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, August 12, 2008)
JAMA NEWS RELEASES
SCHOOL-BASED MENTAL HEALTH INTERVENTION REDUCES POST-TRAUMATIC STRESS AMONG INDONESIAN CHILDREN AFFECTED BY VIOLENCE
RESERVE AND NATIONAL GUARD PERSONNEL AT INCREASED RISK OF ALCOHOL-RELATED PROBLEMS AFTER RETURN FROM COMBAT DEPLOYMENT
LIBERIAN FIGHTERS EXPOSED TO SEXUAL VIOLENCE EXPERIENCE MORE MENTAL HEALTH DISORDERS IN AFTERMATH OF WAR
FORMER CHILD SOLDIERS OF NEPAL AT INCREASED RISK FOR RANGE OF MENTAL HEALTH PROBLEMS
HIV RISK HIGHER AMONG INDIAN WOMEN WHO ARE ABUSED BY HUSBANDS
JAMA REPORT (VIDEO SCRIPT)
VIDEO: Windows Media | Quicktime
MILITARY TROOPS RETURNING FROM COMBAT MAY EXPERIENCE BINGE DRINKING AND ALCOHOL-RELATED PROBLEMS
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 risk of alcohol-related problems among troops returning from combat deployment. The report will be fed Tuesday, August 12, from 9:00 - 9:30 a.m. ET and 2:00 - 2:30 p.m. ET, on Galaxy 28 (C-Band), Transponder 19, downlink frequency: 4080 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, August 12, 2008
Media Advisory: To contact Wietse A Tol, M.A., e-mail:
wtol{at}healthnettpo.org.
SCHOOL-BASED MENTAL HEALTH INTERVENTION REDUCES POST-TRAUMATIC STRESS AMONG INDONESIAN CHILDREN AFFECTED BY VIOLENCE
CHICAGO—A school-based intervention for children in communities affected by political violence in Indonesia reduced post-traumatic stress symptoms and helped maintain hope, but did not reduce traumatic stress-related symptoms, depressive symptoms, anxiety symptoms or functional impairment, according to a study in the August 13 issue of JAMA, a theme issue on violence and human rights.
"Mental health and psychosocial interventions for children and adolescents globally have received little research attention, even though mental health problems are one of the most significant contributors to the global burden of disease," the authors write. "Little is known about the efficacy of mental health interventions for children exposed to armed conflicts in low- and middle-income settings. Childhood mental health problems are difficult to address in situations of ongoing poverty and political instability."
Wietse A. Tol, M.A., of HealthNet TPO, Vrije Universiteit Medical Center, Amsterdam, the Netherlands, and colleagues conducted a study to assess the efficacy of a school-based intervention designed for children exposed to conflict, and implemented in a low-income setting. The study involved 495 children (average age 9.9 years) attending randomly selected schools in communities affected by political violence in Poso, Indonesia. The children were screened for exposure to violent events, post-traumatic stress disorder (PTSD), and anxiety symptoms, and compared with a wait-list control group. The school-based intervention consisted of 15 sessions over five weeks and included trauma-processing activities, cooperative play, and creative-expressive elements, implemented by locally trained paraprofessionals.
The intervention resulted in a moderate reduction in PTSD symptoms and function impairment for girls and retained hope for boys and girls. "No changes were found on the other outcome variables; traumatic idioms, depressive, anxiety symptoms, and functioning (the latter for boys)," the authors report.
"We hypothesize that these results may show that psychosocial interventions alone are unable to reverse the challenges to psychosocial well-being presented by chronic poverty and political instability," they write.
The researchers noted significantly more improvement in post-traumatic stress disorder symptoms and maintained hope in the treatment group than in the control group. Gender influenced both changes in PTSD symptoms and function impairment, with girls benefiting more from the intervention than boys. The study found no effects for age.
"In short, a school-based psychosocial intervention was able to moderately reduce PTSD symptoms, retain hope, and improve functioning for girls, and retain hope for boys affected by communal violence in a low-income context," the authors conclude. "Further adaptations and research to address the full range of post-traumatic outcomes and functioning are necessary."
