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A Different Scientific Perspective About
                                the Causes and Cures of Bullying, and:
                                (ADHD, Obesity, Crime, Substance Abuse and More)
                                        Dennis D. Embry, Ph.D.,president/senior scientist, PAXIS Institute
                                        Co-investigator, Johns Hopkins Center for Prevention & Early Intervention
                                        Scientific advisor, Healthy Child Manitoba,
                                        Co-Investigator, School of Medicine, Yale University




Cape May, March 22, New Jersey, USA • Copyright 2012, PAXIS Institute. All rights reserved.
Housekeeping
What bricks—heavy objects of pain, injury, illness, or
problems—do you NOT want in your childrens’ suitcases
Our Own Children’s Future Rests On Other Children
Our Own Children’s Future Rests On Other Children


                                                                    ADHD

                   stealing                                                     aggression

                                                 asthma                               depression
learning disabilities
                                    obesity                    cancer
                                                                                             bipolar
 depression
                               hi-blood pressure            heart-disease
              violence                                                                 tobacco
                          suicide                diabetes                   alcohol
                                    crime                        drugs
                                              dangerous acts
Our Own Children’s Future
Our Futures
Thinking about all
the children, youth
and adults you
know…
Some international comparisons…
e nt ion
                     p rev
             te on
           vo
     ica’s
   er
Am
America speaks…
 77% believe prevention will save money
 72% say investing in prevention, because it will prevent disease and save
 lives
 57% say they support prevention programs for health and quality-of-life
 reasons
 21% say they support prevention to lower costs
Hearing the Heart of America…
  59% believe the nation needs
  to put more emphasis on
  prevention
  This is a 20% increase over 20
  years
Rationing prevention in America



                           ion
                  pre vent
Is this the
future we
 want for
America?      See video of the story on prisons costing much more than all
                         state supported universities in Arizona
What if…crime or delinquency
could be reduced by 50% in a
                     decade?
What if mental illnesses from ADHD to Depression to
Schizophrenia could be reduced by 50% in a decade?
What if obesity and related illnesses like asthma
or diabetes were reduced by 50% in a decade?
What if bullying and suicides could be reduced by
50% in a decade?
What if tobacco, alcohol, illegal drug & prescription
abuse were reduced by 50% in a decade?
What if child maltreatment were reduced by 50%
in a decade?
What would happen to America over the
next decade if all these these problems
were reduced by large margins?
What would happen to America over the
next decade if all these these problems
were reduced by large margins?


What good things might happen to
America over the next decade if our
children, youth and adults were smarter
and healthier in body, behavior, mind
and spirit?
What would we, in this room, could we do
personally today to help make these things happen?
How are these all related to the same causes?
Obesity
 Conduct
 Disorders

                                  Homicide
                                  & Suicide


                                                             Early Sex

                  Early
               Pregnancy
                           Addictions

                                                       Aggression
                                              Asthma




Disabilities



How are these all related to the same causes?
Psychological flexibility is required…
What if we think about these problems from an
evolutionary angle…instead from a cage of past ideas?
Every species has a Fearsome predator…
The first
capital
crime…
…and Cain rose up
and slew Abel
Humans have been the principle predator of other
humans since the invention of stone tools…
Friend                       Foe
       “Us”                  “Them”

The principal source of safety of humans has been
other humans…
Three evolutionary
mechanism for today’s
mental gymnastics for
heartfelt & principled
protection of our futures…

  Evolutionary Mismatches
  Evolutionary Bottlenecks
  Epigensis
Selection by Consequences –
A Meta-Theory with a Fractal Pattern
  A Fractal is a repeated     Selection Level           Consequences
  pattern at many levels                             Selection of Genes
                                    Genes
                                                     Evolution of species
                                     Cells
                                                     Epigensis
                                    Bodies
                             Individual Behaviors    Wiring of neurons
                               Group Behaviors       Human development
                            Organizational Actions   Selection of behaviors
                                   Language          Reproductive behaviors
                                  Economies          Behavioral economics
                               Species Groups        Organization behavior
                                                     Language /Cultural evolution
Social Biological
Epigenesis                  Environmental Inputs                                         Genesis
                                 Nurturing or Toxic
Epigenetics are                   Environments,                           These
heritable                           Disease, or                         polygenes
                                      Threats
changes in                                                                can be
gene expression                                                          “added”,
caused by                                                             “subtracted”,




                                                     M
mechanisms                  g                                          “divided”, or




                                                      or
                          lin
                                    Phosphorlyation




                                                        ph
other than                                                             “multiplied.”
                        na




                                                           og
                                      Acetylation
                     Sig




                                                                en
changes in the                        Methylation




                                                                 sis
underlying DNA                 Histone Remodeling
                           Chromatin Stucture Changes
sequence.
                   Development   Immunity   Stem Cell Changes   Imprinting

These changes                                                      Parent,
can pass           Three                                           1st Generation

through multiple   Generation                                      Baby,
                                                                   2nd Generation
                   Effects
generations.
                                                                   Reproductive Cells,
                                                                   3rd Generation
Epigensis permits adaptation without risk of mutation, when conditions change.
Methylation dials up or down expression of genes
Methylation dials up or down expression of genes
Evolutionary
Mismatch
Daily Movement &                    Brain Food
 Physical Activity                  Deficiency

                       Human
                     Evolutionary
                     Mismatches

  Ratio/Rate of
                                      Sleep
Reinforcement for
                                    Sufficiency
 Prosocial Acts
The America’s First Peoples…
 26,000 to 12,000 B.E.       1491 AD     Disease & War    Extermination,
   OriginalHuman                                          Marginalization,
    Migrations to                                         & Suppression
   North America
                          30,000,000
                                                300,000
                         ≈ Souls in          ≈   Souls
                         North America
                                                           Residential
                                                            Schools;
                                                           Western Diet




Evolutionary bottleneck
The America’s First Peoples…
 26,000 to 12,000 B.E.       1491 AD     Disease & War    Extermination,
   OriginalHuman                                          Marginalization,
    Migrations to                                         & Suppression
   North America
                          30,000,000
                                                300,000
                         ≈ Souls in          ≈   Souls
                                                                             Today
                         North America
                                                           Residential
                                                            Schools;
                                                           Western Diet




Evolutionary bottleneck
Slavery                                    The Great
African Americans             1863
                                       Middle
                          … 1500’s to Passage
                                                  Institution
                                                  of Slavery
                                                                  Jim
                                                                 Crow
                                                                        Migration
                                                                          North
    Original Human
  Populations in Africa
                                                  Continuing
                           ≈Capture                Trauma


                                      30% to      Separation,
                                                                        Exposure
                                      50% +        violence,
                                                                        to Toxins
                                      mortality   malnutrition




Evolutionary bottleneck
Slavery                                    The Great
African Americans             1863
                                       Middle
                          … 1500’s to Passage
                                                  Institution
                                                  of Slavery
                                                                  Jim
                                                                 Crow
                                                                        Migration
                                                                          North
    Original Human
  Populations in Africa
                                                  Continuing
                           ≈Capture                Trauma
                                                                                    today


                                      30% to      Separation,
                                                                        Exposure
                                      50% +        violence,
                                                                        to Toxins
                                      mortality   malnutrition




Evolutionary bottleneck
Example Lasting Effects of Evolutionary Bottlenecks
                                          US Blacks            Barbados           St. Lucia         Jamaica
Popular political pundits say:            Cameroon (urban)     Cameroon (Rural)   Nigeria (Rural)

“Slavery is over. Jim Crow is       40%
                                                     Slavery Exposure              No Slavery Exposure
over. Everybody should be over
                                    30%
all this.”
Evolution is bigger than pundits,   20%

and epigensis is a solution to a
                                    10%
past evolutionary problem that
might come back. Evolution is       0%
                                                             Hi Blood Pressure Percentage


                                                       Source: Scientific American, February, 1999
Airborne lead levels
predict homicide &
delinquency…
  African Americans have higher lead
  levels in the same geographic area
  as other peoples.
  African Americans absorb lead
  more readily.
  Incarcerated African Americans
  have the highest lead levels.
  Lead is concentrated in the old
  industrial North, where African
  Americans migrated in after WWII.
Audited Life Path of a Male Convicted Criminal , “Billy”
           Age 4             6      8        10         12      14       16    18       20     22     24        26

