JAMA news releases are made available to the public after 3 pm US Central time on the first 4 Tuesdays of each month. The Archives Journals news releases are made available to the public after 3 pm Central time on Mondays. We also provide a list of previous news releases.
THIS WEEK'S CONTENT
JAMA NEWS RELEASES
(Embargoed for Release: 3:00 p.m. CT, Tuesday, July 31, 2007)
JAMA NEWS RELEASES — Theme Issue on Violence and Human Rights
RATES OF CHILD MALTREATMENT IN ENLISTED SOLDIERS' FAMILIES GREATER DURING COMBAT-RELATED DEPLOYMENTS
SEX-TRAFFICKED GIRLS AND WOMEN FROM SOUTH ASIA HAVE HIGH PREVALENCE OF HIV INFECTION
GROUP PSYCHOTHERAPY EFFECTIVE FOR TREATING DEPRESSION OF DISPLACED ADOLESCENT GIRLS WHO ARE SURVIVORS OF WAR IN AFRICA
PTSD SYMPTOMS ASSOCIATED WITH LESS OPENNESS TO RECONCILIATION, MORE FEELINGS OF REVENGE AMONG FORMER AFRICAN CHILD SOLDIERS
HIGH RATES OF PTSD AND DEPRESSION FOUND AMONG ADULTS DISPLACED BY WAR IN UGANDA
JAMA REPORT (VIDEO SCRIPT)
VIDEO: Windows Media | Quicktime
CHILD MALTREATMENT INCREASES IN ARMY FAMILIES WHEN ONE PARENT IS DEPLOYED TO COMBAT
INFORMATION CONTAINED IN THESE NEWS RELEASES IS PROTECTED BY COPYRIGHT. JOURNAL ATTRIBUTION IS REQUIRED.
TV Note: This week's JAMA Report video is on the rate of child maltreatment in U.S. enlisted soldiers' families during military deployments. The report will be fed Tuesday, July 31, from 9:00 - 9:30 a.m. ET and 2:00 - 2:30 p.m. ET, on Galaxy 26 (formerly Intelsat America 6) C-Band, Transponder 09, downlink frequency: 3880 vertical, audio 6.2/6.8. For more information, call 312/464-JAMA.
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Embargoed for Release: 3:00 p.m. CT, Tuesday, July 31, 2007
Media Advisory: To contact Deborah A. Gibbs, M.S.P.H., call Patrick Gibbons at 919-541-6136.
RATES OF CHILD MALTREATMENT IN ENLISTED SOLDIERS' FAMILIES GREATER DURING COMBAT-RELATED DEPLOYMENTS
CHICAGO—Children of enlisted soldiers experience greater rates of neglect and maltreatment during periods of combat-related deployments, according to a study in the August 1 issue of JAMA , a theme issue on violence and human rights.
Parental stress is believed to play an important role in child maltreatment, which includes neglect, physical abuse, emotional abuse and sexual abuse. Combat-related deployments have been associated with increased stress among nondeployed parents. Few studies have examined child maltreatment within U.S. military families, of which there were more than 1.1 million with children younger than 18 years in 2004, according to background information in the article.
Deborah A. Gibbs, M.S.P.H., of RTI International, Research Triangle Park, N.C., and colleagues examined the impact of combat-related deployment between September 2001 and December 2004 on 1,771 families of enlisted soldiers in the U.S. Army who had 1 or more substantiated reports of child maltreatment.
Of these families, the researchers found that a total of 1,858 parents maltreated their children, and that the rate of child maltreatment during soldier deployments was 42 percent higher than the rate of child maltreatment at times when soldiers were not deployed. The occurrence of moderate or severe maltreatment was about 60 percent higher during deployment vs. nondeployment; the rate of child neglect was almost twice as high when soldiers were deployed compared to when the soldiers were not deployed. In contrast, the rates of physical and emotional abuse were lower during deployment than during nondeployment.
Additional analyses found that the child maltreatment incidents during deployment and nondeployment differed in terms of the characteristics of the parent-offenders: the rate of child maltreatment by female civilians was more than three times greater during times of deployment. The occurrence of maltreatment during deployment also was elevated among male civilians but not significantly so. The rate of child neglect by civilian female spouses was especially elevated during the times that their soldier-husbands were deployed, being almost four times the rate of child neglect during other times. In addition, the occurrence of spouses' physical abuse of their children was elevated during deployments, nearly twice the nondeployment rate.
