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Miles LW, Valentine JL, Mabey LJ, Hopkins ES, Stodtmeister PJ, Rockwood RB, Moxley ANH. A Systematic Review of Evidence-Based Treatments for Adolescent and Adult Sexual Assault Victims. J Am Psychiatr Nurses Assoc 2024; 30:480-502. [PMID: 38148646 PMCID: PMC11138126 DOI: 10.1177/10783903231216138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
BACKGROUND Sexual assault (SA) is a serious crime that is a prevalent mental and public health problem. AIMS Addressing the needs of SA victims and providing appropriate treatment are essential to reduce potential adverse short- and long-term outcomes. METHODS Our team undertook an extensive systematic literature review (published between January 2006 and July 2021) to provide evidence-based mental health intervention recommendations for adolescent and adult victims of SA. Where SA-specific research was limited, the literature and clinical practice guidelines on treatments for trauma-induced post-traumatic stress disorder (PTSD) were reviewed to provide additional information to formulate recommendations. RESULTS Findings strongly support several primary psychotherapy treatments: cognitive behavioral therapy, cognitive processing therapy, eye movement desensitization and reprocessing, narrative exposure therapy, and prolonged exposure therapy. Complementary (aerobic exercise, art, drama, and music therapy) and pharmacological treatments were explored. CONCLUSIONS Mental health nurses who provide services for victims of SA can utilize this overview to guide recommendations for treatment of SA trauma and related PTSD symptoms to mitigate the short- and long-term negative impacts after a traumatic event. When victims of SA receive optimal mental health treatments, our communities benefit as victims heal and recover.
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Affiliation(s)
- Leslie W. Miles
- Leslie W. Miles, DNP, PMHNP-BC, Brigham Young University College of Nursing, Provo, UT, USA
| | - Julie L. Valentine
- Julie L. Valentine, PhD, RN, SANE-A, FAAN, University of Utah, Salt Lake City, UT, USA
| | - Linda J. Mabey
- Linda J. Mabey, DNP, PMHCNS-BC, Brigham Young University College of Nursing, Provo, UT, USA
| | | | - Paige J. Stodtmeister
- Paige J. Stodtmeister, DNP, PMHNP-BC Brigham Young University College of Nursing, Provo, UT, USA
| | - Reilly B. Rockwood
- Reilly B. Rockwood, DNP, PMHNP-BC, Brigham Young University College of Nursing, Provo, UT, USA
| | - Alyssa N. H. Moxley
- Alyssa N. H. Moxley, DNP, CNM, WHNP-BC, Brigham Young University College of Nursing, Provo, UT, USA
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Waltzman D, Daugherty J, Haarbauer-Krupa J, Zheng X, Jorge C, Basile KC. Association Between Lifetime Sexual Violence and Recent Traumatic Brain Injury Among Adults: 2017 Connecticut Behavioral Risk Factor Surveillance System. JOURNAL OF INTERPERSONAL VIOLENCE 2024; 39:1351-1367. [PMID: 37804158 PMCID: PMC10962142 DOI: 10.1177/08862605231203962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/09/2023]
Abstract
Sexual violence (SV) is a critical public health problem that is associated with numerous negative health consequences, including immediate- and long-term physical and mental health conditions and health-risk behaviors. Some of these health-risk behaviors (e.g., substance use, unsafe driving practices, poor mental health, lower impulse control, and abnormal brain circuitry) might increase the risk for sustaining a traumatic brain injury (TBI). A TBI causes neurological or neuropsychological changes and may also lead to various symptoms that affect a person's cognition, mobility, behavior, and mental health. Determining if those who have experienced SV are at increased risk of sustaining a TBI in their lifetime is critical given the high prevalence and health impacts of SV, the potential vulnerability to TBI after SV, and the known detrimental effects of TBI. This exploratory study examined data from the 2017 Connecticut behavioral risk factor surveillance system and found that lifetime SV victimization (controlling for age and sex) was associated with increased odds of reporting a recent TBI in the past 12 months (adjusted odds ratio [AOR] = 2.1; 95% confidence interval [CI] [1.03, 4.21]). Further research is needed to better understand how SV history is related to the risk of sustaining a TBI. Healthcare professionals can support patients who experience SV by providing resources to help reduce associated physical and mental health conditions and health-risk behaviors.
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Affiliation(s)
- Dana Waltzman
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jill Daugherty
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Juliet Haarbauer-Krupa
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Xi Zheng
- Connecticut Department of Public Health, Hartford, CT, USA
| | - Celeste Jorge
- Connecticut Department of Public Health, Hartford, CT, USA
| | - Kathleen C. Basile
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
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3
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Spencer CM, Rivas-Koehl M, Astle S, Toews ML, McAlister P, Anders KM. Factors Correlated With Sexual Assault Victimization Among College Students in the United States: A Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2024; 25:246-259. [PMID: 36722372 DOI: 10.1177/15248380221146800] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Sexual assault (SA) continues to be a serious problem on college campuses in the United States. This meta-analysis sought to identify correlates for SA victimization on college campuses, as well as examine if there were any differences in correlates for men and women. Database searches utilizing Boolean search terms were used to identify studies to be included in the meta-analysis. Studies were included if they provided quantitative data on correlates for SA victimization among college students. A total of 118 studies yielding 405 unique effect sizes were included in this study. The strongest correlates for SA victimization among college students were physical intimate partner violence (IPV) perpetration, physical IPV victimization, emotional IPV victimization, and prior SA victimization. Other significant correlates were related to mental health (e.g., hopelessness, suicidal ideation, trauma symptoms, anxiety symptoms, depressive symptoms), and factors related to a campus party culture (e.g., binge drinking, alcohol use, drug use, Greek membership). We were able to compare seven correlates between men and women. Results of the meta-analysis also highlight the need for future research to examine additional correlates for SA victimization, as well as examine race/ethnicity and gender as separate categories when trying to further understand correlates for SA victimization.
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Gephine S, Fry S, Margoline E, Gicquello A, Chenivesse C, Grosbois JM. Home-based pulmonary rehabilitation for adults with severe asthma exposed to psychosocial chronic stressors. Respir Med 2023; 217:107349. [PMID: 37423480 DOI: 10.1016/j.rmed.2023.107349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/26/2023] [Accepted: 07/06/2023] [Indexed: 07/11/2023]
Abstract
OBJECTIVE To evaluate the effects of a home-based pulmonary rehabilitation (PR) programme on hyperventilation symptoms, anxiety and depressive symptoms, general fatigue, health-related quality of life (HRQoL) and exercise capacity in adults with severe asthma who have been exposed to psychosocial chronic stressors. METHODS Data on 111 non-selected consecutive adults with severe asthma who enrolled in an 8-week home-based PR programme (weekly supervised 90-min session) was retrospectively analysed. Chronic stressors included physical, sexual and psychological violence and/or a traumatic experience related to an intensive care unit stay. Hyperventilation symptoms (Nijmegen questionnaire), Hospital Anxiety and Depression Scale, Fatigue Assessment Scale, COPD Assessment Test, Six-Minute Stepper Test and Timed-Up and Go test were assessed at baseline and after PR. RESULTS At baseline, participants who have been exposed to chronic stressors (n = 48, 43.2%) were younger, more often female, more often treated for anxiety and depressive disorders, and had a higher score for anxiety symptoms, hyperventilation symptoms and a poorer HRQoL, compared to those who had not been exposed to chronic stressors (p < 0.05). All the study assessments were statistically improved after PR for both groups (p < 0.001). Anxiety and depressive symptoms, fatigue and health-related quality of life questionnaires were also clinically improved based on the minimal clinically important difference. CONCLUSION A large proportion of adults with severe asthma, mainly women, have been exposed to chronic stressors at the time of starting a PR programme, resulting in higher anxiety symptoms and hyperventilation symptoms. However, it did not prevent these individuals from benefiting from PR.
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Affiliation(s)
- Sarah Gephine
- FormAction Santé, F-59840, Pérenchies, France; Univ. Lille, Univ. Artois, Univ. Littoral Côte D'opale, ULR 7369-Urepsss- Lille, France.
| | | | | | - Alice Gicquello
- Hôpital Saint Vincent de Paul, Service de Pneumologie, F-59000, Lille, France
| | - Cécile Chenivesse
- Univ. Lille, CHU Lille, Inserm, CNRS, Institut Pasteur de Lille, U1019, UMR 9017, Center for Infection and Immunity of Lille (CIIL), CRISALIS, F-CRIN Inserm Network, Lille, France
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5
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Hollender M, Almirol E, Meyer M, Bearden H, Stanford KA. Sexual Assault Nurse Examiners Lead to Improved Uptake of Services: A Cross-Sectional Study. West J Emerg Med 2023; 24:974-982. [PMID: 37788040 PMCID: PMC10527845 DOI: 10.5811/westjem.59514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 04/13/2023] [Accepted: 05/24/2023] [Indexed: 10/04/2023] Open
Abstract
Introduction: Sexual Assault Nurse Examiners (SANE), who are trained to provide comprehensive and compassionate specialty care to sexual assault survivors, are increasingly used in the emergency department (ED), but there is little published literature to support their benefit. In this study we aimed to compare services offered and received by sexual assault survivors in the ED when care was provided by a SANE vs those with traditional care teams, hypothesizing that SANE utilization will be associated with improved uptake of recommended services. Methods: This was a retrospective review examining all patient encounters in which a sexual assault was disclosed in a large, urban, adult ED between June 1, 2019-June 30, 2022. We extracted timeline information from the ED encounter, demographic information, resources offered to and accepted by the patient, clinical care data, and continuity of care data from the medical record. We used unadjusted and adjusted analyses to compare patient demographics and services offered and accepted between SANE and non-SANE encounters. Results: We included a total of 182 encounters in the analysis, of which 130 (71.4%) involved SANEs. Demographics were similar between groups, except there was a larger proportion of cisgender men in the non-SANE group (14.0% vs 5.5%), and the timing of visits differed, with non-SANE visits more common during the overnight shift. All recommended testing, prophylaxis, and resources were offered more frequently during SANE visits, and all but one were more frequently accepted by patients during SANE visits, although not all comparisons reached statistical significance. Conclusion: Patients who received care from a SANE were more often offered recommended services and resources and more frequently accepted them. Making SANE care available at all times to these vulnerable patients would both improve patient outcomes and allow hospitals to meet required quality metrics. States should consider expanding legislation to encourage and fund SANE coverage for all hospitals to support access to vital resources in the ED for survivors of sexual assault.
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Affiliation(s)
| | - Ellen Almirol
- Chicago Center for HIV Elimination, Chicago, Illinois
| | - Makenna Meyer
- Chicago Center for HIV Elimination, Chicago, Illinois
| | - Heather Bearden
- University of Chicago, Section of Emergency Medicine, Chicago, Illinois
| | - Kimberly A Stanford
- Chicago Center for HIV Elimination, Chicago, Illinois
- University of Chicago, Section of Emergency Medicine, Chicago, Illinois
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6
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Behler AC, George N, Collibee C, Hamilton L, Oleson EB, Thamotharan S. A conceptual framework for queer, black womxn sexual assault survivors: an adaptation of the minoritised stress model. CULTURE, HEALTH & SEXUALITY 2023; 25:791-802. [PMID: 35900895 DOI: 10.1080/13691058.2022.2089734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 06/10/2022] [Indexed: 06/02/2023]
Abstract
Queer, Black womxn experience sexual assault at an alarming rate in the USA leading to adverse mental and physical health outcomes in survivors. A synthesis of the literature was conducted to understand their unique lived experiences and needs. This article proposes an adapted Meyer's Minoritised Stress framework to understand salient clinical factors impacting Queer, Black womxn sexual assault survivors, including those associated with multiple minoritised identities: Queer-based trauma, race-based trauma, cultural betrayal trauma, and misogynoir. Given the high rates of victimisation, marginalisation and discrimination, psychologists and others working with members of this population should engage with and address these factors to provide culturally responsive, sexually affirming and effective mental health treatment and care.
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Affiliation(s)
| | - Nevita George
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
| | - Charlene Collibee
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
| | - Lindsey Hamilton
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
| | - Erik B Oleson
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
| | - Sneha Thamotharan
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
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Graugaard C, Bahnsen MK, Boisen KA, Andresen JB, Andersson M, Frisch M. Sexuality Among Young Danes Treated for Long-Lasting or Severe Physical Disease: Baseline Findings in a Nationwide Cohort Study. J Adolesc Health 2023:S1054-139X(23)00149-0. [PMID: 37149809 DOI: 10.1016/j.jadohealth.2023.02.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 02/15/2023] [Accepted: 02/26/2023] [Indexed: 05/08/2023]
Abstract
PURPOSE Sexual ramifications of physical disease are well-documented in adult populations, but are scarcely investigated among adolescents and young adults (AYA). This study compared measures of sexuality and sexual health among 8,696 15-year-old to 24-year-old Danes with and without a history of treatment for long-lasting or severe physical disease. METHODS Using baseline data from Project SEXUS, a nationally representative cohort study on sexual health in the Danish population, differences in various domains of sexual behaviors and sexual health between AYA who have and AYA who have not been treated for long-lasting or severe physical disease were investigated. Logistic regression analyses yielded demographically weighted age-adjusted odds ratios (ORs) for associations between physical diseases and sexual outcomes. RESULTS AYA treated for long-lasting or severe physical disease resembled their healthy peers on fundamental aspects of sexual interest, activity and satisfaction. However, significantly increased odds ratios of various sexual difficulties and dysfunctions, early sexual debut, high sex partner numbers, discontentment with body or genital appearance, gender nonconformity, nonheterosexuality, and exposure to sexual assaults were observed, overall or within specific disease categories. DISCUSSION The overall similarity in sexual profiles between AYA treated for physical disease and healthy peers indicates that clinicians should routinely address questions related to sexuality and relationships when encountering AYA with chronic health conditions. Moreover, the observed excess of certain adversities, including sexual assaults, among physically ill AYA highlights the need for preventive measures and counseling services specifically targeted at AYA afflicted by physical disease.
