Full Text PA-95-068


NIH GUIDE, Volume 24, Number 20, June 2, 1995

PA NUMBER:  PA-95-068

P.T. 34

  Violent Behavior 
  Risk Factors/Analysis 
  Disease Prevention+ 

National Institute of Mental Health


Through this Program Announcement, which addresses the three major
programs of the Violence and Traumatic Stress Research Branch, the
Division of Epidemiology and Services Research, the National
Institute of Mental Health (NIMH) seeks to encourage
investigator-initiated research to enhance the scientific
understanding of and effective interventions for perpetrators and
victims of interpersonal violence and trauma.  This program
announcement both reaffirms the NIMH 40-year program of research
concerning violence and trauma and reflects recent recommendations of
scientific advisors to NIMH in support of research on violence,
particularly in the areas of youth and family violence.  The 1994
Panel on NIH Research on Anti-social, Aggressive, and
Violence-Related Behaviors and Their Consequences strongly
recommended increased support for violence research and for more
involvement of communities and minorities in this research.

The three major areas of concern are: (1) perpetrators of youth
violence, serious adult crime, sexual offenses (adult and juvenile),
and intimate partners assaults; (2) victims of child abuse, rape,
sexual assault, family violence, and other kinds of interpersonal
violence and crime; and (3) victims of major traumatic events, such
as combat and war, natural and technological disaster, refugee trauma
and relocation, and torture.  The populations of concern include
children, youth, adults, and the elderly, males and females, and all
racial and ethnic groups.

Because the consequences of violence and traumatic stress typically
involve several factors, applications are encouraged from a wide
range of disciplines.  Multidisciplinary applications are especially
encouraged so that a more comprehensive understanding of the role of
specific factors can be determined.  Research is encouraged on the
prevalence, incidence, characteristics, course, mental health
consequences, etiological and risk factors, and correlates of
violence and trauma.  Well-developed intervention research is
especially encouraged to help reduce the extent and consequences of
interpersonal violence and trauma.


The Public Health Service (PHS) is committed to achieving the health
promotion and disease prevention objectives of "Healthy People 2000,"
a PHS-led national activity for setting priority areas.  This PA,
Research on Violence and Traumatic Stress, is related to the priority
areas of violence, traumatic stress, abusive behavior, and mental
disorders.  Potential applicants may obtain a copy of "Healthy People
2000" (Full Report:  Stock No.017-001-00474-0 or Summary Report:
Stock No. 017-001-00473-1) through the Superintendent of Documents,
Government Printing Office, Washington, DC 20402-9325 (telephone


Applications may be submitted by foreign and domestic, for- profit
and non-profit organizations, public and private, such as
universities, colleges, hospitals, laboratories, units of State and
local governments, and eligible agencies of the Federal government.
Foreign institutions are not eligible for small research grants
(R03s), First Independent Research Support and Transition (FIRST)
Awards (R29s), and research program and Center (P) awards.
Racial/ethnic minority individuals, women, and persons with
disabilities are encouraged to apply as Principal Investigators.


Applications focused specifically on the study of mental health
issues related to violence and trauma are encouraged, including
research project grants (R01), small grants (R03), program project
grants (P01) and center grants (P20 or P30), Interactive Research
Project Grants (IRPG), FIRST (R29) awards, exploratory/developmental
grants for Psychosocial Treatment (R21), and Rapid Assessment
Post-Impact of Disaster (RAPID) grants (R03).  If an IRPG is
proposed, it must consist of a minimum of two independent
applications (see PA-94-086, NIH Guide for Grants and Contracts, Vol.
23, NO. 28, July 19, 1994).  An IRPG may consist of a combination of
R01s and R29s or R01s only, but may not consist solely of R29
applications.  An IRPG may also contain shared interactive resources
(Cores), which must serve at least two of the research projects to
facilitate achievement of the Group's common research goals.  Other
NIMH mechanisms are also often available to potential applicants; for
more specific and detailed information about different mechanism
requirements, i.e., eligibility, application format, review criteria,
and review dates, applicants are strongly encouraged to consult with
NIMH staff persons (listed under INQUIRIES) and obtain specialized
announcements.  Copies of all announcements may be obtained from the
Division of Extramural Activities, National Institute of Mental
Health, 5600 Fishers Lane, Room 9C-04, Rockville, MD 20857, telephone
(301) 443-4673, or electronically from the NIH Guide to Grants and
Contracts (gopher.nih.gov).

