“We find that children who were involved in child welfare services are at high risk of adult crimes, but once we accounted for childhood socioeconomic status and later marital status and education, many of those effects went away,” said co-author Todd Herrenkohl, an investigator at the , part of the UW’s School of Social Work.

“So the causal relationship isn’t necessarily there in our data.”

In other words, child abuse and neglect don’t always set up children for a life of crime.

The paper was recently published in the .

The data come from the Lehigh Longitudinal Study, which began in the mid-1970s. Participants were recruited from child welfare abuse and protective service programs, as well as daycares, private nursery programs and Head Start classrooms. Children came from diverse economic backgrounds.

As adults, participants were asked about 29 kinds of criminal offenses ranging in seriousness, including fighting, involvement with gangs, forcing sexual relations, theft and dealing drugs.

In this study of 357 adults, 79 percent who had been maltreated as children reported committing at least one crime in their lifetime, compared with 66 percent of children who had not been maltreated. About 46 percent of the maltreatment group had been arrested at some point, compared with 30 percent in the comparison group.

Lead author Hyunzee Jung, a 91̽»¨research scientist, said researchers were not surprised to find a link between officially recorded child maltreatment and later crime. But what was surprising was that that link faded after they took into account other variables: socioeconomic status, gender, race, marital status, age and education. Poverty especially is a major predictor of crime and incarceration. The data lead researchers to believe it’s a combination of factors, not just maltreatment, which leads to later involvement in crime.

The researchers found that graduating from high school or earning a GED and being married were protective factors that reduced a child maltreatment victim’s later involvement with crime. A high school diploma reduced the odds of arrest by 53 percent and odds of incarceration by 66 percent. Being married lowered the odds of crime within the past year by 40 percent and the odds of ever being convicted of a crime by 58 percent. Those who had been convicted of crimes were convicted fewer times if they were married.

“These later life experiences – graduating high school, getting married – can still have a very profound effect on an individual’s life,” Herrenkohl said. “Many individuals, through their own determination and the support of others, find a way to move beyond adverse experiences and appear to go on to lead productive lives.”

He said being married appears to be a consistent protective factor for a variety of outcomes, demonstrating the potential for strong, committed relationships to change lives for the better.

“It’s an indication of the power of positive relationships, of positive bonding,” he said. “We all benefit from having individuals in our lives who can provide us with guidance and support. These results show that strong adult relationships can make a difference for those who were not treated well as children.”

Co-authors are and at the 91̽»¨ and at the University of Montana. The study was funded by the National Institute of Child Health and Human Development and the National Institute of Justice.

Researchers at the 91̽»¨, Boston Children’s Hospital, Harvard Medical School and Boston University collaborated on a unique opportunity to study whether patterns of brain activity predict teenagers’ response to a terrorist attack.

The team had already performed brain scans on Boston-area adolescents for a study on childhood trauma. Then in April 2013 two bombs went off at the finish line of the Boston Marathon, killing three people and injuring hundreds more. Even people who were nowhere near the bombing reported distress about the attack and the days-long manhunt for the suspects.

So, one month after the attack, , then at Boston Children’s Hospital and Harvard Medical School and now an assistant professor of psychology at the UW; co-author Margaret Sheridan, of Boston Children’s Hospital and Harvard Medical School; and their fellow researchers sent online surveys to teenagers who had previously participated in studies to assess PTSD symptoms related to the attack.

By using functional Magnetic Resonance Imaging scans from before the attack and survey data from after, the researchers found that heightened amygdala reaction to negative emotional stimuli was a risk factor for later developing symptoms of PTSD.

The was published July 3 in the journal Depression and Anxiety.

“The amygdala responds to both negative and positive stimuli, but it’s particularly attuned to identifying potential threats in the environment,” said McLaughlin, the study’s first author. “In the current study of adolescents the more their amygdala responded to negative images, the more likely they were to have symptoms of PTSD following the terrorist attacks.”

