1
|
Salim AA, Elsayed M, Mohamed MH, Yousef H, Hemeda MS, Ramadan A, Kengo NE, Abu Bakr Elsaid NM. Prevalence and factors associated with anxiety disorder among married women exposed to violence in rural area, Ismailia, Egypt: A cross-sectional study. Glob Epidemiol 2024; 7:100139. [PMID: 38419782 PMCID: PMC10899053 DOI: 10.1016/j.gloepi.2024.100139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 02/04/2024] [Accepted: 02/08/2024] [Indexed: 03/02/2024] Open
Abstract
Background Domestic abuse is a widespread health issue that negatively impacts both mental health and quality of life. Objectives To determine the prevalence of domestic violence and anxiety among women visiting primary healthcare facilities in the rural Ismailia governorate. Methods Between October 2021 and December 2021, a cross-sectional study was conducted. Simple random methods were used to choose the participants from those who attended a clinic. 350 married women were included in the estimated sample size. By using an interview questionnaire, data were gathered including the following parts: The socio-demographic data, designed scale for assessment of violence and anxiety symptoms were assessed by the Hamilton anxiety scale. Results The prevalence of domestic violence was 41% and both physical and sexual abuse was 43%. The most predominant sexual abuse was practice without consent (63%). The prevalence of anxiety was 76%, the predominance was mild degree 46% followed by mild to moderate 18%. The significant predictors for anxiety in the total sample were the increase in age of women, rural residence, and exposure to abuse (OR = 11.2 (4.9-25.4). The use of the husband's stimulant drugs was the most predictor factor for women's abuse (OR = 2.3 (1.4-3.9). Conclusion forty-one of the women exposed to every form of violence, anxiety was present in more than three-quarters of the studied women. It is essential to screen any wife attending primary health care for the manifestation of domestic violence especially in rural areas and increase the awareness of family physicians towards screening of mental health problems.
Collapse
Affiliation(s)
- Almaza A. Salim
- Lecturer of Family Medicine, Faculty of Medicine, Port Said University, Port Said, Egypt
| | - Mona Elsayed
- Psychiatry, Faculty of Medicine, Suez Canal University, Suez Canal, Egypt
| | - Mohamed Hafez Mohamed
- Lecturer of Gynecology and obstetrics, Faculty of Medicine, Port Said University, Port Said, Egypt
| | - Heba Yousef
- Forensic and Toxicology, Faculty of Medicine, Port Said University, Port Said, Egypt
| | - Mohamed S. Hemeda
- Lecturer of Forensic and Toxicology, Faculty of Medicine, Port Said University, Port Said, Egypt
| | - Alaa Ramadan
- Faculty of Medicine, South Valley University, Qena, Egypt
| | - Nathan Ezie Kengo
- Faculty of Medicine and Biomedical Sciences, University of Garoua, Garoua, Cameroon
- Research Division, Winners Foundation, Yaounde, Cameroon
| | - Noha M. Abu Bakr Elsaid
- Lecturer of Public Health, Department of Public Health, Community, Environmental and Occupational Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
- Department of Clinical Medical Sciences, Faculty of Medicine, King Salman International University, South Sini, Egypt
| |
Collapse
|
2
|
Gümüş F, Duman M, Dolu R. Child sexual abuse knowledge and attitudes of Syrian refugee parents and related factors. J Pediatr Nurs 2024:S0882-5963(24)00170-2. [PMID: 38729896 DOI: 10.1016/j.pedn.2024.04.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 04/18/2024] [Accepted: 04/19/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND Child sexual abuse is an important health problem that disrupts the physical and mental health of children. In order to protect children from abuse, the knowledge and attitude levels of their families need to be increased. PURPOSE This study was to determine the knowledge and attitude levels of Syrian refugee parents regarding child sexual abuse who lived in Turkey. DESIGN AND METHODS The study was carried out using a cross-sectional, descriptive, relationship-seeking design. A personal information form and the Child Sexual Abuse Knowledge/Attitude Scale for Parents (CSAKAS) were used. RESULTS In the study, the mean age of the participants was 33.0 ± 8.2; 74.7% were women; 93.7%. It was also found that the mean scores of the participants regarding such sub-dimensions of CSAKAS as myths/facts, belief, information, attitudes, services and reporting information and preventive attitudes differed statistically significantly with respect to their education level, income level, family type, employment status and having a disabled child (p < 0,05). CONCLUSION Based on the results, it could be stated that the parents who were university graduates, who had good levels of perceived income, who had a nuclear family, who were employed and who had disabled children had better levels of knowledge and attitude regarding child sexual abuse, and it could also be stated that the participants had moderate levels of knowledge and attitudes regarding child sexual abuse. PRACTICE IMPLICATIONS This study shows that pediatric nurses can play an important role in protecting, developing and improving the physical and mental health of children by increasing the knowledge and attitude levels of families in order to prevent child sexual abuse.
Collapse
Affiliation(s)
- Funda Gümüş
- Dicle University, Faculty of Atatürk Health Sciences, Department of Nursing, Diyarbakir, Turkey.