Because the nature and scope of the research proposed in response to
this program announcement will vary, it is anticipated that the size
of the awards will also vary.  The small grant (R03) is especially
suited for initial research by junior investigators and pilot
research prior to large-scale studies.  The R21 mechanism may be used
for methods development (pilot) studies of psychosocial treatment,
where the research methodology (e.g., instruments, protocols)
requires further development prior to systematic assessment of
intervention strategies.  The IRPG mechanism may be used where such
collaboration will clearly facilitate the design and evaluation of
high-quality, multi-faceted intervention packages (e.g., to
facilitate recruitment of sufficient numbers of hard-to-reach
participants to test hypotheses) and/or study of these interventions
with diverse populations.  Research Center Grants (P20 or P30)
provide support for multidisciplinary, long-term research programs
with a particular major objective, with the intention that the Center
serve as a regional resource for special research purposes.

Applicants may request support for up to five years for research
project grants (R01).  Small grants (R03) are limited to two years
and may not be renewed.  RAPID grants are typically limited to one
year only.  Exploratory/Developmental Grants for Psychosocial
Treatment offer support for up to three years.  Annual awards will be
made, subject to continued availability of funds and progress


For 1995, it is estimated that $3,500,000 will be available for
approximately 20 awards.  Some mechanisms have restrictions regarding
the maximum period of support.  Grant funds may not be used to
operate a treatment, rehabilitation, or other service program.
Prospective applicants are encouraged to contact NIMH staff (listed
under INQUIRIES) before preparing an application to ascertain the
dollar limitations associated with each award mechanism.  Applicants
are strongly encouraged to contact program staff before submitting
any application requesting $500,000 or more in total costs for any
year of support requested; however, this dollar trigger excludes
indirect costs of any subcontracts that are reported as a direct cost
on the application budget page summary.  Opportunities for
cross-collaborative studies and funding may also be available (e.g.,
through the National Institute of Justice); applicants are encouraged
to contact program staff about such opportunities as well.


The effects of violence and trauma constitute a major public health
problem for all Americans, with consequences of severe psychological
and social dysfunction as well as injury and death.  Moreover,
certain segments of the population appear to be disproportionately at
greater risk than others for violence perpetration and/or
victimization, namely, children, youths, families, and women.  Little
is known about effective approaches to preventing the occurrence and
re-occurrence of violence or to ameliorate its deleterious effects on
victims.  This need and the deficits in scientific knowledge it
represents provide the impetus for this announcement.

The past two decades have witnessed an increasing recognition of the
magnitude of interpersonal violence and its mental health
consequences, in youth violence as well as in the underreported areas
of domestic violence, rape, and sexual assault.  With increasing
documentation of its scope and dimensions, interpersonal violence has
in recent years come to be widely viewed as a serious public health

Studies have shown that many youth who commit serious violent acts do
so in the context of an array of anti-social behaviors, sometimes of
many years duration.  Self-report surveys have indicated that
millions of children are physically abused each year, and hundreds of
thousands are victims of sexual abuse.  An estimated 22 million women
are victims of rape or sexual assault in their lifetimes; and other
forms of intimate partner violence, such as the assaults on women by
their husbands or other male partners, are widespread.  Studies have
shown that homicide is the leading cause of death in Black males,
aged 15-24, and that approximately one-quarter of all homicides are
committed against family members.

Exposure to other types of traumatic events also constitutes a major
public health problem.  Although precise estimates of the incidence
of exposure to traumatic events are not known, a recent study of four
southeastern cities found that 69 percent of the adults sampled had
been exposed to at least one major traumatic event at some time in
their lives, and fully 21 percent had experienced one or more such
events in the past year.  Lifetime rates of post-traumatic stress
disorder (PTSD) have been found to vary for different types of
traumatic events (e.g., 57 percent following rape, 30 percent
following combat), and a recent study of a general population
(Detroit HMO) found a lifetime prevalence of 9.2 percent.
Individuals with PTSD are at increased risk for other psychiatric
disorders as well.

Although these selective findings highlight the public health
significance of interpersonal violence, many aspects of trauma and
violence have not been adequately studied.  Through this
announcement, studies are encouraged that will address critical gaps
in knowledge concerning the accurate measurement of the perpetration
of violence in various domains; the role of intrapersonal,
biological, family, peer, community, and cultural factors, and the
interaction of these factors in the initiation, escalation, and
cessation of violent behavior; the impact of these factors on the
response to violence and traumatic events; and the development and
evaluation of research-based prevention, treatment, and management
approaches that will provide more effective, humane, replicable, and
cost-effective intervention approaches.

