The broad goal of this proposal is to understand how young black men experience interpersonal violence and how that experience impacts their lives. The proposed research is an extension of the applicant's pilot work consisting of open-ended interviews with 18 young black men who were victims of violence. The analysis of these data revealed several types - innocent bystander, object of revenge, mistaken victim, escalating argument and injured avenger - reflecting the circumstances which led to the injury. In the proposed study, the applicant will conduct interviews with up to 120 young men who have been shot, stabbed or assaulted and are hospitalized at Boston City Hospital. These interviews will explore the patient's story of his injury and the impact of violence upon his life. Standardized assessments of post traumatic stress disorder (PTSD) and substance abuse will also be administered. The transcripts of the interviews will be analyzed using grounded theory to understand the participant's interpretation of the meaning of his injury, and narrative analyses to understand the sequence of events leading to the injury. Through the analysis of the patient's story, each case will be assigned to one of the types identified in the pilot study or will be used to define a type. Using the cases in the study a topology will be developed, based upon the participant's narrative of his injury. The relationship between victim type and PTSD and substance abuse will also be examined. In a second study, the applicant will also identify a subset of cases and conduct interviews with the patient and the health care providers involved in his care. The applicant will analyze these cases to uncover discrepancies between the patients understanding of his injury and the impressions of his providers. The applicant's research and career development plan will permit him to (1) acquire greater expertise in the areas of victimization, post traumatic stress, urban street culture and provider attitudes and (2) acquire expertise in the application of qualitative methods to the study of urban violence and other mental health issues. These goals will be accomplished with the guidance of two preceptors Catherine Riessman, Ph.D., an experienced sociologist and expert in the analysis of qualitative data and Elliot Mishler, Ph.D. a senior researcher in mental health and patient-provider interaction. In addition, the applicant will receive training in post traumatic stress disorder, victimology and urban street culture through individual tutorials. Tutorials will be conducted by Jacquelyn Campbell, Ph.D. (victimology and family violence), Richard Famularo, M.D. (PTSD) and Terry Williams, Ph.D. (urban street culture). The applicant will also complete course work in research methods in epidemiology, field methods, survey research methods and crime and delinquency in the graduate schools of Boston University.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Clinical Investigator Award (CIA) (K08)
Project #
5K08MH001339-02
Application #
2655343
Study Section
Special Emphasis Panel (ZMH1-BRB-N (O1))
Project Start
1997-02-01
Project End
2002-01-31
Budget Start
1998-02-01
Budget End
1999-01-31
Support Year
2
Fiscal Year
1998
Total Cost
Indirect Cost
Name
Boston University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
604483045
City
Boston
State
MA
Country
United States
Zip Code
02118
Rich, John A; Grey, Courtney M (2005) Pathways to recurrent trauma among young Black men: traumatic stress, substance use, and the ""code of the street"". Am J Public Health 95:816-24
Rich, John A; Grey, Courtney M (2003) Qualitative research on trauma surgery: getting beyond the numbers. World J Surg 27:957-61; discussion 961-2