| | - Mesude Duman
- Dicle University, Faculty of Atatürk Health Sciences, Department of Nursing, Diyarbakir, Turkey
| | - Roza Dolu
- Women's Health and Diseases Nursing, Faculty of Atatürk Health Sciences, Dicle University, Diyarbakir, Türkiye
| |
Collapse
|
3
|
Niu L, French DC, Wang Y, Sun J, Lin D. Childhood maltreatment and alcohol and tobacco use trajectories in rural Chinese adolescents. Child Adolesc Psychiatry Ment Health 2024; 18:51. [PMID: 38702797 PMCID: PMC11067222 DOI: 10.1186/s13034-024-00744-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 04/24/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND There is a high prevalence of childhood maltreatment among Chinese children and adolescents, but little is known about its impact on alcohol and tobacco use trajectories and how positive school and neighborhood environments moderate the associations. The objective of this study was to assess the association between multiple forms of childhood maltreatment and longitudinal alcohol and tobacco use trajectories, and to assess the possibility that perceived connections to school and neighborhood moderate these associations. METHODS This longitudinal cohort study included 2594 adolescents (9 to 13 years) from a low-income rural area in China. Childhood exposure to abuse and neglect was assessed using the Childhood Trauma Questionnaire. Participants reported past-month alcohol and tobacco use at three time points over 1 year. RESULTS Growth curve models revealed that childhood sexual abuse was associated with a higher risk of past-month drinking (OR = 1.53, 95% CI 1.19-2.03, p < 0.001) and smoking (OR = 1.82, 95% CI 1.30-2.55, p < 0.001). Neglect was associated with a higher risk of past-month drinking (OR = 1.52, 95% CI 1.06-1.90, p < 0.05) and smoking (OR = 2.02, 95% CI 1.34-3.02, p < 0.001). None of the maltreatment forms predicted a faster increase in either drinking or smoking. These associations were found independent of personal, family, and contextual characteristics. School and neighborhood connection moderated the association between physical abuse and past-month drinking, such that physical abuse was associated with a greater risk of drinking only for youth who perceived low school or neighborhood connections. CONCLUSIONS Findings demonstrate the importance of early experiences of childhood maltreatment for adolescent alcohol and tobacco use. Enhancing school and neighborhood connectedness for physically abused youth may help protect them from alcohol use.
Collapse
Affiliation(s)
- Li Niu
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Doran C French
- Department of Human Development and Family Science, Purdue University, West Lafayette, IN, USA
| | - Yuyan Wang
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Jianing Sun
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Danhua Lin
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, 19 XinJieKouWai St., Haidian District, Beijing, China.
| |
Collapse
|
4
|
Frank P, Batty GD, Pentti J, Jokela M, Ervasti J, Steptoe A, Lewis G, Kivimäki M. Impact of physical and sexual abuse on risk of hospitalisations for physical and mental illnesses: insights from two large prospective cohort studies. Lancet Reg Health Eur 2024; 40:100883. [PMID: 38495556 PMCID: PMC10944261 DOI: 10.1016/j.lanepe.2024.100883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 02/22/2024] [Accepted: 02/26/2024] [Indexed: 03/19/2024]
Abstract
Background Physical abuse can lead to severe health consequences that extend beyond immediate harm. We explored the associations of physical abuse experienced during childhood and adulthood with a wide range of adult health conditions requiring hospital treatment. Methods We utilised data from a sub-cohort of 157,366 UK Biobank participants (46.4% of the baseline population; age range 45-81; 89,101 women) and repeated analyses in an independent population of 85,929 adults from the Finnish Public Sector (FPS) study (age range 17-78; 68,544 women). Participants in both cohorts reported instances of physical and sexual abuse at study baseline. Follow-up included 77 common health conditions ascertained from linkage data to national hospital and mortality registries. Findings Mean follow-up duration was 4.6 years (SD 0.14) in UK Biobank and 10.6 years (4.3) in FPS. Physical and sexual abuse was associated with 22 mental and physical health conditions. After multivariable adjustments, participants who experienced abuse during both early and later stages of life had a 2.12- (95% confidence interval 1.39-3.23) to 3.37-fold (1.52-7.45) increased risk of mental and behavioural disorders, a 1.46 (1.20-1.79) to 1.83 (1.05-3.20) times increased risk of metabolic, haematologic, and respiratory diseases, and a 1.24 (1.07-1.45) times higher risk of inflammatory diseases compared with non-exposed participants. The absolute risk difference between these groups was greatest for metabolic and haematologic conditions (rate 381 and risk difference 160 per 100,000 person-years). Frailty, comorbidities, and competing risk of death did not modify these associations, but the possibility of bias or residual confounding cannot be excluded. Interpretation Repeated exposure to physical and sexual abuse amplifies the risk of hospitalisations from mental disorders and physical diseases spanning diverse organ systems. Addressing this issue may necessitate multifaceted strategies, including shifts in societal norms, legal measures, and increased healthcare provision for affected individuals and their families. Funding Wellcome Trust, UK Medical Research Council, U.S. National Institute on Aging, Academy of Finland.
Collapse
Affiliation(s)
- Philipp Frank
- UCL Brain Sciences, University College London, 149 Tottenham Court Rd, London, W1T 7BN, UK
- Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK
| | - G. David Batty
- Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK
| | - Jaana Pentti
- Clinicum, Faculty of Medicine, University of Helsinki, Tukholmankatu 8 B, Helsinki, FI-00014, Finland
- Department of Public Health, University of Turku, Turku, Finland
- Finnish Institute of Occupational Health, Topeliuksenkatu 41 B, Helsinki, FI-00250, Finland
| | - Markus Jokela
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, Helsinki, 00290, Finland
| | - Jenni Ervasti
- Finnish Institute of Occupational Health, Topeliuksenkatu 41 B, Helsinki, FI-00250, Finland
| | - Andrew Steptoe
- Research Department of Behavioural Science and Health, University College, London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Glyn Lewis
- UCL Brain Sciences, University College London, 149 Tottenham Court Rd, London, W1T 7BN, UK
| | - Mika Kivimäki
- UCL Brain Sciences, University College London, 149 Tottenham Court Rd, London, W1T 7BN, UK
- Clinicum, Faculty of Medicine, University of Helsinki, Tukholmankatu 8 B, Helsinki, FI-00014, Finland
- Finnish Institute of Occupational Health, Topeliuksenkatu 41 B, Helsinki, FI-00250, Finland
| |
Collapse
|
5
|
Di Nicola M, Pepe M, Montanari S, Marcelli I, Panaccione I, Janiri D, Janiri L, Sani G. Childhood sexual abuse and suicide attempts in patients with substance use disorders: The mediating role of emotion dysregulation. Child Abuse Negl 2024; 151:106731. [PMID: 38507922 DOI: 10.1016/j.chiabu.2024.106731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 02/19/2024] [Accepted: 03/02/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Suicide attempts (SA) are a public health concern because of increasing prevalence and clinical implications. Childhood trauma (CT) and emotion dysregulation (ED) have been proposed as predictors of SA, but few data are available in patients with Substance Use Disorder (SUD). OBJECTIVE Our study aims to investigate the association of sociodemographic/clinical variables, CT typologies, and ED features with SA in SUD patients. PARTICIPANTS AND SETTING Subjects with SUD were screened in an outpatient setting. The final sample consisted of 226 patients, subdivided according to the presence of lifetime SA (SUD, n = 163 vs. SUD-SA, n = 63). METHODS Participants were compared for sociodemographic and clinical information. CT and ED were assessed through the Childhood Trauma Questionnaire - Short Form (CTQ-SF) and the Difficulties in Emotion Regulation Scale (DERS), respectively. We performed a mediation analysis to test the effect of CT and ED on SA. RESULTS Patients with a history of SA (27.9 %) displayed more psychiatric comorbidities (p = 0.002) and hospitalizations (p < 0.001), higher scores at CTQ-SF sexual abuse (p < 0.001) and DERS 'impulse' (p = 0.002), 'goals', 'non-acceptance', 'strategies' (p < 0.001) subscales. The relationship between CTQ-SF sexual abuse and SA was significantly mediated by DERS 'strategies' (p = 0.04; bootstrapped 95 % LLCI-ULCI = 0.004-0.024). CONCLUSIONS CT and different dimensions of ED were associated with SA in SUD patients. In our sample, the effects of childhood sexual abuse on SA were mediated by limited access to emotion regulation strategies. SUD patients are burdened with higher all-cause mortality, and CT and lifetime SA can worsen clinical outcomes. Clarifying the reciprocal interactions of psychopathological dimensions may help deliver targeted interventions and reduce suicide risk in specific populations.
