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Caught in adversity

Segeren, M.W.

2020

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citation for published version (APA)

Segeren, M. W. (2020). Caught in adversity: The development, persistence and escalation of criminal behavior

from a public mental health care perspective.

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CHAPTER 5

VIOLENT OFFENDERS AS A

TARGET POPULATION FOR PUBLIC

MENTAL HEALTH CARE

Thijs Fassaert Menno Segeren Christel Grimbergen Wilco Tuinebreijer Matty de Wit

ϭϬϰ ŚĂƉƚĞƌϱ

ABSTRACT

dŚŝƐƐƚƵĚLJƐŽƵŐŚƚƚŽƐƉĞĐŝĨLJǁŚŝĐŚƉĂƌƚŽĨĂƉŽƉƵůĂƟŽŶŽĨLJŽƵŶŐĂĚƵůƚǀŝŽůĞŶƚŽīĞŶĚĞƌƐ ŝŶŵƐƚĞƌĚĂŵ;ŵĞĂŶĂŐĞϮϰ͘ϵLJĞĂƌƐ͕ƐĚсϴ͘ϮͿǁĞƌĞĞůŝŐŝďůĞĨŽƌWƵďůŝĐDĞŶƚĂů,ĞĂůƚŚ ĂƌĞ;WD,Ϳ͘dŚĞƌĞƐƵůƚƐŽĨĂƐĞŵŝͲƐƚƌƵĐƚƵƌĞĚĐůŝŶŝĐĂůŝŶƚĞƌǀŝĞǁǁĞƌĞƵƐĞĚ;EсϰϱϰͿ͕ ǁŚŝĐŚŝŶĐůƵĚĞĚƚŚĞ^ĞůĨͲ^ƵĸĐŝĞŶĐLJDĂƚƌŝdž;^^DͲͿ͘hƐŝŶŐƚŚĞ^^DͲĂŶĚƚǁŽĚŝƐƟŶĐƚ ĚĞĮŶŝƟŽŶƐŽĨǁŚĂƚĐŽŶƐƟƚƵƚĞƐĂŶĞĞĚĨŽƌWD,͕ƚŚĞƐŝnjĞŽĨƚŚĞWD,ƚĂƌŐĞƚƉŽƉƵůĂƟŽŶ ǁĂƐĚĞƚĞƌŵŝŶĞĚƚǁŝĐĞ͘ĞƉĞŶĚŝŶŐŽŶǁŚŝĐŚĚĞĮŶŝƟŽŶǁĂƐƵƐĞĚ͕ϯϱ͘ϵй;ŵĂƚŚĞŵĂƟĐĂů ĂůŐŽƌŝƚŚŵǁŚŝĐŚƉƵƚǁĞŝŐŚƚƐƚŽƐŝŶŐůĞ^^DͲĚŽŵĂŝŶƐͿĂŶĚϯϰ͘ϴй;ƉƌŽďůĞŵĂƟĐůĞǀĞůƐ ŽĨƐĞůĨͲƐƵĸĐŝĞŶĐLJŽŶĂƐĞůĞĐƟŽŶŽĨĚŽŵĂŝŶƐͿĂƉƉĞĂƌĞĚƚŽďĞĞůŝŐŝďůĞĨŽƌĞŶƚĞƌŝŶŐƚŚĞ WD,ƐLJƐƚĞŵ͘dŚĞƐƚƵĚLJĐŽŶĮƌŵƐƚŚĂƚĂƐƵďƐƚĂŶƟĂůƉƌŽƉŽƌƟŽŶŽĨǀƵůŶĞƌĂďůĞƉĞŽƉůĞ ĂƌĞĂŵŽŶŐƚŚĞĨŽƌĞŶƐŝĐƉŽƉƵůĂƟŽŶ͘

