Showing posts with label Psychology. Show all posts
Showing posts with label Psychology. Show all posts

Thursday, September 29, 2022

Adverse health outcomes associated with long-term antidepressant use

Long-term antidepressant use may double the risk of heart disease, finds the most comprehensive epidemiological study to date to investigate the health consequences from using the medication over ten years. The University of Bristol-led study, published in the British Journal of Psychiatry Open, analyzed data on over 200,000 people.

Antidepressants are one of the most widely prescribed drugs in England. In 2018, over 70-million antidepressant prescriptions were dispensed. The striking rise in prescribing (nearly doubling in a decade) is due mainly to long-term treatment rather than increased diagnosis. However, little is known about the health consequences of long-term use of these medicines.

Researchers from Bristol’s Centre for Academic Mental Health aimed to find out if long-term antidepressant use (over five and ten years) was associated with the onset of six health problems: diabetes, high blood pressure, coronary heart disease, stroke and related syndromes, and two mortality outcomes (death from cardiovascular disease and from any cause).

Using data from UK Biobank, a large-scale biomedical database and research resource containing anonymized genetic, lifestyle and health information from half a million UK participants, the team linked comprehensive health data with prescription and disease data (using GP records) on 222,121 adults aged between 40 to 69-years old.

Friday, September 23, 2022

New research reveals the relationship between particular brain circuits and different aspects of mental wellbeing

Brain circuits and wellbeing
Credit: Miriam Klein-Flugge 

Associate Professor Miriam Klein-Flügge and colleagues looked at brain connectivity and mental health data from nearly 500 people. In particular, they looked at the connectivity of the amygdala – a brain region well known for its importance in emotion and reward processing. The researchers used functional magnetic resonance imaging to consider seven small subdivisions of the amygdala and their associated networks rather than combining the whole region together as previous studies have done.

The team also adopted a more precise approach to the data on mental wellbeing, looking at a large group of healthy people and using questionnaires that captured information about wellbeing in the social, emotional, sleep, and anger domains. This generated more precise data than many investigations which still use broad diagnoses such as depression or anxiety, which involve many different symptoms.

The paper, published in Nature Human Behavior, shows how the improved level of detail about both brain connectivity and wellbeing made it possible to characterize the exact brain networks that relate to these distinct aspects of mental health. The brain connections that mattered most for discerning whether an individual was struggling with sleep problems, for example, looked very different from those that carried information about their social wellbeing.

Monday, September 19, 2022

Statin use is not justified for healthy people with high cholesterol

Professor David Diamond, Department of Psychology
Credit: University of South Florida
About 40 million adults in the United States regularly take statins to lower their cholesterol levels and reduce their risk of heart disease and stroke, according to American Heart Association data from 2020.

However, many of them don’t stand to benefit from these drugs based on new research from David Diamond, a neuroscientist and cardiovascular disease researcher in the Department of Psychology at the University of South Florida.

Diamond and his co-authors reviewed literature from medical trials involving patients taking either a statin or placebo. They then narrowed their review to look at study participants with elevated levels of low-density lipoprotein-cholesterol (LDL), the so-called “bad cholesterol,” which can be reduced with a statin. Some individuals with high LDL also had high triglycerides (fat in the blood) and low high-density lipoprotein (HDL), the “good cholesterol,” which put them at the highest risk of having a heart attack.

But others with high LDL were very different. They had low triglycerides and high HDL, which meant they were healthier. People with optimal triglycerides and HDL levels typically exercise, have low blood pressure and low blood sugar, and are at a low risk of a heart attack.

Diamond and his co-authors asked two questions: If people are at a low risk of a heart attack based on having optimal triglycerides and HDL, but they also have high LDL, does that raise their risk? Further, would these people benefit from lowering their LDL with a statin?

Tuesday, September 13, 2022

Study finds white children more likely to be overdiagnosed for ADHD

A new study by Professor Paul Morgan finds that white children are more likely to be overdiagnosed for ADHD than children of color.
Photo credit: Ben White on Unsplash

A new study led by Paul Morgan, Harry and Marion Eberly Faculty Fellow and professor of education (educational theory and policy) and demography, and published in the Journal of Learning Disabilities, examines which sociodemographic groups of children are more likely to be overdiagnosed and overtreated for ADHD. The researchers analyzed data from 1,070 U.S. elementary school children who had previously displayed above-average behavioral, academic or executive functioning the year before their initial ADHD diagnoses. The team said those children were considered unlikely to have ADHD by the researchers because children diagnosed and treated for ADHD should displaychronically inattentive, hyperactive or impulsive behaviors that impair their functioning and result in below-average academic or social development.

