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Hernandez Chilatra JA, Browning WR, Yildiz M, Sullivan TP, Pickering CE. Emotion Regulation, Coping Strategies, and Hazardous Drinking Among Family Caregivers of People With Alzheimer's Disease and Related Dementias. Res Gerontol Nurs 2024; 17:81-90. [PMID: 38507290 DOI: 10.3928/19404921-20240229-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
PURPOSE The current study investigated hazardous drinking and alcohol use disorders among 453 family caregivers of individuals living with Alzheimer's disease and related dementias (ADRD). METHOD We examined the prevalence of hazardous drinking and its relationship with emotion regulation and coping strategies (problem-solving, social support, and avoidance) using data from the first wave of a longitudinal study on daily ADRD caregiving experiences. A binary logistic regression model was performed to predict the relationship between potential risk factors and hazardous drinking. RESULTS Findings revealed that 18.1% of ADRD caregivers screened positive for hazardous drinking based on the Alcohol Use Disorders Identification Test-Consumption. Caregivers experiencing greater difficulties in emotion regulation and greater reliance on avoidance as a coping strategy were at higher risk of screening positive for hazardous drinking. CONCLUSION These findings stress the importance of targeted interventions to improve emotion regulation and reduce avoidance coping in ADRD caregivers, ultimately enhancing their well-being. [Research in Gerontological Nursing, 17(2), 81-90.].
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Fettig N, Mitchell H, Gassoumis Z, Nizam Z, Whittier Eliason S, Cory S. Adult Maltreatment Risk Factors: Adding Community-Level Factors to an Individual-Level Field. TRAUMA, VIOLENCE & ABUSE 2024; 25:5-21. [PMID: 36636944 DOI: 10.1177/15248380221137659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Adult maltreatment is a pervasive problem in the United States and has serious individual and societal consequences. Adult protective services (APS) agencies are the social services programs responsible for serving older adults and adults with disabilities who may be experiencing adult maltreatment. The adult maltreatment literature differentiates elder maltreatment from the maltreatment of adults with disabilities, yet APS agencies serve both groups. Understanding the etiology of adult maltreatment as well as the associated risk and protective factors is crucial for APS workers, clinical practitioners, researchers, and policymakers. To advance the evidence in this area, we undertook a scoping review to examine recent evidence on risk and protective factors associated with adult maltreatment. Searches of nine electronic databases were conducted in 2020 to identify studies published in peer-reviewed journals since 2010. A total of 29 studies were included in the final review. The findings identified several categories of risk factors associated with the individual: demographic traits, socioeconomic characteristics, physical and mental health, interpersonal issues, and historical events. Several studies identified caregiver and alleged perpetrator risk factors. However, the current body of research lacks community and contextual risk and protective factors. Therefore, we present several potential data sources that may be leveraged to examine the links between social-contextual characteristics and adult maltreatment. These data may be combined with APS data to advance the field's understanding of risk and protective factors through advanced analytic techniques.
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Affiliation(s)
| | | | | | - Zainab Nizam
- WRMA, Inc., a TriMetrix Company, Arlington, VA, USA
| | | | - Scott Cory
- Administration for Community Living, Washington, DC, USA
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Zanbar L, Lev S, Faran Y. Can Physical, Psychological, and Social Vulnerabilities Predict Ageism? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:171. [PMID: 36612491 PMCID: PMC9819222 DOI: 10.3390/ijerph20010171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/19/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
Ageism can be expressed as the discrimination, social exclusion, and even abuse of older adults. The literature suggests that certain vulnerabilities could be risk factors affecting people's ageism. Based on the Social Identity Theory, the present study aimed to examine the association of physical/psychological and social vulnerabilities with ageism. The sample consisted of 200 Israelis from the general population who completed self-report questionnaires. Hierarchical regression indicated that low well-being, high post-traumatic distress, and limited social support were associated with ageism. Furthermore, the association of post-traumatic distress with ageism increased with age. The findings expand the knowledge of vulnerabilities as risk factors for ageism, perhaps reflecting its unconscious nature, and can assist in designing interventions for people interacting with older adults.
