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Psychosocial Environment

Common Stressors

Stress, much like beauty, is in the eye of the beholder. What is stressful for one person may not be for another. However, there are some events and environments which typically cause stress:1

  • Changes to family: marriage, pregnancy, death, divorce, a new child
  • Work environment: job change, job loss, promotion, work overload, conflict at work, business failure, employee strike
  • Living environment: new house, relocation to a new community, loss of a home, neighborhood crime
  • Physical environment or conditions: noise, pollution, traffic, violence, illness, disability, injury, pain, cold, heat, lack of sleep, hunger, malnutrition, natural disaster, unsafe surroundings, physical abuse or neglect
  • Economic environment: poverty, escalating bills, unanticipated expenses, theft
  • Social environment: isolation, family or peer demands, forced separation (such as from military service, prison, abandonment or conflict), grief, emotional abuse or neglect, legal entanglements, bullying, difficult roommates or neighbors

Games are serious business in China. The country's online game market will reach 41 billion yuan by 2012 ($6 billion), accounting for half the global market, according to newly released data from Cnzz.com Inc., a Beijing-based third-party data analysis firm (related report in Chinese here).

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Carmelo
Of the 27 provincial-level regions that outpaced the country's 6.7% GDP growth in 2016, only three regions - Chongqing, Guizhou and Tibet - achieved double-digit growth.
The world's first flying bicycle flew on November 9, 1961, when Derek Pigott of the University of Southampton flew in a bicycle with an airplane-like body. It was called the Southampton University Man Powered Aircraft (sumpac). Derek furiously pedaled the air-bike to get it off the ground. It then flew 1.8 meters (about 6 ft) above the ground over a distance of 64 meters (210 ft). While the flight was short and slow, it still does not change the fact that it was the first bicycle to fly and at the same time, the first human-powered flight.

Well, at least Hilary has won something this year. I'm sure she's thrilled.
Immigrant populations in Arkansas, North Carolina and Tennessee have more than tripled since 1990, noted Lee Drutman, a senior fellow at the New America Foundation, in an analysis for Vox. Anxiety over those changes may explain why the Republican Party became so much more focused on limiting immigration over that period — and why white voters in those states overwhelmingly support Mr. Trump.
1. Bubble With No Name Yet triggers the biggest crash in 30 years

Our psychosocial environment includes our responses to stressors in our lives, from temporary ones such as a traffic jam to major stressors such as war, homelessness or major disease. Our relationships with family members, friends, colleagues and other individuals and groups with whom we interact in our communities are an important part of this environment. These can impact our capacity to deal with stressors. Nurturing, supportive relationships allow us to better access all our innate resources to respond to stress in positive ways.2

family support

 

近5年70城房价报告:26城二手住宅价跌回5年前

Recipient: President-elect Donald Trump and Hilary Clinton (joint winners)
We had everything before us, we had nothing before us…
节目10 歌曲《茉莉花》,宋祖英 席琳-迪翁

Stress and the Body's Response

Our bodies, families, communities and lives are embedded in a complex network of systems. The degree of support in the environment can shape a person’s resilience. Likewise, an environment that is stressful can foster disease. The conditions of a person’s social and psychological environment—those in which they are born, grow, live, work and age—are known as the social determinants of health. These conditions are shaped by the distribution of money, power and resources at global, national and local levels.3

Risks for Stress: Riskscapes

A riskscape, or landscape of risks, captures the overlapping threats to health occurring in a physical location that increase risk for disease.4 An example of overlapping risks can be seen in impoverished neighborhoods,5 which often experience many of the stressors listed above simultaneously. We discuss poverty in more detail on our Socioeconomic Environment page.

Minority status, age and gender further interact to increase risk for disease.6 Individuals experience additional adversity when they live amid wealth and affluence but do not share those resources.7

大师级别的老式、线性的动作电影拍摄,充满污秽、朋克、反乌托邦的澳大利亚式幽默。也是最近除玛格丽特·阿斯特伍德(Margaret Atwood)的小说之外,最好的生态-女权-社会主义作品。
adj. 透视的
谷歌2017搜索排名靠前的包括马特·劳尔和飓风厄玛。搜索巨头公布了它今年的年度搜索结果榜单,内容主要是在全球各类行业中谷歌搜索排名靠前的几位。

Stressful Environments and the Social Ecological Model of Health

The rise of chronic disease is a complex and growing problem for public health in the US.8 Stress, particularly exposure to long-term chronic stress, is associated with the majority of chronic health conditions.9

