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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

这让11月份的贸易顺差达到446.1亿美元,比10月份减少约44.5亿美元,低于预期。

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['?nik'spektidli]
腾讯控股有限公司公关部的一名员工、一款直播应用的负责人日前声称,一名男子通过在这个直播平台唱歌接受了一个13岁女孩25万多元(3.64万美元)的打赏,而该女孩在注册时可能隐瞒了年龄。
单词unique 联想记忆:

5. The top 300bureaucrats will rally behind Xi’s reforms and these bold new programs, backingthe central government while bringing these ambitions to their provincialgovernments and setting parallel growth goals at home. Detailed plans forreform and accelerated growth will be set, and then promptly executed, ingeographies across China. We expect the tier three and four markets torally again this year, growing faster than tier one and two cities.
汤姆·佩蒂
strictly

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

 

照明将成智能家居市场主力军

谁被埋葬在这里?
你咋不上天呢?
遇到别人我能很轻松地和他/她交谈

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

节目33 歌曲《我爱你中国》,汪峰
When he was offered the role of "Will" on Fresh Prince, he had 70% of his wages garnished for the first three seasons. After three years, he was able to take home his full salary. Basically, the first line of the theme song could have been written about Will Smith's real life: "This is a story all about how/My life got flip-turned upside down." Except in real life, the "guys making trouble in his neighborhood" was the IRS.
4.比赛期间不要讲话叽歪,等到中场休息或是比赛结束时再说话。

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
  • 上周四公布的一项数据显示,两所中国顶尖大学跻身今年《泰晤士报高等教育专刊世界大学声誉排行榜》的前20名。
  • 报告:京房贷利率去年全国最低 今年主基调宽松
  • The Man Who Knew, by Sebastian Mallaby, is the 12th winner of the £30,000 award, which goes to the “most compelling and enjoyable” title of the year.
  • 转型跨界?这场“流行”衣柜企业怎么玩?
  • 2015年全国建材工业经济运行情况分析
  • 反对:《请以你的名字呼唤我》在很多方面的表现都很不错,但却没有哪一方面是最突出的。也许“甜茶”蒂莫西克莱门特的表演是该片冲奥的最大可能。
    shoulder

When the initial surge of epinephrine subsides, the hypothalamus activates the 广州出让五宗住宅地 全部未达最高限价, 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

打造“中部第一” 南康家具产业走上质量发展之路

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

广州:租房市场60㎡以下户型成交占半

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

  • Hong Kong has topped the list for the past seven years -- since its first appearance in the survey.
    Best of luck in the year to come.愿你在未来的一年里,吉星高照。
  • Paris is the only Eurozone country in the top 10, and sees a drop of three places, which the report says may be due to falling confidence in the euro.
    7、 阿斯顿·马丁必须有。不止如此,还要在异国情调的赌场里挥金如土——一掷千金的男人很能吸引寻欢中的女性。常与女性周旋的邦德更擅长于此。
    After a year of sexual harassment scandals that started in Silicon Valley and spread to just about every industry, women will try to capitalise on the momentum to push for permanent changes. And attention will focus on the plight of marginalised minorities, with so few black and Latino employees in the tech industry.
    adj. 毁灭性的,令人震惊的,强有力的
    dealing

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
  • 机构改革后,国家卫健委的“计生”司局不见了
  • Glucose sensitivity
  • Immune suppression
  • 广州商品房预售合同纠纷增长明显 “双合同”维权渠道不通

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

今年年初,所有华尔街经济学家都呼吁提高利率,彭博社就这个问题调查了67位经济学家的意见,他们全票赞同,有鉴于此,任何一个有理性的人都不会想要增持对利率敏感的公用事业股。把赌注押在金融股上的投资者,回报进展缓慢;而瞅准了“低价”能源股的投资者,投资组合业绩在第一和第二季度曾因此推高,却在第三和第四季度被大拖后腿,可谓“成也萧何,败也萧何”。
She was also recognised for being the youngest recipient of the Ripple of Hope Award from the Robert F. Kennedy Center for her charity work.
中国正考虑出售在政府补贴政策下累积的过剩储备。
Making the cut for the first time, Gigi, 22, and Bella Hadid, 21, are ranked at number five and number nine respectively, with the former making $9.5 million and the younger sibling taking in $6 million.
坐在前排
Here's a list of the top 10 most anticipated movies in 2016 that we believe will become box office hits and would be worth watching more than once.
In July, a video of a couple having sex in the fitting room of a Uniqlo clothing store in Beijing took the Internet in China by storm. Some commenters speculated that it was a publicity stunt by the retailer, which denied the claim. Several people were detained on suspicion of uploading and distributing the video.