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Affiliation(s)
- Lea Zanbar
- School of Social Work, Ariel University, Ariel 40700, Israel
- Faculty of Social Work, Ashkelon Academic College, Ashkelon 78211, Israel
| | - Sagit Lev
- School of Social Work, Bar Ilan University, Ramat-Gan 52900, Israel
| | - Yifat Faran
- Faculty of Social Work, Ashkelon Academic College, Ashkelon 78211, Israel
- Department of Special Education, Hemdat Hadarom College Sdot Hanegev Regional Council, Netivot 8771302, Israel
- Department of Gerontology, Ben Gurion University, Be’er Sheva 8410501, Israel
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Khani F, Pourmotabbed A, Hosseinmardi N, Nedaei SE, Fathollahi Y, Azizi H. Impairment of spatial memory and dorsal hippocampal synaptic plasticity in adulthood due to adolescent morphine exposure. Prog Neuropsychopharmacol Biol Psychiatry 2022; 116:110532. [PMID: 35149126 DOI: 10.1016/j.pnpbp.2022.110532] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 02/02/2022] [Accepted: 02/05/2022] [Indexed: 12/12/2022]
Abstract
Opioid exposure during adolescence, a crucial period of neurodevelopment, has lasting neurological and behavioral consequences and affects the cognitive functions in adulthood. This study investigated the effects of adolescent morphine exposure in spatial learning and memory and synaptic plasticity of the CA1 area of the dorsal hippocampus. Adolescent Wistar rats received increasing doses of morphine for 1, 5, and 10 days. Acute morphine group was injected 2.5 mg/kg morphine for 1 day, subchronic morphine group for 5 days, with an increasing dose of 2.5 mg/kg and reached to the dose of 12.5 mg/kg and chronic morphine group for 10 days that began with an increasing dose of 2.5 mg/kg and reached to the dose of 25 mg/kg. Then after 25 days and reaching adulthood, spatial learning and memory were evaluated via the Morris water maze (MWM) test. Moreover, we test the electrophysiological properties of dorsal hippocampal plasticity in adult rats by in vitro field potential recordings. Subchronic and chronic adolescent morphine exposure impaired spatial learning and memory in the MWM test. Baseline synaptic responses in the chronic morphine group were increased and long-term potentiation (LTP) impaired in the CA1 area in subchronic and chronic morphine groups. In adulthood, the slope of the field excitatory postsynaptic potential (fEPSP) required to elicit a half-maximal population spike (PS) amplitude was significantly larger in subchronic and chronic adolescent morphine exposure compared to the saline group. Therefore, subchronic and chronic adolescent morphine exposure altered synaptic transmission and plasticity in addition to learning and memory. Long-term morphine exposure during adolescence can interfere with neurodevelopment, making a persistent impression on plasticity and cognitive capability in adulthood.
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Affiliation(s)
- Fatemeh Khani
- Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Ali Pourmotabbed
- Department of Physiology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Narges Hosseinmardi
- Department of Physiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Ershad Nedaei
- Department of Physiology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Yaghoub Fathollahi
- Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Hossein Azizi
- Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
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Contact-Fraud Victimization among Urban Seniors: An Analysis of Multilevel Influencing Factors. ISPRS INTERNATIONAL JOURNAL OF GEO-INFORMATION 2022. [DOI: 10.3390/ijgi11030201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Fraud crime against seniors has become a serious social problem both at home and abroad. While most of the relevant research focuses on non-contact fraud against seniors, a few studies attend to contact fraud targeted at seniors. By constructing a theoretical framework of “environment–activity–fraud victimization” based on the integration of multiple theories, this study conducts a multilevel logit analysis of contact-fraud victimization among urban seniors in the downtown area of Guangzhou at the individual and neighborhood levels. The results show that contact-fraud victimization among urban seniors is influenced by individual-level factors and neighborhood-level factors, and that individual-level factors play a more significant role. More specifically, seniors with higher education levels and lower levels of self-control are more likely to experience contact-fraud victimization, while seniors who are older and healthier, and have higher household income are significantly less likely to experience contact-fraud victimization. Further, higher levels of collective efficacy and better living environments in the neighborhood significantly reduce the probability of contact-fraud victimization among urban seniors, while the percentage of the migrant population, the percentage of the aging population, and developed traffic environments significantly increase the probability of seniors experiencing contact fraud. This study confirms the feasibility of examining contact-fraud victimization among urban seniors based on the integration of theories, and enriches the research results of crime geography in terms of contact-fraud victimization among urban seniors.