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Affiliation(s)
- Christian Graugaard
- Center for Sexology Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
| | - Mikkel Kjær Bahnsen
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Kirsten A Boisen
- Center of Adolescent Medicine, Department of Pediatric and Adolescent Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Josefine Bernhard Andresen
- Center for Sexology Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Mikael Andersson
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Morten Frisch
- Center for Sexology Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
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8
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Wang YX, Sun Y, Missmer SA, Rexrode KM, Roberts AL, Chavarro JE, Rich-Edwards JW. Association of early life physical and sexual abuse with premature mortality among female nurses: prospective cohort study. BMJ 2023; 381:e073613. [PMID: 37137504 PMCID: PMC10155244 DOI: 10.1136/bmj-2022-073613] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
OBJECTIVE To explore associations between early life physical and sexual abuse and subsequent risk of premature mortality (death before age 70 years). DESIGN Prospective cohort study. SETTING The Nurses' Health Study II (2001-19). PARTICIPANTS 67 726 female nurses aged 37-54 years when completing a violence victimization questionnaire in 2001. MAIN OUTCOME MEASURES Hazard ratios and 95% confidence intervals for total and cause specific premature mortality by childhood or adolescent physical and sexual abuse, estimated by multivariable Cox proportional hazard models. RESULTS 2410 premature deaths were identified over 18 years of follow-up. Nurses who experienced severe physical abuse or forced sexual activity in childhood and adolescence had a higher crude premature mortality rate than nurses without such abuse in childhood or adolescence (3.15 v 1.83 and 4.00 v 1.90 per 1000 person years, respectively). The corresponding age adjusted hazard ratios for premature deaths were 1.65 (95% confidence interval 1.45 to 1.87) and 2.04 (1.71 to 2.44), respectively, which were materially unchanged after further adjusting for personal characteristics and early life socioeconomic status (1.53, 1.35 to 1.74, and 1.80, 1.50 to 2.15, respectively). Cause specific analyses indicated that severe physical abuse was associated with a greater risk of mortality due to external causes of injury and poisoning (multivariable adjusted hazard ratio 2.81, 95% confidence interval 1.62 to 4.89), suicide (3.05, 1.41 to 6.60), and diseases of the digestive system (2.40, 1.01 to 5.68). Forced sexual activity as a child and adolescent was associated with greater risk of mortality due to cardiovascular disease (2.48, 1.37 to 4.46), external injury or poisoning (3.25, 1.53 to 6.91), suicide (4.30, 1.74 to 10.61), respiratory disease (3.74, 1.40 to 9.99), and diseases of the digestive system (4.83, 1.77 to 13.21). The association of sexual abuse with premature mortality was stronger among women who smoked or had higher levels of anxiety during adulthood. Smoking, low physical activity, anxiety, and depression each explained 3.9-22.4% of the association between early life abuse and premature mortality. CONCLUSION Early life physical and sexual abuse could be associated with a greater risk of adult premature mortality.
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Affiliation(s)
- Yi-Xin Wang
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Yang Sun
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Stacey A Missmer
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
- Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
| | - Kathryn M Rexrode
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Andrea L Roberts
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Jorge E Chavarro
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Janet W Rich-Edwards
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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Kilpatrick DG, Hahn CK. Understanding and Addressing Alcohol and Sexual Violence: We Have Made Progress but Still Have Miles to Go. NEBRASKA SYMPOSIUM ON MOTIVATION 2023. [DOI: 10.1007/978-3-031-24426-1_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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10
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Strenth CR, Mo A, Kale NJ, Day PG, Gonzalez L, Green R, Cruz II, Schneider FD. Adverse Childhood Experiences and Diabetes: Testing Violence and Distress Mediational Pathways in Family Medicine Patients. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP23035-NP23056. [PMID: 35225043 DOI: 10.1177/08862605221076536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Type 2 diabetes mellitus (diabetes) is increasing in frequency and creating a significant burden on the United States healthcare system. Adverse childhood experiences (ACE) and interpersonal violence (IV) have been shown to have detrimental effects on mental and physical health. How ACE can influence IV as an adult and how this can influence the management of diabetes is not known. The purpose of the current study is to understand the relationship between violence and social determinants of health (SDoH), and its effect on patients with type 2 diabetes mellitus. A practiced-based research network (PBRN) of family medicine residency programs was utilized to collect cross-sectional data from seven family medicine residency program primary care clinics. In total, 581 participants with type 2 diabetes were recruited. A serial/parallel mediation model were analyzed. The majority of participants (58.3%) had a Hemoglobin A1c (HbA1c) that was not controlled. ACE was associated with an increase in Hurt-Insult-Threaten-Scream (HITS) scores, which in turn was positively associated with an increase in emotional burden, and finally, emotional burden decreased the likelihood that one's HbA1c was controlled (Effect = -.054, SE = .026 CI [-.115, -.013]). This indirect pathway remained significant even after controlling for several SDoH and gender. The impact of ACE persists into adulthood by altering behaviors that make adults more prone to experiencing family/partner violence. This in turn makes one more emotionally distressed about their diabetes, which influences how people manage their chronic condition. Family physicians should consider screening for both ACE and family/partner violence in those patients with poorly controlled diabetes.
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Affiliation(s)
| | - Albert Mo
- 23458Memorial Hermann Hospital, Houston, TX, USA
| | - Neelima J Kale
- 12252University of Kentucky College of Medicine, Lexington, KY, USA
| | - Philip G Day
- 12262University of Massachusetts Chan Medical School, Worcester, MA, USA
| | | | - Ronya Green
- 427554TriStar Southern Hills Medical Center, Nashville, TN, USA
| | - Inez I Cruz
- 14742UT Health San Antonio, San Antonio, TX, USA
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11
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Pebole MM, Greco CE, Gobin RL, Phillips BN, Strauser DR. Impact of childhood maltreatment on psychosomatic outcomes among men and women with disabilities. Disabil Rehabil 2022; 44:7491-7499. [PMID: 34762011 DOI: 10.1080/09638288.2021.1998666] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE This project examined the impact of childhood maltreatment types on psychosomatic outcomes among adults with a range of self-reported disabilities. MATERIALS AND METHODS Participants (n = 643) were recruited using Amazon Mechanical Turk and Cloud Research. Single-item questions assessed sociodemographic information. The Childhood Trauma Questionnaire measured childhood maltreatment types (emotional, physical, and sexual abuse, and emotional and physical neglect) and the RAND-36 Item Health Survey evaluated physical functioning, pain, and energy/fatigue. Logistic regressions determined associations between childhood trauma and psychosomatic outcomes; stratified models compared men and women. RESULTS Multivariate-adjusted models indicated physical abuse was positively associated with poor physical functioning (OR: 2.03; 95%CI: 1.35-3.06) with this relationship being stronger for men (OR: 3.25; 95%CI: 1.42-7.43) than women (OR: 1.91; 95%CI: 1.17-3.13). Adjusted models showed that physical neglect was protective against fatigue (OR: 0.58; 95% CI: 0.36-0.94), while emotional neglect increased the risk of fatigue (OR: 1.74; 95%CI: 1.02-2.95). Lastly, physical abuse was positively associated with pain (OR: 1.53; 95%CI: 1.01-2.33). This relationship was stronger in men (OR: 4.99; 95%CI: 1.91-12.99). CONCLUSIONS Results improve our understanding of risk factors for poor physical health outcomes and can guide the development of trauma-sensitive rehabilitation services.Implications for RehabilitationIndividuals with disabilities who report childhood maltreatment may experience poor psychosomatic outcomes in adulthood.Consequences of experiencing childhood maltreatment may manifest differently between men and women over the course of the lifespan.It is essential to integrate trauma-informed principles into treatment plans for individuals with poor psychosomatic health.Rehabilitation professionals should screen for abuse and refer individuals to the appropriate mental and physical health services.
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Affiliation(s)
- Michelle M Pebole
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Chelsea E Greco
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Robyn L Gobin
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Brian N Phillips
- Department of Special Education and Rehabilitation Counseling, Utah State University, Logan, UT, USA
| | - David R Strauser
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
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12
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Sánchez-Peña JF, Jáñez-Álvarez M, Álvarez-Cotoli PG, García-Laredo E. Dual diagnosis in immigrant patients with alcohol use disorder: 2-years of follow-up treatment. ACTAS ESPANOLAS DE PSIQUIATRIA 2022; 50:276-286. [PMID: 36622715 PMCID: PMC10803857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 11/01/2022] [Indexed: 01/10/2023]
Abstract
There is a high prevalence of comorbid psychiatric disorders in alcohol abuse disorder. The presence of dual diagnosis in patients decreases the maintenance of abstinence and increases the likelihood of relapse, which makes treatment more complicated.
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13
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Vogt EL, Jiang C, Jenkins Q, Millette MJ, Caldwell MT, Mehari KS, Marsh EE. Trends in US Emergency Department Use After Sexual Assault, 2006-2019. JAMA Netw Open 2022; 5:e2236273. [PMID: 36264580 PMCID: PMC9585426 DOI: 10.1001/jamanetworkopen.2022.36273] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Adult sexual assault (SA) survivors experience numerous emergent health problems, yet few seek emergency medical care. Quantifying the number and types of survivors presenting to US emergency departments (EDs) after SA can inform health care delivery strategies to reduce survivor morbidity and mortality. OBJECTIVE To quantify ED use and factors that influenced seeking ED care for adult SA from 2006 through 2019. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used SA data from the Nationwide Emergency Department Sample from 2006 through 2019, which includes more than 35.8 million observations of US ED visits from 989 hospitals, a 20% stratified sample of hospital-based EDs. The study also used the Federal Bureau of Investigation's Uniform Crime Reporting Program, which includes annual crime data from more than 18 000 law enforcement agencies representing more than 300 million US inhabitants. The study sample included any adult aged 18 to 65 years with an ED visit in the Nationwide Emergency Department Sample coded as SA. The data were analyzed between January 2020 and June 2022. MAIN OUTCOMES AND MEASURES Annual SA-related ED visits, subsequent hospital admissions, and associated patient-related factors (age, sex, race and ethnicity, income quartile, and insurance) were analyzed using descriptive statistics. RESULTS Data were from 120 to 143 million weighted ED visits reported annually from 2006 through 2019. Sexual assault-related ED visits increased more than 1533.0% from 3607 in 2006 to 55 296 in 2019. Concurrently, admission rates for these visits declined from 12.6% to 4.3%. Female, younger, and lower-income individuals were more likely to present to the ED after SA. Older and Medicaid-insured patients were more likely to be admitted. Overall, the rate of ED visits for SA outpaced law enforcement reporting. CONCLUSIONS AND RELEVANCE This cross-sectional study found that US adult SA ED visits increased from 2006 through 2019 and highlighted the populations who access emergency care most frequently and who more likely need inpatient care. These data can inform policies and the programming needed to support this vulnerable population.
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Affiliation(s)
- Emily L. Vogt
- University of Michigan Medical School, University of Michigan, Ann Arbor
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor
| | - Charley Jiang
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor
| | - Quinton Jenkins
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor
- School of Public Health, University of Michigan, Ann Arbor
| | - Maya J. Millette
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor
- School of Public Health, University of Michigan, Ann Arbor
| | | | - Kathleen S. Mehari
- Division of Women’s Health, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor
| | - Erica E. Marsh
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor
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14
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Dworkin ER, DeCou CR, Fitzpatrick S. Associations between sexual assault and suicidal thoughts and behavior: A meta-analysis. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2022; 14:1208-1211. [PMID: 32202845 PMCID: PMC7508844 DOI: 10.1037/tra0000570] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The goal of the present study was to conduct a quantitative review to determine the degree to which specific forms of suicidality (i.e., lifetime and past-year suicidal ideation and attempts) are associated with sexual assault (SA). It also examined whether the strength of the association between SA and suicidality was moderated by sample characteristics or the type of suicidality assessed. METHOD A subset of studies (25 samples and 36 effects, reflecting N = 88,376 participants) from a prior meta-analysis assessing associations between SA and psychopathology was examined. Included studies provided the prevalence of suicidality in subsamples that had and had not been exposed to SA and/or an odds ratio comparing the prevalence in these groups. Random effects metaregression models aggregated prevalence estimates and odds ratios for lifetime and past-year suicidal ideation and suicide attempts in individuals in SA and no-SA groups. Analyses also examined whether sample characteristics (i.e., percent women, college sample) or type of suicidality moderated the magnitude of odds ratios. RESULTS Subsamples exposed to SA reported a substantially higher prevalence of suicidality (27.25%) compared with unassaulted subsamples (9.37%). There were significantly higher rates of lifetime and past-year suicidal ideation, and lifetime suicide attempts in assaulted subsamples than in unassaulted subsamples. No tested moderators had significant associations with the strength of the relationship between SA and suicidality. CONCLUSION Findings underscore the robust relationship between SA and both suicidal ideation and attempts and suggest that identifying moderators and mediators that explain it is a key directive for future research. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Emily R Dworkin
- Department of Psychiatry & Behavioral Sciences, University of Washington School of Medicine
| | - Christopher R DeCou
- Department of Psychiatry & Behavioral Sciences, University of Washington School of Medicine
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15
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Miles L, Valentine JL, Mabey L, Downing NR. Mental Illness as a Vulnerability for Sexual Assault: A Retrospective Study of 7,455 Sexual Assault Forensic Medical Examinations. JOURNAL OF FORENSIC NURSING 2022; 18:131-138. [PMID: 35045047 PMCID: PMC9415228 DOI: 10.1097/jfn.0000000000000361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 11/30/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Persons with severe mental illness (MI) are at a high risk of becoming victims of sexual assault (SA). Vulnerability for SA with any type of MI is unknown. This study aimed to identify the prevalence of preexisting MI and other significant factors in patients reporting preexisting MI at the time of their SA medical forensic examinations (SAMFEs). METHOD A retrospective SAMFE chart review of patients ( N = 7,455) from 2010 to 2020 was conducted. Sexual assault nurse examiners completed SAMFEs. Inclusion criteria included (a) aged 14 years and older, (b) completed SAMFE with SA kit evidence collection, and (c) reported to law enforcement (restricted cases not included). Descriptive statistics and chi-square analyses were completed. FINDINGS It was found that 46.7% of study participants reported preexisting MI and/or current use of psychotropic medications, more than double the MI prevalence rates in the general population. MI in patients seen for SAMFE was associated with prior history of SA, medical health problems, and physical or mental impairment. In addition, patients with MI reported more violent SAs with increased anogenital and nonanogenital injuries. DISCUSSION The high prevalence rate of any MI in patients seen for SAMFE indicates MI in varying severity is a significant vulnerability for SA. The association of preexisting MI with a history of SA, health problems, and physical or mental impairment expands understanding of associated MI factors. These findings support the development of interventions by healthcare providers and stakeholders to address SA vulnerabilities in individuals with MI.