Collapse
Affiliation(s)
- Marco Di Nicola
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, L.go Agostino Gemelli 8, 00168 Rome, Italy; Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, L.go Francesco Vito 1, 00168 Rome, Italy.
| | - Maria Pepe
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, L.go Francesco Vito 1, 00168 Rome, Italy
| | - Silvia Montanari
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, L.go Francesco Vito 1, 00168 Rome, Italy
| | - Ilaria Marcelli
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, L.go Francesco Vito 1, 00168 Rome, Italy
| | | | - Delfina Janiri
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, L.go Agostino Gemelli 8, 00168 Rome, Italy
| | - Luigi Janiri
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, L.go Agostino Gemelli 8, 00168 Rome, Italy; Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, L.go Francesco Vito 1, 00168 Rome, Italy
| | - Gabriele Sani
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, L.go Agostino Gemelli 8, 00168 Rome, Italy; Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, L.go Francesco Vito 1, 00168 Rome, Italy
| |
Collapse
|
6
|
Estruch-García V, Gil-Llario MD, Fernández-García O. Sexual experiences and knowledge of people with moderate intellectual disability. J Intellect Disabil Res 2024; 68:512-523. [PMID: 38304997 DOI: 10.1111/jir.13125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/09/2024] [Accepted: 01/10/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND This study addresses the sexuality of people with moderate intellectual disabilities (PMID), a topic that has been little studied. Understanding romantic and sexual experiences is highly relevant for reducing stigma and prejudice related to their sexuality. Additionally, comprehending the level of sexual knowledge of PMID contributes to the development of preventive and sexual health education programmes tailored for this group. Our aim is to explore the sexual history (relationships, sexual behaviour, condom use and sexual abuse), sex education received and the level of sexual knowledge of PMID. METHOD The total of 142 PMID completed questionnaires about sexual knowledge and experiences, and their support staff provided additional information. Data were analysed using chi-square test (χ2) and descriptive statistical analysis. RESULTS Masturbation was the most common sexual behaviour (75.7%), especially among men (χ2 = 5.81, P < 0.05). Sexual intercourse was rare, and only 30.5% reported using condoms. Women reported a higher prevalence of self-reported sexual abuse (27.3% vs. 6% in men). The study also highlighted misconceptions about sexual intercourse risks and contraceptive methods. CONCLUSION The results suggest that PMID need sexual education to ensure healthy sexual experiences and prevent risky behaviour.
Collapse
Affiliation(s)
- V Estruch-García
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - M D Gil-Llario
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - O Fernández-García
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain
| |
Collapse
|
7
|
Schaathun IL, Nenseth IR, Rognmo K, Hafstad GS. Factors differentiating risk of sexual abuse victimization by adults and peers among adolescents. Child Abuse Negl 2024; 151:106707. [PMID: 38430619 DOI: 10.1016/j.chiabu.2024.106707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 02/10/2024] [Accepted: 02/14/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Research suggests that around half of all cases of sexual abuse among children and adolescents are perpetrated by peers. Yet, there is limited understanding of the distinct risk factors associated with adult versus peer offenders. OBJECTIVE To identify factors that increase the risk of sexual abuse victimization and explores variations in these factors depending on whether the perpetrator was an adult or a peer. PARTICIPANTS AND SETTING 9240 secondary school students aged between 12 and 16 years (M = 14, SD = 0.88) in Norway participated. METHODS An electronic questionnaire was administered in schools to investigate experiences of sexual abuse and potential risk factors. The data were analyzed using multiple logistic regression analyses. RESULTS Two factors were related to a greater risk of being a victim of sexual abuse committed by an adult than a peer: background from a non-European country (OR = 1.93, p = 0.038) and other experiences of violence (OR = 1.63-2.91, p < 0.005). The use of alcohol was found to be related to a greater risk of victimization by peers than by adults (OR = 0.53, p = 0.031). CONCLUSIONS Adolescents vulnerable to sexual abuse exhibit common traits, regardless of whether the perpetrator is an adult or peer. Yet, specific factors heighten the risk with peers over adults, and vice versa. Recognizing distinct risk factors for abuse by adults and peers enables decision-makers and community workers to create targeted prevention strategies for children and adolescents.