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Steinman KJ, Liu PJ, Anetzberger G, Pettey Rockwood A, Teferra A, Ejaz FK. Using administrative data from adult protective services: opportunities and considerations. J Elder Abuse Negl 2022; 34:77-92. [PMID: 35034566 DOI: 10.1080/08946566.2021.2020700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
As federal agencies support the development of data systems for adult protective services (APS), researchers and practitioners are increasingly using administrative data to study types of adult maltreatment, including self-neglect, and the systems that respond to them. To date, however, APS has worked with little guidance about how best to use these data. This situation has contributed to inconsistent findings and uneven quality of research. Based on the authors' experience in multiple states and using examples from research and practice, this paper reviews practical considerations related to organizing and analyzing APS administrative data. We address concerns related to time-limited, erroneous, and missing data, as well as defining metrics and accounting for the multilevel structure of data with repeated observations. Reviewing these methodological details can help APS practitioners strengthen quality assurance processes and improve research in this important area.
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Affiliation(s)
- Kenneth J Steinman
- College of Education and Human Ecology, The Ohio State University, Columbus, Ohio USA
| | - Pi-Ju Liu
- School of Nursing and Center on Aging and the Life Course, Purdue University, West Lafayette, Indiana USA
| | - Georgia Anetzberger
- Mandel School of Applied Social Sciences and School of Medicine, Case Western Reserve University, South Euclid, Ohio USA
| | | | - Andreas Teferra
- Division of Epidemiology, College of Public Health, the Ohio State University, Columbus, Ohio USA
| | - Farida Kassim Ejaz
- Center for Research and Education, Benjamin Rose Institute on Aging, Cleveland, Ohio USA
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Liu PJ, Hass Z, Stratton SK, Conrad KM, Conrad KJ. OUP accepted manuscript. THE GERONTOLOGIST 2022; 62:1359-1368. [PMID: 35323945 PMCID: PMC9579456 DOI: 10.1093/geront/gnac040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Indexed: 12/02/2022] Open
Abstract
Background and Objectives Adult Protective Services (APS) are the frontline agencies investigating elder mistreatment and providing/coordinating postinvestigation services. Yet, their effectiveness in reducing different types of mistreatment in relation to services is unknown. This study aimed to address the knowledge gap by identifying services provided by mistreatment type, and examining the associations of services with mistreatment reduction. Research Design and Methods A pretest–post-test design was implemented using the Identification, Services, and Outcomes (ISO) Matrix to assess mistreatment levels during case investigation and at case closure after services were provided. San Francisco and Napa APS participated in a 6-month data collection. Results The 4 most prevalent types of mistreatment were examined: emotional, physical, financial abuse, and neglect by others. On average, level of mistreatment decreased across mistreatment types after APS intervention. Care/case management, mental health, and other services were most common, while specific services differed depending on type of mistreatment. Care/case management services were associated with physical and emotional abuse reduction, legal services further correlated with emotional abuse reduction; financial planning services were associated with financial abuse reduction; care/case management and other services were associated with neglect reduction. Discussion and Implications This is the first study to address APS services by mistreatment type and the outcomes of services. Adoption of the ISO Matrix by APS programs opens the possibility of research and practice collaboration in APS outcomes research using a standardized approach.
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Affiliation(s)
- Pi-Ju Liu
- Address correspondence to: Pi-Ju Liu, PhD, School of Nursing, Purdue University, 502 North University Street, West Lafayette, IN 47907, USA. E-mail:
| | - Zachary Hass
- Schools of Nursing and Industrial Engineering and Regenstrief Center for Healthcare Engineering, Purdue University, West Lafayette, Indiana,USA
| | - Sara K Stratton
- San Francisco Adult Protective Services, Department of Aging and Adult Services, City and County of San Francisco, San Francisco, California, USA
| | - Karen M Conrad
- Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Kendon J Conrad
- Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, Illinois, USA
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Dash K, Breckman R, Lees-Haggerty K, Elman A, Lachs M, Stoeckle RJ, Fulmer T, Rosen T. Developing a tool to assess and monitor institutional readiness to address elder mistreatment in hospital emergency departments. J Elder Abuse Negl 2021; 33:311-326. [PMID: 34496716 DOI: 10.1080/08946566.2021.1965930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Hospital emergency departments (EDs) lack the tools and processes required to facilitate consistent screening and intervention in cases of elder abuse and neglect. To address this need, the National Collaboratory to Address Elder Mistreatment has developed a clinical care model that ED's can implement to improve screening, referral, and linkage to coordinated care and support services for older adults who are at risk of mistreatment. To gauge ED readiness to change and facilitate adoption of the care model, we developed an organizational assessment tool, the Elder Mistreatment Emergency Department Assessment Profile (EM-EDAP). Development included a phased approach in which we reviewed evidence on best practice; consulted with multidisciplinary experts; and sought input from ED staff. Based on this formative research, we developed a tool that can be used to guide EDs in focusing on practice improvements for addressing elder mistreatment that are most responsive to local needs and opportunities.