(JAMA. 2008;300[6]:655-662. 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, August 12, 2008
Media Advisory: To contact Isabel G. Jacobson, M.P.H., call Karl VanOrden at 619-553-9289.
RESERVE AND NATIONAL GUARD PERSONNEL AT INCREASED RISK OF ALCOHOL-RELATED PROBLEMS AFTER RETURN FROM COMBAT DEPLOYMENT
CHICAGO—Younger service members and Reserve and National Guard combat personnel returning from the wars in Iraq and Afghanistan are at increased risk of new-onset heavy drinking, binge drinking and other alcohol-related problems, according to a study in the August 13 issue of JAMA, a theme issue on violence and human rights.
Substance abuse is strongly associated with posttraumatic stress disorder (PTSD) and other psychological disorders that may occur after stressful and traumatic events, such as those connected with war. Because alcohol use may serve as a coping mechanism after traumatic events, it is plausible that deployment is associated with increased rates of alcohol consumption or problem drinking, according to background information in the article. High rates of alcohol misuse after deployment have been reported among personnel returning from past conflicts, but there is little information regarding alcohol misuse after return from the current wars in Iraq and Afghanistan.
Isabel G. Jacobson, M.P.H., of the Naval Health Research Center, San Diego, and colleagues examined whether military deployment to the wars in Iraq and Afghanistan is associated with new-onset or changes in alcohol consumption, binge drinking behavior and other alcohol-related problems. Data were derived from questionnaires completed by participants at the beginning (baseline) of the study (July 2001 to June 2003; n = 77,047) and follow-up (June 2004 to February 2006; n = 55,021). After the researchers applied exclusion criteria, the analyses included 48,481 participants (active duty, n = 26,613; Reserve or National Guard, n = 21,868). Of these, 5,510 deployed with combat exposures, 5,661 deployed without combat exposures, and 37,310 did not deploy.
The researchers found that among Reserve or National Guard personnel who deployed with combat exposures the rate of new-onset heavy weekly drinking was 8.8 percent; the rate for new-onset binge drinking was 25.6 percent; and for new-onset alcohol-related problems, 7.1 percent. Among active-duty personnel, new-onset rates were 6.0 percent, 26.6 percent, and 4.8 percent, respectively. Among Reserve/Guard personnel, deployment with combat exposures was associated with increased odds of new onset of all three drinking outcomes compared with nondeployed personnel, with heavy weekly drinking (63 percent) and alcohol-related problems (63 percent) showing the strongest association.
Among active-duty personnel, those deployed with combat exposures were at increased odds (31 percent) of new-onset binge drinking at follow-up. Women were 1.2 times more likely to report new-onset heavy weekly drinking, whereas they were significantly less likely to report new-onset or changes in binge drinking or alcohol-related problems. Those born after 1980 were at 6.7 times increased odds of new-onset binge drinking and 4.7 times increased odds of new-onset alcohol-related problems. Those with PTSD and depression were at increased odds of new-onset and continued alcohol-related problems at follow-up.
"These results are the first to prospectively quantify changes in alcohol use in relation to recent combat deployments. Interventions should focus on at-risk groups, including Reserve/Guard personnel, younger individuals, and those with previous or existing mental health disorders. Further prospective analyses using É data [from this study group] will evaluate timing, duration, and [co-existing illnesses] of alcohol misuse and other-alcohol related problems, better defining the long-term effect of military combat deployments on these important health outcomes," the authors conclude.
(JAMA. 2008;300[6]:663-675. 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, August 12, 2008
Media Advisory: To contact corresponding author Lynn Lawry, M.D., M.S.P.H., M.Sc., call Andre Nicholson at 301-295-1219.
LIBERIAN FIGHTERS EXPOSED TO SEXUAL VIOLENCE EXPERIENCE MORE MENTAL HEALTH DISORDERS IN AFTERMATH OF WAR
CHICAGO—Men and women who experienced sexual violence while fighting in Liberian civil wars report higher rates of symptoms of depression, post-traumatic stress disorder (PTSD), and thoughts of suicide than non-combatants or other former combatants who were not exposed to sexual violence, according to a study in the August 13 issue of JAMA, a theme issue on violence and human rights.
