An exploration of generational status and enculturation as putative protective factors for disordered eating behaviors and cognitions among college students.

Police officers are exposed to potentially psychological traumatic events and are at high risk of developing post-traumatic stress injuries (PTSI). Development and wide implementation of best practices for managing PTSI are needed. The psychological first aid (PFA) framework encompasses trauma-informed knowledge to guide the development of best practices. Based on the framework and on a pilot performed among Canadian police officers, we propose a PFA program including: 1) PTSI awareness e-learning; 2) PFA training provided by local trainers; and, 3) peer-to-peer PFA intervention to mitigate PTSI in police officers. The study was designed to evaluate the feasibility and effectiveness of a large-scale PFA program implementation among Canadian police officers. A multi-phase mixed-methods participatory action research study is being performed in five phases according to the PFA implementation and the dynamic sustainability frameworks. The program 1) was adapted to environmental needs; 2) is progressively deployed; and, to be evaluated for 3) feasibility; 4) effectiveness; and, 5) sustainability. Local trainers (N = 10) were trained to then train PFA providers (N = 322 police officers) who could then administer the intervention to police officers as needed (i.e., PFA recipients). The e-learning is being co-developed and will be disseminated. Program feasibility (i.e., acceptability, demand, practicality, implementation) will be assessed through interviews with trainers (n = 10), providers (n = 30), and recipients (n = 20). The program effectiveness will be assessed by tracking changes in PTSI literacy and stigma among officers who complete the e-learning (n = 5700) using pre-post e-learning questionnaires. Pre-post training questionnaires with participating providers (n = 175) will track perceived competence to provide the intervention. Pre-post intervention questionnaires with recipients (n = 64) will track changes in putative protective factors (i.e., professional quality of life, work safety, coping, sense of efficacy, sense of hope) and symptoms of PTSI (i.e., anxiety-, depressive-, and post-traumatic stress disorder symptoms). The PFA program is designed to help officers to recognize PTSI, promote self-care strategies and help-seeking, enhance organizational support, and expand psychological support. The study could provide trauma-informed guidelines for implementation and evaluation practices in high-risk and interdependent organizations and inform future directions for policy decisions. The study was pre-registered on OSF ( https://osf.io/7khgs/?view_only=33260c704ffc46ffb75a704320283ccf ).

Background and objectiveIn recent years, growing scientific and public awareness has highlighted the negative impacts of climate change on mental health, particularly among young people, who are disproportionately affected. These findings underscore the need for effective and scalable interventions to support individuals experiencing climate change-related distress (CCD). At the initial stage, it is crucial to understand how this distress manifests and what the momentary risk and protective factors are that exacerbate and modulate its dynamic occurrence in everyday life.MethodsIn this context of need, nine qualitative, semistructured interviews with young individuals, aged between 14 and 25 and living in Germany, with CCD were conducted. Interviews centred on individuals’ burdens, putative triggers eliciting the experience, as well as putative protective factors. We analysed the data and developed themes via Braun and Clarke’s reflexive thematic analysis and electively structured the analysis according to the coding paradigm adopted from Strauss and Corbin.ResultsParticipants reported experiencing a wide range of negative emotions as well as mental health difficulties associated with climate change, including sleep disturbances, reduced well-being and difficulties concentrating. The experience emerges from the understanding and awareness of the complexity of climate change and its associated consequences for the environment. Protective factors were reported, including positive emotions (eg, hope, finding meaning and purpose), self-efficacy, conceptual knowledge about climate change-related emotions and external factors (ie, social support). Participants employed various strategies to regulate their emotions, ranging from avoidance and distraction to strategies like acceptance, cognitive reappraisal and active engagement in pro-environmental behaviour or activism.Conclusion and clinical implicationsOverall, this study enhances our understanding of young individuals’ emergence and daily life experience of CCD. The findings suggest that a prolonged or overly extensive occurrence may result in mental health difficulties. Moreover, the results highlight the importance of strengthening factors associated with resilience at a young age, enabling individuals to cope with CCD. The findings have implications for the development of potential intervention components and suggest imparting conceptual knowledge and adaptive regulatory strategies, supporting habit formation and providing networking opportunities with others affected by CCD.