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Affiliation(s)
- Kim Dash
- Health Promotion, Practice, and Innovation, US Division, Education Development Center, Waltham, MA, USA
| | - Risa Breckman
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine/Ne York Presbyterian Hospital, New York, NY, USA
| | - Kristin Lees-Haggerty
- Health Promotion, Practice, and Innovation, US Division, Education Development Center, Waltham, MA, USA
| | - Alyssa Elman
- Department of Emergency Medicine, Weill Cornell Medicine/New York Presbyterian Hospital, New York, NY, USA
| | - Mark Lachs
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine/Ne York Presbyterian Hospital, New York, NY, USA
| | - Rebecca Jackson Stoeckle
- Health Promotion, Practice, and Innovation, US Division, Education Development Center, Waltham, MA, USA
| | - Terry Fulmer
- The John A. Hartford Foundation, New York, NY, USA
| | - Tony Rosen
- Department of Emergency Medicine, Weill Cornell Medicine/New York Presbyterian Hospital, New York, NY, USA
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Schwab-Reese LM, Murfree L, Coppola EC, Liu PJ, Hunter AA. Homicide-suicide across the lifespan: a mixed methods examination of factors contributing to older adult perpetration. Aging Ment Health 2021; 25:1750-1758. [PMID: 32686960 DOI: 10.1080/13607863.2020.1795620] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The purpose of this study is to determine how individual and contextual factors that contribute to homicide-suicide (HS) differ between young adults, middle-aged adults, and older adults, and to describe, in detail, the circumstances that lead to HS by older adults. METHODS Data were obtained from the Center for Disease Control and Prevention (CDC) National Violent Death Reporting System. We used a sequential mixed methods approach to the analysis. Guided by the Marzuk HS framework, we conducted quantitative analyses to identify characteristics distinguishing older adult HS perpetrators from younger HS perpetrators. These results guided the qualitative content analysis, which further described the circumstances surrounding HS incidents perpetrated by older adults. RESULTS While HS perpetrated by young and middle-aged adults were quite similar, the demographic characteristics, victim-perpetrator relationship, and contributing factors in HS incidents perpetrated by older adults were substantially different. Mental health and depressed mood were more common among older adult perpetrators, and jealousy, fights, and substance use issues were less common, relative to younger perpetrators. Escalating intimate partner violence and caregiving/health-related issues, including caregiving strain, housing transitions, and financial problems, were the primary contributors to older adult HS. CONCLUSION HS perpetrated by older adults was both similar and different from incidents perpetrated by younger adults. Programs that prevent or de-escalate intimate partner violence would likely prevent many HS incidents perpetrated by older adults, but health and aging-related issues must also be considered.
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Affiliation(s)
| | - Lauren Murfree
- Department of Health & Kinesiology, Purdue University, West Lafayette, IN, USA
| | - Elizabeth C Coppola
- Department of Human Development & Family Studies, Purdue University, West Lafayette, IN, USA
| | - Pi-Ju Liu
- School of Nursing and Center on Aging and the Life Course, Purdue University, West Lafayette, IN, USA
| | - Amy A Hunter
- Injury Prevention Center at Connecticut Children's and Hartford Hospital, Departments of Pediatrics and Public Health Sciences, UCONN School of Medicine, Hartford, CT, USA
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Ghadigaonkar DS, Kandasamy A, Sivakumar PT. Forensic Aspects of Substance Use in Older Adults. Indian J Psychol Med 2021; 43:S128-S133. [PMID: 34732965 PMCID: PMC8543613 DOI: 10.1177/02537176211047957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Older adults are at high risk of developing more severe consequences of substance use. Due to aging, they may also have multiple medical and psychiatric comorbidities as well as cognitive impairment. This may lead to forensic issues both in terms of civil and criminal matters. This article will review the forensic issues of substance use and their relevance to the older population in particular.
