Posttraumatic stress disorder among Sri Lankan University students as a consequence of their exposure to family violence

Healthcare Professionals' Own Experiences of Domestic Violence and Abuse: A Meta-Analysis of Prevalence and Systematic Review of Risk Markers and Consequences

Background: Globally, healthcare professionals (HCPs) are increasingly asked to identify and respond to domestic violence and abuse (DVA) among patients. However, their own experiences of DVA have been largely ignored.Aim: To determine the prevalence of current and lifetime DVA victimisation among HCPs globally, and identify risk markers, consequences and support-seeking for DVA.Method: PubMed, EMBASE, PsycINFO, CINAHL ASSIA and ProQuest were searched. Studies about HCPs' personal experience of any type of DVA from any health service/country were included. Meta-analysis and narrative synthesis were adopted.Results: Fifty-one reports were included. Pooled lifetime prevalence was 31.3% (95% CI [24.7%, 38.7%] p < .001)) and past-year prevalence was 10.4% (95% CI [5.8%, 17.9%] p <.001). Pooled lifetime prevalence significantly differed (Qb=6.96, p < .01) between men (14.8%) and women (41.8%), and between HCPs in low-middle income (64.0%) and high-income countries (20.7%) (Qb = 31.41, p <.001). Risk markers were similar to those in the general population, but aspects of the HCP role posed additional and unique risks/vulnerabilities. Direct and indirect consequences of DVA meant HCP-survivors were less able to work to their best ability. While HCP-survivors were more likely than other HCPs to identify and respond to DVA among patients, doing so could be distressing. HCP-survivors faced unique barriers to seeking support. Being unable to access support - which is crucial for leaving or ending relationships with abusive people - leaves HCP-survivors entrapped.Conclusion: Specialised DVA interventions for HCPs are urgently needed, with adaptations for different groups and country settings. Future research should focus on developing interventions with HCP-survivors.

Exposure to Family Violence in Childhood, Self-Efficacy, and Posttraumatic Stress Symptoms in Young Adulthood

This study aimed to examine the relationship of exposure to family violence (i.e., experiencing parental physical violence [PH] and psychological aggression [PA] and witnessing interparental PH and PA) during childhood and adolescence with posttraumatic stress symptoms (PTSS) during young adulthood. In addition, the mediating role of self-efficacy in this relationship was investigated. Data were collected from a convenience sample of 516 university and college students in Israel (90.7% female and 9.3% male; M_age = 24.9, SD = 2.7). The results revealed that experiencing parental violence and witnessing interparental violence during childhood and adolescence were associated with high levels of current PTSS. The results also indicate that experiencing parental violence was associated with lower levels of self-efficacy, whereas no such significant relationship was found between witnessing interparental violence and self-efficacy. Furthermore, a negative relationship was found between self-efficacy and PTSS. In addition, the results show a partial mediation effect of self-efficacy only on the relationship between experiencing parental violence and PTSS. The findings are interpreted in light of Bandura's Social Cognitive Theory. The strengths and limitations of the study as well as implications for future research are discussed.

Psycho-social profile of battered women in Galicia, Spain: Distress as a result of intimate partner violence and child abuse

In Spain, a country of great cultural diversity, there is an increasing demand for psychosocial care for victims of gender-based violence. The objective is to describe the psychosocial profile of these women residing in the Autonomous Community of Galicia. In a sample (n = 40) of victims of intimate partner violence, it was found a high incidence of PTSD, depression, and low self-esteem associated with greater severity of PTSD and depression. A prolonged relationship increases the types of violence experienced, which is associated with particular psychosocial conditions that are analyzed quanti-qualitatively in order to recommend interventions consistent with the problems detected.

Exposure to Family Violence, Perceived Psychological Adjustment of Parents, and the Development of Post-Traumatic Stress Symptoms Among Palestinian University Students

The article presents the results of a study on the relationship between exposure to (i.e., witnessing and experiencing) different patterns and types of family violence during childhood, during adolescence, and during young adulthood, on one hand, and adult post-traumatic stress symptoms (PTSS), on the other. A cross-sectional survey was conducted among 1,969 Palestinian students using a self-administered questionnaire. The results reveal that the more the participants witnessed and experienced psychological aggression (PS) and physical violence (PH) in their families of origin, the more they exhibited PTSS. Furthermore, the results indicate that a significant amount of the variance in the participants' PTSS could be attributed to their exposure to family violence, over and above the amounts of variance that were explained by their sociodemographic characteristics and by their perceptions of their parents' psychological adjustment. The limitations of the study and implications for future research are discussed.