Social Ecological Model of Health

The Social Ecological Model of Health Promotion (SEM) describes how our psychosocial experiences are nested inside layers that influence health and well-being:10

  • individual
  • interpersonal (familial)
  • communal (neighborhood)
  • societal

The Human Stress Response System

This response system is evolutionarily old and has been shaped by the environmental experiences of thousands of preceding generations. Through millennia of adverse environmental challenges, adaptations and collective evolution, humans have developed a sophisticated stress response system.11

The physical stress response is a complex network of coordinated physical and behavioral activations from the endocrine and nervous systems:12

When a threat is perceived, the hypothalamus activates the sympathetic nervous system (the "fight or flight" response) by sending signals through the autonomic nerves to the adrenal glands. The adrenal glands pump the hormone epinephrine—also known as adrenaline—into the bloodstream, causing several physiological changes:13
  • ['pail?t]
  • 京二手房现全面"砍价" 年成交13.4万套跌一半
  • 这部20世纪70年代黑色幽默犯罪电影的主角,是诈骗高手欧文·罗森菲尔德和他的情妇西德尼·普鲁塞尔,他们被一名联邦调查局(FBI)干员抓获,然后被迫欺骗腐败的政治家。二人继续与干员、政治家目标以及自己的家人周旋,最终达成豁免协议,得以不受任何刑事指控就脱离苦海。
  • 学区房购买风险增大:房价领涨、入学政策收紧
  • 又一住房制度配套政策出台!险资获准进入长租市场
  • Remember Anthropoid. A rather overlooked drama from earlier this year, it starred Jamie Dornan and Cillian Murphy in the story of a failed assassination attempt on Hitler's third in command, SS General Reinhard Heydrich. Another crack at this story is being attempted with HHhH, this time round with Jacks Reynor and O'Connell as the plotting soldiers, plus Rosamund Pike and Mia Wasikowska as the objects of their affections, and Jason Clarke the target of their anger.
    The school ranks first for alumni satisfaction.

When the initial surge of epinephrine subsides, the hypothalamus activates the 楼市利好政策显效?18城房价回升北上广深领涨, signaling the release of cortisol to keep the sympathetic nervous system engaged.

When the threat passes, the parasympathetic nervous system (the "rest and digest" function) calms the body and returns it to a pre-threat state.

PsychosocialHPA

Click to zoom

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The SEM is particularly useful in allowing researchers to study stressors from the micro scale (cellular) to the macro scale (social policy), positioning their work in the larger social ecological context.14 Layers are labeled with their corresponding social determinants of health.

PsychosocialSEMModelLWalker

北京房租上涨:400万间租赁缺口引发对存量房疯抢

Policies that affect economic and social determinants (top level) can decrease access to income and education, and have powerful effects on neighborhood stressors.15

These policies shape disparities in local environments (second level)16 such as poverty, pollution, crime rates and political power.

Daily opportunities (third level) create or suppress nurturing environments and govern the frequency and intensity of daily hassles (discrimination and microaggressions).17

These layers affect our daily behaviors and patterns (fourth level) and daily interactions.

As these pressures funnel down from the political to the community to the individual, they become observational cues (fifth level) that the environment is threatening, unpredictable or uncontrollable and thus stressful.18

Upon activation, the brain sends signals to the body to mount a stress response.19

stressed child

宽松货币政策难改楼市走向 去库存仍是关键

Allostasis: The Body’s Stress Response

When the brain interprets a threat, it sends a cascading signal through the body that causes a stress response, known casually as "fight or flight" and more formally as an allostatic response.20 See The Human Stress Response System at right for more detail.

In healthy doses and supportive environments, this response is tempered and can foster learning.21 In adversarial environments the allostatic response can manifest as chest pain, heart palpitations, headaches, dysphagia (difficulty swallowing), intestinal cramping, anxiety, panic, immobility, frustration, muscle tension and inflammation.22

These reactions can be exhausting and imprint a strong memory of fear on the brain.23 Fortunately, a feedback system in the brain is capable of stopping the stress response. 24 Terminating the stress response and restoring the body to pre-stress response states is important to protecting the body’s long-term health.25

Programming the Stress Response

When early-life experiences signal that the environment is unpredictable, threatening or uncontrollable, the stress response system may be reprogrammed, becoming blunted,26 or may be programmed to be sensitized and thus more responsive.

