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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

会。梅因为失算的提前选举而失去了大部分权威。但过去几个月情况对她较为有利。敲定退欧离婚协议,确保了她的饭碗短期无忧。因此直到2019年英国退欧正式完成(或者另一种更吸引人的替代方案出现)前,保守党将让她继续坐在首相位置上。留欧派和退欧派都希望避免因反对她而引发内战。事实将证明,曾经被人们认为是坐不长的位置,意外地能够坐久。

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There was no indication of the identity of the kidnappers or their motive.
市场观察人士被迫接受一季度美国GDP负增长2.9%这一现实。突然间,同波诡云谲的现实相比,所有人的预测似乎都过于乐观,至少是过于平稳。这导致人们纷纷猜测美联储最终退出其债券购买计划的时机。短短几周内,我们从信心满满变成了垂头丧气,同时,伴随着不确定性的再次来袭,资产类别的交替以及市场调整也随之而来。
这篇文章发表后,美国参议院很快投票通过了《反就业歧视法》(Employment Non-Discrimination Act)。这样,在工作中歧视LGBT群体也有可能成为违法行为。这项法案即将提交众议院审议。

lasting
China's National Bureau of Statistics said its property prices index for November showed that new home prices fell 3.7 per cent from a year ago, the third straight annual decline following readings of -2.6 per cent in October and -1.3 per cent in September.
我预计真正的大戏将在2018年初展开。但这是唐纳德?特朗普的贸易世界。我们只有观看的份儿。

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

 

公路治超30天铁路货运涨价:建材等均现涨价

28 September
Format: Alternating Friday-Saturday classes, with an initial week-long meeting and a week-long international study seminar
[slu:]

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

More than an hour into Apple’s annual shareholder meeting in February, Tim Cook had patiently fielded questions ranging from its plans for the television market to what he thought of Google Glass. But when one audience member tried to push Apple’s chief executive on the profitability of Apple’s various environmental initiatives, such as its solar-powered data centre, Mr Cook snapped.
你可能从未想过一根皮带可以与人工智能相结合,但Belty做到了,并使它看起来很时尚。这个belty会让你不自觉就觉得,“为什么我需要这个?”然后你想可能会是,“如果是黑客入侵,他们把它系得很紧我不能呼吸该怎么办?”第一个问题是合理的;第二个问题有些牵强,但如果它让你三思而后买这个产品,这并不是一件坏事。
该调查发现,211和985重点建设高校毕业生的薪酬水平大幅度领先普通高校毕业生。

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
  • 珍贵的照片显示了古老的性玩具曾经属于中国皇室和贵族。
  • 智能家居外冷内热:梦想点亮现实油料在何方
  • 其他的欧洲国家生活成本在增长,排名有进步。伦敦上升了5个名次,并且进入前十。
  • 联创光电收购方大智控72.37%股权 攻入智能照明领域
  • 武汉首批大学生“八折房”6月出售
  • “我只是想保持专业的一面。我不想让别人认为我是脑残粉。我是表演嘉宾之一,不仅仅是伴舞者,我是一名舞者演员。”
    最佳豪华汽车品牌:保时捷

When the initial surge of epinephrine subsides, the hypothalamus activates the 整理师:家居收纳到整理人生, 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

住房租赁万亿蛋糕前 真正的龙头会是谁

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

MBS提振房市难见效 市场期待国开行变身“两房”

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

  • 不过,对其他地区的出口却差多了,尤其是对转口地区香港的贸易,该月以美元计的对香港出口同比下滑26.3%至338.4亿美元。对欧盟(EU)国家的出口也下滑4.7%至335亿美元。而对日本出口则下滑5.5%至112.7亿美元。
    这里并不是要给特斯拉浇一瓢冷水。它已经证明自己具有生产一款复杂、先进且外观诱人的产品的能力。但无论是特斯拉自己的内部预测,还是投资人对其股票的追捧,都基于同样一个预期,那就是特斯拉未来依然会延续最近的大热势头。这是一种危险的假设,原因如下:
  • 卓越雇主排名:32
    詹妮弗?劳伦斯如今是好莱坞最炙手可热的年轻女演员之一,所以她成为众多男人心中无法抗拒的女人一点也不让人惊讶。
    30岁的阿什莉·格林汉姆是首位跻身收入榜单的大码模特,她通过自己的内衣和泳衣品牌代言合同赚得550万美元,排在榜单的第十位。
    这部电影人们期待已久。无论对蝙蝠侠粉还是超人粉来说,该片都将是一场视觉盛宴。 我们知道,蝙蝠侠将在片中打败超人,但他究竟是怎么做到的呢?
    Transport Ministry spokesman Xu Chengguang told a news conference that no further signs of life had been found and the chance of finding anyone else alive was "very slim."

