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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

神经系统科学家发现了小脑的一项全新功能。长期以来人们一直认为小脑基本上与意识直觉等活动无关,它的主要作用是协调站立、呼吸等基本的身体活动,然而,实际上小脑在影响人类行为上也发挥着重要作用。

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12) I often find myself worrying about something 0 1 2 3 4
据上周一发布的全球创新指数显示,中国成为首个跻身世界最具创新力经济体25强的中等收入国家。
8月11日

Warm greetings and best wishes for happiness and good luck in the coming year.衷心祝福来年快乐、幸运!
Right now, she's focusing on her modeling career, but also hopes to branch out into acting.
经济学人智库全球生活成本指数发现,亚洲和澳大利亚共有11个城市跻身全球最贵20城市之列,其余有8个是欧洲城市,一个为南美城市。北美没有一个城市进入前20名。

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

 

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Ohsumi’s research on autophagy shines a light on ubiquitous diseases such as Parkinson’s and diabetes.
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The tween is a huge star with three million Instagram followers, whose music videos with the popstar Sia have been viewed more than a billion times on YouTube.

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

将学习放在最重要的位置
最近两年你都没有涨薪水
“中国银行业面临的逆风将延续很长时间,”他说。“除了盈利来源减少,它们还将不得不为坏账带来的亏损做好准备。”

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
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  • 2017年LED市场持续激战 车载应用成最后“净土”
  • 10. Deepika Padukone - $10 million
    demo人民+-ic…的→民主的,民主主义的;民主政体的

When the initial surge of epinephrine subsides, the hypothalamus activates the 《长春市城市照明管理办法》 最高处罚3万元, 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

国家统计局:热点城市房价上涨压力较大 加快推进相关举措

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

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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

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    达奇斯说:强大的财务性能和一系列新的特性使得邻客音成为2012年吸引用户的公司。这样的吸引力有助于公司在2013年从专业的业务网络转向活跃的交流平台。
  • FRESH OFF THE BOAT (ABC, Feb. 4) A Chinese-American family adjusts to life in mid-'90s Florida in this culture-clash comedy based on a memoir by the restaurateur and food-and-travel-show host Eddie Huang. Hudson Yang plays the 11-year-old hip-hop wannabe Eddie, and Randall Park (Kim Jong-un in “The Interview”) plays his father, proud proprietor of a suburban steakhouse.
    Such highlighted talents also include cult director David Lynch of the United States and the versatile Taiwan filmmaker Sylvia Chang, whose representative works are on the recommended lineup.
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    Price growth in top cities was slower, however, with Beijing, for instance, reporting a rise of only 0.5 per cent from the previous month, compared to 4.9 per cent in September.
    民粹主义的兴起(即使在美国和英国这样的就业人数众多的国家也是如此)使得政客们认识到,就业的质量和数量同等重要。

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
  • 绿色装修从建材产品和软装家具开始打造
  • Glucose sensitivity
  • Immune suppression
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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

“我们现在从中国看到的情况不仅仅是巴西一国的现象,我们在整个拉美都看到了同样的情况,中国对所有市场的出口都在下降,”负责马士基航运在巴西、巴拉圭、乌拉圭和阿根廷业务的执行董事安东尼奥?多明格斯(Antonio Dominguez)表示,“已经连续几个季度出现这种情况,但随着我们进入(2016)年,这种局面变得越来越明显了。”
当新员工迈入QuikTrip位于塔尔萨的总部时,他们可没功夫去害羞:刚开始的几天,他们的办公桌上都摆着满满一大桶糖果。路过的同事常常停下来做自我介绍,顺手也抓块糖吃。
这个触动人心的成长故事完美捕捉了一个人从青少年初长为成年人的甜蜜又苦涩的阶段。
One suggested change: require rent-stabilized tenants to verify their income.
今年27岁的黑人安娜(Ana Beatriz Ferreira)是里约的一名看车员,她说:“门票那么贵,当然只有白人才买得起,进去看球怎么可能轮到我?”
单词check 联想记忆:
Historical and fictional films each have their own strengths when it comes to storytelling. Every now and then, though, movies pop up that don't quite fit into either category. The stories are wildly unrealistic, but they carry an inkling of truth between their pages. While these are some of the most interesting films out there, viewers often don't even know that what they're watching really happened. Well, wonder no more! Keep reading to learn about some of Hollywood's zanier scripts that took their inspiration from good old-fashioned real-life drama.

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

  • 'In total I've spent about £5,000 in three months on my three girls. One dress cost me $200 and she only wore it twice before she grew out if it - but I don't intend to lower my spending.
  • 个税时间表:5000元起征点新政有望10月1日起施行
  • He said game and live-broadcast apps currently hosted by Tencent don't require real-name registration, but the company is considering establishing a platform for parents to monitor their children's behavior.
    ['vid?il?ns]
  • 房企急了!11月推盘规模创历史新高
  • Build social connectedness

Interactions between Chronic Psychosocial Stress and Environmental Toxicants

Research shows impacts of combined stress and toxicants:79

  • 明星大撞衫 看谁更好看(二)
    定义自己
  • Forget giving at least two weeks notice, finessing an exit interview, and tactfully networking your way out the door. Some people are in too big a hurry for any of that.
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  • 此器于2012年由考古学家发掘出土,此后一直保存在仪征博物馆,未向对外展示。
    鉴于她的成功,她再也无法过上平凡人的生活。
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    经过救援人员一夜的船体扶正工作,5日7时30分,在长江倾覆的"东方之星"船体已侧翻过来,露出水面的船体写着"东方之星"四个汉字。
    Estimates for the size of the industry vary but Goldman Sachs figures suggest that sector loans grew from Rmb6bn to Rmb83bn between 2012 and 2014.
  • 8. Software engineer
    3.Oh, yeah. That makes sense. – Because option B involves admitting that I am clueless。
  • 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 中国钢厂4月日产量创新高 G7或联手施压中国钢铁 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

房贷申请量有所增加 天量信贷造楼市疯牛行情?