Responsivity is informed by the number of steroid receptors available during stress termination.27 The feedback system in the brain—cells in the hippocampus—have glucocorticoid receptors that, once filled, signal the termination of the stress response. When there are fewer glucocorticoid receptors in these cells, it takes a higher circulating quantity of cortisol to terminate the stress response.

The number of receptors available in the feedback system is dependent on how many proteins are produced in that cell. This is determined by the availability of the receptor gene to be transcribed into proteins. Stress signals, such as cortisol, circulating in maternal blood during pregnancy, can epigenetically alter the glucocorticoid receptor gene to be permanently downregulated, causing fewer receptor proteins to be produced.28

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How our bodies respond to stress varies across the population,29 determined by genetic predisposition30 and previous experiences including exposure to maternal stress signals before birth31 The typical responsivity can be modified by genetic predisposition32 but is generally neither amplified nor repressed.33 This neutral programming is optimal in moderately stressful environment where life is not overly threatening nor consistently safe. Over an individual’s life, neutral programming is optimal in balancing the risk for internal burnout from repetitive stress burden and survival in adverse environments long enough to maximize periods for mating and parenting.34

Chronic Stress and Disease: Weathering

With repeated exposure to stressors, the HPA axis activation is sustained, and stress signals continue to flood the body. This sustained activation delays the onset of restorative repair and pushes the body into pre-disease states.35 Chronic stress acts on the cardiovascular, metabolic, neuroendocrine and immune systems:36

  • predecessor
    支持:洛杉矶影评人协会将其评为最佳影片。
  • 德银资产管理公司(Deutsche AM)亚太区被动型资产管理部门主管马尔科?蒙塔纳里(Marco Montanari)也认为,在亚洲ETF市场迈向更高台阶之前,必须从根本上改革分销制度。
    在领英平台上高频出现是找工作的关键。你知道这点,你们经理也知道这点。你的经理兴许还知道你知道这点。所以她会从开始关注周一你的个人简介只是有个大概框架,到周五你增加了工作经历,新人脉,状态更新,推荐信慢慢被顶起,别一夜之间从0涨到500那样太明显了Foss提醒道。
    保安负责监管烘焙坊一次能容纳多少蛋糕狂热者。当然,木兰烘焙坊并没有因为人多而怨气冲冲。烘焙坊把电视剧纪念品展览于多家分店的墙上,并引以为豪。现在,木兰烘焙坊以香蕉布丁而闻名,但他们的最初成功应该归功于凯莉·布拉德肖以及红天鹅绒纸杯蛋糕。
    adj. 荒谬的,可笑的
    1. 碧昂斯(Beyoncé),《碧昂斯》,Parkwood Entertainment/Columbia。这张专辑是继去年的平淡后的一次突击,是碧昂斯的力作,它光彩夺目地展示了充满情感的统治力、精良的制作、欲望的放纵与女性主义的力量(不一定是按这个顺序),在漫长而充满众多娱乐的一年里一直令人关注。她的歌唱与她的态度一样,极为自信而又充满细节;她所传达的信息复杂而又清晰。这是高端的流行乐,拒绝曲意逢迎。

Over time, stress deteriorates health and resilience. This process is referred to as weathering.37 Just as a flag that weathers many storms begins to fray, so too does the body when it experiences harsh environments of social inequity.38 The health outcomes are mental illness, chronic disease morbidity and premature death.39 In short, stress causes physical changes that impact our health and functioning.

The frequency, duration, intensity, source, target and proximity of stressors influence the extent of the stress response. The duration of response can increase an individual’s risk for physical and mental burnout. Stressors that are higher intensity or longer duration carry a high internal burden (allostatic load).40 Over time this internal pressure forces body systems to adapt in ways that foster pre-disease states.41

In weathering, each body system adapts to this internal pressure through secondary changes:42

Dysregulation in these areas  can cause these secondary changes.43   With chronic stress, such changes increase the risk for these conditions:44
  • Cardiopulmonary system
  • Metabolism
  • Mental functioning
  • Autoimmune response
  • Aging
  • Increased startle response
  • Anxiety and vigilance
  • 吴振程:要因地制宜确定棚改安置方式
  • Glucose sensitivity
  • Immune suppression
  • 全国二手房价一年来首涨 一线城市涨幅位居前列

Stress-induced Gene Expression

Physiologic shifts following stressful exposures occur in large part through hormone-activated gene expression.45 When cortisol is released by the adrenal glands into the blood stream, it targets glucocorticoid responsive genes in tissues distributed throughout the body,46 including the central nervous system, metabolism, immune, cardiovascular, endocrine and renal systems.47

Within each cell nucleus, the steroid hormone binds with its receptor, and this complex binds to a stretch of DNA called a hormone response element.48 This binding activates gene expression to shift the physiologic activity of the target cell. In this way, stressful experiences, mediated through the allostatic response, have an epigenetic effect on the body.

