Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Psychiatry
Published in: BMC Psychiatry 1/2015

Open Access 01-12-2015 | Research article

Direct and indirect exposure to violence and psychological distress among civil servants in Rio de Janeiro, Brazil: a prospective cohort study

Authors: Claudia S Lopes, Claudia L Moraes, Washington L Junger, Guilherme L Werneck, Antonio C Ponce de Leon, Eduardo Faerstein

Published in: BMC Psychiatry | Issue 1/2015

Login to get access

Abstract

Background

Important social and economic changes accompanying the recent fast rate of urbanization have been considered a major factor in triggering and sustaining urban violence in Brazil. The purpose of this paper is to investigate the effects of exposure to direct, indirect, and contextual violence on the risk of psychological distress.

Methods

Prospective longitudinal study carried out among 3,058 civil servants working at university campuses in Rio de Janeiro. Psychological distress was measured using the General Health Questionnaire, and exposure to individual violence was assessed as direct (DV), indirect (IV), and both direct and indirect (DIV). Contextual violence was assessed through the geocoding of residential addresses of study participants and the rates of homicides in 2005 at the corresponding weighting area. Multiple logistic regression was used to evaluate individual and contextual correlates of psychological distress.

Results

Exposure to DIV increased more than six times (95% CI 2.7–16.0) the odds of psychological distress occurrence at the six-year follow-up. Regarding persistence of psychological distress, the association with violence exposure was 1.6 (95% CI 1.0–2.4) for DV and 2.7 (95% CI 1.3–5.3) for IV. Contextual violence was not associated with psychological distress, and no interaction effect was found between exposure to individual and contextual violence in the occurrence/persistence of psychological distress.