The brain scans were conducted during the year prior to the bombing. At that time, the teens were evaluated for their responses to emotional stimuli by viewing neutral and negative images. Neutral images included items such as a chair or button. Negative images showed people who were sad, fighting or threatening someone else. Participants rated the degree of emotion they felt while looking at each image. The MRIs measured whether blood flow increased to the amygdala and the hippocampus when viewing negative images as compared to neutral images.

In the follow-up survey the teens were asked whether they were at the finish line during the bombing, how much media exposure they had after the attack, whether they were part of the lockdown at home or school while authorities searched for the suspects, and how their parents responded to the incident. They also were asked about specific PTSD symptoms, such as how often they had trouble concentrating and whether they kept thinking about the bombing when they tried not to.

Researchers found a significant association between amygdala activation while viewing negative images and whether the teens developed PTSD symptoms after the bombing.

McLaughlin said a number of previous studies have shown that people with PTSD had heightened amygdala responses to negative emotions, but researchers didn’t know whether that came before or after the trauma.

“It’s often really difficult to collect neurobiological markers before a traumatic event has occurred,” she said. By scanning the adolescents’ brains before the bombing, she and her fellow researchers were able to show that “amygdala reactivity before a traumatic event predicts your response to that traumatic event.”

While two-thirds of Americans will be exposed to some kind of traumatic event during their lifetime, most, fortunately, will not develop PTSD.

“The more we understand the underlying neurobiological systems that shape reactions to traumatic events, the closer we move to understanding a person’s increased vulnerability to them,” McLaughlin said. “That could help us develop early interventions to help people who might develop PTSD later.”

Other co-authors are Andrea Duys, of UW; Daniel Busso and Sonia Alves at Harvard; and Jennifer Greif Green at Boston University. The research was funded by the National Institutes of Health.

# # #

For more information, contact McLaughlin at mclaughk@uw.edu or 206-616-7863. To reach Sheridan, contact Meghan Weber at 617-919-3656 or meghan.weber@childrens.harvard.edu.

NIH grants: K01-MH092526 and K01-MH092555.

Link to research study: http://onlinelibrary.wiley.com/doi/10.1002/da.22284/abstract

91̽»¨ researchers studied , a collaborative effort to dramatically improve student achievement in seven school districts in South Seattle and South King County. In their after a yearlong study of the initiative, they found that students were most successful when schools and communities found creative and culturally responsive ways of engaging parents.

“The Road Map Project was very clear that parent-community engagement was one of the key mechanisms for achieving its 2020 goal, to double the number of young people who are on track to college and career and to close the opportunity gap,” said , assistant professor in the and co-author of the report.

The 91̽»¨is also one of many community partners of the project.

The idea of The Road Map Project is to go beyond traditional involvement such as parent-teacher conferences and associations and school open houses to offer parents more relevant ways to help their children succeed.

“We know from decades of research that it makes a difference when parents are involved in their child’s education,” Ishimaru said. “It helps not only students’ test scores, but also their behavior in school, attendance, the coursework they take. They are involved in higher-level programs and they’re more likely to graduate. Our study suggests promising ways to create more meaningful opportunities for family participation, especially in a region of such dramatic cultural and linguistic diversity.”

Districts in the project are Auburn, Federal Way, Highline, Kent, Renton, Seattle (only South Seattle schools) and Tukwila. Of the 119,000 students in that region, 66 percent are students of color, 58 percent come from low-income families and 167 different primary languages are spoken. Ishimaru and colleagues studied two of those districts – Federal Way and Kent – plus a community effort called White Center Promise Initiative.

Each Road Map Project entity is engaging parents in different ways. Federal Way uses family liaisons to help parents cultivate good relationships with school staff, and parents are given a “menu” of choices about how to be involved, from using specific tutorials at home to observing school board meetings or participating in leadership training.

Kent uses parent facilitators in different languages to teach a nine-week evening , which helps parents learn how to best advocate for their child and create educational partnerships with teachers and staff.

is a long-term effort to eradicate poverty by involving families in the services and support they need through schools and community organizations, and to help students graduate and go on to living-wage careers.