Sexual violence victimisation among deaf adolescents: A multi-school-based cross-sectional study from Ghana.

CANN2021 is a nationwide cohort of Norwegian high school students created with the aim of addressing emerging issues in epidemiology of cannabis use through the initial surveillance and examination of its correlates, causes and consequences. Between 25 February 2021 and 10 April 2021, a core baseline sample of 3490 students (48% boys; 11th grade 35.5%, 12th grade 31.2%, 13th grade 33.3%) from 34 high schools in Norway anonymously completed comprehensive e-surveys assessing their cannabis-related involvement and experiences. A total of 1510 (43.3%) participants (45.8% boys; 11th grade 28.9%, 12th grade 31.1%, 13th grade 40.0%) provided identifying information and consented to administrative contact entailing individual-level linkages of their survey responses to their health and census data as recorded in various national registries since 2010, thus establishing the CANN2021 registry-linkages cohort. The core baseline sample (N=3490) was largely representative of the Norwegian high school youth between the ages of 17 and 19 years, and as such of relevance to national surveillance needs. One in five (20.3%) reported having used cannabis at least once during their lifetime; of these, 40.9% consented to registry linkages. E-survey data from the registry cohort will be linked at the individual level to health and administrative registries such as the Norwegian Patient Registry, Education, Crime, Income and Population Registry in 2025, 2029 and 2031. The retrospective and prospective linkages of baseline e-surveys with registry data can thus be used to address a range of epidemiological and public health questions, including examination of temporal associations between various types of early cannabis involvement and putative risk and protective factors, and subsequent health and social outcomes.

BackgroundMental health is a term frequently used to describe mental health problems. However, mental health includes both mental health problems and well-being. Therefore, mental health can be seen as having two distinct yet related dimensions, as described in the two-continua model of mental health (Westerhof & Keyes, 2010) where an individual can simultaneously experience any combination of well-being and problems, suggesting four classes: (i) high well-being, low problems; (ii) high well-being, high problems; (iii) low well-being, low problems; and (iv) low well-being, high problems. Through this framework an understanding of differences in putative risk and protective factors can be gained when compared across classes. While the model has received support, it is unclear how it applies to children. In particular, children with disabilities, as disabilities pose a risk factor to poor mental health. A greater understanding of similarities and differences between children with and without disabilities, and of risk and protective factors, could help tailor support focused on enhancing well-being, both as a goal and as a means to better self-management of mental health.MethodsThe present project utilizes Sweden Statistics (SCB) study (barnULF) to measure life conditions. Nearly 4000 children aged 10–18, with and without disabilities, and their caregivers (ULF/SILC) were studied through yearly interview-based sample surveys conducted between 2013 and 2019. Latent class analysis was performed to assess whether the data fit a 4-class model in line with the two-continua model. Possible factors influencing mental health, including participation, were compared across the identified classes and between children with and without disabilities.ResultsThe analysis confirmed the predicted model. Each class showed distinct features regarding putative risk and protective factors of mental health and demographics in both the child and caregiver. These features differed significantly between children with and without disabilities, especially relating to participation, social bonds, family functioning, digital media use, and perceived safety. Age, disability, and gender predicted class adversity.ConclusionsThe results suggest that mental health problems and well-being are two related but separate constructs, highlighting the importance of promoting participation and recognizing well-being and not just mental health problems when planning interventions. The results also highlight the importance of providing support for not only the child but also their caregiver.

Machine learning (ML) techniques have shown promise for enhancing prediction of clinical outcomes; however, its application to predicting binge eating has been scarcely explored. We applied ML techniques to predict binge eating onset (vs. continued absence) and persistence (vs. remission) over time. Data were used from a larger prospective study of 1106 participants who were assessed on a range of putative risk, maintaining, and protective factors at baseline and 8months follow-up. Nine ML models for classification were developed and compared against a generalised linear model (GLM) for predicting onset (n=334) and persistence (n=623) outcomes using 39 self-reported baseline variables as predictors. All models performed poorly at predicting onset (AUC=0.49-0.61) and persistence (AUC=0.50-0.59) outcomes, with ML models demonstrating comparable performance to the GLM. We suspect that poor ML performance may have been a result of the limited set of self-reported baseline predictors used to generate prediction models. Improved predictive accuracy and optimisation of ML models in future research may require consideration of a larger, more disparate set of predictors that also incorporate various data types, such as neuroimaging, physiological, or smartphone sensor data.