Collapse
Affiliation(s)
- Iris Linnea Schaathun
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway; UiT the Arctic University of Norway, Tromsø, Norway
| | - Ian Revhaug Nenseth
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway; UiT the Arctic University of Norway, Tromsø, Norway
| | | | | |
Collapse
|
8
|
Odini F, Amuzie C, Kalu KU, Nwamoh U, Emma-Ukaegbu U, Izuka M, Odini U, Ezepue C. Prevalence, pattern and predictors of intimate partner violence amongst female undergraduates in Abia State, Nigeria; public health implications. BMC Womens Health 2024; 24:259. [PMID: 38664690 PMCID: PMC11044364 DOI: 10.1186/s12905-024-03088-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 04/10/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Intimate Partner Violence (IPV) is the range of sexually, psychologically and physically coercive acts used against adult and adolescent women by a current or former male partner. It is a major public health problem globally. This study determined the prevalence, patterns and predictors of IPV amongst female undergraduates in Abia State. METHODS A cross-sectional study was conducted from January - February 2022 amongst 306 female undergraduates in Abia State. A mixed method of an online structured questionnaire created on Google forms & onsite self-administered questionnaire were deployed for data collection. Descriptive, bivariate and multivariate analyses were done using IBM SPSS Version 26.0. The level of significance was set at 5%. RESULTS A total of 306 respondents participated in the survey. The overall prevalence of IPV amongst female undergraduates was 51.2% (95% CI: 44.8-57.6%). Emotional abuse was the most common form of abuse 78.9%, followed by Physical abuse 42.0% and Sexual abuse 30.8%. Predictors of IPV reported include female earning/receiving more than their partner monthly (aOR = 2.30; 95% CI: 1.20-4.41); male (partner) alcohol consumption (aOR = 5.17; 95% CI: 2.46-10.88), being a smoker of cigarette/marijuana (aOR = 11.01; 95% CI: 1.26-96.25) and having witnessed domestic violence as a child (aOR = 3.55; 95% CI: I.56-8.07). Adverse effects such as unwanted pregnancies (12%), miscarriages (10%), eating/sleeping disorders (21%) and bruises (23%) amongst others were noted in some of the victims. CONCLUSION Over half of all female undergraduates in Abia State have experienced IPV with emotional abuse being the commonest. Some Individual and relationship factors were identified as predictors of IPV. We recommend intensifying primary prevention campaigns against risk factors identified like smoking and alcohol consumption.
Collapse
Affiliation(s)
- Franklin Odini
- Department of Community Medicine, Federal Medical Centre, Umuahia, Abia State, Nigeria.
| | - Chidinma Amuzie
- Department of Community Medicine, Federal Medical Centre, Umuahia, Abia State, Nigeria
| | - Kalu Ulu Kalu
- Department of Community Medicine, Federal Medical Centre, Umuahia, Abia State, Nigeria
| | - Uche Nwamoh
- Department of Community Medicine, Federal Medical Centre, Umuahia, Abia State, Nigeria
| | - Uloaku Emma-Ukaegbu
- Department of Community Medicine, Federal Medical Centre, Umuahia, Abia State, Nigeria
| | - Michael Izuka
- Department of Community Medicine, Federal Medical Centre, Umuahia, Abia State, Nigeria
| | - Uchechukwu Odini
- University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria
| | - Chukwubuike Ezepue
- University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria
| |
Collapse
|
9
|
Okonji AM, Ishola AG, Ayamolowo LB, Femi-Akinlosotu OM, Mapayi B, Folayan MO. Healers that hurt: a scoping review of media reports of cases of rape in healthcare settings. BMC Psychol 2024; 12:210. [PMID: 38627793 PMCID: PMC11020642 DOI: 10.1186/s40359-024-01721-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 04/08/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Sexual assault occurring within healthcare settings represents a significant breach of public trust. This scoping review aimed to highlight the profile of people raped, those who committed the rape within the health facilities, and the legal actions taken to resolved cases. METHODS Media-reported data on incidents of rape in healthcare settings were collected. The search was conducted in May and June 2023, focusing on English-language publications with accessible full texts. Reports that lacked information on the survivors or incidents that occurred outside of healthcare settings were excluded. Descriptive statistics were used to summarize the categories of the collected publications, and graphical representations were employed for visualization purposes. RESULTS A total of 62 cases were retrieved, originating from Africa (n = 17; 27.4%), Europe (n = 14; 22.6%), Southeast Asia (n = 14; 22.6%), the Americas (n = 11; 17.7%), the Western Pacific Region (n = 5; 8.1%) and Eastern Mediterranean region (n = 1; 1.6%). In addition, 69 individuals were implicated in 59 cases. They were 31 doctors (44.9%), 17 (24.6%) nurses, four (5.8%) nurse/healthcare assistants, three (4.3%) cleaners/ward boy, two (2.9%) traditional medical doctors, and two (2.9%) security guards. Others included six (8.7%) staff members without designations and one (1.4%) ambulance driver. All perpetrators were male, ranging in age from 22 to 67 years. There were 66 victims identified in the 62 cases with age ranging from 2 to 92 years. Except for one case, all victims were female, and all but one case were patients. Most assaults occurred in consulting rooms/clinics (n = 21; 31.8%), 16 (24.2%) happened under sedation, and six (9.1%) were repeatedly raped, Survivors typically reported the cases the police (n = 12; 19.4%), family/friends (n = 11; 17.7%) or to hospital authorities (n = 10; 16.1%). Out of the 69 perpetrators, 19 (30.6%) were imprisoned with sentences ranging from 12 months to an indefinite period and one (1.6%) received a death sentence. CONCLUSION The raping of patients by healthcare providers within healthcare settings calls for urgent and extensive measures. Stakeholders in healthcare management need to prioritize raising awareness about the problem, implement robust prevention and reporting strategies, and create healthcare environments that are safe, respectful, and supportive for all individuals seeking care.
Collapse
Affiliation(s)
- Adaobi Margaret Okonji
- Girls Club, Department of Mental Health, Obafemi Awolowo University, Ile-Ife, Nigeria
- Department of Medical Rehabilitation, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Adeyinka G Ishola
- Girls Club, Department of Mental Health, Obafemi Awolowo University, Ile-Ife, Nigeria
- Department of Nursing, University of Ibadan, Ibadan, Nigeria
| | - Love Bukola Ayamolowo
- Girls Club, Department of Mental Health, Obafemi Awolowo University, Ile-Ife, Nigeria
- Department of Nursing Science, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Omowumi M Femi-Akinlosotu
- Girls Club, Department of Mental Health, Obafemi Awolowo University, Ile-Ife, Nigeria
- Developmental Neurobiology and Forensic Anatomy Unit, Department of Anatomy, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Boladale Mapayi
- Girls Club, Department of Mental Health, Obafemi Awolowo University, Ile-Ife, Nigeria
- Department of Mental Health, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Morenike Oluwatoyin Folayan
- Girls Club, Department of Mental Health, Obafemi Awolowo University, Ile-Ife, Nigeria.
- Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria.
- Oral Health Initiative, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria.
| |
Collapse
|
10
|
Adakpa I, McLuskey J. Identification and responses by nurses to sexual exploitation of young people. Br J Nurs 2024; 33:338-345. [PMID: 38578936 DOI: 10.12968/bjon.2024.33.7.338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/07/2024]
Abstract
BACKGROUND Nurses are uniquely positioned to identify and respond to the sexual exploitation of young people. They treat sexually transmitted infections, unplanned pregnancies, and mental health issues, often collaborating with social services and law enforcement to safeguard young people. AIM This narrative review explores the pivotal role of nurses in identifying and responding to sexual exploitation among young people. METHODS Empirical evidence from 1997 to 2021 was examined through a comprehensive search of databases such as CINAHL-EBSCO, ASSIA, PubMed (including Medline), and manual screening of abstracts. The PRISMA guideline was applied. Thematic analysis of 12 selected studies revealed three overarching themes. FINDINGS The themes identified were the influence of technology on the sexual exploitation of young people, identification and response to sexual exploitation in both clinical and non-clinical settings, and organisational support. CONCLUSION These findings shed light on sexual exploitation and underscore the significance of a person-centred approach to nursing care that addresses the health and social impacts of sexual exploitation. It emphasises the importance of interagency collaboration and appropriate clinical interventions to effectively support young people at risk. Increased professional development, support, and supervision for nurses are relevant to identifying, responding to, and preventing the sexual exploitation of young people.
Collapse
Affiliation(s)
- Itodo Adakpa
- Lecturer, School of Nursing and Midwifery, University of Bolton
| | - John McLuskey
- Assistant Professor, Director of Professions, School of Health Sciences, University of Nottingham
| |
Collapse
|
11
|
García-Rico MA, Ricarte JJ, Jimeno MV, Latorre JM. Role of psychopathology on children credibility of sexual abuse testimony. Int J Law Psychiatry 2024; 94:101972. [PMID: 38460237 DOI: 10.1016/j.ijlp.2024.101972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 01/29/2024] [Accepted: 02/23/2024] [Indexed: 03/11/2024]
Abstract
When an alleged victim has a pre-existing psychopathological diagnosis, this can affect the rating of their version of the abuse in terms of credibility. The objective of this work is to analyze the relationship between the assessment of the credibility of the testimony of a CSA victim, the psychological problems that the child may have presented prior to sexual abuse and the possible psychological sequelae that she may present as a result of the abuse. 109 cases were selected in which the credibility of the testimony could be determined. Through forensic interviews and the study of the corresponding professional reports, the following were obtained: sociodemographic data, data on their previous psychological state and data on their psychological state after the reported events. The psychological state of the child after the reported events shows no relation to the forensic evaluation of the credibility of her testimony. The existence of a relationship between the absence of previous psychopathology and the fact that the victim's testimony is valued as a credible account is confirmed. This study reveals that children who presented psychological manifestations prior to their experience of abuse receive a lower credibility rating than those without previous psychopathological symptoms or diagnoses.
Collapse
Affiliation(s)
- María A García-Rico
- Equipo Psicosocial-Unidad Forense de Valoración Integral, Instituto de Medicina Legal y Ciencias Forenses de Albacete, Cuenca y Guadalajara. Subdirección de Cuenca. Ministerio de Justicia, Spain
| | - Jorge J Ricarte
- Unidad de Psicología Cognitiva Aplicada, IDINE, Spain; Facultad de Educación de Albacete, Spain
| | - María V Jimeno
- Unidad de Psicología Cognitiva Aplicada, IDINE, Spain; Facultad de Derecho de Albacete, Spain.
| | - José M Latorre
- Unidad de Psicología Cognitiva Aplicada, IDINE, Spain; Facultad de Medicina de Albacete, Spain
| |
Collapse
|
12
|
Armoon B, Mohammadi R, Griffiths MD. The Global Prevalence of Non-suicidal Self-injury, Suicide Behaviors, and Associated Risk Factors Among Runaway and Homeless Youth: A Meta-analysis. Community Ment Health J 2024:10.1007/s10597-024-01245-y. [PMID: 38451378 DOI: 10.1007/s10597-024-01245-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 01/29/2024] [Indexed: 03/08/2024]
Abstract
A meta-analysis was performed to determine pooled prevalence of non-suicidal self-injury (NSSI), suicide behaviors (including ideation, attempts), and associated risk factors among runaway and homeless youth (RHY). The databases PubMed, Scopus, Web of Science, and Cochrane Library were searched for relevant studies published from January 1995 to May 2023. Initially, 8465 papers were screened, resulting in 69 included studies. The results showed that among RHY, lifetime prevalence rates were 42% for NSSI, 38% for suicidal ideation, and 27% for suicide attempts. Lifetime prevalence of NSSI and suicide behaviors was higher among adolescent minors (aged 12-17 years) compared to young adults (aged 18-24 years). Also, NSSI and suicide behaviors were associated with having a childhood history of physical and sexual abuse. Developing an impactful community-based suicide prevention campaign tailored for RHY appears warranted. Peer groups and mentorship programs would provide invaluable support for young individuals, as supportive friendships protect against NSSI.