The topics listed below are examples of studies that cut across all
of the areas of violence perpetration, victimization, and exposure to
trauma that are the focus of this program announcement.  The list is
not exhaustive; it is expected that additional important topics will
be identified by investigators who respond to this program
announcement.  Projects may focus on:

o  Studies of the incidence and prevalence of violent behavior and of
victimization experiences of all types

o  Studies of the etiological, risk, protective, and ameliorative
factors for violence perpetration and victimization of all types

o  Studies of the interactions among psychosocial and biological risk
factors that contribute to the occurrence of violent behavior, and
influence the course (escalation, persistence, and cessation) of
violent behavior (e.g., biological factors related to neurochemistry,
neuroendocrinology, and neuroimmunology, genetic vulnerabilities,
neural deficits and differences, exposure to neural toxins, poor
nutrition; fetal exposure to alcohol or drugs); factors related to
individual and social contexts, (e.g., personality traits, parental
child-rearing practices, poverty, racial discrimination, peer
influences); and individual life experiences, (e.g., exposure to
violence and other traumatic events as a victim and/or witness,
educational deficits, unemployment)

o  Studies of factors that ameliorate symptom severity or dysfunction
resulting from exposure to violence or traumatic events (e.g.,
individual strength and resilience factors, response of significant
others, social support, community and service sector response)

o  Studies of the relationships between developmental processes and
aggressive/violent behavior and of the impact of different types of
victimization on developmental processes in different age groups

o  Studies of the type and incidence of mental disorders resulting
from exposure to violence and traumatic events, including studies of
psychological or biological changes; also studies of the diagnosis,
assessment, and course of PTSD and other trauma-related disorders and
the appropriate threshold for clinical significance

o  Studies of psychosocial and psychobiological risk factors
associated with differential risk of negative effects in different
victim subgroups, as well as studies of psychosocial and
psychobiological parameters and processes that examine the mechanisms
by which interventions work, or help identify which subgroups of at
risk populations can benefit from particular interventions

o  Studies investigating the effects of violence within the community
(e.g., workplace violence, gang violence, hate crimes, cults, and

o  Development of nomenclature and classification schemes (e.g., DSM
categorical diagnoses, dimensional assessments) for describing types
of violent behavior, that can be useful in predicting, preventing,
treating, and managing different types of violent behavior and
response to violence and other traumatic events

o  Development of assessment and screening instruments to guide
treatment planning and management plans for perpetrators and victims
of violence and traumatic events

o  Intervention studies testing the efficacy and refinement of
individual, family, and/or community-level models and methods of
intervention for violent behaviors (e.g., pharmacological and other
medical procedures, psychosocial methods, family support and crisis
intervention programs, home visitation programs, psychiatric and
social service placements, mentoring programs, and community-based

o  Studies of the effectiveness of interventions for violence
perpetration or victimization in various social and community
settings, and the influence of social, institution, and community
settings on the availability of interventions, program participation,
and outcomes; use of different conceptual and intervention models
with various social and cultural groups

o  Development of innovative, effective, and ethical methods of
obtaining and maintaining the participation in research of
perpetrators and victims of violence and traumatic events

In addition to these cross-cutting objectives, other research
priorities specific to each at-risk population will be highlighted in
succeeding sections of this announcement.

Perpetrators of Interpersonal Violence

Within the area of perpetrator research, the scope of interpersonal
violence encompassed by this announcement includes child aggression
and anti-social behavior, youth delinquency and violence, adult
criminals with records of serious and chronic offending, spouse
batterers, sex offenders, including rapists and child molesters, and
hate crimes.  Studies have shown that child and youth conduct
problems account for one-third to one-half of all child and
adolescent clinical referrals.  Serious youth violence, especially
assaults and homicides, has shown dramatic increases in the last
decade, with the result that youth violence is a critical problem in
many communities.  Among African Americans, homicide is the leading
cause of death for adolescent and young adult males.  For both
adolescents and adults, a small number of perpetrators perform a
substantial proportion of the serious, often violent offenses, and a
significant proportion of all offenses.  Effective approaches for
these serious and chronic offenders thus has enormous potential for
reducing violence.

Intimacy and family membership are no bar to the perpetration of
interpersonal violence.  Self-report surveys have indicated that
approximately 1,500,000 children are physically abused each year,
700,000 are victims of sexual abuse, and hundreds of thousands of
women are severely beaten by their husbands or a significant male
intimate.  A recent national survey estimated that 22 percent or 21.7
million American women have been victims of rape or attempted rape
during their lifetime.  Two-thirds were assaulted before the age of
18.  While data on hate crimes have only recently begun to be
collected systematically, early reports indicate that this is a
growing and serious problem.