See our Gene-Environment Interaction page for further explanation.

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Through this process, chronic stress responses cause weathering on the body, eroding health status.49 As years turn into decades, the physiologic changes (such as hypertension, metabolic disorder or anxiety) may become irreversible, often increasing co-morbidities, potentially increasing maladaptive coping mechanisms (such as social aversion, drug and alcohol dependence) and decreasing life expectancy.50

Through these mechanisms social structures can get under the skin, alter our bodies and cause disease. The loss of productivity and financial burden of systemic disease further erodes family and community resilience, especially when the chronic stress starts in childhood.51

Disadvantaged Populations

Lower social classes experience longer durations of chronic stress, such as lengthy unemployment or institutionalized discrimination. Those with less power experience barriers to achievement of life goals, such as high costs of educational programs or lack of childcare options, inadequate recognition and rewards for personal qualification (such as gender pay differences) or for invested effort in the workplace. In the US and other White-majority countries, minorities and women in these environments are exposed to more chronic stressors than their White male counterparts due to differential expectations resulting in role strain and interpersonal conflict.52

Both the sources and frequency of stressors are not distributed equally in society, with heavier burdens borne by those with less advantage.53 These systems of inequity create differences in health outcomes, known as health disparities.54

Stressful Environments and the Developing Child

Stress Effects on Brain Development

它是一种受谅解和制度制约的权力争斗。
我倒是并不担心费城、凤凰城和明尼苏达的球队。他们队伍都很年轻,都在重建的路上。如果他们能够取得进步,那很好,就算没有,他们也能获得高顺位的选秀权。而篮网队则是另一个故事了,我们稍后会讨论到他们。
报告称,去年销售的手机大部分是预装安卓系统和支持4G的智能手机。
在不久的将来,罗根(休?杰克曼饰)已迈入暮年。他在墨西哥边境附近的一个藏身所里照顾着重病的X教授(帕特里克?斯图尔特饰)。他计划隐世度日,但他遇见了一个非常像他的年轻变异人劳拉(达芙妮?基恩饰)后,这个计划搁置了。罗根必须保护这个女孩,与要捕杀她的黑暗势力斗争。
Ellen DeGeneres:
韩语用户设置的"你的出生地"猜10次就能成功破译的概率是39%。
影片大量借鉴了亚瑟·布雷默的事迹,此人于1972年枪击了总统候选人和隔离主义者乔治·华莱士。与电影中一样,布雷默枪击华莱士也是在被一个年轻女孩拒绝后不久。尽管如此,他的生活总的来说不如德尼罗的角色那么激动人心,他俩最大的共同点,就是都没有真的杀死目标。

These exposures increased amygdala function, which enhances fear, anxiety, and emotional dysfunction, while it decreased prefrontal cortex function, which participates in regulating and terminating the stress response.55

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Our stress system responds to environmental conditions even before birth56 and is especially sensitive early in development.57 Glucocorticoid receptors are found in most fetal tissue and in the placenta, suggesting they are capable of responding to high maternal cortisol. Early-life experiences shape our stress response and therefore the impact stress has on our health over the life course.

A person’s individual responsiveness to stress signals can shape brain development.58 Highly responsive individuals demonstrate better learning and health outcomes in supportive environments and worse health outcomes in high adversity environments.59 Supportive environments foster better mental and social learning, increase memory and improve decision-making; in such environments, children have adequate time for stress response termination and are generally characterized by openness to information.