Collapse
Affiliation(s)
- Bahram Armoon
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran.
| | - Rasool Mohammadi
- Social Determinants of Health Research Center, School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| |
Collapse
|
13
|
Wood L, Baumler E, PettyJohn ME, Temple JR. Teen dating violence and the COVID-19 pandemic: trends from a longitudinal study in Texas. Inj Prev 2024:ip-2023-045115. [PMID: 38443162 DOI: 10.1136/ip-2023-045115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 02/18/2024] [Indexed: 03/07/2024]
Abstract
PURPOSE Teen dating violence (TDV) is a global public health and safety issue causing health impacts to youth people. This study aimed to examine: (1) the impact of the pandemic on TDV victimisation rates and (2) socioecological factors associated with sustained risk for TDV victimisation during the first year of COVID-19. METHODS Data are from an ongoing randomised controlled trial of a TDV prevention programme in Texas (n=2768). We conducted annual assessments in 2019-2021. We used regression modelling to assess demographic, individual, peer and family factors associated with TDV risks. RESULTS TDV rates declined from 11.9% in 2019 to 5.2% in 2021. While demographic, peer and family/household factors were not associated with TDV victimisation during the pandemic, individual-level factors (ie, early sexual debut, substance use, acceptance of violence and prior TDV involvement) were related to COVID-era risks. Only early sexual debut was uniquely linked to TDV victimisation risk the first year of COVID-19. CONCLUSIONS While TDV rates declined during the pandemic, previous victimisation, substance use and early sexual debut remained potent risks for relationship harm.
Collapse
Affiliation(s)
- Leila Wood
- The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Elizabeth Baumler
- The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Morgan E PettyJohn
- Social Work, The University of Texas at Arlington, Arlington, Texas, USA
| | - Jeff R Temple
- The University of Texas Health Science Center at Houston, Houston, Texas, USA
| |
Collapse
|
14
|
Adjimi Nyemgah C, Ranganathan M, Stöckl H. Intimate partner violence during pregnancy against adolescents in sub-Saharan Africa: a systematic review. Inj Prev 2024:ip-2023-044985. [PMID: 38195654 DOI: 10.1136/ip-2023-044985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 12/03/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND Adolescent pregnancy and intimate partner violence (IPV) are major public health issues that are linked to poor health outcomes particularly during pregnancy. In sub-Saharan Africa (SSA), previous studies on IPV during pregnancy have primarily focused on adults. This review examines the available evidence on adolescents' experience of IPV during pregnancy in SSA. DESIGN Systematic review. METHODS We searched multiple databases for articles that met our inclusion criteria. Included studies investigated IPV during pregnancy, including prevalence, risk factors and health outcomes among ever-pregnant adolescents aged 10-19 years old or younger in SSA. Studies were peer-reviewed studies from SSA, quantitative and/or qualitative; and published in English regardless of the year of publication. RESULTS Nine studies out of 570 abstracts screened, published between 2007 and 2020, met the inclusion criteria. The prevalence of IPV during pregnancy among adolescents in SSA ranged from 8.3% to 41%. Mental health symptoms, particularly depression, and anxiety, were associated with adolescent IPV during pregnancy and qualitatively linked to poor coping strategies when dealing with IPV. CONCLUSION This review found evidence of a linkage between pregnancy and IPV during pregnancy among adolescents. Given the long-term negative effects of IPV during pregnancy on adolescents and children, this conclusion points to the critical need for developing interventions to improve IPV detection during pregnancy in SSA among adolescents to interrupt its continuation into adulthood.
Collapse
Affiliation(s)
| | - Meghna Ranganathan
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Heidi Stöckl
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
- Institute for Medical Information Processing, Biometry and Epidemiology, Faculty of Medicine, Ludwig-Maximilians-Universität München, München, Bayern, Germany
| |
Collapse
|
15
|
Georgoulis H, Beauregard E, Chopin J. A Criminological Perspective on the Sexual Victimization of Older Adults. Curr Psychiatry Rep 2024; 26:53-59. [PMID: 38349575 DOI: 10.1007/s11920-024-01482-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/18/2024] [Indexed: 03/19/2024]
Abstract
PURPOSE OF REVIEW This review presents recent research on the sexual abuse of older adults and examines this phenomenon from a criminological perspective. Much of the previous work has neglected to consider the entirety of the crime-commission process. Therefore, the work highlighted in this review showcases important information regarding the individual who committed the crime, the victim, and the criminal event as a whole. RECENT FINDINGS Comparative studies suggest that the motivations of people who commit sexually victimize older adults are vast and can include those that are sexually and anger motivated, while the victims present with unique vulnerabilities, such as disabilities and spending most of their time at home, that make them more susceptible to excessive violence. People who commit sexual abuse against older adults are a heterogenous group, and the context of victim vulnerabilities is key to understanding why they are targeted. Specific prevention and investigative practices can be formed to better address this crime and protect older adults from future victimization.
Collapse
Affiliation(s)
- Hana Georgoulis
- School of Criminology, Simon Fraser University, 8888 University Dr, Burnaby, Canada.
| | - Eric Beauregard
- School of Criminology, Simon Fraser University, 8888 University Dr, Burnaby, Canada
| | - Julien Chopin
- School of Criminology, Simon Fraser University, 8888 University Dr, Burnaby, Canada
- School of Criminal Justice, University of Lausanne, Lausanne, Switzerland
- School of Social Work and Criminology, Laval University, Quebec City, Canada
| |
Collapse
|
16
|
Millon EM, Alqueza KL, Kamath RA, Marsh R, Pagliaccio D, Blumberg HP, Stewart JG, Auerbach RP. Non-suicidal Self-injurious Thoughts and Behaviors Among Adolescent Inpatients. Child Psychiatry Hum Dev 2024; 55:48-59. [PMID: 35727385 PMCID: PMC9782727 DOI: 10.1007/s10578-022-01380-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/19/2022] [Indexed: 01/07/2023]
Abstract
Non-suicidal self-injury (NSSI) is a serious public health concern that typically onsets during early adolescence. Adolescents (N = 980, ages 12-19 years) admitted for acute, residential psychiatric treatment completed baseline clinical interviews assessing mental disorders and questionnaires measuring demographics, early life adversity, and symptom severity. Prevalence rates of NSSI for lifetime (thoughts: 78%; behaviors: 72%), past year (thoughts: 74%; behaviors: 65%), and past month (thoughts: 68%; behaviors: 51%) were high. Although effect sizes were modest, the presence of a lifetime depressive disorder, sexual abuse, and comorbidity (i.e., three or more current disorders) were significant correlates of experiencing NSSI thoughts and behaviors. Furthermore, lifetime depressive disorder, current anxiety disorder, and comorbidity were associated with a greater odds of persistent NSSI thoughts and/or behaviors. Longitudinal studies are needed to determine whether targeting these factors reduces the persistence of NSSI thoughts and behaviors.