Abstract: Theoretical Background: Suicide is among the leading causes of death for young people and a major public health concern. While intervention programs targeting youth at risk seem promising, more research is warranted to determine what works for whom. The HEYLiFE universal school-based suicide prevention program aims to promote three putative protective factors, namely, knowledge about mental health, agency, and help-seeking intention in students aged 14 years and older. While its overall efficacy was confirmed previously, specific effects in adolescents with different risk profiles remain to be determined. Objective: We explored whether program efficacy differed for students aged 14 – 18 years (mean age M= 16.2 years, SD = 1.2 years) at low, medium, and high risk for suicidality. Method: A pre–post within-group comparison trial was designed to evaluate the HEYLiFE suicide prevention program in a convenience sample of 304 adolescents from five public schools. The data of 218 adolescents (45.2 % female) with completed data sets were analyzed. Using a two-step cluster analysis, we identified three distinct at-risk clusters for suicidality based on self-reported suicidality, depression, impulsivity/carelessness, and avoidance. We then applied a mixed-model analysis of covariance to evaluate program efficacy in these clusters. Results: While knowledge improved to a similar degree across all clusters, agency and help-seeking intentions improved in the low- and medium-risk cluster but not in the high-risk cluster. Efficacy across time ranged from small to medium effects. Conclusion: Our results confirm that the HEYLiFE suicide prevention program is efficacious for the majority of students. The promotion of protective factors among students with different risk profiles is a viable strategy for universal suicide prevention, although efforts are warranted to specifically target individuals exhibiting the greatest risk for suicide.

AimsExposure to multiple forms of victimisation in childhood (often referred to as poly-victimisation) has lifelong adverse effects, including an elevated risk of early-adulthood psychopathology. However, not all poly-victimised children develop mental health difficulties and identifying what protects them could inform preventive interventions. The present study investigated whether individual-, family- and/or community-level factors were associated with lower levels of general psychopathology at age 18, among children exposed to poly-victimisation. Additionally, it examined whether these factors were specific to poly-victimised children or also associated with fewer mental health difficulties in young adults regardless of whether they had been poly-victimised.MethodsWe used data from the Environmental Risk (E-Risk) Longitudinal Twin Study, a population-representative cohort of 2,232 children born in 1994–1995 across England and Wales and followed to 18 years of age (with 93% retention, n = 2,066). Poly-victimisation (i.e., exposure to two or more of physical abuse, sexual abuse, emotional abuse and neglect, physical neglect, bullying by peers, and domestic violence) and nine putative protective factors (intelligence quotient, executive functioning, temperament, maternal and sibling warmth, atmosphere at home, maternal monitoring, neighbourhood social cohesion, and presence of a supportive adult) were measured prospectively between ages 5 and 12 years from interviews with mothers and children, surveys of neighbours, child-protection referrals, and researchers’ observations. Early-adulthood psychopathology was assessed in interviews with each twin at age 18 and used to construct a latent factor of general psychopathology.ResultsApproximately a third (n = 720) of participants were prospectively defined as exposed to poly-victimisation (53% male). Poly-victimised children had greater levels of general psychopathology at age 18 than non-poly-victimised children (adjusted [adj.] β = 4.80; 95% confidence interval [95% CI] 3.13, 6.47). Presence of a supportive adult was the only factor robustly associated with lower levels of general psychopathology among poly-victimised children (adj.β = −0.61; 95% CI −0.99, −0.23). However, this association was also evident in the whole sample regardless of poly-victimisation exposure (adj.β = −0.52; 95% CI −0.81, −0.24) and no significant interaction was observed between the presence of a supportive adult and poly-victimisation in relation to age-18 general psychopathology.ConclusionsHaving at least one adult to turn to for support was found to be associated with less psychopathology in early adulthood among both poly-victimised and non-poly-victimised children. This suggests that strategies to promote better availability and utilisation of supportive adults should be implemented universally. However, it may be beneficial to target these interventions at poly-victimised children, given their higher burden of psychopathology in early adulthood.