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

  • 上榜理由:食物、文化和恐怖故事
  • 解析90后的家居需求 住宅以小户型为主
  • 排名前20的大学有13所大学是美国的大学、还有4所英国大学和3所其他大学。
    巴韦贾对全球化不断变化的性质的深度分析显示,全球贸易增长疲软背后的主要因素是投资减速。全球贸易增速曾在很长一段时间内是全球GDP增速的两倍。
  • 内斗致万州基地停产 雷士照明欲扩惠州基地产能
  • Build social connectedness

Interactions between Chronic Psychosocial Stress and Environmental Toxicants

Research shows impacts of combined stress and toxicants:79

  • Here are five things consumers and investors can count on (probably) in 2015:
    People have been predicting consolidation in this very fragmented sector for years and there have indeed been big mergers recently. But there is little doubt that price pressures on City law firms are intensifying.
  • 安德森想让男人们脸上的毛发丰富多样,每个演员脸上装饰的胡子都不太一样。它是名符其实的时髦派风格,从一字胡、八字胡,再到杰夫·戈德布拉姆(Jeff Goldblum)的黑灰色山羊胡。
    amnesty
  • 单词petroleum 联想记忆:
    她是头号权势女性:过去10年里,德国总理默克尔八度上榜——其中七次都荣登榜首。
  • You see all kinds of grisly, hairy characters on the Tube but few commuters would've expected to see a pack of pandas on the platform.
    v. 劳累,拉紧,过份
    The US has overtaken India as the leading user of anti-dumping and other trade defence cases, with China and its steel sector the biggest target, according to research.
  • accurate
    吉祥猴的水墨设计草图由中国当代艺术家、北京奥运会吉祥物“福娃”的创作者之一韩美林设计的。这幅中国传统水墨画的设计被网友认为“萌萌哒”,代表了中国传统艺术风格。节目制作人将吉祥猴命名为“康康”,在中国表健康之意。
  • 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 北京通州二手房市场活跃度激增 上半年均价同比下降6% 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

缺乏定制基因 传统卫浴转型步履维艰

Gastrointestinal disorders

Joint disease

Migraines

Headaches 

Reproductive conditions

Gynecological disorders

Pelvic inflammatory disease

Sexual dysfunction

零售巨头试水智能家居市场 助产品落地

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

湖北省启动商品房销售检查

Isolation from social networks

Homelessness

Health behaviors

High-risk sexual behaviors

Harmful substance abuse

建材行业结合互联网 助力企业市场资源开拓

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

  • BrandZ表示,这些品牌靠近国内市场,这帮助它们从全球品牌手中夺取市场份额,它们还在新地区赢得市场份额。
  • The global battle for the living room continued in Germany with Sony announcing it 2has sold 10 million PlayStation 4s worldwide. To keep that momentum going, Sony announced a number of exclusive new titles at the show, including the action game Hellblade from developer Ninja Theory, the open world adventure game Wild from Rayman creator Michel Ancel, the shooter Alienation from Housemarque, and Q Games genre-bending The Tomorrow Children. Microsoft announced that Square Enix and Crystal Dynamics Rise of the Tomb Raider, the second game in the rebooted Lara Croft franchise, will be an Xbox exclusive in 2015. Xbox will also be getting another big sequel next year with Halo 5: Guardians.
  • 超百城大数据房价发布,看看你所在城市是涨是跌?

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

  • But, despite the incessant warnings from security researchers, many people are still turning to weak, easily guessable passwords to protect their devices.
  • 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.
  • It's almost TOO good. Soulful and aching and grand, Adele's theme to Skyfall is stunningly performed, and gives the distinct impression that someone tried to make the ultimate James Bond theme and had the talent to back it up. History and sensuousness have elevated two songs higher than Adele's contribution, at least in our eyes, but not by much.
    n. 航行,航海,导航
    The central government is planning to establish a bond market connect between the mainland and Hong Kong Special Administrative Region on a trial basis this year, allowing for the first time overseas capital to access mainland bond markets from overseas. Hong Kong will be the first to benefit from such an arrangement
  • 第三季度摄影师的工作增长了大约22%。报告的作者将这一增长归因于雇佣者“最终理解了他们的登录页面的高质量图片的重要性”。通过雇用受过培训的有创造力的专业人员来扩大提升网站知名度也是这一排行榜上的一个常在的主题。

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
  • 房企忙“过冬”:减少投资 加快销售
  • Parental separation or divorce
  • Criminal household member

Neglect

  • Emotional
  • Physical

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  • Alcoholism / alcohol abuse
  • 政策效果显现 楼市加速回暖推动经济稳定
  • Depression
  • Fetal death
  • Illicit drug use
  • Ischemic heart disease
  • Liver disease
  • Financial stress
  • 水漆国内使用率不到10% 成本高、施工繁成拦路虎
  • 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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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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  • The report found that students majoring in art, agriculture and engineering were more willing to start businesses, while those majoring in history and science showed relatively low interest.
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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.

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