ϭϬϱ

BACKGROUND

dŚĞWƵďůŝĐDĞŶƚĂů,ĞĂůƚŚĂƌĞ;WD,ͿƐLJƐƚĞŵƉƌŽǀŝĚĞƐĐĂƌĞĂŶĚƐƵƉƉŽƌƚĨŽƌŝŶĚŝǀŝĚƵĂůƐ ĂŶĚĨĂŵŝůŝĞƐǁŝƚŚƐĞǀĞƌĞĂŶĚĐŽŵƉůĞdžƉƌŽďůĞŵƐ͕ĂŵŽŶŐƐƚŽƚŚĞƌƚĂƌŐĞƚƉŽƉƵůĂƟŽŶƐ͘ ůŝĞŶƚƐŽĨƚŚĞWD,ƐLJƐƚĞŵĂƌĞƚLJƉŝĐĂůůLJƚŚŽƐĞǁŚŽĚŽŶŽƚĂĐƟǀĞůLJŽƌŝŶĚĞƉĞŶĚĞŶƚůLJƐĞĞŬ ŚĞůƉĨŽƌƚŚĞŝƌƉƌŽďůĞŵƐŽƌǁŚŽĚŽŶŽƚŚĂǀĞƚŚĞŝƌŶĞĞĚƐŵĞƚďLJƌĞŐƵůĂƌŚĞĂůƚŚƐĞƌǀŝĐĞƐ ;>ĂƵƌŝŬƐ͕ƵƐƚĞƌ͕Ğtŝƚ͕ƌĂŚ͕Θ<ůĂnjŝŶŐĂ͕ϮϬϭϮͿ͘WŽƐƐŝďůĞĞdžƉůĂŶĂƟŽŶƐĨŽƌƚŚŝƐƐƉĞĐŝĮĐ ƚLJƉĞŽĨǀƵůŶĞƌĂďŝůŝƚLJŝŶĐůƵĚĞƚŚĞƉƌĞƐĞŶĐĞŽĨŵƵůƟƉůĞĐŽŵƉĞƟŶŐŶĞĞĚƐ͕ƚŚĞĐŽŶĚŝƟŽŶĂů ŶĂƚƵƌĞŽĨƚŚĞŚĞĂůƚŚĐĂƌĞƐLJƐƚĞŵ;Ğ͘Ő͘ŽŶĞŚĂƐƚŽŚĂǀĞŚĞĂůƚŚŝŶƐƵƌĂŶĐĞͿĂŶĚƚŚĞůĂĐŬŽĨ ĂƉĞƌĐĞŝǀĞĚŶĞĞĚĨŽƌĐĂƌĞ;ŶĚĞƌƐĞŶ͕ϭϵϵϱ͖'ĞůďĞƌŐ͕ŶĚĞƌƐĞŶ͕Θ>ĞĂŬĞ͕ϮϬϬϬͿ͘ ^ƚƵĚŝĞƐ ŚĂǀĞ ƐŚŽǁŶ ƚŚĂƚ ŵĂŶLJ ĨŽƌĞŶƐŝĐ ƉŽƉƵůĂƟŽŶƐ ;Ğ͘Ő͕͘ ĚĞůŝŶƋƵĞŶƚƐ͕ ĂƌƌĞƐƚĞĞƐ͕ ƉƌŝƐŽŶĞƌƐ͕ĚĞƚĂŝŶĞĞƐͿĐŽŶƐƟƚƵƚĞ;ĨƵƚƵƌĞͿƚĂƌŐĞƚƉŽƉƵůĂƟŽŶƐĨŽƌƚŚĞWD,ƐLJƐƚĞŵ ;ƵůƚĞŶ͕EŝũŵĂŶ͕ΘsĂŶĚĞƌ^ƚĂĂŬ͕ϮϬϬϵ͖ƵƐƚĞƌ͕ŽƌŶ͕ĞĞůĞŶ͕ΘĂƐ͕ϮϬϭϰ͖<ƵŚůŵĂŶŶ ΘZƵĚĚĞůů͕ϮϬϬϱͿ͘dŚŝƐŝƐŝŶĚŝĐĂƚĞĚďLJĂŶĂĐĐƵŵƵůĂƟŽŶŽĨĂĚĚŝĐƟǀĞďĞŚĂǀŝŽƌ͕ƉƐLJĐŚŝĂƚƌŝĐ ĚŝƐŽƌĚĞƌƐĂŶĚƐŽĐŝĂůƉƌŽďůĞŵƐ͕ŝŶĐŽŵďŝŶĂƟŽŶǁŝƚŚĂŐĞŶĞƌĂůůĂĐŬŽĨƉĞƌƐŽŶĂůĐŽƉŝŶŐ ƐŬŝůůƐ͕ŝŶĐůƵĚŝŶŐƚŚĞƚĞŶĚĞŶĐLJƚŽŝŶĂĚĞƋƵĂƚĞůLJƵƐĞ ŚĞĂůƚŚƐĞƌǀŝĐĞƐ;ďƌĂŵ͕dĞƉůŝŶ͕ DĐůĞůůĂŶĚ͕ΘƵůĐĂŶ͕ϮϬϬϯ͖ƵƐƚĞƌĞƚĂů͕͘ϮϬϭϰ͖^ŬŽŐƐƚĂĚ͕ĞĂŶĞ͕Θ^ƉŝĐĞƌ͕ϮϬϬϲͿ͘ DŽƌĞŽǀĞƌ͕ƚŚĞŵĂũŽƌŝƚLJŽĨWD,ĐůŝĞŶƚƐĂƌĞƐŝŐŶĂůĞĚďLJƚŚĞƉŽůŝĐĞŽƌ;ǀŝĂŚŽƚůŝŶĞƐͿďLJ ĐŝƟnjĞŶƐǁŚŽǁŽƌƌLJĂďŽƵƚŽƌĞdžƉĞƌŝĞŶĐĞŶƵŝƐĂŶĐĞĨƌŽŵĨĞůůŽǁůŽĐĂůƌĞƐŝĚĞŶƚƐ;ƵƐƚĞƌ ĞƚĂů͕͘ϮϬϭϰ͖>ĂƵƌŝŬƐĞƚĂů͕͘ϮϬϭϮͿ͘ ĞƐƉŝƚĞĐŽŶƐĞŶƐƵƐĂďŽƵƚƚŚĞǀƵůŶĞƌĂďŝůŝƚLJŽĨĨŽƌĞŶƐŝĐƉŽƉƵůĂƟŽŶƐ͕ĂĐƚƵĂůůLJĚĞƚĞƌŵŝŶŝŶŐ ǁŚŽŵƚŚĞWD,ƐŚŽƵůĚƚƌĞĂƚŝƐĚŝĸĐƵůƚ͘/ŶĚĞĐŝĚŝŶŐǁŚŽŵƚŽĂůůŽĐĂƚĞƚŽWD,ĂŶĚ ǁŚŽŵƚŽƌĞĨĞƌƚŽĚŝīĞƌĞŶƚ;ƉƌŝǀĂƚĞͿƐŽĐŝĂůŽƌŚĞĂůƚŚĐĂƌĞƉƌŽǀŝĚĞƌƐ͕ƉƌŽĨĞƐƐŝŽŶĂůƐ ƚLJƉŝĐĂůůLJǁĞŝŐŚĂůůĂǀĂŝůĂďůĞŝŶĨŽƌŵĂƟŽŶĂďŽƵƚƚŚĞĐůŝĞŶƚƐ͛ƐŝƚƵĂƟŽŶƐĂŐĂŝŶƐƚĂŶŝŵƉůŝĐŝƚ ƌĞĨĞƌĞŶĐĞĨƌĂŵĞǁŽƌŬŽĨƚŚĞWD,ƚĂƌŐĞƚŐƌŽƵƉ͕ĐƵƌƌĞŶƚŵƵŶŝĐŝƉĂůƉŽůŝĐLJĂŶĚƉĞƌƐŽŶĂů ĞdžƉĞƌŝĞŶĐĞ͘dŚĞƌĞĨŽƌĞ͕ƚŚĞƉƌĞƐĞŶƚƐƚƵĚLJƐŽƵŐŚƚƚŽĨƵƌƚŚĞƌŝŶǀĞƐƟŐĂƚĞĂŶĚƐƉĞĐŝĨLJƚŚĞ ǀƵůŶĞƌĂďŝůŝƚLJŽĨĂŶĞŵĞƌŐŝŶŐĨŽƌĞŶƐŝĐƉŽƉƵůĂƟŽŶŽĨǀŝŽůĞŶƚŽīĞŶĚĞƌƐ͘

METHODS

^dd/E'E^dhzWKWh>d/KE ĚŝǀĞƌƐŝŽŶƉƌŽŐƌĂŵǁĂƐŝŶŝƟĂƚĞĚŝŶŵƐƚĞƌĚĂŵŝŶϮϬϭϭƚŽƌĞĚƵĐĞƚŚĞŶƵŵďĞƌŽĨǀŝŽůĞŶƚ ŚŝŐŚŝŵƉĂĐƚ;ŝ͘Ğ͘ǀŝĐƟŵͿĐƌŝŵĞƐ͘džĂŵƉůĞƐŽĨƐƵĐŚĐƌŝŵĞƐĂƌĞƚŚĞŌĂŶĚďƵƌŐůĂƌLJ͕ƉƵďůŝĐͬ ĂŐŐƌĂǀĂƚĞĚĂƐƐĂƵůƚĂŶĚĂƌŵĞĚŝŶǀĂƐŝŽŶͬƌŽďďĞƌLJ͘dŚĞĚŝǀĞƌƐŝŽŶƉƌŽŐƌĂŵŝƐƉƌŝŵĂƌŝůLJ ďĂƐĞĚŽŶĐŝǀŝůůĂǁ͕ƌĂƚŚĞƌƚŚĂŶĐƌŝŵŝŶĂůůĂǁ͕ĂŶĚǁĂƐŝŵƉůĞŵĞŶƚĞĚďLJƚŚĞŵƵŶŝĐŝƉĂůŝƚLJ ŽŶĂĐŝƚLJůĞǀĞů͘KƌŐĂŶŝnjĂƟŽŶƐƚŚĂƚĐŽŶƚƌŝďƵƚĞƚŽƚŚĞƉƌŽŐƌĂŵƌĞƉƌĞƐĞŶƚĂǁŝĚĞĂƌƌĂLJŽĨ ƐƚĂŬĞŚŽůĚĞƌƐ͕ŝŶĐůƵĚŝŶŐůĂǁĞŶĨŽƌĐĞŵĞŶƚ;ƉŽůŝĐĞ͕ƉƵďůŝĐƉƌŽƐĞĐƵƟŽŶ͕ũĂŝůƐ͕ĂŶĚƉƌŽďĂƟŽŶ