Through better scientific understanding of the factors associated
with those who commit interpersonal violence, NIMH hopes to reduce
the prevalence of such acts.  By enhancing the scientific knowledge
base, more effective interventions, treatment, and management models
can be developed and applied.  Through rigorous scientific
evaluations of policies, interventions, treatments, and management
programs, NIMH hopes to further contribute to a reduction of
interpersonal violence.

Because research has shown that the perpetration of interpersonal
violence usually involves several factors, including individual,
family, and community variables, investigators from a variety of
disciplines are encouraged to contribute to a scientifically sound
and comprehensive approach to the development of effective
interventions for interpersonal violence.  These disciplines include,
but are not limited to, psychology, psychiatry, biology,
anthropology, social work, and psychiatric nursing.  Variables of
major interest include (but are not limited to) individual variables
(e.g., behavioral, biological, and personality factors) and social
and relationship variables (involving elements within the family and
community, such as employment, poverty, and racism/sexism issues).
While investigations of the role of possible individual risk and
protective variables are encouraged, a multidisciplinary approach is
often indicated.

Similarly for intervention studies, while rigorous evaluations of the
effects of single variable interventions are encouraged, the role of
several variables in most interpersonal violence points to the need
for interventions that address several risk factors through a
multi-component intervention.

Listed below are examples of research topic areas within the
perpetration research area.  This list is illustrative, not
exhaustive; it is expected that additional important research topics
will be identified by researchers who respond to this program

o  Studies of risk and protective factors for various aggressive,
anti-social and violent behaviors, including intrapersonal,
biological, family, community, and other variables, their course,
incidence, and interactions.  Biological variables of interest
include central nervous system functioning; autonomic nervous system
functioning; the role of hormones; the impact of toxins such as lead,
fetal exposure to alcohol or drugs, and trace minerals; physical
trauma (e.g., head injuries) and diseases.  Social factors include
parenting practices, exposure to violence (as a victim and as a
witness), educational deficits, peer influences, the social network
of the community, and economic and employment variables

o  Studies of risk factors for acute episodes of violent behavior,
e.g., hormone variation, thought disorder, depression, pervasive
anger, or intoxication, that have potential for targeted preventive
interventions and long-term management programs

o  Studies of existing diagnostic schemes and development of new
reliable and valid schemes and methodologies for identifying
subgroups, with distinct implications for etiology, assessment,
diagnosis, prognosis, and intervention; extension of research
laboratory procedures for reliable and valid clinical use

o  Development of scientifically sound measures of individual,
family, community, and other factors, including the various forms of
aggressive, anti-social, and violent behaviors; development of
measures of relevant ethnic and cultural variables; modification of
existing measures for ethnic and cultural sensitivity and validity

o  Development of a brief and psychometrically robust measure of
psychopathy; extension of measurement of psychopathy to youth; more
precise determination of basic behavioral, biological, emotional, and
social aspects of psychopathy; and prevalence and course studies that
assess the role of other variables as they affect functioning and

o  Development and testing of innovative, effective, humane, and
cost-effective interventions, including pharmacological,
psychosocial, psychiatric, and social service-related approaches for
chronic offenders; community interventions to reduce violence, e.g.,
changes in the physical environment to facilitate monitoring of
public areas, increased recreational programs, job programs for the
unemployed.  (Because violence is multiply determined and resistant
to change, successful treatments are likely to be multi-phased and
intensive.  Accordingly, once the effectiveness of such an
intervention is demonstrated, research is needed to determine the
critical key components for cost-effective dissemination.)

o  Development and pilot testing of specific treatments (preferably
manual-based), including the development or modification of
interventions for appropriate use with different cultural and ethnic

o  Studies of preventive interventions to counteract or ameliorate
the contribution of violence in the media (television, movies, print,
video-game) to the development of violent behavior and related
attitudes, including desensitization to the adverse effects of

o  Studies of approaches for the effective dissemination and
utilization of assessment and intervention programs in clinical,
social service, community, and other settings.

Victims of Interpersonal Violence

Physical and sexual violence on children and adults can arise from
the direct experiencing or witnessing of such violence or,
indirectly, through the impact of violence on people significant in
the individual's life, e.g., loss of parent, child, or intimate
partner resulting from violence.  Much of such violence occurs in the
home; other violence occurs among friends, acquaintances, or from
strangers in the community.

