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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

3.葡萄牙波尔图

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交通运输部科学研究院近日发布的报告显示,北京位居全国十大最拥堵城市排行榜第三,排在济南、哈尔滨之后。
Gender diversity is increasing among graduates working in the financial industry, according to data collected for the 2017 edition of the Financial Times ranking of masters in finance programmes.
单词amnesty 联想记忆:

1. How to make pancakes
n. 城堡
14. On the Other Hand Here is an estimate of the movies directed by women that were released by major studios this year: Warner Bros. (five! — Lana Wachowski, Anne Fletcher, Dana Nachman, Nancy Meyers, Patricia Riggen); Universal (three — Sam Taylor Johnson, Elizabeth Banks, Angelina Jolie); Disney (one — Niki Caro); Paramount (0); Fox (0); and Sony (0). (I excluded Fox and Sony’s specialty units.)

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

 

面朝大海,该不该买?当海景房的理想照进现实

Will businesses finally shed their caution?
冲击奖项:自从在特莱瑞德电影节首映以来,奥德曼一直就是最佳男主角奖项的宠儿。
周二在上海举办的中国国际机器人产业发展高峰论坛称,2017年,工业机器人的销量和增速均创新高。在这些工业机器人当中,有37825台为国产制造,同比增长29.8%。

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

减薪前奥朗德的年收入为25.56万欧元(约合27万4522美元),仅次于美国总统奥巴马。但现在他的年收入仅为19.87万美元。众所周知,他的御用理发师年收入高达13.2万美元。
葡萄牙的成就说明这种转变是可行的,它为各国政府和能源公司提供了一个实实在在的范例,也告诉他们为什么现在应该投资太阳能、风能、波浪能和其他可再生技术。
According to a 2014 survey it conducted, 86 per cent of respondents who finished the two years said they were taking action to end educational in-equality through their work and 65 per cent outside of their work.

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
  • v. 戴面具,掩饰,遮
  • 37万/㎡!北京6.7平房子拍出250万 实地探访房子啥样
  • 反对派是合法的,可以自由表达观点而且权力受到限制。
  • 发改委出文规范电商市场 地板企业征战双11如何取胜?
  • 上半年北京房产市场回暖 二手房成交量同比增长93%
  • 考察指标包括“智力资本和创新”、“技术成熟度”、“区域重要城市”、“健康、安全与治安”、“交通和城市规划”、“可持续发展与自然环境”、“文化与居民生活”、“经济影响力”、“成本”和“宜商环境”。
    adv.

When the initial surge of epinephrine subsides, the hypothalamus activates the 家居商业文明的反思:进步背后的浮躁, 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

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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

京津冀企业达成11项钢铁行业节能减排合作协议

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

家具市场正向大品牌集中 行业洗牌将持续

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

  • Nothing Gold Can Stay
    “Who’s going to pay for that?” said Marc J. Luxemburg, the president of the Council of New York Cooperatives and Condominiums. “This has a real-world cost for many buildings.”
  • 《银河护卫队》之所以能成为一部大获成功的超级英雄系列电影,原因之一就是它的幽默感。这部影片充满了自嘲和讽刺。观看这部影片的时候,你不会一直笑个不停,但至少会有一些瞬间让你哈哈大笑,比如树人和克里斯?帕特出场的时候。
    Average age: 36 for English blended program
    Best chance: Oldman has been the favorite for best actor since the film's Telluride premiere.
    麦高恩出生于多配偶制的邪教家庭,少年时离家出走。
    而相对来说,普遍推出的新限购政策,并未让其他许多最近几个月表现突出的城市受到影响,房价同比依然大幅上涨。

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
  • 电商与家装渠道崛起,木门企业“马太效应”凸显
  • Glucose sensitivity
  • Immune suppression
  • 价格“超标” 北京五六环限房价项目难觅普宅

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

It is a timely warning. His findings, he writes, “point to a heightened risk of emerging market crises in the coming years as the Fed continues to normalise interest rates”.
The book — published by Basic Books and Oneworld Publications — won out against a strong shortlist dominated by books on technology.
在中国版推特新浪微博上,很多网民为男孩危急情况下的勇敢、淡定点赞。
Warm greetings and best wishes for the New Year!致以热烈的祝贺和良好的祝福,新年快乐。
卢华东表示:“今年是西藏反贫困的重要时期,我们将根据不同情况和引起贫困的原因,继续制定政策和计划,并持续增加资金。”
Given that travel costs to Russia may surge in 2018 when the FIFA World Cup will take place there, visiting this year would be a smarter choice.
2014年,世界杯在1978年以后又重新回到南美的怀抱,当时,马里奥·肯佩斯(Mario Kempes)带领阿根廷队战胜了荷兰队,保持着南美球队在南美洲大陆上举行的世界杯中赢得冠军的记录。那么,2014年会有所不同吗?包括卫冕冠军西班牙队在内的欧洲诸强能够实现那些在过去的比赛中的欧洲球队未能做到的吗?抑或,有其他任何大陆能够有实力挑战强大的南美球队吗?