5

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ϭϬϳ ϱс͚ĐŽŵƉůĞƚĞůLJƐĞůĨͲƐƵĸĐŝĞŶƚ͕͛ƚŚƵƐĨŽƌŵŝŶŐĂŵĂƚƌŝdž͘/ŶĚŝĐĂƚŽƌƐƚŚĂƚƐƉĞĐŝĨLJĞĂĐŚůĞǀĞů ŽĨƐĞůĨͲƐƵĸĐŝĞŶĐLJĨŽƌĞǀĞƌLJĚŽŵĂŝŶĂƌĞĚĞĮŶĞĚ͕ĂŶĚĚĞƐĐƌŝďĞĚŝŶĞĂĐŚĐĞůůŽĨƚŚĞŵĂƚƌŝdž͘ dŚĞ^^DͲŚĂƐĂĚĞƋƵĂƚĞƉƐLJĐŚŽŵĞƚƌŝĐƉƌŽƉĞƌƟĞƐ;ŝ͘Ğ͘ŝŶƚĞƌŶĂůĐŽŶƐŝƐƚĞŶĐLJ͕ĐŽŶǀĞƌŐĞŶƚ ǀĂůŝĚŝƚLJĂŶĚŝŶƚĞƌͲƌĂƚĞƌĂŐƌĞĞŵĞŶƚͿ;&ĂƐƐĂĞƌƚĞƚĂů͕͘ϮϬϭϰͿ͘ dǁŽ^^DͲďĂƐĞĚĚĞĮŶŝƟŽŶƐŽĨƚŚĞWD,ƚĂƌŐĞƚƉŽƉƵůĂƟŽŶǁĞƌĞĂƉƉůŝĞĚ͘&ŝƌƐƚ͕>ĂƵƌŝŬƐ ĞƚĂů͕͘;ϮϬϭϰͿƉƌĞǀŝŽƵƐůLJƵƐĞĚƚŚĞ^^DͲƚŽĚĞǀĞůŽƉĂĚĞĐŝƐŝŽŶƐƵƉƉŽƌƚƚŽŽů;^dͿ͕ŝŶ ŽƌĚĞƌƚŽƐƵďƐƚĂŶƟĂƚĞĂůůŽĐĂƟŽŶĚĞĐŝƐŝŽŶƐƚŽWD,ĨŽƌŚŽŵĞůĞƐƐƉĞŽƉůĞŝŶŵƐƚĞƌĚĂŵ͘ /ŶŽƚŚĞƌǁŽƌĚƐ͕ƚŚĞ^^DͲĐĂŶďĞƵƐĞĚƚŽƉƌĞĚŝĐƚǁŚŝĐŚƉĂƌƚŽĨĂŚŽŵĞůĞƐƐƉŽƉƵůĂƟŽŶ ǁŽƵůĚďĞĂůůŽĐĂƚĞĚƚŽƚŚĞWD,ƐLJƐƚĞŵďLJƉƌŽĨĞƐƐŝŽŶĂůƐ͕ƐŽůĞůLJďĂƐĞĚŽŶƚŚĞŝƌŝŶĚŝǀŝĚƵĂů ^^DͲƉƌŽĮůĞ;>ĂƵƌŝŬƐĞƚĂů͕͘ϮϬϭϰͿ͘dŚĞƉƌĞĚŝĐƚĞĚƉƌŽďĂďŝůŝƚLJŽĨďĞŝŶŐĞůŝŐŝďůĞĨŽƌWD,͕ ŐŝǀĞŶƚŚĞƐĐŽƌĞƐŽŶƚŚĞ^^DͲĚŽŵĂŝŶƐ͕ĐĂŶďĞĐĂůĐƵůĂƚĞĚĂƐĨŽůůŽǁƐ͗ where Fс&ŝŶĂŶĐĞƐƐĐŽƌĞ͖DсĂLJͲƟŵĞĂĐƟǀŝƟĞƐƐĐŽƌĞ͖Hс,ŽƵƐŝŶŐƐĐŽƌĞ͖Do = ŽŵĞƐƟĐ ƌĞůĂƟŽŶƐ; MсDĞŶƚĂůŚĞĂůƚŚƐĐŽƌĞ͖PhсWŚLJƐŝĐĂůŚĞĂůƚŚƐĐŽƌĞ͖AсĚĚŝĐƟŽŶƐĐŽƌĞ͖ADLсĂŝůLJ ůŝĨĞƐŬŝůůƐƐĐŽƌĞ͖Sс^ŽĐŝĂůŶĞƚǁŽƌŬƐĐŽƌĞ͖ CсŽŵŵƵŶŝƚLJWĂƌƟĐŝƉĂƟŽŶƐĐŽƌĞ͖ Jс:ƵĚŝĐŝĂůƐĐŽƌĞ͘ dŚŝƐ ĨŽƌŵƵůĂ ƐŚŽǁƐ ƚŚĂƚ Ăůů ^^DͲ ĚŽŵĂŝŶƐ ŵĂƩĞƌ͕ ĂŶĚ ƚŚĂƚ DĞŶƚĂů ŚĞĂůƚŚ ĂŶĚ ĚĚŝĐƟŽŶŚĂǀĞƚŚĞůĂƌŐĞƐƚŝŶŇƵĞŶĐĞŽŶƚŚĞĮŶĂůƉƌŽďĂďŝůŝƚLJŽĨĂůůŽĐĂƟŽŶ͘dŚĞĂůŐŽƌŝƚŚŵ ǁĂƐĂƉƉůŝĞĚƚŽƚŚĞƉƌĞƐĞŶƚƐƚƵĚLJƉŽƉƵůĂƟŽŶ͘/ŶůŝŶĞǁŝƚŚƚŚĞŽƌŝŐŝŶĂů^d͕ƚŚĞƉƌŽďĂďŝůŝƚLJ ŽĨƚŚĞŝƌĞůŝŐŝďŝůŝƚLJĨŽƌWD,ǁĂƐůĂďĞůĞĚĂƐ͚ĞĮŶŝƚĞůLJ͛;WшϬ͘ϴϬͿ͕͚WƌŽďĂďůLJ͛;Ϭ͘ϱϬчWф Ϭ͘ϴϬͿ͕͚WƌŽďĂďůLJŶŽƚ͛;Ϭ͘ϮϭфWфϬ͘ϱϬͿĂŶĚ͚ĞĮŶŝƚĞůLJŶŽƚ͛;WчϬ͘ϮϭͿ͘ ĞĐĂƵƐĞƚŚĞ^dǁĂƐĚĞǀĞůŽƉĞĚŝŶĂǀĞƌLJƐƉĞĐŝĮĐĐŽŶƚĞdžƚĂŶĚƉŽƉƵůĂƟŽŶĂŶĚĂƐŝƚ ƉƌŽǀŝĚĞƐ ŽŶůLJ Ă ƌŽƵŐŚ ĂŶĚ ƉƌĞůŝŵŝŶĂƌLJ ĞƐƟŵĂƟŽŶ ŽĨ ǀƵůŶĞƌĂďŝůŝƚLJ͕ ĂŶ ĂĚĚŝƟŽŶĂů ĚĞĮŶŝƟŽŶǁĂƐĐŽŶƐƚƌƵĐƚĞĚ͘ĂƐĞĚŽŶƵƐƚĞƌĞƚĂů͕͘;ϮϬϭϰͿ͕WD,ĞůŝŐŝďŝůŝƚLJǁĂƐĚĞĮŶĞĚ ĂƐƐŚŽǁŝŶŐƉƌŽďůĞŵĂƟĐůĞǀĞůƐŽĨƐĞůĨͲƐƵĸĐŝĞŶĐLJ;^^DͲƐĐŽƌĞƐфϯͿŝŶƚŚĞĚŽŵĂŝŶƐŽĨ DĞŶƚĂů,ĞĂůƚŚŽƌĚĚŝĐƟŽŶ͕ĐŽŵďŝŶĞĚǁŝƚŚŚĂǀŝŶŐƐŽĐŝĂůƉƌŽďůĞŵƐ;ŝ͘Ğ͘ƉƌŽďůĞŵĂƟĐ ůĞǀĞůƐŽĨƐĞůĨͲƐƵĸĐŝĞŶĐLJŝŶ&ŝŶĂŶĐĞƐŽƌĂLJͲƟŵĞĂĐƟǀŝƟĞƐŽƌ,ŽƵƐŝŶŐͿ͘ OTHER VARIABLES ĞŵŽŐƌĂƉŚŝĐ ĐŚĂƌĂĐƚĞƌŝƐƟĐƐ͕ ŝŶĐůƵĚŝŶŐ ĂŐĞ͕ ŐĞŶĚĞƌ͕ ĞĚƵĐĂƟŽŶĂů ůĞǀĞů ĂŶĚ ĞƚŚŶŝĐ ďĂĐŬŐƌŽƵŶĚǁĞƌĞĂǀĂŝůĂďůĞĂƐǁĞůů͘ĐĐŽƌĚŝŶŐƚŽƚŚĞĚĞĮŶŝƟŽŶŽĨƚŚĞƵƚĐŚĞŶƚƌĂů ƵƌĞĂƵŽĨ^ƚĂƟƐƟĐƐ͕ĞƚŚŶŝĐŝƚLJǁĂƐĚĞĮŶĞĚĂĐĐŽƌĚŝŶŐƚŽĐůŝĞŶƚƐ͛ĐŽƵŶƚƌLJŽĨďŝƌƚŚĂŶĚƚŚĂƚ ŽĨƚŚĞŝƌƉĂƌĞŶƚƐ͘WƐLJĐŚŝĂƚƌŝĐĚŝĂŐŶŽƐĞƐ ǁĞƌĞƌĞŐŝƐƚĞƌĞĚĂĐĐŽƌĚŝŶŐƚŽƚŚĞ^DͲ/sƐLJƐƚĞŵ͘ &ƌŽŵƚŚĞĐůŝŶŝĐĂůŝŶƚĞƌǀŝĞǁ͕ŝŶĨŽƌŵĂƟŽŶǁĂƐŐĂƚŚĞƌĞĚĐŽŶĐĞƌŶŝŶŐĮǀĞ;ĐĂƚĞŐŽƌŝĞƐŽĨͿ