Studies of the incidence and prevalence of physical and sexual
violence in the lives of children and adults have documented the
severity of the problem.  In 1992, State agencies reported
approximately 211,000 confirmed cases of child physical abuse and
128,000 cases of child sexual abuse.  At least 1,200 children died as
a result of child maltreatment.  The Second National Survey of Family
Violence estimated that, in 1985, at least four percent of couples
engaged in acts of physical aggression towards each other severe
enough to cause serious physical injury.  Surveys have shown that
from 20 to 30 percent of urban hospital emergency room visits by
women are the result of injuries received in domestic violence.
Spousal homicides comprised approximately 10 percent of the total
homicides in the United States in the past decade.  It has been
estimated that at least one in four women may experience a sexual
assault.  For children, an estimate is that about one in five females
and one in ten males may experience sexual molestation.

Recent studies of exposure to community violence indicate relatively
high percentages of direct and indirect exposure to assaults,
especially among children and adolescents in high-crime urban areas,
with significant impact on children's psychiatric symptomatology.
Moreover, these studies also indicate that the children and
adolescents who are victims of or witness violence in their
communities, also experience high rates of violence in their homes.
Approximately 10 percent of children will experience episodes of
bullying at their schools.  One study estimated that approximately 10
percent of sexual assaults that occurred at home were witnessed by

As the scope of America's violence problem has reached epidemic
proportions, its mental health impact on victims is equally severe.
Studies have indicated that children who are physically abused in
childhood display deficits in cognitive performance, peer social
relationships, and managing aggression and hostility as compared to
nonabused children.  Studies of the short-term consequences of sexual
abuse in clinically referred samples indicate a large number of
psychological symptoms, including depression, anxiety, and sexual
acting out, occurring acutely and then decreasing gradually over a
year period.  Recent research has reported high rates of PTSD in
children who have experienced severe violence, e.g., up to 50 percent
of children exposed to a playground sniper attack, and from 10
percent to 50 percent in sexually abused children.  As many as 80
percent of rape victims experience post-traumatic stress symptoms
after the assault, and one-third suffer chronic PTSD in the year
following the assault.

Moreover, the consequences of childhood violence may be such that
psychological disturbance might not be prominent at the age of
occurrence, but may affect functioning at later stages of
development, especially in adolescence when sexual and aggressive
issues become prominent, creating long-term adjustment problems for
individuals.  Clinic studies indicate that adults who have
experienced childhood abuse are over-represented in samples with
serious mental health symptomatology, such as substance abuse and
addiction, depression, suicide, and sexual dysfunction, and with such
psychiatric diagnoses as dissociative disorders, multiple personality
disorder, borderline personality disorder, somatic disorders, and
antisocial personality disorder.  Moreover, other non-clinical but
dysfunctional groups, such as violent criminals and prostitutes, have
high percentages of sexually or physically abused individuals.
Community surveys have indicated that women who report sexual abuse
in childhood have more psychiatric symptoms, greater severity of
symptomatology, and higher rates of utilization of mental health
services than do nonabused women.  Other studies indicate that
sexually abused women represent a relatively high percentage -- as
much as 25 percent -- of women seeking outpatient treatment and up to
one-half of women psychiatric inpatients, although sexual abuse
usually is not the presenting complaint for the latter.  In addition
to physical trauma resulting from acts of physical abuse, battered
women suffer mental health consequences from abusive experiences,
including higher levels of depression, drug and alcohol abuse,
suicide attempts, and low self-esteem.  Many of the mental health
consequences of spousal violence result from chronic intimidation and
fear, which are often as significant as the actual acts of physical

Witnessing spousal violence contributes to the cycle of violence
within families and outside the home.  Children in violent families
may learn aggression as a means of solving interpersonal problems and
as a response to stress and frustration.  Both the batterer and the
battered spouse can become role models for the child's later adult
relationships. Studies of battered women indicate that more than half
of battered women were also abused as children. In addition, there is
an increased likelihood of child abuse in homes where there has
already been spouse abuse.

Significant research progress has been made in studying the incidence
and prevalence, risk factors, characteristics and course, and
consequences of various forms of violent victimization.  However,
there are significant gaps in knowledge of each of these areas.  In
many areas of violent victimization only a few well-designed studies
exist, making generalizability of results tenuous.  Accordingly,
through this announcement, NIMH seeks to encourage investigator-
initiated research on the epidemiology of violence victimization;
characteristics and course of response to victimization; etiological,
risk, protective, and ameliorative factors for severe reactions to
traumatic violence; mental health and other consequences of exposure
to different types of violent victimization; and interventions to
prevent exposure to violence and to reverse, ameliorate, or
compensate for the short-term and long-term effects of exposure to
violence among victims. Studies may focus on the individual
experiences of victims of violence; the dynamics of the relationship
between perpetrator and victim; the relationship between victims and
others in the family or larger social system; or the larger social
contexts in which violence occurs and its impact on victims.