The 91̽»¨report shows one of the most effective strategies across school districts is to listen to parents to find out their concerns, priorities and expertise, and to do it in their own language. For instance, Federal Way Schools hosts workshops that allow parents to speak in their native language while the director of the district’s Family and Community Partnerships Office hears real-time translation through a headset. Those workshops, part of the district’s Parent Leadership Institute, also allow parents to share concerns and ideas with each other.

“Sometimes parents can’t speak English and schools don’t even think to plan for that,” Ishimaru said. “But more broadly, the problem is whether parents feel like they belong or are welcome. When schools only have traditional activities, like joining the PTA or giving money to a fundraiser, that’s telling parents there’s only one way to interact with the school.”

Ishimaru said it’s important for schools to be culturally responsive and use “cultural brokers.” Those are parents or others in the community who are usually bicultural and bilingual, and can guide immigrant and other non-English-speaking parents through the world of American public schools. They also can help educators better understand multi-cultural families and communities.

“These cultural brokers exist in every school and every community,” Ishimaru said. “At one school we found it was the woman who worked in the cafeteria. There was no family liaison at the school but everyone knew to just walk into the lunchroom and she would tell them what was going on.”

Ishimaru said the three sites they studied continue to refine their approaches to parent engagement. The Kent School District is now moving beyond the copyrighted California parent-engagement curriculum it bought to engage parents in developing its own curriculum, which adds components to help students develop a positive racial identity and better deal with bullying. Kent would then be able to share its curriculum with the rest of The Road Map region.

The report was co-authored by and a team of doctoral students in the 91̽»¨College of Education.

Ìý###

For more information, contact Ishimaru at 206-543-9840 or aishi@uw.edu, or Lott at 206-685-9204 or jlott1@uw.edu.

The 91̽»¨competed against 14 other teams from the U.S. and two from Canada in the three-year competition, sponsored by the U.S. Department of Energy and General Motors Co. Teams spent the first year designing their car, the second year implementing the designs, and the third year refining those designs and testing the car on a variety of benchmarks.

“This was a big surprise because this is our first time doing an advanced vehicle competition,” said Kate Kitto, the team’s communications manager, who is a rising sophomore in communications. “Ohio State, which won, has been doing this kind of thing for 30 years, and we’ve been doing it for only three years, so we were really happy to get second place. We’re just building the foundation for the program.”

The 91̽»¨team’s Malibu has a biodiesel engine that powers the front wheels, while the back end’s 250-horsepower electric motor uses a 400-pound battery pack. The car can travel 48 miles on one electric charge before switching to the biodiesel engine.

The vehicle design is called Parallel-Through-the-Road Plug-in Hybrid, which means the front and back wheels are not connected through a drive train. “Hypothetically, if you cut the car in half the front could operate itself and the back could operate itself,” Kitto said.

Team members spent a week in Detroit testing out their car at GM’s Milford Proving Ground, then traveled to Washington, D.C., to give technical presentations to panels of judges.

In addition to second place overall, the team won another nine awards, including best 0-60 mph time (6.95 seconds), lowest greenhouse gas emissions and lowest energy consumption.

The 91̽»¨team has about 40 to 50 team members, majoring in engineering, business, communications and graphic design.

The team received $25,000 in seed money from the competition organizers, which the UW’s Department of Mechanical Engineering matched. With additional money from donors and thousands of hours of labor, Kitto said, the team estimates the Chevy Malibu has cost about $800,000 to develop.

“They give you three years to build a hybrid car while we’re all going to school and working and doing other things,” Kitto said. “A lot of the engineers this spring were working 70 to 80 hours a week on the car in addition to going to school. We’re really proud of the car we built.”

The team has been selected to participate in , which begins in the fall and requires reworking a Chevrolet Camaro. That competition will last four years to give teams more time to work on implementation and testing.

###

For more information, or to join the team for EcoCAR 3, contact Kitto at kkitto3@gmail.com. More photos are available on the team’s .