"...our research findings provide information that may help to inform policy and practice regarding child maltreatment, including the Army's Family Advocacy Program and clinicians and child welfare professionals in communities with military populations. The findings confirm the need for supportive and preventive services for Army families during times of deployment," the authors write.
The researchers add that the Army does offer a number of services to families to address these issues, including child care and support groups for spouses of deployed soldiers. "Nevertheless, the greater rate of child maltreatment associated with deployments suggests the need for enhanced support for civilian parents in terms of additional resources, more effective services, development of services that those parents at greatest risk will be likely to seek out and accept, and greater outreach to connect parents to services."
(JAMA. 2007;298(5):528-535. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For More Information: Contact the JAMA/Archives Media Relations Department at 312/464-JAMA (5262) or email: mediarelations{at}jama-archives.org.
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Embargoed for Release: 3:00 p.m. CT, Tuesday, July 31, 2007
Media Advisory: To contact Jay G. Silverman, Ph.D., call Christina Roache at 617-432-6052.
SEX-TRAFFICKED GIRLS AND WOMEN FROM SOUTH ASIA HAVE HIGH PREVALENCE OF HIV INFECTION
CHICAGO—Nearly 40 percent of repatriated Nepalese sex-trafficked girls and women tested were positive for HIV infection, with girls trafficked before age 15 having higher rates of infection, according to a study in the August 1 issue of JAMA, a theme issue on violence and human rights.
"Trafficking across or within national borders for purposes of sexual exploitation including forced prostitution, i.e., sex trafficking, is recognized as a major gender-based human rights violation with significant individual and public health consequences and is increasingly discussed as a potentially critical mechanism in the spread of human immunodeficiency virus (HIV) across developing nations," the authors write.
There are an estimated 150,000 girls and women trafficked each year within and across the countries of South Asia, with approximately 5,000 to 7,000 Nepalese girls and women trafficked to India's commercial sex industry each year, according to background information in the article. Data on HIV prevalence among survivors of sex trafficking and roles of trafficking-related exposures in HIV infection have been limited.
Jay G. Silverman, Ph.D., of the Harvard School of Public Health, Boston, and colleagues examined the prevalence and risk factors for HIV infection among 287 repatriated Nepalese girls and women sex trafficked to brothels in India. Medical and case records were reviewed of the girls and women, who received rehabilitative services between January 1997 and December 2005.
The researchers found that among the 287 girls and women, 38.0 percent tested positive for HIV. Among those with complete documentation of trafficking experiences (n = 225), median (midpoint) age at time of trafficking was 17.0 years, with 33 girls (14.7 percent) trafficked prior to age 15 years. Compared with those trafficked at 18 years or older, girls trafficked prior to age 15 years had an increased risk for HIV, with 20 of 33 (60.6 percent) infected among this youngest age group.
Additional factors associated with being HIV positive included being trafficked to Mumbai (India's second largest city) and longer duration of forced prostitution (indicating increased risk per additional month in a brothel). Additional analyses indicated that girls trafficked prior to age 15 years had five times the increased odds of having been detained in multiple brothels and more likely to be in brothels for a duration of 1 year or more vs. those trafficked at age 18 years or older.
The authors write, "Findings of the present study emphasize the critical need to strengthen efforts to prevent sex trafficking and to intervene to protect trafficking survivors so as to shield young girls and women, both from this form of sexual violence and from the high risk of HIV infection. Currently, relatively few such efforts exist, and organizations that do engage in this work often lack adequate political or financial support. Furthermore, the high rates of HIV documented herein support concerns that sex trafficking may be a significant factor in the expansion of the South Asian HIV epidemic, both within higher-prevalence nations such as India and also from such nations to their lower-prevalence neighbors (e.g., Nepal). Moreover, the current demonstration of the very young age of many of those trafficked and sexually exploited, and the further harm to these young lives through high rates of HIV infection, requires attention from public health researchers and strategists to better understand and reduce the demand for sexual services from prostituted girls and women."
(JAMA. 2007;298(5):536-542. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For More Information: Contact the JAMA/Archives Media Relations Department at 312/464-JAMA (5262) or email: mediarelations{at}jama-archives.org.
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Embargoed for Release: 3:00 p.m. CT, Tuesday, July 31, 2007
Media Advisory: To contact corresponding author Judith Bass, Ph.D., call Kenna Lowe at 410-955-6878. To contact editorial co-author Robert J. Ursano, M.D., call Andre Nicholson at 301-295-3981.