Listed below are examples of research projects that could advance
scientific knowledge on the effects of victimization.  The list is
not exhaustive, and it is expected that additional important research
topics may be identified by those who respond to the announcement.
Studies in these areas can include, but are not limited to:

o  Studies of the interactions among psychosocial and biological risk
factors that contribute to the individual's reaction to violence
victimization and that influence the short-term and long-term mental
health effects of violence exposure

o  Studies of specific traumatized populations (e.g., victims of
child sexual and physical abuse, witnesses to violence,
culturally/ethnically diverse samples, male victims, and victims of
hate crimes) to determine similarities and differences within and
across groups in terms of their rates of exposure to different types
of violence, their response to exposure to violence, and to examine
cumulative effects of exposure to multiple incidents, chronic, or
multiple types of violence

o  Studies of the impact of exposure to violence on individual
psychological, biological, and psychosocial development and progress
during infancy, childhood, adolescence, or adulthood, and on the
development and persistence of psychiatric symptoms, distress, and
dysfunctional behaviors

o  Development of more adequate instruments or procedures to assess
psychological, biological, and psychosocial consequences of exposure
to physical and sexual violence, including co-morbidity of types of

o  Development of identification and assessment approaches for
individuals likely to experience acute trauma reactions versus
chronic disorders (e.g., PTSD, depression, anxiety, substance abuse)
resulting from exposure to violence

o  Development and testing of intervention models at the individual,
family, group, and community levels, to reduce exposure to violence
and to treat the short-term and chronic effects of exposure to

o  Development of measurement instruments and procedures to assess
more adequately the consequences of violent victimization,
characteristics of victims correlated with their response to
victimization, and response of victims to interventions

Victims of Traumatic Events

Studies of traumatic stress in general and PTSD in particular have
assumed a heightened importance in recent years, attributable to the
frequency of psychiatric sequelae resulting from exposure to
traumatic events.  Events associated with the growing numbers of
natural and technological disasters in the United States and the
rising national and international rates of trauma associated with war
underscore the importance of the problem.  NIMH expects to support
research designed to promote an understanding of victims'
psychological responses to traumatic events, as well as to encourage
the development of interventions to assist victims with mental health
problems resulting from this exposure.

Traumatic events whose effects are the focus of this announcement
include mass violence (e.g., war, terrorism, forced relocation),
natural disaster (e.g., flood, earthquake, hurricanes), human-made
hazards (e.g., toxic spill, dam break, explosion), transportation
accidents (e.g., air crash, train crash, automobile collision), and
other individual and collective traumatic events.  Studies focusing
on the measurement and diagnosis of PTSD are also a focus of this

Research supported in this program includes studies of the immediate
and long-term psychopathological and stress reactions in victims,
families, service workers, and community members; individual
(behavioral, biological, personality) and environmental risk factors
associated with the development and perpetuation of mental and
physical disorders; informal support networks and coping mechanisms
as mediators of traumatic stress; and design, implementation, and
effectiveness of formal intervention programs to prevent and treat
mental health problems.

Listed below are examples of research projects that could advance
scientific knowledge on the effects of exposure to traumatic events.
The list is not exhaustive, and it is expected that additional
important research topics may be identified by those who respond to
the announcement.  Some applications may address more than one of
these topics in the same study.

o  Studies of the type and incidence of mental disorders resulting
from exposure to traumatic events; also studies of the diagnosis,
assessment, and course of PTSD and other trauma-related disorders,
and the appropriate threshold for clinical significance

o  Studies of changes in life functioning and other early behavioral
problems following exposure to traumatic events which may or may not
lead to a mental disorder in victims

o  Studies of psychosocial and psychobiological risk factors
associated with differential risk of negative effects in different
victim subgroups

o  Studies of environmental risk factors associated with collective
emergencies, such as community and agency response, origin, duration,
severity and type of emergency event, threat or potential for

o  Studies of both short-term crisis intervention and long- term
mental health treatment for male and female victims of all ages and
racial and ethnic groups

o  Studies evaluating mental health treatment modes designed to avoid
burnout or other psychological disturbance among human service
personnel working under conditions of extreme stress

o  Studies of social support systems and coping mechanisms as
mediators of psychological response to traumatic events

o  Studies of community programs for reducing or ameliorating
emotional trauma and long-term consequences of traumatic events

o  Research on methodologies and/or techniques required to advance
research in the understanding of the effects of exposure to traumatic