In his new book, “,” 91̽»¨ sociologist takes on the popular notion that the unemployed are more likely to commit crimes. A former juvenile probation officer and parole agent, Crutchfield explains the nuanced links between work, unemployment and crime.

Q. You write that the stratification of labor contributes significantly to a person’s lifestyle and whether or not they commit crimes. Can you explain?

A. When someone has a low-end job (what some scholars refer to as secondary sector jobs), such jobs don’t pay well, and have few or no benefits and limited prospects for the future. Young adults in that situation may feel like they don’t have to conform to society’s expectations, and are at risk of getting involved in crime because they are likely to spend time with similar young men. People with good jobs, what some scholars call primary sector jobs, by contrast have something to lose if they do not constrain their own lifestyles. So they spend less time in situations where crime might occur. The stratification of labor that I write about is the structuring of the labor market into primary sector (good) jobs and secondary sector (bad) jobs.

Q. Explain your contention that rejecting a so-called “slave job” – one with low wages, little future and no respect – doesn’t mean someone is unwilling to work.

A. All the evidence indicates that most people who are out of work will accept work that is offered to them. So it’s not true to say that people won’t take a “slave job” because they’re holding out for something better. People who reject a “slave job” are willing to work, but they want work that will give them a livable wage and allows them some dignity. That dignity comes from working hard and being reasonably and fairly compensated for that work.

Q. You say the general public unquestionably accepts the idea that a poor economy will lead to more crime, but that’s not always the case. Can you give some examples?

A. Well, during the Great Depression, some types of crime rates went up, like burglary, but others went down, like homicides. More recently, during the Great Recession that began in 2008, the decline in crime rates that has been going on since the 1990s has continued, even though the overall unemployment rate in the U.S. was in double digits for a time and hovered at high levels (7 to 9 percent) for several years. What happened during that time was that the overall crime rate declined (contrary to popular expectations), but in pockets within some cities there appears to have been less of a crime decline and in some other places, actual increases in offenses.

Q. When it comes to jobs and crime, what are the differences between urban and rural areas?

A. We know that there are far fewer employment options available in rural areas, but at this point the evidence is limited about what effect that has on crime and delinquency rates. And, in rural areas, without the concentration of poverty and disadvantage that exist in urban areas the negative effect of being unemployed or being in a bad job or being poor do not appear to be amplified the way it appears to be in urban disadvantaged settings.

Q. So, where do we go from here?

A. Too many of the jobs that are being created in recent years are low-end, secondary sector jobs. This does not bode well for the future. The $15 minimum wage is one promising way to improve the quality of jobs, but it raises a lot of unanswered questions. Other ways to improve the job sector for everyone includes improving benefits (paid health care, sick leave and vacation), as well as job security and opportunities for advancement. We need to take seriously efforts to reverse the trend of increasing income inequality in the U.S. It is bad for individuals, bad for communities, and likely bad for the country and the U.S. economy.

# # #

“When winter temperatures fluctuate between being cold and warm enough for growth, plants deplete their resources trying to photosynthesize and end the winter with fewer reserves than they initially had. In the summer they have to play catch up,” said , a 91̽»¨ postdoctoral researcher in biology and applied mathematics. She is lead author of a on the subject recently published in PLOS One.

The roots are especially sensitive to temperature fluctuations, Harsch said. Warming winters result in higher root respiration, which uses up carbon reserves as plants make and release oxygen, leading to less carbon available during the regular growing season.

Harsch and her colleagues studied two species of shrubs on Campbell Island, an uninhabited UNESCO World Heritage site in the southwest Pacific Ocean about 375 miles south of New Zealand’s mainland. They studied two large shrubs, Dracophyllum longifolium and Dracophyllum scoparium, which are evergreen broadleaf species that can grow up to about 15 feet tall and live up to 240 years.

Researchers found that while warmer, drier winters helped seedlings get established, it adversely affected growth of older plants.

“For growth to occur you need sufficient precipitation and temperature and nutrients. Growth should only happen during the summer on Campbell Island when temperatures are above 5 degrees Celsius,” Harsch said. Five degrees C is about 40 F. “On Campbell Island most winters are cool and below this 5 degrees Celsius, so the plants are not active. The plants we studied are evergreen and there is little snow cover, so they are sensitive to changes in temperature.”