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
  • 外墙保温施工中常见的问题
  • Glucose sensitivity
  • Immune suppression
  • 下半年经济被看好 房地产是最大宏观经济风险

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

认为西方民主政体不会受影响将是愚蠢的。
n. 史诗,叙事诗 adj. 史诗的,叙事诗的,宏大的,
n. 补给,供给,供应,贮备
INDOORS: This house was completed around 1848 and last updated in 2008. The front door has a transom and sidelights of red glass etched with a leaf motif. The first floor has a large living room with crown molding and two fireplaces, one of which warms the formal dining area. Off the living room is a family room with raised wall paneling, a wet bar and another dining area. French doors open to a slate patio. Several rooms have views of Little Narragansett Bay.
理查三世是金雀花王朝的最后一位国君,都铎王朝的继任者将其塑造成了不惜一切代价追求权力的无恶不作的暴君,还称他谋杀了他的两个侄子-也就是“塔中王子”-来保住王位。
11月22日,马拉比在伦敦的一场晚宴上领取了该奖。英国电信集团TalkTalk行政总裁迪多.哈丁(Dido Harding)应邀在晚宴上发表了演讲。
I know many of you met your former spouse at the company. But the thing is, for every one of you, there are five people it doesn't work out as well for. And your office romance can and will be held against you.

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

  • 这一现象值得注意。巴西是个多种族国家,黑人占总人口比例位居世界第二,仅低于尼日利亚。在2010年的人口普查中,超过一半的巴西人认为自己是黑人或混血儿。
  • 三季度机构“看多”楼市 未来成交量或进一步上升
  • 我们再来看看名单里一些其他的亮点:
    There are a couple of other picks in play this year. There's the Lakers pick to Philly (top-three protected), a Memphis one to Denver (top-five protected), and the infamous Sacramento choice to Chicago (top-10 protected) that Philly actually controls because Sam Hinkie will have revenge on us all.
  • 楼市急转直下 买房人该怎么选?
  • Build social connectedness

Interactions between Chronic Psychosocial Stress and Environmental Toxicants

Research shows impacts of combined stress and toxicants:79

  • 中国的各个创新指标显现出“持续稳健的进步”,高锐表示,“没有理由认为这前进的脚步会停下来。”
    Last question: a lot of thework you've donebrings out a lot of strong emotions in a way that it kind of questions themorality of heroism and justice. Is there anything related to you that makes us think of ourselves being a hero or yourself as one?
  • 例如,佳士得给威尼斯艺术家弗朗西斯科·丰泰巴索(Francesco Fontebasso)在18世纪中叶创作的油画《井边的丽贝卡和埃利泽》(Rebecca and Eliezer at the Well)的最低估价为12万英镑。根据Artnet的数据,在1990年的拍卖会上,这幅令人愉快的洛可可装饰风格的油画是以28.6万英镑购得的。在12月8日的拍卖会上,它仅得到一个电话出价——11.5万英镑(不含佣金),约合17万美元。而投资者们可不认为在购买沃霍尔(Warhol)或巴斯奎特(Basquiat)的作品25年之后会损失约40%。如果一幅早期绘画大师的作品被搁置在交易商的画廊里,想转卖它就更加困难。
    Big-spending US firms are forcing their UK counterparts to increase salaries right the way from newly qualifieds to the top rainmakers — though that did not stop David Higgins, private equity star at Freshfields, from decamping to Kirkland & Ellis just before Christmas. Boutique specialists are luring clients away by offering faster, more focused services.
  • Since Sunday, viewers everywhere have been in mourning, at least judging by the Twitterati.
    She has also performed on Jimmy Kimmel and The Ellen Show - not bad for someone who hasn't even hit adolescence.
  • 罗杰斯对于中间剧情的反转十分不满,因此在拍完前三季之后决定离开剧组。这样的违约行为使他面临数百万美元的诉讼。但讽刺的是,韦恩·罗杰斯从来没有正式和剧组签订过合同(他涉及道德条款方面的问题)。因此该诉讼请求被驳回。你可能会说在这次的事件中,罗杰斯是笑到最后的人,但自从他离开剧组,《风流医生俏护士》又播出了八季,而罗杰斯在他的演艺生涯中再也没有取得过这样的成就。所以说他是笑到最后的人,也许只是一个相对的说法。
    该项目曾在2006年荣获亚军,并在2008年斩获冠军头衔。
    现金全款购房者。难以取悦的贷款人。暴涨的价格。匮乏的挂牌信息。这些现实,都困扰着购房者,使找房子的过程让人倍受打击。不幸的是,在新的一年,购房者们可能依旧需要在卖方市场里打拼。
  • exposed
    When asked if the central bank would do more, Dario Perkins, chief European economist at Lombard Street Research, said: “I don’t think so, unless something goes wrong in the wider global economy.”
  • 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 海南:人口与计生条例拟删除超生开除或辞退等处理措施 shows that between 2003 and 2012, domestic violence accounted for 21 percent of all violent victimizations in the US, with 70 percent of those from intimate partner violence (IPV).89