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Affiliation(s)
| | - Arun Kandasamy
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
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Herrenkohl TI, Roberto KA, Fedina L, Hong S, Love J. A Prospective Study on Child Abuse and Elder Mistreatment: Assessing Direct Effects and Associations With Depression and Substance Use Problems During Adolescence and Middle Adulthood. Innov Aging 2021; 5:igab028. [PMID: 34568586 PMCID: PMC8457646 DOI: 10.1093/geroni/igab028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND AND OBJECTIVES We examined the prospective association between 2 measures of child abuse, one based on official child welfare records and the other based on parent self-reports, and the perpetration of elder mistreatment by an adult child. We also examined measures of adolescent and adult depression and substance use problems as predictors of elder mistreatment. RESEARCH DESIGN AND METHODS Data are from a prospective study that began in the 1970s with a sample of children aged 18 months to 6 years of age. Analyses draw on data collected when child participants were in preschool and elementary school, when they were adolescents, and as adults at midlife (at ages 36 and 46, on average). Results are from bivariate correlations and multivariable path models in which variables from different life stages were entered in steps to assess their prediction of elder mistreatment. RESULTS All variables were significantly correlated with elder mistreatment. In a final path model, parent self-reports of physical child abuse remained a significant, unique predictor of elder mistreatment. Adolescent and adult substance use problems were also statistically significant. DISCUSSION AND IMPLICATIONS Few longitudinal studies have tracked patterns of abuse over time and relationships. Findings suggest that child abuse is a risk factor for the perpetration of elder mistreatment by an adult child. Substance use problems may also increase the risk for the perpetration of elder mistreatment. Further longitudinal research is needed to replicate and extend these findings in order to advance prevention and intervention programs and policies.
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Affiliation(s)
- Todd I Herrenkohl
- School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
| | - Karen A Roberto
- Center for Gerontology & Institute for Society, Culture and Environment, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
| | - Lisa Fedina
- School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
| | - Sunghyun Hong
- School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
| | - Jasmine Love
- School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
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Roberto KA, McCann BR. Violence and Abuse in Rural Older Women's Lives: A Life Course Perspective. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP2205-2227NP. [PMID: 29448906 PMCID: PMC10225066 DOI: 10.1177/0886260518755490] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Intimate partner violence in later life includes physical, psychological, sexual, and financial abuse. Although some researchers have investigated how women in long-term violent partnerships cope with abuse, little is known about the history, experiences, and needs of older women who leave abusive relationships. From a feminist, life course perspective, we interviewed 10 women who had left their abusive partners later in life. We used qualitative methods to analyze the data and found four major themes: (a) the women used the past to account for abuse in their relationships later in life, (b) recognizing abuse signaled to the women to fight back and exit the relationship, (c) financial abuse and exploitation affected women's mental and physical health, and (d) rebuilding was especially challenging as the women faced their future alone with financial, physical, or mental health problems. We conclude that abuse presents lasting and unique challenges for older women.
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Affiliation(s)
- Karen A. Roberto
- Virginia Polytechnic Institute and State University, Blacksburg, USA
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Liu PJ, Stratton SK, Hass Z, Conrad KJ. Can standardized measures provide helpful feedback about adult protective services substantiation? Pilot data from a short self-neglect assessment. J Elder Abuse Negl 2020; 32:259-274. [PMID: 32242767 DOI: 10.1080/08946566.2020.1742837] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Can standardized assessment contribute to improving Adult Protective Services (APS) practice? In this exploratory study, San Francisco and Napa APS utilized a newly developed short self-neglect assessment to test how standardized measures provide information for substantiation decision making. Findings demonstrated satisfactory reliability and validity for the short self-neglect assessment, and analyses revealed important issues that could improve practice. Review of outliers revealed: (1) problems using the assessment tool, (2) misunderstandings of APS procedures, and (3) struggles navigating the case management system. These revelations could all be easily addressed in training. Caseworker's clinical judgment and experience also continue to have a place in complementing the use of the standardized assessment.
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Affiliation(s)
- Pi-Ju Liu
- School of Nursing and Center on Aging and the Life Course, Purdue University , West Lafayette, Indiana, USA
| | - Sara K Stratton
- San Francisco Adult Protective Services, Department of Aging and Adult Services, San Francisco, California, USA
| | - Zachary Hass
- Schools of Nursing and Industrial Engineering and Regenstrief Center for Healthcare Engineering, Purdue University , West Lafayette, Indiana, USA
| | - Kendon J Conrad
- Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago , Chicago, Illinois, USA
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Burnett J, Suchting R, Green CE, Cannell MB, Dyer CB. Socioecological indicators of senior financial exploitation: an application of data science to 8,800 substantiated mistreatment cases. J Elder Abuse Negl 2020; 32:105-120. [PMID: 32151209 DOI: 10.1080/08946566.2020.1737615] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Senior financial exploitation (FE) is prevalent and harmful. Its often insidious nature and co-occurrence with other forms of mistreatment make detection and substantiation challenging. A secondary data analysis of N = 8,800 Adult Protective Services substantiated senior mistreatment cases, using machine learning algorithms, was conducted to determine when pure FE versus hybrid FE was occurring. FE represented N = 2514 (29%) of the cases with 78% being pure FE. Victim suicidal ideation and threatening behaviors, injuries, drug paraphernalia, contentious relationships, caregiver stress, and burnout and victims needing assistance were most important for differentiating FE vs non-FE-related mistreatment. The inability to afford housing, medications, food, and medical care as well as victims suffering from intellectual disability disorder(s) predicted hybrid FE. This study distinguishes socioecological factors strongly associated with the presence of FE during protective service investigations. These findings support existing and new indicators of FE and could inform protective service investigation practices.