In this study, researchers cut out discs, called “cookies,” from just above the shrubs’ root collar, and measured the width between each ring to determine growth. They found that plant growth decreased as winter temperatures went up.

“On Campbell Island the snow is ephemeral, so the plants usually are not covered,” Harsch said. “If we’re going to see an effect in changing winter conditions, we’re going to see it at Campbell Island decades before we see it at, say, Mt. Rainier, where there is a lot of snow and winters are colder.”

Harsch said plants in areas like Campbell Island may eventually adjust to warmer winters, but the transition period will be tough as temperatures bounce above and below what plants need to stay dormant, causing the plants to draw down their resources.

“It may eventually be warm enough in the winters so that plants can photosynthesize and grow year round, like they do in the tropics,” she said. “It’s this transition part that plants are not adapted for.”

Harsch plans to do a follow-up study that would measure the microbes and carbon reserves in the soil, and manipulate snow packs to see how it affects establishment and growth.

“How much of this can our tree species withstand?” Harsch said. “Will summer growth eventually compensate for these hard winters, or is this some sort of extra stressor on trees that will be one more nail in the coffin? If you think of all the different factors of increasing vulnerability in climate change, is this really significant? We just don’t know.”

Co-authors are and at Landcare Research in New Zealand. Harsch started the work while pursuing her doctorate at Lincoln University in New Zealand and finished the analysis at the UW. The work was supported in part by the National Science Foundation.

# # #

For more information, contact Harsch at harsch.melanie@gmail.com or 253-365-1555.

NSF grant: DEB-1103734.

“We can produce discrimination without having any intent to discriminate or any dislike for those who end up being disadvantaged by our behavior,” said 91̽»¨ psychologist , who co-authored the review with of the University of California, Santa Cruz.

Greenwald and Pettigrew reviewed experiments and survey methods from published scientific research on discrimination from the last five decades. They were surprised to find that the discrimination observed in those studies occurred much more often as helping rather than harming someone. But they also found that most researchers defined discrimination as based on negative attitudes and hostility, only rarely treating favoritism as a component of discrimination.

That makes sense, Greenwald said, because most people think of discrimination as the result of hostility: a white person spouting anti-black rhetoric, or a homophobe yelling slurs at a gay couple. But, he argues, it’s more subtle acts, ones people don’t even recognize as causing disadvantage to anyone, that are likely to be much more significant.

Take this hypothetical scenario: When conducting reviews of two employees, a manager finds they both fall between two performance categories. The manager gives a higher category to the employee whose child is friends with the manager’s child, leading to a promotion and salary raise, while the other employee receives a smaller raise and no promotion.

Was the manager consciously discriminating against the second employee? Or did she simply give a boost to someone to whom she had an “ingroup” connection?

“Your ‘ingroup’ involves people that you feel comfortable with, people you identify with,” Greenwald explained. “We usually think first of demographic characteristics like age, race, sex, religion and ethnicity as establishing an ingroup, but there are also ingroups based on occupation, neighborhood and schools attended, among other things. Outgroups are those with whom you don’t identify.”

Greenwald and Pettigrew propose that unequal treatment in the form of doing favors for those like you, rather than inflicting harm on those unlike you, causes the majority of discrimination in the U.S.

“This is not to say that prejudice and hostility are not related to outgroup discrimination,” Pettigrew said. “But they are not as central to most discrimination as ingroup favoritism.”

Yet, historically, social scientists have emphasized prejudicial hostility as the root of discrimination.

“We looked at how prejudice has been defined in the history of psychology. It has generally been understood as hostility toward outgroups. That’s easy to do, because inter-group conflict is an obvious fact of life,” Greenwald said. “There are international conflicts, wars, gang battles, labor-management conflicts. When such conflicts are going on it’s natural to think of them as rooted in hostility.”