A problem with ADHD overdiagnosis, Morgan said, is that it contributes to stigma and skepticism toward those experiencing more serious impairments.

“It undermines a confidence in the disorder,” he said. “If anyone can be diagnosed with ADHD, then what is ADHD? For those who have significant impairments, they may experience greater skepticism about the condition. Mental health resources are already scarce, those with serious impairments could lose out.”

Wednesday, September 7, 2022

More than 10 million children were affected by COVID-19-associated parental and caregiver deaths

According to a new modeling study, published in JAMA Pediatrics, the number of children estimated to have experienced the death of a parent or caregiver as a result of the COVID-19 pandemic has climbed to more than 10.5 million globally as of May 1, 2022.

The new study, involving the University of Oxford, Imperial College, the African Institute for Mathematical Sciences, the Centers for Disease Control and Prevention (CDC), and the World Health Organization (WHO), builds on the best available and most conservative data recently published by WHO on excess COVID-19 deaths (14.9 million as of Dec 31, 2021), to establish estimates of orphaned children in every country. This is the first-time availability of these comprehensive data on excess deaths for every country, and it enabled the data modelers to update global minimum estimates of pandemic orphanhood and caregiver death among children based on these excess deaths.

Excess deaths are typically defined as the difference between the observed numbers of deaths in specific time periods and expected numbers of deaths in the same time periods. Estimates of excess deaths can provide information about the burden of mortality potentially related to the COVID-19 pandemic, including deaths that are directly or indirectly attributed to COVID-19.

In this study, authors analyzed country-level deaths, fertility rates, and national excess mortality data provided by the WHO, the Economist, and the Institute for Health Metrics and Evaluation, and used mathematical modelling to develop global estimates based on the WHO estimates, which were the most conservative.

Tuesday, September 6, 2022

How does nature nurture the brain?

Credit: Jessica Rockowitz on Unsplash

After a 60-minute walk in nature, activity in brain regions involved in stress processing decreases. This is the finding of a recent study by the Lise Meitner Group for Environmental Neuroscience at the Max Planck Institute for Human Development, published in Molecular Psychiatry.

Living in a city is a well-known risk factor for developing a mental disorder, while living close to nature is largely beneficial for mental health and the brain. A central brain region involved in stress processing, the amygdala, has been shown to be less activated during stress in people who live in rural areas, compared to those who live in cities, hinting at the potential benefits of nature. “But so far the hen-and-egg problem could not be disentangled, namely whether nature actually caused the effects in the brain or whether the particular individuals chose to live in rural or urban regions”, says Sonja Sudimac, predoctoral fellow in the Lise Meitner Group for Environmental Neuroscience and lead author of the study.

To achieve causal evidence, the researchers from the Lise Meitner Group for Environmental Neuroscience examined brain activity in regions involved in stress processing in 63 healthy volunteers before and after a one-hour walk in Grunewald forest or a shopping street with traffic in Berlin using functional magnetic resonance imaging (fMRI). The results of the study revealed that activity in the amygdala decreased after the walk in nature, suggesting that nature elicits beneficial effects on brain regions related to stress.

Thursday, September 1, 2022

Cannabis users no less likely to be motivated or able to enjoy life’s pleasure

Credit: RODNAE Productions

Cannabis users also show no difference in motivation for rewards, pleasure taken from rewards, or the brain’s response when seeking rewards, compared to non-users.

Cannabis is the third most commonly used controlled substance worldwide, after alcohol and nicotine. A 2018 report from the NHS Digital Lifestyles Team stated that almost one in five (19%) of 15-year-olds in England had used cannabis in the previous 12 months, while in 2020 the National Institute on Drug Abuse reported the proportion in the United States to be 28% of 15-16-year-olds.

A common stereotype of cannabis users is the ‘stoner’ – think Jesse Pinkman in Breaking Bad, The Dude in The Big Lebowski, or, more recently, Argyle in Stranger Things. These are individuals who are generally depicted as lazy and apathetic.

At the same time, there has been considerable concern of the potential impact of cannabis use on the developing brain and that using cannabis during adolescence might have a damaging effect at an important time in an individual’s life.