GROUP PSYCHOTHERAPY EFFECTIVE FOR TREATING DEPRESSION OF DISPLACED ADOLESCENT GIRLS WHO ARE SURVIVORS OF WAR IN AFRICA
CHICAGO—Group psychotherapy was effective in reducing depression among displaced adolescent girls who are survivors of war in northern Uganda, though the intervention was not effective for adolescent boys, according to a study in the August 1 issue of JAMA, a theme issue on violence and human rights.
"Over 1.8 million individuals, mainly ethnic Acholi, have been internally displaced during 20 years of conflict between the government of Uganda and the Lord's Resistance Army. The Lord's Resistance Army has been accused of human rights abuses including mass violence, rape, and the abduction of more than 25,000 children. Local populations have crowded into internally displaced persons camps where they face threats to their health and well being," the authors write. Prior research on children affected by armed conflicts documents increased risk of mental health problems, yet few interventions have been evaluated rigorously in randomized trials or have generated mixed results.
Paul Bolton, M.B.B.S., of the Johns Hopkins Bloomberg School of Public Health, Baltimore, and colleagues investigated whether a therapy-based intervention (interpersonal psychotherapy for groups, [IPT-G]) and an activity-based intervention (creative play, [CP]) were effective for relieving mental health and psychosocial problems resulting from war and displacement among 314 adolescents (age 14-17 years), living in two camps in northern Uganda. The randomized controlled trial was conducted from May 2005 through December 2005.
Both interventions comprised 16 weekly group meetings, lasting 1.5 to 2 hours each. Locally developed screening tools assessed the effectiveness of the interventions in reducing symptoms of depression and anxiety, improving conduct problems and functioning among those who met study criteria and were randomly allocated to one of three study groups: 105, interpersonal psychotherapy for groups; 105, creative play; and 104, wait-control group (individuals wait listed to receive treatment at study end).
The researchers found that interpersonal psychotherapy was superior to the wait-list control condition in reducing depression symptoms, but statistically significant improvement was limited to the girl participants in the study. Creative play was not superior to the wait-list control condition. Neither interpersonal psychotherapy for groups nor creative play was effective in improving anxiety, conduct problems or functioning among boys or girls.
The failure of both interpersonal psychotherapy for groups and creative play "to significantly assist boys in this study raises the question of whether other interventions may be needed to assist war-affected boys with depression symptoms. Since both group psychotherapy and activity-based interventions were not effective, some form of individual psychotherapy or an entirely different type of intervention may be indicated as the basis for a future trial," the researchers write.
This study suggests that group-based psychological interventions can help adolescents who have been traumatized by war and displacement and who live in poor, rural, and illiterate communities.
(JAMA. 2007;298(5):519-527. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
EDITORIAL: CHILDREN OF WAR AND OPPORTUNITIES FOR PEACE
In an accompanying editorial, Robert J. Ursano, M.D., of Uniformed Services University, Bethesda, Md., and Jon A. Shaw, M.D., of the University of Miami, comment on the issue of children and war.
"No one endures war-related traumatic events unchanged. Little is known about the changes in values and hopes and views of the future that exposure to such trauma engenders. Children who are still learning to regulate mood and aggression are certainly even more vulnerable to these life-changing forces. The researchers reporting the results of their studies in this issue bring much-needed attention to the violence of war and the resulting mental health problems. Deeper appreciation of the effects of exposure to war-related trauma as well as improved understanding of individuals' attitudes toward reconciliation and the means to achieve peace may contribute to development of interventions to address the barriers to recovery not only from disease and illness but from lost futures and visions of life."
(JAMA. 2007;298(5):567-568. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: Please see the article for additional information, including financial disclosures, funding and support, etc.
For More Information: Contact the JAMA/Archives Media Relations Department at 312/464-JAMA (5262) or email: mediarelations{at}jama-archives.org.
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Embargoed for Release: 3:00 p.m. CT, Tuesday, July 31, 2007
Media Advisory: To contact corresponding author Fionna Klasen, Dipl.-Psych., email: klasen{at}children-for-tomorrow.de.
PTSD SYMPTOMS ASSOCIATED WITH LESS OPENNESS TO RECONCILIATION, MORE FEELINGS OF REVENGE AMONG FORMER AFRICAN CHILD SOLDIERS
CHICAGO—Former Ugandan and Congolese child soldiers who have more symptoms of posttraumatic stress disorder (PTSD) are less likely to be open to reconciliation and more likely to have feelings of revenge, according to a study in the August 1 issue of JAMA, a theme issue on violence and human rights.