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Affiliation(s)
| | | | - Linda Mabey
- Author Affiliations:Brigham Young University
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16
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Zubair F, Husnain MIU, Zhao T, Ahmad H, Khanam R. A gender-specific assessment of tobacco use risk factors: evidence from the latest Pakistan demographic and health survey. BMC Public Health 2022; 22:1133. [PMID: 35668426 PMCID: PMC9172179 DOI: 10.1186/s12889-022-13574-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 05/30/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The high prevalence of tobacco use in Pakistan poses a substantial health and economic burden to Pakistani individuals, families, and society. However, a comprehensive assessment of the key risk factors of tobacco use in Pakistan is very limited in the literature. A better understanding of the key risk factors of tobacco use is needed to identify and implement effective tobacco control measures. OBJECTIVES To investigate the key socioeconomic, demographic, and psychosocial determinants of tobacco smoking in a recent large nationally representative sample of Pakistani adults. METHODS N = 18,737 participants (15,057 females and 3680 males) from the 2017-18 Pakistan Demographic Health Survey, aged 15-49 years, with data on smoking use and related factors were included. Characteristics of male and female participants were compared using T-tests (for continuous variables) and χ2-tests (for categorical variables). Multivariable logistic regression models were used to identify gender-specific risk factors of tobacco use. The Receiver Operating Characteristic Curve test was used to evaluate the predictive power of models. RESULTS We found that the probability of smoking for both males and females is significantly associated with factors such as their age, province/region of usual residence, education level, wealth, and marital status. For instance, the odds of smoking increased with age (from 1.00 [for ages 15-19 years] to 3.01 and 5.78 respectively for females and males aged 45-49 years) and decreased with increasing education (from 1.00 [for no education] to 0.47 and 0.50 for females and males with higher education) and wealth (from 1.00 [poorest] to 0.43 and 0.47 for richest females and males). Whilst the odd ratio of smoking for rural males (0.67) was significantly lower than that of urban males (1.00), the odds did not differ significantly between rural and urban females. Finally, factors such as occupation type, media influence, and domestic violence were associated with the probability of smoking for Pakistani females only. CONCLUSIONS This study identified gender-specific factors contributing to the risk of tobacco usage in Pakistani adults, suggesting that policy interventions to curb tobacco consumption in Pakistan should be tailored to specific population sub-groups based on their sociodemographic and psychosocial features.
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Affiliation(s)
- Faiqa Zubair
- Department of Economics, COMSATS University, Islamabad, 45550 Pakistan
| | | | - Ting Zhao
- Menzies Institute for Medical Research, University of Tasmania, Hobart, 7000 Australia
| | - Hasnat Ahmad
- Menzies Institute for Medical Research, University of Tasmania, Hobart, 7000 Australia
| | - Rasheda Khanam
- School of Business, University of Southern Queensland, Toowoomba, QLD 4350 Australia
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17
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Thurston RC, Chang Y, Matthews KA, Harlow S, El Khoudary SR, Janssen I, Derby C. Interpersonal Trauma and Risk of Incident Cardiovascular Disease Events Among Women. J Am Heart Assoc 2022; 11:e024724. [PMID: 35322675 PMCID: PMC9075461 DOI: 10.1161/jaha.121.024724] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Background Traumatic experiences have been linked to risk for cardiovascular disease (CVD). Interpersonal violence is a trauma that is prevalent in women. Among midlife women followed up for 2 decades, we examined whether interpersonal violence (childhood abuse, adulthood abuse, or intimate partner violence [IPV]) was related to increased risk of subsequent clinical CVD events. Methods and Results A total of 2201 women, aged 42 to 52 years at baseline, underwent up to 16 in-person visits over 22 years. Measures included questionnaires (including of childhood physical/sexual abuse, adult physical/sexual abuse, and IPV), physical measures, phlebotomy, and reported CVD events (myocardial infarction, stroke, heart failure, and revascularization). Death certificates were collected. Relationships between childhood abuse, adult abuse, and IPV with incident fatal/nonfatal CVD were tested in Cox proportional hazards models. Women with a childhood abuse history had increased risk for incident CVD (versus no abuse; hazard ratio [HR] [95% CI], 1.65 [1.12-2.44]; P=0.01; adjusted for demographics and CVD risk factors); associations were strongest for childhood sexual abuse. Adult abuse was not significantly associated with CVD. Women with IPV had a doubling of risk for incident CVD in demographic-adjusted models (versus no IPV; IPV: HR [95% CI], 2.06 [1.01-4.23]; P=0.04; no partner: HR [95% CI], 1.79 [0.91-3.53]; P=0.09); systolic blood pressure partially mediated relationships between IPV and CVD. Conclusions Childhood abuse, particularly sexual abuse, was associated with increased risk of CVD in women. IPV was associated with risk for CVD, with the higher systolic blood pressure among IPV-exposed women important in these associations. Interpersonal violence prevention may contribute to CVD risk reduction in women.
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Affiliation(s)
- Rebecca C Thurston
- Department of Psychiatry University of Pittsburgh School of Medicine Pittsburgh PA.,Department of Epidemiology and Population Health University of Pittsburgh Graduate School of Public Health Pittsburgh PA
| | - Yuefang Chang
- Department of Neurosurgery University of Pittsburgh School of Medicine Pittsburgh PA
| | - Karen A Matthews
- Department of Psychiatry University of Pittsburgh School of Medicine Pittsburgh PA.,Department of Epidemiology and Population Health University of Pittsburgh Graduate School of Public Health Pittsburgh PA
| | - Sioban Harlow
- Department of Epidemiology University of MichiganHenry F. Vaughn School of Public Health Ann Arbor MI
| | - Samar R El Khoudary
- Department of Epidemiology and Population Health University of Pittsburgh Graduate School of Public Health Pittsburgh PA
| | - Imke Janssen
- Department of Preventive Medicine Rush University Medical Center Chicago IL
| | - Carol Derby
- Department of Epidemiology Albert Einstein College of Medicine Bronx NY
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18
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Thurston RC, Jakubowski KP, Wu M, Aizenstein HJ, Chang Y, Derby CA, Koenen KC, Barinas-Mitchell E, Maki PM. Sexual assault and white matter hyperintensities among midlife women. Brain Imaging Behav 2022; 16:773-780. [PMID: 34553332 PMCID: PMC8940746 DOI: 10.1007/s11682-021-00536-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2021] [Indexed: 01/09/2023]
Abstract
Traumatic experiences have been linked to poor mental and physical health. However, there has been little examination of their relationship to neuroimaging markers of cerebrovascular risk. White matter hyperintensities (WMHs) are markers of brain small vessel disease. WMHs can be detected decades before the onset of dementia and other disorders and can serve as early markers for these brain disorders. We tested whether traumatic experiences were associated with brain WMH volume among midlife women. In the MsBrain study, 145 women (mean age = 59 years) without cardiovascular disease, stroke, or dementia were recruited. Women completed questionnaires [trauma checklist, depression, post-traumatic stress measures]; physical measures [body mass index (BMI), blood pressure (BP)]; phlebotomy; actigraphy sleep measurement, and 3 Tesla magnetic resonance brain imaging for WMHs. Cross-sectional associations between traumatic experiences and WMH volume were assessed in linear regression models. Covariates were age, race/ethnicity, education, BMI, BP, lipids, preeclampsia, sleep, and additionally depressive and post-traumatic stress disorder symptoms. 68% of women endorsed at least one of the traumas assessed. The most common trauma was sexual assault (23% of women). Women with trauma exposure had greater WMH volume than women without trauma [B(SE) = .24 (.09), p = .01, multivariable]. The single trauma most associated with WMH was sexual assault [B(SE) = .25 (.11), p = .02, multivariable]. Results persisted adjusting for depressive or post-traumatic stress symptoms. A trauma history, particularly sexual assault, was associated with greater WMH volume controlling for covariates, including depressive and post-traumatic symptoms. Sexual assault may place women at risk for poor brain health.
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Affiliation(s)
- Rebecca C Thurston
- Department of Psychiatry, University of Pittsburgh, 3811 O'Hara St, Pittsburgh, PA, 15213, USA.
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA.
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Karen P Jakubowski
- Department of Psychiatry, University of Pittsburgh, 3811 O'Hara St, Pittsburgh, PA, 15213, USA
| | - Minjie Wu
- Department of Psychiatry, University of Pittsburgh, 3811 O'Hara St, Pittsburgh, PA, 15213, USA
| | - Howard J Aizenstein
- Department of Psychiatry, University of Pittsburgh, 3811 O'Hara St, Pittsburgh, PA, 15213, USA
| | - Yuefang Chang
- Department of Neurosurgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Carol A Derby
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Karestan C Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Pauline M Maki
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
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19
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Lawn RB, Nishimi KM, Sumner JA, Chibnik LB, Roberts AL, Kubzansky LD, Rich‐Edwards JW, Koenen KC, Thurston RC. Sexual Violence and Risk of Hypertension in Women in the Nurses' Health Study II: A 7-Year Prospective Analysis. J Am Heart Assoc 2022; 11:e023015. [PMID: 35189695 PMCID: PMC9075082 DOI: 10.1161/jaha.121.023015] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 11/09/2021] [Indexed: 01/22/2023]
Abstract
Background Hypertension is a prevalent condition in women and an important modifiable risk factor for cardiovascular disease. Despite women's experiences of sexual violence being common, no prospective studies have examined lifetime sexual assault and workplace sexual harassment in relationship to hypertension in large civilian samples with extended follow-up. Here, we examined whether these experiences were prospectively associated with greater risk of developing hypertension over 7 years. Methods and Results Data are from a substudy of the Nurses' Health Study II and include women free of hypertension at the time of sexual assault and workplace sexual harassment assessment in 2008 (n=33 127). Hypertension was defined as self-reported doctor diagnosis or initiating antihypertensive medication use, assessed biennially through 2015. We performed Cox proportional hazards regression models to predict time to developing hypertension associated with sexual violence exposure, adjusting for relevant covariates. Over follow-up, 7096 women developed hypertension. Sexual assault and workplace sexual harassment were prevalent (23% and 12%, respectively; 6% of women experienced both). Compared with women with no exposure, women who experienced both sexual assault and workplace sexual harassment had the highest risk of developing hypertension (hazard ratio [HR], 1.21; 95% CI, 1.09-1.35), followed by women who experienced workplace sexual harassment (HR, 1.15; 95% CI, 1.05-1.25) and then by women who experienced sexual assault (HR, 1.11; 95% CI, 1.03-1.19), after adjusting for relevant covariates. Conclusions Sexual assault and workplace sexual harassment are prospectively associated with greater risk of hypertension. Reducing such violence is important in its own right and may also improve women's cardiovascular health.
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Affiliation(s)
- Rebecca B. Lawn
- Department of EpidemiologyHarvard T.H. Chan School of Public HealthBostonMA
| | - Kristen M. Nishimi
- Mental Health ServiceSan Francisco Veterans Affairs Medical CenterSan FranciscoCA
- Department of Psychiatry and Weill Institute for NeurosciencesUniversity of California San FranciscoSan FranciscoCA
| | | | - Lori B. Chibnik
- Department of EpidemiologyHarvard T.H. Chan School of Public HealthBostonMA
- Department of NeurologyMassachusetts General Hospital and Harvard Medical SchoolBostonMA
| | - Andrea L. Roberts
- Department of Environmental HealthHarvard T.H. Chan School of Public HealthBostonMA
| | - Laura D. Kubzansky
- Department of Social and Behavioral SciencesHarvard T.H. Chan School of Public HealthBostonMA
| | - Janet W. Rich‐Edwards
- Department of EpidemiologyHarvard T.H. Chan School of Public HealthBostonMA
- Division of Women’s HealthDepartment of MedicineBrigham and Women’s Hospital and Harvard Medical SchoolBostonMA
| | - Karestan C. Koenen
- Department of EpidemiologyHarvard T.H. Chan School of Public HealthBostonMA
- Department of Social and Behavioral SciencesHarvard T.H. Chan School of Public HealthBostonMA
- Psychiatric and Neurodevelopmental Genetics UnitDepartment of PsychiatryMassachusetts General HospitalBostonMA
| | - Rebecca C. Thurston
- Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPA
- Department of EpidemiologyUniversity of Pittsburgh Graduate School of Public HealthPittsburghPA
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20
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Meyer SR, Stöckl H, Vorfeld C, Kamenov K, García-Moreno C. A scoping review of measurement of violence against women and disability. PLoS One 2022; 17:e0263020. [PMID: 35100320 PMCID: PMC8803172 DOI: 10.1371/journal.pone.0263020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 01/10/2022] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION Existing evidence indicates that prevalence of violence against women with disability is elevated compared to women without disability. We conducted a scoping review with a focus on measurement to assess the forms of measurement and study design utilized to explore the intersection of violence against women with disabilities, and to identify strengths and limitations in current approaches to measuring violence against women with disabilities. This scoping review is designed to inform current debates and discussions regarding how to generate evidence concerning violence against women with disabilities. METHODS AND RESULTS We conducted systematic searches of the following databases: PubMed, PsycINFO, Embase, CINAHL, PILOTS, ERIC, Social Work Abstracts, International Bibliography of the Social Sciences, Social Services Abstracts, ProQuest Criminal Justice, and Dissertations & Theses Global, and conducted structured searches of national statistics and surveys and grey literature available on-line. We identified 174 manuscripts or reports for inclusion. n = 113 manuscripts or reports utilized acts-specific measurement of violence. In terms of measurement of disability, we found that amongst the included manuscripts and reports, n = 75 utilized measures of functioning limitations (n = 20 of these were Washington Group questions), n = 15 utilized a single question approach and n = 67 defined participants in the research as having a disability based on a diagnosis or self-report of a health condition or impairment. DISCUSSION This scoping review provides a comprehensive overview of measurement of violence against women with disabilities and measurement of violence within disability-focused research. We identified several important gaps in the evidence, including lack of sex and disability disaggregation, limited evidence concerning adaptation of data collection methods to ensure accessibility of research activities for women with disabilities, and limited evidence concerning differential relationships between types of disability and violence exposure. This scoping review provides directions for sub-analyses of the included studies and further research to address gaps in evidence.