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Affiliation(s)
- Jason Burnett
- UTHealth McGovern Medical School, Division of Geriatric and Palliative Medicine, Houston, Texas, USA.,UTHealth McGovern Medical School, Texas Elder Abuse and Mistreatment Institute (TEAM), Houston, Texas, USA
| | - Robert Suchting
- Department of Psychiatry and Behavioral Sciences, UTHealth McGovern Medical School, Houston, Texas, USA
| | - Charles E Green
- Department of Psychiatry and Behavioral Sciences, UTHealth McGovern Medical School, Houston, Texas, USA.,UTHealth McGovern Medical School, Center for Clinical and Evidence-Based Medicine, Houston, Texas, USA
| | - M Brad Cannell
- UTHealth McGovern Medical School, Texas Elder Abuse and Mistreatment Institute (TEAM), Houston, Texas, USA.,Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, Dallas, Texas, USA
| | - Carmel B Dyer
- UTHealth McGovern Medical School, Division of Geriatric and Palliative Medicine, Houston, Texas, USA.,UTHealth McGovern Medical School, Texas Elder Abuse and Mistreatment Institute (TEAM), Houston, Texas, USA
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15
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DeLiema M. Elder Fraud and Financial Exploitation: Application of Routine Activity Theory. THE GERONTOLOGIST 2018; 58:706-718. [PMID: 28329818 PMCID: PMC6044329 DOI: 10.1093/geront/gnw258] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Indexed: 11/13/2022] Open
Abstract
Background and Objectives Elder financial exploitation, committed by individuals in positions of trust, and elder fraud, committed by predatory strangers, are two forms of financial victimization that target vulnerable older adults. This study analyzes differences between fraud and financial exploitation victims and tests routine activity theory as a contextual model for victimization. Routine activity theory predicts that criminal opportunities arise when a motivated offender and suitable target meet in the absence of capable guardians. Research Design and Methods Fifty-three financial exploitation and fraud cases were sampled from an elder abuse forensic center. Data include law enforcement and caseworker investigation reports, victim medical records, perpetrator demographic information, and forensic assessments of victim health and cognitive functioning. Results Fraud and financial exploitation victims performed poorly on tests of cognitive functioning and financial decision making administered by a forensic neuropsychologist following the allegations. Based on retrospective record review, there were few significant differences in physical health and cognitive functioning at the time victims' assets were taken, although their social contexts were different. Significantly more fraud victims were childless compared with financial exploitation victims. Fraud perpetrators took advantage of elders when they had no trustworthy friends or relatives to safeguard their assets. Discussion and Implications Findings support an adapted routine activity theory as a contextual model for financial victimization. Fraud most often occurred when a vulnerable elder was solicited by a financial predator in the absence of capable guardians. Prevention efforts should focus on reducing social isolation to enhance protection.