The impact of SARS-CoV-2 infection in Africa is still unclear. In comparison to Europe and North America, morbidity and death rates are lower. Several factors have been proposed, including geographical variation in virus impact, environmental factors, differences in age distribution, and the impact of infectious diseases such as malaria, HIV infection and tuberculosis. We investigated the clinical characteristics and putative determinants linked with COVID-19 in Angolan patients. Cross-sectional study undertaken at Military Hospital, Luanda, from March 2020 to March 2021. The survey collected sociodemographic and clinical information. The sample included 1,683 patients aged ≥18 years, 64% men, with mean age of 46.3 years. SARS-CoV-2 was positive in 39% of the cases with RT-PCR. Patients ≥46 years with a level of education of ≥12 years had a considerably higher likelihood of testing positive. About 58% of positive patients had at least one comorbidity, of which hypertension and Diabetes were associated with SARS-CoV-2 infection. HIV and pulmonary TB were putative protective factors. About 14% of positive patients died. Most deaths occurred in patients ≥46 years, with less education and unemployed. Working as a healthcare practitioner was linked to a protective effect. Malignant diseases were the most common comorbidities associated with death. We identified putative factors related to SARS-CoV-2 infection and mortality. HIV and TB were protective and not associated with mortality. Further study with a broader scope should be conducted to explain the main features related to COVID-19 mortality in Angola.

BackgroundMaladaptive and adaptive emotion regulation are putative risk and protective factors for depression and anxiety, but most prior research does not differentiate within-person effects from between-person individual differences. The current study does so during the early part of the Covid-19 pandemic when internalizing symptoms were high.MethodsA sample of emerging adult undergraduate students (N = 154) completed online questionnaires bi-weekly on depression, anxiety, and emotion regulation across eight weeks during the early days of the Covid-19 pandemic (April 2nd to June 27th, 2020).ResultsDepression demonstrated significantly positive between-person correlations with overall maladaptive emotion regulation, catastrophizing, and self-blame, and negative correlations with overall adaptive emotion regulation and reappraisal. Anxiety demonstrated significantly positive between-person correlations with overall maladaptive emotion regulation, rumination, and catastrophizing, and a negative correlation with reappraisal. After controlling for these between-person associations, however, there were generally no within-person associations between emotion regulation and internalizing symptoms.ConclusionsEmotion regulation and internalizing symptoms might be temporally stable individual differences that cooccur with one another as opposed to having a more dynamic relation. Alternatively, these dynamic mechanisms might operate over much shorter or longer periods compared to the two-week time lag in the current study.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10608-023-10366-9.

According to the International Study of Unruptured Intracranial Aneurysms, small (<7 mm) unruptured intracranial aneurysms (IAs) of the anterior circulation (aC) carry a neglectable 5-year rupture risk. In contrast, some studies report frequencies of >20% of all ruptured IAs being small IAs of the aC. This contradiction was addressed in this study by analyzing the rates and risk factors for rupture of small IAs within the aC. Of the institutional observational cohort, 1676 small IAs of the aC were included. Different demographic, clinical, laboratory, and radiographic characteristics were collected. A rupture risk score was established using all independent prognostic factors. The score performance was checked using receiver operating characteristic curve analysis. Of all registered small IAs of the aC, 20.1% were ruptured. The developed small IAs of the aC (SIAAC) score (range = -4 to +13 points) contained five major risk factors: IA location and size, arterial hypertension, alcohol abuse, and chronic renal failure. In addition, three putative protective factors were also included in the score: hypothyroidism, dyslipidemia, and peripheral arterial disease. Increasing rates of ruptured IA with increasing SIAAC scores were observed, from 0% (≤-1 points) through >50% (≥8 points) and up to 100% in patients scoring ≥12 points. The SIAAC score achieved excellent discrimination (area under the curveSIAAC = 0.803) and performed better than the PHASES (Population,Hypertension, Age, Size of the aneurysm, Earlier SAH from another aneurysm, Site of aneurysm) score. Small IAs of the aC carry a considerable rupture risk. After external validation, the proposed rupture risk score might provide a basis for better decision-making regarding the treatment of small unruptured IAs of the aC.