Greenwald hopes researchers will change how they study discrimination, because research results have substantial implications both for how discrimination is identified and how it can be ameliorated in employment, health care, education and daily life.

He said overt acts of discrimination began to decline starting in the 1960s following civil rights laws. But prejudicial attitudes didn’t necessarily change. What changed is that people were no longer legally allowed to act on their prejudices by, for example, denying housing to blacks or jobs to women.

The co-authors say that racial ingroup favoritism can be very subtle. For instance, if you work in an office that is mostly white and you’re asked to recommend someone for a job opening, you’re more likely to recommend someone who is like you and the rest of your ingroup.

This sort of ingroup favoritism happens at all ages and in different situations. Greenwald said it can happen on the playground, where children may exhibit ingroup favoritism based on race, economic class, or the same school or sports team.

“Hostility isn’t integral to the definition of discrimination; you can treat people differently without being hostile to anyone,” Greenwald said. “But it is societally important to understand how discrimination can occur both without hostility and without any intent to discriminate.”

# # #

For more information, contact Greenwald at agg@uw.edu or 206-543-7227, or Pettigrew at pettigr@ucsc.edu or 831-425-4777.

Note to media: For a PDF of the American Psychologist article, please contact Doree Armstrong, 91̽»¨News Office, at doreea@uw.edu or 206-543-2580.

The will be published in the July 2014 issue of Addictive Behaviors, but is already online.

Synthetic marijuana, sometimes called “Spice,” is made with shredded plant material coated with chemicals that are designed to mimic THC, the psychoactive compound found naturally in marijuana. The U.S. Drug Enforcement Administration has listed several of synthetic marijuana’s main compounds as Schedule 1 substances, making them illegal. But producers of the drug keep synthesizing new compounds to try to get around those bans.

“Because the formulation is constantly changing, one batch could be innocuous while the next batch affects you totally differently and you land in the hospital with seizures,” said , project director for the 91̽»¨study and a research coordinator in social work. “So the health effects are very unpredictable.”

Those health effects have not been widely studied yet, but emergency rooms have reported seizures, nausea, vomiting, and cardiovascular and respiratory problems. Psychological effects of using synthetic marijuana can include anxiety, confusion, agitation, irritability, depression and memory issues.

The U.S. military has banned synthetic marijuana in all branches of the service.

Participants in the 91̽»¨study came from the Department of Defense-funded , a telephone-based intervention trial for Army personnel with untreated substance use issues who are ambivalent about making changes or engaging in treatment. All participants were stationed at Joint Base Lewis-McChord in Washington state at some point during the 2011-2014 recruitment period.

Nearly one-third said they had used illicit substances within the previous 90 days; 38 percent of those used synthetic marijuana, twice as many as had used regular marijuana.

Study participants told researchers they believed that use of synthetic marijuana was significantly higher in the military than in the civilian population. It was the only substance that soldiers believed they used more than civilians, which supports the idea that synthetic marijuana is particularly attractive to military personnel, the researchers said.

“What we think other people do tends to be important in prevention efforts and intervention efforts,” said , lead author of the study and a 91̽»¨research associate professor of social work. “If soldiers think it’s common for military personnel to use Spice, then they might think it’s OK to use it.”

Walker said soldiers tend to avoid treatment for substance abuse issues because seeking treatment automatically goes on their record.

“Who would sign up for that in the civilian population if your boss and your coworkers will immediately know?” Walker said.

The Warrior Check-Up is not considered treatment, and participation is strictly confidential.

Users of synthetic marijuana were younger and less educated than those who were dependent only on alcohol. They were more likely to be single and earned less money than those who were dependent on other drugs or alcohol. But there were no differences in ethnicity, race, deployment history or religion. Researchers also found that synthetic marijuana users were two-and-a-half times more likely to develop drug dependence than those who used other drugs (but not alcohol).

The majority of participants believed their use of synthetic marijuana resulted in failing to meet obligations, such as being late for work, doing their job poorly, or not handling home and child care responsibilities well.