Research Plan

Proposed studies should be based on a strong conceptual framework,
drawing on existing literature and relevant theory, for both the
selection of the research components and the specific research
hypotheses.  The design should include control or comparison groups
as needed, and the data should be collected, analyzed, and
interpreted in such a manner that scientifically valid inferences
about the research results can be drawn.  In addition, it is
suggested that the following considerations be addressed in the
preparation of an application:

o  Applicants are encouraged to propose the most rigorous research
design possible as appropriate to the proposed study.  For example,
in instances where the study question lends itself to a controlled
design, a controlled design should be used.

o  The selection of each component of the study (including its
timing, duration, and strength) should reflect existing research
findings, but may also include new components which focus on
variables identified in basic studies as important to the progression
of aggressive behaviors or traumatic stress responses.  A variety of
models may be proposed.

o  Applicants proposing intervention studies are encouraged to offer
a standardized intervention package, including the development of
manuals that clearly describe the content and procedures for all
intervention components, so as to permit reliable implementation and
potential replication.

o  Feasibility issues should be clearly addressed.  Plans for
implementation of the research should include procedures for
obtaining and maintaining the necessary community relations, training
and supervising project staff, insuring implementation fidelity,
securing ongoing access to the subject population pool, recruiting a
representative sample of the target population, recruiting minorities
for the staff of the research intervention, and monitoring subject
participation over time.

o  Applicants are encouraged to document the commitment, support,
cooperation, and nature of proposed collaboration of community
agencies or other entities or settings outside the applicant
organization whose support is essential for the conduct of the
research.  For example, a university- based project could demonstrate
a working relationship with existing community service projects which
provide services to other high-risk populations.

o  In response to the recommendations of the DHHS Secretary's Blue
Ribbon Panel on Violence Prevention, all applicants are strongly
encouraged to include a representative community and scientific
advisory panel in their applications to assist them during all phases
of the project, including the development of the application itself.
Special attention should be directed toward the unique needs and
special concerns of racial and ethnic minority group members and
females, so that services and opportunities are appropriate and
acceptable to these individuals (where feasible and appropriate to
the study question).

Community Involvement

In violence and traumatic stress research conducted in communities,
the community itself may be an important source of innovative ideas
for addressing sensitive social problems.  Researchers should have
the cooperation and participation of those who are the focus of their
work. Working with a researcher or a community service agency that is
viewed as an integral part of the community, and is well- respected
in the community, may greatly enhance the quality of the research
study.  Opinions differ about how communities can most appropriately
contribute to a research study.  Community representatives may be
given a voice in choosing research topics, collecting data, or
interpreting results, among other possibilities.  Community input may
be most meaningful if it is built into the research process from the
beginning.  Basing the research project in the community being
studied is a positive first step.


It is the policy of the NIH that women and members of minority groups
and their subpopulations must be included in all NIH supported
biomedical and behavioral research projects involving human subjects,
unless a clear and compelling rationale and justification is provided
that inclusion is inappropriate with respect to the health of the
subjects or the purpose of the research.  This new policy results
from the NIH Revitalization Act of 1993 (Section 492B of Public Law
103-43) and supersedes and strengthens the previous policies
(Concerning the Inclusion of Women in Study Populations, and
Concerning the Inclusion of Minorities in Study Populations), which
have been in effect since 1990.  The new policy contains some
provisions that are substantially different from the 1990 policies.

All investigators proposing research involving human subjects should
read the "NIH Guidelines for Inclusion of Women and Minorities as
Subjects in Clinical Research," which have been published in the
Federal Register of March 28, 1994 (FR 59 14508-14513) and reprinted
in the NIH Guide for Grants and Contracts, Volume 23, Number 11,
March 18, 1994.

Investigators also may obtain copies of the policy from the program
staff listed under INQUIRIES.  Program staff may also provide
additional relevant information concerning the policy.


Applications are to be submitted on the grant application form PHS
398 (rev. 9/91) and will be accepted at the standard application
deadlines as indicated in the application kit.  Application kits are
available at most institutional offices of sponsored research and may
be obtained from the Office of Grants Information, Division of
Research Grants, National Institutes of Health, 6701 Rockledge Drive,
Room 3032, MSC 7762, Bethesda, MD 20892-7762, telephone 301/435-0715.
The title and number of the program announcement must be typed in
Section 2a on the face page of the application.

Applications for the FIRST award (R29) are instructed to include at
least three sealed letters of reference attached to the face page of
the original application.  FIRST award (R29) applications submitted
without the required number of reference letters will be considered
incomplete and will be returned without review.

If an IRPG is proposed, each application should be identified along
with the number of the PA and the phrase "Investigator-initiated
IRPG."  All R01 or R29 applications constituting the proposed IRPG
cohort must be submitted in a single package, whether or not the
applications arise from the same institutions.  For detailed
instructions for preparation and submission of IRPG applications,
refer to PA-94-086, NIH Guide for Grants and Contracts, Volume 23,
Number 28, July 29, 1994.