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Affiliation(s)
- Sarah R. Meyer
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Heidi Stöckl
- The Institute for Medical Information Processing, Biometry, and Epidemiology, University of Munich, Munich, Germany
| | - Cecilia Vorfeld
- Department of Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
| | - Kaloyan Kamenov
- Department of Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
| | - Claudia García-Moreno
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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21
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Basile KC, Smith SG, Chen J, Zwald M. Chronic Diseases, Health Conditions, and Other Impacts Associated With Rape Victimization of U.S. Women. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP12504-NP12520. [PMID: 31971055 PMCID: PMC7375935 DOI: 10.1177/0886260519900335] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Sexual violence (SV) is an urgent public health issue that is common and has lifelong effects on health. Previous scholarship has documented the association of SV victimization with numerous health conditions and impacts, but much of this past work has focused on negative health outcomes associated with child sexual abuse using non-nationally representative samples. This article used a nationally representative female sample to examine health conditions associated with any lifetime experience of rape. We also examined injury and health outcomes (e.g., fear, injury) resulting from any violence by a perpetrator of rape. About two in five rape victims (39.1%) reported injury (e.g., bruises, vaginal tears), and 12.3% reported a sexually transmitted disease as a result of the rape victimization. Approximately 71.3% of rape victims (an estimated 16.4 million women) experienced some form of impact as a result of violence by a rape perpetrator. Among U.S. women, the adjusted odds of experiencing asthma, irritable bowel syndrome, frequent headaches, chronic pain, difficulty sleeping, activity limitations, poor physical or mental health, and use of special equipment (e.g., wheelchair) were significantly higher for lifetime rape victims compared with non-victims. This article fills gaps in our understanding of health impacts associated with rape of women and is the only nationally representative source of this information to our knowledge. Primary prevention efforts in youth that seek to prevent the first occurrence of rape and other forms of SV may be most effective for reducing the long-term health effects of this violence.
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Affiliation(s)
| | - Sharon G. Smith
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jieru Chen
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Marissa Zwald
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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22
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Jakubowski KP, Murray V, Stokes N, Thurston RC. Sexual violence and cardiovascular disease risk: A systematic review and meta-analysis. Maturitas 2021; 153:48-60. [PMID: 34654528 DOI: 10.1016/j.maturitas.2021.07.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/22/2021] [Accepted: 07/30/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cardiovascular disease (CVD) is a leading cause of death among adults. Over 35% of women worldwide report lifetime exposure to sexual violence. While psychosocial factors broadly have been linked to CVD risk, it is unclear if a history of sexual violence is associated with increased risk for CVD. This study employed quantitative meta-analysis to investigate the association between sexual violence and CVD risk. METHODS PubMed and PsycINFO databases were searched through March 1, 2021. Included articles had a measure of sexual violence and at least one cardiovascular outcome (i.e., clinical CVD, subclinical CVD, select CVD risk factors) in women and men aged 18 years or older. Data were expressed as odds ratios (OR) or hazard ratios (HR) with 95% confidence intervals (CI) extracted from fully-adjusted models. OR and HR effects were pooled separately, given the inability to statistically harmonize these effects and differences in interpretation, using random effects meta-analysis. Heterogeneity of effects was tested using Cochran's Q test. RESULTS Overall, 45 articles based on 830,579 adults (77.1% women) were included (113 individual effects expressed as OR and 9 individual effects expressed as HR). Results indicated that sexual violence was related to adult CVD risk (OR [95%CI] = 1.25 [1.11-1.40]; HR [95%CI] = 1.17 [1.05-1.31]). Results varied by outcome type and measurement, and timing of violence. CONCLUSIONS Adults with a history of sexual violence demonstrate greater CVD risk relative to those without this history. The results highlight the importance of addressing sexual violence in CVD risk reduction efforts.
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Affiliation(s)
- Karen P Jakubowski
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
| | - Vanessa Murray
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
| | - Natalie Stokes
- Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
| | - Rebecca C Thurston
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA; Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA.
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23
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Clemens V, Bürgin D, Huber-Lang M, Plener PL, Brähler E, Fegert JM. The Interplay between Child Maltreatment and Stressful Life Events during Adulthood and Cardiovascular Problems-A Representative Study. J Clin Med 2021; 10:jcm10173937. [PMID: 34501385 PMCID: PMC8432252 DOI: 10.3390/jcm10173937] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/28/2021] [Accepted: 08/29/2021] [Indexed: 01/01/2023] Open
Abstract
Psychological stress is a major risk factor for cardiovascular diseases. While the relevance of early life stress, such as that which is due to child maltreatment (CM), is well known to impact individual stress responses in the long-term, and data on the interplay between CM and stressful events in adulthood on cardiovascular health are sparse. Here, we aimed to assess how stressful life events in adulthood are associated with cardiovascular health infarction in later life and whether this association is independent of CM. In a cross-sectional design, a probability sample of the German population above the age of 14 was drawn using different sampling steps. The final sample included 2510 persons (53.3% women, mean age: 48.4 years). Participants were asked about sociodemographic factors, adult life events, CM, and health conditions in adulthood. Results indicate that the number of experienced adverse life events in adulthood is associated with significantly increased odds for obesity (Odds Ration (OR)women = 1.6 [1.3; 2.0], ORmen = 1.4 [1.1; 1.9]), diabetes (ORwomen = 1.5 [1.1; 2.1], ORmen = 1.5 [1.1; 2.3]) and myocardial infarction (ORwomen = 2.1 [1.0; 4.3], ORmen = 1.8 [1.1; 2.8]). This association is not moderated by the experience of CM, which is associated with cardiovascular problems independently. Taken together, adult stressful life events and CM are significantly and independently associated with cardiovascular health in men and women in the German population in a dose-dependent manner. General practitioners, cardiologists and health policy-makers should be aware of this association between psychosocial stressors during childhood and adulthood and cardiovascular health.
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Affiliation(s)
- Vera Clemens
- Department for Child and Adolescent Psychiatry/Psychotherapy, Steinhövelstraße 5, University of Ulm, 89075 Ulm, Germany; (P.L.P.); (J.M.F.)
- Correspondence: ; Tel.: +49-731-500-61611
| | - David Bürgin
- Department of Child and Adolescent Psychiatry, Psychiatric Hospitals of the University of Basel, Wilhelm Klein-Strasse 27, 4002 Basel, Switzerland;
| | - Markus Huber-Lang
- Institute of Clinical and Experimental Trauma Immunology, Ulm University Medical Centre, Helmholtzstraße 8/1, 89081 Ulm, Germany;
| | - Paul L. Plener
- Department for Child and Adolescent Psychiatry/Psychotherapy, Steinhövelstraße 5, University of Ulm, 89075 Ulm, Germany; (P.L.P.); (J.M.F.)
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Elmar Brähler
- Department for Psychosomatic Medicine and Psychotherapy, University Medical Center of Johannes Gutenberg University of Mainz, Untere Zahlbacher Str. 8, 55131 Mainz, Germany;
- Integrated Research and Treatment Center (IFB) Adiposity Diseases-Behavioral Medicine, Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Philipp-Rosenthal-Str. 27, 04103 Leipzig, Germany
| | - Jörg M. Fegert
- Department for Child and Adolescent Psychiatry/Psychotherapy, Steinhövelstraße 5, University of Ulm, 89075 Ulm, Germany; (P.L.P.); (J.M.F.)
- Head of the Competence Area Mental Health Prevention Network Baden-Württemberg, Steinhövelstraße 5, 89075 Ulm, Germany
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24
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Pebole M, Gobin RL, Hall KS. Trauma-informed exercise for women survivors of sexual violence. Transl Behav Med 2021; 11:686-691. [PMID: 32535635 DOI: 10.1093/tbm/ibaa043] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Compared to their male counterparts, women experience alarmingly high rates of sexual violence (SV). Nearly 20% of women in the USA have been victims of SV, and prevalence of sexual assault among female service members is reported to be even higher, up to 50%. SV results in negative health outcomes like posttraumatic stress disorder, depression, obesity, poor body image, and pain-related disability. Exercise has been shown to positively impact both mental and physical health outcomes in populations experiencing posttraumatic symptoms, yet women survivors of SV are often excluded from exercise trials in trauma-affected populations. The purpose of this paper is to comment on the importance of incorporating women-specific trauma-informed principles in the content and delivery of exercise interventions in trauma-affected populations, particularly as it relates to SV. Researchers discuss the implications of female-specific and trauma-informed exercise considerations for SV survivors. This commentary highlights the need for trauma-informed implementation efforts and outcome measurements in exercise interventions involving women affected by SV. Researchers call for (a) increased qualitative work on trauma-specific implementation efforts across exercise intervention domains and (b) increased assessment of trauma-specific outcomes in exercise trials.
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Affiliation(s)
- Michelle Pebole
- Department of Kinesiology and Community Health, University of Illinois at Urbana Champaign, Champaign, IL, USA
| | - Robyn L Gobin
- Department of Kinesiology and Community Health, University of Illinois at Urbana Champaign, Champaign, IL, USA
| | - Katherine S Hall
- Geriatric Research, Education, and Clinical Center, Durham Veterans Affairs Healthcare System, Durham, NC, USA.,Department of Medicine, Duke University, Durham, NC, USA
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Schmahl OC, Jeuring HW, Aprahamian I, Naarding P, Marijnissen RM, Hendriks GJ, Fluiter M, Rhebergen D, Lugtenburg A, Lammers MW, van den Brink RHS, Oude Voshaar RC. Impact of childhood trauma on multidimensional frailty in older patients with a unipolar depressive-, anxiety- or somatic symptom disorder. Arch Gerontol Geriatr 2021; 96:104452. [PMID: 34111719 DOI: 10.1016/j.archger.2021.104452] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 05/19/2021] [Accepted: 05/27/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Frailty marks an increased risk for adverse health outcomes. Since childhood trauma is associated with the onset of physical and mental health diseases during the lifespan, we examined the link between childhood trauma and multidimensional frailty. METHOD A cross-sectional study embedded in a clinical cohort study (ROM-GPS) of older (≥60 years) patients (n=182) with a unipolar depressive-, anxiety- and/or somatic symptom disorder according to DSM-criteria referred to specialized geriatric mental health care. Frailty was assessed with the Tilburg Frailty Indicator (TFI), comprising a physical, psychological, and social dimension. Physical, sexual and psychological abuse and emotional neglect before the age of 16 years was measured with a structured interview. RESULTS Of 182 patients, 103 (56.6%) had experienced any childhood trauma and 154 (84.6%) were frail (TFI sum score ≥5). Linear regression analyses, adjusted for lifestyle, psychological and physical-health factors, showed that the presence of any type of childhood trauma was not associated with the TFI sum score, however when considered separately, physical abuse was (ß=0.16, p=.037). Regarding the specific frailty dimensions, any childhood trauma was associated with social frailty (ß=0.18, p=.019), with emotional neglect as main contributor. CONCLUSION These findings demonstrate a complex link between different types of childhood trauma and multidimensional frailty among older psychiatric patients. Regarding the three dimensions of frailty, social frailty seems most affected by childhood trauma. This may have been underestimated until now and should receive more attention in clinical care and future research.
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Affiliation(s)
- O C Schmahl
- University of Groningen, University Medical Center Groningen, Rob Giel Research center (RGOc), The Netherlands
| | - H W Jeuring
- University of Groningen, University Medical Center Groningen, Rob Giel Research center (RGOc), The Netherlands
| | - I Aprahamian
- University of Groningen, University Medical Center Groningen, Rob Giel Research center (RGOc), The Netherlands; Group of Investigation on Multimorbidity and Mental Health in Aging (GIMMA), Geriatrics Division, Internal Medicine Department, Jundiaí Medical School, Jundiaí, Brazil
| | - P Naarding
- GGNet Mental Health, Division of Old Age Psychiatry, Warnsveld & Apeldoorn, The Netherlands
| | - R M Marijnissen
- University of Groningen, University Medical Center Groningen, Rob Giel Research center (RGOc), The Netherlands
| | - G J Hendriks
- Behavioural Science Institute, Radboud University & Pro Persona Institute for Integrated Mental Health Care, Nijmegen, The Netherlands
| | - M Fluiter
- Mental Health Center GGZ Noord-Holland Noord, Heerhugowaard, The Netherlands
| | - D Rhebergen
- Mental Health Center GGZ Centraal, Ermelo, The Netherlands & Psychiatry, Amsterdam UMC, VU University Medical Center, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - A Lugtenburg
- Mental Health Center GGZ Drenthe, Assen, The Netherlands
| | - M W Lammers
- Mediant Mental Health Center, Enschede, The Netherlands
| | - R H S van den Brink
- University of Groningen, University Medical Center Groningen, Rob Giel Research center (RGOc), The Netherlands
| | - R C Oude Voshaar
- University of Groningen, University Medical Center Groningen, Rob Giel Research center (RGOc), The Netherlands.