One hazard of using synthetic marijuana was needing more and more to get the same effect, a hallmark of drug dependence. More than three-quarters of users reported using it for much longer than intended (i.e., planning to take just a few puffs after work, but then smoking it for hours).

Walker said there are many reasons why someone would become dependent on alcohol or drugs, but soldiers face added stressors.

“They live very stressful lives. Most of them are young, and they may be going to war or coming back from war,” she said. “Being in the Army is very demanding.”

The military recently announced that it has developed a urinalysis that can detect synthetic marijuana, but Walton said that test doesn’t necessarily have a very high success rate.

“Those drug tests aren’t identifying all the users out there,” he said. “And, unfortunately, because of the consequences of self-reporting to substance use treatment, positive drug tests are the primary reason soldiers enter treatment. The Warrior Check-Up hopes to change that by helping military personnel change their substance use before it negatively impacts their lives and careers.”

Co-authors are Adam Pierce, , and of the UW; and of the University of Houston. The study was funded by the Department of Defense.

# # #

For more information, contact Walker at ddwalker@uw.edu or 206-543-7511, or Walton at towalton@uw.edu or 206-543-7511.

Department of Defense grant: W81XWH-09-2-0135.

A 91̽»¨ researcher has found that a 20-minute conversation with a social worker has the potential to significantly reduce the functional decline of those diagnosed with a mild traumatic brain injury.

The is published in the April issue of .

in the UW’s is training social workers in emergency departments to provide education and resources to patients with mild traumatic brain injuries to help them deal with symptoms and the recovery process.

“Social workers are masters-level trained clinicians who are already embedded in emergency room treatment teams,” Moore said. “The goal of my work is to provide them with specialized training on mild traumatic brain injuries to help bridge the psychological and social aspects of treatment with medical care.”

Traumatic brain injury occurs when the head is hit by an outside force, causing the brain to move rapidly within the skull, altering consciousness and damaging the nervous system. Anyone who experiences a fall, car or bike accident, sports head injury or an assault, may experience a traumatic brain injury, but most are considered mild.

While a serious traumatic brain injury is usually obvious, mild brain injuries are often harder to detect, and can cause unexplained physical, cognitive, behavioral or emotional symptoms. Typical symptoms – nausea, vomiting, dizziness, headache, blurred vision, fatigue and sleep disturbances – are common in many other diagnoses, or resolve quickly, and patients don’t always seek medical care.

If a patient does go to the emergency room to be evaluated, he or she may go home thinking they’re physically OK, but then continue to have trouble with memory, depression, or completing once-routine tasks. That makes it all the more important that a social worker completes an evaluation while the patient is still in the emergency room, Moore said.

“It’s a critical intervention point not only for the patients with mild traumatic brain injuries, but also for patients with other types of medical and psychosocial problems,” she said.

Moore, who joined the 91̽»¨in the fall of 2012, also is affiliated with the r. While conducting her doctoral research at the University of California, Berkeley, she designed a that is currently running at San Francisco General Hospital, a Level 1 Trauma Center. There, medical staff identify patients with mild traumatic brain injuries and refer them to social workers, who provide education, coping strategies, resources and a brief alcohol intervention screening. Social workers later follow up with a phone call to see how the patient is doing.

Moore’s initial study showed that an intervention lasting less than 20 minutes significantly reduced brain injury patients’ alcohol use and prevented functional decline. (A second, randomized trial is now under way.)

Moore said social workers already conduct evaluations and provide resources for patients in hospitals and emergency rooms, and would need only a small amount of training on recognizing and dealing with mild traumatic brain injuries. They could provide patients with education about symptoms and the recovery process, as well as coping strategies such as getting enough rest and avoiding alcohol and drugs (which increase the risk of re-injury). Social workers also link patients to support groups, counselors, substance abuse services and appropriate medical care.

Moore is especially concerned with thousands of soldiers returning from the battlefield with such brain injuries. The estimated that more than 220,000 U.S. service members were diagnosed with traumatic brain injuries between 2000 and the third quarter of 2011; 77 percent were considered mild. Such cases may not be detected or treated immediately because of more serious battlefield injuries taking precedence, and once the patients return home they may not report to a hospital for follow-up care.