5

ϭϬϴ ŚĂƉƚĞƌϱ ŵĂũŽƌƉƐLJĐŚŝĂƚƌŝĐĚŝƐŽƌĚĞƌƐ͕ŶĂŵĞůLJŵŽŽĚͲ͕ĂŶdžŝĞƚLJͲ͕ƉƐLJĐŚŽƟĐͲ͕ƐƵďƐƚĂŶĐĞƵƐĞͲĂŶĚ ŝŵƉƵůƐĞĐŽŶƚƌŽůĚŝƐŽƌĚĞƌƐ;ŝŶĐůƵĚŝŶŐ,Ϳ͘ ANALYSIS ĞƐĐƌŝƉƟǀĞĂŶĂůLJƐĞƐǁĞƌĞĐŽŶĚƵĐƚĞĚƚŽĐĂůĐƵůĂƚĞƚŚĞƉƌŽƉŽƌƟŽŶŽĨƚŚĞƐĂŵƉůĞƚŚĂƚ ŝƐĂƚĂƌŐĞƚŐƌŽƵƉĨŽƌWD,ĂŶĚƚŚĞƉŽŝŶƚͲƉƌĞǀĂůĞŶĐĞƐŽĨƚŚĞƐĞůĞĐƚĞĚǀĂƌŝĂďůĞƐǁŝƚŚŝŶ ĞĂĐŚŐƌŽƵƉ͘^DͲ/sĚŝīĞƌĞŶƟĂůĚŝĂŐŶŽƐĞƐǁĞƌĞĞdžĐůƵĚĞĚĨƌŽŵƚŚĞĐĂůĐƵůĂƟŽŶŽĨƚŚĞ ƉƌĞǀĂůĞŶĐĞŽĨƉƐLJĐŚŝĂƚƌŝĐĚŝƐŽƌĚĞƌƐ͘ůůĂŶĂůLJƐĞƐǁĞƌĞĚŽŶĞŝŶ^W^^ǀĞƌƐŝŽŶϮϭ͘