   Birth
                  ADHD           ODD                   A/D      A/D   A/D A/D A/D             A/D    A/D

 DSM IV                    TS                CD        SA       SA       SA SA SA             SA     SA
 Labels                                                                  depression
                                                                          anxiety
 Self-Rep.       Likes      Stole             Binge            Daily        Meth &     IV
               Violent TV Cigarettes         Drinking        Marijuana    Other Drugs Use
 School             SD       SD         LD        LD         LD SED Dropout
 Labels
 Medical     Prenatal Unintentional Injuries          Sexually     Serious      Hepatitis C
             Smoking Ashtma                           Transmitted Car Crash
 Notes &                             Intentional      Diseases          Gunshot
                Low Birth Weight
 Bio              Fussy,Irritable
                                     Injuries at
                                                                Fathers
                                                                        Wound
                                                                                Fathers
                                     School
 Markers     Mom is 16.5 years old Underactive                  Child           Child
                   Low omega-3       Beh. Inhibition Reduced Prefontal Function
                   Serotonin         System            Lower Resting Heart Rate                                      Case study
 Police      Mom DV
 Records     Has
                             Abused     Assault
                     Calls by Mom's at School Theft
                                                   Various      Drug sales;     Armed
                                                                Felony Assault Robbery
                                                                                                                     from Reclaim-
             Multiple        Live-in Witness       Complaints;                                                       ing Wyoming
             Offenses                Homicde       Truancy
                                                                                                                     Blueprint by
                                                         Legend                                                      Embry and
             ADHD    =   Attention Deficit Hyperactivity Disorder        SA    =    Substance Abuse
             TS      =   Tourette's Syndrome (tics diagnosed)            SD    =    Speech Delay                     Rodgers, 2002,
             ODD
             A/D
                     =
                     =
                         Oppositional Defiant Disorder
                         Antisocial Personality Disorder
                                                                         LD
                                                                         SED
                                                                               =
                                                                               =
                                                                                    Learning Disabilityr
                                                                                    Severe Emotional Disorder
                                                                                                                     for Wyoming
             CD      =   Conduct Disorder                                                                            Legislature
Audited Life Path of a Male Convicted Criminal , “Billy”
                                                                                                                                      When could this path
           Age 4             6      8        10         12      14       16    18       20     22     24        26
                                                                                                                                       have been altered
   Birth
                                                                                                                                       based on scientific
                  ADHD           ODD                   A/D      A/D   A/D A/D A/D             A/D    A/D
                                                                                                                                          evidence?
 DSM IV                    TS                CD        SA       SA       SA SA SA             SA     SA
 Labels                                                                  depression
                                                                          anxiety
 Self-Rep.       Likes      Stole             Binge            Daily        Meth &     IV
               Violent TV Cigarettes         Drinking        Marijuana    Other Drugs Use
 School             SD       SD         LD        LD         LD SED Dropout
 Labels
 Medical     Prenatal Unintentional Injuries          Sexually     Serious      Hepatitis C
             Smoking Ashtma                           Transmitted Car Crash
 Notes &                             Intentional      Diseases          Gunshot
                Low Birth Weight
 Bio              Fussy,Irritable
                                     Injuries at
                                                                Fathers
                                                                        Wound
                                                                                Fathers
                                     School
 Markers     Mom is 16.5 years old Underactive                  Child           Child
                   Low omega-3       Beh. Inhibition Reduced Prefontal Function
                   Serotonin         System            Lower Resting Heart Rate                                      Case study
 Police      Mom DV
 Records     Has
                             Abused     Assault
                     Calls by Mom's at School Theft
                                                   Various      Drug sales;     Armed
                                                                Felony Assault Robbery
                                                                                                                     from Reclaim-
             Multiple        Live-in Witness       Complaints;                                                       ing Wyoming
             Offenses                Homicde       Truancy
                                                                                                                     Blueprint by
                                                         Legend                                                      Embry and
             ADHD    =   Attention Deficit Hyperactivity Disorder        SA    =    Substance Abuse
             TS      =   Tourette's Syndrome (tics diagnosed)            SD    =    Speech Delay                     Rodgers, 2002,
             ODD
             A/D
                     =
                     =
                         Oppositional Defiant Disorder
                         Antisocial Personality Disorder
                                                                         LD
                                                                         SED
                                                                               =
                                                                               =
                                                                                    Learning Disabilityr
                                                                                    Severe Emotional Disorder
                                                                                                                     for Wyoming
             CD      =   Conduct Disorder                                                                            Legislature
Audited Life Path of a Male Convicted Criminal , “Billy”
                                                                                                                                      When could this path
           Age 4             6      8        10         12      14       16    18       20     22     24        26
                                                                                                                                       have been altered
   Birth
                                                                                                                                       based on scientific
                  ADHD           ODD                   A/D      A/D   A/D A/D A/D             A/D    A/D
                                                                                                                                          evidence?
 DSM IV                    TS                CD        SA       SA       SA SA SA             SA     SA
 Labels                                                                  depression
                                                                          anxiety
 Self-Rep.       Likes      Stole
               Violent TV Cigarettes
                                              Binge
                                             Drinking
                                                               Daily
                                                             Marijuana
                                                                            Meth &     IV
                                                                          Other Drugs Use                                             What is the cost of
                                                                                                                                      human suffering to
 School             SD       SD         LD        LD         LD SED Dropout
 Labels
 Medical
 Notes &
             Prenatal Unintentional Injuries
             Smoking Ashtma
                                                      Sexually     Serious
                                                      Transmitted Car Crash
                                                                                Hepatitis C
                                                                                                                                      this family, victims,
                                     Intentional
                                                                                                                                         and society?
                Low Birth Weight                      Diseases          Gunshot
 Bio              Fussy,Irritable
                                     Injuries at
                                                                Fathers
                                                                        Wound
                                                                                Fathers
                                     School
 Markers     Mom is 16.5 years old Underactive                  Child           Child
                   Low omega-3       Beh. Inhibition Reduced Prefontal Function
                   Serotonin         System            Lower Resting Heart Rate                                      Case study
 Police      Mom DV
 Records     Has
                             Abused     Assault
                     Calls by Mom's at School Theft
                                                   Various      Drug sales;     Armed
                                                                Felony Assault Robbery
                                                                                                                     from Reclaim-
             Multiple        Live-in Witness       Complaints;                                                       ing Wyoming
             Offenses                Homicde       Truancy
                                                                                                                     Blueprint by
                                                         Legend                                                      Embry and
             ADHD    =   Attention Deficit Hyperactivity Disorder        SA    =    Substance Abuse
             TS      =   Tourette's Syndrome (tics diagnosed)            SD    =    Speech Delay                     Rodgers, 2002,
             ODD
             A/D
                     =
                     =
                         Oppositional Defiant Disorder
                         Antisocial Personality Disorder
                                                                         LD
                                                                         SED
                                                                               =
                                                                               =
                                                                                    Learning Disabilityr
                                                                                    Severe Emotional Disorder
                                                                                                                     for Wyoming
             CD      =   Conduct Disorder                                                                            Legislature
Audited Life Path of a Male Convicted Criminal , “Billy”
                                                                                                                                      When could this path
           Age 4             6      8        10         12      14       16    18       20     22     24        26
                                                                                                                                       have been altered
   Birth
                                                                                                                                       based on scientific
                  ADHD           ODD                   A/D      A/D   A/D A/D A/D             A/D    A/D
                                                                                                                                          evidence?
 DSM IV                    TS                CD        SA       SA       SA SA SA             SA     SA
 Labels                                                                  depression
                                                                          anxiety
 Self-Rep.       Likes      Stole
               Violent TV Cigarettes
                                              Binge
                                             Drinking
                                                               Daily
                                                             Marijuana
                                                                            Meth &     IV
                                                                          Other Drugs Use                                              What is the cost of
                                                                                                                                       human suffering to
 School             SD       SD         LD        LD         LD SED Dropout
 Labels
 Medical
 Notes &
             Prenatal Unintentional Injuries
             Smoking Ashtma
                                                      Sexually     Serious
                                                      Transmitted Car Crash
                                                                                Hepatitis C
                                                                                                                                       this family, victims,
                                     Intentional
                                                                                                                                          and society?
                Low Birth Weight                      Diseases          Gunshot
 Bio              Fussy,Irritable
                                     Injuries at
                                                                Fathers
                                                                        Wound
                                                                                Fathers
                                     School
 Markers     Mom is 16.5 years old Underactive                  Child           Child
                   Low omega-3       Beh. Inhibition Reduced Prefontal Function
                   Serotonin         System            Lower Resting Heart Rate                                      Case study
 Police      Mom DV          Abused     Assault    Various      Drug sales;     Armed                                from Reclaim-
                                                                                                                                      What are the costs of
 Records     Has     Calls by Mom's at School Theft             Felony Assault Robbery
             Multiple        Live-in Witness       Complaints;                                                       ing Wyoming
             Offenses                Homicde       Truancy
                                                                                                                     Blueprint by
             ADHD    =
                                                         Legend
                         Attention Deficit Hyperactivity Disorder        SA    =    Substance Abuse
                                                                                                                     Embry and          evidence-based
             TS
             ODD
                     =
                     =
                         Tourette's Syndrome (tics diagnosed)
                         Oppositional Defiant Disorder
                                                                         SD
                                                                         LD
                                                                               =
                                                                               =
                                                                                    Speech Delay
                                                                                    Learning Disabilityr
                                                                                                                     Rodgers, 2002,
                                                                                                                     for Wyoming
                                                                                                                                       practices to avert?
             A/D     =   Antisocial Personality Disorder                 SED   =    Severe Emotional Disorder
             CD      =   Conduct Disorder                                                                            Legislature
If modern society is to flourish for all,
we must alter the predator-prey
relationships between human groups.

This means fewer humans as prey,
This means fewer humans as predators;
This means more humans as cooperators.
Whether the talon, claw or weapon
carries human rank or authority
matters not to the blind engine of evolution
when trying to suppress one group of
humans in favor of another.

Life finds a way.
Hypothesis: Evolutionary “inflammatory” processes
Redness, rubor, a response of body
                           tissues to injury or irritation; characterized
                           by pain and swelling and redness and
                           heat.
                           Excitation, excitement, fervor, fervour the
                           state of being emotionally aroused and
                           worked up
                           Inflaming arousal to violent emotion
                           Firing, ignition, kindling, lighting



Hypothesis: Evolutionary “inflammatory” processes
Human Infectious/Biological Threats                      Human Predatory Threats


   Evolutionary Adaptive Responses                     Evolutionary Adaptive Responses
              (Simplified)             Neuro-Hormones              (Simplified)

                                          Mood
                                        Modulators

                                         Reward                                 Threat Attributional
                                          Delay         Intra-Group
Generalized           Localized         Modulators      Affiliation               Bias (Inflammatory)
Inflammatory       Inflammatory                           (Anti-Inflammatory)
                                                                                         Out-Group
Response             Response            Stress
                                                                             Aggress. (Inflammatory)
                                        Modulators      Intra-Group
                                                        Cooperation            Tit-for-Tat Beh. Bias
  Anti-Inflammatory Regulators           Puberty/Sex     (Anti-Inflammatory)
                                        Modulators                                     (Inflammatory)
Evolutionary Path
 of a Child’s Life
K                                                                         R
    Path                                                                      Path



                               Evolutionary Path
                                of a Child’s Life




                                                     Probability of short-life and
Probability of long-life and                        doubtful reproductive success
  reproductive success
Multi-Inflammatory Brain & Body Response




Major Connected Ecologic Causes of the Adverse Trends Predicting MEBs & Related Illnesses

      Reinforcement        Antecedents         Physiological       Verbal Relations
     more for anti-social cue anti-social    influences trigger    occasion perceived
       than prosocial     acts and threats   adverse biological   threats and related
         behaviors                              mechanisms             reactions
Mood                               Lo Reward     Lo Executive      Lo Behavioral
                            Inattention        Delay        Function
        Instability                                                          Competencies
         Poor                                                                 Immune-
         Motor                                                                 Healing
         Skills         Multi-Inflammatory Brain & Body Response              Dysfunction




Major Connected Ecologic Causes of the Adverse Trends Predicting MEBs & Related Illnesses

      Reinforcement        Antecedents           Physiological             Verbal Relations
     more for anti-social cue anti-social      influences trigger          occasion perceived
       than prosocial     acts and threats     adverse biological         threats and related
         behaviors                                mechanisms                   reactions
Substance                        Work      Obesity,
 Early      Mental Illness                    Violence                                 Cancer       School
                                Abuse                        Problems      etc
 Sex                                                                                                Failure

              Mood                               Lo Reward     Lo Executive      Lo Behavioral
                                Inattention        Delay        Function
            Instability                                                          Competencies
             Poor                                                                 Immune-
STD’s        Motor                                                                 Healing           Special
             Skills          Multi-Inflammatory Brain & Body Response             Dysfunction           Ed




 Major Connected Ecologic Causes of the Adverse Trends Predicting MEBs & Related Illnesses

          Reinforcement        Antecedents           Physiological             Verbal Relations
         more for anti-social cue anti-social      influences trigger          occasion perceived
           than prosocial     acts and threats     adverse biological         threats and related
             behaviors                                mechanisms                   reactions
Obesity
 Conduct
 Disorders

                                  Homicide
                                  & Suicide


                                                             Early Sex

                  Early
               Pregnancy
                           Addictions

                                                       Aggression
                                              Asthma




Disabilities



R PATH = risky adolescence, predator and prey
The metaphor of stopping a
         past epidemic…
Epidemiological survey of mental, emotional,
and behavioral disorders…an epidemic?
Depression Onset By Birth Cohort
Depression Onset By Birth Cohort


Born
Now?
Lifetime Prevalence of Disorders in US Adolescents (N=10,123)

 35%

 30%

 25%

 20%

 15%

 10%

  5%
                                                                        Merikangas et al., 2010
  0%
       4   5   6   7   8   9   10 11 12       13   14   15   16   17   18
                               Age in Years
Lifetime Prevalence of Disorders in US Adolescents (N=10,123)

 35%
                                                                            Anxiety
 30%

 25%

 20%

 15%

 10%

  5%
                                                                        Merikangas et al., 2010
  0%
       4   5   6   7   8   9   10 11 12       13   14   15   16   17   18
                               Age in Years
Lifetime Prevalence of Disorders in US Adolescents (N=10,123)

 35%
                                                                            Anxiety
 30%

 25%
                                                                            Behavior
 20%

 15%

 10%

  5%
                                                                        Merikangas et al., 2010
  0%
       4   5   6   7   8   9   10 11 12       13   14   15   16   17   18
                               Age in Years
Lifetime Prevalence of Disorders in US Adolescents (N=10,123)

 35%
                                                                            Anxiety
 30%

 25%
                                                                            Behavior
 20%
                                                                            Mood
 15%

 10%

  5%
                                                                        Merikangas et al., 2010
  0%
       4   5   6   7   8   9   10 11 12       13   14   15   16   17   18
                               Age in Years
Lifetime Prevalence of Disorders in US Adolescents (N=10,123)

 35%
                                                                            Anxiety
 30%

 25%
                                                                            Substance
                                                                            Behavior
 20%
                                                                            Mood
 15%

 10%

  5%
                                                                        Merikangas et al., 2010
  0%
       4   5   6   7   8   9   10 11 12       13   14   15   16   17   18
                               Age in Years
Nearly 3 out of 4 of United States 17- to 24-year-olds are
ineligible for military service for based on national
epidemiological data (not service entrance exams)

                                                                        Medical/physical problems, 35
                                                                        percent.
                                                                        Illegal drug use, 18 percent.
                                                                        Mental Category V (the lowest 10
                                                                        percent of the population), 9
                                                                        percent.
                                                                        Too many dependents under age
                                                                        18, 6 percent.
                                                                        Criminal record, 5 percent.


       Army Times, Nov 5, 2009 • www.missionreadiness.org/PAEE0609.pd
Cumulative prevalence of psychiatric disorders by
young adulthood: a prospective cohort analysis
from the Great Smoky Mountains Study.
By 21 years of age,
61.1% of participants
had met criteria for a
well-specified psychiatric
disorder. An additional
21.4% had met criteria
for a not otherwise
specified disorder only,
increasing the total
cumulative prevalence
for any disorder to
82.5%.
The US has 75
  million children
  and teens.
  40.4 million are
  on psychotropic
  medications



Wall Street Journal, 12-28-2010
Participant brain buzz…
a) What does these trends mean for the future?
b) What must change to fix these trends?
Evolutionary Mismatches                   Evolutionary Consequences


                                          Change in                  Increased
                                           Genes                       Cancer


                                        Rise in                      Increased
                                        Obesity
                                                                       Autism
                                         Rates

               Rise in              Rise in           ATOD
                                                    Addictions       Increased
             Depression           Aggression
               Rates                Rates
                                                                       Schizo.