Collapse
Affiliation(s)
- Emma M Millon
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, Pardes 2407, New York, NY, 10032, USA
| | - Kira L Alqueza
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, Pardes 2407, New York, NY, 10032, USA
| | - Rahil A Kamath
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, Pardes 2407, New York, NY, 10032, USA
| | - Rachel Marsh
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, Pardes 2407, New York, NY, 10032, USA
| | - David Pagliaccio
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, Pardes 2407, New York, NY, 10032, USA
| | - Hilary P Blumberg
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Jeremy G Stewart
- Department of Psychology and Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, NY, USA.
- New York State Psychiatric Institute, 1051 Riverside Drive, Pardes 2407, New York, NY, 10032, USA.
- Division of Clinical Developmental Neuroscience, Sackler Institute, New York, NY, USA.
| |
Collapse
|
17
|
Dion J, Attard V, Guyon R, De La Sablonnière-Griffin M, Perreault É, Hébert M. Implementing a sexual violence prevention program in two Canadian Indigenous communities: Challenges and lessons learned. Child Abuse Negl 2024; 148:106271. [PMID: 37357071 DOI: 10.1016/j.chiabu.2023.106271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 04/22/2023] [Accepted: 05/31/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND The prevalence of child sexual violence remains overwhelming, particularly among Indigenous populations, despite increased awareness. Therefore, implementing efficient initiatives is crucial in preventing and reducing sexual violence rates among these groups. OBJECTIVE This study aimed to examine the processes involved in the implementation of a sexual violence prevention program in two Indigenous communities in Canada and assess application of culturally safe practices. METHOD Eight Indigenous and non-Indigenous project managers underwent semi-structured interviews before the program's implementation; five of them also participated in the follow-up interviews. Moreover, thirteen Indigenous service providers from the two communities answered open-ended questions when the included training ended. RESULTS Thematic analysis revealed the importance of following an ongoing process (not only before implementing a program) to assess the needs of community members and involving them in decision-making. Administrative injunctions were also identified as a significant challenge during implementation. Results showed that participants reported the taboo of sexual violence as a challenge but that constant discussions about the prevention of sexual violence helped defuse the discomfort and foster trust between Indigenous and non-Indigenous professionals. Finally, participants provided recommendations to improve research and intervention practices. CONCLUSIONS Several takeaways were discussed to improve research practices with, by, and for Indigenous peoples, such as using collaborative communication, developing common understanding relative to work agendas, and increasing cultural competencies to build trust within the partnership.
Collapse
Affiliation(s)
- Jacinthe Dion
- Intersectoral Center for Sustainable Health, Department of Health Sciences, Université du Québec à Chicoutimi, 555 bl. Université, Saguenay, Québec G7H 2B1, Canada; Interdisciplinary Research Center on Intimate Relationship Problems and Sexual Abuse, Department of Psychology, Université de Montréal, C.P 6128, succursale Centre-Ville, Montréal, Québec H3C 3J7, Canada.
| | - Virginie Attard
- Urbanisation Culture Société Research Centre, Institut National de la Recherche Scientifique (INRS), INRS-UQAT Joint Research Unit in Indigenous Studies, Val-d'Or Campus, 663, 1re Avenue, Val-d'Or, Québec J9P 1Y3, Canada.
| | - Roxanne Guyon
- Interdisciplinary Research Center on Intimate Relationship Problems and Sexual Abuse, Department of Psychology, Université de Montréal, C.P 6128, succursale Centre-Ville, Montréal, Québec H3C 3J7, Canada; Department of Sexology, Université du Québec à Montréal, 455, boul. René-Lévesque Est, Montréal, Québec H2L 4Y2, Canada.
| | - Mireille De La Sablonnière-Griffin
- Urbanisation Culture Société Research Centre, Institut National de la Recherche Scientifique (INRS), INRS-UQAT Joint Research Unit in Indigenous Studies, Val-d'Or Campus, 663, 1re Avenue, Val-d'Or, Québec J9P 1Y3, Canada.
| | - Émilie Perreault
- Intersectoral Center for Sustainable Health, Department of Health Sciences, Université du Québec à Chicoutimi, 555 bl. Université, Saguenay, Québec G7H 2B1, Canada.
| | - Martine Hébert
- Interdisciplinary Research Center on Intimate Relationship Problems and Sexual Abuse, Department of Psychology, Université de Montréal, C.P 6128, succursale Centre-Ville, Montréal, Québec H3C 3J7, Canada; Department of Sexology, Université du Québec à Montréal, 455, boul. René-Lévesque Est, Montréal, Québec H2L 4Y2, Canada.
| |
Collapse
|
18
|
Allard-Gaudreau N, Poirier S, Cyr M. Factors associated with delayed disclosure of child sexual abuse: A focus on the victim's having been led to perform sexual acts on the perpetrator. Child Abuse Negl 2024; 147:106537. [PMID: 37956501 DOI: 10.1016/j.chiabu.2023.106537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 10/25/2023] [Accepted: 11/03/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND Contextual variables associated with children's willingness to disclose sexual abuse have been identified in previous studies, but further investigation is needed to better understand delayed disclosure of child sexual abuse (CSA). OBJECTIVES This study aimed to examine the factors associated with the risk of delayed disclosure of CSA. More specifically, it focused on a factor that has rarely, if ever, been looked into: the fact that some victims are led to perform sexual acts on the perpetrator. PARTICIPANTS AND SETTING A content analysis was performed on 68 transcripts of investigative interviews with CSA victims aged 4 to 12 years old. METHODS Based on our content analysis, the time between the first abuse and the first disclosure was determined for each victim. The age and gender of the victim, the victim's relationship with the perpetrator, the age of the perpetrator, the frequency and severity of the abuse, and whether or not the victim mentioned having performed sexual acts on the perpetrator were also coded. RESULTS Chi-square analyses showed that the risk of delayed disclosure was associated with the victim's having performed, or not performed, sexual acts on the perpetrator (χ2 = 16.327, p < 0.001), the victim's relationship with the perpetrator (χ2 = 10.013, p = 0.002), and the frequency of the abuse (χ2 = 11.617, p < 0.001). CONCLUSION Our study is the first to demonstrate that having been led to sexually touch the perpetrator is associated with delayed disclosure of CSA.
