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Background As part of a larger epidemiological study of depression among rural Chinese women, we sought to understand their explanatory models of depression. We explored how participants describe depression, to what cause they attribute depression, and what sources of treatment they would recommend. Methods Participants first were assessed with the Center for Epidemiological-Depression scale (CES-D), with a cut-point of 16 or greater indicative of depression. The Short Explanatory Model Interview (SEMI), a semi-structured questionnaire, was our primary tool for exploring participants’ explanatory models relating to a vignette describing a rural Chinese woman with depression. Results Among the 416 women who consented and completed the SEMI, 277(66.6%) reported that the woman in the vignette had something wrong with her health. Among these, only 8(2.9%) women provided a specific psychiatric name for the condition, while 150(54.2%) provided non-specific psychiatric disease names or affective symptoms, and 78(28.2%)of the sample provided physical disease names. Participants attributed causes largely to internal factors (41.5%) or external factors (36.8%). In terms of help-seeking, 101(36.4%) said the woman in the vignette should see a doctor, 70(25.3%) indicated that she should solve the problem herself, and 42(15.2%) recommended seeking support from family members and friends. We did not find any differences in recognition, causal attribution, and help-seeking suggestions between women with a CES-D ≥ 16 and those with CES-D Limitations The use of a vignette to prompt discussion was not the same as talking about real-life personal situations. Conclusion Our results point to potential challenges and opportunities that lay ahead as China develops mental health services in its vast rural areas among women who may be at risk for developing depression. We found that our participants often attributed their symptoms to internal or external social causes, and preferred not speaking with family members and friends. Our findings suggest that rural Chinese women may be reticent to recognize or describe categorical concepts such as “depression” as a health problem, and they invite further consideration about how best to develop new health services in China's rural regions.

Objective This study examined a primary care-based program to address the health needs of women recently released from incarceration by facilitating access to primary medical, mental health, and substance use disorder (SUD) treatment. Study Design Peer community health workers recruited women released from incarceration within the past 9 months into the Women's Initiative Supporting Health Transitions Clinic (WISH-TC). Located within an urban academic medical center, WISH-TC uses cultural, gender, and trauma-specific strategies grounded in the self-determination theory of motivation. Data abstracted from intake forms and medical charts were examined using bivariate and multivariable regression analyses. Results Of the 200 women recruited, 100 attended the program at least once. Most (83.0%) did not have a primary care provider before enrollment. Conditions more prevalent than in the general population included psychiatric disorders (94.0%), substance use (90.0%), intimate partner violence (66.0%), chronic pain (66.0%), and hepatitis C infection (12.0%). Patients received screening and vaccinations (65.9%–87.0%), mental health treatment (91.5%), and SUD treatment (64.0%). Logistic regression revealed that receipt of mental health treatment was associated with number of psychiatric (adjusted odds ratio [AOR], = 4.09; p p = .04), and higher median income (AOR, 1.07; p = .05); African American race predicted lower receipt of SUD treatment (AOR, 0.08; p Conclusions An innovative primary care transitions program successfully helped women recently released from incarceration to receive medical, mental health, and SUD treatment. Primary care settings with specialty programs, including community health workers, may provide a venue to screen, assess, and help recently incarcerated women access needed care.

Intimate partner violence is a public health problem with increasing prevalence and harmful influence to both individuals and society. Automated screening for intimate partner violence is still an unsolved problem in academic research and practical applications. Current detection methods use self-reporting scales and in-person interviews, which are laborious, expensive, and often lack precision and sensitivity, making it essential to develop new approaches. This paper proposes a scalable and lightweight ubiquitous screening technique, validated via ground truth data collected through self assessment survey, for detecting signs of intimate partner violence by analyzing individual-level Google search histories. Initial analysis shows that there are temporal, textual, contextual differences in search behavior between individuals who have/haven't experienced intimate partner violence. Using these differentiating signals, we were able to build a model that can detect violence in intimate relationships with an F1 score of 0.80. Though preliminary, we hope our findings pave the way for the AI community to address this important public health problem.