“Soldiers are coming back with different issues than civilian populations that are injured in a car accident,” Moore said. “Social workers definitely need to know the unique issues of soldiers coming back from the battlefield.”

# # #

Moore can be reached at mm99@uw.edu or 206-616-2862.

Moore’s research is funded in part by the Institute of Translational Health Sciences at the UW, NIH grant KL2 TR000421-06.

Q: Your first experience with marijuana laws was during a court martial for a fellow soldier in Vietnam who was caught with the equivalent of 10 joints. How did that start your journey as a marijuana activist?

A: In 1967 I was a social work officer with the 9^th Infantry Division. Doing that work, I began to have an inkling of what we’d much later recognize as the severe psychological injuries many soldiers experienced. Alcohol was the universal de-stressor, with shared drinking contributing to group cohesion and camaraderie. While illegal under the Code of Military Justice, shared pot smoking appeared to fulfill a similar purpose. When serving on the board that conducted that soldier’s court martial, I argued imprisonment would be excessive given the context. I was outvoted, he went to jail for four months, and the injustice of that penalty troubled me.

Q: While you’ve long been in favor of decriminalizing marijuana, you also believe it’s not just a harmless drug, that it has health and behavioral consequences.

A: Marijuana is not harmless, although many adults use it moderately and without apparent harm. One consequence of our efforts to dissuade people from using marijuana through the threat of criminal penalties has been a widespread and unfortunate belief that valid public health warnings about the drug are just propaganda. I’d encourage readers seeking science-based information about the health and behavioral risks to visit the 91̽»¨Alcohol and Drug Abuse Institute’s marijuana website: .

Q: Talk about your own struggles with marijuana dependence and why you quit smoking it.

A: In 1978 at the age of 36, what once had been a casual pattern of getting high evolved into near daily use. My wife let me know how hurt she was by my preoccupation with marijuana. Her experience, along with my slipping productivity as a faculty member, made it evident that the price she and I were paying was far greater than any benefits.

Q: You were an intermediary in providing marijuana to cancer patients long before medical marijuana became legal in Washington. Why?

A: A 1975 article in The New England Journal of Medicine raised the possibility that marijuana use prior to chemotherapy would alleviate the side effects of nausea and vomiting. Because I was known as a marijuana researcher, I began to receive calls requesting information from cancer patients and visited many of them in their homes or hospital rooms. Pharmacists, the source of expert information concerning conventional medicines, were not able to be helpful in this context. With assistance from 91̽»¨colleagues in oncology and pharmacology, I wrote a booklet for the lay person on marijuana use in the reduction of nausea and vomiting associated with chemotherapy. When a grower offered to donate marijuana to cancer patients if I’d be the intermediary, I accepted his offer, because for many grievously ill people there were just no other alternatives.

Q: Are you surprised it took this long for recreational marijuana to become legal in Washington?

A: No. When legalization was proposed in the past, it involved simply repealing all criminal penalties for growing, selling, and possessing marijuana. That approach to undoing prohibition’s injustices wouldn’t address the drug’s health, behavioral and safety risks. In 2012, voters in our state were presented with a public health alternative to prohibition, i.e., tight regulation of the market and the earmarking of substantial marijuana tax revenues for public education, youth-focused prevention, treatment, research and evaluation of the new law’s impact. This model of policy reform was a major innovation, and clearly the voters found it preferable to criminal prohibition.

Q: You write that your ideas about marijuana continue to evolve. Have any of your beliefs changed since I-502 was approved by Washington voters?

A: Only to view I-502’s health and safety provisions as even more important. Over time I expect to see reductions in marijuana use disorders, fewer marijuana-related automobile accidents, fewer young people initiating marijuana use in their early teens, and fewer marijuana-related dropouts from school. If our state gets it right in how it implements the initiative-funded harm reduction components of this new policy, I believe there will be fewer victims even if marijuana is as or more popular than it is now.

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