A team led by scientists at UCL, the University of Cambridge and the Institute of Psychiatry, Psychology & Neuroscience at King’s College London carried out a study examining whether cannabis users show higher levels of apathy (loss of motivation) and anhedonia (loss of interest in or pleasure from rewards) when compared to controls and whether they were less willing to exert physical effort to receive a reward. The research was part of the CannTEEN study.

Wednesday, August 31, 2022

Study finds tiny brain area controls work for rewards

The lateral habenula in the mouse brain, with axons streaming down to dopaminergic and serotonergic centers. Credit: Warden Lab

A tiny but important area in the middle of the brain acts as a switch that determines when an animal is willing to work for a reward and when it stops working, according to a study published Aug. 31 in the journal Current Biology.

“The study changes how we think about this particular brain region,” said senior author Melissa Warden, assistant professor and Miriam M. Salpeter Fellow in the Department of Neurobiology and Behavior, which is shared between the College of Arts and Sciences and the College of Agriculture and Life Sciences.

“It has implications for psychiatric disorders, particularly depression and anxiety,” Warden said.

The paper, “Tonic Activity in Lateral Habenula Neurons Acts as a Neutral Valence Brake on Reward-Seeking Behavior,” illuminates the role of the lateral habenula, a small structure on top of the thalamus, which funnels higher-level information from the front and center of the brain to areas that produce neurotransmitters such as serotonin and dopamine.

The lateral habenula’s exact role has been unclear until now. The new study shows that when neurons in this brain area turn off, an animal will work for rewards; when those neurons fire, the animal becomes disengaged and stops working. Experiments revealed that the lateral habenula turns on specifically when an animal has had enough of a reward and is satisfied, or when it finds its work no longer yields a reward.

Brain activity during sleep differs in young people with genetic risk of psychiatric disorders

Photo by Lux Graves on Unsplash

Young people living with a genetic alteration that increases the risk of psychiatric disorders have markedly different brain activity during sleep, a study led by researchers from the Universities of Bristol and Cardiff published in the journal eLife shows.

The brain activity patterns during sleep shed light on the neurobiology behind a genetic condition called 22q11.2 Deletion Syndrome (22q11.2DS) and could be used as a biomarker to detect the onset of neuropsychiatric disorders in people with 22q11.2DS.

Caused by a gene deletion of around 30 genes on chromosome 22, 22q11.2DS occurs in one in 3000 births. It increases the risk of intellectual disability, autism spectrum disorder (ASD), attention-deficit hyperactivity disorder (ADHD) and epileptic seizures. It is also one of the largest biological risk factors for schizophrenia. However, the biological mechanisms underlying psychiatric symptoms in 22q11.2DS are unclear.

Marianne van den Bree, co-senior author and Professor of Psychological Medicine at Cardiff said: “We have recently shown that the majority of young people with 22q11.2DS have sleep problems, particularly insomnia and sleep fragmentation, that are linked with psychiatric disorders. However, our previous analysis was based on parents reporting on sleep quality of their children, and the neurophysiology – what’s happening to brain activity – has not yet been explored.”

Tuesday, August 23, 2022

Sleepless and selfish: Lack of sleep makes us less generous

The new study shows how sleep loss dramatically reduces the desire to help others, triggered by a breakdown in the activity of key prosocial brain networks.
Image credit: Eti Ben Simon and Matthew Walker, UC Berkeley

Humans help each other — it’s one of the foundations of civilized society. But a new study by scientists at the University of California, Berkeley, reveals that a lack of sleep blunts this fundamental human attribute, with real-world consequences.

Lack of sleep is known to be associated with an increased risk of cardiovascular disease, depression, diabetes, hypertension and overall mortality. However, these new discoveries show that a lack of sleep also impairs our basic social conscience, making us withdraw our desire and willingness to help other people.

In one portion of the new study, the scientists showed that charitable giving in the week after the beginning of Daylight-Saving Time, when residents of most states “spring forward” and lose one hour of their day, dropped by 10% — a decrease not seen in states that do not change their clocks or when states return to standard time in the fall.

The study, led by UC Berkeley research scientist Eti Ben Simon and Matthew Walker, a UC Berkeley professor of psychology, adds to a growing body of evidence demonstrating that inadequate sleep not only harms the mental and physical well-being of an individual, but also compromises the bonds between individuals — and even the altruistic sentiment of an entire nation.