Sleep disturbance is a common feature of posttraumatic stress disorder (PTSD), but is not a focus of standard PTSD treatments. Psychological trauma exposure is associated with considerable physical and mental health morbidity, possibly due to the alterations in neuroendocrine function and inflammation observed in trauma exposed individuals. Although PTSD treatments are efficacious, they are associated with high drop-out rates in clinical trials and clinical practice. Finally, individuals with PTSD stemming from exposure to interpersonal violence represent an especially under-treated population with significant sleep disturbance. Community-based participatory research was utilized to design and prepare a clinical trial that randomizes recent survivors of interpersonal violence who have PTSD, depression, and insomnia to receive either: (1) Cognitive Behavioral Therapy for Insomnia (CBTi) followed by Cognitive Processing Therapy (CPT) for trauma, or (2) attention control followed by CPT. Outcome measures include subjective and objective measures of sleep, clinician-administered PTSD and depression scales, inflammatory cytokines, and salivary cortisol. Assessments are conducted at baseline, following the sleep or control intervention, and again following CPT. The design allows for: (1) the first test of a sleep intervention in this population; (2) the comparison of sequenced CBTi and CPT to attention control followed by CPT, and (3) assessing the roles of neuroendocrine function, inflammatory processes, and objective sleep markers in mediating treatment outcomes. The study's overarching hypothesis is that treating insomnia will produce reduction in insomnia, PTSD, and depression severity, allowing patients to more fully engage in, and derive optimal benefits from, cognitive processing therapy.

Objective To explore the associations among dating violence (DV), aggression, relationship power, and depressive symptoms. Design A cross‐sectional survey secondary analysis. Setting An urban, school based health center, October, 2009 through May, 2009. Participants Low income, adolescent girls ( n = 155), ages 14–18. Methods Descriptive and bivariate analyses were conducted to illustrate patterns and associations among variables. Key variables included depressive symptoms, DV victimization and aggression, and relationship power. We used mediation analyses to determine the direct and indirect effects among variables. Results Both DV victimization and aggression were reported frequently. Furthermore, DV victimization had a significant direct effect on depression and an indirect effect through relationship power. Depressive symptoms and relationship power were associated with DV aggression. Although relationship power did have a significant inverse effect on depressive symptoms, it was not through DV aggression. Conclusions Complex associations remain between mental health and DV; however, relationship power partially accounts for DV victimization's effect on depressive symptoms. Depressive symptoms are associated with DV victimization and aggression; therefore, nurses should address relationship power in clinical and community interventions.

This paper explores the impact of intimate partner violence on victim health and proposes interdisciplinary coordination between legal and mental health services as a means to assist victims. Data was collected from 95 female petitioners at an upstate New York Domestic Violence Intensive Intervention Court (DVIIC). Study participants completed surveys on physical health, mental health, and social functioning. Survey results demonstrated decreased mental health and social functioning as well as a strong willingness to utilize court-based mental health services if offered. Findings from this study support court-based settings as appropriate sites for addressing mental health needs through collaborative efforts between legal and mental health professionals.

Objectives To explore whether the health status of intimate partner violence (IPV) victims warrants pharmacies to be portals for public health promotion. Specific objectives included (1) identifying prevalence of IPV including domestic violence (DV) and sexual assault (SA) in a community sample, (2) describing characteristics and correlates of DV/SA between participants who reported and did not report DV/SA, and (3) exploring whether DV/SA status is related to mental health medication use. Design Cross sectional. Setting Upstate New York during 2006. Participants English- and Spanish-speaking respondents younger than 65 years of age answering four questions to assess DV/SA. Intervention Secondary analysis of a countywide random telephone survey, the 2006 Monroe County Adult Health Survey, which collects prevalence data on health behaviors and health status indicators. Main outcome measure To determine whether those reporting DV/SA are at increased odds for mental health medication use, controlling for other sociodemographic- and health-related variables. Results The survey response rate was 30.3%, with 1,881 respondents meeting inclusion criteria. Those reporting DV/SA were almost twice as likely to use mental health medications. However, when controlling for other variables, only poor mental and physical health were significant in increasing the odds of mental health medication use. Conclusion The analyses reported here suggest that DV/SA victims in a community sample use mental health medications. When controlling for other variables, survey respondents reported worse physical and mental health. If pharmacies are suitable portals for DV/SA outreach, curricula would need to provide the knowledge and skills needed to take an active role in this public health promotion.