"Liberia's wars since 1989 have cost tens of thousands of lives and left many people mentally and physically traumatized," the authors write. "This conflict has been characterized by ethnic killings and massive abuses against the civilian population between 1989 and 1997, and again in 2003 and 2004."
Kirsten Johnson, M.D., M.P.H., of the Harvard Humanitarian Initiative, Harvard University, Cambridge, Mass., and colleagues conducted a study to assess the prevalence and impact of war-related psychosocial trauma, including information on participation in the Liberian civil wars, exposure to sexual violence, social functioning, and mental health. The researchers surveyed 1,666 adults aged 18 or older using structured interviews and questionnaires. The survey was conducted in Liberia during a three-week period in May 2008.
In the Liberian adult household-based population, 40 percent met symptom criteria for major depressive disorder, 44 percent met symptom criteria for PTSD and 8 percent met criteria for social dysfunction. Thirty-three percent of the respondents reported serving time with fighting forces, and 33.2 percent of the former combatant respondents were women.
"Both female and male former combatants who experienced sexual violence had worse mental health outcomes than non-combatants and other former combatants who did not experience exposure to sexual violence," the authors report.
Among women, 42.3 percent of former combatants experienced exposure to sexual violence, compared with 9.2 percent of non-combatants. Among men, 32.6 percent of former combatants experienced exposure to sexual violence, compared with 7.4 percent of non-combatants. Symptoms of depression, PTSD and thoughts of suicide were higher among former combatants than non-combatants, and higher among those who experienced sexual violence than those who did not.
Seventy-four percent of female former combatants who experienced sexual violence had symptoms of PTSD, compared with 44 percent who did not experience sexual violence. Among male former combatants, 81 percent who experienced sexual violence had symptoms of PTSD, compared with 46 percent who did not experience sexual violence. Male former combatants who experienced sexual violence also reported higher rates of depression symptoms and thoughts of suicide.
"Like their female counterparts, male former combatants who experienced sexual violence have worse mental health outcomes than both the general population and also other former combatants," the authors write. "Rehabilitation programs that do not address this specific population risk failing a critically vulnerable group."
"This unexpected finding suggests that standard post-conflict rehabilitation programs and gender-based programs will need to adjust current programming to take into account males who have experienced sexual violence, especially former combatants," they conclude.
(JAMA. 2008;300[6]:676-690. 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, August 12, 2008
Media Advisory: To contact Brandon A. Kohrt, M.A., call Beverly Clark at 404-712-8780.
FORMER CHILD SOLDIERS OF NEPAL AT INCREASED RISK FOR RANGE OF MENTAL HEALTH PROBLEMS
CHICAGO—In Nepal, former child soldiers display greater severity of mental health problems, such as symptoms of posttraumatic stress disorder (PTSD) and depression, compared with children who were not forced into military service, according to a study in the August 13 issue of JAMA, a theme issue on violence and human rights.
Armed groups throughout the world continue to exploit children to wage war, according to background information in the article. Former child soldiers are considered in need of special mental health interventions. However, there is a lack of studies investigating the mental health of child soldiers compared with civilian children in armed conflicts.
Brandon A. Kohrt, M.A., of Emory University, Atlanta, and colleagues conducted a study to determine if former child soldiers have more mental health problems than never-conscripted (compulsorily enrolled into military service) children. The study, conducted in March and April 2007 in Nepal, compared the mental health of 141 former child soldiers and 141 never conscripted children matched on age, sex, education, and ethnicity. Participants were an average of 15.75 years old at the time of the study, and former child soldiers ranged in age from 5 to 16 years at the time of conscription. All participants experienced at least 1 type of trauma.
The researchers found that the numbers of child soldiers meeting symptom cutoff scores on various measures and scales were 75 (53.2 percent) for depression, 65 (46.1 percent) for anxiety, 78 (55.3 percent) for PTSD, 55 (39.0 percent) for general psychological difficulties, and 88 (62.4 percent) for function impairment. After adjusting for traumatic exposures and other variables, soldier status was significantly associated with depression (2.4 times higher odds) and PTSD among girls (6.8 times higher odds), and PTSD among boys (3.8 times higher odds), but was not associated with general psychological difficulties, anxiety, or function impairment.