New cultural trends predict new challenges and risks
Evolutionary Mismatches                    Evolutionary Consequences


                                           Change in                  Increased
                                            Genes                       Cancer


                        Lower Rates      Rise in                      Increased
                         of Positive     Obesity
                       Reinforcement                                    Autism
                                          Rates

               Rise in               Rise in           ATOD
                                                     Addictions       Increased
             Depression            Aggression
               Rates                 Rates
                                                                        Schizo.




New cultural trends predict new challenges and risks
Evolutionary Mismatches                         Evolutionary Consequences


  Fear of           Reduced
Violence &          Outdoor
                                       Vitamin D     Change in                  Increased
                                       Deficiency      Genes
  Crime             Activities                                                    Cancer


Increased                         Lower Rates      Rise in                      Increased
Electronic                         of Positive     Obesity
Media Use                        Reinforcement                                    Autism
                                                    Rates

                    Rise in                    Rise in           ATOD
Omega 3                                                        Addictions       Increased
Fatty Acid        Depression                 Aggression
Deficiency           Rates                      Rates
                                                                                  Schizo.




New cultural trends predict new challenges and risks
Inukshuk points the way
Apparent consumption ofl inoleic acid (% of dietary energy) among
                                                                           Australia, Canada, UK and USA for the years 1961–2000


                                                                                                                   10        Australia       Canada         UK        USA




                                                                           Apparent consumption of linoleic acid
                                                                                                                    9

                                                                                                                    8

                                                                                                                    7




                                                                                       (% energy)
                                                                                                                    6

                                                                                                                    5

                                                                                                                    4

                                                                                                                    3

                                                                                                                    2

                                                                                                                    1

                                                                                                                    0
                                                                                                                        1960 1965   1970   1975 1980 1985    1990   1995 2000




    Evolution                            Neonates                                                                  Breast Milk                                                  “Risky” Beh.
 In the Rife Valley, the               Successful human                                                 American infants have                                                    Almost all adolescent
      human brain                      neonates born with                                                been getting steadily                                                   risky behaviors have
 evolution the result of                60-day supply of                                                less omega-3 (n3) and                                                   now been documented
   eating fish high in                     omega-3 in                                                    more pro-inflammatory                                                    to be related to low n3
      omega-3 not                       subcutaneous fat                                                omega-6 (n6) in breast                                                  and high n6 in US diet
   savannah animals                    from mother’s diet                                                       milk                                                            change in last 50 years
   See Broadhurst, Cunnane, &         See HIbbeln et al. (2007).Maternal                                           See Ailhaud et al. (2006).Temporal
 Crawford (1998). Rift Valley lake    seafood consumption in pregnancy                                             changes in dietary fats: Role of n6
 fish and shellfish provided brain-    and neurodevelopmental outcomes in                                              polyunsaturated fatty acids in                              Hibbeln et al. (2006). Healthy intakes
       specific nutrition for            childhood (ALSPAC study): an                                                   excessive adipose tissue                                 of n-3 and n-6 fatty acids: estimations
           early Homo                     observational cohort study                                                development and relationship to                                considering worldwide diversity.
                                                                                                                                obesity




Physiological Adaptation
Out of Africa migration	   Stringer, C. Nature 2000; 405: 24-26
Essential Fats: Metabolism and Dietary Sources
Essential Fats: Metabolism and Dietary Sources
                             Omega-3




                                                         O

                                                          C- OH
                           20:5n-3,eicosapentaenoic acid,
                              EPA                                   Seafood
                                                                   Breast milk
                                                                     (DHA)


                                                                        O

                                                                         C- OH

                                    22:6n-3, docosahexaenoic acid,
                                       DHA
                                         (brain, retina, testis)
Essential Fats: Metabolism and Dietary Sources
                                   Omega-3
                                                           O
                                                           C- OH
                                 18:3n-3 alfa-linolenic acid,
                                   ALA                                     Flax
                                                                           ~ Canola
                                                                           Leaf plants
                      FADS 1-2




                                                                   O

                                                                   C- OH
                                 20:5n-3,eicosapentaenoic acid,
                                    EPA                                      Seafood
                                                                            Breast milk
                                                                              (DHA)


                                                                                  O

                                                                                  C- OH

                                          22:6n-3, docosahexaenoic acid,
                                              DHA
                                                (brain, retina, testis)
Essential Fats: Metabolism and Dietary Sources
                           Omega-6                                              Omega-3
                                             O                                                          O

                                             C- OH                                                      C- OH
                         18:2n-6 linoleic acid,                               18:3n-3 alfa-linolenic acid,
                                           LA               - Competition -     ALA                                     Flax
         Soy bean oil                                                                                                   ~ Canola
         Safflower oil                                                                                                  Leaf plants
                                                              FADS 1-2
           Corn oil




                                                    O                                                           O

                                                    C- OH                                                       C- OH
                  20:4n-6, arachidonic acid                                   20:5n-3,eicosapentaenoic acid,
                                            AA                                   EPA                                      Seafood
                                                                                                                         Breast milk
         Meat,                                                                                                             (DHA)
         Organs

                                                                                                                               O

                                            O                                                                                  C- OH

                                            C- OH
                                                                                       22:6n-3, docosahexaenoic acid,
            22:5n-6              DPA n-6                                                   DHA
                                                                                             (brain, retina, testis)
Essential Fats: Metabolism and Dietary Sources
                           Omega-6                                                        Omega-3
                                             O                                                                     O

                                             C- OH                                                                 C- OH
                         18:2n-6 linoleic acid,                                       18:3n-3 alfa-linolenic acid,
                                           LA               - Competition -               ALA                                      Flax
         Soy bean oil                                                                                                              ~ Canola
         Safflower oil                                                                                                             Leaf plants
                                                                FADS 1-2
           Corn oil




                                                    O                                                                      O

                                                    C- OH                                                                  C- OH
                  20:4n-6, arachidonic acid                                           20:5n-3,eicosapentaenoic acid,
                                            AA                                               EPA                                     Seafood
                                                                                                                                    Breast milk
         Meat,                                                                                                                        (DHA)
         Organs

                                                                                                                                          O
                                                        Series 2           Series 3
                                            O            Prostaglandins     Prostaglandins                                                C- OH
                                                         Thromboxanes       Thromboxanes
                                            C- OH       Series 4           Series 5
                                                         Leukotrienes        Leukotrienes          22:6n-3, docosahexaenoic acid,
            22:5n-6              DPA n-6                                                              DHA
                                                            immune - metabolic - developmental          (brain, retina, testis)
                                                                       responses
DHA dietary deficiency impairs synapse development

                          Adequate                             Deficient

Hippocampal      DHA      6.6 ± 0.7%        0.5 ± 0.1%
Fatty Acids      DPAn-6   0.4 ± 0.1%        4.7 ± 0.1%




                                                         Cao et al. J. Neurochem. 2009
DHA dietary deficiency impairs synapse development

                                Adequate                                     Deficient

Hippocampal            DHA      6.6 ± 0.7%                0.5 ± 0.1%
Fatty Acids            DPAn-6   0.4 ± 0.1%                4.7 ± 0.1%




              Synapes in
              Hippocampal
              Neurons




                                                                                      30 µm




              Mother mice fed adequate of deficient diets, embryo neurons harvested day 18
                                                                       Cao et al. J. Neurochem. 2009
Low maternal omega-3 consumption from seafood and
                                                                   suboptimal verbal IQ among their children
                                                     34

                                                     32

                                                     30

                                                     28
                              - UK , 8y




                                                     26
                              III




                                                                                                                                                 r = 0.97
Percentage of children with




                                                     24                                                                                          r2 = 0.95
                                                                                                                                                 F=27.2
                                                                                                                                                 p<0.02.
                               low verbal IQ, WISC




                                                     22

                                                     20

                                                     18

                                                     16

                                                     14


                                                          0     0.05   0.10    0.15   0.20   0.25    0.30   0.35   0.40       0.45      0.50     0.55    0.60

                                                                                              -
                                                                              Estimated omega 3 fatty acids from seafood (en %)
                                                                                          Mother at 32 wk gestation
                                                                                                                          Hibbeln et al, Lancet 2007: 369: 578-585
Oilseeds in the US Food Supply in the 20th Century
                                    12


                                    10

                                                                                                               Soybean
                                    8                                                                          Cottonseed
                                                                                                               Corn
                                    6                                                                          Olive
                                                                                                               Coconut

                                    4
Disappearance (kg/person/y)




                                    2


                                    0
                                                                                                                Canola
                              0.9
                              0.8                                                                               Peanut
                              0.7
                                                                                                                Palm/Palm
                              0.6
                                                                                                                Kernel
                              0.5
                              0.4                                                                               Safflower
                              0.3
                              0.2                                                                               Sunflower
                              0.1                                                                               Sesame




                                                                                                 1989

                                                                                                        1999
                                                                                   1969

                                                                                          1979
                                                                     1949

                                                                            1959
                                                       1929

                                                              1939
                                         1909

                                                1919




                                                                       Year
3500              All Cause Mortality (M)                                                                                                               Stroke Mortality (M)                                                                                             CVD Mortality (M)
                                                                                                                                                                     400                                                                              1400

                                        3000                                                                                                                         350
                                                                                                                                                                                                                                                      1200
                                                                                                                                                                     300
                                        2500
                                                                                                                                                                                                                                                      1000
                                                                                                                                                                     250
                                        2000
                                                                                                                                                                                                                                                      800
                                                                                                                                                                     200
Total mortality (M) /100,000




                                                                                                                                   Total mortality (M) /100,000
                                        1500




                                                                                                                                                                                                                                                             Total mortality (M) /100,000
                                                                                                                                                                                                                                                      600
                                                                                                                                                                     150
                                        1000                                                                                                                                                                                                          400
                                                                                                                                                                     100
                                                                                           Japan                                                                                                                                                                                                                                          Japan
                                         500                                                                                                                                                                            Japan
                                                                                                           Iceland                                                    50                                                                              200                                                                                                       Iceland
                                                                                                                                                                                                                                        Iceland
                                          0                                                                                                                            0                                                                               0
                                               0   0.05   0.10   0.15   0.20   0.25   0.30   0.35   0.40   0.45   0.50                                                     0        0.05 0.10    0.15   0.20   0.25 0.30    0.35   0.40 0.45   0.50                                               0   0.05     0.10 0.15    0.20   0.25   0.30    0.35   0.40   0.45   0.50
                                                      n-3 LCFA from commodities (en%)                                                                                                n-3 LCFA from commodities (en%)                                                                                         n-3 LCFA from commodities (en%)




                                        1200                All Cause Mortality (F)                                                                                                          Stroke Mortality (F)                                                                                                CVD Mortality (F)
                                                                                                                                                                               250                                                                                                          700

                                        1000                                                                                                                                                                                                                                                600
                                                                                                                                                                               200
                                         800                                                                                                                                                                                                                                                500

                                                                                                                                                                               150
                                                                                                                                                                                                                                                                                            400
                                         600
          Total Mortality (F)/100,000




                                                                                                                                      Total mortality (F) /100,000




                                                                                                                                                                                                                                                                                            300




                                                                                                                                                                                                                                                             Total mortality (F) /100,000
                                                                                                                                                                               100
                                         400
                                                                                   Japan
                                                                                                                                                                                                                                                                                            200
                                                                                                       Iceland
                                                                                                                                                                               50
                                         200                                                                                                                                                                        Japan
                                                                                                                                                                                                                                                                                            100                                           Japan
                                                                                                                                                                                                                                          Iceland                                                                                                               Iceland

                                          0                                                                                                                                     0
                                                                                                                                                                                                                                                                                             0
                                                                               0   0.05 0.10 0.15 0.20 0.25 0.30 0.35 0.40 0.45 0.50                                                 0    0.05 0.10 0.15 0.20 0.25 0.30 0.35 0.40 0.45 0.50                                                       0   0.05    0.10   0.15   0.20   0.25   0.30    0.35   0.40   0.45   0.50

                                                          n-3 LCFA from commodities (en%)                                                                                                n-3 LCFA from commodities (en%)                                                                                 n-3 LCFA from commodities (en%)