In negative environments, however, high responsivity magnifies the body’s response to intense or chronic stressors, increasing the risk for weathering over the life span. Highly responsive individuals can become hypersensitive to social feedback and psychological manipulation, both capable of detracting individuals from achieving goals.60 This increases the risk for future stressful experiences, further increasing the risk for weathering.

cycle of stress and performance

Stress responsivity shapes the intensity of weathering and has implications for later adult health outcomes.61 Responsivity biased toward either under- or over-reactivity can predispose children to adult disease.62 For example, overexposure to maternal stress hormones before birth can restrict birth weight and predispose the developing child to hypertension later in life.63 Effects of parental stress, such as reduced opportunities for bonding and distant parent-child relationships, significantly increase the risk up to fourfold for a child to experience anxiety, depression, diabetes and heart disease as an adult.64 Higher prenatal glucocorticoid exposure is directly associated with higher circulating glucocorticoids in adulthood, and both are associated with increased hypertension and hyperglycemia and changes in adult behaviors.65

Investigating Brain Changes

We rely heavily on animal models to understand early-life stress programming because sampling a core of living human brain is not an option. However, we do have direct human associations: the brains of suicide completers show epigenetic changes in the glucocorticoid receptor gene66 as well as methylation changes in other important genes that inform the intensity of the stress response.67

Newborns of mothers with depressive symptoms during pregnancy also demonstrated increased methylation of the GR gene in umbilical cord blood cells. As three-month-old infants, these children had higher levels of salivary cortisol.68

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Brain Changes

With exposure to chronic stress, the brain changes shape, reducing connections that support nuanced cognitive function, self-regulation and memory; this process is less reversible as a child ages. Through these changes, chronic stress increases the likelihood of aggression, vigilance and anxiety.69 Because an individual suffering from these changes and conditions is handicapped in becoming a nurturing parent (although many people do overcome adversity and become terrific parents), the effects of stress can be self-perpetuating down generations. Through stress biasing, the social determinants can become multigenerational stimulants of chronic disease.70

To the individual, there is a cost for high responsivity. Early life stressors that reshape the brain affect hippocampal and amygdala development that can affect a child’s transition into adolescence. Chronic early stress impacting social learning may predispose teens to depression and substance abuse, both feeding into adult chronic diseases.71 This is a vicious cycle of early childhood adversity. The stress that parents experience can have direct influences on a child’s biological capacity in responding to future stressful situations.72 The parent-child relationship, in utero and through development, provides experiential information that programs stress responsivity.

Telomere Changes

Telomeres are structures on the ends of chromosomes that protect and stabilize chromosomes. They are essential for avoiding cellular dysfunction. Telomere length is reduced with age, smoking and stress, and shorter telomeres can impair health.73

Telomere length in specific blood cells is viewed as a biomarker for cellular aging that is closely associated with age-related and chronic diseases.74 This biomarker may reflect population-level weathering in communities. For example, a study of nine-year-old boys found that adverse environments shaped by low income, low maternal education, unstable family structure and harsh parenting were associated with a 19 percent shortening of white blood cell telomeres as compared to a cohort in more nurturing environments. These boys physically aged faster than their chronical age would suggest. Children with the most sensitivity (highest responsivity) to stress showed the longest telomeres in advantaged environments and the shortest in disadvantaged environments.75

Resilience

Resilience, the capacity to recover quickly from difficulties, is a characteristic of both individuals and communities. Parental bonding is a resilience factor, protecting children from the adverse effects of poverty on emotional and cognitive development.76

Community resilience is difficult to define and measure; the US Department of Health & Human Services defines it as "the ability of a community to use its assets to strengthen public health and healthcare systems and to improve the community’s physical, behavioral, and social health to withstand, adapt to, and recover from adversity".77   A resilient community is one that is socially connected, takes collective action, and has access to necessary resources.

Substantial risks to community health and well-being lie within community adversities such as climate change, urbanization and disparities. In the context of a natural or manmade disaster, increasing community resilience includes better preparedness and disaster planning, promoting community systems, and reducing threats to health. These are some steps communities and public health can take to build resilience:78

  • 在定制课程排行榜上,排在第二名瑞士洛桑国际管理发展学院之后的是杜克企业教育学院(Duke Corporate Education)。这是这所美国学校连续第3年位列第三。该校在2014年连续第12年占据定制课程排行榜榜首位置,创下纪录。
  • 智能家居市场暗流涌动 离爆发期还有多久?
  • According to the report, students from prestigious universities were less willing to start businesses, likely because of high opportunity cost.
    [wi:t]
  • 一周内42家网贷平台爆雷 国资民营系都不靠谱
  • Build social connectedness