"The difference in mental health outcomes between child soldiers and never-conscripted children can be explained in part by greater exposure to traumatic events among child soldiers, especially for general psychological difficulties and function impairment," the authors write.
"The study has several clinical and programmatic implications. First, the greater burden of mental health problems among former child soldiers supports the need for focused programming, which should include, but not consist solely of, interventions to reduce depression symptoms and the psychological sequelae of trauma, especially bombings and torture, as well as incorporate belongingness and income generation. Second, girl soldiers may require focused attention, possibly for factors not addressed in this study, such as problems of sexual violence and reintegration difficulties. Third, the variation in type and severity of mental health problems highlights the importance of screening, including locally developed measures of function impairment, as a base for intervention."
"Without screening there is a risk of pathologizing child soldiers as a group rather than providing support to those individuals most impaired. Finally, the presence of mental health problems among never-conscripted children illustrates the need for comprehensive postconflict community-based psychosocial care not restricted only to child soldiers," the authors conclude.
(JAMA. 2008;300[6]:691-702. 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, August 12, 2008
Media Advisory: To contact Jay G. Silverman, Ph.D., call Christina Roache at 617-432-6052.
HIV RISK HIGHER AMONG INDIAN WOMEN WHO ARE ABUSED BY HUSBANDS
CHICAGO—Married women in India who experience physical and sexual violence from their husbands have an increased risk of HIV infection, compared with women who are not abused by their husbands, according to a study in the August 13 issue of JAMA, a theme issue on violence and human rights.
"India is home to approximately 2.5 million people living with human immunodeficiency virus (HIV), the third largest number of cases of any country in the world, and is recognized as the source of increasing HIV prevalence among its South Asian neighbors," the authors write. "Despite reductions in prevalence of É infection among the general population of India, women account for a rising percentage of all HIV cases, with husbands' risk behavior described as the major source of women's infection. Intimate partner violence (IPV) has been described as being associated with heterosexual transmission of HIV to women in India and elsewhere."
Jay G. Silverman, Ph.D., of the Harvard School of Public Health, Boston, and colleagues conducted a study in 2007 and 2008 to assess the relationship between experiencing IPV and the occurrence of HIV infection in a nationally representative sample of married Indian women tested for HIV. The researchers analyzed data on 28,139 married women who provided IPV data and HIV test results as part of a national family health survey conducted across India during 2005 and 2006.
Approximately one-third of married Indian women (35.49 percent) reported they had experienced physical IPV, with or without sexual violence, from their husbands. About one-fourth (27.8 percent) reported experiencing physical IPV without sexual violence, while 7.68 percent reported both physical and sexual IPV. Approximately one in 450 women (0.22 percent) tested positive for HIV.
"In this first national population-based study of the relationship of husbands' violence against wives to wives' HIV infection status (as indicated via diagnostic testing), married Indian women who experienced both physical and sexual IPV demonstrated an HIV infection prevalence approximately four times greater than that of non-abused women," the authors report.
Physical IPV alone was not associated with the risk of HIV infection. Women's personal sexual risk behaviors (condom use and multiple partners) were not associated with HIV infection prevalence.
"Prevention of IPV may augment efforts to reduce the spread of HIV/AIDS," the authors assert.
"Findings of the present study, based on both the large population-based sample and the use of standard diagnostic testing for HIV infection, should serve to confirm the nature of this relationship and move public health policy-makers and practitioners to increase recognition of IPV as a critically important target in the global fight against HIV/AIDS," they conclude.
(JAMA. 2008;300[6]:703-710. 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
MILITARY TROOPS RETURNING FROM COMBAT MAY EXPERIENCE BINGE DRINKING AND ALCOHOL-RELATED PROBLEMS
INTRO:
Military troops returning from war often have to deal with a number of serious health problems. A new study finds heavy drinking and binge drinking may be a particular problem for some soldiers, especially those who have been exposed to combat. Jennifer Mitchell explains in this week's JAMA Report.