                                                                                                                                                                                                                               Hibbeln et al Am J Clin Nutr 2006; 83; 1483S-93S
800
                                                                          CHD Mortality (M)                                                                                        300
                                                                                                                                                                                                        CHD Mortality (F)                                                                                                      Homicide Mortality
                                                                                                                                                                                                                                                                                                          12
                                                 700
                                                                                                                                                                                   250
                                                                                                                                                                                                                                                                                                          10
                                                 600
                                                                                                                                                                                   200                                                                                                                     8
                                                 500
Total mortality (M) /100,000




                                                 400                                                                                                                               150




                                                                                                                                                                                                                                                                               Total mortality /100,000
                                                                                                                                                                                                                                                                                                           6




                                                                                                                                                    Total mortality (M) /100,000
                                                 300
                                                                                                                                                                                   100                                                                                                                     4
                                                 200

                                                                                                                          Iceland                                                  50                                                                                                                      2                                            Japan
                                                 100                                                                                                                                                                                                      Iceland                                                                                                              Iceland
                                                                                                                                                                                                                                    Japan
                                                                                                              Japan
                                                                                                                                                                                    0                                                                                                                      0
                                                   0                                                                                                                                                                                                                                                           0   0.05     0.10   0.15   0.20   0.25   0.30     0.35   0.40   0.45   0.50
                                                           0    0.05    0.10   0.15   0.20   0.25   0.30   0.35   0.40    0.45    0.50                                                   0   0.05    0.10     0.15   0.20   0.25    0.30   0.35    0.40   0.45   0.50

                                                                                                                                                                                                                                                                                                                     n-3 LCFA from commodities (en%)
                                                                      n-3 LCFA from commodities (en%)
                                                                                                                                                                                             n-3 LCFA from commodities (en%)




                                                                       Postpartum Depression
                                                                                 30                                                                                                                           Major Depression                                                                                               Bipolar Disorder
                                                                                                                                                                                             7                                                                            12


                                                                                        25                                                                                                   6                                                                            10

                                                                                                                                                                                             5
                                                                                        20                                                                                                                                                                                8

                                                                                                                                                                                             4




                                                                                                                                                                                                                                                                               Lifetime prevalence (%)
                                                                                        15                                                                                                                                                                                6
                                                                                                                                          Annual prevalence (%)
                          Point prevalence (%)




                                                                                                                                                                                             3
                                                                                        10                                                                                                                                                                                4
                                                                                                                                                                                             2
                                                                                                                           Iceland
                                                                                         5                                                                                                                                                                                2
                                                                                                                                                                                             1                                                              Japan
                                                                                                                  Japan                                                                                                                                                                                                                                        Japan           Iceland
                                                                                         0                                                                                                   0                                                                            0
                                                       0       0.05    0.10    0.15   0.20   0.25   0.30   0.35    0.40    0.45    0.50                                                  0       0.05       0.10     0.15    0.20      0.25       0.30    0.35     0.40                                        0   0.05     0.10   0.15   0.20   0.25   0.30    0.35    0.40   0.45   0.50
                                                                n-3 LCFA from commodities (en%)                                                                                                     n-3 LCFA from commodities (en%)                                                                                       n-3 LCFA from commodities (en%)


                                                                                                                                                                                                                                                  Hibbeln et al Am J Clin Nutr 2006; 83; 1483S-93S
Increasing Mismatch Causes Homicides
Homicide Rate

                10



                 8



                 6



                 4

                                United        2000
                                Kingdom
                 2

                         1961


                 0
                     0                    2           4        6         8   10

                     Lo                                                      Hi
                                                     Omega 3 Deficiency
Increasing Mismatch Causes Homicides
Homicide Rate

                10



                 8



                 6



                 4

                                United                      2000
                                              2000
                                                1961
                                Kingdom                        Canada
                 2

                         1961


                 0
                     0                    2             4               6   8   10

                     Lo                                                         Hi
                                                       Omega 3 Deficiency
Increasing Mismatch Causes Homicides
Homicide Rate

                10



                 8



                 6



                 4

                                United                             2000
                                              2000
                                                1961
                                Kingdom                                  Canada
                 2
                                                                  2000
                         1961
                          1961                   Australia
                 0
                     0                    2                   4                   6   8   10

                     Lo                                                                   Hi
                                                             Omega 3 Deficiency
Increasing Mismatch Causes Homicides
Homicide Rate

                10



                 8



                 6                                                                       1988




                 4                                            1961                       Argentina

                                United                                2000
                                              2000
                                                1961
                                Kingdom                                     Canada
                 2
                                                                     2000
                         1961
                          1961                   Australia
                 0
                     0                    2                   4                      6               8   10

                     Lo                                                                                  Hi
                                                             Omega 3 Deficiency
Increasing Mismatch Causes Homicides
Homicide Rate
                                                                                                             1985
                10


                                                                                                               United
                 8                                                                                             States



                 6                                                                        1988        1999

                                                                     1961


                 4                                            1961                        Argentina

                                United                                 2000
                                              2000
                                                1961
                                Kingdom                                      Canada
                 2
                                                                      2000
                         1961
                          1961                   Australia
                 0
                     0                    2                   4                       6               8                 10

                     Lo                                                                                                 Hi
                                                             Omega 3 Deficiency
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)
CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)

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POST NATAL EXERCISES AND ITS IMPACT.pptx
 

CAPE MAY: A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More)

