Abstract
BackgroundImportant 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.MethodsProspective 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.ResultsExposure 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.ConclusionsResults 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.
Highlights
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
Our findings concur with Hedtke et al [37], who using a household sample of 4,008 adult women found that lifetime violence exposure was associated with increased risk of depression and PTSD, and the odds of occurrence of these disorders increased with the number of different types of violence experienced, including witnessed violence
Results of this study highlight the importance of assessing multiple forms of violence in research
Summary
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. Brazil has faced major social, economic, and demographic changes. Data from Brazilian Institute of Geography and Statistics (IBGE), which is responsible for the official census of Brazil, show that from 1950 to 2010 the population increased from 52 million to 190 million people, with a rate of urbanization rising from 40% to 80%. The fast rate of urbanization led to the concentration of the population in large metropolitan areas, Lopes et al BMC Psychiatry (2015) 15:109. In the sub-regions in South America, 74% of homicides are committed with a firearm [3]. Data from the Pan American Health Organization [4] show that in the period 2000–2007, the average rate of homicides in the Americas was 17.8 per 100,000, and that in Brazil the rate was the highest in the Americas, reaching 31.0 per 100,000 inhabitants
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