VIDEO:
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File: military troops
AUDIO:
AS U.S. TROOPS RETURN FROM WAR, A NEW STUDY FINDS SOME MAY EXPERIENCE SERIOUS PROBLEMS WITH ALCOHOL.
VIDEO:
SOT/FULL
Super @08
Isabel Jacobson, M.P.H.
Department of Defense, Center for Deployment Health Research
Runs: 09
AUDIO:
"We saw an increased risk in newly reported heavy weekly drinking, newly reported binge drinking and newly reported alcohol related problems."
VIDEO:
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Walking shot
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File : military troops
Alcoholic drinks being made
AUDIO:
ISABEL JACOBSON IS A RESEARCHER WITH THE DEPARTMENT OF DEFENSE CENTER FOR DEPLOYMENT HEALTH RESEARCH. SHE AND HER COLLEAGUES ANALYZED DATA FROM MORE THAN FORTY-EIGHT THOUSAND SERVICEMEN AND WOMEN ACROSS ALL BRANCHES OF THE U.S. MILITARY. DATA WERE COMPILED FROM QUESTIONNAIRES THAT TRACKED ALCOHOL CONSUMPTION BEFORE DEPLOYMENT AND AFTER FROM 2001 THROUGH 2006.
VIDEO:
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Isabel Jacobson, M.P.H.
Department of Defense, Center for Deployment Health Research
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AUDIO:
"Our findings showed that the individuals who deployed and reported combat exposures were at increased risk for newly reported alcohol behaviors."
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People drinking/bar video
Graphic:
Reserve & National Guard (title)
50% more likely
Heavy weekly drinking
Binge drinking
AUDIO:
RESERVE AND NATIONAL GUARD PERSONNEL WHO DEPLOY AND ARE SENT INTO COMBAT SHOW THE MOST INCREASED RISK COMPARED TO THOSE NONDEPLOYED. THE STUDY FINDS THEY ARE APPROXIMATELY FIFTY PERCENT MORE LIKELY TO EXPERIENCE NEWLY REPORTED HEAVY WEEKLY DRINKING, DEFINED AS HAVING MORE THAN FOURTEEN DRINKS PER WEEK FOR MEN OR MORE THAN SEVEN DRINKS PER WEEK FOR WOMEN, AND TO EXPERIENCE NEWLY REPORTED BINGE DRINKING, DEFINED AS HAVING FIVE OR MORE DRINKS PER DAY ON OCCASION.
VIDEO:
SOT/FULL
Super @1:15
Tyler Smith, Ph.D., M.S.
Department of Defense, Center for Deployment Health Research
Runs: 08
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"Our goal was to give answers to the leadership and let them take these answers and refine our policy and prevention strategies."
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GXF/JAMA COVER
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THE STUDY APPEARS THIS WEEK IN JAMA, JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION.
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Isabel Jacobson, M.P.H.
Department of Defense, Center for Deployment Health Research
Runs: 13
AUDIO:
"We did not see the same findings in those deployed who did not report combat exposures which led us to believe that it was the combat exposures rather than the deployment itself that led to this increased risk in alcohol use."
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Alcoholic drinks
Hand holding drink
Person drinking
AUDIO:
WOMEN SERVICE MEMBERS WERE MORE LIKELY TO EXPERIENCE NEW HEAVY WEEKLY DRINKING COMPARED TO MEN. YOUNGER SERVICE MEMBERS, THOSE BORN AFTER 1980, WERE AT THE HIGHEST RISK FOR NEWLY REPORTED BINGE DRINKING. JENNIFER MITCHELL THE JAMA REPORT.
TAG:
Researchers say their findings indicate that Marines experienced the highest prevalence for all alcohol problems looked at in the study. Active duty personnel did not appear to be at an increased risk for alcohol-related problems even when exposed to combat. Researchers hope the findings help increase awareness among service members as well as military leadership. For more information about this study you can log on to www.jama.com.