  • 1. A Different Scientific Perspective About the Causes and Cures of Bullying, and: (ADHD, Obesity, Crime, Substance Abuse and More) Dennis D. Embry, Ph.D.,president/senior scientist, PAXIS Institute Co-investigator, Johns Hopkins Center for Prevention & Early Intervention Scientific advisor, Healthy Child Manitoba, Co-Investigator, School of Medicine, Yale University Cape May, March 22, New Jersey, USA • Copyright 2012, PAXIS Institute. All rights reserved.
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  • 4. What bricks—heavy objects of pain, injury, illness, or problems—do you NOT want in your childrens’ suitcases
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  • 6. Our Own Children’s Future Rests On Other Children
  • 7. Our Own Children’s Future Rests On Other Children ADHD stealing aggression asthma depression learning disabilities obesity cancer bipolar depression hi-blood pressure heart-disease violence tobacco suicide diabetes alcohol crime drugs dangerous acts
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  • 11. Thinking about all the children, youth and adults you know…
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  • 14. e nt ion p rev te on vo ica’s er Am
  • 15. America speaks… 77% believe prevention will save money 72% say investing in prevention, because it will prevent disease and save lives 57% say they support prevention programs for health and quality-of-life reasons 21% say they support prevention to lower costs
  • 16. Hearing the Heart of America… 59% believe the nation needs to put more emphasis on prevention This is a 20% increase over 20 years
  • 17. Rationing prevention in America ion pre vent
  • 18. Is this the future we want for America? See video of the story on prisons costing much more than all state supported universities in Arizona
  • 19. What if…crime or delinquency could be reduced by 50% in a decade?
  • 20. What if mental illnesses from ADHD to Depression to Schizophrenia could be reduced by 50% in a decade?
  • 21. What if obesity and related illnesses like asthma or diabetes were reduced by 50% in a decade?
  • 22. What if bullying and suicides could be reduced by 50% in a decade?
  • 23. What if tobacco, alcohol, illegal drug & prescription abuse were reduced by 50% in a decade?
  • 24. What if child maltreatment were reduced by 50% in a decade?
  • 25. What would happen to America over the next decade if all these these problems were reduced by large margins?
  • 26. What would happen to America over the next decade if all these these problems were reduced by large margins? What good things might happen to America over the next decade if our children, youth and adults were smarter and healthier in body, behavior, mind and spirit?
  • 27. What would we, in this room, could we do personally today to help make these things happen?
  • 28. How are these all related to the same causes?
  • 29. Obesity Conduct Disorders Homicide & Suicide Early Sex Early Pregnancy Addictions Aggression Asthma Disabilities How are these all related to the same causes?
  • 31. What if we think about these problems from an evolutionary angle…instead from a cage of past ideas?
  • 32. Every species has a Fearsome predator…
  • 34. Humans have been the principle predator of other humans since the invention of stone tools…
  • 35. Friend Foe “Us” “Them” The principal source of safety of humans has been other humans…
  • 36. Three evolutionary mechanism for today’s mental gymnastics for heartfelt & principled protection of our futures… Evolutionary Mismatches Evolutionary Bottlenecks Epigensis
  • 37. Selection by Consequences – A Meta-Theory with a Fractal Pattern A Fractal is a repeated Selection Level Consequences pattern at many levels Selection of Genes Genes Evolution of species Cells Epigensis Bodies Individual Behaviors Wiring of neurons Group Behaviors Human development Organizational Actions Selection of behaviors Language Reproductive behaviors Economies Behavioral economics Species Groups Organization behavior Language /Cultural evolution
  • 38. Social Biological Epigenesis Environmental Inputs Genesis Nurturing or Toxic Epigenetics are Environments, These heritable Disease, or polygenes Threats changes in can be gene expression “added”, caused by “subtracted”, M mechanisms g “divided”, or or lin Phosphorlyation ph other than “multiplied.” na og Acetylation Sig en changes in the Methylation sis underlying DNA Histone Remodeling Chromatin Stucture Changes sequence. Development Immunity Stem Cell Changes Imprinting These changes Parent, can pass Three 1st Generation through multiple Generation Baby, 2nd Generation Effects generations. Reproductive Cells, 3rd Generation
  • 39.
  • 40. Epigensis permits adaptation without risk of mutation, when conditions change.
  • 41. Methylation dials up or down expression of genes
  • 42. Methylation dials up or down expression of genes
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  • 46. Daily Movement & Brain Food Physical Activity Deficiency Human Evolutionary Mismatches Ratio/Rate of Sleep Reinforcement for Sufficiency Prosocial Acts
  • 47. The America’s First Peoples… 26,000 to 12,000 B.E. 1491 AD Disease & War Extermination, OriginalHuman Marginalization, Migrations to & Suppression North America 30,000,000 300,000 ≈ Souls in ≈ Souls North America Residential Schools; Western Diet Evolutionary bottleneck
  • 48. The America’s First Peoples… 26,000 to 12,000 B.E. 1491 AD Disease & War Extermination, OriginalHuman Marginalization, Migrations to & Suppression North America 30,000,000 300,000 ≈ Souls in ≈ Souls Today North America Residential Schools; Western Diet Evolutionary bottleneck
  • 49. Slavery The Great African Americans 1863 Middle … 1500’s to Passage Institution of Slavery Jim Crow Migration North Original Human Populations in Africa Continuing ≈Capture Trauma 30% to Separation, Exposure 50% + violence, to Toxins mortality malnutrition Evolutionary bottleneck
  • 50. Slavery The Great African Americans 1863 Middle … 1500’s to Passage Institution of Slavery Jim Crow Migration North Original Human Populations in Africa Continuing ≈Capture Trauma today 30% to Separation, Exposure 50% + violence, to Toxins mortality malnutrition Evolutionary bottleneck
  • 51. Example Lasting Effects of Evolutionary Bottlenecks US Blacks Barbados St. Lucia Jamaica Popular political pundits say: Cameroon (urban) Cameroon (Rural) Nigeria (Rural) “Slavery is over. Jim Crow is 40% Slavery Exposure No Slavery Exposure over. Everybody should be over 30% all this.” Evolution is bigger than pundits, 20% and epigensis is a solution to a 10% past evolutionary problem that might come back. Evolution is 0% Hi Blood Pressure Percentage Source: Scientific American, February, 1999
  • 52. Airborne lead levels predict homicide & delinquency… African Americans have higher lead levels in the same geographic area as other peoples. African Americans absorb lead more readily. Incarcerated African Americans have the highest lead levels. Lead is concentrated in the old industrial North, where African Americans migrated in after WWII.
  • 53. Audited Life Path of a Male Convicted Criminal , “Billy” Age 4 6 8 10 12 14 16 18 20 22 24 26 Birth ADHD ODD A/D A/D A/D A/D A/D A/D A/D DSM IV TS CD SA SA SA SA SA SA SA Labels depression anxiety Self-Rep. Likes Stole Binge Daily Meth & IV Violent TV Cigarettes Drinking Marijuana Other Drugs Use School SD SD LD LD LD SED Dropout Labels Medical Prenatal Unintentional Injuries Sexually Serious Hepatitis C Smoking Ashtma Transmitted Car Crash Notes & Intentional Diseases Gunshot Low Birth Weight Bio Fussy,Irritable Injuries at Fathers Wound Fathers School Markers Mom is 16.5 years old Underactive Child Child Low omega-3 Beh. Inhibition Reduced Prefontal Function Serotonin System Lower Resting Heart Rate Case study Police Mom DV Records Has Abused Assault Calls by Mom's at School Theft Various Drug sales; Armed Felony Assault Robbery from Reclaim- Multiple Live-in Witness Complaints; ing Wyoming Offenses Homicde Truancy Blueprint by Legend Embry and ADHD = Attention Deficit Hyperactivity Disorder SA = Substance Abuse TS = Tourette's Syndrome (tics diagnosed) SD = Speech Delay Rodgers, 2002, ODD A/D = = Oppositional Defiant Disorder Antisocial Personality Disorder LD SED = = Learning Disabilityr Severe Emotional Disorder for Wyoming CD = Conduct Disorder Legislature
  • 54. Audited Life Path of a Male Convicted Criminal , “Billy” When could this path Age 4 6 8 10 12 14 16 18 20 22 24 26 have been altered Birth based on scientific ADHD ODD A/D A/D A/D A/D A/D A/D A/D evidence? DSM IV TS CD SA SA SA SA SA SA SA Labels depression anxiety Self-Rep. Likes Stole Binge Daily Meth & IV Violent TV Cigarettes Drinking Marijuana Other Drugs Use School SD SD LD LD LD SED Dropout Labels Medical Prenatal Unintentional Injuries Sexually Serious Hepatitis C Smoking Ashtma Transmitted Car Crash Notes & Intentional Diseases Gunshot Low Birth Weight Bio Fussy,Irritable Injuries at Fathers Wound Fathers School Markers Mom is 16.5 years old Underactive Child Child Low omega-3 Beh. Inhibition Reduced Prefontal Function Serotonin System Lower Resting Heart Rate Case study Police Mom DV Records Has Abused Assault Calls by Mom's at School Theft Various Drug sales; Armed Felony Assault Robbery from Reclaim- Multiple Live-in Witness Complaints; ing Wyoming Offenses Homicde Truancy Blueprint by Legend Embry and ADHD = Attention Deficit Hyperactivity Disorder SA = Substance Abuse TS = Tourette's Syndrome (tics diagnosed) SD = Speech Delay Rodgers, 2002, ODD A/D = = Oppositional Defiant Disorder Antisocial Personality Disorder LD SED = = Learning Disabilityr Severe Emotional Disorder for Wyoming CD = Conduct Disorder Legislature
  • 55. Audited Life Path of a Male Convicted Criminal , “Billy” When could this path Age 4 6 8 10 12 14 16 18 20 22 24 26 have been altered Birth based on scientific ADHD ODD A/D A/D A/D A/D A/D A/D A/D evidence? DSM IV TS CD SA SA SA SA SA SA SA Labels depression anxiety Self-Rep. Likes Stole Violent TV Cigarettes Binge Drinking Daily Marijuana Meth & IV Other Drugs Use What is the cost of human suffering to School SD SD LD LD LD SED Dropout Labels Medical Notes & Prenatal Unintentional Injuries Smoking Ashtma Sexually Serious Transmitted Car Crash Hepatitis C this family, victims, Intentional and society? Low Birth Weight Diseases Gunshot Bio Fussy,Irritable Injuries at Fathers Wound Fathers School Markers Mom is 16.5 years old Underactive Child Child Low omega-3 Beh. Inhibition Reduced Prefontal Function Serotonin System Lower Resting Heart Rate Case study Police Mom DV Records Has Abused Assault Calls by Mom's at School Theft Various Drug sales; Armed Felony Assault Robbery from Reclaim- Multiple Live-in Witness Complaints; ing Wyoming Offenses Homicde Truancy Blueprint by Legend Embry and ADHD = Attention Deficit Hyperactivity Disorder SA = Substance Abuse TS = Tourette's Syndrome (tics diagnosed) SD = Speech Delay Rodgers, 2002, ODD A/D = = Oppositional Defiant Disorder Antisocial Personality Disorder LD SED = = Learning Disabilityr Severe Emotional Disorder for Wyoming CD = Conduct Disorder Legislature
  • 56. Audited Life Path of a Male Convicted Criminal , “Billy” When could this path Age 4 6 8 10 12 14 16 18 20 22 24 26 have been altered Birth based on scientific ADHD ODD A/D A/D A/D A/D A/D A/D A/D evidence? DSM IV TS CD SA SA SA SA SA SA SA Labels depression anxiety Self-Rep. Likes Stole Violent TV Cigarettes Binge Drinking Daily Marijuana Meth & IV Other Drugs Use What is the cost of human suffering to School SD SD LD LD LD SED Dropout Labels Medical Notes & Prenatal Unintentional Injuries Smoking Ashtma Sexually Serious Transmitted Car Crash Hepatitis C this family, victims, Intentional and society? Low Birth Weight Diseases Gunshot Bio Fussy,Irritable Injuries at Fathers Wound Fathers School Markers Mom is 16.5 years old Underactive Child Child Low omega-3 Beh. Inhibition Reduced Prefontal Function Serotonin System Lower Resting Heart Rate Case study Police Mom DV Abused Assault Various Drug sales; Armed from Reclaim- What are the costs of Records Has Calls by Mom's at School Theft Felony Assault Robbery Multiple Live-in Witness Complaints; ing Wyoming Offenses Homicde Truancy Blueprint by ADHD = Legend Attention Deficit Hyperactivity Disorder SA = Substance Abuse Embry and evidence-based TS ODD = = Tourette's Syndrome (tics diagnosed) Oppositional Defiant Disorder SD LD = = Speech Delay Learning Disabilityr Rodgers, 2002, for Wyoming practices to avert? A/D = Antisocial Personality Disorder SED = Severe Emotional Disorder CD = Conduct Disorder Legislature
  • 57. If modern society is to flourish for all, we must alter the predator-prey relationships between human groups. This means fewer humans as prey, This means fewer humans as predators; This means more humans as cooperators.
  • 58. Whether the talon, claw or weapon carries human rank or authority matters not to the blind engine of evolution when trying to suppress one group of humans in favor of another. Life finds a way.