s / Drug and Alcohol Dependence 146 (2015) e34–e117 e47 Support, traumatization, and employment differences in drug court outcomes Diane Morse1, Catherine Cerulli 1, Sanjukta Bandyopadhyay2, Joseph J. Guido2, Hongmei Yang2, John L. Wilson1, F. Taxman3 1 Psychiatry, University of Rochester School of Medicine, Rochester, NY, United States 2 Biostatistics, University of Rochester School of Medicine, Rochester, NY, United States 3 Criminology, Law & Society, George Mason University, Fairfax, VA, United States Aims: Adult drug treatment court (ADTC) outcomes in relation to social support, trauma, and employment are poorly understood. We examined these outcomes and related factors. Methods: Bivariate analysis using chi square and t-test assessed the following outcomes: substance abuse, arrests, health problems, emotional problems, social risk problems, and recovery environment risk using Global Appraisal of Individual Need data collected as part of a multi-site study examining drug use, recidivism, service utilization and treatment. ADTC clients from twelve sites were included (N=666 male, 915 female). Independent variables included: gender, race, age, years of education, income, partner status, employment, social support, traumatization, and traumagenic factors. Results: Social support was associated with a decreased likelihood of arrest (p< .033), substance abuse (p< .001), recovery environment risk (p< .001) and social risk index (p< .001). Victimization within the past year was associated with increased substance use (p< .001), social risk problems (p< .008), and recovery environment risk (p< .001). Employment within the past year was associated with decreased recovery environmental risk (p< .024) and substance use (p< .001). Female gender was associated with an increased likelihood of reduction in substance abuse (p< .038). Conclusions:Desirable ADTCoutcomes derive from: Social support related to 4 of 6 outcomes. Victimization history related to 3 of 6 outcomes. Employment related to 2 of 4 outcomes. Client victimization related to ADTC outcomes. Addressing victimization and employment appear important to improve outcomes, as supported by these findings. Future analyses will examine whether these findings are robust in a multivariate analysis, controlling for trauma-informed treatment as well as a rasch based outcome model to determine factors that affect multiple outcomes. Financial support: NIDA 1K23DA031612-01A1, SAMHSA/Center for Substance Abuse Treatment 270201200001c. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.498 Effect of methylphenidate preexposure on methylphenidate-induced conditioned taste avoidance Mirabella Muller, Bradley B. Wetzell, Shaun M. Flax, Heather E. King, Anthony L. Riley Psychopharmacology Laboratory, Department of Psychology, American University, Washington, DC

Study objective Recent systematic reviews have noted a lack of evidence that screening for intimate partner violence does more good than harm. We assess whether patients screened for intimate partner violence on a computer kiosk in the emergency department (ED) experienced any adverse events during or subsequent to the ED visit and whether computer kiosk identification and referral of intimate partner violence in the ED setting resulted in safety behaviors or contact with referrals. Methods We conducted a prospective, observational study in which a convenience sample of male and female ED patients triaged to the waiting room who screened positive (on a computer kiosk-based questionnaire) for intimate partner violence in the past year were provided with resources and information and invited to participate in a series of follow-up interviews. At 1-week and 3-month follow-up visits, we assessed intimate partner violence, safety issues, and use of resources. In addition, to obtain an objective measure of safety, we assessed the number of violence-related 911 calls to participant addresses within a call district 6 months before and 6 months after the index ED visit. Results Of the 2,134 participants in a relationship in the last year, 548 (25.7%) screened positive for intimate partner violence. No safety issues, such as calling security or a partner's interference with the screening, occurred during the ED visit for any patient who disclosed intimate partner violence. Of the 216 intimate partner violence victims interviewed in person and 65 contacted by telephone 1 week later, no intimate partner violence victims reported any injuries or increased intimate partner violence resulting from participating in the study. For the sample in the local police district, there was no increase in the number of intimate partner violence victims who called 911 in the 6 months after the ED visit. Finally, 35% (n=131) reported they had contacted community resources during the 3-month follow-up period. Conclusion Among patients screening positive for intimate partner violence, there were no identified adverse events related to screening, and many had contacted community resources.