We studied youth injury fatality rates in America, the Northeast region of the US, andinthe state... more We studied youth injury fatality rates in America, the Northeast region of the US, andinthe state of Connecticut for the years 1990 and 2013 to evaluate the incidence of injury. All areas of injury showed a decrease in mortality rates with the exception of deaths by suffocation and poisoning. Ihe age group most affected by suffocation is infants younger than one year. Adolescents between the ages of 15 and 19 years appear to be at increased risk for poisoning deaths. Injury surveillance provides important guidance for the implementation of community based programs to prevent injury.
Most research on the consequences of violence exposure on adolescent mental health (1) focuses on... more Most research on the consequences of violence exposure on adolescent mental health (1) focuses on acute forms of exposure (e.g. being shot or shot at) and ignores chronic exposure and (2) treats violent behavior as a problem of delinquent individuals often ignoring the environment in which violent behaviors develop. The neighborhood effect, as outlined by W.J. Wilson, points to the cultural level and superorganic properties that affect perceptions and decisions of individuals within that neighborhood. If perceptions are developed and decisions are made in a neighborhood environment where violence is chronic, individuals\u27 perceptions and decisions may vary from those where violence is spurious. Perceptions and decisions of adolescents who grow up surrounded by violence may share ideas and behaviors that reflect a normalization of violence. ^ This dissertation examines data on violence exposure and mental health collected from 56 boys incarcerated in a CT juvenile detention center. The data reveal that the detainees are exposed to high levels of violence in their neighborhoods. The chronic violence the boys are exposed to leads to a perception of violence that differs from \u27mainstream\u27 culture. Detainees know about the prevailing culture and can state that culture\u27s version of how they should respond to potentially violent situations—nonviolently. To detainees, however, those norms belong to another world. They define violence as normal, and engage in behaviors that reflect survival strategies in a violence environment. By criteria enshrined in DSM-IV, detainees exhibit a high incidence of mental health disorders, particularly oppositional defiant disorder and other forms of psychopathology. These criteria assume the norms of the prevailing culture. They pathologize these alternative cultural understandings, which appear to constitute reasoned responses to the violent environments in which detainees consistently report growing up.
Intimate partner violence (IPV) is prevalent, costly, and detrimental to children’s health and de... more Intimate partner violence (IPV) is prevalent, costly, and detrimental to children’s health and development. It often co-occurs with child abuse and neglect. Most children referred to child protective services (CPS) have witnessed IPV and are at increased risk for subsequent exposure, as well as repeat maltreatment. For CPS referred children, there is often a missed opportunity to interrupt family violence and prevent future occurrences. Fathers for Change (F4C) is a family level intervention designed to reduce IPV by improving emotion regulation and reflective functioning in fathers. To date, no study has examined whether F4C is associated with reduced recidivism in families referred to CPS. Using propensity score matching (PSM) to simulate an experimental design, the current study tests the hypothesis that families with fathers who completed F4C will have significantly lower rates of new CPS reports over a 12-month period compared to a PSM sample of families of fathers not referred...
Purpose: Violence is a leading cause of morbidity and mortality among children. Many children car... more Purpose: Violence is a leading cause of morbidity and mortality among children. Many children cared for in Emergency Departments (EDs) have been exposed to violence, regardless of their presenting complaint. There are no validated screening tools to identify children at risk for future violence. The Violence Prevention Emergency Tool (VPET) is a 7-item questionnaire that quantifies prior exposure as a witness, victim, or perpetrator. It …
Supplemental material, SupplementalTables-Final for Quantifying Severity of Maltreatment, Adversi... more Supplemental material, SupplementalTables-Final for Quantifying Severity of Maltreatment, Adversity, and Trauma From Child Protective Services Case Record Files by Damion J. Grasso, Susan DiVietro, Rebecca Beebe, Meghan Clough and Garry Lapidus in Journal of Interpersonal Violence
Children referred to child protective services (CPS) for allegations of abuse or neglect often ha... more Children referred to child protective services (CPS) for allegations of abuse or neglect often have diverse experiences of maltreatment, adversity, and trauma. Severity of these experiences is associated with greater mental health impairment and increased risk of revictimization and other adversities. Although aspects of these experiences are often captured during CPS investigations and stored in case records as narrative documents, much of this information is underutilized in estimating risk and service planning. The current study extracted case record information from a randomly selected sample of 100 families, with 150 children referred to CPS during a 12-month period. The Yale-Vermont Adversity in Childhood Scale (Y-VACS) was applied to extracted information for quantifying severity of various forms of childhood maltreatment, adversity, and trauma. Study aims were to examine (a) the scope and severity of maltreatment, adversity, and trauma types and their associations; (b) linka...