  • 60. Redness, rubor, a response of body tissues to injury or irritation; characterized by pain and swelling and redness and heat. Excitation, excitement, fervor, fervour the state of being emotionally aroused and worked up Inflaming arousal to violent emotion Firing, ignition, kindling, lighting Hypothesis: Evolutionary “inflammatory” processes
  • 61. Human Infectious/Biological Threats Human Predatory Threats Evolutionary Adaptive Responses Evolutionary Adaptive Responses (Simplified) Neuro-Hormones (Simplified) Mood Modulators Reward Threat Attributional Delay Intra-Group Generalized Localized Modulators Affiliation Bias (Inflammatory) Inflammatory Inflammatory (Anti-Inflammatory) Out-Group Response Response Stress Aggress. (Inflammatory) Modulators Intra-Group Cooperation Tit-for-Tat Beh. Bias Anti-Inflammatory Regulators Puberty/Sex (Anti-Inflammatory) Modulators (Inflammatory)
  • 62. Evolutionary Path of a Child’s Life
  • 63. K R Path Path Evolutionary Path of a Child’s Life Probability of short-life and Probability of long-life and doubtful reproductive success reproductive success
  • 64. Multi-Inflammatory Brain & Body Response Major Connected Ecologic Causes of the Adverse Trends Predicting MEBs & Related Illnesses Reinforcement Antecedents Physiological Verbal Relations more for anti-social cue anti-social influences trigger occasion perceived than prosocial acts and threats adverse biological threats and related behaviors mechanisms reactions
  • 65. Mood Lo Reward Lo Executive Lo Behavioral Inattention Delay Function Instability Competencies Poor Immune- Motor Healing Skills Multi-Inflammatory Brain & Body Response Dysfunction Major Connected Ecologic Causes of the Adverse Trends Predicting MEBs & Related Illnesses Reinforcement Antecedents Physiological Verbal Relations more for anti-social cue anti-social influences trigger occasion perceived than prosocial acts and threats adverse biological threats and related behaviors mechanisms reactions
  • 66. Substance Work Obesity, Early Mental Illness Violence Cancer School Abuse Problems etc Sex Failure Mood Lo Reward Lo Executive Lo Behavioral Inattention Delay Function Instability Competencies Poor Immune- STD’s Motor Healing Special Skills Multi-Inflammatory Brain & Body Response Dysfunction Ed Major Connected Ecologic Causes of the Adverse Trends Predicting MEBs & Related Illnesses Reinforcement Antecedents Physiological Verbal Relations more for anti-social cue anti-social influences trigger occasion perceived than prosocial acts and threats adverse biological threats and related behaviors mechanisms reactions
  • 67. Obesity Conduct Disorders Homicide & Suicide Early Sex Early Pregnancy Addictions Aggression Asthma Disabilities R PATH = risky adolescence, predator and prey
  • 68. The metaphor of stopping a past epidemic…
  • 69. Epidemiological survey of mental, emotional, and behavioral disorders…an epidemic?
  • 70. Depression Onset By Birth Cohort
  • 71. Depression Onset By Birth Cohort Born Now?
  • 72. Lifetime Prevalence of Disorders in US Adolescents (N=10,123) 35% 30% 25% 20% 15% 10% 5% Merikangas et al., 2010 0% 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Age in Years
  • 73. Lifetime Prevalence of Disorders in US Adolescents (N=10,123) 35% Anxiety 30% 25% 20% 15% 10% 5% Merikangas et al., 2010 0% 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Age in Years
  • 74. Lifetime Prevalence of Disorders in US Adolescents (N=10,123) 35% Anxiety 30% 25% Behavior 20% 15% 10% 5% Merikangas et al., 2010 0% 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Age in Years
  • 75. Lifetime Prevalence of Disorders in US Adolescents (N=10,123) 35% Anxiety 30% 25% Behavior 20% Mood 15% 10% 5% Merikangas et al., 2010 0% 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Age in Years
  • 76. Lifetime Prevalence of Disorders in US Adolescents (N=10,123) 35% Anxiety 30% 25% Substance Behavior 20% Mood 15% 10% 5% Merikangas et al., 2010 0% 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Age in Years
  • 77. Nearly 3 out of 4 of United States 17- to 24-year-olds are ineligible for military service for based on national epidemiological data (not service entrance exams) Medical/physical problems, 35 percent. Illegal drug use, 18 percent. Mental Category V (the lowest 10 percent of the population), 9 percent. Too many dependents under age 18, 6 percent. Criminal record, 5 percent. Army Times, Nov 5, 2009 • www.missionreadiness.org/PAEE0609.pd
  • 78. Cumulative prevalence of psychiatric disorders by young adulthood: a prospective cohort analysis from the Great Smoky Mountains Study. By 21 years of age, 61.1% of participants had met criteria for a well-specified psychiatric disorder. An additional 21.4% had met criteria for a not otherwise specified disorder only, increasing the total cumulative prevalence for any disorder to 82.5%.
  • 79. The US has 75 million children and teens. 40.4 million are on psychotropic medications Wall Street Journal, 12-28-2010
  • 80. Participant brain buzz… a) What does these trends mean for the future? b) What must change to fix these trends?
  • 81. Evolutionary Mismatches Evolutionary Consequences Change in Increased Genes Cancer Rise in Increased Obesity Autism Rates Rise in Rise in ATOD Addictions Increased Depression Aggression Rates Rates Schizo. New cultural trends predict new challenges and risks
  • 82. Evolutionary Mismatches Evolutionary Consequences Change in Increased Genes Cancer Lower Rates Rise in Increased of Positive Obesity Reinforcement Autism Rates Rise in Rise in ATOD Addictions Increased Depression Aggression Rates Rates Schizo. New cultural trends predict new challenges and risks
  • 83. Evolutionary Mismatches Evolutionary Consequences Fear of Reduced Violence & Outdoor Vitamin D Change in Increased Deficiency Genes Crime Activities Cancer Increased Lower Rates Rise in Increased Electronic of Positive Obesity Media Use Reinforcement Autism Rates Rise in Rise in ATOD Omega 3 Addictions Increased Fatty Acid Depression Aggression Deficiency Rates Rates Schizo. New cultural trends predict new challenges and risks
  • 85. Apparent consumption ofl inoleic acid (% of dietary energy) among Australia, Canada, UK and USA for the years 1961–2000 10 Australia Canada UK USA Apparent consumption of linoleic acid 9 8 7 (% energy) 6 5 4 3 2 1 0 1960 1965 1970 1975 1980 1985 1990 1995 2000 Evolution Neonates Breast Milk “Risky” Beh. In the Rife Valley, the Successful human American infants have Almost all adolescent human brain neonates born with been getting steadily risky behaviors have evolution the result of 60-day supply of less omega-3 (n3) and now been documented eating fish high in omega-3 in more pro-inflammatory to be related to low n3 omega-3 not subcutaneous fat omega-6 (n6) in breast and high n6 in US diet savannah animals from mother’s diet milk change in last 50 years See Broadhurst, Cunnane, & See HIbbeln et al. (2007).Maternal See Ailhaud et al. (2006).Temporal Crawford (1998). Rift Valley lake seafood consumption in pregnancy changes in dietary fats: Role of n6 fish and shellfish provided brain- and neurodevelopmental outcomes in polyunsaturated fatty acids in Hibbeln et al. (2006). Healthy intakes specific nutrition for childhood (ALSPAC study): an excessive adipose tissue of n-3 and n-6 fatty acids: estimations early Homo observational cohort study development and relationship to considering worldwide diversity. obesity Physiological Adaptation
  • 86. Out of Africa migration Stringer, C. Nature 2000; 405: 24-26
  • 87. Essential Fats: Metabolism and Dietary Sources
  • 88. Essential Fats: Metabolism and Dietary Sources Omega-3 O C- OH 20:5n-3,eicosapentaenoic acid, EPA Seafood Breast milk (DHA) O C- OH 22:6n-3, docosahexaenoic acid, DHA (brain, retina, testis)
  • 89. Essential Fats: Metabolism and Dietary Sources Omega-3 O C- OH 18:3n-3 alfa-linolenic acid, ALA Flax ~ Canola Leaf plants FADS 1-2 O C- OH 20:5n-3,eicosapentaenoic acid, EPA Seafood Breast milk (DHA) O C- OH 22:6n-3, docosahexaenoic acid, DHA (brain, retina, testis)
  • 90. Essential Fats: Metabolism and Dietary Sources Omega-6 Omega-3 O O C- OH C- OH 18:2n-6 linoleic acid, 18:3n-3 alfa-linolenic acid, LA - Competition - ALA Flax Soy bean oil ~ Canola Safflower oil Leaf plants FADS 1-2 Corn oil O O C- OH C- OH 20:4n-6, arachidonic acid 20:5n-3,eicosapentaenoic acid, AA EPA Seafood Breast milk Meat, (DHA) Organs O O C- OH C- OH 22:6n-3, docosahexaenoic acid, 22:5n-6 DPA n-6 DHA (brain, retina, testis)
  • 91. Essential Fats: Metabolism and Dietary Sources Omega-6 Omega-3 O O C- OH C- OH 18:2n-6 linoleic acid, 18:3n-3 alfa-linolenic acid, LA - Competition - ALA Flax Soy bean oil ~ Canola Safflower oil Leaf plants FADS 1-2 Corn oil O O C- OH C- OH 20:4n-6, arachidonic acid 20:5n-3,eicosapentaenoic acid, AA EPA Seafood Breast milk Meat, (DHA) Organs O Series 2 Series 3 O Prostaglandins Prostaglandins C- OH Thromboxanes Thromboxanes C- OH Series 4 Series 5 Leukotrienes Leukotrienes 22:6n-3, docosahexaenoic acid, 22:5n-6 DPA n-6 DHA immune - metabolic - developmental (brain, retina, testis) responses
  • 92. DHA dietary deficiency impairs synapse development Adequate Deficient Hippocampal DHA 6.6 ± 0.7% 0.5 ± 0.1% Fatty Acids DPAn-6 0.4 ± 0.1% 4.7 ± 0.1% Cao et al. J. Neurochem. 2009
  • 93. DHA dietary deficiency impairs synapse development Adequate Deficient Hippocampal DHA 6.6 ± 0.7% 0.5 ± 0.1% Fatty Acids DPAn-6 0.4 ± 0.1% 4.7 ± 0.1% Synapes in Hippocampal Neurons 30 µm Mother mice fed adequate of deficient diets, embryo neurons harvested day 18 Cao et al. J. Neurochem. 2009
  • 94. Low maternal omega-3 consumption from seafood and suboptimal verbal IQ among their children 34 32 30 28 - UK , 8y 26 III r = 0.97 Percentage of children with 24 r2 = 0.95 F=27.2 p<0.02. low verbal IQ, WISC 22 20 18 16 14 0 0.05 0.10 0.15 0.20 0.25 0.30 0.35 0.40 0.45 0.50 0.55 0.60 - Estimated omega 3 fatty acids from seafood (en %) Mother at 32 wk gestation Hibbeln et al, Lancet 2007: 369: 578-585
  • 95. Oilseeds in the US Food Supply in the 20th Century 12 10 Soybean 8 Cottonseed Corn 6 Olive Coconut 4 Disappearance (kg/person/y) 2 0 Canola 0.9 0.8 Peanut 0.7 Palm/Palm 0.6 Kernel 0.5 0.4 Safflower 0.3 0.2 Sunflower 0.1 Sesame 1989 1999 1969 1979 1949 1959 1929 1939 1909 1919 Year
  • 96. 3500 All Cause Mortality (M) Stroke Mortality (M) CVD Mortality (M) 400 1400 3000 350 1200 300 2500 1000 250 2000 800 200 Total mortality (M) /100,000 Total mortality (M) /100,000 1500 Total mortality (M) /100,000 600 150 1000 400 100 Japan Japan 500 Japan Iceland 50 200 Iceland Iceland 0 0 0 0 0.05 0.10 0.15 0.20 0.25 0.30 0.35 0.40 0.45 0.50 0 0.05 0.10 0.15 0.20 0.25 0.30 0.35 0.40 0.45 0.50 0 0.05 0.10 0.15 0.20 0.25 0.30 0.35 0.40 0.45 0.50 n-3 LCFA from commodities (en%) n-3 LCFA from commodities (en%) n-3 LCFA from commodities (en%) 1200 All Cause Mortality (F) Stroke Mortality (F) CVD Mortality (F) 250 700 1000 600 200 800 500 150 400 600 Total Mortality (F)/100,000 Total mortality (F) /100,000 300 Total mortality (F) /100,000 100 400 Japan 200 Iceland 50 200 Japan 100 Japan Iceland Iceland 0 0 0 0 0.05 0.10 0.15 0.20 0.25 0.30 0.35 0.40 0.45 0.50 0 0.05 0.10 0.15 0.20 0.25 0.30 0.35 0.40 0.45 0.50 0 0.05 0.10 0.15 0.20 0.25 0.30 0.35 0.40 0.45 0.50 n-3 LCFA from commodities (en%) n-3 LCFA from commodities (en%) n-3 LCFA from commodities (en%) Hibbeln et al Am J Clin Nutr 2006; 83; 1483S-93S
  • 97. 800 CHD Mortality (M) 300 CHD Mortality (F) Homicide Mortality 12 700 250 10 600 200 8 500 Total mortality (M) /100,000 400 150 Total mortality /100,000 6 Total mortality (M) /100,000 300 100 4 200 Iceland 50 2 Japan 100 Iceland Iceland Japan Japan 0 0 0 0 0.05 0.10 0.15 0.20 0.25 0.30 0.35 0.40 0.45 0.50 0 0.05 0.10 0.15 0.20 0.25 0.30 0.35 0.40 0.45 0.50 0 0.05 0.10 0.15 0.20 0.25 0.30 0.35 0.40 0.45 0.50 n-3 LCFA from commodities (en%) n-3 LCFA from commodities (en%) n-3 LCFA from commodities (en%) Postpartum Depression 30 Major Depression Bipolar Disorder 7 12 25 6 10 5 20 8 4 Lifetime prevalence (%) 15 6 Annual prevalence (%) Point prevalence (%) 3 10 4 2 Iceland 5 2 1 Japan Japan Japan Iceland 0 0 0 0 0.05 0.10 0.15 0.20 0.25 0.30 0.35 0.40 0.45 0.50 0 0.05 0.10 0.15 0.20 0.25 0.30 0.35 0.40 0 0.05 0.10 0.15 0.20 0.25 0.30 0.35 0.40 0.45 0.50 n-3 LCFA from commodities (en%) n-3 LCFA from commodities (en%) n-3 LCFA from commodities (en%) Hibbeln et al Am J Clin Nutr 2006; 83; 1483S-93S
  • 98.
  • 99. Increasing Mismatch Causes Homicides Homicide Rate 10 8 6 4 United 2000 Kingdom 2 1961 0 0 2 4 6 8 10 Lo Hi Omega 3 Deficiency
  • 100. Increasing Mismatch Causes Homicides Homicide Rate 10 8 6 4 United 2000 2000 1961 Kingdom Canada 2 1961 0 0 2 4 6 8 10 Lo Hi Omega 3 Deficiency
  • 101. Increasing Mismatch Causes Homicides Homicide Rate 10 8 6 4 United 2000 2000 1961 Kingdom Canada 2 2000 1961 1961 Australia 0 0 2 4 6 8 10 Lo Hi Omega 3 Deficiency
  • 102. Increasing Mismatch Causes Homicides Homicide Rate 10 8 6 1988 4 1961 Argentina United 2000 2000 1961 Kingdom Canada 2 2000 1961 1961 Australia 0 0 2 4 6 8 10 Lo Hi Omega 3 Deficiency
  • 103. Increasing Mismatch Causes Homicides Homicide Rate 1985 10 United 8 States 6 1988 1999 1961 4 1961 Argentina United 2000 2000 1961 Kingdom Canada 2 2000 1961 1961 Australia 0 0 2 4 6 8 10 Lo Hi Omega 3 Deficiency