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26
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McQueen K, Murphy-Oikonen J, Miller A, Chambers L. Sexual assault: women's voices on the health impacts of not being believed by police. BMC WOMENS HEALTH 2021; 21:217. [PMID: 34022858 PMCID: PMC8141152 DOI: 10.1186/s12905-021-01358-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 05/13/2021] [Indexed: 11/25/2022]
Abstract
Background Sexual assault is a prevalent crime against women globally with known negative effects on health. Recent media reports in Canada indicate that many sexual assault reports are not believed by police. Negative reporting experiences of sexual assault have been associated with secondary victimization and trauma among survivors. However, little is known about the impact that being sexually assaulted and not believed by police has on a survivor’s health and well-being. The purpose of this study was to explore women’s experiences of not being believed by police after sexual assault and their perceived impact on health. Methods We conducted open-ended and semi-structured interviews with 23 sexual assault survivors who were sexually assaulted and not believed by police. The interviews explored the self-reported health impacts of not being believed by police and were conducted from April to July, 2019. All interviews were audio-recorded, transcribed, and entered into NVIVO for analysis. Data were analyzed using Colaizzi’s analytic method. Results Analysis revealed three salient themes regarding the health and social impact of not being believed by police on survivors of sexual assault: (1) Broken Expectations which resulted in loss of trust and secondary victimization, (2) Loss of Self, and (3) Cumulative Health and Social Effects. The findings showed that not being believed by police resulted in additional mental and social burdens beyond that of the sexual assault. Many survivors felt further victimized by police at a time when they needed support, leading to the use taking of alcohol and/or drugs as a coping strategy. Conclusion Reporting a sexual assault and not being believed by police has negative health outcomes for survivors. Improving the disclosure experience is needed to mitigate the negative health and social impacts and promote healing. This is important for police, health, and social service providers who receive sexual assault disclosures and may be able to positively influence the reporting experience and overall health effects. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-021-01358-6.
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Affiliation(s)
- Karen McQueen
- School of Nursing, Lakehead University, 955 Oliver Rd, Thunder Bay, ON, P7B5E1, Canada.
| | | | - Ainsley Miller
- School of Nursing, Lakehead University, 955 Oliver Rd, Thunder Bay, ON, P7B5E1, Canada
| | - Lori Chambers
- Lakehead University, Gender and Women's Studies, Thunder Bay, Canada
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Agbaje OS, Arua CK, Umeifekwem JE, Umoke PCI, Igbokwe CC, Iwuagwu TE, Iweama CN, Ozoemena EL, Obande-Ogbuinya EN. Workplace gender-based violence and associated factors among university women in Enugu, South-East Nigeria: an institutional-based cross-sectional study. BMC WOMENS HEALTH 2021; 21:124. [PMID: 33757498 PMCID: PMC7988966 DOI: 10.1186/s12905-021-01273-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 03/18/2021] [Indexed: 11/23/2022]
Abstract
Background Exposure to workplace gender-based violence (GBV) can affect women's mental and physical health and work productivity in higher educational settings. Therefore, this study aimed to examine the prevalence of GBV (workplace incivility, bullying, sexual harassment), and associated factors among Nigerian university women. Methods The study was an institutional-based cross-sectional survey. The multi-stage sampling technique was used to select 339 female staff from public and private universities in Enugu, south-east Nigeria. Data was collected using the Workplace Incivility Scale (WIS), Modified Workplace Incivility Scale (MWIS), Negative Acts Questionnaire-Revised (NAQ-R), and Sexual Experiences Questionnaire (SEQ). Descriptive statistics, independent samples t-test, Pearson’s Chi-square test, univariate ANOVA, bivariate, and multivariable logistic regression analyses were conducted at 0.05 level of significance. Results The prevalence of workplace incivility, bullying, and sexual harassment (SH) was 63.8%, 53.5%, and 40.5%. The 12-month experience of the supervisor, coworker, and instigated incivilities was 67.4%, 58.8%, and 52.8%, respectively. Also, 47.5% of the participants initiated personal bullying, 62.5% experienced work-related bullying, and 42.2% experienced physical bullying. The 12-month experience of gender harassment, unwanted sexual attention, and sexual coercion were 36.5%, 25.6%, and 26.6%, respectively. Being aged 35–49 years (AOR 0.15; 95% CI (0.06, 0.40), and ≥ 50 years (AOR 0.04; 95% CI (0.01, 0.14) were associated with workplace incivility among female staff. Having a temporary appointment (AOR 7.79, 95% CI (2.26, 26.91) and casual/contract employment status (AOR 29.93, 95% CI (4.57, 192.2) were reported to be associated with workplace bullying. Having a doctoral degree (AOR 3.57, 95% CI (1.24, 10.34), temporary appointment (AOR 91.26, 95% CI (14.27, 583.4) and casual/contract employment status (AOR 73.81, 95% CI (7.26, 750.78) were associated with workplace SH. Conclusions The prevalence of GBV was high. There is an urgent need for workplace interventions to eliminate different forms of GBV and address associated factors to reduce the adverse mental, physical, and social health outcomes among university women. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-021-01273-w.
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Affiliation(s)
- Olaoluwa Samson Agbaje
- Department of Human Kinetics and Health Education, Faculty of Education, University of Nigeria, Nsukka, Nigeria
| | - Chinenye Kalu Arua
- Department of Human Kinetics and Health Education, Faculty of Education, University of Nigeria, Nsukka, Nigeria
| | - Joshua Emeka Umeifekwem
- Department of Human Kinetics and Health Education, Faculty of Education, University of Nigeria, Nsukka, Nigeria
| | | | - Chima Charles Igbokwe
- Department of Human Kinetics and Health Education, Faculty of Education, University of Nigeria, Nsukka, Nigeria
| | - Tochi Emmanuel Iwuagwu
- Department of Human Kinetics and Health Education, Faculty of Education, University of Nigeria, Nsukka, Nigeria
| | - Cylia Nkechi Iweama
- Department of Human Kinetics and Health Education, Faculty of Education, University of Nigeria, Nsukka, Nigeria
| | - Eyuche Lawretta Ozoemena
- Department of Human Kinetics and Health Education, Faculty of Education, University of Nigeria, Nsukka, Nigeria
| | - Edith N Obande-Ogbuinya
- Department of Physical and Health Education, Faculty of Education, Alex-Ekwueme Federal University, Ndufu-Alike, Ebonyi State, Nigeria
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Thurston RC, Jakubowski K, Chang Y, Koenen K, Maki PM, Barinas Mitchell E. Sexual Assault and Carotid Plaque Among Midlife Women. J Am Heart Assoc 2021; 10:e017629. [PMID: 33619993 PMCID: PMC8174296 DOI: 10.1161/jaha.120.017629] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background Sexual assault is a risk factor for poor mental health, yet its relationship to cardiovascular disease risk is not understood. We tested whether women with a sexual assault history had greater carotid atherosclerosis levels and progression over midlife. Methods and Results A total of 169 non‐smoking, cardiovascular disease‐free women aged 40 to 60 years were assessed twice over 5 years. At each point, women completed questionnaires, physical measures, phlebotomy, and carotid ultrasounds. Associations between sexual assault and carotid plaque level (score 0, 1, ≥2) and progression (score change) were assessed in multinomial logistic and linear regression models, adjusted for age, race/ethnicity, education, body mass index, blood pressure, lipids, insulin resistance, and additionally depression/post‐traumatic stress symptoms; 28% of the women reported a sexual assault history. Relative to non‐exposed women, women with a sexual assault history had an over 4‐fold odds of a plaque score of ≥2 at baseline (≥2, odds ratio [OR] [95% CI]=4.35 [1.48–12.79], P=0.008; 1, OR [95% CI]=0.49 [0.12–1.97], P=0.32, versus no plaque; multivariable); and an over 3‐fold odds of plaque ≥2 at follow‐up (≥2, OR [95% CI]=3.65 [1.40–9.51], P=0.008; 1, OR [95% CI]=1.52 [0.46–4.99], P=0.49, versus no plaque; multivariable). Women with a sexual assault history also had an over 3‐folds greater odds of a plaque score progression of ≥2 (OR [95% CI]=3.48[1.11–10.93], P=0.033, multivariable). Neither depression nor post‐traumatic symptoms were related to plaque. Conclusions Sexual assault is associated with greater carotid atherosclerosis level and progression over midlife. Associations were not explained by standard cardiovascular disease risk factors. Future work should consider whether sexual assault prevention reduces women's cardiovascular disease risk.
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Affiliation(s)
- Rebecca C Thurston
- Department of Psychiatry University of Pittsburgh PA.,Department of Epidemiology University of Pittsburgh PA.,Department of Psychology University of Pittsburgh PA
| | | | - Yuefang Chang
- Department of Neurosurgery University of Pittsburgh PA
| | - Karestan Koenen
- Department of Epidemiology Harvard T.H. Chan School of Public Health Boston MA
| | - Pauline M Maki
- Department of Psychiatry University of Illinois at Chicago IL
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Baert S, Gilles C, Van Belle S, Bicanic I, Roelens K, Keygnaert I. Piloting sexual assault care centres in Belgium: who do they reach and what care is offered? Eur J Psychotraumatol 2021; 12:1935592. [PMID: 34367523 PMCID: PMC8317926 DOI: 10.1080/20008198.2021.1935592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Sexual assault (SA) is highly prevalent in Belgium. In order to mitigate the negative consequences for victims of acute SA, Sexual Assault Care Centres (SACCs) were piloted from October 2017 to October 2018 in three Belgian hospitals. SACCs offer medical and psychological care, forensic examination and the possibility to report to the police at the SACC. OBJECTIVE Aiming to improve SACC services, we quantitatively assessed the number and characteristics of victims attending the SACC, the SA they experienced, and the care they received over 12 months upon admission. METHOD Data on victims presenting at the SACC were routinely collected in electronic patient files by the SACC personnel between 25 October 2017 and 31 October 2019. These data were analysed in IBM SPSS Statistics 25. RESULTS Within the first year 931 victims attended the SACCs. Mean age was 24.5 years (SD = 12.8), and one-third were under 18. The majority were female (90.5%) and 63.1% presented for rape. About one-third of the victims were considered vulnerable due to previous SA (35.6%), prior psychiatric consultation (38.7%) or disability (8.5%). The assailant was known to the victim in 59.2% of the cases. Of all SACC presentations, 35.2% self-referred to the SACC while 40.9% were referred by the police. Two out of three victims attended the SACC within 72 h post-assault. Respectively 74.7% of victims received medical care, 60.6% a forensic examination, 50.2% psychological care, and 68.7% reported to the police. CONCLUSION Despite the absence of promotion campaigns, the SACCs received a high number of victims during the pilot year. Use of acute and follow-up services was high, although new approaches to offer more accessible psychological support should be explored. The big proportion of vulnerable victims warrants careful monitoring and adaptation of care pathways.
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Affiliation(s)
- Saar Baert
- Department of Public Health and Primary Care, International Centre for Reproductive Health, Ghent University, Ghent, Belgium
| | - Christine Gilles
- Department of Obstetrics and Gynecology, Saint-Pierre University Hospital Brussels, Brussels, Belgium
| | - Sara Van Belle
- Department of Public Health, Institute of Tropical Medicine Antwerp, Antwerp, Belgium
| | - Iva Bicanic
- National Psychotrauma Center for Children and Youth, University Medical Center, Utrecht, The Netherlands
| | - Kristien Roelens
- Department of Human Structure and Repair, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - Ines Keygnaert
- Department of Public Health and Primary Care, International Centre for Reproductive Health, Ghent University, Ghent, Belgium
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Lippus H, Laanpere M, Part K, Ringmets I, Karro H. What do we know about the impact of sexual violence on health and health behaviour of women in Estonia? BMC Public Health 2020; 20:1897. [PMID: 33302901 PMCID: PMC7727120 DOI: 10.1186/s12889-020-09953-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 11/22/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sexual violence against women is a major public health issue and a breach of human rights. Although various consequences of sexual violence on health have been described in a large number of scientific publications, very little is known about this topic in Estonia. The aim of this study was to examine the prevalence of sexual violence and associations between exposure to sexual violence and risky health and sexual behaviours among women in Estonia. METHODS A population-based cross-sectional study was carried out in Estonia in 2014. Self-reported data regarding selected indicators of risky health and sexual behaviours were collected from 1670 women, aged 18-44 years, via a self-administered questionnaire. To measure the prevalence of sexual violence, questions from the NorVold Abuse Questionnaire were included. Chi-square and multivariate logistic regression were used to analyse the data. RESULTS Of the respondents, 22.7% (n = 379) reported being exposed to sexual violence during their lifetime, and over half of these women had had these experiences before the age of 18. Statistically significant associations were found between sexual violence and smoking (adjusted odds ratio (AOR) 1.32, 95% CI 1.03-1.70), alcohol consumption (AOR 1.52, 95% CI 1.18-1.95), illicit drug use (AOR 2.21, 95% CI 1.70-2.89), sexual intercourse for money or other material reward (AOR 3.51, 95% CI 1.62-7.61), concurrent sexual relationships (AOR 2.64; 95% CI 1.80-3.86), and being diagnosed with sexually transmitted infections (AOR 1.48, 95% CI 1.09-2.01). CONCLUSIONS In Estonia, sexual violence against women is widespread and is associated with several risky health and sexual behaviours. Efforts should be made, both among the general public and professionals, to raise awareness regarding the prevalence and negative impact of sexual violence. Women who have been exposed to sexual violence are in need of professional medical, legal and psychological help free from prejudice to help them recover from such traumatic events.