Conclusions

Results of this study highlight the importance of assessing multiple forms of violence in research on the social determinants of mental disorders and support the view that individual exposure to different forms of violence increases the risk of psychological distress.
Literature
1.
Briceno-Leon R. Urban violence and public health in Latin America: a sociological explanatory framework. Cadernos de Saúde Pública. 2005;21(6):1629–48. discussion 1649–1664. doi:/S0102-311X2005000600002.PubMed
2.
Reichenheim ME, de Souza ER, Moraes CL, de Mello Jorge MH, da Silva CM, de Souza Minayo MC. Violence and injuries in Brazil: the effect, progress made, and challenges ahead. Lancet. 2011;377(9781):1962–75. doi:10.1016/S0140-6736(11)60053-6.CrossRefPubMed
3.
4.
PAHO. Health situation in the Americas. Basic Indicators. Pan American Health Organization. 2007.
5.
6.
Reichenheim ME, Werneck GL. Violent death as a cause of years of potential life lost in Rio de Janeiro, 1990. 1994.
7.
Pastore DR, Fisher M, Friedman SB. Violence and mental health problems among urban high school students. J Adolesc Health. 1996;18(5):320–4. doi:10.1016/1054-139X(95)00063-X.CrossRefPubMed
8.
Lai DW. Violence exposure and mental health of adolescents in small towns: an exploratory study. Can J Public Health. 1999;90(3):181–5.PubMed
9.
Kilpatrick DG, Acierno R. Mental health needs of crime victims: epidemiology and outcomes. J Trauma Stress. 2003;16(2):119–32. doi:10.1023/A:1022891005388.CrossRefPubMed
10.
11.
Ludermir AB, Schraiber LB, D'Oliveira AF, Franca-Junior I, Jansen HA. Violence against women by their intimate partner and common mental disorders. Soc Sci Med. 2008;66(4):1008–18. doi:10.1016/j.socscimed.2007.10.021.CrossRefPubMed
12.
Lima MS, Beria JU, Tomasi E, Conceicao AT, Mari JJ. Stressful life events and minor psychiatric disorders: an estimate of the population attributable fraction in a Brazilian community-based study. Int J Psychiatry Med. 1996;26(2):211–22.CrossRefPubMed
13.
Andrade LH, Wang YP, Andreoni S, Silveira CM, Alexandrino-Silva C, Siu ER, et al. Mental disorders in megacities: findings from the Sao Paulo megacity mental health survey, Brazil. PLoS One. 2012;7(2):e31879. doi:10.1371/journal.pone.0031879.
14.
Ribeiro WS, Mari Jde J, Quintana MI, Dewey ME, Evans-Lacko S, Vilete LM, et al. The impact of epidemic violence on the prevalence of psychiatric disorders in São Paulo and Rio de Janeiro, Brazil. PLoS One. 2013;8(5), e63545. doi:10.1371/journal.pone.0063545.
15.
Lopes CS, Faerstein E, Chor D. Stressful life events and common mental disorders: results of the Pro-Saude Study. Cadernos de Saude Publica. 2003;19(6):1713–20.CrossRefPubMed
16.
Lopes CS, Faerstein E, Chor D, Werneck GL. Higher risk of common mental disorders after experiencing physical violence in Rio de Janeiro, Brazil: the Pro-Saude Study. Int J Soc Psychiatry. 2008;54(2):112–7.CrossRefPubMed
17.
Sampson RJ, Raudenbush SW, Earls F. Neighborhoods and violent crime: a multilevel study of collective efficacy. Science. 1997;277(5328):918–24.CrossRefPubMed
18.
Harpham T, Snoxell S, Grant E, Rodriguez C. Common mental disorders in a young urban population in Colombia. Br J Psychiatry J Ment Sci. 2005;187:161–7. doi:10.1192/bjp.187.2.161.CrossRef
19.
Villareal AS, B.F.A. Social cohesion, criminal victimization and perceived risk of crime in Brazilian neighborhoods. Soc Forces. 2006;84(3):1725–53.CrossRef
20.
Araya R, Dunstan F, Playle R, Thomas H, Palmer S, Lewis G. Perceptions of social capital and the built environment and mental health. Soc Sci Med. 2006;62(12):3072–83. doi:10.1016/j.socscimed.2005.11.037.CrossRefPubMed
21.
Bordin IA, Duarte CS, Peres CA, Nascimento R, Curto BM, Paula CS. Severe physical punishment: risk of mental health problems for poor urban children in Brazil. Bull World Health Organ. 2009;87(5):336–44.CrossRefPubMedPubMedCentral
22.
Pillai A, Andrews T, Patel V. Violence, psychological distress and the risk of suicidal behaviour in young people in India. Int J Epidemiol. 2009;38(2):459–69. doi:10.1093/ije/dyn166.CrossRefPubMed
23.
Maciel MR, Mello AF, Fossaluza V, Nobrega LP, Cividanes GC, Mari JJ, et al. Children working on the streets in Brazil: predictors of mental health problems. Eur Child Adolesc Psychiatry. 2013;22(3):165–75. doi:10.​1007/​s00787-012-0335-0.
24.
Qouta S, Punamaki RL, El Sarraj E. Prevalence and determinants of PTSD among Palestinian children exposed to military violence. Eur Child Adolesc Psychiatry. 2003;12(6):265–72. doi:10.1007/s00787-003-0328-0.CrossRefPubMed
25.
de Jong JT, Komproe IH, Van Ommeren M. Common mental disorders in postconflict settings. Lancet. 2003;361(9375):2128–30. doi:10.1016/S0140-6736(03)13692-6.CrossRefPubMed
26.
Rocha-Rego V, Pereira MG, Oliveira L, Mendlowicz MV, Fiszman A, Marques-Portella C, et al. Decreased premotor cortex volume in victims of urban violence with posttraumatic stress disorder. PLoS One. 2012;7(8), e42560. doi:10.1371/journal.pone.0042560.
27.
Goldberg DP. The Detection of Psychiatric Illness by Questionnaire. London: Oxford University Press; 1972.
28.
Mari JJ, Williams P. Misclassification by psychiatric screening questionnaires. J Chronic Dis. 1986;39(5):371–8.CrossRefPubMed
29.
Goldberg D, Williams P. The User's Guide to the General Health Questionnaire. Windsor: Nfer-Nelson; 1988.
30.
Wang YP, Gorenstein C, Andrade LH. Patterns of psychopathological manifestations among ethnic Chinese living in Brazil. Eur Arch Psychiatry Clin Neurosci. 2004;254(1):36–42. doi:10.1007/s00406-004-0452-y.CrossRefPubMed
31.
32.
Aneshensel CS, Sucoff CA. The neighborhood context of adolescent mental health. J Health Soc Behav. 1996;37(4):293–310.CrossRefPubMed
33.
Cutrona CE, Russell DW, Hessling RM, Brown PA, Murry V. Direct and moderating effects of community context on the psychological well-being of African American women. J Pers Soc Psychol. 2000;79(6):1088–101.CrossRefPubMedPubMedCentral