Applicants for the RAPID award are strongly encouraged to contact
program staff following the acute traumatic event to be investigated;
each application must be identified along with the number of the PA
and the phrase "NIMH Expedited Review."  Submission dates are linked
to the date of the event and other circumstances surrounding the
proposed study.  For detailed instructions for preparation and
submission of a RAPID application, refer to PA-91-04, NIH Guide for
Grants and Contracts, September, 1990.

The completed original application and five legible copies must be
sent or delivered to:

BETHESDA, MD 20892-7710
BETHESDA, MD 20817 (for courier/overnight service)


Applications that are complete and responsive to the program
announcement will be evaluated for scientific and technical merit by
an appropriate peer review group convened in accordance with the
standard NIH peer review procedures. Incomplete and/or non-responsive
applications will be returned to sender without review.  As part of
the initial merit review, all applications will receive a written
critique and undergo a process in which only those applications
deemed to have the highest scientific merit, generally the top half
of applications under review, will be discussed, assigned a priority
score, and receive a second level review by the appropriate national
advisory council or board, when applicable.

Review Criteria:

o  scientific, technical, or mental health significance and
originality of the proposed research;

o  appropriateness and adequacy of the experimental approach and
methodology proposed to carry out the research;

o  qualifications and research experience of the Principal
Investigator and staff, particularly, but not exclusively in the area
of the proposed research;

o  availability of the resources necessary to perform the research;

o  appropriateness of the proposed budget and duration in relation to
the proposed research;

o  adequacy of plans to include both genders and minorities and their
subgroups as appropriate for the scientific goals of the research.
Plans for the recruitment and retention of subjects will also be

The initial review group will also examine the provisions for the
protection of human and animal subjects and the safety of the
research environment.

The review criteria for other grant mechanisms vary and potential
applicants should obtain copies of the Program Announcements that
describe those mechanisms from the address listed under INQUIRIES.


Applications will compete for available funds with all other approved
applications.  The following will be considered in making funding
decisions:  Quality of the proposed project as determined by peer
review, availability of funds, and program priority.


Inquiries are encouraged.  The opportunity to clarify any issues or
questions from potential applicants is welcome.

Direct inquiries regarding programmatic issues to:

Susan Solomon, Ph.D.
Violence and Traumatic Stress Research Branch
5600 Fishers Lane, Room 10C-24
Rockville, MD  20857
Telephone:  (301) 443-3728
FAX:  (301) 443-1726
Email:  Susan_Solomon@nih.gov)

Program Officials for specific research areas:

James Breiling, Ph.D.
Perpetrator Research: Youth Aggression (prevention, risk factors,
Community Violence (perpetrators)
Email: James_Breiling@nih.gov

Malcolm Gordon, Ph.D.
Victims of Interpersonal Violence: Family Violence, Child Abuse,
Community Violence (victims)
Email:  Malcolm_Gordon@nih.gov

Ellen Gerrity, Ph.D.
Victims of Traumatic Events: Natural and Technological Disasters,
Veteran and War-related Research; Rape and Sexual Assault;
Post-Traumatic Stress Disorder
Email: Ellen_Gerrity@nih.gov

Direct inquiries regarding fiscal matters to:

Diana S. Trunnell
Grants Management Branch
National Institute of Mental Health
Parklawn Building, Room 7C-08
Rockville, MD  20857
Telephone:  (301) 443-3065
FAX:  (301) 443-6885
Email:  Diana_Trunnell@nih.gov


These programs are described in the Catalog of Federal Domestic
Assistance No. 93.242.  Awards are made under authorization of the
Public Health Service Act, Title IV, Part A (Public Law 78-410, as
amended by Public Law 99-158, 42 USC 241 and 285) and administered
under PHS grants policies and Federal Regulations 42 CFR 52 and 45
CFR Part 74.  This program is not subject to the intergovernmental
review requirements of Executive Order 12372 or Health Systems Agency
review.  Awards will be administered under PHS grants policy as
stated in the Public Health Service Grants Policy Statement (April 1,

The PHS strongly encourages all grant and contract recipients to
provide a smoke-free workplace and promote the non-use of all tobacco
products.  In addition, Public Law 103-227, the Pro-Children Act of
1994, prohibits smoking in certain facilities (or in some cases, any
portion of a facility) in which regular or routing education,
library, day care, health care or early childhood development
services are provided to children.  This is consistent with the PHS
mission to protect and advance the physical and mental health of the
american people.


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