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Affiliation(s)
- Hedda Lippus
- Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Tartu, 8 Puusepa, 51014 Tartu, Estonia
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA USA
| | - Made Laanpere
- Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Tartu, 8 Puusepa, 51014 Tartu, Estonia
- Sexual Health Clinic of Tartu, Tartu, Estonia
- Tartu University Hospital Women’s Clinic, Tartu, Estonia
| | - Kai Part
- Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Tartu, 8 Puusepa, 51014 Tartu, Estonia
- Sexual Health Clinic of Tartu, Tartu, Estonia
- Tartu University Hospital Women’s Clinic, Tartu, Estonia
| | - Inge Ringmets
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Helle Karro
- Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Tartu, 8 Puusepa, 51014 Tartu, Estonia
- Tartu University Hospital Women’s Clinic, Tartu, Estonia
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31
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Lee MR, Cha C. A Mobile Healing Program Using Virtual Reality for Sexual Violence Survivors: A Randomized Controlled Pilot Study. Worldviews Evid Based Nurs 2020; 18:50-59. [PMID: 33245631 DOI: 10.1111/wvn.12478] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Many young women suffer from sexual violence, but few practice self-healing activities. AIMS This study evaluated the feasibility and preliminary effects of a mobile virtual intervention, Sister, I will tell you!©, to heal young women after sexual violence in South Korea. METHODS A mobile virtual intervention, Sister, I will tell you!©, was developed based on a literature review and preliminary studies. In collaboration with sexual violence survivors and experts, eight modules for reflective writing and six modules for mindfulness meditation were included in this 4-week mobile virtual intervention. Thirty-four female sexual violence survivors were randomly assigned to either experimental (n = 19) or control groups (n = 15). The experimental group practiced reflective writing and mindfulness meditation, guided by the mobile virtual intervention. The control group practiced audio-guided mindfulness meditation. Pretest, posttest, and post-4-week evaluations with standardized instruments measured perceived support, negative impact from sexual violence, and suicidal ideation. Descriptive and inferential statistics were used to analyze survey data and content analysis to analyze reflective writing. RESULTS Among 34 enrolled participants, 26 completed the 4-week intervention and posttest evaluations; 24 completed post-4-week evaluations. Significant improvements were found among participants in the areas of perceived support, negative impact from sexual violence, and suicidal ideation. The effect size of the intervention was moderate. Four themes that emerged from reflective writings were objectifying sexual violence, healing beginning with action, confronting issues, and sharing experiences. LINKING EVIDENCE TO ACTION The intervention showed potential for initiating young women's engagement in healing from sexual violence. A simple mobile audio intervention without human interaction could benefit sexual violence survivors.
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Affiliation(s)
- Mi-Ran Lee
- College of Nursing, Ewha Womans University, Seoul, South Korea
| | - Chiyoung Cha
- College of Nursing, Ewha Research Institute of Nursing Science, & System Health & Engineering major in graduate school, Ewha Womans University, Seoul, South Korea
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32
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Vander Weg MW, Sadler AG, Abrams TE, Richardson K, Torner JC, Syrop CH, Mengeling MA. Lifetime History of Sexual Assault and Emergency Department Service Use among Women Veterans. Womens Health Issues 2020; 30:374-383. [PMID: 32571623 DOI: 10.1016/j.whi.2020.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 05/19/2020] [Accepted: 05/27/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Although sexual assault survivors are at increased risk for adverse physical and mental health outcomes and tend to use more health care services, little is known about women veterans' lifetime history of experiencing sexual assault (lifetime sexual assault [LSA]) and emergency department (ED) use. We sought to examine associations between experiencing LSA, mental health diagnoses, and ED use among women veterans. METHODS Computer-assisted telephone interviews were conducted with 980 women veterans enrolled at two Veterans Affairs (VA) Medical Centers to assess history of experiencing LSA, health care use, sociodemographic characteristics, and military history. Administrative data provided VA use, mental health, and medical diagnoses. Logistic regression analyses examined associations between experiencing LSA and mental health diagnoses and past 5-year ED use. Classification tree analysis characterized ED use in participant subgroups. RESULTS Sixty-four percent of participants visited a VA or non-VA ED during the previous 5 years. Women veterans with histories of mental health diagnoses and who experienced sexual assault had an odds of ED use almost two times greater than those with no history of experiencing sexual assault and no mental health diagnoses. The odds were similar for experiencing attempted (adjusted odds ratio, 1.85) and completed (adjusted odds ratio, 1.95) sexual assault. Classification tree analysis identified reliance on VA care and the composite variable representing experiencing LSA and mental health diagnoses as factors that best discriminated ED users from nonusers. CONCLUSIONS Experiencing LSA is associated with greater ED use in women veterans enrolled in the VA. Whether finding this reflects greater emergent health care needs, suboptimal access and treatment for conditions that could be managed in other settings, lack of health care coordination, or some combination of these factors is unclear.
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Affiliation(s)
- Mark W Vander Weg
- Center for Access & Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, Iowa City, Iowa; Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa; Department of Psychological and Brain Sciences, University of Iowa, Iowa City, Iowa.
| | - Anne G Sadler
- Center for Access & Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, Iowa City, Iowa; Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Thad E Abrams
- Center for Access & Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, Iowa City, Iowa; Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa; Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Kelly Richardson
- Center for Access & Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, Iowa City, Iowa
| | - James C Torner
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa; Departments of Neurosurgery and Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Craig H Syrop
- Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Michelle A Mengeling
- Center for Access & Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, Iowa City, Iowa; Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa; VA Office of Rural Health (ORH), Veterans Rural Health Resource Center-Iowa City, Iowa City VA Health Care System, Iowa City, Iowa
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An Integrated, Trauma-Informed Care Model for Female Survivors of Sexual Violence: The Engage, Motivate, Protect, Organize, Self-Worth, Educate, Respect (EMPOWER) Clinic. Obstet Gynecol 2020; 133:803-809. [PMID: 30870277 DOI: 10.1097/aog.0000000000003186] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This article describes the Engage, Motivate, Protect, Organize, self-Worth, Educate, Respect (EMPOWER) Clinic for Survivors of Sex Trafficking and Sexual Violence located at Gouverneur Health in New York, New York, as a model for integrated gynecologic and psychiatric care of survivors of sexual and gender-based violence. Although patients with a history of sexual trauma often have critical health needs that persist long after the traumatic event, most existing services for survivors of sexual violence focus solely on the provision of acute care immediately after the violence has occurred. There are very few clinics in the United States dedicated to managing the significant long-term medical consequences and sequelae of sexual violence in a trauma-informed setting. We report on best practices for the provision of trauma-sensitive medical care to this patient population based on those employed at the EMPOWER Clinic. In particular, we outline some of the unique considerations for treating survivors relating to taking a patient history, conducting the physical and gynecologic examinations, ensuring confidentiality, and managing legal issues. Finally, we reflect on the challenges faced in sustaining the EMPOWER Clinic and the importance of the existence of a clinic dedicated to this specific population.
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Lopes S, Hallak JEC, Machado de Sousa JP, Osório FDL. Adverse childhood experiences and chronic lung diseases in adulthood: a systematic review and meta-analysis. Eur J Psychotraumatol 2020; 11:1720336. [PMID: 32128046 PMCID: PMC7034480 DOI: 10.1080/20008198.2020.1720336] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 12/18/2019] [Accepted: 01/08/2020] [Indexed: 12/24/2022] Open
Abstract
Background: Adverse childhood experiences (ACE) affect physical and mental health and may appear as risk factors for the development of different conditions in adult life. Objective: To perform a literature review and meta-analysis on risk indicators for the development of chronic lung diseases in adulthood associated with ACE. Method: We conducted a systematic literature review according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using the online databases PubMed, PsycINFO, and Web of Science. Quantitative studies involving male and female adults were included. Fixed- and random-effect models were used in the estimation of meta-analytical measures. The heterogeneity between studies was assessed using I2 statistics and Cochran's Q test. Results: A total of 19 studies were selected for the meta-analysis. The analyses showed statistically significant associations between ACE and lung diseases in general (OR = 1.41; CI 95%: 1.28-1.54), besides specific associations with asthma (OR = 1.32; CI 95%: 1.13-1.50) and COPD (OR = 1.44; CI 95%: 1.13-1.76). When the mediating effect of smoking was assessed separately we found a significant - although not quite expressive - association (OR = 1.06; CI 95%: 1.02 to 1.10), which weakens the hypothesis that a direct relationship exists between childhood trauma and the occurrence of lung diseases. Conclusions: ACE are an important risk factor for the development of lung diseases in adulthood, whether through direct or indirect contribution to this outcome, which highlights the relevance of increasing the awareness of health staff for the early detection and intervention in situations of vulnerability or risk in childhood as an important preventative measure.
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Affiliation(s)
- Samuel Lopes
- Medical School of Ribeirão Preto, São Paulo University, Ribeirão Preto, Brazil
| | - Jaime Eduardo Cecilio Hallak
- Medical School of Ribeirão Preto, São Paulo University, Ribeirão Preto, Brazil.,National Institute for Science and Technology (INCT-TM, CNPq), Brasília, Brazil
| | - João Paulo Machado de Sousa
- Medical School of Ribeirão Preto, São Paulo University, Ribeirão Preto, Brazil.,National Institute for Science and Technology (INCT-TM, CNPq), Brasília, Brazil
| | - Flávia de Lima Osório
- Medical School of Ribeirão Preto, São Paulo University, Ribeirão Preto, Brazil.,National Institute for Science and Technology (INCT-TM, CNPq), Brasília, Brazil
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Ross-Reed DE, Reno J, Peñaloza L, Green D, FitzGerald C. Family, School, and Peer Support Are Associated With Rates of Violence Victimization and Self-Harm Among Gender Minority and Cisgender Youth. J Adolesc Health 2019; 65:776-783. [PMID: 31564618 DOI: 10.1016/j.jadohealth.2019.07.013] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 07/11/2019] [Accepted: 07/12/2019] [Indexed: 12/31/2022]
Abstract
PURPOSE Gender minority (GM) youth experience high rates of violence, and research on protective factors to reduce violence victimization and self-harm is lacking. The purpose of this study was to determine how family, school, peer, and community support influenced rates of violence victimization and self-harm among GM and cisgender adolescents. METHODS This research uses data from the 2017 New Mexico Youth Risk and Resiliency Survey (N = 18,451). The main independent variable was gender, dichotomized into GM and cisgender, and the secondary independent variables were family, school, community, and peer support. Dependent variables were sexual and dating violence, suicide attempts, and nonsuicidal self-injury. Logistic regression models were built for the four dependent variables, including demographics, support scores, and interaction terms between gender and support. RESULTS Six percent of high school students in New Mexico identified as GM are unsure of their gender. GM students experienced higher rates of violence and self-harm and lower levels of support than cisgender students. Among all students, family support was associated with lower odds of sexual violence and self-harm, while school support was associated with lower odds of dating violence and nonsuicidal self-injury. There were significant interactions between gender, violence, and support. The protective effects of support were less pronounced for GM students than for cisgender students. CONCLUSIONS Family and school support are associated with lower rates of some forms of violence and self-harm among adolescents. Additional support may be necessary to reduce harm among GM adolescents, who are at higher risk for violence and its sequelae.
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Affiliation(s)
- Danielle E Ross-Reed
- University of New Mexico Health Sciences Center, Department of Pediatrics, University of New Mexico, Albuquerque, New Mexico.
| | - Jessica Reno
- University of New Mexico Health Sciences Center, Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico
| | - Linda Peñaloza
- University of New Mexico Health Sciences Center, Department of Pediatrics, University of New Mexico, Albuquerque, New Mexico
| | - Dan Green
- New Mexico Department of Health, Epidemiology and Response Division, Santa Fe, New Mexico
| | - Courtney FitzGerald
- University of New Mexico Health Sciences Center, Department of Pediatrics, University of New Mexico, Albuquerque, New Mexico
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Dallelucci CC, Bragiato EC, Areco KCN, Fidalgo TM, da Silveira DX. Sexual risky behavior, cocaine and alcohol use among substance users in an outpatient facility: a cross section study. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2019; 14:46. [PMID: 31694694 PMCID: PMC6836442 DOI: 10.1186/s13011-019-0238-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 10/23/2019] [Indexed: 11/10/2022]
Abstract
Background Substance dependence is considered an international health issue and studies that access the characteristic of this population are required to develop public health programs for harm reduction. To this aim, we purpose to to identify, in a population undergo addiction treatment, if the use of substances leads to sexual risky behavior and also check if another variables influences in this behavior. Method Observational study of clinical sample collected of adult patients seeking treatment to dependence of alcohol and cocaine. The data collected were: socio-demographic, substance use, sexual behavior and childhood abuse. Risky sexual behaviors were considered: inconsistent use of condoms and presence of multiple sexual partners in the past six months. An exploratory analysis of the association between the variable “risky sexual behavior” and the other variables was performed using Pearson’s chi-square, followed by a multivariate logistic regression analysis. Results After analyzing the variables with the presence or absence of risky sexual behavior, were included in the logistic regression the data that presented association with sexual risk behavior, and age appears as an independent factor for risky sexual behaviors. Other factors, such as schooling and unemployment, influence as much as the use of substances in risky sexual behaviors. Conclusion Attributing just to the substance use this risky sexual behavior seems too simplistic. Other structural factors such as schooling, work, age and sexual abuse in childhood can influence decision making for safe sex.
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Affiliation(s)
- Claudia Chaves Dallelucci
- Psychiatry Department, Universidade Federal de São Paulo, Major Maragliano Street, 241, São Paulo, SP, 04017-030, Brazil.
| | - Emi Carneiro Bragiato
- Psychiatry Department, Universidade Federal de São Paulo, Major Maragliano Street, 241, São Paulo, SP, 04017-030, Brazil
| | | | - Thiago Marques Fidalgo
- Psychiatry Department, Universidade Federal de São Paulo, Major Maragliano Street, 241, São Paulo, SP, 04017-030, Brazil
| | - Dartiu Xavier da Silveira
- Psychiatry Department, Universidade Federal de São Paulo, Major Maragliano Street, 241, São Paulo, SP, 04017-030, Brazil
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Okasako-Schmucker DL, Cole KH, Finnie RKC, Basile KC, DeGue S, Niolon PH, Swider SM, Remington PL. Using a Community Preventive Services Task Force Recommendation to Prevent and Reduce Intimate Partner Violence and Sexual Violence. J Womens Health (Larchmt) 2019; 28:1335-1337. [PMID: 31622189 DOI: 10.1089/jwh.2019.8104] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Intimate partner violence (IPV) and sexual violence (SV) are preventable public health problems affecting millions in the United States. The Community Preventive Services Task Force (CPSTF), an independent panel of experts that develops evidence-based recommendations based on rigorous systematic reviews, recommends interventions that aim to prevent or reduce IPV and SV among youth aged 12-24 years. Decision makers can use these findings to select interventions appropriate for their populations, identify additional areas for research, and justify funding requests.