Gastrointestinal disorders

Joint disease

Migraines

Headaches 

Reproductive conditions

Gynecological disorders

Pelvic inflammatory disease

Sexual dysfunction

广西出台政策大力推进城乡LED道路照明改造

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

济南取消购房和投资纳税落户条件限制

Isolation from social networks

Homelessness

Health behaviors

High-risk sexual behaviors

Harmful substance abuse

山西发展绿色建材 保障房将执行绿建标准

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

  • 在西方国家更新、更广泛的国民身份认同里,白人们也有自己的一席之地。但是除非他们接受这一点,“白”的危机仍会持续存在下去。
  • 坐在前排
  • 阿里飞利浦联手抢占智能家居市场 未来可用语音操控空调?

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

  • 美国的药品支出费用约占总量三分之一,据艾美仕研究所专家估计,2014年这个数值将上升11.7个百分点。据报道,美国的药品支出费用价格特别高,但制药商解释说这是由于研制新药的成本猛增。
  • 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.
  • 蒙塔纳里表示:“澳大利亚表现突出,它在从佣金模式转为收费模式后蓬勃发展。这将是一件改变亚洲ETF市场游戏规则的事情。”
    这是伦敦商学院(London Business School)和哥伦比亚商学院(Columbia Business School)合办的EMBA-Global项目首次跌出前5名。
    反对:可以把这部电影当作一部演技在线的影片,而不是一部真正伟大的作品吗?
  • Whether China opens the stock floodgates or not will be a major price-driver in cotton and sugar — and potentially also in corn, soyabean or vegetable oil — markets in 2017, the bank said in its report.

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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  • 5月制造业PMI为51.2 连续10个月保持在荣枯线以上
  • Attractions: Festivities for the 2014 World Cup

Examples of Adverse Childhood Experiences

Abuse

  • Emotional
  • Physical
  • Sexual

Household challenges

  • A股房企一季度盈利近400亿 超过一半进了前十家口袋
  • Household substance abuse
  • 生死存亡还是负利血拼? 大咖谈LED照明市场战况
  • Parental separation or divorce
  • Criminal household member

Neglect

  • Emotional
  • Physical

北京多部门启动调查”租房贷“

  • Alcoholism / alcohol abuse
  • 节后广州楼市迅速回温 成交回复节前正常水平
  • Depression
  • Fetal death
  • Illicit drug use
  • Ischemic heart disease
  • Liver disease
  • Financial stress
  • 银川住房公积金实现“网上办”“就近办”
  • 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

Current edition of the World Cup is on pace to average more goals per game than any tournament since 1958.
时间:2009-11-09 编辑:vicki
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As a point of comparison, the combined 29.1 million total from those old master sales was 34 percent less than the 44.2 million Christie’s and Sotheby’s took in at equivalent events five years ago, in December 2011.
"Students are not suited for starting businesses on their own," said Zhang, adding that vocational students are more eager to start businesses than university undergraduates.
Pyongyang, which refers to Park as "human scum' has long condemned the balloon launches and in recen onths has stepped up its demands for Seoul to ban them.
“我想不出还有哪家公司抵挡住了对冲基金丛林中两头最凶猛的猛兽的攻击,”加州公务员退休基金的辛普森说,“他很酷,很冷静,泰然自若,是‘保持冷静,继续前进(Keep calm and carry on)’这句话在企业界的模范体现。”
想知道2013年的最差工作是哪些吗?报社记者以其令人尴尬的特质,取代伐木工人成为今年的最差工作。
自2008年北京奥运会后,北京入境游客数量持续增加。然而2012年这一数字下降了3.8%,并在去年进一步下滑。
三月四日在好莱坞高地中心Mary J. Blige, Miguel, Gael García Bernal, Andra Day, Natalia LaFourcade, Keala Settle, Sufjan Stevens and Common将会演唱自己的原创歌曲来庆贺第90届奥斯卡。

Stress and Addiction

substances often abused

 

房地产投资增速连续20个月下滑 楼市政策或加码

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
  • ……在面试过程中开始咒骂。
  • Cut out the caffeine
  • Face the problem

What we know about stress and addiction:110

  • Considering Stryker's founder invented the turning frame -- a device that allows patients to be repositioned in bed while keeping their bodies immobile -- it only makes sense that this medical equipment manufacturer lends employees and their families medical beds, free of charge.
  • 2016年陶瓷砖产量完成110.76亿平米
  • “图特摩斯三世是埃及新王朝最重要的法老之一。他使埃及在迦南完成了从一个地域性王国向洲际大帝国的质变。”“圣殿山筛选项目”的联合发起人和总负责人Gabriel Barkay如是说。
  • 势不可挡 传化涂料战略签约中昊北方研究院
  • 每季度,英特尔(Intel)都会铺上红地毯,欢迎加入公司的新员工。在入职培训的第一天,每位新人都会受到摄影师和摄像师的夹道欢迎,上台做完自我介绍,新人们就能领取一份欢迎大礼包(还有周围新同事们的热烈掌声)。

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
  • 家居业上市队伍逐渐壮大 对资本合作蠢蠢欲动
  • Psychotherapy
  • Promoting positive parenting
  • Which brands most improved their reputations in social media in 2012? And which companies made them worse?
  • n. 卷轴,目录 v. 卷动

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.

恒生指数收涨0.65%创近8月新高 多只物业股涨逾7%

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