Sports participation, physical activity, and friendship quality are theorized to have protective effects on the developmental emergence of substance use and self-harm behavior in adolescence, but existing research has been mixed. This ambiguity could reflect, in part, the potential for confounding of observed associations by genetic and environmental factors, which previous research has been unable to rigorously rule out. We used data from the prospective, population-based Child and Adolescent Twin Study in Sweden (n = 18,234 born 1994-2001) and applied a co-twin control design to account for potential genetic and environmental confounding of sports participation, physical activity, and friendship quality (assessed at age 15) as presumed protective factors for adolescent substance use and self-harm behavior (assessed at age 18). While confidence intervals widened to include the null in numerous co-twin control analyses adjusting for childhood psychopathology, parent-reported sports participation and twin-reported positive friendship quality were associated with increased odds of alcohol problems and nicotine use. However, parent-reported sports participation, twin-reported physical activity, and twin-reported friendship quality were associated with decreased odds of self-harm behavior. The findings provide a more nuanced understanding of the risks and benefits of putative protective factors for risky behaviors that emerge during adolescence.

Hypertension is a public health issue touted as a “silent killer” worldwide. The present study aimed to explore the sex differential in the association of anthropometric measures including body mass index, waist circumference, and waist-hip ratio with hypertension among older adults in India. The study used data from the Longitudinal Aging Study in India (LASI) conducted during 2017–18. The sample contains 15,098 males and 16,366 females aged 60 years and above. Descriptive statistics (percentages) along with bivariate analysis were presented. Multivariable binary logistic regression analyses were used to examine the associations between the outcome variable (hypertension) and putative risk or protective factors. About 33.9% of males and 38.2% of females aged 60 years and above suffered from hypertension. After adjusting for the socioeconomic, demographic and health-behavioral factors, the odds of hypertension were 1.37 times (CI: 1.27–1.47), significantly higher among older adults who were obese or overweight than those with no overweight/obese condition. Older adults with high-risk waist circumference and waist-hip ratio had 1.16 times (CI: 1.08–1.25) and 1.42 times (CI: 1.32–1.51) higher odds of suffering from hypertension, respectively compared to their counterparts with no high-risk waist circumference or waist-hip ratio. The interaction effects showed that older females with overweight/obesity [OR: 0.84; CI: 0.61–0.74], high-risk waist circumference [OR: 0.89; CI: 0.78–0.99], and high-risk waist-hip ratio [OR: 0.90; CI: 0.83–0.97] had a lower chance of suffering from hypertension than their male counterparts with the similar anthropometric status. The findings suggested a larger magnitude of the association between obesity, high-risk waist circumference, high-risk waist-hip ratio and prevalent hypertension among older males than females. The study also highlights the importance of measuring obesity and central adiposity in older individuals and using such measures as screening tools for timely identification of hypertension.

ABSTRACT A public health approach to countering the threat from extremism aims to manage vulnerability before behaviour escalates to require involvement from the criminal justice system. Fundamental to applying a public health approach is understanding how risk (and protective) factors can be modified, in other words, the functional roles of these factors. To unpack the functional roles of risk factors, a more dynamic approach to modelling the complex relationships between factors is needed. In the present study we surveyed a representative sample of the UK general population (n = 1500) where participants self-reported risk factors and indicators for vulnerability to radicalisation. Operationalising analytical guidance from a Risk Analysis Framework (RAF), we applied psychometric network modelling to visualise the relationships among risk factors relating to individual-level propensities, situational influences, and exposure to extremism-enabling environments. We present our results as a series of network graphs and discuss (a) how risk factors ‘cluster’ or ‘co-occur’, (b) the most influential risk factors which may be important for intervention and prevention, and (c) ‘risk pathways’ which suggest potential putative risk and/or protective factors. We present our findings as evidence for a public health approach to countering the threat from extremism.

