' homes; rape by policemen; and rape by political influentials. Most offenders are young, married, and socioeconomically poor. Mass media portrayals fuel the frustrations of poor and lonely men in cities. Rapists exhibit anti-social behavior or psychopathology. Sexual offenses are related to society's moral values.
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PMID:Child rape: facets of a heinous crime. 1215 4

The incidence of episodes of harassment and rape among military populations has only recently been examined. In the present study, a sample of 336 female veterans in a primary care setting was assessed. The incidences of lifetime sexual victimization, anxiety, depression, and impact of trauma for victims of specific trauma contexts are presented. Results of the study indicated that female veterans with a history of cumulative rape experiences and civilian rape experiences are more at risk for anxiety and depression than those with only a military experience of rape. No significant differences were found for impact of event scores for different contexts of rape, however. Reporting of trauma was not associated with psychological well-being for women veterans. The results highlight the role of the socioenvironmental context of abuse as an important variable to examine, especially in military populations.
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PMID:Socioenvironmental context of sexual trauma and well-being of women veterans. 1277 77

This article describes some of the special health and safety concerns that many lesbian, gay, bisexual, and questioning youth face in schools. Among these problems are increased drug and alcohol use, sexually transmitted infections and pregnancy risks, depression and suicidality, and increased likelihood of being a victim of harassment or assault. School nurses can play a unique role in the lives of these students. A needs assessment is reviewed that describes school nurses' perceived professional responsibility and their actual practice with regard to lesbian, gay, bisexual, and questioning youth. Five barriers to optimal health care for these students are discussed. Methods that encourage students to view the school nurse as an ally, as well as issues surrounding disclosure or "coming out," are discussed. Special considerations of confidentiality, community agency referral, and family disclosure are discussed. Appropriate interventions at school and ways to begin to change the school climate are also presented.
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PMID:Making schools safer and healthier for lesbian, gay, bisexual, and questioning students. 1449 73

Recent reports indicate 97% of youth are connected to the Internet. As more young people have access to online communication, it is integrally important to identify youth who may be more vulnerable to negative experiences. Based upon accounts of traditional bullying, youth with depressive symptomatology may be especially likely to be the target of Internet harassment. The current investigation will examine the cross-sectional relationship between depressive symptomatology and Internet harassment, as well as underlying factors that may help explain the observed association. Youth between the ages of 10 and 17 (N = 1,501) participated in a telephone survey about their Internet behaviors and experiences. Subjects were required to have used the Internet at least six times in the previous 6 months to ensure a minimum level of exposure. The caregiver self-identified as most knowledgeable about the young person's Internet behaviors was also interviewed. The odds of reporting an Internet harassment experience in the previous year were more than three times higher (OR: 3.38, CI: 1.78, 6.45) for youth who reported major depressive symptomatology compared to mild/absent symptomatology. When female and male respondents were assessed separately, the adjusted odds of reporting Internet harassment for males who also reported DSM IV symptoms of major depression were more than three times greater (OR: 3.64, CI: 1.16, 11.39) than for males who indicated mild or no symptoms of depression. No significant association was observed among otherwise similar females. Instead, the association was largely explained by differences in Internet usage characteristics and other psychosocial challenges. Internet harassment is an important public mental health issue affecting youth today. Among young, regular Internet users, those who report DSM IV-like depressive symptomatology are significantly more likely to also report being the target of Internet harassment. Future studies should focus on establishing the temporality of events, that is, whether young people report depressive symptoms in response to the negative Internet experience, or whether symptomatology confers risks for later negative online incidents. Based on these cross-sectional results, gender differences in the odds of reporting an unwanted Internet experience are suggested, and deserve special attention in future studies.
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PMID:Linkages between depressive symptomatology and Internet harassment among young regular Internet users. 1514 Mar 67

The authors developed a model of childhood perceived peer harassment, using several personality, peer, and familial characteristics of victims, and tested it with children 10 to 11 years old (N = 3,434) drawn from the Canadian National Survey of Children and Youth, which is a stratified random sample of 22,831 households in Canada. A 3-step analytic procedure with 3 separate subsamples of the children was used to explore psychosocial correlates of peer harassment. Results from the latent variable path analysis (comparative fit index = .90) showed that victims are likely to feel anxious and disliked by their peers. Their parents reported using high levels of control and low levels of warmth with their children and reported high levels of depression and marital conflict themselves. These results are discussed from a social-cognitive perspective.
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PMID:A model of childhood perceived peer harassment: analyses of the Canadian National Longitudinal Survey of Children and Youth Data. 1521 85


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