The journal of trauma and acute care surgery, 2018
Intimate partner violence (IPV) is a serious public health problem leading many health care organ... more Intimate partner violence (IPV) is a serious public health problem leading many health care organizations to recommend universal screening as part of standard health care practice. Prior work shows that most IPV victims and perpetrators are unidentified by health care staff. We sought to enhance the capacity of an urban trauma center to identify IPV using a dual-method screening tool, and to establish prevalence of IPV victimization and perpetration among this population. Patients aged 18 and older were recruited from a Level 1 trauma center from May 2015 to July 2017. Participants were assessed for IPV using a touch-screen tablet and then via face-to-face assessment. The data were used to determine feasibility of this dual method and to establish prevalence of IPV in this sample. Of 586 eligible patients, 250 were successfully recruited for the study (43% response rate). Using the subscales of physical abuse, severe psychological abuse, and sexual coercion from the tablet-based Con...
We studied youth injury fatality rates in America, the Northeast region of the US, andinthe state... more We studied youth injury fatality rates in America, the Northeast region of the US, andinthe state of Connecticut for the years 1990 and 2013 to evaluate the incidence of injury. All areas of injury showed a decrease in mortality rates with the exception of deaths by suffocation and poisoning. Ihe age group most affected by suffocation is infants younger than one year. Adolescents between the ages of 15 and 19 years appear to be at increased risk for poisoning deaths. Injury surveillance provides important guidance for the implementation of community based programs to prevent injury.
This study determined prevalence of intimate partner violence (IPV) victimization among female cl... more This study determined prevalence of intimate partner violence (IPV) victimization among female clients at three hair salons in Connecticut using an anonymous tablet based screening tool. While many may assume that women receive services at hair salons, victims of IPV are often isolated by their partners and unable to access help. Of the 203 clients who participated, 40 (20%) had experienced IPV in her lifetime. In identifying the prevalence of IPV within the salon setting, this study provides support for community-based programs and supports their legitimacy as an important locus for identifying women experiencing IPV and connecting them to resources.
The journal of trauma and acute care surgery, 2016
Intimate partner violence (IPV) is a source of severe health consequences, and therefore, health ... more Intimate partner violence (IPV) is a source of severe health consequences, and therefore, health care organizations have recommended routine IPV screening. Implementing health-related screenings outside of health care facilities is common public health practice, but to date, IPV screening in hair salons has not been reported. The objective of this study was to determine the prevalence of IPV among women at hair salons. We hypothesized that women would disclose IPV in this setting and that rates of abuse would reflect national averages. We recruited a convenience sample of hair salons in Connecticut in 2014. Hair stylists were trained on how to recognize and refer IPV victims. Self-reported IPV of salon clients was measured by a tablet-based validated screening tool, the Patient Satisfaction and Safety Survey. Overall, reported past-year prevalence of physical abuse was 3.6%, past-year prevalence of sexual abuse was 2.7%, lifetime prevalence of emotional or physical abuse was 34.2%, ...
The mission of the Connecticut Injury Prevention Center (CIPC), jointly housed in Connecticut Chi... more The mission of the Connecticut Injury Prevention Center (CIPC), jointly housed in Connecticut Children's Medical Center and Hartford Hospital, is to reduce unintentional injury and violence among Connecticut residents, with a special focus on translating research into injury prevention programmes and policy. The CIPC engages in four core activities: research, education and training, community outreach programmes and public policy. As surveillance is an essential element of injury prevention, the CIPC has developed a robust statewide fatal and non-fatal injury surveillance system that has guided our prior work and continues to inform our current projects. The purpose of this article is to review the projects, programmes, and collaborative relationships that have made the CIPC successful in reducing unintentional injury and violence in Connecticut throughout the course of its 25 years history. Retrospective review of the application of injury surveillance. We believe that the application of our surveillance system can serve as a model for others who wish to engage in collaborative, community-based, data-driven injury prevention programmes in their own communities.
The Structured Trauma-Related Experiences and Symptoms Screener (STRESS) is a self-report instrum... more The Structured Trauma-Related Experiences and Symptoms Screener (STRESS) is a self-report instrument for youth of age 7-18 that inventories 25 adverse childhood experiences and potentially traumatic events and assesses symptoms of post-traumatic stress disorder using the revised criteria published in the Diagnostic and Statistical Manual for Mental Disorders, fifth edition (DSM-5). The STRESS can be administered by computer such that questions are read aloud and automatic scoring and feedback are provided. Data were collected on a sample of 229 children and adolescents of age 7-17 undergoing a forensic child abuse and neglect evaluation. The purpose of the current study was to examine preliminary psychometric characteristics of the computer-administered STRESS as well as its underlying factor structure in relation to the four-factor DSM-5 model. Results provide initial support for the use of the STRESS in assessing adverse and potentially traumatic experiences and traumatic stress i...