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  103. MISSION: READINESS\nIn a study being released Thursday Nov 5, 2009 in Washington, Education Secretary Arne Duncan and a group of retired military officers led by former Army Gen. Wesley Clark will sound the alarm bells and call young Americans&amp;#x2019; relative lack of overall fitness for military duty a national security threat. The group, Mission: Readiness, will release a report that draws on Pentagon data showing that 75 percent of the nation&amp;#x2019;s 17- to 24-year-olds are ineligible for service for a variety of reasons.\n\nPut another way, only 4.7 million of the 31.2 million 17- to 24-year-olds in a 2007 survey are eligible to enlist, according to a periodic survey commissioned by the Pentagon. This group includes those who have scored in the top four categories on the Armed Forces Qualification Test, or AQFT; eligible college graduates; and qualified college students.\n\nAccording to the Pentagon, the ineligible population breaks down this way:\n\n&amp;#x2022;Medical/physical problems, 35 percent.\n&amp;#x2022;Illegal drug use, 18 percent.\n&amp;#x2022;Mental Category V (the lowest 10 percent of the population), 9 percent.\n&amp;#x2022;Too many dependents under age 18, 6 percent.\n&amp;#x2022;Criminal record, 5 percent.\n
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  132. There are now studies showing that grades and behavior improve in school when children and teens increase their daily intake of omega-3 brain food. \n\nIn a randomized study on Durham school district in the England, children got omega-3 or placebo. During the first 3 months the average gain for children taking fatty acids was 9.5 months for reading and 6.5 months for spelling. Yes, this was very statistically significant. Notice the improvement in writing skills, as an example of change.\n\nLater the children who got the placebo received omega-3, and their results then improved.\n\n\n
  133. When people consume lots of the omega 6s, they are 2.5 times more likely to develop depression, compared to people who consume omega-3&amp;#x2018;s. Depression in the United States has been steadily increasing, and our young people consume the most omega-6&amp;#x2019;s in the world.\n
  134. When people consume lots of the omega 6s, they are 2.5 times more likely to develop depression, compared to people who consume omega-3&amp;#x2018;s. Depression in the United States has been steadily increasing, and our young people consume the most omega-6&amp;#x2019;s in the world.\n
  135. When people consume lots of the omega 6s, they are 2.5 times more likely to develop depression, compared to people who consume omega-3&amp;#x2018;s. Depression in the United States has been steadily increasing, and our young people consume the most omega-6&amp;#x2019;s in the world.\n
  136. When people consume lots of the omega 6s, they are 2.5 times more likely to develop depression, compared to people who consume omega-3&amp;#x2018;s. Depression in the United States has been steadily increasing, and our young people consume the most omega-6&amp;#x2019;s in the world.\n
  137. When people consume lots of the omega 6s, they are 2.5 times more likely to develop depression, compared to people who consume omega-3&amp;#x2018;s. Depression in the United States has been steadily increasing, and our young people consume the most omega-6&amp;#x2019;s in the world.\n
  138. Too much omega 6&amp;#x2014;the bad brain food&amp;#x2014;hurts intelligence and school performance. American children have the highest levels of omega-6 in the world, and countries like Japan have the lowest level. And which country has children scoring high on standardized achievement tests?\n
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  148. Explain:\n\nBilly&amp;#x2019;s behavior can be predicted by a mathematical formula&amp;#x2014;just like many things in nature can be predicted by a formula. The formula is simple just like E=MC2 by Einstein is simple&amp;#x2014;though powerful and complex in many ways.\n
  149. So here is our estimate of the frequency of reinforcement for PAX and the reinforcement of Spleems. What does that mean for the amount of PAX time wherein the conditions of teaching and learning favor success?\n
  150. And the answer?\n
  151. The question is how to solve the situation. \n
  152. The question is how to solve the situation. \n
  153. The question is how to solve the situation. \n
  154. The question is how to solve the situation. \n
  155. The question is how to solve the situation. \n
  156. The question is how to solve the situation. \n
  157. The question is how to solve the situation. \n
  158. The question is how to solve the situation. \n
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  199. Preventing Sleep Deprivation\nThe IOM Report (IOM, page 212) points out that there is a need for a public campaign to increase healthy sleep among the nation&amp;#x2019;s children and youth to prevent mental, emotional and behavioral disorders&amp;#x2014;including risk of addictions.1-4 Good sleep also reduces obesity in children and young adults.5-7\nSleep deprivation is rapidly increasing in children and teens&amp;#x2014;by virtue of electronic media (e.g., cellphones, instant messaging, TV&amp;#x2019;s and electronic games in children&amp;#x2019;s bedrooms) is now firmly linked to increased risk of ATOD use and other problematic behaviors for multiple biological, media modeling, and adverse norming reasons.\nOur children today sleep a lot less than children just 10-20 years ago. The lack of sleep, even as a young child, significantly predicts getting drunk, stoned, or in trouble with the law including for violence as well as doing poorly in school.4 8-11 The reason is not more homework or family stress. The reason is simple: Children&amp;#x2019;s bedrooms today are like electronic super-stores&amp;#x2014;often with a TV, a computer, electronic games, and now cell phones.10 12-20 These electronic things are a lot more exciting and sleep depriving than reading a book under the covers with a flashlight.20 When parents significantly reduce use of these things&amp;#x2014;especially in children&amp;#x2019;s bedrooms&amp;#x2014;children and teens are healthier, less irritable, do better in school and less likely to get into all manner of trouble.21 22 There are some strategies to slim your child&amp;#x2019;s media diet if families are unsure what to do.23\nBibliography\n1. Abe T, Hagihara A, Nobutomo K. Sleep patterns and impulse control among Japanese junior high school students. J Adolesc 2009.2. Holm SM, Forbes EE, Ryan ND, Phillips ML, Tarr JA, Dahl RE. Reward-related brain function and sleep in pre/early pubertal and mid/late pubertal adolescents. Journal of Adolescent Health 2009;45(4):326-34.3. Wong CJ, Sheppard J-M, Dallery J, Bedient G, Robles E, Svikis D, et al. Effects of reinforcer magnitude on data-entry productivity in chronically unemployed drug abusers participating in a therapeutic workplace. Experimental &amp; Clinical Psychopharmacology 2003;11(1):46-55.4. Wong MM, Brower KJ, Fitzgerald HE, Zucker RA. Sleep problems in early childhood and early onset of alcohol and other drug use in adolescence. Alcoholism: Clinical &amp; Experimental Research 2004;28(4):578-87.5. Nielsen LS, Danielsen KV, Sorensen TI. Short sleep duration as a possible cause of obesity: critical analysis of the epidemiological evidence. Obes Rev 2010.6. Cappuccio FP, Taggart FM, Kandala NB, Currie A, Peile E, Stranges S, et al. Meta-analysis of short sleep duration and obesity in children and adults. Sleep 2008;31(5):619-26.7. Al Mamun A, Lawlor DA, Cramb S, O&apos;Callaghan M, Williams G, Najman J. Do childhood sleeping problems predict obesity in young adulthood? Evidence from a prospective birth cohort study. Am J Epidemiol 2007;166(12):1368-73.8. Chervin RD, Dillon JE, Archbold KH, Ruzicka DL. Conduct problems and symptoms of sleep disorders in children. Journal of the American Academy of Child &amp; Adolescent Psychiatry 2003;42(2):201-08.9. Owens J, Maxim R, McGuinn M, Nobile C, Msall M, Alario A. Television-viewing habits and sleep disturbance in school children. Pediatrics 1999;104(3):e27.10. Dworak M, Schierl T, Bruns T, Str&amp;#xB8;der HK. Impact of singular excessive computer game and television exposure on sleep patterns and memory performance of school-aged children. Pediatrics 2007;120(5):978-85.11. Meijer AM. Chronic sleep reduction, functioning at school and school achievement in preadolescents. Journal of Sleep Research 2008;17(4):395-405.12. Van den Bulck J. Television viewing, computer game playing, and Internet use and self-reported time to bed and time out of bed in secondary-school children.[see comment]. Sleep 2004;27(1):101-4.13. Van den Bulck J. Text messaging as a cause of sleep interruption in adolescents, evidence from a cross-sectional study. Journal of Sleep Research 2003;12(3):263-63.14. Tazawa Y, Okada K. Physical signs associated with excessive television-game playing and sleep deprivation. Pediatrics International 2001;43(6):647-50.15. Johnson JG, Cohen P, Kasen S, First MB, Brook JS. Association between television viewing and sleep problems during adolescence and early adulthood.[see comment]. Archives of Pediatrics &amp; Adolescent Medicine 2004;158(6):562-8.16. Thompson DA, Christakis DA. The association between television viewing and irregular sleep schedules among children less than 3 years of age. Pediatrics 2005;116(4):851-6.17. Paavonen EJ, Pennonen M, Roine M, Valkonen S, Lahikainen AR. TV exposure associated with sleep disturbances in 5- to 6-year-old children. Journal of Sleep Research 2006;15(2):154-61.18. Toyran M, Ozmert E, Yurdakok K. Television viewing and its effect on physical health of schoolage children. Turkish Journal of Pediatrics 2002;44(3):194-203.19. Borzekowski DLG, Robinson TN. The Remote, the Mouse, and the No. 2 Pencil: The Household Media Environment and Academic Achievement Among Third Grade Students. Arch Pediatr Adolesc Med 2005;159(7):607-13.20. Suganuma N, Kikuchi T, Yanagi K, Yamamura S, Morishima H, Adachi H, et al. Using electronic media before sleep can curtail sleep time and result in self-perceived insufficient sleep. Sleep and Biological Rhythms 2007;5(3):204-14.21. Barkin SL, Finch SA, Ip EH, Scheindlin B, Craig JA, Steffes J, et al. Is Office-Based Counseling About Media Use, Timeouts, and Firearm Storage Effective? Results From a Cluster-Randomized, Controlled Trial. Pediatrics 2008;122(1):e15-25.22. Gorin A, Raynor H, Chula-Maguire K, Wing R. Decreasing household television time: A pilot study of a combined behavioral and environmental intervention. Behavioral Interventions 2006;21(4):273-80.23. Jordan AB, Hersey JC, McDivitt JA, Heitzler CD. Reducing Children&apos;s Television-Viewing Time: A Qualitative Study of Parents and Their Children. Pediatrics 2006;118(5):e1303-10.\n
  200. Sleep deprivation is particularly a problem for children. In studies of elementary aged children, nearly 40% had some type of sleep problem, 15% exhibited bedtime resistance and 10% had daytime sleepiness. Nearly half of teens reported at least occasional difficulty in falling or staying asleep and almost 13% experiencing chronic and severe insomnia. This lack of sleep greatly affects mood, behavior, and academic performance. In pediatric research, poor sleepers reported being significantly more depressed and were even more likely to have a negative self-image. They were also more likely to exhibit negative behavior patterns and inferior coping behaviors and have more behavioral problems at home and in school. One study showed that students that students with C&amp;#x2019;s, D&amp;#x2019;s and F&amp;#x2019;s went to bed an average of 40 minutes later and got 20 minutes less sleep than A students. Insufficient sleep has also been associated with Attention Deficit Hyperactivity Disorder (ADHD), lower social skills and learning difficulties.\n
  201. \n
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  204. Here is one example of an experimental study to reduce TV and electronic media.\n\nRobinson, T. N., M. L. Wilde, et al. (2001). &quot;Effects of reducing children&apos;s television and video game use on aggressive behavior: a randomized controlled trial.[see comment].&quot; Archives of Pediatrics &amp; Adolescent Medicine 155(1): 17-23.CONTEXT: The relationship between exposure to aggression in the media and children&apos;s aggressive behavior is well documented. However, few potential solutions have been evaluated. OBJECTIVE: To assess the effects of reducing television, videotape, and video game use on aggressive behavior and perceptions of a mean and scary world. DESIGN: Randomized, controlled, school-based trial. \nSETTING: Two sociodemographically and scholastically matched public elementary schools in San Jose, Calif. PARTICIPANTS: Third- and fourth-grade students (mean age, 8.9 years) and their parents or guardians. \nINTERVENTION: Children in one elementary school received an 18-lesson, 6-month classroom curriculum to reduce television, videotape, and video game use. MAIN OUTCOME MEASURES: In September (preintervention) and April (postintervention) of a single school year, children rated their peers&apos; aggressive behavior and reported their perceptions of the world as a mean and scary place. A 60% random sample of children were observed for physical and verbal aggression on the playground. Parents were interviewed by telephone and reported aggressive and delinquent behaviors on the child behavior checklist. The primary outcome measure was peer ratings of aggressive behavior. \nRESULTS: Compared with controls, children in the intervention group had statistically significant decreases in peer ratings of aggression (adjusted mean difference, -2.4%; 95% confidence interval [CI], -4.6 to -0.2; P =.03) and observed verbal aggression (adjusted mean difference, -0.10 act per minute per child; 95% CI, -0.18 to -0.03; P =.01). Differences in observed physical aggression, parent reports of aggressive behavior, and perceptions of a mean and scary world were not statistically significant but favored the intervention group. CONCLUSIONS: An intervention to reduce television, videotape, and video game use decreases aggressive behavior in elementary schoolchildren. These findings support the causal influences of these media on aggression and the potential benefits of reducing children&apos;s media use.\n
  205. \n
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  211. Theodore, A. D., Chang, J. J., Runyan, D. K., Hunter, W. M., Bangdiwala, S. I., &amp; Agans, R. (2005). Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics, 115(3), e331-337. These investigators examined the extent of the underestimate of child maltreatment, one of the few studies to do so. Here is the abstract.Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children &lt;2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states. Conclusions. Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.\n
  212. Theodore, A. D., Chang, J. J., Runyan, D. K., Hunter, W. M., Bangdiwala, S. I., &amp; Agans, R. (2005). Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics, 115(3), e331-337. These investigators examined the extent of the underestimate of child maltreatment, one of the few studies to do so. Here is the abstract.Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children &lt;2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states. Conclusions. Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.\n
  213. Theodore, A. D., Chang, J. J., Runyan, D. K., Hunter, W. M., Bangdiwala, S. I., &amp; Agans, R. (2005). Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics, 115(3), e331-337. These investigators examined the extent of the underestimate of child maltreatment, one of the few studies to do so. Here is the abstract.Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children &lt;2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states. Conclusions. Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.\n
  214. Theodore, A. D., Chang, J. J., Runyan, D. K., Hunter, W. M., Bangdiwala, S. I., &amp; Agans, R. (2005). Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics, 115(3), e331-337. These investigators examined the extent of the underestimate of child maltreatment, one of the few studies to do so. Here is the abstract.Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children &lt;2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states. Conclusions. Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.\n
  215. Theodore, A. D., Chang, J. J., Runyan, D. K., Hunter, W. M., Bangdiwala, S. I., &amp; Agans, R. (2005). Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics, 115(3), e331-337. These investigators examined the extent of the underestimate of child maltreatment, one of the few studies to do so. Here is the abstract.Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children &lt;2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states. Conclusions. Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.\n
  216. Theodore, A. D., Chang, J. J., Runyan, D. K., Hunter, W. M., Bangdiwala, S. I., &amp; Agans, R. (2005). Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics, 115(3), e331-337. These investigators examined the extent of the underestimate of child maltreatment, one of the few studies to do so. Here is the abstract.Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children &lt;2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states. Conclusions. Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.\n
  217. Theodore, A. D., Chang, J. J., Runyan, D. K., Hunter, W. M., Bangdiwala, S. I., &amp; Agans, R. (2005). Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics, 115(3), e331-337. These investigators examined the extent of the underestimate of child maltreatment, one of the few studies to do so. Here is the abstract.Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children &lt;2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states. Conclusions. Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.\n
