title: Investigating exposure to violence and mental health in a diverse urban community sample: data from the South East London Community Health (SELCoH) survey.
abstract: BACKGROUND
  General population surveys have seldom examined violence as a multidimensional concept and in relation to an array of mental disorders.
  
  
  METHODS
  Data from the South East London Community Health Study was used to examine the prevalence, overlap and distribution of proximal witnessed, victimised and perpetrated violence and their association with current mental disorders. We further investigated the cumulative effect of lifetime exposure to violence on current mental disorders. Unadjusted and adjusted (for confounders and violence) models were examined.
  
  
  RESULTS
  In the last twelve months, 7.4% reported witnessing violence, 6.3% victimisation and 3.2% perpetration of violence. There was a significant overlap across violence types, with some shared correlates across the groups such as being younger and male. Witnessing violence in the past year was associated with current common mental disorders (CMD) and post-traumatic stress disorder (PTSD) symptoms. Proximal perpetration was associated with current CMD, PTSD symptoms and past 12 months drug use; whereas proximal victimisation was associated with lifetime and past 12 months drug use. Lifetime exposure to two or more types of violence was associated with increased risk for all mental health outcomes, suggesting a cumulative effect.
  
  
  CONCLUSIONS
  Exposure to violence needs to be examined in a multi-faceted manner: i) as discrete distal and proximal events, which may have distinct patterns of association with mental health and ii) as a concept with different but overlapping dimensions, thus also accounting for possible cumulative effects.
authors.affiliation: Biomedical Research Centre Nucleus, Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, United Kingdom.
authors.forename: Giouliana
authors.initials: G
authors.lastname: Kadra
authors.affiliation: School of Psychiatry, University of New South Wales and Justice Health & Forensic Mental Health Network, Sydney, Australia.
authors.forename: Kimberlie
authors.initials: K
authors.lastname: Dean
authors.affiliation: Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, United Kingdom.
authors.forename: Matthew
authors.initials: M
authors.lastname: Hotopf
authors.affiliation: Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, United Kingdom.
authors.forename: Stephani L
authors.initials: SL
authors.lastname: Hatch
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003625:Data Collection; D005260:Female; D006801:Humans; D008131:London; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology*; D008875:Middle Aged; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000523:psychology*; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology*; D011795:Surveys and Questionnaires; D014504:Urban Health; D014754:Violence / Q000523:psychology*; D055815:Young Adult