Given that death by suicide continues to rank among the top three causes of death during adolescence, new psychological models may contribute critical insight towards understanding the complex interactions between risk and protective factors in suicidal behaviour. The main objective of this study was to analyse the psychological network structure of suicidal behaviour and putative risk and protective factors in school-aged adolescents. Methods: Stratified random cluster sampling was performed. The final sample comprised 1790 students (53.7% female, M = 15.7 years, SD = 1.26). Instruments were administered to assess suicidal behaviour, emotional and behavioural difficulties, prosocial behaviour, subjective well-being, self-esteem, depressive symptomatology, academic performance, socio-economic status, school engagement, bullying, and cyberbullying. Results: In the estimated psychological network, the node with the highest strength was depressive symptomatology, and that with the highest expected influence value was bullying. Suicidal behaviour was positively connected to symptoms of depression and behavioural problems. In addition, suicidal behaviour was negatively connected to self-esteem and personal well-being. The results of the stability analysis indicated that the network was accurately estimated. Conclusions: Suicidal behaviour can be conceptualised as a dynamic, complex system of cognitive, emotional, and affective characteristics. New psychological models allow us to analyse and understand human behaviour from a new perspective, suggesting new forms of conceptualisation, evaluation, intervention, and prevention.

Decades of research have revealed numerous risk factors for mental disorders beyond genetics, but their consistency and magnitude remainuncer-tain. We conducted a "meta-umbrella" systematic synthesis of umbrella reviews, which are systematic reviews of meta-analyses of individual studies, by searching international databases from inception to January 1, 2021. We included umbrella reviews on non-purely genetic risk or protective factors for any ICD/DSM mental disorders, applying an established classification of the credibility of the evidence: class I (convincing), class II (highly suggestive), class III (suggestive), class IV (weak). Sensitivity analyses were conducted on prospective studies to test for temporality (reverse causation), TRANSD criteria were applied to test transdiagnosticity of factors, and A Measurement Tool to Assess Systematic Reviews (AMSTAR) was employed to address the quality of meta-analyses. Fourteen eligible umbrella reviews were retrieved, summarizing 390 meta-analyses and 1,180 associations between putative risk or protective factors and mental disorders. We included 176 class I to III evidence associations, relating to 142 risk/protective factors. The most robust risk factors (class I or II, from prospective designs) were 21. For dementia, they included type 2 diabetes mellitus (risk ratio, RR from 1.54 to 2.28), depression (RR from 1.65 to 1.99) and low frequency of social contacts (RR=1.57). For opioid use disorders, the most robust risk factor was tobacco smoking (odds ratio, OR=3.07). For non-organic psychotic disorders, the most robust risk factors were clinical high risk state for psychosis (OR=9.32), cannabis use (OR=3.90), and childhood adversities (OR=2.80). For depressive disorders, they were widowhood (RR=5.59), sexual dysfunction (OR=2.71), three (OR=1.99) or four-five (OR=2.06) metabolic factors, childhood physical (OR=1.98) and sexual (OR=2.42) abuse, job strain (OR=1.77), obesity (OR=1.35), and sleep disturbances (RR=1.92). For autism spectrum disorder, the most robust risk factor was maternal overweight pre/during pregnancy (RR=1.28). For attention-deficit/hyperactivity disorder (ADHD), they were maternal pre-pregnancy obesity (OR=1.63), maternal smoking during pregnancy (OR=1.60), and maternal overweight pre/during pregnancy (OR=1.28). Only one robust protective factor was detected: high physical activity (hazard ratio, HR=0.62) for Alzheimer's disease. In all, 32.9% of the associations were of high quality, 48.9% of medium quality, and 18.2% of low quality. Transdiagnostic class I-III risk/protective factors were mostly involved in the early neurodevelopmental period. The evidence-based atlas of key risk and protective factors identified in this study represents a benchmark for advancing clinical characterization and research, and for expanding early intervention and preventive strategies for mental disorders.