Interactions between Chronic Psychosocial Stress and Environmental Toxicants

Research shows impacts of combined stress and toxicants:79

  • 参与本次突袭犯罪活动的警察说,他们还发现了牛百叶、软骨和其它早已过期的动物器官,这些都是从邻国越南走私来的。警方共查处非法肉类20吨。
    Although Downey has a few movies coming out next year, they’re much smaller than his superhero films. He won’t see another huge payday until 2015 when Avengers: Age of Ultron hits theaters.
  • Sam Smith, 'The Thrill of It All'
    e出,pi,sode与sell的过去试sold发音一样:出门把pi卖了,这绝对是人生的一个插曲。
  • 至于说比特币进入主流银行体系?卢德温表示:“据我们估计,现在距离知名金融服务公司采用比特币,还有很长的路要走。但是用不了10年那么久。而且一旦出现萌芽,其推广的速度之快将令人震惊。”(财富中文网)
    adj. 代理的,副的
  • 理想化地描述并粉饰往昔,把往昔置于想象中的玫瑰色光环中,这是人类的天性。
    “I’m 17 – I want to be with my family and friends and school,” he said. “I’m going to be in London for the foreseeable future.”
    Bubloons are a hybrid between bubbles and balloons.
  • 在进行融资时,约40%的创业者并未寻求任何外部帮助。他们中的半数完全依靠自己的积蓄及(或者)家人和朋友的资助,相比之下,只有40%的创业者向学校或校友网络寻求帮助。
    The company is hardly alone in its efforts to woo talent of a different sort. Earlier this year Intel announced a collaboration with the Council of Fashion Designers of America, or CFDA, kicking off a partnership with the high-concept retailer Opening Ceremony to design its smart bracelet. Tory Burch partnered with Fitbit to design pendants and bracelets akin to the Shine Tracker by Misfit Wearables. And Apple AAPL -1.03% has tapped a diverse group of people, including former Burberry chief executive Angela Ahrendts (to lead its retail efforts), former Yves Saint Laurent CEO Paul Deneve, and former Nike NKE -0.71% design director Ben Shaffer.
  • Research in Southern California children found that living in a high-stress home is associated with more susceptibility to the negative effects of air pollution on the lungs.80  
  • In a study of children from birth to age seven, children who experienced high levels of air pollution in utero had lower IQ scores than those not exposed, but only when their mothers experienced material hardship.81

Selected Sources of Stress and Impacts on Health

Psychosocial risk factors for disease include family conflict, neighborhood violence, work stress and social discrimination; these factors can hinder mental and physical health.82

Domestic and Intimate Partner Violence

Global Domestic and Intimate Partner Violence

Globally, most data available is on intimate partner violence and sexual assault against women. An estimated 35 percent of women worldwide have experienced intimate partner violence over their lifetimes. Violence rates range from 71 percent of all women in Ethiopia to 15 percent of all women in Japan. Worldwide, up to 38 percent of all murders of women are committed by their partners.83

Domestic and Intimate Partner Violence: United States

Domestic violence includes violence from spouses, partners, parents, children, siblings or relatives. Three-quarters of incidents occur against women.84 In fact, it is estimated that a US woman is assaulted or beaten every nine seconds.85

Types of Domestic Violence.86

  • Rape
  • Sexual assault
  • Robbery
  • Intimate partner assault

Most violence occurs around the home (77 percent),87 and 19 percent of all violent incidents include the use of a weapon.88

The 专家解读以房养老 如何把好事办好? shows that between 2003 and 2012, domestic violence accounted for 21 percent of all violent victimizations in the US, with 70 percent of those from intimate partner violence (IPV).89

graph of violent relationships

data from Truman and Morgan90

Preventing Violence in Relationships

Research in high-income areas indicates school-based programs can help prevent relationship violence among young people.91

Costs. Intimate partner violence accounted for $4 billion annually in 1995 in health care services and an additional $900 million in lost productivity.92 When these amounts are updated to 2003 figures, $8.3 billion in annual expenses are estimated, a combination of higher medical costs ($5.8 billion) and lost productivity ($2.5 billion).93

Health outcomes of intimate partner violence. In addition to death and injury (bruising, flesh wounds, fractures, brain injury and headaches), the cardiovascular, gastrointestinal, immune, and endocrine systems are impacted from violence-induced stress, as discussed above.