34.
Fitzpatrick KM, Piko BF, Wright DR, LaGory M. Depressive symptomatology, exposure to violence, and the role of social capital among African American adolescents. Am J Orthopsychiatry. 2005;75(2):262–74. doi:10.1037/0002-9432.75.2.262.CrossRefPubMed
35.
Natsuaki MN, Ge X, Brody GH, Simons RL, Gibbons FX, Cutrona CE. African American children's depressive symptoms: the prospective effects of neighborhood disorder, stressful life events, and parenting. Am J Community Psychol. 2007;39(1–2):163–76. doi:10.1007/s10464-007-9092-5.CrossRefPubMedPubMedCentral
36.
Mair C, Diez Roux AV, Shen M, Shea S, Seeman T, Echeverria S, et al. Cross-sectional and longitudinal associations of neighborhood cohesion and stressors with depressive symptoms in the multiethnic study of atherosclerosis. Ann Epidemiol. 2009;19(1):49–57. doi:10.​1016/​j.​annepidem.​2008.​10.​002.
37.
Hedtke KA, Ruggiero KJ, Fitzgerald MM, Zinzow HM, Saunders BE, Resnick HS, et al. A longitudinal investigation of interpersonal violence in relation to mental health and substance use. J Consult Clin Psychol. 2008;76(4):633–47. doi:10.1037/0022-006X.76.4.633.
38.
Curry A, Latkin C, Davey-Rothwell M. Pathways to depression: the impact of neighborhood violent crime on inner-city residents in Baltimore, Maryland, USA. Soc Sci Med. 2008;67(1):23–30. doi:10.1016/j.socscimed.2008.03.007.CrossRefPubMedPubMedCentral
39.
Zinzow HM, Ruggiero KJ, Resnick H, Hanson R, Smith D, Saunders B, et al. Prevalence and mental health correlates of witnessed parental and community violence in a national sample of adolescents. J Child Psychol Psychiatry. 2009;50(4):441–50. doi:10.1111/j.1469-7610.2008.02004.x.
40.
Clark C, Ryan L, Kawachi I, Canner MJ, Berkman L, Wright RJ. Witnessing community violence in residential neighborhoods: a mental health hazard for urban women. J Urban Health. 2008;85(1):22–38. doi:10.1007/s11524-007-9229-8.CrossRefPubMed
41.
Krug EG, Dahlberg LL, Mercy JA, Zwi AB, Lozano R, editors. World report on violence and health. Geneva: World Health Organization; 2002.
42.
Brewer-Smyth K, Cornelius ME, Pickelsimer EE. Childhood adversity, mental health, and violent crime. J Forensic Nurs. 2015;11(1):4–14. doi:10.1097/JFN.0000000000000062.CrossRefPubMed
43.
Javdani S, Abdul-Adil J, Suarez L, Nichols SR, Farmer AD. Gender Differences in the Effects of Community Violence on Mental Health Outcomes in a Sample of Low-Income Youth Receiving Psychiatric Care. Am J Community Psychol. 2014;53(3–4):235–48. doi:10.1007/s10464-014-9638-2.CrossRefPubMed
44.
Yi S, Poudel KC, Yasuoka J, Yi S, Palmer PH, Jimba M. Exposure to violence in relation to depressive symptoms among male and female adolescent students in Cambodia. Soc Psychiatry Psychiatr Epidemiol. 2013;48(3):397–405.CrossRefPubMed
45.
Dupere V, Leventhal T, Vitaro F. Neighborhood processes, self-efficacy, and adolescent mental health. J Health Soc Behav. 2012;53(2):183–98. doi:10.1177/0022146512442676.CrossRefPubMed
46.
Karriker-Jaffe KJ, Foshee VA, Ennett ST. Examining how neighborhood disadvantage influences trajectories of adolescent violence: a look at social bonding and psychological distress. J Sch Health. 2011;81(12):764–73. doi:10.1111/j.1746-1561.2011.00656.x.CrossRefPubMedPubMedCentral
47.
Stockdale SE, Wells KB, Tang L, Belin TR, Zhang L, Sherbourne CD. The importance of social context: neighborhood stressors, stress-buffering mechanisms, and alcohol, drug, and mental health disorders. Soc Sci Med. 2007;65(9):1867–81. doi:10.1016/j.socscimed.2007.05.045.CrossRefPubMedPubMedCentral
48.
Fowler PJ, Tompsett CJ, Braciszewski JM, Jacques-Tiura AJ, Baltes BB. Community violence: a meta-analysis on the effect of exposure and mental health outcomes of children and adolescents. Dev Psychopathol. 2009;21(1):227–59. doi:10.1017/S0954579409000145.CrossRefPubMed
49.
McDonald CC, Richmond TR. The relationship between community violence exposure and mental health symptoms in urban adolescents. J Psychiatr Ment Health Nurs. 2008;15(10):833–49. doi:10.1111/j.1365-2850.2008.01321.x.CrossRefPubMedPubMedCentral
50.
Kiss L, Schraiber LB, Heise L, Zimmerman C, Gouveia N, Watts C. Gender-based violence and socioeconomic inequalities: does living in more deprived neighbourhoods increase women's risk of intimate partner violence? Soc Sci Med. 2012;74(8):1172–9. doi:10.1016/j.socscimed.2011.11.033.
Metadata
Title
Direct and indirect exposure to violence and psychological distress among civil servants in Rio de Janeiro, Brazil: a prospective cohort study
Authors
Claudia S Lopes
Claudia L Moraes
Washington L Junger
Guilherme L Werneck
Antonio C Ponce de Leon
Eduardo Faerstein
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2015
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-015-0487-9

Other articles of this Issue 1/2015

BMC Psychiatry 1/2015 Go to the issue

Study protocol

A cluster randomized clinical trial of a stepped care intervention for depression in primary care (STEPCARE)- study protocol

Research article

Associations between depression subtypes, depression severity and diet quality: cross-sectional findings from the BiDirect Study

Erratum

Erratum: Neurobehavioral consequences of chronic intrauterine opioid exposure in infants and preschool children: a systematic review and meta-analysis

Study protocol

Cost-effectiveness of blended vs. face-to-face cognitive behavioural therapy for severe anxiety disorders: study protocol of a randomized controlled trial

Study protocol

Evaluating a selective prevention program for substance use and comorbid behavioral problems in adolescents with mild to borderline intellectual disabilities: Study protocol of a randomized controlled trial

Study protocol

Primary prevention of psychosis through interventions in the symptomatic prodromal phase, a pragmatic Norwegian Ultra High Risk study