COVID-19 pandemic fallout worse for women

Dr Terry Fitzsimmons, Lead author
Credit: University of Queensland

Researchers from The University of Queensland have found the COVID-19 pandemic in Australia has had a greater financial and psychological impact on women than men.

A study conducted by the UQ Business School shows women have experienced more significant impacts on their overall employment, hours of work, domestic labor and mental health and wellbeing.

Lead researcher Dr Terry Fitzsimmons said one reason was the over-representation of women in industries most affected by lockdowns.

“Women are also more likely to be casual, part-time or contract workers which were among the first to lose their jobs as businesses struggled in response to lockdown,” Dr Fitzsimmons said.

Additionally, the study found women were less likely to be considered ‘essential workers’, so bore a greater share of caring responsibilities including home schooling, when schools and child care centers closed.

“Women either reduced their work hours or stopped working altogether and took on more domestic labor than their male counterparts while at home with their children,” Dr Fitzsimmons said.

Friday, August 19, 2022

Random Acts of Kindness Make a Bigger Splash Than Expected


Even though they often enhance happiness, acts of kindness such as giving a friend a ride or bringing food for a sick family member can be somewhat rare because people underestimate how good these actions make recipients feel, according to new research from The University of Texas at Austin.

The study by UT Austin McCombs School of Business Assistant Professor of Marketing Amit Kumar, along with Nicholas Epley of the University of Chicago, found that although givers tend to focus on the object they’re providing or action they’re performing, receivers instead concentrate on the feelings of warmth the act of kindness has conjured up. This means that givers’ “miscalibrated expectations” can function as a barrier to performing more prosocial behaviors such as helping, sharing or donating.

The research is online in advance in the Journal of Experimental Psychology: General.

To quantify these attitudes and behaviors, the researchers conducted a series of experiments.

In one, the researchers recruited 84 participants in Chicago’s Maggie Daley Park. Participants could choose whether to give away to a stranger a cup of hot chocolate from the park’s food kiosk or keep it for themselves. Seventy-five agreed to give it away.

Researchers delivered the hot chocolate to the stranger and told them the study participant had chosen to give them their drink. Recipients reported their mood, and performers indicated how they thought recipients felt after getting the drink.

Thursday, August 18, 2022

Increased risk of some neurological and psychiatric disorders remains two years after COVID-19 infection

New diagnoses of disorders including psychosis, dementia, seizures and ‘brain fog’ remain commoner two years after COVID-19 than after other respiratory infections, whereas the increased risks of depression and anxiety after COVID-19 are short-lived and there is no overall excess of cases.

Published in The Lancet Psychiatry, the new study from the University of Oxford and the National Institute for Health and Care Research (NIHR) Oxford Health Biomedical Research Centre investigated neurological and psychiatric diagnoses in over 1.25 million people following diagnosed COVID-19 infection, using data from the US-based TriNetX electronic health record network.

The study reports on 14 neurological and psychiatric diagnoses over a 2-year period and compares their frequency with a matched group of people recovering from other respiratory infections. It also reports data on children and older adults separately, and compares data across three waves of the pandemic. To our knowledge, these are the first robust data addressing these important questions.

Confirming previous studies, many of the disorders are more common after COVID-19. Notably, the increased risk of anxiety and depression subsides within two months of COVID-19 and, over the whole 2-year period, are no more likely to occur than after other respiratory infections. In contrast, diagnoses of many neurological disorders (such as dementia and seizures), as well as psychotic disorders and ‘brain fog’, continue to be made more often after COVID-19 throughout the 2 years.

Results in children (under 18) showed similarities and differences to adults. The likelihood of most diagnoses after COVID-19 was lower than in adults, and they were not at greater risk of anxiety or depression than children who had other respiratory infections. However, like adults, children recovering from COVID-19 were more likely to be diagnosed with some conditions, including seizures and psychotic disorders.

Thursday, August 11, 2022

Do you keep secrets from your loved ones, family, or friends?

Ninety percent of people have kept an everyday consumer decision a secret from a spouse or other close relationship 
Photo Credit: Noelle Otto

It turns out that many people do. Whether ordering something online and hiding the package when it arrives, hiring a cleaning service and not telling your roommate, or eating a pizza instead of dieting, we often have secret purchases that we just prefer not to divulge.