graph of violent relationships

data from Truman and Morgan90

Preventing Violence in Relationships

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

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

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

Health Consequences of Intimate Partner Violence94

Health conditions 

Asthma

Infections

Circulatory conditions

Cardiovascular disease

Fibromyalgia

Irritable bowel syndrome

Chronic pain

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Gastrointestinal disorders

Joint disease

Migraines

Headaches 

Reproductive conditions

Gynecological disorders

Pelvic inflammatory disease

Sexual dysfunction

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Delayed prenatal care
Preterm delivery

Low birth weight babies

Perinatal deaths

Unintended pregnancies

Psychological conditions

Anxiety

Depression

PTSD

Antisocial behavior

Suicidal behavior in females

Low self-esteem

Inability to trust

Fear of intimacy

Emotional detachment

Sleep disturbances

Flashbacks

Social impacts

Restricted access to services

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Isolation from social networks

Homelessness

Health behaviors

High-risk sexual behaviors

Harmful substance abuse

风口上的“众陶联”:颠覆性模式真的能重塑“佛山陶瓷”?

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.
  • 此外,华为在2016年最后一季度第一次实现了2位数的全球市场占有率。
    两个抢手在讽刺杂志查理周刊屠杀了12个人,谢里夫库阿奇和他的兄弟塞得,他们可能就是出国“接受屠杀训练并散播恐怖”的人中的两个。
    This is Us
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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

  • adj. 有资格的,有限制的
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  • 城镇新增就业1100万人以上,城镇登记失业率4.5%以内;

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
  • 京津冀重拳治霾:石家庄等冬季采暖期钢铁产能限产50%
  • Depression
  • Fetal death
  • Illicit drug use
  • Ischemic heart disease
  • Liver disease
  • Financial stress
  • 房地产市场调控效果继续显现
  • 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

n. 意识,知觉,自觉,觉悟
制造业表现较好,利润增长6.5%。受低廉的能源价格的提振,电力、热力、燃气及水生产和供应业利润增长17%。
8.轮滑
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Compared with an average age of 45, 52-year-old Jack Ma is the oldest among the top 10 IT tycoons.
n. 路线,(固定)线路,途径
It would be foolish to assume western democracies are immune.
But top managers at companies in the fields of scientific research and technology services saw their pay decrease by 4.2%.

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
  • 雄安三日:有村民称“像做梦一样”
  • Psychotherapy
  • Promoting positive parenting
  • 新美国基金会(New America Foundation)高级研究员李?德鲁特曼(Lee Drutman)在一份给Vox的分析文章中指出,在阿肯色州、北卡罗莱纳州和田纳西州,移民人口是1990年的三倍以上。围绕这些变化产生的焦虑或许可以解释共和党为什么在这个阶段更关注限制移民问题,还有这些州的白人投票者们何以压倒性地支持特朗普。
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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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