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Sneider JT, Cohen-Gilbert JE, Hamilton DA, Stein ER, Golan N, Oot EN, Seraikas AM, Rohan ML, Harris SK, Nickerson LD, Silveri MM. Adolescent Hippocampal and Prefrontal Brain Activation During Performance of the Virtual Morris Water Task. Front Hum Neurosci 2018; 12:238. [PMID: 29997486 PMCID: PMC6028523 DOI: 10.3389/fnhum.2018.00238] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 05/24/2018] [Indexed: 12/17/2022] Open
Abstract
The frontal cortex undergoes substantial structural and functional changes during adolescence and significant developmental changes also occur in the hippocampus. Both of these regions are notably vulnerable to alcohol and other substance use, which is typically initiated during adolescence. Identifying measures of brain function during adolescence, particularly before initiation of drug or alcohol use, is critical to understanding how such behaviors may affect brain development, especially in these vulnerable brain regions. While there is a substantial developmental literature on adolescent working memory, less is known about spatial memory. Thus, a virtual Morris water task (vMWT) was applied to probe function of the adolescent hippocampus. Multiband blood oxygen level dependent (BOLD) functional magnetic resonance imaging (fMRI) data were acquired at 3T during task performance. Participants included 32 healthy, alcohol- and drug-naïve adolescents, 13–14 years old, examined at baseline of a 3-year longitudinal MRI study. Significantly greater BOLD activation was observed in the hippocampus and surrounding areas, and in prefrontal regions involved in executive function, during retrieval relative to motor performance. In contrast, significantly greater BOLD activation was observed in components of the default mode network, including frontal medial cortex, during the motor condition (when task demands were minimal) relative to the retrieval condition. Worse performance (longer path length) during retrieval was associated with greater activation of angular gyrus/supramarginal gyrus, whereas worse performance (longer path length/latency) during motor control was associated with less activation of frontal pole. Furthermore, while latency (time to complete task) was greater in females than in males, there were no sex differences in path length (accuracy), suggesting that females required more time to navigate the virtual environment, but did so as effectively as males. These findings demonstrate that performance of the vMWT elicits hippocampal and prefrontal activation patterns in early adolescence, similar to activation observed during spatial memory retrieval in adults. Given that this task is sensitive to hippocampal function, and that the adolescent hippocampus is notably vulnerable to the effects of alcohol and other substances, data acquired using this task during healthy adolescent development may provide a framework for understanding neurobiological impact of later initiation of use.
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Affiliation(s)
- Jennifer T Sneider
- Neurodevelopmental Laboratory on Addictions and Mental Health, McLean Hospital, Belmont, MA, United States.,Department of Psychiatry, Harvard Medical School, Harvard University, Boston, MA, United States
| | - Julia E Cohen-Gilbert
- Neurodevelopmental Laboratory on Addictions and Mental Health, McLean Hospital, Belmont, MA, United States.,Department of Psychiatry, Harvard Medical School, Harvard University, Boston, MA, United States
| | - Derek A Hamilton
- Department of Psychology, University of New Mexico, Albuquerque, NM, United States
| | - Elena R Stein
- Neurodevelopmental Laboratory on Addictions and Mental Health, McLean Hospital, Belmont, MA, United States
| | - Noa Golan
- Neurodevelopmental Laboratory on Addictions and Mental Health, McLean Hospital, Belmont, MA, United States
| | - Emily N Oot
- Neurodevelopmental Laboratory on Addictions and Mental Health, McLean Hospital, Belmont, MA, United States.,School of Medicine, Boston University, Boston, MA, United States
| | - Anna M Seraikas
- Neurodevelopmental Laboratory on Addictions and Mental Health, McLean Hospital, Belmont, MA, United States
| | - Michael L Rohan
- Department of Psychiatry, Harvard Medical School, Harvard University, Boston, MA, United States.,Brain Imaging Center, McLean Hospital, Belmont, MA, United States
| | - Sion K Harris
- Boston Children's Hospital, Harvard Medical School, Harvard University, Boston, MA, United States
| | - Lisa D Nickerson
- Department of Psychiatry, Harvard Medical School, Harvard University, Boston, MA, United States.,Applied Neuroimaging Statistics Laboratory, McLean Hospital, Belmont, MA, United States
| | - Marisa M Silveri
- Neurodevelopmental Laboratory on Addictions and Mental Health, McLean Hospital, Belmont, MA, United States.,Department of Psychiatry, Harvard Medical School, Harvard University, Boston, MA, United States.,School of Medicine, Boston University, Boston, MA, United States
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18
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Labrum T, Solomon PL. Elder Mistreatment Perpetrators with Substance Abuse and/or Mental Health Conditions: Results from the National Elder Mistreatment Study. Psychiatr Q 2018; 89:117-128. [PMID: 28534281 DOI: 10.1007/s11126-017-9513-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A large portion of persons who commit elder mistreatment have long been known to have indicators of substance abuse and/or mental health conditions (SAMHC). However, few studies have specifically examined elder mistreatment by persons with SAMHC, preventing the development of specialized intervention strategies. Using results from the National Elder Mistreatment Study, the current article examines victim, perpetrator, and interaction characteristics between cases of emotional and physical elder mistreatment in which the perpetrator is reported to have vs. not have SAMHC. Chi square tests and Mann-Whitney-Wilcoxon non-parametric tests were performed. 210 perpetrators of emotional elder mistreatment were reported to have SAMHC with 412 perpetrators of emotional mistreatment reported to not have SAMHC. 57 perpetrators of physical elder mistreatment were reported to have SAMHC with 38 perpetrators of physical mistreatment not having SAMHC. Emotional elder mistreatment committed by persons with SAMHC was associated with the following characteristics: perpetrator-unemployment, history of involvement with police, and fewer friendships; victim-female gender, greater emotional problems, and greater occurrences of lifetime emotional mistreatment; interaction-co-residence, and reporting of mistreatment to authorities. Physical elder mistreatment committed by persons with SAMHC was associated with police involvement of the perpetrator and greater occurrences of lifetime physical mistreatment experienced by the victim. These findings indicate that victims of elder mistreatment by persons with SAMHC are in particular need of intervention services as they have greater histories of mistreatment and experience greater emotional problems. Implications for effectively intervening in cases of elder mistreatment by persons with SAMHC are discussed.