RESULTS

LJƚŚĞĞŶĚŽĨKĐƚŽďĞƌϮϬϭϰ͕ϵϮϮǀŝŽůĞŶƚŽīĞŶĚĞƌƐŚĂĚďĞĞŶŝĚĞŶƟĮĞĚďLJƚŚĞĚŝǀĞƌƐŝŽŶ ƉƌŽŐƌĂŵ͕ ŽĨ ǁŚŽŵ ϱϱϴ ;ϲϭйͿ ŚĂĚ ďĞĞŶ ƐĐƌĞĞŶĞĚ ďLJ ƚŚĞ W,^͘ KŶůLJ ƉĞƌƐŽŶƐ ǁŝƚŚ ĐŽŵƉůĞƚĞĚĂƚĂŽŶƚŚĞ^^DͲ;ϰϱϰƉĞŽƉůĞŽƌϴϭйͿǁĞƌĞŝŶĐůƵĚĞĚŝŶƚŚĞƉƌĞƐĞŶƚƐƚƵĚLJ͘ dŚĞŝƌĂǀĞƌĂŐĞĂŐĞǁĂƐϮϰ͘ϵLJĞĂƌƐ;sdсϴ͘ϮͿ͘KǀĞƌĂůů͕ϭϴ͘ϱйĚŝĚŶŽƚĮŶŝƐŚĂŶLJŬŝŶĚ ŽĨĞĚƵĐĂƟŽŶ͕ϯϰ͘ϴйŽŶůLJĮŶŝƐŚĞĚĞůĞŵĞŶƚĂƌLJƐĐŚŽŽů͕ϯϬ͘ϲйŚĂĚůŽǁĞƌǀŽĐĂƟŽŶĂůŽƌ ŚŝŐŚƐĐŚŽŽůĞĚƵĐĂƟŽŶ͕ǁŚŝůĞϭϭ͘ϮйŚĂĚƐŽŵĞĨŽƌŵŽĨŚŝŐŚĞƌĞĚƵĐĂƟŽŶ;ϰ͘ϴйǁŝƚŚ ĞĚƵĐĂƟŽŶĂůůĞǀĞůƵŶŬŶŽǁŶͿ͘ŵŝŐƌĂŶƚďĂĐŬŐƌŽƵŶĚǁĂƐĞƐƚĂďůŝƐŚĞĚĨŽƌϴϴ͘ϯй;ϯϰ͘ϭй ĮƌƐƚŐĞŶĞƌĂƟŽŶ͕ϯ͘ϱйƵŶŬŶŽǁŶĞƚŚŶŝĐďĂĐŬŐƌŽƵŶĚͿ͘dŚĞƉƌĞǀĂůĞŶĐĞŽĨĂŶLJƉƐLJĐŚŝĂƚƌŝĐ ĚŝƐŽƌĚĞƌǁĂƐϲϴ͘ϳй͘^ƉĞĐŝĮĐƉƌĞǀĂůĞŶĐĞƌĂƚĞƐǁĞƌĞϲ͘ϰй;ĚĞƉƌĞƐƐŝǀĞĂŶĚͬŽƌĂŶdžŝĞƚLJ ĚŝƐŽƌĚĞƌƐͿ͕ϯ͘ϳй;ƉƐLJĐŚŽƟĐĚŝƐŽƌĚĞƌƐͿ͕ϰϴ͘ϳй;ƐƵďƐƚĂŶĐĞĂďƵƐĞͿĂŶĚϲ͘Ϯй;,Ϳ͘ /ŶƚĞůůĞĐƚƵĂůĚŝƐĂďŝůŝƟĞƐǁĞƌĞƐƵƐƉĞĐƚĞĚŝŶϱϰ͘ϬйŽĨĂůůĐĂƐĞƐ͘ dĂďůĞϭŝŶĚŝĐĂƚĞƐƚŚĂƚĂƐƵďƐƚĂŶƟĂůƉƌŽƉŽƌƟŽŶŽĨƚŚĞƐƚƵĚLJƉŽƉƵůĂƟŽŶǁĂƐŶŽƚƐĞůĨͲ ƐƵĸĐŝĞŶƚŽƌŚĂĚĂĐƵƚĞƉƌŽďůĞŵƐŽŶĂŶƵŵďĞƌŽĨĞƐƐĞŶƟĂůůŝĨĞĚŽŵĂŝŶƐ͘ƉĂƌƚĨƌŽŵƚŚĞ :ƵĚŝĐŝĂůĚŽŵĂŝŶ͕ƉƌŽŵŝŶĞŶƚƉƌŽďůĞŵĂƌĞĂƐǁĞƌĞ&ŝŶĂŶĐĞƐ;ĂůůƚŽŐĞƚŚĞƌ͕ϱϱ͘ϱйŚĂĚŶŽ ŽƌŝŶƐƵĸĐŝĞŶƚŝŶĐŽŵĞŝŶĐŽŵďŝŶĂƟŽŶǁŝƚŚŚŝŐŚĂŶĚͬŽƌŝŶĐƌĞĂƐŝŶŐĮŶĂŶĐŝĂůĚĞďƚƐͿĂŶĚ ĂLJͲƟŵĞĂĐƟǀŝƟĞƐ;ϱϬ͘ϮйŚĂĚŶŽũŽďŽƌĚŝĚŶŽƚĨŽůůŽǁĂŶLJĞĚƵĐĂƟŽŶĂŶĚͲŝŶĐĂƐĞŽĨ ŝŶͲĐƌŝƐŝƐƐŝƚƵĂƟŽŶƐͲĐĂƵƐĞĚŶƵŝƐĂŶĐĞͿ͘ĐĐŽƌĚŝŶŐƚŽƚŚĞ^d͕ŶĞĞĚƐǁĞƌĞůŝŬĞůLJƚŽďĞŵĞƚ ŝŶƚŚĞWD,ĨŽƌϯϱ͘ϵй͖ĂŶŽƚŚĞƌϭϯ͘Ϭй͚ƉƌŽďĂďůLJ͛ďĞůŽŶŐĞĚƚŚĞƌĞ͘hƐŝŶŐƚŚĞƐĞĐŽŶĚ ĚĞĮŶŝƟŽŶ͕ϯϰ͘ϴйŽĨƚŚĞƐƚƵĚLJƉŽƉƵůĂƟŽŶďĞůŽŶŐĞĚƚŽƚŚĞƚĂƌŐĞƚƉŽƉƵůĂƟŽŶŽĨƚŚĞ WD,͘dŚĞƌĞǁĂƐƐƵďƐƚĂŶƟĂůŽǀĞƌůĂƉďĞƚǁĞĞŶďŽƚŚƚĂƌŐĞƚŐƌŽƵƉƐ͖ŵŽƐƚƉĞƌƐŽŶƐ;ϳϳ͘ϯйͿ ǁŚŽ͚ĚĞĮŶŝƚĞůLJ͛ŵĞƚƚŚĞ^dĐƌŝƚĞƌŝĂĂůƐŽďĞůŽŶŐĞĚŝŶƚŚĞWD,ƐLJƐƚĞŵĂĐĐŽƌĚŝŶŐƚŽ ƚŚĞƐĞĐŽŶĚĚĞĮŶŝƟŽŶ͘