Tens of thousands of the estimated 250,000 child soldiers worldwide are abused or have been abused during the last decade in Africa's Great Lakes Region, according to background information in the article. Christophe Pierre Bayer, L.L.B., of University Clinic Hamburg, Germany, and colleagues conducted a study to assess the prevalence of PTSD symptoms in 169 former Ugandan and Congolese child soldiers and to examine how PTSD symptoms are associated with these children's openness to reconciliation and feelings of revenge on the person or group they consider their enemy. The participants, age 11-18 years, were living in rehabilitation centers in Uganda and the Democratic Republic of the Congo at the time of the study in 2005.
Of the 169 former child soldiers interviewed, 34.9 percent met symptom criteria for PTSD. Children who showed clinically relevant symptoms of PTSD had significantly less openness to reconciliation and significantly more feelings of revenge than those with fewer symptoms.
The children reported that they had been (violently) recruited by armed forces at a young age (average, 12 years), had served an average of 38 months, and had been demobilized an average of 2.3 months before participating in this study. They reported having been exposed to a high level of potentially traumatic events (average, 11.1). The most commonly reported traumatic experiences were having witnessed shooting, having witnessed someone being wounded, and having been seriously beaten. A total of 54.4 percent reported having killed someone, and 27.8 percent reported that they were forced to engage in sexual contact.
"The results of this study cannot determine whether openness to reconciliation and fewer feelings of revenge are inner personal characteristics that prevent PTSD symptoms or whether PTSD symptoms mediate the openness to reconciliation and feelings of revenge. However, our findings indicate that mental distress and mental illness, namely, symptoms of PTSD, are associated with war-affected children's attitudes toward reconciliation and could therefore impose barriers to sustainable and long-term peace building. Hence, the results of this study support the need to fulfill the obligation under the United Nations Convention on the Rights of the Child to promote psychological recovery for war-affected children, such as child soldiers," the authors conclude.
(JAMA. 2007;298(5):555-559. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For More Information: Contact the JAMA/Archives Media Relations Department at 312/464-JAMA (5262) or email: mediarelations{at}jama-archives.org.
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Embargoed for Release: 3:00 p.m. CT, Tuesday, July 31, 2007
Media Advisory: To contact Patrick Vinck, Ph.D., call Kathleen Maclay at 510-643-5651.
HIGH RATES OF PTSD AND DEPRESSION FOUND AMONG ADULTS DISPLACED BY WAR IN UGANDA
CHICAGO—A survey of adults displaced by war in northern Uganda found high rates of posttraumatic stress disorder (PTSD) and depression, and that these individuals were more likely to favor violent means to end the conflict compared to persons without these symptoms, according to a study in the August 1 issue of JAMA, a theme issue on violence and human rights.
Patrick Vinck, Ph.D., of the University of California, Berkeley, and colleagues assessed the level of exposure to war-related violence and the prevalence of PTSD and depression symptoms by surveying 2,585 adults in villages and camps for internally displaced persons in four districts of northern Uganda in April and May 2005. The researchers also examined if these factors are associated with respondents' views as to whether violent or nonviolent means should be pursued to achieve peace in northern Uganda.
War in Uganda has been waged since the late 1980s by the Lord's Resistance Army (LRA) against the Ugandan People's Democratic Army and the people of Uganda. Numerous people have been killed or abducted and up to a million and a half people have been displaced in camps, where they live in poverty and despair, according to background information in the article.
The researchers found that about three-quarters of the respondents (74.3 percent) met PTSD symptom criteria and almost half (44.5 percent) met depression symptom criteria. Four patterns of exposure to trauma were distinguished: those with low exposure (group 1; 21.4 percent); witnesses to war-related violence (group 2; 17.8 percent); those threatened with death and/or physically injured (group 3; 16.4 percent); and those abducted (group 4; 44.3 percent). Respondents in groups 3 and 4, who experienced the most traumatic exposures, were more likely to have PTSD and depression symptoms compared with group 1. Respondents who met the PTSD symptom criteria were more likely to identify violence as a means to achieve peace. Respondents who met the depression symptom criteria were less likely to identify nonviolence as a means to achieve peace.
According to the authors, "...local cultures, beliefs, and social factors play a role in shaping attitudes and opinions toward peace. Efforts to establish peace and accountability mechanisms must be informed by population-based data that reflect the opinions, attitudes, and needs of all sectors of a society. Such research should identify how patterns of war-related exposure to violence, psychosocial trauma, and cultural and political factors influence the process of social reconstruction and peace building in the aftermath of mass violence."
(JAMA. 2007;298(5):543-554. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For More Information: Contact the JAMA/Archives Media Relations Department at 312/464-JAMA (5262) or email: mediarelations{at}jama-archives.org.