We studied youth injury fatality rates in America, the Northeast region of the US, andinthe state... more We studied youth injury fatality rates in America, the Northeast region of the US, andinthe state of Connecticut for the years 1990 and 2013 to evaluate the incidence of injury. All areas of injury showed a decrease in mortality rates with the exception of deaths by suffocation and poisoning. Ihe age group most affected by suffocation is infants younger than one year. Adolescents between the ages of 15 and 19 years appear to be at increased risk for poisoning deaths. Injury surveillance provides important guidance for the implementation of community based programs to prevent injury.
Most research on the consequences of violence exposure on adolescent mental health (1) focuses on... more Most research on the consequences of violence exposure on adolescent mental health (1) focuses on acute forms of exposure (e.g. being shot or shot at) and ignores chronic exposure and (2) treats violent behavior as a problem of delinquent individuals often ignoring the environment in which violent behaviors develop. The neighborhood effect, as outlined by W.J. Wilson, points to the cultural level and superorganic properties that affect perceptions and decisions of individuals within that neighborhood. If perceptions are developed and decisions are made in a neighborhood environment where violence is chronic, individuals\u27 perceptions and decisions may vary from those where violence is spurious. Perceptions and decisions of adolescents who grow up surrounded by violence may share ideas and behaviors that reflect a normalization of violence. ^ This dissertation examines data on violence exposure and mental health collected from 56 boys incarcerated in a CT juvenile detention center. The data reveal that the detainees are exposed to high levels of violence in their neighborhoods. The chronic violence the boys are exposed to leads to a perception of violence that differs from \u27mainstream\u27 culture. Detainees know about the prevailing culture and can state that culture\u27s version of how they should respond to potentially violent situations—nonviolently. To detainees, however, those norms belong to another world. They define violence as normal, and engage in behaviors that reflect survival strategies in a violence environment. By criteria enshrined in DSM-IV, detainees exhibit a high incidence of mental health disorders, particularly oppositional defiant disorder and other forms of psychopathology. These criteria assume the norms of the prevailing culture. They pathologize these alternative cultural understandings, which appear to constitute reasoned responses to the violent environments in which detainees consistently report growing up.
Intimate partner violence (IPV) is prevalent, costly, and detrimental to children’s health and de... more Intimate partner violence (IPV) is prevalent, costly, and detrimental to children’s health and development. It often co-occurs with child abuse and neglect. Most children referred to child protective services (CPS) have witnessed IPV and are at increased risk for subsequent exposure, as well as repeat maltreatment. For CPS referred children, there is often a missed opportunity to interrupt family violence and prevent future occurrences. Fathers for Change (F4C) is a family level intervention designed to reduce IPV by improving emotion regulation and reflective functioning in fathers. To date, no study has examined whether F4C is associated with reduced recidivism in families referred to CPS. Using propensity score matching (PSM) to simulate an experimental design, the current study tests the hypothesis that families with fathers who completed F4C will have significantly lower rates of new CPS reports over a 12-month period compared to a PSM sample of families of fathers not referred...
Purpose: Violence is a leading cause of morbidity and mortality among children. Many children car... more Purpose: Violence is a leading cause of morbidity and mortality among children. Many children cared for in Emergency Departments (EDs) have been exposed to violence, regardless of their presenting complaint. There are no validated screening tools to identify children at risk for future violence. The Violence Prevention Emergency Tool (VPET) is a 7-item questionnaire that quantifies prior exposure as a witness, victim, or perpetrator. It …
Supplemental material, SupplementalTables-Final for Quantifying Severity of Maltreatment, Adversi... more Supplemental material, SupplementalTables-Final for Quantifying Severity of Maltreatment, Adversity, and Trauma From Child Protective Services Case Record Files by Damion J. Grasso, Susan DiVietro, Rebecca Beebe, Meghan Clough and Garry Lapidus in Journal of Interpersonal Violence
Children referred to child protective services (CPS) for allegations of abuse or neglect often ha... more Children referred to child protective services (CPS) for allegations of abuse or neglect often have diverse experiences of maltreatment, adversity, and trauma. Severity of these experiences is associated with greater mental health impairment and increased risk of revictimization and other adversities. Although aspects of these experiences are often captured during CPS investigations and stored in case records as narrative documents, much of this information is underutilized in estimating risk and service planning. The current study extracted case record information from a randomly selected sample of 100 families, with 150 children referred to CPS during a 12-month period. The Yale-Vermont Adversity in Childhood Scale (Y-VACS) was applied to extracted information for quantifying severity of various forms of childhood maltreatment, adversity, and trauma. Study aims were to examine (a) the scope and severity of maltreatment, adversity, and trauma types and their associations; (b) linka...