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Affiliation(s)
- Devon L Okasako-Schmucker
- Community Guide Office, Office of the Associate Director for Policy and Strategy, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | | | - Ramona K C Finnie
- Community Guide Office, Office of the Associate Director for Policy and Strategy, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Kathleen C Basile
- Division of Violence Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Sarah DeGue
- Division of Violence Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Phyllis Holditch Niolon
- Division of Violence Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Susan M Swider
- Department of Community, Systems and Mental Health Nursing, Rush University, Chicago, Illinois
| | - Patrick L Remington
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
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Post-traumatic stress disorder and asthma risk: A nationwide longitudinal study. Psychiatry Res 2019; 276:25-30. [PMID: 30991276 DOI: 10.1016/j.psychres.2019.04.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 04/09/2019] [Accepted: 04/09/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND Increasing evidence suggests that post-traumatic stress disorder (PTSD) interferes with the immunological system and is correlated with cardiovascular disease, respiratory disease, and chronic pain conditions. However, the association between PTSD and asthma remains unknown. METHODS A total of 5518 patients with PTSD and 22,072 age- and sex-matched healthy individuals were enrolled between 2001 and 2009 and followed until the end of 2011. Individuals who developed asthma during the follow-up period were identified. RESULTS During the follow-up period, the patients with PTSD had an increased risk of asthma (hazard ratio [HR] = 2.27), particularly those belonging to the youngest age group (HR = 4.01). The findings were consistent in subsequent sensitivity analyses after the exclusion of the first year of surveillance or allergic disorders. DISCUSSION This study showed a significant link between PTSD and asthma after adjusting for demographic data and related comorbidities. The risk of developing asthma in patients with PTSD was consistently higher than that in the controls during the study period. Additional studies are necessary to clarify the underlying mechanisms involved in this association between PTSD and asthma.
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Leone M, Lapucci E, De Sario M, Davoli M, Farchi S, Michelozzi P. Social network analysis to characterize women victims of violence. BMC Public Health 2019; 19:494. [PMID: 31046717 PMCID: PMC6498634 DOI: 10.1186/s12889-019-6797-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 04/11/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In Europe, it is estimated that one third of women had experienced at least one physical or sexual violence after their 15. Taking into account the severe health consequences, the Emergency Department (ED), may offer an opportunity to recognize when an aggression is part of the spectrum of violence. This study applies Social Network analysis (SNA) to ED data in the Lazio region with the objective to identify patterns of diagnoses, within all the ED accesses of women experiencing an aggression, that are signals for gender-based violence against women. We aim to develop a risk assessment tool for ED professionals in order to strength their ability to manage victims of violence. METHODS A cohort of 124,691 women aged 15-70 with an ED visit for aggression between 2003 and 2015 was selected and, for each woman, the ED history of diagnoses and traumas was reconstructed. SNA was applied on all these diagnoses and traumas, including also 9 specific violence diagnoses. SNA community detection algorithms and network centrality measures were used to detect diagnostic patterns more strongly associated to violence. A logistic model was developed to validate the capability of these patterns to predict the odds for a woman of having an history of violence. Model results were summed up into a risk chart. RESULTS Among women experiencing an aggression, SNA identified four communities representing specific violence-related patterns of diagnoses. Diagnoses having a central role in the violence network were alcohol or substance abuse, pregnancy-related conditions and psychoses. These high-risk violence related patterns accounted for at most 20% of our cohort. The logistic model had good predictive accuracy and predictive power confirming that diagnosis patterns identified through the SNA are meaningful in the violence recognition. CONCLUSIONS Routine ED data, analyzed using SNA, can be a first-line warning to recognize when an aggression related access is part of the spectrum of gender-based violence against women. Increasing the available number of predictors, such procedures may be proven to support ED staff in identifying early signs of violence to adequately support the victims and mitigate the harms.
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Affiliation(s)
- Michela Leone
- Department of Epidemiology of Lazio Regional Health Service - ASL Roma 1, Via Cristoforo Colombo, 112, Rome, 00147, Italy
| | - Enrica Lapucci
- Department of Epidemiology of Lazio Regional Health Service - ASL Roma 1, Via Cristoforo Colombo, 112, Rome, 00147, Italy.
| | - Manuela De Sario
- Department of Epidemiology of Lazio Regional Health Service - ASL Roma 1, Via Cristoforo Colombo, 112, Rome, 00147, Italy
| | - Marina Davoli
- Department of Epidemiology of Lazio Regional Health Service - ASL Roma 1, Via Cristoforo Colombo, 112, Rome, 00147, Italy
| | - Sara Farchi
- Hospital network and risk management area of the Lazio Region, Via Rosa Raimondi Garibaldi 7, Rome, 00145, Italy
| | - Paola Michelozzi
- Department of Epidemiology of Lazio Regional Health Service - ASL Roma 1, Via Cristoforo Colombo, 112, Rome, 00147, Italy
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Changes in Psychiatric and Medical Conditions and Health Care Utilization Following a Diagnosis of Sexual Assault: A Retrospective Cohort Study. Med Care 2019; 56:649-657. [PMID: 29781924 DOI: 10.1097/mlr.0000000000000930] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Sexual assault (SA) is alarmingly common and is associated with higher prevalence of psychiatric and medical conditions. However, many prior studies are limited to cross-sectional designs. Health care systems with electronic health records provide unique longitudinal data to examine whether SA is associated with changes in health and health care utilization. METHODS The sample included 1350 Kaiser Permanente Northern California adult female patients with a SA diagnosis from 2009 to 2015 and 4050 adult female patients without a SA diagnosis, matched on age, medical facility, and continuous enrollment during the study period. Using a retrospective cohort design, we tested whether a SA diagnosis was associated with 12-month changes in psychiatric and medical comorbidities and health care utilization using difference-in-difference models. Analyses were conducted in 2017. RESULTS Patients with a SA diagnosis had a higher prevalence of psychiatric and medical comorbidities and greater health care utilization than matched patients without SA in the 12 months before the SA diagnosis, and greater increases in the prevalence of psychiatric disorders and stress-related somatic conditions, and psychiatry and obstetrics/gynecology utilization (all P<0.001), 12 months after the SA diagnosis, relative to matched non-SA patients during this time. DISCUSSION SA is associated with increases in psychiatric disorders and stress-related somatic conditions as well as increases in utilization of psychiatry and obstetrics/gynecology. Clinicians should be trained in how to inquire about, respond to, and refer women who have experienced SA.
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Bateson DJ, Black KI, Sawleshwarkar S. The Guttmacher–
Lancet
Commission on sexual and reproductive health and rights: how does Australia measure up? Med J Aust 2019; 210:250-252.e1. [DOI: 10.5694/mja2.50058] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | - Kirsten I Black
- University of Sydney Sydney NSW
- Royal Prince Alfred Hospital Sydney NSW
| | - Shailendra Sawleshwarkar
- Westmead Clinical SchoolUniversity of Sydney Sydney NSW
- Western Sydney Sexual Health CentreWestmead Hospital Sydney NSW
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Stensvehagen MT, Bronken BA, Lien L, Larsson G. How women experience and cope with daily hassles after sexual abuse - a retrospective qualitative study. Scand J Caring Sci 2019; 33:487-497. [PMID: 30628733 DOI: 10.1111/scs.12649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 12/11/2018] [Indexed: 11/29/2022]
Abstract
The impact of stress on health can depend on factors such as frequency, heightening of stress during a given period or the presence of one or a few repeated hassles of psychological importance. The aim of this study was to gain a deeper understanding of how adult women experience and cope with daily hassles after sexual abuse. Ten interviews were analysed using the grounded theory method. The theoretical model of 'protecting armor in daily life' emerged. The aftermath of sexual abuse related coping with daily stress can be understood as a three-phase process: (1) avoiding and escaping-coping after experiencing sexual abuse; (2) accepting and disclosing-starting a process of recovery; and (3) reconciling and repossessing-living with the experience in the present. The model contributes to a deeper understanding of the everyday life of women who have experienced sexual abuse. Increased knowledge of coping behaviours that can be used to deal with daily hassles may also serve as a tool for health professionals, other helpers and family to help these women rebuild a good life.
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Affiliation(s)
| | | | - Lars Lien
- Inland Norway University of Applied Sciences, Elverum, Norway.,University of Oslo, Oslo, Norway.,Innlandet Hospital Trust, Brumunddal, Norway
| | - Gerry Larsson
- Inland Norway University of Applied Sciences, Elverum, Norway.,Swedish Defence University, Karlstad, Sweden
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Tsegay G, Deribe K, Deyessa N, Addissie A, Davey G, Cooper M, Trueba ML. 'I should not feed such a weak woman'. Intimate partner violence among women living with podoconiosis: A qualitative study in northern Ethiopia. PLoS One 2018; 13:e0207571. [PMID: 30521548 PMCID: PMC6283553 DOI: 10.1371/journal.pone.0207571] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 11/03/2018] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Intimate Partner Violence (IPV) is a serious, preventable public health problem that affects millions of people worldwide. Research indicates that adults suffering from long term, disabling conditions are more likely to be victims of IPV due to the intersection of disease-associated stigma and discrimination. IPV in turn is known to worsen the overall health and wellbeing of those affected by it. Little research however explores the relationship between neglected tropical diseases such as podoconiosis and IPV. This study explores the relationship between IPV and podoconiosis in northern Ethiopia with the aim of identifying new avenues for limiting disability and promoting the wellbeing of people affected by this neglected tropical disease. METHODS The study was conducted in East and West Gojjam zones, located in the Amhara Regional State of Ethiopia. Research participants were first screened using the domestic violence screening tool Hurt-Insult-Threaten-Scream (HITS). Data were collected by native speakers of the local language (Amharic) in the form of semi-structured interviews during January and February 2016. Thematic and content data analysis was carried out, using the Open Code 3.4 qualitative data analysis software for coding. RESULTS A total of 15 women living with podoconiosis and experiencing IPV were interviewed (aged 31 to 75). Women experienced different forms of IPV, including beatings (with or without an object), insults, name calling, undermining, denial of equal rights over common assets, movement monitoring, cheating, abandonment, forced divorce, obstruction of health care access, inhibition of decision-making and sexual coercion. Podoconiosis increases the frequency and severity of IPV and in occasions shapes a change from physical to psychological and financial violence. In turn, frequent episodes of IPV worsen disease outcomes and contribute to disease persistence in the region, in that these impede women's ability to manage the disease and help perpetuate the conditions of poverty that influence disease onset. CONCLUSIONS Women living with podoconiosis are victims of various, overlapping forms of IPV that negatively impact their health and wellbeing. Poverty, scarce IPV prevention services in the area together with a social acceptance of IPV and these women's decreased ability to work due to the debilitating effects of podoconiosis and childcare responsibilities frequently prompt these women to tolerate IPV and remain in abusive relationships. Tackling disease-associated taboo and stigma, developing accessible IPV interventions, working towards greater gender equality at the household and societal levels and developing sustainable strategies for improving the socio-economic assets of women affected by podoconiosis are all necessary to both prevent IPV and to improve disease outcome.
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Affiliation(s)
- Girmay Tsegay
- College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Kebede Deribe
- Wellcome Trust Brighton & Sussex Centre for Global Health Research, Brighton & Sussex Medical School, Falmer, Brighton, United Kingdom
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Negussie Deyessa
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Adamu Addissie
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Gail Davey
- Wellcome Trust Brighton & Sussex Centre for Global Health Research, Brighton & Sussex Medical School, Falmer, Brighton, United Kingdom
| | - Max Cooper
- Wellcome Trust Brighton & Sussex Centre for Global Health Research, Brighton & Sussex Medical School, Falmer, Brighton, United Kingdom
| | - Mei L. Trueba
- Wellcome Trust Brighton & Sussex Centre for Global Health Research, Brighton & Sussex Medical School, Falmer, Brighton, United Kingdom
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Caudillo Ortega L, Valdez Montero C, Flores Arias ML, Ahumada Cortez JG, Gámez Medina ME, Ramos Frausto VM. Relación entre la violencia contra la mujer y el índice de masa corporal: revisión integradora. AVANCES EN ENFERMERÍA 2018. [DOI: 10.15446/av.enferm.v36n2.66009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objetivo: el propósito de esta revisión es conocer la evidencia científica existente de la relación entre la violencia contra la mujer (VCM) y su índice de masa corporal (IMC) (alto y bajo).Síntesis del contenido: se realizó una revisión integradora de las publicaciones científicas que abordaran y relacionaran la VCM y el IMC en diferentes bases de datos. Se consideraron los siete pasos de Cooper. Se analizaron por título, año de publicación, autores y fuente; finalmente, se estudiaron los aspectos metodológicos. Se identificaron 85 artículos y se excluyeron 67 por no cumplir con los criterios de inclusión. De los artículos incluidos en la revisión, 5 reportaron correlación positiva y significativa entre la VCM con el índice de masa corporal alto (sobrepeso/obesidad). Asimismo, 6 de los artículos refieren una relación positiva entre la VCM y el IMC bajo; es decir, a mayor violencia, se reporta un IMC alto. Pero, también, 1 reporta una relación negativa y significativa; es decir, a menor violencia, menor el IMC de las mujeres.Conclusión: los resultados encontrados muestran la existencia escasa literatura científica que aborde la temática de la VCM y el IMC. Algunos estudios muestran la relación entre la VCM y el IMC alto y bajo. Los resultados no son concluyentes, por lo que se requiere generar líneas de acción y atención a las mujeres receptoras de los diferentes tipos de violencia.