UConn marketing professor Danielle Brick is investigating this behavior and discovering the little “errors of omissions” that go on in many households.

“I think what makes this research important, and fun, is how relatable it is,’ says Brick, a new member of the UConn School of Business faculty.

Her research, titled “Secret Consumer Behaviors in Close Relationships,” has just been published in the Journal of Consumer Psychology.

She and her colleagues found that this clandestine behavior not only impacts relationships in an unexpected and significant way, but also has considerable marketing implications.

Monday, August 8, 2022

Prevalence of gender-diverse youth in rural Appalachia exceeds previous estimates

The prevalence of gender diversity is largely unknown, especially in rural areas. To fill that knowledge gap, WVU researchers surveyed junior high and high school students in rural Appalachia about their gender identity. Over 7% of young people surveyed shared a gender identity that did not fully align with the sex they were assigned at birth.
Credit: WVU Photo/Sean Hines

Gender-diverse youth are at an increased risk of suicide and depression, according to the Centers for Disease Control and Prevention. But the prevalence of gender diversity is largely unknown—especially in rural areas, where studies of the topic are rare.

To fill that knowledge gap, researchers at West Virginia University— along with their colleagues at the University of Washington and Boise State University — surveyed junior high and high school students in rural Appalachia about their gender identity. They asked about the students’ internal sense of being male, being female or having another identity, like nonbinary. They found that more than 7% of young people surveyed shared a gender identity that did not fully align with the sex they were assigned at birth.

These findings were published in JAMA Pediatrics.

Being gender diverse, including being transgender, nonbinary or having another gender identity that doesn’t match the sex assigned at birth, is not a medical concern and is considered a normal part of human experience, according to the American Academy of Pediatrics.

Even though gender diversity isn’t an illness, some young people who are gender diverse experience distress when their gender doesn’t align with their physical characteristics or treatment in society. This distress, called “gender dysphoria,” can be associated with higher rates of depression or even thoughts of self-harm, prior research suggests.

Wednesday, July 27, 2022

Gaming does not appear harmful to mental health, unless the gamer can't stop

Video gaming: Although today’s research suggests gaming may only be a negative influence only for those who feel compelled to game, rather than all users, there is much more to be learned, according to the Oii research.
Credit: Ella Don on Unsplash

Societies may tremble when a hot new video game is released, but the hours spent playing popular video games do not appear to be damaging players’ mental health, according to the largest-ever survey of nearly 40,000 gamers and their gaming habits, which was conducted over six weeks by a team from Oxford’s Internet Institute. That does not mean, however, that the research did not throw up some concerns – and, the team argues, much more information is needed before tech regulators can really rest easy.

The research, published in the journal Royal Society Open Science, found no ‘causal link’ between gaming and poor mental health – whatever sort of games are being played. But Professor Andrew K. Przybylski, OII Senior Research Fellow, says the research did show a distinct difference in the experience of gamers who play ‘because they want to’ and those who play ‘because they feel they have to’.

He maintains, ‘We found it really does not matter how much gamers played [in terms of their sense of well-being]. It wasn’t the quantity of gaming, but the quality that counted…if they felt they had to play, they felt worse. If they played because they loved it, then the data did not suggest it affected their mental health. It seemed to give them a strong positive feeling.’

"It wasn’t the quantity of gaming, but the quality that counted…if they felt they had to play, they felt worse. If they played because they loved it, then the data did not suggest it affected their mental health"
Professor Andrew K. Przybylski

Friday, June 24, 2022

Developmental dyslexia essential to human adaptive success, study argues

Photo by Allan Mas
Cambridge researchers studying cognition, behavior and the brain have concluded that people with dyslexia are specialized in exploring the unknown. This is likely to play a fundamental role in human adaptation to changing environments.

They think this ‘explorative bias’ has an evolutionary basis and plays a crucial role in our survival.

Based on these findings − which were apparent across multiple domains from visual processing to memory and at all levels of analysis − the researchers argue that we need to change our perspective of dyslexia as a neurological disorder.

The findings, reported today in the journal Frontiers in Psychology, have implications both at the individual and societal level, says lead author Dr Helen Taylor, an affiliated Scholar at the McDonald Institute for Archaeological Research at the University of Cambridge and a Research Associate at the University of Strathclyde.