ϭϬϵ dĂďůĞϭ͘^ĞůĨͲƐƵĸĐŝĞŶĐLJŽĨƐƵďũĞĐƚƐ;EсϰϱϰͿ ^^DͲĚŽŵĂŝŶƐ ĐƵƚĞ problems ;йͿ EŽƚƐĞůĨͲ ƐƵĸĐŝĞŶƚ ;йͿ ĂƌĞůLJƐĞůĨͲ ƐƵĸĐŝĞŶƚ ;йͿ ĚĞƋƵĂƚĞůLJ ƐĞůĨͲƐƵĸĐŝĞŶƚ ;йͿ ŽŵƉůĞƚĞůLJ ƐĞůĨͲƐƵĸĐŝĞŶƚ ;йͿ Finances Ϯϵ͘ϯ Ϯϲ͘Ϯ Ϯϳ͘ϱ ϵ͘ϳ ϳ͘ϯ ĂLJͲƟŵĞĂĐƟǀŝƟĞƐ ϮϬ͘ϯ ϯϵ͘ϵ ϮϬ͘Ϭ ϭϲ͘ϯ ϯ͘ϱ Housing ϭϴ͘ϳ ϳ͘ϯ ϰϬ͘ϳ Ϯϱ͘ϯ ϳ͘ϵ ŽŵĞƐƟĐƌĞůĂƟŽŶƐ Ϯ͘ϵ ϭϴ͘ϱ ϰϮ͘ϭ Ϯϲ͘ϰ ϭϬ͘ϭ DĞŶƚĂů,ĞĂůƚŚ Ϯ͘Ϭ Ϯϰ͘ϵ Ϯϲ͘Ϯ ϯϬ͘ϰ ϭϲ͘ϱ WŚLJƐŝĐĂů,ĞĂůƚŚ Ϭ͘Ϯ ϰ͘Ϯ ϴ͘ϲ ϭϯ͘ϵ ϳϯ͘ϭ ĚĚŝĐƟŽŶ ϱ͘ϵ ϭϴ͘ϭ Ϯϯ͘ϯ ϭϳ͘ϴ ϯϰ͘ϴ ĐƟǀŝƟĞƐĚĂŝůLJůŝĨĞ Ϭ͘Ϯ Ϯ͘Ϭ ϯϯ͘ϯ Ϯϴ͘Ϭ ϯϲ͘ϲ ^ŽĐŝĂůEĞƚǁŽƌŬ ϴ͘ϰ Ϯϯ͘ϭ ϰϵ͘ϴ ϭϳ͘ϴ Ϭ͘ϵ ŽŵŵƵŶŝƚLJƉĂƌƟĐŝƉĂƟŽŶ ϭϯ͘ϵ ϮϮ͘Ϭ ϯϮ͘Ϯ Ϯϯ͘ϴ ϴ͘ϭ :ƵĚŝĐŝĂů ϭϳ͘ϰ ϱϯ͘ϳ Ϯϭ͘ϰ ϳ͘ϯ Ϭ͘Ϯ dĂƌŐĞƚƉŽƉƵůĂƟŽŶWD,΀ϭ΁ dŽƚĂů;йͿ ϭϬϬ͘Ϭ ĞĮŶŝƚĞůLJ;йͿ ϯϱ͘ϵ WƌŽďĂďůLJ;йͿ ϭϯ͘Ϭ WƌŽďĂďůLJŶŽƚ;йͿ ϭϱ͘Ϭ ĞĮŶŝƚĞůLJŶŽƚ;йͿ ϯϲ͘ϭ dĂƌŐĞƚƉŽƉƵůĂƟŽŶWD,΀Ϯ΁ zĞƐ ϯϰ͘ϴ ΀ϭ΁ĐĐŽƌĚŝŶŐƚŽƚŚĞĚĞĐŝƐŝŽŶƐƵƉƉŽƌƚƚŽŽůĚĞƐŝŐŶĞĚďLJ>ĂƵƌŝŬƐĞƚĂů͕͘;ϮϬϭϰͿĨŽƌƚŚĞŵƐƚĞƌĚĂŵ WƵďůŝĐDĞŶƚĂů,ĞĂůƚŚĂƌĞ;WD,ͿƐLJƐƚĞŵ͘ ΀Ϯ΁WƌŽďůĞŵĂƟĐůĞǀĞůƐŽĨƐĞůĨͲƐƵĸĐŝĞŶĐLJ;^^DͲƐĐŽƌĞƐфϯͿŝŶƚŚĞĚŽŵĂŝŶƐDĞŶƚĂů,ĞĂůƚŚĂŶĚͬŽƌ ĚĚŝĐƟŽŶŝŶĐŽŵďŝŶĂƟŽŶǁŝƚŚƐŽĐŝĂůƉƌŽďůĞŵƐ;&ŝŶĂŶĐĞƐŽƌĂLJͲƟŵĞĂĐƟǀŝƟĞƐŽƌ,ŽƵƐŝŶŐͿ͘