Two of the most central questions in radicalization research are, (1) why do some individuals radicalize when most of those from the same groups or exposed to similar conditions do not? and (2) why do radicalized individuals turn to radical violence while the majority remain inert? It has been suggested that the answer to both questions lie in the cumulative and interactive effects of a range of risk factors. While risk assessment and counter-radicalization take a risk-protective factor approach, there is widespread debate as to what these factors are and which are most important. This review has two primary objectives.1) To identify what the putative risk and protective factors for different radicalization outcomes are, without any predeterminations.2) To synthesize the evidence and identify the relative magnitude of the effects of different factors.The review's secondary objectives are to:1) Identify consistencies in the estimates of factors across different radicalization outcomes.2) Identify whether any significant heterogeneity exists within factors between (a) geographic regions, and (b) strains of radicalizing ideologies. Over 20 databases were searched for both published and gray literature. In order to provide a more comprehensive review, supplementary searches were conducted in two German and one Dutch database. Reference harvesting was conducted from previous reviews and contact was made with leading researchers to identify and acquire missing or unpublished studies. The review included observational studies assessing the outcomes of radical attitudes, intentions, and/or radical behaviors in OECD countries and which provided sufficient data to calculate effect sizes for individual-level risk and protective factors. One-hundred and twenty-seven studies, containing 206 samples met the inclusion criteria and provided 1302 effect sizes pertaining to over 100 different factors. Random effects meta-analyses were carried out for each factor, and meta-regression and moderator analysis were used to explore differences across studies. Studies were primarily cross-sectional, with samples representing 20 countries OECD countries. Most studies examined no specific radicalizing ideology, while others focussed on specific ideologies (e.g., Islamist, right-wing, and left-wing ideologies). The studies generally demonstrated low risk of bias and utilized validated or widely acceptable measures for both indicators and outcomes. With some exceptions, sociodemographic factors tend to have the smallest estimates, with larger estimates for experiential and attitudinal factors, followed by traditional criminogenic and psychological factors. While sociodemographic factors are the most commonly examined factors (selective availability), they also tend to have the smallest estimates. So too, attitudinal and even experiential factors, do not have effect sizes of the magnitude that could lead to significant reductions in risk through targeting by interventions. Conversely, traditional criminogenic factors, as well as psychological factors tend to display the largest estimates. These findings suggest the need to broaden the scope of factors considered in both risk assessment and intervention, and this review provides much needed evidence for guiding the selection of factors.

BackgroundThe validity of observational studies and their meta-analyses is contested. Here, we aimed to appraise thousands of meta-analyses of observational studies using a pre-specified set of quantitative criteria that assess the significance, amount, consistency, and bias of the evidence. We also aimed to compare results from meta-analyses of observational studies against meta-analyses of randomized controlled trials (RCTs) and Mendelian randomization (MR) studies.MethodsWe retrieved from PubMed (last update, November 19, 2020) umbrella reviews including meta-analyses of observational studies assessing putative risk or protective factors, regardless of the nature of the exposure and health outcome. We extracted information on 7 quantitative criteria that reflect the level of statistical support, the amount of data, the consistency across different studies, and hints pointing to potential bias. These criteria were level of statistical significance (pre-categorized according to 10−6, 0.001, and 0.05 p-value thresholds), sample size, statistical significance for the largest study, 95% prediction intervals, between-study heterogeneity, and the results of tests for small study effects and for excess significance.Results3744 associations (in 57 umbrella reviews) assessed by a median number of 7 (interquartile range 4 to 11) observational studies were eligible. Most associations were statistically significant at P < 0.05 (61.1%, 2289/3744). Only 2.6% of associations had P < 10−6, ≥1000 cases (or ≥20,000 participants for continuous factors), P < 0.05 in the largest study, 95% prediction interval excluding the null, and no large between-study heterogeneity, small study effects, or excess significance. Across the 57 topics, large heterogeneity was observed in the proportion of associations fulfilling various quantitative criteria. The quantitative criteria were mostly independent from one another. Across 62 associations assessed in both RCTs and in observational studies, 37.1% had effect estimates in opposite directions and 43.5% had effect estimates differing beyond chance in the two designs. Across 94 comparisons assessed in both MR and observational studies, such discrepancies occurred in 30.8% and 54.7%, respectively.ConclusionsAcknowledging that no gold-standard exists to judge whether an observational association is genuine, statistically significant results are common in observational studies, but they are rarely convincing or corroborated by randomized evidence.

ObjectivesThis systematic review seeks to collate and synthesize putative risk and protective factors for the different outcomes of radicalization.MethodologyDrawing on an established theoretical framework, we will categorize putative risk and protective factors as they relate to the domains of radical attitudes, intentions, and behaviors. We will utilize meta‐analytic techniques to develop a rank‐order of factors according to effect size. Meta‐regression and sub‐group analyses will be used to assess sources of heterogeneity.ImplicationsThe results of the review are intended to inform evidence‐based policy in the areas of both assessment and intervention.