Health Consequences of Intimate Partner Violence94

Health conditions 

Asthma

Infections

Circulatory conditions

Cardiovascular disease

Fibromyalgia

Irritable bowel syndrome

Chronic pain

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Gastrointestinal disorders

Joint disease

Migraines

Headaches 

Reproductive conditions

Gynecological disorders

Pelvic inflammatory disease

Sexual dysfunction

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Delayed prenatal care
Preterm delivery

Low birth weight babies

Perinatal deaths

Unintended pregnancies

Psychological conditions

Anxiety

Depression

PTSD

Antisocial behavior

Suicidal behavior in females

Low self-esteem

Inability to trust

Fear of intimacy

Emotional detachment

Sleep disturbances

Flashbacks

Social impacts

Restricted access to services

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Isolation from social networks

Homelessness

Health behaviors

High-risk sexual behaviors

Harmful substance abuse

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Overuse of health services

Child Abuse and Neglect

The CDC provides some 2014 facts on child maltreatment (either abuse or neglect) in the US:95

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The CDC estimates total lifetime costs of child maltreatment at $124 billion annually.:96

Youth Violence

Any violence—including being a victim, offender or witness—in early childhood extending into young adulthood is considered youth violence. The US CDC provides some important US statistics to consider:97

  • It replaces strollers and big backpack carriers that might even make it heavier or cumbersome for you to take your children out.
  • In 2012, an average of 13 people ages 10 to 24 were victims of homicide and 1642 more were treated in emergency departments each day.
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    6. Cutting Down on Saturated Fats Could Preserve Your Memory
  • 就这一点而言,他预计美国投资会回升,“因为投资一直太弱——除非在经济衰退期,我们通常不会看到投资增长低于消费增长”。

Inspire strategies

World Health Organization with CDC and other global partners created INSPIRE, a technical package of seven evidence-based strategies to end violence against children. Click to open the Inspire infographic from the WHO website.

Risk factors for youth violence:98

  • A history of violence
  • Substance abuse
  • Delinquent behaviors
  • Poor family functioning
  • Poor grades in school
  • Community poverty

Adverse Childhood Experiences

PsychosocialCDCACEpyramid

graphic from the CDC;99 click to zoom

Adverse childhood experiences—ACEs—were first identified in the late 1990s. The risk for violence, victimization, and disease outcomes are heavily impacted by early childhood experiences. As shown at right, adverse childhood experiences can set children on an arduous path that increases risk for poor health behaviors, disease, disability, social problems and early death outcomes.100

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  • Investors are divided as to whether the anticipated rate increase by the US Federal Reserve tomorrow has already played out, or will intensify stress for indebted companies and economies.

Examples of Adverse Childhood Experiences

Abuse

  • Emotional
  • Physical
  • Sexual

Household challenges

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  • Household substance abuse
  • 非京籍买共有产权房可落户北京? 专家:系误读
  • Parental separation or divorce
  • Criminal household member

Neglect

  • Emotional
  • Physical

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  • Alcoholism / alcohol abuse
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  • Depression
  • Fetal death
  • Illicit drug use
  • Ischemic heart disease
  • Liver disease
  • Financial stress
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  • Sexually transmitted diseases
  • Suicide attempts
  • Smoking
  • Adolescent pregnancy
  • Risk for sexual violence
  • Poor academic achievement

Neighborhood Violence

Living in a neighborhood that experiences high levels of violence can have a devastating impact on people’s long-term mental and physical health.  People who live in neighborhoods with high rates of violence suffer from trauma-related illnesses such as post-traumatic stress disorder (PTSD), at higher rates.101

child memorial in a poor neighborhood

The number of students who will study abroad after graduation has also seen a drop, down from 4.8 percent last year to 3.4 percent.

Exposure to neighborhood violence is especially harmful for children—it has been shown to impair children’s cognitive abilities and academic performance, and potentially contribute to inattentive and compulsive behaviors.102

Other health outcomes are associated with negative characteristics of residential settings including fewer cancer screenings, cardiovascular disease, and the outcomes of violence discussed above. The risk or resilience of a community can directly affect the prevalence of child maltreatment.103

A 2015 review of national and international studies in urban areas found these associations. More research is needed in rural areas to understand if these factors are generalizable:104

  • In the US community unemployment rate, per capita income, poverty rate and educational status were associated with intimate partner violence.
  • Internationally, though lacking representation from Europe or the Middle East, intimate partner violence was associated with community norms, community attitudes towards women, women’s literacy, education, and murder rates. Women’s empowerment is also shown to be protective against IPV.
  • Households with higher proportions of children were also associated with an increased risk of IPV.
  • Community characteristics such as lower collective efficacy, social cohesion, higher perceived neighborhood disorder, and general social disorganization are associated with an increase of IPV. Although crime and violence rates themselves have mixed results with association to IPV, higher levels of perceived violence and worry about violence are associated with IPV.