5

ϭϭϬ ŚĂƉƚĞƌϱ

DISCUSSION

dŚŝƐƐŚŽƌƚƐƚƵĚLJƐŽƵŐŚƚƚŽŝŶǀĞƐƟŐĂƚĞĂŶĚƐƉĞĐŝĨLJǁŚŝĐŚƉĂƌƚŽĨĂŶĞŵĞƌŐŝŶŐĨŽƌĞŶƐŝĐ ƉŽƉƵůĂƟŽŶŽĨǀŝŽůĞŶƚŽīĞŶĚĞƌƐŝŶŵƐƚĞƌĚĂŵĂƉƉĞĂƌƐƚŽďĞĞůŝŐŝďůĞĨŽƌĂĚŵŝƩĂŶĐĞƚŽ ƚŚĞĐĂƉŝƚĂů͛ƐWD,ƐLJƐƚĞŵ͘ĂƐĞĚŽŶƚǁŽĚŝīĞƌĞŶƚĚĞĮŶŝƟŽŶƐ͕ŝƚǁĂƐŝŶĚŝĐĂƚĞĚƚŚĂƚ ƚŚŝƐĐŽƵŶƚĞĚĨŽƌĂƚůĞĂƐƚŽŶĞƚŚŝƌĚŽĨƚŚĞƐƚƵĚLJƉŽƉƵůĂƟŽŶ͕ǁŚŝĐŚŝƐĐŽŶƐŝĚĞƌĂďůĞ͘&Žƌ ĞdžĂŵƉůĞ͕ƵƐƚĞƌĞƚĂů͘ĨŽƵŶĚĂŶĂĐĐƵŵƵůĂƟŽŶŽĨĂĚĚŝĐƟŽŶ͕ŵĞŶƚĂůŚĞĂůƚŚĂŶĚƐŽĐŝĂů ƉƌŽďůĞŵƐŝŶϯϱйŽĨƚŚĞŝƌƐƚƵĚLJƉŽƉƵůĂƟŽŶĐŽŶƐŝƐƟŶŐŽĨĂƌƌĞƐƚĞĞƐ;ƵƐƚĞƌĞƚĂů͕͘ϮϬϭϰͿ͘ ,ŽǁĞǀĞƌ͕ƚŚĞŝƌƐƚƵĚLJƉŽƉƵůĂƟŽŶǁĂƐŽůĚĞƌƚŚĂŶŽƵƌƉŽƉƵůĂƟŽŶŽĨǀŝŽůĞŶƚŽīĞŶĚĞƌƐĂŶĚ ƚŚĞƐŝnjĞŽĨƚŚĞWD,ƚĂƌŐĞƚƉŽƉƵůĂƟŽŶǁĂƐƐŵĂůůĞƌŝŶůŽǁĞƌĂŐĞĐĂƚĞŐŽƌŝĞƐ͘ůƐŽ͕ƵƐƚĞƌ ĞƚĂů͕͘;ϮϬϭϰͿŵĞĂƐƵƌĞĚƚŚĞƉƌĞƐĞŶĐĞŽĨƉƌŽďůĞŵƐ͕ǁŚŝůĞ^^DͲƐĐŽƌĞƐĂůƐŽƚĂŬĞŝŶƚŽ ĂĐĐŽƵŶƚŚŽǁƚŚĞƐĞƉƌŽďůĞŵƐĂƌĞĚĞĂůƚǁŝƚŚ;>ĂƵƌŝŬƐĞƚĂů͕͘ϮϬϭϰͿ͘dŚƵƐ͕ƚŚĞƉƌŽƉŽƌƟŽŶ of persons in our sample who had problems, but were able to cope with them and were ĐŽŶƐĞƋƵĞŶƚůLJƐĞůĨͲƐƵĸĐŝĞŶƚ͕ŵĂLJŚĂǀĞďĞĞŶŚŝŐŚĞƌ͘ ƐĂŵĂƩĞƌŽĨĨĂĐƚ͕ĂƐŝŐŶŝĮĐĂŶƚƉĂƌƚŽĨƚŚĞƐƚƵĚLJƉŽƉƵůĂƟŽŶƌĞǀĞĂůĞĚĂŶŽďũĞĐƟǀĞ ŶĞĞĚĨŽƌŵĞŶƚĂůŚĞĂůƚŚĂŶĚĂĚĚŝĐƟŽŶĐĂƌĞ͗ƚŚĞƉŽŝŶƚͲƉƌĞǀĂůĞŶĐĞŽĨĂŶLJƉƐLJĐŚŝĂƚƌŝĐ ĚŝƐŽƌĚĞƌ;ŝŶĐůƵĚŝŶŐĂĚĚŝĐƟŽŶĂŶĚƉĞƌƐŽŶĂůŝƚLJĚŝƐŽƌĚĞƌƐͿŶĞĂƌĞĚϳϬй͘dŚŝƐĮŶĚŝŶŐŝƐŝŶ ĂĐĐŽƌĚĂŶĐĞǁŝƚŚƌĞƐƵůƚƐĨƌŽŵŽƚŚĞƌƵƚĐŚƐƚƵĚŝĞƐĂŵŽŶŐĚŝīĞƌĞŶƚĨŽƌĞŶƐŝĐƉŽƉƵůĂƟŽŶ͘ /ƚŝƐŽŌĞŶƐƵŐŐĞƐƚĞĚ͕ƚŚŽƵŐŚŶŽƚĐŽŶĐůƵƐŝǀĞůLJƉƌŽǀĞŶ͕ƚŚĂƚƚŚĞƌĞŝƐĂĐĂƵƐĂůƌĞůĂƟŽŶ ďĞƚǁĞĞŶƉƌĞƐĞŶĐĞŽĨƉƐLJĐŚŝĂƚƌŝĐĚŝƐŽƌĚĞƌƐĂŶĚƉĞƌƐŝƐƚĞŶĐĞŽĨĐƌŝŵŝŶĂůďĞŚĂǀŝŽƌŽƌ ĐƌŝŵŝŶĂůƌĞĐŝĚŝǀŝƐŵ;ůĂĂƵǁ͕sĞŐƚĞƌ͕ΘDŽŶƚĞƌŝĞ͕ϮϬϬϮ͖>ŽĞďĞƌ͕,ŽĞǀĞ͕^ůŽƚ͕ΘǀĂŶĚĞƌ >ĂĂŶ͕ϮϬϭϱ͖Z^:͕ϮϬϭϮ͖^ĐŚŽĞŵĂŬĞƌ͕ǀĂŶĞƐƐĞŶ͕ΘKůŝũ͕ϭϵϵϳͿ͘,ŽǁĞǀĞƌ͕ĞdžĂĐƚƉƌĞǀĂůĞŶĐĞ ƌĂƚĞƐŝŶƚŚĞƐĞƐƚƵĚŝĞƐǀĂƌLJ͘&ŽƌĞdžĂŵƉůĞ͕ƵůƚĞŶΘEŝũŵĂŶ;ϮϬϬϵͿƌĞƉŽƌƚĞĚĂƉŽŝŶƚͲ ƉƌĞǀĂůĞŶĐĞŽĨƉƐLJĐŚŝĂƚƌŝĐĚŝƐŽƌĚĞƌƐĂŵŽŶŐĚĞƚĂŝŶĞĞƐŽĨϱϲ͘ϱй;ϵϱйͲ/͗ϰϵ͘ϱͲϲϯ͘ϳͿĂŶĚ ĂůŝĨĞƟŵĞƉƌĞǀĂůĞŶĐĞŽĨϴϬͲϵϬй;ƵůƚĞŶĞƚĂů͕͘ϮϬϬϵͿ͘dŚĞƌĞĂƌĞǀĂƌŝŽƵƐĞdžƉůĂŶĂƟŽŶƐ ĨŽƌƚŚĞƐĞǀĂƌŝĂƟŽŶƐ͕ŝŶĐůƵĚŝŶŐŵĞƚŚŽĚŽůŽŐŝĐĂůĚŝīĞƌĞŶĐĞƐďĞƚǁĞĞŶƐƚƵĚŝĞƐ;Ğ͘Ő͘ǀĂƌŝĞƚLJ ŽĨŝŶƐƚƌƵŵĞŶƚĂƟŽŶ͕ĚĞĮŶŝƟŽŶƐŽĨƉƐLJĐŚŽƉĂƚŚŽůŽŐLJͿ;KŐůŽī͕tĂƌƌĞŶ͕dLJĞ͕ůĂŚĞƌ͕Θ dŚŽŵĂƐ͕ϮϬϭϭͿ͘/ŶƚŚĞƉƌĞƐĞŶƚƐƚƵĚLJ͕ĂŶĂĚĚŝƟŽŶĂůƐŽƵƌĐĞŽĨǀĂƌŝĂƟŽŶŵĂLJŚĂǀĞďĞĞŶ ƚŚĞĨĂĐƚƚŚĂƚĂƐŝŐŶŝĮĐĂŶƚƉĂƌƚŽĨƚŚĞƐƚƵĚLJƉŽƉƵůĂƟŽŶ;ΕϯϬйͿǁĂƐŶŽƚŝŵƉƌŝƐŽŶĞĚ ĂƚƚŚĞƟŵĞŽĨƚŚĞƐĐƌĞĞŶŝŶŐ͘dŚĂƚŝƐ͕ŽƚŚĞƌƐŚĂǀĞƉŽŝŶƚĞĚĂƚƚŚĞƉŽƐƐŝďůĞĂƐƐŽĐŝĂƟŽŶ ďĞƚǁĞĞŶ;ĚƵƌĂƟŽŶŽĨͿƉƌŝƐŽŶƟŵĞĂŶĚƚŚĞŝŶĐŝĚĞŶĐĞĂŶĚƉƌĞǀĂůĞŶĐĞŽĨŵĞŶƚĂůĚŝƐŽƌĚĞƌƐ ;ŶĚĞƌƐĞŶ͕ϮϬϬϰͿ͘ ůŝŵŝƚĂƟŽŶŽĨƚŚŝƐƐƚƵĚLJŝƐƚŚĂƚƚŚĞ^dďĂƐĞĚŽŶƚŚĞ^^DͲǁĂƐĐŽŶƐƚƌƵĐƚĞĚƚŽ ĚŝƐƟŶŐƵŝƐŚĂWD,ƚĂƌŐĞƚŐƌŽƵƉĂŵŽŶŐƐƚƉĞŽƉůĞŝŶŶĞĞĚĨŽƌƐƚĂďůĞŚŽƵƐŝŶŐĂŶĚƐŽĐŝĂů ďĞŶĞĮƚ͘ƐĂĐŽŶƐĞƋƵĞŶĐĞ͕ƚŚĞǁĞŝŐŚƚŽĨƚŚĞĚŽŵĂŝŶƐ,ŽƵƐŝŶŐĂŶĚ&ŝŶĂŶĐĞǁŝƚŚŝŶƚŚĞ ^dĂůŐŽƌŝƚŚŵŝƐůŝŵŝƚĞĚ͕ǁŚĞƌĞĂƐŝŶĂƉŽƉƵůĂƟŽŶŽĨĐƌŝŵŝŶĂůŽīĞŶĚĞƌƐƚŚĞƐĞǁĞŝŐŚƚƐ ĂƌĞůŝŬĞůLJƚŽďĞůĂƌŐĞƌ͘dŽĐŚĞĐŬĨŽƌŝŵƉĂĐƚ͕ĂƐĞŶƐŝƟǀŝƚLJĂŶĂůLJƐŝƐǁĂƐĐŽŶĚƵĐƚĞĚŝŶǁŚŝĐŚ

