The proposed research plan requests 4 years of funding to broaden and extend the scope of an ongoing NIMH-funded prospective study designed to examine the mental health consequences of exposure to community violence in young adults. Six hundred adult physical trauma survivors will be recruited from three large Level I urban trauma centers serving the most populous, and ethnically diverse, county in the United States. Participants will represent three different ethnic groups: Latino-Americans (N = 200), African-Americans (N = 200), and non-Latino Caucasians (N 200). Following our ongoing protocol, all participants will complete three lay-administered face-to-face assessment interviews, conducted over a 12-month period: within days of hospitalization, at 3-months and 12-months after initial interview. Each participant will also complete a telephone interview conducted by a trained clinician at 2-months after initial interview. ? ? The broad aims of the proposed research are: 1). To characterize and compare the post-trauma adjustment of ethnic minority (i.e., Black, Latino), and non-minority (i.e., non-Latino Caucasian) adults with respect to symptoms of acute stress disorder, posttraumatic stress disorder, and health-related functional status, after adjusting for mechanism and severity of injury. Attention will also be directed at characterizing cross-group gender differences with respect to post-trauma adjustment outcomes. 2). To describe the contribution of pre- and post-trauma resilience and vulnerability factors that influence post-trauma adjustment outcomes, with special emphasis on mechanisms that explain differences that may emerge across ethnic groups and gender. 3). To identify unmet need for services and barriers to care, with a particular emphasis on determining whether unmet needs and barriers to care vary as a function of ethnic minority status or gender. Special attention will be devoted to identifying mechanisms that may underlie any apparent ethnic- or gender-based service utilization disparities.
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