Investigating exposure to violence and mental health in a diverse urban community sample: data from the South East London Community Health (SELCoH) survey

PLoS One. 2014 Apr 1;9(4):e93660. doi: 10.1371/journal.pone.0093660. eCollection 2014.

Abstract

Background: General population surveys have seldom examined violence as a multidimensional concept and in relation to an array of mental disorders.

Methods: Data from the South East London Community Health Study was used to examine the prevalence, overlap and distribution of proximal witnessed, victimised and perpetrated violence and their association with current mental disorders. We further investigated the cumulative effect of lifetime exposure to violence on current mental disorders. Unadjusted and adjusted (for confounders and violence) models were examined.

Results: In the last twelve months, 7.4% reported witnessing violence, 6.3% victimisation and 3.2% perpetration of violence. There was a significant overlap across violence types, with some shared correlates across the groups such as being younger and male. Witnessing violence in the past year was associated with current common mental disorders (CMD) and post-traumatic stress disorder (PTSD) symptoms. Proximal perpetration was associated with current CMD, PTSD symptoms and past 12 months drug use; whereas proximal victimisation was associated with lifetime and past 12 months drug use. Lifetime exposure to two or more types of violence was associated with increased risk for all mental health outcomes, suggesting a cumulative effect.

Conclusion: Exposure to violence needs to be examined in a multi-faceted manner: i) as discrete distal and proximal events, which may have distinct patterns of association with mental health and ii) as a concept with different but overlapping dimensions, thus also accounting for possible cumulative effects.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Data Collection*
  • Female
  • Humans
  • London
  • Male
  • Mental Disorders / epidemiology
  • Mental Disorders / psychology*
  • Middle Aged
  • Socioeconomic Factors
  • Stress Disorders, Post-Traumatic / epidemiology
  • Stress Disorders, Post-Traumatic / psychology*
  • Substance-Related Disorders / epidemiology
  • Substance-Related Disorders / psychology*
  • Surveys and Questionnaires
  • Urban Health
  • Violence / psychology*
  • Young Adult

Grants and funding

This research was supported by the Biomedical Research Nucleus data management and informatics facility at South London and Maudsley NHS Foundation Trust, which is funded by the National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London and a joint infrastructure grant from Guy's and St Thomas' Charity and the Maudsley Charity. G Kadra, SL Hatch and M Hotopf receive salary support from the National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. K Dean receives salary support from the Justice Health & Forensic Mental Health Network, New South Wales, Australia. The funders did not have a role in the study design; collection, analysis or interpretation of data; the writing of the manuscript; or in the decision to submit the manuscript for publication.