  218. Theodore, A. D., Chang, J. J., Runyan, D. K., Hunter, W. M., Bangdiwala, S. I., &amp; Agans, R. (2005). Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics, 115(3), e331-337. These investigators examined the extent of the underestimate of child maltreatment, one of the few studies to do so. Here is the abstract.Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children &lt;2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states. Conclusions. Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.\n
  219. Theodore, A. D., Chang, J. J., Runyan, D. K., Hunter, W. M., Bangdiwala, S. I., &amp; Agans, R. (2005). Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics, 115(3), e331-337. These investigators examined the extent of the underestimate of child maltreatment, one of the few studies to do so. Here is the abstract.Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children &lt;2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states. Conclusions. Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.\n
  220. Theodore, A. D., Chang, J. J., Runyan, D. K., Hunter, W. M., Bangdiwala, S. I., &amp; Agans, R. (2005). Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics, 115(3), e331-337. These investigators examined the extent of the underestimate of child maltreatment, one of the few studies to do so. Here is the abstract.Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children &lt;2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states. Conclusions. Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.\n
  221. Theodore, A. D., Chang, J. J., Runyan, D. K., Hunter, W. M., Bangdiwala, S. I., &amp; Agans, R. (2005). Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics, 115(3), e331-337. These investigators examined the extent of the underestimate of child maltreatment, one of the few studies to do so. Here is the abstract.Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children &lt;2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states. Conclusions. Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.\n
  222. Theodore, A. D., Chang, J. J., Runyan, D. K., Hunter, W. M., Bangdiwala, S. I., &amp; Agans, R. (2005). Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics, 115(3), e331-337. These investigators examined the extent of the underestimate of child maltreatment, one of the few studies to do so. Here is the abstract.Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children &lt;2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states. Conclusions. Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.\n
  223. Theodore, A. D., Chang, J. J., Runyan, D. K., Hunter, W. M., Bangdiwala, S. I., &amp; Agans, R. (2005). Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics, 115(3), e331-337. These investigators examined the extent of the underestimate of child maltreatment, one of the few studies to do so. Here is the abstract.Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children &lt;2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states. Conclusions. Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.\n
  224. Theodore, A. D., Chang, J. J., Runyan, D. K., Hunter, W. M., Bangdiwala, S. I., &amp; Agans, R. (2005). Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics, 115(3), e331-337. These investigators examined the extent of the underestimate of child maltreatment, one of the few studies to do so. Here is the abstract.Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children &lt;2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states. Conclusions. Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.\n
  225. Theodore, A. D., Chang, J. J., Runyan, D. K., Hunter, W. M., Bangdiwala, S. I., &amp; Agans, R. (2005). Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics, 115(3), e331-337. These investigators examined the extent of the underestimate of child maltreatment, one of the few studies to do so. Here is the abstract.Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children &lt;2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states. Conclusions. Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.\n
  226. Theodore, A. D., Chang, J. J., Runyan, D. K., Hunter, W. M., Bangdiwala, S. I., &amp; Agans, R. (2005). Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics, 115(3), e331-337. These investigators examined the extent of the underestimate of child maltreatment, one of the few studies to do so. Here is the abstract.Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children &lt;2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states. Conclusions. Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.\n
  227. Theodore, A. D., Chang, J. J., Runyan, D. K., Hunter, W. M., Bangdiwala, S. I., &amp; Agans, R. (2005). Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics, 115(3), e331-337. These investigators examined the extent of the underestimate of child maltreatment, one of the few studies to do so. Here is the abstract.Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children &lt;2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states. Conclusions. Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.\n
  228. Theodore, A. D., Chang, J. J., Runyan, D. K., Hunter, W. M., Bangdiwala, S. I., &amp; Agans, R. (2005). Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics, 115(3), e331-337. These investigators examined the extent of the underestimate of child maltreatment, one of the few studies to do so. Here is the abstract.Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children &lt;2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states. Conclusions. Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.\n
  229. Theodore, A. D., Chang, J. J., Runyan, D. K., Hunter, W. M., Bangdiwala, S. I., &amp; Agans, R. (2005). Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics, 115(3), e331-337. These investigators examined the extent of the underestimate of child maltreatment, one of the few studies to do so. Here is the abstract.Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children &lt;2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states. Conclusions. Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.\n
  230. Theodore, A. D., Chang, J. J., Runyan, D. K., Hunter, W. M., Bangdiwala, S. I., &amp; Agans, R. (2005). Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics, 115(3), e331-337. These investigators examined the extent of the underestimate of child maltreatment, one of the few studies to do so. Here is the abstract.Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children &lt;2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states. Conclusions. Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.\n
  231. Theodore, A. D., Chang, J. J., Runyan, D. K., Hunter, W. M., Bangdiwala, S. I., &amp; Agans, R. (2005). Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics, 115(3), e331-337. These investigators examined the extent of the underestimate of child maltreatment, one of the few studies to do so. Here is the abstract.Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children &lt;2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states. Conclusions. Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.\n
  232. Theodore, A. D., Chang, J. J., Runyan, D. K., Hunter, W. M., Bangdiwala, S. I., &amp; Agans, R. (2005). Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics, 115(3), e331-337. These investigators examined the extent of the underestimate of child maltreatment, one of the few studies to do so. Here is the abstract.Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children &lt;2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states. Conclusions. Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.\n
  233. Theodore, A. D., Chang, J. J., Runyan, D. K., Hunter, W. M., Bangdiwala, S. I., &amp; Agans, R. (2005). Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics, 115(3), e331-337. These investigators examined the extent of the underestimate of child maltreatment, one of the few studies to do so. Here is the abstract.Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children &lt;2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states. Conclusions. Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.\n
  234. Theodore, A. D., Chang, J. J., Runyan, D. K., Hunter, W. M., Bangdiwala, S. I., &amp; Agans, R. (2005). Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics, 115(3), e331-337. These investigators examined the extent of the underestimate of child maltreatment, one of the few studies to do so. Here is the abstract.Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children &lt;2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states. Conclusions. Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.\n
  235. Theodore, A. D., Chang, J. J., Runyan, D. K., Hunter, W. M., Bangdiwala, S. I., &amp; Agans, R. (2005). Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics, 115(3), e331-337. These investigators examined the extent of the underestimate of child maltreatment, one of the few studies to do so. Here is the abstract.Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children &lt;2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states. Conclusions. Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.\n
  236. Theodore, A. D., Chang, J. J., Runyan, D. K., Hunter, W. M., Bangdiwala, S. I., &amp; Agans, R. (2005). Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics, 115(3), e331-337. These investigators examined the extent of the underestimate of child maltreatment, one of the few studies to do so. Here is the abstract.Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children &lt;2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states. Conclusions. Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.\n
  237. Theodore, A. D., Chang, J. J., Runyan, D. K., Hunter, W. M., Bangdiwala, S. I., &amp; Agans, R. (2005). Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics, 115(3), e331-337. These investigators examined the extent of the underestimate of child maltreatment, one of the few studies to do so. Here is the abstract.Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children &lt;2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states. Conclusions. Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.\n
  238. Theodore, A. D., Chang, J. J., Runyan, D. K., Hunter, W. M., Bangdiwala, S. I., &amp; Agans, R. (2005). Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics, 115(3), e331-337. These investigators examined the extent of the underestimate of child maltreatment, one of the few studies to do so. Here is the abstract.Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children &lt;2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states. Conclusions. Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.\n
  239. Theodore, A. D., Chang, J. J., Runyan, D. K., Hunter, W. M., Bangdiwala, S. I., &amp; Agans, R. (2005). Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics, 115(3), e331-337. These investigators examined the extent of the underestimate of child maltreatment, one of the few studies to do so. Here is the abstract.Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children &lt;2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states. Conclusions. Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.\n
  240. Theodore, A. D., Chang, J. J., Runyan, D. K., Hunter, W. M., Bangdiwala, S. I., &amp; Agans, R. (2005). Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics, 115(3), e331-337. These investigators examined the extent of the underestimate of child maltreatment, one of the few studies to do so. Here is the abstract.Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children &lt;2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states. Conclusions. Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.\n
  241. Theodore, A. D., Chang, J. J., Runyan, D. K., Hunter, W. M., Bangdiwala, S. I., &amp; Agans, R. (2005). Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics, 115(3), e331-337. These investigators examined the extent of the underestimate of child maltreatment, one of the few studies to do so. Here is the abstract.Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children &lt;2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states. Conclusions. Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.\n
  242. Theodore, A. D., Chang, J. J., Runyan, D. K., Hunter, W. M., Bangdiwala, S. I., &amp; Agans, R. (2005). Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics, 115(3), e331-337. These investigators examined the extent of the underestimate of child maltreatment, one of the few studies to do so. Here is the abstract.Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children &lt;2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states. Conclusions. Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.\n
  243. Theodore, A. D., Chang, J. J., Runyan, D. K., Hunter, W. M., Bangdiwala, S. I., &amp; Agans, R. (2005). Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics, 115(3), e331-337. These investigators examined the extent of the underestimate of child maltreatment, one of the few studies to do so. Here is the abstract.Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children &lt;2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states. Conclusions. Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.\n
  244. Theodore, A. D., Chang, J. J., Runyan, D. K., Hunter, W. M., Bangdiwala, S. I., &amp; Agans, R. (2005). Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics, 115(3), e331-337. These investigators examined the extent of the underestimate of child maltreatment, one of the few studies to do so. Here is the abstract.Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children &lt;2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states. Conclusions. Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.\n
  245. Theodore, A. D., Chang, J. J., Runyan, D. K., Hunter, W. M., Bangdiwala, S. I., &amp; Agans, R. (2005). Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics, 115(3), e331-337. These investigators examined the extent of the underestimate of child maltreatment, one of the few studies to do so. Here is the abstract.Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children &lt;2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states. Conclusions. Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.\n
  246. Theodore, A. D., Chang, J. J., Runyan, D. K., Hunter, W. M., Bangdiwala, S. I., &amp; Agans, R. (2005). Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics, 115(3), e331-337. These investigators examined the extent of the underestimate of child maltreatment, one of the few studies to do so. Here is the abstract.Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children &lt;2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states. Conclusions. Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.\n
  247. Theodore, A. D., Chang, J. J., Runyan, D. K., Hunter, W. M., Bangdiwala, S. I., &amp; Agans, R. (2005). Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics, 115(3), e331-337. These investigators examined the extent of the underestimate of child maltreatment, one of the few studies to do so. Here is the abstract.Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children &lt;2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states. Conclusions. Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.\n
  248. Theodore, A. D., Chang, J. J., Runyan, D. K., Hunter, W. M., Bangdiwala, S. I., &amp; Agans, R. (2005). Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics, 115(3), e331-337. These investigators examined the extent of the underestimate of child maltreatment, one of the few studies to do so. Here is the abstract.Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children &lt;2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states. Conclusions. Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.\n
  249. Theodore, A. D., Chang, J. J., Runyan, D. K., Hunter, W. M., Bangdiwala, S. I., &amp; Agans, R. (2005). Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics, 115(3), e331-337. These investigators examined the extent of the underestimate of child maltreatment, one of the few studies to do so. Here is the abstract.Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children &lt;2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states. Conclusions. Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.\n
  250. Theodore, A. D., Chang, J. J., Runyan, D. K., Hunter, W. M., Bangdiwala, S. I., &amp; Agans, R. (2005). Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics, 115(3), e331-337. These investigators examined the extent of the underestimate of child maltreatment, one of the few studies to do so. Here is the abstract.Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children &lt;2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states. Conclusions. Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.\n
  251. Theodore, A. D., Chang, J. J., Runyan, D. K., Hunter, W. M., Bangdiwala, S. I., &amp; Agans, R. (2005). Epidemiologic Features of the Physical and Sexual Maltreatment of Children in the Carolinas. Pediatrics, 115(3), e331-337. These investigators examined the extent of the underestimate of child maltreatment, one of the few studies to do so. Here is the abstract.Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies. Objective. The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports. Design, Setting, and Participants. Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced. Main Outcome Measures. The incidence of physical and sexual maltreatment determined through maternal reports. Results. Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children &lt;2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states. Conclusions. Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.\n
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