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Dos Santos Gomes C, Pirkle CM, Zunzunegui MV, Taurino Guedes D, Fernandes De Souza Barbosa J, Hwang P, Oliveira Guerra R. Frailty and life course violence: The international mobility in aging study. Arch Gerontol Geriatr 2018; 76:26-33. [PMID: 29454241 DOI: 10.1016/j.archger.2018.02.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 01/04/2018] [Accepted: 02/04/2018] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To estimate the prevalence of frailty in older adults in the IMIAS population, to examine associations between lifelong domestic violence and frailty and possible pathways to explain these associations. METHODS A cross-sectional study with 2002 men and women in the International Mobility in Aging Study, aged between 65 and 74 years old living in five cities of Tirana (Albania), Natal (Brazil), Kingston and Saint-Hyacinthe (Canada), and Manizales (Colombia). Domestic physical and psychological violence by family and intimate partner was assessed by the Hurt, Insult, Threaten and Scream (HITS) scale. Fried's phenotype was adopted to define frailty. Logistic regressions were fitted to estimate between frailty and lifelong violence. Mediation analyses using the Preacher and Hayes method was used to examine potential health pathways. RESULTS Frailty prevalence varies across cities, being lowest in Saint-Hyacinthe and Kingston, and highest in women in Natal. Women had a higher prevalence in Tirana and Natal. Adjusting for age, sex, education and research city, those reporting childhood physical abuse (CPA) had higher odds of frailty (OR = 1.68; 95% CI: 1.01; 2.78); those who had been exposed to psychological violence by their intimate partner had also higher odds of frailty (OR = 2.07; 95% CI: 1.37; 3.12). CPA effect on frailty was totally mediated by chronic conditions and depression symptoms. Effects of psychological violence by intimate partner were partially mediated by chronic conditions and depression symptoms. CONCLUSIONS Childhood physical abuse and psychological violence during adulthood leave marks on life trajectory, being conducive to adverse health outcomes and frailty in old age.
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Affiliation(s)
- Cristiano Dos Santos Gomes
- Department of Physioterapy, Federal University of Rio Grande Do Norte, Avenida Senador Salgado Filho, 3000, Lagoa Nova, Natal, RN, 59064-741, Brazil.
| | - Catherine McLean Pirkle
- Office of Public Health Studies, University of Hawaii, 2500 Campus Rd., Honolulu, HI 96822, United States
| | - Maria Vitoria Zunzunegui
- Department of Social Medicine, Montreal University, 2900 Boulevard Edouard-Montpetit, Montréal, QC, H3T 1J4, Canada
| | - Dimitri Taurino Guedes
- Department of Physioterapy, Faculty of Health Sciences of Trairí, Federal University of Rio Grande Do Norte, R. Teodorico Bezerra, 2-122, Santa Cruz, RN, 59200-000, Brazil
| | - Juliana Fernandes De Souza Barbosa
- Department of Physioterapy, Federal University of Rio Grande Do Norte, Avenida Senador Salgado Filho, 3000, Lagoa Nova, Natal, RN, 59064-741, Brazil
| | - Phoebe Hwang
- Department of Social Medicine, Montreal University, 2900 Boulevard Edouard-Montpetit, Montréal, QC, H3T 1J4, Canada
| | - Ricardo Oliveira Guerra
- Department of Physioterapy, Federal University of Rio Grande Do Norte, Avenida Senador Salgado Filho, 3000, Lagoa Nova, Natal, RN, 59064-741, Brazil
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Caldwell R, Cochran C. Infusing Social Justice in Undergraduate Nursing Education: Fostering Praxis Through Simulation. JOURNAL OF FORENSIC NURSING 2018; 14:88-97. [PMID: 29781968 DOI: 10.1097/jfn.0000000000000198] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
SCOPE OF THE PROBLEM Forensic clinical experiences are often inconsistent in undergraduate nursing education. Nursing students are not included in the process of forensic evidence collection, often because of the sensitive nature of the situation. Unfortunately, nursing students are forced to rely on theoretical knowledge provided by the nurse educator to understand the complexities of forensic nursing care. Nursing students must be able to identify and provide appropriate nursing care for individuals in all forensic situations. SOCIAL JUSTICE IN CLINICAL NURSING EDUCATION Comprehensive clinical laboratory experiences should be provided through active teaching-learning strategies, which replicate nursing care of the forensic patient. Simulated patient experiences provide a unique opportunity to explore the sensitive nature of sexual trauma in a safe learning environment. This strategy facilitates the application of theoretical forensic principles by utilizing live actors or high-fidelity manikins in laboratory settings. CONCLUSION The application of theory to each simulated patient infuses conceptual knowledge at the point of care. Change in social consciousness begins at the bedside. The moral imperative of nursing continues to be the preparation of socially responsible, professional nurses who strive to end social injustices.
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Harris DA, Mainardi A, Iyamu O, Rosenthal MS, Bruce RD, Pisani MA, Redlich CA. Improving the asthma disparity gap with legal advocacy? A qualitative study of patient-identified challenges to improve social and environmental factors that contribute to poorly controlled asthma. J Asthma 2017; 55:924-932. [PMID: 28872933 DOI: 10.1080/02770903.2017.1373393] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To identify challenges that disadvantaged adults with asthma face in mitigating social and environmental factors associated with poor symptom control. METHODS Using a community-engaged approach, we partnered with a community health center in New Haven, CT to conduct in-person interviews and a written survey of asthmatic adults with poor symptom control. Using the constant comparative method, we analyzed participant interviews to establish emerging themes and identify common barriers to improved outcomes. Through a written survey utilizing clinically validated questions, we assessed information on access to medical care, asthma control, and selected social and environmental risk factors. RESULTS Twenty-one patients (mean age 47, 62% female, 71% Black, 95% insured by Medicaid) participated. The average Asthma Control Test (ACT) score was 11.6. Seventy-six percent of participants were currently employed and of those, 75% reported work-related symptoms. Among participants currently in housing, 59% reported exposure to domiciliary mice and 47% to mold. We identified three themes that summarize the challenges the study participants face: 1) Lack of knowledge about home and workplace asthma triggers; 2) Lack of awareness of legal rights or resources available to mitigate adverse conditions in the home or work environment; and 3) Fear of retaliation from landlords or employers, including threats of eviction, sexual assault, and job loss. CONCLUSION Patients with poorly controlled asthma in a disadvantaged urban northeast community identified common barriers in both the domestic and work environments that impeded attainment of symptom control. These challenges may be best addressed through legal advocacy for those most at risk.
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Affiliation(s)
- Drew A Harris
- a Division of Pulmonary and Critical Care Medicine , Yale University , New Haven , CT , USA
| | - Anne Mainardi
- a Division of Pulmonary and Critical Care Medicine , Yale University , New Haven , CT , USA
| | | | - Marjorie S Rosenthal
- c Department of Pediatrics , Yale University , New Haven , CT , USA.,d Yale Robert Wood Johnson Foundation Clinician Scholars Program , New Haven , CT , USA
| | - R Douglas Bruce
- e Division of Infectious Disease , Yale University , New Haven , CT , USA.,f Cornell Scott Hill Health Center , New Haven , CT , USA
| | - Margaret A Pisani
- a Division of Pulmonary and Critical Care Medicine , Yale University , New Haven , CT , USA
| | - Carrie A Redlich
- a Division of Pulmonary and Critical Care Medicine , Yale University , New Haven , CT , USA.,g Yale Occupational and Environmental Medicine Program, Yale University , New Haven , CT , USA
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Friborg MK, Hansen JV, Aldrich PT, Folker AP, Kjær S, Nielsen MBD, Rugulies R, Madsen IEH. Workplace sexual harassment and depressive symptoms: a cross-sectional multilevel analysis comparing harassment from clients or customers to harassment from other employees amongst 7603 Danish employees from 1041 organizations. BMC Public Health 2017; 17:675. [PMID: 28942730 PMCID: PMC5611567 DOI: 10.1186/s12889-017-4669-x] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Accepted: 08/06/2017] [Indexed: 11/21/2022] Open
Abstract
Background Previous research has reported that sexual harassment can lead to reduced mental health. Few studies have focused on sexual harassment conducted by clients or customers, which might occur in person-related occupations such as eldercare work, social work or customer service work. This study examined the cross-sectional association between sexual harassment by clients or customers and depressive symptoms. We also examined if this association was different compared to sexual harassment conducted by a colleague, supervisor or subordinate. Further, we investigated if psychosocial workplace initiatives modified the association between sexual harassment by clients or customers and level of depressive symptoms. Methods We used data from the Work Environment and Health in Denmark cohort study (WEHD) and the Work Environment Activities in Danish Workplaces Study (WEADW) collected in 2012. WEHD is based on a random sample of employed individuals aged 18–64. In WEADW, organizational supervisors or employee representatives provided information on workplace characteristics. By combining WEHD and WEADW we included self-reported information on working conditions and health from 7603 employees and supervisors in 1041 organizations within 5 occupations. Data were analyzed using multilevel regression and analyses adjusted for gender, age, occupation and socioeconomic position. Results Exposure to workplace sexual harassment from clients or customers was statistically significantly associated with a higher level of depressive symptoms (2.05; 95% CI: 0.98–3.12) compared to no exposure. Employees harassed by colleagues, supervisors or subordinates had a higher mean level of depressive symptoms (2.45; 95% CI: 0.57–4.34) than employees harassed by clients or customers. We observed no statistically significant interactions between harassment from clients and customers and any of the examined psychosocial workplace initiatives (all p > 0.05). Conclusions The association between sexual harassment and depressive symptoms differed for employees harassed by clients or customers and those harassed by colleagues, supervisors or subordinates. The results underline the importance of investigating sexual harassment from clients or customers and sexual harassment by colleagues, supervisors or subordinates as distinct types of harassment. We found no modification of the association between sexual harassment by clients or customers and depressive symptoms by any of the examined psychosocial workplace initiatives. Electronic supplementary material The online version of this article (doi:10.1186/s12889-017-4669-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Maria K Friborg
- National Research Centre for the Working Environment, Lerso Parkalle 105, DK-2100, Copenhagen, Denmark
| | - Jørgen V Hansen
- National Research Centre for the Working Environment, Lerso Parkalle 105, DK-2100, Copenhagen, Denmark
| | - Per T Aldrich
- COWI A/S, parallelvej 2, DK-2800, Kongens Lyngby, Denmark
| | - Anna P Folker
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, DK-1353, Copenhagen K, Denmark
| | - Susie Kjær
- COWI A/S, parallelvej 2, DK-2800, Kongens Lyngby, Denmark
| | | | - Reiner Rugulies
- National Research Centre for the Working Environment, Lerso Parkalle 105, DK-2100, Copenhagen, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Ida E H Madsen
- National Research Centre for the Working Environment, Lerso Parkalle 105, DK-2100, Copenhagen, Denmark.
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Dworkin ER, Menon SV, Bystrynski J, Allen NE. Sexual assault victimization and psychopathology: A review and meta-analysis. Clin Psychol Rev 2017; 56:65-81. [PMID: 28689071 PMCID: PMC5576571 DOI: 10.1016/j.cpr.2017.06.002] [Citation(s) in RCA: 328] [Impact Index Per Article: 46.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 05/22/2017] [Accepted: 06/18/2017] [Indexed: 01/18/2023]
Abstract
Sexual assault (SA) is a common and deleterious form of trauma. Over 40years of research on its impact has suggested that SA has particularly severe effects on a variety of forms of psychopathology, and has highlighted unique aspects of SA as a form of trauma that contribute to these outcomes. The goal of this meta-analytic review was to synthesize the empirical literature from 1970 to 2014 (reflecting 497 effect sizes) to understand the degree to which (a) SA confers general risk for psychological dysfunction rather than specific risk for posttraumatic stress, and (b) differences in studies and samples account for variation in observed effects. Results indicate that people who have been sexually assaulted report significantly worse psychopathology than unassaulted comparisons (average Hedges' g=0.61). SA was associated with increased risk for all forms of psychopathology assessed, and relatively stronger associations were observed for posttraumatic stress and suicidality. Effects endured across differences in sample demographics. The use of broader SA operationalizations (e.g., including incapacitated, coerced, or nonpenetrative SA) was not associated with differences in effects, although including attempted SA in operationalizations resulted in lower effects. Larger effects were observed in samples with more assaults involving stranger perpetrators, weapons, or physical injury. In the context of the broader literature, our findings provide evidence that experiencing SA is major risk factor for multiple forms of psychological dysfunction across populations and assault types.
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Tarzia L, Maxwell S, Valpied J, Novy K, Quake R, Hegarty K. Sexual violence associated with poor mental health in women attending Australian general practices. Aust N Z J Public Health 2017; 41:518-523. [PMID: 28712124 DOI: 10.1111/1753-6405.12685] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 02/01/2017] [Accepted: 03/01/2017] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Sexual violence (SV) against adult women is prevalent and associated with a range of mental health issues. General practitioners could potentially have a role in responding, however, there is little information to help guide them. Data around prevalence of all forms of adult SV (not just rape) is inconsistent, particularly in clinical samples, and the links between other forms of SV and mental health issues are not well supported. This study aimed to address these gaps in the knowledge base. METHODS A descriptive, cross-sectional study was conducted in Australian general practice clinics. Two hundred and thirty adult women completed an anonymous iPad survey while waiting to see the doctor. RESULTS More than half the sample had experienced at least one incident of adult SV. Most commonly, women reported public harassment or flashing, unwanted groping and being coerced into sex. Women who had experienced adult SV were more likely to experience anxiety than women who had not, even after controlling for other factors. Women who had experienced adult SV were more likely to feel down, depressed or hopeless than women who had not; however, this association disappeared after controlling for childhood sexual abuse. CONCLUSIONS The findings support the association between SV and poor mental health, even when 'lesser' incidents have occurred. Implications for public health: General practitioners should consider an experience of SV as a possible factor in otherwise unexplained anxiety and depressive symptoms in female patients.
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Affiliation(s)
- Laura Tarzia
- Department of General Practice, The University of Melbourne, Victoria
| | - Sarah Maxwell
- Department of General Practice, The University of Melbourne, Victoria
| | - Jodie Valpied
- Department of General Practice, The University of Melbourne, Victoria
| | - Kitty Novy
- Department of General Practice, The University of Melbourne, Victoria
| | - Rebecca Quake
- Department of General Practice, The University of Melbourne, Victoria
| | - Kelsey Hegarty
- Department of General Practice, The University of Melbourne, Victoria
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