The journal of trauma and acute care surgery, 2018
Intimate partner violence (IPV) is a serious public health problem leading many health care organ... more Intimate partner violence (IPV) is a serious public health problem leading many health care organizations to recommend universal screening as part of standard health care practice. Prior work shows that most IPV victims and perpetrators are unidentified by health care staff. We sought to enhance the capacity of an urban trauma center to identify IPV using a dual-method screening tool, and to establish prevalence of IPV victimization and perpetration among this population. Patients aged 18 and older were recruited from a Level 1 trauma center from May 2015 to July 2017. Participants were assessed for IPV using a touch-screen tablet and then via face-to-face assessment. The data were used to determine feasibility of this dual method and to establish prevalence of IPV in this sample. Of 586 eligible patients, 250 were successfully recruited for the study (43% response rate). Using the subscales of physical abuse, severe psychological abuse, and sexual coercion from the tablet-based Con...
We studied youth injury fatality rates in America, the Northeast region of the US, andinthe state... more We studied youth injury fatality rates in America, the Northeast region of the US, andinthe state of Connecticut for the years 1990 and 2013 to evaluate the incidence of injury. All areas of injury showed a decrease in mortality rates with the exception of deaths by suffocation and poisoning. Ihe age group most affected by suffocation is infants younger than one year. Adolescents between the ages of 15 and 19 years appear to be at increased risk for poisoning deaths. Injury surveillance provides important guidance for the implementation of community based programs to prevent injury.
This study determined prevalence of intimate partner violence (IPV) victimization among female cl... more This study determined prevalence of intimate partner violence (IPV) victimization among female clients at three hair salons in Connecticut using an anonymous tablet based screening tool. While many may assume that women receive services at hair salons, victims of IPV are often isolated by their partners and unable to access help. Of the 203 clients who participated, 40 (20%) had experienced IPV in her lifetime. In identifying the prevalence of IPV within the salon setting, this study provides support for community-based programs and supports their legitimacy as an important locus for identifying women experiencing IPV and connecting them to resources.
The journal of trauma and acute care surgery, 2016
Intimate partner violence (IPV) is a source of severe health consequences, and therefore, health ... more Intimate partner violence (IPV) is a source of severe health consequences, and therefore, health care organizations have recommended routine IPV screening. Implementing health-related screenings outside of health care facilities is common public health practice, but to date, IPV screening in hair salons has not been reported. The objective of this study was to determine the prevalence of IPV among women at hair salons. We hypothesized that women would disclose IPV in this setting and that rates of abuse would reflect national averages. We recruited a convenience sample of hair salons in Connecticut in 2014. Hair stylists were trained on how to recognize and refer IPV victims. Self-reported IPV of salon clients was measured by a tablet-based validated screening tool, the Patient Satisfaction and Safety Survey. Overall, reported past-year prevalence of physical abuse was 3.6%, past-year prevalence of sexual abuse was 2.7%, lifetime prevalence of emotional or physical abuse was 34.2%, ...
The mission of the Connecticut Injury Prevention Center (CIPC), jointly housed in Connecticut Chi... more The mission of the Connecticut Injury Prevention Center (CIPC), jointly housed in Connecticut Children's Medical Center and Hartford Hospital, is to reduce unintentional injury and violence among Connecticut residents, with a special focus on translating research into injury prevention programmes and policy. The CIPC engages in four core activities: research, education and training, community outreach programmes and public policy. As surveillance is an essential element of injury prevention, the CIPC has developed a robust statewide fatal and non-fatal injury surveillance system that has guided our prior work and continues to inform our current projects. The purpose of this article is to review the projects, programmes, and collaborative relationships that have made the CIPC successful in reducing unintentional injury and violence in Connecticut throughout the course of its 25 years history. Retrospective review of the application of injury surveillance. We believe that the application of our surveillance system can serve as a model for others who wish to engage in collaborative, community-based, data-driven injury prevention programmes in their own communities.
The Structured Trauma-Related Experiences and Symptoms Screener (STRESS) is a self-report instrum... more The Structured Trauma-Related Experiences and Symptoms Screener (STRESS) is a self-report instrument for youth of age 7-18 that inventories 25 adverse childhood experiences and potentially traumatic events and assesses symptoms of post-traumatic stress disorder using the revised criteria published in the Diagnostic and Statistical Manual for Mental Disorders, fifth edition (DSM-5). The STRESS can be administered by computer such that questions are read aloud and automatic scoring and feedback are provided. Data were collected on a sample of 229 children and adolescents of age 7-17 undergoing a forensic child abuse and neglect evaluation. The purpose of the current study was to examine preliminary psychometric characteristics of the computer-administered STRESS as well as its underlying factor structure in relation to the four-factor DSM-5 model. Results provide initial support for the use of the STRESS in assessing adverse and potentially traumatic experiences and traumatic stress i...
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Papers by Rebecca Beebe