Prevalence of depression and its correlates among undergraduates in Sri Lanka

AIMS

There is a dearth of mental health research on undergraduates in Sri Lanka. This study examines the prevalence of depression in a sample of Sri Lankan undergraduates, their exposure to threatening life events and the predictors of their depression.

METHODS

Responses of 4304 undergraduates were obtained on the Patient Health Questionnaire-9 and a measure of exposure to threatening life events, with binary logistic regression models used to identify the demographic and life event correlates of screening positive for Major Depressive Disorder (MDD).

RESULTS

PHQ-9 diagnoses of 'Major' and 'Other' depression were obtained by 9.3% and 13.5% of undergraduates, respectively. A higher likelihood of MDD was seen among those who were older and those living in hostels (compared to home), although no differences were seen between genders or those studying in different faculties. Likelihood of MDD was higher in undergraduates exposed to multiple threatening life events as well as those exposed to physical threat; family deaths; romantic break-ups; a problem with a close associate; educational difficulties; unemployment and domestic violence, and among male undergraduates harassed by another student.

CONCLUSIONS

MDD is prevalent in these undergraduates and universities need to develop services to assist them. Such services may also need to focus on supporting those who have experienced threatening life events, particularly those that arise as a result of being an undergraduate, as these may increase the risk of MDD.

Post-traumatic stress problems among poly-victimized Spanish youth: time effect of past vs. recent interpersonal victimizations

The cumulative effect of lifetime interpersonal victimization experiences (e.g., child maltreatment, sexual victimizations, conventional crime, witnessing indirect victimization, peer and sibling victimizations) on posttraumatic stress (PTS) symptoms is an important topic in the scientific literature. The objectives of the present study were: (a) to analyze the relationship between lifetime interpersonal victimizations and PTS symptoms, (b) to determine the most prevalent specific PTS symptoms among poly-victimized adolescents, and (c) to establish the time-based effect of interpersonal victimization experiences that occurred in the last year versus those that occurred years before on current level of PTS symptoms. Gender differences were taken into account for each of these objectives. Participants were 823 Spanish adolescents (63% girls and 37% boys) between 14 and 18 years of age recruited from May 2010 to November 2011 from schools in Barcelona, Spain. The majority (87.6%) was of Spanish nationality. The results highlighted the cumulative effect of interpersonal victimizations on PTS symptoms. Among poly-victims adolescents, the most prevalent PTS symptom was intrusive thoughts, but some differences were observed according to gender. The time-based effect of interpersonal victimizations showed a different pattern for girls and boys. For girls, the victimizing events occurring in past years had more explanatory power of the current PTS symptoms than those that occurred more recently. In boys, the interpersonal victimizing events occurring in the last year had the greater explanatory power. These results may have clinical and therapeutic value.

Childhood Exposure to Family Violence and Adult Trauma Symptoms: The Importance of Social Support from a Spouse

This study examines the roles of both positive and negative social support from a spouse as potential moderators of associations between experiences of physical abuse and exposure to intimate partner violence (IPV) as a child and adult trauma symptoms. We hypothesized that positive social support received from a spouse would have a buffering effect on trauma symptoms, while negative social support from a spouse would have a potentiating effect. Participants were 193 newlywed couples (total N = 386) randomly recruited from a marriage license database. Participants completed self-report questionnaires measuring the nature and severity of child maltreatment and trauma symptoms, and engaged in a brief video-taped task in which they discussed a personal problem with their partner. Positive and negative support behaviors exhibited during the recorded task were then coded. Results of a dyadic data analysis (actor partner interdependence model) indicated that positive social support from a spouse buffered against trauma symptoms among men who were exposed to IPV during childhood, while negative social support from a spouse potentiated trauma symptoms among men who were exposed either to IPV or child physical abuse (CPA). The buffering and potentiating effects of spousal support were reduced among men who were exposed to increasingly severe levels of both IPV and CPA. By contrast, women's trauma symptoms were unrelated to either positive or negative support from a spouse. These findings extend prior research by suggesting that, for men, day-to-day provisions of support from a spouse may play a key role in posttraumatic recovery.