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

  • The Republican candidate appeared unsure at times and occasionally stumbled over his lines as if struggling to remember his briefing notes. He began sweating as Obama, aggressive from the start, got the better of him during exchanges on Iran, Iraq and Russia as well as on US military spending.
  • O2O将至,建材经销商如何转型做电商?
  • 5.英国人喜欢冷幽默:这就是为什么所有出租的自行车都刻着同一家银行的名字,而这家银行正因为固定利率而在被调查阶段。他们也许觉得这很有趣吧。
    超过35万的欧洲玩家(还有一些北美和亚洲玩家)带着朝圣般的心情,赶赴人口刚过100万的德国科隆市,参加一年一度的游戏盛会。美国动视(Activision)在展览中首次公布了Sledgehammer Games工作室的多人游戏《使命召唤:高级战争》(Call of Duty: Advanced Warfare),现场玩家亲身体验了这款将于11月3日正式发布的游戏。
  • 西安官方:成立调查组 查实摇号信息登记真实性
  • Build social connectedness

Interactions between Chronic Psychosocial Stress and Environmental Toxicants

Research shows impacts of combined stress and toxicants:79

  • 某种程度上,这种借鉴是基于这样的假设:把一种时装风格从它自身的环境中剥离出来,就能同时去除它所有潜在的负面寓意:譬如战争和王朝。它会变成一种独立存在的审美形式,不再象征任何复杂的社会和政治动荡。
    n. 粉底霜,基
  • 以美元计算的话,这一跌幅就更加明显了,上个月出口同比下滑11.2%至1774.8亿美元。这一跌幅不仅超过了去年12月1.4%的跌幅,也超过了下滑1.8%的预期。这是自去年3月下滑15%以来的最大跌幅。
    global
  • 智能冰箱
    Yes, they hedge on the timing but the ticking time bombs are loud, close. And 'the precious-metals crash, starting in April of 2013, was the first warning of what is coming globally.'
  • 《我们这一天/我们的生活》
    你是有人脉,是的没错。但是你是在你的业界彻底地撒下关系网这样你说的话又传到你老板耳朵里了。这个世界太小了Andrea Kay说。他是一位职业顾客也是《如何获得下一份工作》这本书的作者。这样的事情经常发生。当你和新老人脉分享你的简历和其他跟找工作相关的材料时,明确地表明你这次找工作是秘密的Foss说。
    库迪斯认为,这一点在预防21世纪的泡沫和破灭方面具有重要的监管意义。
  • 金球奖的独特之处在于其同时设置电影和电视奖项。而当地时间周日的这场典礼更是前所未有地模糊了二者的界限,大大褒奖了电视领域这一年来的出众表现。现已剧终的热门电视剧集《绝命毒师》(Breaking Bad)今年首次拿下金球奖,赢得了当晚最热烈的欢呼声。该片荣获剧情类最佳系列剧集奖,片中演员布赖恩?克兰斯顿(Bryan Cranston)荣获剧情类系列剧最佳男演员。
    明年,寻找新楼盘的买家将会有更多的选择。根据科克伦阳光营销集团(Corcoran Sunshine Marketing Group)提供的数据,明年(2015年——译注)曼哈顿、布鲁克林和皇后区长岛市(Long Island City)新上市的共管公寓预计将增加一倍以上,从2014年的3444套增加到8366套。
  • 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 2017年LED芯片将处于供不应求状态 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

北京家具产业谨慎转移 三大产业园PK软硬皆施

Gastrointestinal disorders

Joint disease

Migraines

Headaches 

Reproductive conditions

Gynecological disorders

Pelvic inflammatory disease

Sexual dysfunction

2015淋浴房十大品牌最新排行榜

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

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  • 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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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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Examples of Adverse Childhood Experiences

Abuse

  • Emotional
  • Physical
  • Sexual

Household challenges

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  • Household substance abuse
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  • 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

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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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单词lasting 联想记忆:
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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
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  • Cut out the caffeine
  • Face the problem

What we know about stress and addiction:110

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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.

发改委:城乡二元的土地制度是影响中国实现城乡融合发展的重要制度

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