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JAMA REPORTS
VIDEO: Windows Media | Quicktime
CHILD MALTREATMENT INCREASES IN ARMY FAMILIES WHEN ONE PARENT IS DEPLOYED TO COMBAT
INTRO:
Everyone knows parenting is one of the hardest jobs there is. And it gets even harder when the other parent is deployed to combat in Iraq or Afghanistan. In fact, a new study says that during such deployment, there’s more child maltreatment by the spouses left behind with the kids. Mavis Prall explains in this week’s JAMA Report.
VIDEO:
SOT/FULL 1
@ :02
Super: Sally Hines
Military mom
Runs :11
AUDIO:
“My husband is U.S. Army special forces. He has been deployed six times. Three times in Afghanistan and three times to Iraq.”
VIDEO:
B-ROLL
Pan from Sally at stove to daughters, older daughter pokes younger one
AUDIO:
SO SALLY HINES IS USED TO RAISING HER TWO YOUNG DAUGHTERS ON HER OWN.
VIDEO:
NAT SOT UP FULL FOR :02
Younger girl talking/whining to older girl
AUDIO:
“Stop”
VIDEO:
SOT/FULL
Sally Hines
Military mom
Runs :10
AUDIO:
“It’s hard. You try to be the best mother when the father is not here. Being a mother is one of the hardest jobs out there.”
VIDEO:
B-ROLL
Researchers sitting at table looking at data
Combat video provided by U.S. Department of Defense
GFX/JAMA COVER
AUDIO:
THAT’S WHY THE U.S. DEPARTMENT OF DEFENSE ASKED RESEARCHERS AT R-T-I INTERNATIONAL AND UNIVERSITY OF NORTH CAROLINA, CHAPEL HILL TO STUDY ARMY DATA, LOOKING AT RATES OF CHILD MALTREATMENT AT HOME WHEN ONE SPOUSE IS AWAY IN COMBAT. THEIR FINDINGS APPEAR IN JAMA, JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION.
VIDEO:
SOT/FULL
@ :47
Super: Deborah Gibbs, M.S.P.H.
RTI International
Runs :10
AUDIO:
“The rate of maltreatment by female parents, mothers, or step-mothers, was more than three times greater during soldier’s deployment as it was during other times.”
VIDEO:
B-ROLL
Wide Deborah Gibbs with colleagues,
Cutaway to data
AUDIO:
R-T-I RESEARCHER DEBORAH GIBBS SAYS PHYSICAL ABUSE BY MOMS DID INCREASE, BUT THE MALTREATMENT WAS USUALLY NEGLECT.
VIDEO:
SOT
Deborah Gibbs, M.S.P.H.
RTI International
Runs :13
AUDIO:
“The rate of child neglect, when a parent doesn’t provide for the basic needs of the child, or doesn’t supervise the child in a way that’s appropriate for the child’s age, was nearly four times as high during deployments compared to other times.”
VIDEO:
B-ROLL
Sally carrying sleeping child up the stairs
AUDIO:
SO WHAT KIND OF HELP DO MOMS NEED WHEN DAD IS AWAY IN COMBAT?
VIDEO:
SOT/FULL 1:9:37-:50
Deborah Gibbs, M.S.P.H.
RTI International
Runs :13
AUDIO:
“Our findings make it clear that there’s a real need for services to families while soldiers are deployed and that these services have to be delivered in a way that the parents who are most in need are going to be able to take advantage of them.”
VIDEO:
NAT SOT UP FULL FOR :03
Sally at stove
AUDIO:
“No no no no, no no.”
VIDEO:
B-ROLL
Sally up through her name
Kids outside on scooters
Sally watching kids as one on scooter approaches her
AUDIO:
FOR SALLY, A SUPPORT GROUP FOR MILITARY FAMILIES, AND TALKING WITH OTHER MOMS, HAS BEEN THE ANSWER. SHE SAYS FOCUSING ON HER KIDS DURING TIMES OF STRESS AND SADNESS ALSO HELPS HER.
VIDEO:
SOT/FULL
Sally Hines
Military mom
Runs :09
AUDIO:
“To accommodate for them and to be sure that they’re safe and that they can be in a happy environment even when the parent, the second parent is not at home.”
VIDEO:
B-ROLL
Kids on scooters
AUDIO:
THIS IS MAVIS PRALL WITH THE JAMA REPORT.
TAG:
In the study, about seventeen percent of the women in both diet groups had an additional breast cancer over the ten years after the study started. For more information, visit www.jama.com.
