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      The impact of COVID‐19 on the safety, housing stability, and mental health of unstably housed domestic violence survivors

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          Abstract

          Using data from an ongoing longitudinal study, we examined the impact of the COVID‐19 stay‐at‐home orders on a racially diverse population of unstably housed domestic violence (DV) survivors over time. Specifically, we examined survivors' safety, housing stability, and mental health before, during, and after the onset of COVID‐19, and how demographic, social, and familial factors attenuated or exacerbated the effect of the stay‐at‐home orders. Approximately 300 participants were initially interviewed after they sought services from a DV agency, and then again, every 6 months over 2 years. COVID‐19 stay‐at‐home orders occurred midway through the completion of this multi‐year study. Longitudinal mixed effects models were estimated to examine the impact of COVID‐19 on the safety, housing stability, and mental health of survivors over time. We also examined models with several time‐varying (e.g., employment, income, social support, and number of children) and time‐invariant (baseline outcome scores, racial/ethnic identity, education, and disability status) control variables. Results revealed that safety, housing stability and mental health were improving for study participants before the onset of the COVID‐19 pandemic but plateaued after the stay‐at‐home orders were issued. Experiences of abuse, housing instability, and mental health symptomatology did not worsen as a result of the COVID‐19 stay‐at‐home orders. Notably, social support and housing services emerged as important predictors of outcomes, such that participants who received housing‐related services and greater social support reported less abuse, less housing instability, and lower mental health distress. COVID‐19 temporarily disrupted the positive trajectory unstably housed DV survivors were experiencing in regard to safety, housing stability and mental health. These findings provide critical insight into the importance of service access during and after global catastrophes. Additional resources and support may be helpful in assisting survivors to return to their pre‐pandemic recovery and growth trajectories.

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          A brief measure for assessing generalized anxiety disorder: the GAD-7.

          Generalized anxiety disorder (GAD) is one of the most common mental disorders; however, there is no brief clinical measure for assessing GAD. The objective of this study was to develop a brief self-report scale to identify probable cases of GAD and evaluate its reliability and validity. A criterion-standard study was performed in 15 primary care clinics in the United States from November 2004 through June 2005. Of a total of 2740 adult patients completing a study questionnaire, 965 patients had a telephone interview with a mental health professional within 1 week. For criterion and construct validity, GAD self-report scale diagnoses were compared with independent diagnoses made by mental health professionals; functional status measures; disability days; and health care use. A 7-item anxiety scale (GAD-7) had good reliability, as well as criterion, construct, factorial, and procedural validity. A cut point was identified that optimized sensitivity (89%) and specificity (82%). Increasing scores on the scale were strongly associated with multiple domains of functional impairment (all 6 Medical Outcomes Study Short-Form General Health Survey scales and disability days). Although GAD and depression symptoms frequently co-occurred, factor analysis confirmed them as distinct dimensions. Moreover, GAD and depression symptoms had differing but independent effects on functional impairment and disability. There was good agreement between self-report and interviewer-administered versions of the scale. The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.
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            The PHQ-9: validity of a brief depression severity measure.

            While considerable attention has focused on improving the detection of depression, assessment of severity is also important in guiding treatment decisions. Therefore, we examined the validity of a brief, new measure of depression severity. The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-9 is the depression module, which scores each of the 9 DSM-IV criteria as "0" (not at all) to "3" (nearly every day). The PHQ-9 was completed by 6,000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics. Construct validity was assessed using the 20-item Short-Form General Health Survey, self-reported sick days and clinic visits, and symptom-related difficulty. Criterion validity was assessed against an independent structured mental health professional (MHP) interview in a sample of 580 patients. As PHQ-9 depression severity increased, there was a substantial decrease in functional status on all 6 SF-20 subscales. Also, symptom-related difficulty, sick days, and health care utilization increased. Using the MHP reinterview as the criterion standard, a PHQ-9 score > or =10 had a sensitivity of 88% and a specificity of 88% for major depression. PHQ-9 scores of 5, 10, 15, and 20 represented mild, moderate, moderately severe, and severe depression, respectively. Results were similar in the primary care and obstetrics-gynecology samples. In addition to making criteria-based diagnoses of depressive disorders, the PHQ-9 is also a reliable and valid measure of depression severity. These characteristics plus its brevity make the PHQ-9 a useful clinical and research tool.
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              The PHQ-9

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                Author and article information

                Contributors
                danielle.chiaramonte@yale.edu
                Journal
                J Community Psychol
                J Community Psychol
                10.1002/(ISSN)1520-6629
                JCOP
                Journal of Community Psychology
                John Wiley and Sons Inc. (Hoboken )
                0090-4392
                1520-6629
                18 December 2021
                August 2022
                : 50
                : 6 , COVID‐19 and Vulnerable Populations Volume/Section 1 ( doiID: 10.1002/jcop.v50.6 )
                : 2659-2681
                Affiliations
                [ 1 ] Department of Psychiatry, Department of Psychology Yale University New Haven Connecticut USA
                [ 2 ] Department of Pyschology Drakeford, Scott, & Associates, LLC Upper Marlboro Maryland USA
                [ 3 ] Department of Psychology University of Michigan Ann Arbor Michigan USA
                Author notes
                [*] [* ] Correspondence Danielle Chiaramonte, Department of Psychiatry, Department of Psychology, Yale University, New Haven, CT 06520, USA.

                Email: danielle.chiaramonte@ 123456yale.edu

                Author information
                http://orcid.org/0000-0002-8385-5981
                https://orcid.org/0000-0001-5457-4681
                https://orcid.org/0000-0001-8782-0105
                https://orcid.org/0000-0002-4865-6303
                https://orcid.org/0000-0001-5857-2974
                https://orcid.org/0000-0002-7377-0685
                https://orcid.org/0000-0003-1806-6668
                Article
                JCOP22765
                10.1002/jcop.22765
                9206039
                34921735
                d1c71a42-bafa-47c5-b7a9-aa8878e13871
                © 2021 The Authors. Journal of Community Psychology published by Wiley Periodicals LLC

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 01 October 2021
                : 08 July 2021
                : 15 November 2021
                Page count
                Figures: 3, Tables: 4, Pages: 23, Words: 10048
                Funding
                Funded by: U.S. Department of Health and Human Services' Office of the Assistant Secretary for Planning and Evaluation (ASPE) in partnership with the Department of Justice's Office for Victims of Crime
                Award ID: HHSP233201600070C
                Funded by: Bill and Melinda Gates Foundation
                Award ID: OPP1117416
                Funded by: National Institute of Drug Abuse
                Award ID: T32DA019426
                Categories
                Special Issue Article
                Special Issue Articles
                Custom metadata
                2.0
                August 2022
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.2.0 mode:remove_FC converted:07.10.2022

                covid‐19,intimate partner violence,longitudinal
                covid‐19, intimate partner violence, longitudinal

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