“The deficit-centered view of dyslexia isn’t telling the whole story,” said Taylor. “This research proposes a new framework to help us better understand the cognitive strengths of people with dyslexia.”

She added: “We believe that the areas of difficulty experienced by people with dyslexia result from a cognitive trade-off between exploration of new information and exploitation of existing knowledge, with the upside being an explorative bias that could explain enhanced abilities observed in certain realms like discovery, invention and creativity.”

This is the first-time a cross-disciplinary approach using an evolutionary perspective has been applied in the analysis of studies on dyslexia.

Wednesday, June 22, 2022

Brain imaging links stimulant-use relapse to distinct nerve pathway

Researchers used advanced brain imaging techniques to study nerve fibers connecting to the nucleus accumbens, which plays an important role in motivation and addiction.
Credit: Loreen Tisdall and Kelly H. MacNiven.

You might assume that people who are most prone to developing a substance use disorder in the first place would also have the hardest time avoiding relapse following treatment. But a new study by scientists with the Wu Tsai Neurosciences Institute’s NeuroChoice Initiative reveals that relapse may be linked to quite different brain circuits than addiction itself.

“There’s a huge revolving door problem with relapse,” said Brian Knutson, a professor of psychology. “These findings suggest ​​that what gets you into taking drugs may not be the same processes that get you out of it, which could be very valuable to help predict who is at highest risk of relapse coming out of treatment.”

Drug addiction presents a major global challenge. More than 35 million people worldwide self-report problematic use of drugs and admissions to drug treatment programs have surged in the United States in recent years. For many drugs, in particular stimulants such as cocaine and amphetamines, relapse remains a common problem. For example, as many as 50 percent of people with stimulant use disorders relapse within 6 months of release from treatment.

“The statistics are disheartening,” said Kelly MacNiven, a social science research scholar in the Knutson lab and co-author of the new study. “Unfortunately not much is known at a biological level about the drivers of relapse — understanding this better is going to be the first step to developing better ways to help people get out of dependence.”

Monday, June 20, 2022

New report finds smoking is a cause of depression and schizophrenia

Credit: Uki Eiri from Pixabay
Smoking increases the risk of developing schizophrenia by between 53% and 127% and of developing depression by 54% to 132%, a report by academics from the University of Bristol published today has shown. More research is needed to identify why this is the case, and more evidence is needed for other mental health conditions such as anxiety or bipolar disorder.

The evidence presented today at the Royal College of Psychiatrists International Congress has been shared with the Government which is currently developing a new Tobacco Control Plan for publication later this year.

The Congress will also be given new data on the numbers of smokers with mental health conditions. Rates of smoking are much higher among people with mental health conditions than those without, and among England’s 6 million smokers there are an estimated:

  • 230k smokers with severe mental illness (e.g., schizophrenia and bi-polar disorder)
  • 1.6 million with depression and anxiety

These analyses are timely as the Government is currently considering recommendations by the Khan Review for the forthcoming Tobacco Control Plan to deliver its Smokefree 2030 ambition. The independent review by Javed Khan was commissioned by the Secretary of State to help the Government to identify the most impactful interventions to reduce the uptake of smoking, and support people to stop smoking, for good. One of Khan’s 15 recommendations was that action is needed to tackle the issue of smoking and mental health.

Monday, June 13, 2022

Extreme weather and climate events likely to drive an increase in gender-based violence

Aftermath of Hurricane Katrina 
Credit: NOAA Images

In a study published in The Lancet Planetary Health, a team led by a researcher at the University of Cambridge analyzed current scientific literature and found that the evidence paints a bleak picture for the future as extreme events drive economic instability, food insecurity, and mental stress, and disrupt infrastructure and exacerbate gender inequality.

Between 2000 and 2019, floods, droughts, and storms alone affected nearly 4 billion people worldwide, costing over 300,000 lives. The occurrences of these extreme events represent a drastic change, with the frequency of floods increasing by 134%, storms by 40%, and droughts by 29% over the past two decades. These figures are expected to rise further as climate change progresses.

Extreme weather and climate events have been seen to increase gender-based violence, due to socioeconomic instability, structural power inequalities, health-care inaccessibility, resource scarcity and breakdowns in safety and law enforcement, among other reasons. This violence can lead to long-term consequences including physical injury, unwanted pregnancy, exposure to HIV or other sexually transmitted infections, fertility problems, internalized stigma, mental health conditions, and ramifications for children.

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