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Affiliation(s)
- Travis Labrum
- Division of Social Work, College of Health Sciences, University of Wyoming, Dept. 3632, 1000 E. University Ave., Laramie, WY, 82071, USA.
| | - Phyllis L Solomon
- School of Social Policy and Practice, University of Pennsylvania, 3701 Locust Walk, Philadelphia, PA 19104, USA
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Beach SR, Liu PJ, DeLiema M, Iris M, Howe MJK, Conrad KJ. Development of short-form measures to assess four types of elder mistreatment: Findings from an evidence-based study of APS elder abuse substantiation decisions. J Elder Abuse Negl 2017; 29:229-253. [PMID: 28590799 DOI: 10.1080/08946566.2017.1338171] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Improving the standardization and efficiency of adult protective services (APS) investigations is a top priority in APS practice. Using data from the Elder Abuse Decision Support System (EADSS), we developed short-form measures of four types of elder abuse: financial, emotional/psychological, physical, and neglect. The EADSS data set contains 948 elder abuse cases (age 60+) with yes/no abuse substantiation decisions for each abuse type following a 30-day investigation. Item sensitivity/specificity analyses were conducted on long-form items with the substantiation decision for each abuse type as the criterion. Validity was further tested using receiver-operator characteristic (ROC) curve analysis, correlation with long forms and internal consistency. The four resulting short-form measures, containing 36 of the 82 original items, have validity similar to the original long forms. These short forms can be used to standardize and increase efficiency of APS investigations, and may also offer researchers new options for brief elder abuse assessments.
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Affiliation(s)
- Scott R Beach
- a University Center for Social and Urban Research , University of Pittsburgh , Pittsburgh , Pennsylvania , USA
| | - Pi-Ju Liu
- b Institute for Health and Aging , University of California, San Francisco , San Francisco , California , USA
| | - Marguerite DeLiema
- c Stanford Center on Longevity , Stanford University , Stanford , California , USA
| | - Madelyn Iris
- d Feinberg School of Medicine , Northwestern University , Evanston , Illinois , USA
| | | | - Kendon J Conrad
- f School of Public Health , University of Illinois at Chicago , Chicago , Illinois , USA
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Liu PJ, Wood S, Xi P, Berger DE, Wilber K. The Role of Social Support in Elder Financial Exploitation Using a Community Sample. Innov Aging 2017; 1:igx016. [PMID: 30480110 PMCID: PMC6234911 DOI: 10.1093/geroni/igx016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Social support is known to be an important protective factor against elder financial exploitation (FE), yet few empirical studies have examined the relationship between FE and distinct components of social support. Perceived social support, social network size, and interactions with close network members (positive and negative) were measured separately and tested as potential predictors of FE. RESEARCH DESIGN AND METHODS Three hundred and ninety-five community-dwelling adults aged 60 and older were recruited to complete a 90-minute survey and interview. We used OLS regression to examine the role of social support in FE. Other risk factors associated with FE including dependency, poor physical health, depression, cognition, and demographic characteristics were included as potential predictors. RESULTS Negative interactions with close network members predicted FE, and remained predictive when all other variables and social support factors were included in the model. Other social support factors were not unique predictors of FE. DISCUSSION AND IMPLICATIONS Negative social interactions with close network members are important to assess and consider in FE prevention and intervention programs; relationships between social interactions and other risk factors warrant further attention.
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Affiliation(s)
- Pi-Ju Liu
- Institute for Health and Aging, University of California, San Francisco
| | - Stacey Wood
- Psychology Department, Scripps College, Claremont, California
| | - Patricia Xi
- Division of Behavioral and Organizational Sciences, Claremont Graduate University, California
| | - Dale E Berger
- Division of Behavioral and Organizational Sciences, Claremont Graduate University, California
| | - Kathleen Wilber
- School of Gerontology, University of Southern California, Los Angeles
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