Discrimination

Racism, sexism, and other forms of discrimination exert a negative influence on mental health in a variety of ways. While experiencing discrimination within a person’s community is deeply stressful in and of itself, discrimination can also place certain groups at a higher risk of other adversities (poverty, segregation, unemployment, violence), which can also negatively impact health. Systematic racism, for example, raises exposure of communities of color to social exclusion and economic adversity, thereby placing them at a higher risk of stress, anxiety and chronic disease.105

Work Stress

Many factors in a person’s workplace can have a negative impact on their mental well-being. Factors such as poor work satisfaction, high demand, low job security, harassment and work disorganization can all cause people to feel substantially stressed while on the job. A 2016 investigation found 43 percent of working adults said their job negatively affects their stress levels. Others said their job negatively affects their eating habits (28 percent), sleeping habits (27 percent) and weight (22 percent).106

Behavioral Responses to Stress

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Stress and Addiction

substances often abused

 

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Stress a powerful risk factor for both developing an addiction and relapsing back into addiction.107 Stress affects the reward pathways of the brain, those same pathways involved in stress, in ways that make people especially prone to become addicted to substances such as nicotine, alcohol and drugs.108

Health-supporting Mechanisms

CDC offers healthy ways to cope with stress:109

  • Take a break, even a short one
  • Breathe deeply
  • Exercise
  • Visualize
  • Scan your body for tension
  • Talk to someone
  • Focus on the here and now
  • 对民主主义者而言,此类原始情绪的爆发之所以令人担忧是因为它们很难遏制。
  • Cut out the caffeine
  • Face the problem

What we know about stress and addiction:110

  • It was also the first time Shanghai witnessed a decrease in its permanent population since China adopted the policy of reform and opening-up in 1978, Guo Feng, a research fellow at Shanghai Finance Institute, was quoted by news site wallstreetcn.com as saying on Tuesday.
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  • 理查三世是金雀花王朝的最后一位国君,都铎王朝的继任者将其塑造成了不惜一切代价追求权力的无恶不作的暴君,还称他谋杀了他的两个侄子-也就是“塔中王子”-来保住王位。
  • 北京市规划部门回应东四环商业项目变住宅
  • A separate Caixin PMI tracking growth in China’s services sector is slated for release on Tuesday.

One reason stress is a such a risk factor for substance abuse is that substance abuse can temporarily reduce anxiety caused by stressful events. As stress levels become chronic, the body responds with dysregulated hormonal states and stress-related behaviors that can produce anxiety. This predisposes an individual to seek substances that temporarily alleviate this stress-induced physical state. After the 9/11 terrorist event in the US, researchers noted a corresponding increase in the sales of various street drugs.111

Those who drink alcohol report that doing so makes them feel relaxed and less stressed. However, using alcohol as a coping mechanism for stress, especially on a regular basis, increases alcohol's harm to the body.

Stress and Antisocial or Violent Behavior

Stressors early in life are heavily associated with aggressive tendencies later in adulthood.112 Universally, childhood maltreatment is a risk factor for conduct disorders, antisocial personality symptoms, and becoming a violent offender. Research has found that abused boys experiencing erratic, coercive and punitive parenting were most at risk of antisocial behaviors later in adulthood, with the earlier the experience the more likely the negative behaviors were. Early child abuse doubles the risk a person will engage in criminal activities later in life.113

Environments That Break the Cycle of Violence114

  • Securing a stable environment
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  • Psychotherapy
  • Promoting positive parenting
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This "cycle of violence" describes the association between experiencing violence during childhood and the increased risk of either becoming violent or being a victim of violence. Although the majority of maltreated do not grow up to abuse others, we do know that one in six maltreated children becomes a violent offender and one in eight sexually abused boys becomes a sex offender.115 Victims of childhood abuse are at an increased risk of abusing their own children. Researchers also have found that up to one in seven children who experienced maltreatment in childhood also experienced abuse by their spouse. Violent experiences can be collective (gang membership), self-directed (harming oneself) or interpersonal (by a parent or other).116


This page's content was created by Lorelei Walker, PhD, and Nancy Hepp, and last revised in September 2016.

CHE invites our partners to submit corrections and clarifications to this page. Please include links to research to support your submissions through the comment form on our Contact page.

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