ϭϭϭ ƚŚĞ^dǁĂƐůŝŵŝƚĞĚƚŽĂƐƵďŐƌŽƵƉǁŚŽǁĂƐĂƚďĞƐƚ͚ďĂƌĞůLJƐĞůĨͲƐƵĸĐŝĞŶƚ͛ŝŶƚŚĞĚŽŵĂŝŶ ,ŽƵƐŝŶŐ;EсϯϬϯͿ͘/ŶƚŚŝƐƐƉĞĐŝĮĐŐƌŽƵƉ͕ƚŚĞĞƐƟŵĂƚĞĚƐŝnjĞŽĨƚŚĞWD,ƉŽƉƵůĂƟŽŶ ǁĂƐĂƐŚŝŐŚĂƐϰϴ͘ϴй͘dŚƵƐ͕ĂƉƉůLJŝŶŐƚŚĞ^dŝŶƚŚĞƉƌĞƐĞŶƚƐƚƵĚLJŵĂLJŚĂǀĞůĞĂĚƚŽĂŶ ƵŶĚĞƌĞƐƟŵĂƟŽŶŽĨƚŚĞWD,ƉŽƉƵůĂƟŽŶƐŝnjĞ͘ /ŶƐŚŽƌƚ͕ƚŚŝƐƐƚƵĚLJĐŽŶĮƌŵƐƚŚĞƉƌĞƐƵŵƉƟŽŶƚŚĂƚĂĨŽƌĞŶƐŝĐƉŽƉƵůĂƟŽŶŽĨǀŝŽůĞŶƚ ŽīĞŶĚĞƌƐŵĂLJŚŽƐƚĂůĂƌŐĞŶƵŵďĞƌŽĨǀƵůŶĞƌĂďůĞƉĞŽƉůĞ͕ĚĞĮŶĞĚĂƐƚŚĞĞdžƚĞŶƚƚŽǁŚŝĐŚ ƚŚĞLJŵĞĞƚĐƌŝƚĞƌŝĂĨŽƌĞŶƚĞƌŝŶŐƚŚĞWD,ƐLJƐƚĞŵ͘ƐƐƵĐŚ͕ŝƚƐƚƌĞƐƐĞƐƚŚĞŝŵƉŽƌƚĂŶĐĞŽĨ ĐŽŵďŝŶŝŶŐũƵĚŝĐŝĂůĂĐƟŽŶƐŝŶĂĚŝǀĞƌƐŝŽŶƉƌŽŐƌĂŵǁŝƚŚƐĐƌĞĞŶŝŶŐĂŶĚƟŵĞůLJŽƌŐĂŶŝnjĂƟŽŶ ŽĨĂƉƉƌŽƉƌŝĂƚĞƐƵƉƉŽƌƚ͕ŝŶĐůƵĚŝŶŐƉƌŽǀŝƐŝŽŶŽĨ;ŵĞŶƚĂůͿŚĞĂůƚŚĐĂƌĞ͘ŌĞƌĂůů͕ŽŶůLJĂ ŵŝŶŽƌŝƚLJŽĨƚŚŽƐĞĞŶƚĞƌŝŶŐƉƌŝƐŽŶĂƌĞůŝŬĞůLJƚŽďĞŝŶĐŽŶƚĂĐƚǁŝƚŚŚĞĂůƚŚĐĂƌĞ;ŝŶĐůƵĚŝŶŐ ĂŐĞŶĞƌĂůƉƌĂĐƟƟŽŶĞƌͿďĞĨŽƌĞĞŶƚĞƌŝŶŐƉƌŝƐŽŶ;DŽƌĞΘtĞŝũƚĞƌƐ͕ϮϬϭϭͿĂŶĚƐƚƵĚŝĞƐ ŝŶĚŝĐĂƚĞƚŚĂƚƚƌĞĂƚŵĞŶƚŐĂƉƐĂƚƚŚĞƐƚĂƌƚŽĨĚĞƚĞŶƟŽŶƉĞƌŝŽĚƐƚĞŶĚƚŽĞŶĚƵƌĞďŽƚŚ ĚƵƌŝŶŐĂŶĚĂŌĞƌŝŵƉƌŝƐŽŶŵĞŶƚ;ĚĞtŝƚ͕^ĞŐĞƌĞŶ͕ΘtŝƩĞǀĞĞŶ͕ϮϬϭϮ͖dĞƌĂŬĞ͕Ğ :ŽŶŐŚ͕ĞĂŬŬĞƌ͕ΘĞǀŝůůĠ͕ϮϬϬϱͿ͘dŚŝƐŝƐƵŶĨŽƌƚƵŶĂƚĞ͕ƐŝŶĐĞƉƌŝƐŽŶƟŵĞƉƌŽǀŝĚĞƐ ĂŶŽƉƉŽƌƚƵŶŝƚLJƚŽƌĞĂĐŚƉĞƌƐŽŶƐǁŚŽĂƌĞŽƚŚĞƌǁŝƐĞĚŝĸĐƵůƚƚŽĞŶŐĂŐĞ͘tĞĮŶĚƚŚĞ ĨĂĐƚƚŚĂƚ͕ƚŽĚĂƚĞ͕ĂƚůĞĂƐƚϲϬйŽĨǀŝŽůĞŶƚŽīĞŶĚĞƌƐŝŶŵƐƚĞƌĚĂŵĐŽŽƉĞƌĂƚĞĚǁŝƚŚĂ ǀŽůƵŶƚĂƌLJƐĐƌĞĞŶŝŶŐ͕ŽĨǁŚŽŵϳϬйǁŚŝůĞŝŵƉƌŝƐŽŶĞĚ͕ƉƌŽŵŝƐŝŶŐŝŶƚŚĂƚƌĞƐƉĞĐƚ͘

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