Collapse
Affiliation(s)
- Noémie Allard-Gaudreau
- Department of Health Sciences, Université du Québec en Abitibi-Témiscaminque, 445 Bd de l'Université, Rouyn-Noranda J9X 5E4, Québec, Canada.
| | - Sebastien Poirier
- Department of Health Sciences, Université du Québec en Abitibi-Témiscaminque, 445 Bd de l'Université, Rouyn-Noranda J9X 5E4, Québec, Canada.
| | - Mireille Cyr
- Department of Psychology, Université de Montréal, 90 avenue Vincent d'Indy, Montréal H2V 2S9, Québec, Canada.
| |
Collapse
|
19
|
Goodman LC, Elmore JS, Mayes TL, Minhajuddin A, Slater H, Blader JC, Liberzon I, Baronia RB, Bivins EJ, LaGrone JM, Jackson S, Martin SL, Brown R, Soares JC, Wakefield SM, Trivedi MH. Linking trauma to mental health in the statewide Texas Youth Depression and Suicide Research Network (TX-YDSRN). Psychiatry Res 2024; 331:115620. [PMID: 38091894 DOI: 10.1016/j.psychres.2023.115620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 11/10/2023] [Accepted: 11/18/2023] [Indexed: 01/02/2024]
Abstract
Rates of youth depression and suicide are rising worldwide and represent public health crises. The present study examined the relationship between trauma history and symptoms of depression, suicidal ideation, and anxiety among suicidal and depressed youth. A diverse group of 1000 8-20-year-olds enrolled in the statewide Texas Youth Depression and Suicide Research Network (TX-YDSRN) reported their trauma history (Traumatic Events Screening Inventory for Children) and symptoms of depression (Patient Health Questionnaire for adolescents; PHQ-A), anxiety (Generalized Anxiety Disorder scale; GAD-7), and suicidality (Concise Health Risk Tracking scale; CHRT-SR). Nearly half of the sample reported exposure to multiple categories of traumatic experiences. Number of trauma exposure categories significantly predicted PHQ-A and GAD-7 scores. Exposure to interpersonal trauma and to sexual trauma were significantly associated with PHQ-A, GAD-7, and CHRT-SR scores. The number of trauma exposure categories was associated with increased levels of anxiety and depression; however, only exposure to interpersonal or sexual trauma was associated with more suicidality. Clinicians should assess trauma exposure in patients seeking psychiatric care, especially for interpersonal and sexual trauma, which may be predictive of increased risk for suicidality in depressed youth. Future work should disentangle the effects of specific trauma types from multiple trauma exposure.
Collapse
Affiliation(s)
- Lynnel C Goodman
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and the Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA
| | - Joshua S Elmore
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and the Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA
| | - Taryn L Mayes
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and the Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA
| | - Abu Minhajuddin
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and the Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA; Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Holli Slater
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and the Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA
| | - Joseph C Blader
- University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Israel Liberzon
- Department of Psychiatry and Behavioral Science, Texas A&M University Health Science Center, Bryan, TX, USA
| | - Regina B Baronia
- Department of Psychiatry, Texas Tech University Health Science Center, Lubbock, TX, USA
| | - Emily J Bivins
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | | | - Sierra Jackson
- Office of Clinical Research, JPS Health Network, Fort Worth, TX, USA
| | - Sarah L Martin
- Department of Psychiatry, Texas Tech University Health Science Center El Paso, El Paso, USA
| | - Ryan Brown
- Department of Psychiatry & Behavioral Sciences, University of Texas at Austin Dell Medical School, Austin, TX, USA
| | - Jair C Soares
- Department of Psychiatry and Behavioral Sciences, UT Health Center of Excellence on Mood Disorders, UT Houston Medical School, Houston, TX, USA
| | - Sarah M Wakefield
- Department of Psychiatry, Texas Tech University Health Science Center, Lubbock, TX, USA
| | - Madhukar H Trivedi
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and the Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA.
| |
Collapse
|
20
|
Picard EH, Bopp LL, Rosenfeld B. Neuropsychological Functioning in Sexual Offenders With and Without Pedophilic Disorder. Arch Sex Behav 2024; 53:43-56. [PMID: 37749338 DOI: 10.1007/s10508-023-02689-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 08/14/2023] [Accepted: 08/16/2023] [Indexed: 09/27/2023]
Abstract
This study sought to examine neuropsychological functioning in men with pedophilic disorder (PD), in order to assess whether findings from prior neuropsychological studies are replicated in a diverse sample including men with non-contact sexual offenses. It was hypothesized that when non-contact offenders are included in the study, a slowed processing speed will emerge as the only finding unique to men with PD. A comprehensive neuropsychological battery was administered to 58 men convicted of a sexual offense, 20 of whom were classified as having PD. The sample included men with contact sexual offenses (n = 33), non-contact sexual offenses (n = 5), and child sexual abuse material (CSAM) offenses (n = 20). Test performance was compared by PD status. Participants with PD performed significantly better on verbal memory and visual discrimination than those without PD. Men with PD made more errors on a set-shifting task but no significant differences were seen in domains of attention, intellectual functioning, visual learning and memory, visuospatial ability, or language ability. Effect sizes were generally small, although some medium effects were seen (visual discrimination and verbal learning and memory). Scores in both groups (with and without PD) were generally in the average range across tasks. Within the subgroup of CSAM offenders, minimal differences emerged between those with and without PD, although those with PD were slower on visuomotor set-shifting but made fewer errors (d = - 0.89). CSAM offenders with PD were in the high average range on many tasks of intellectual functioning; however, a potential trend was identified such that CSAM offenders without PD had lower scores on a task of verbal learning and memory, with medium effect sizes observed. As few differences in neuropsychological functioning emerged when comparing offenders with and without PD, differences demonstrated in prior research may be better attributed to contact offending status rather than sexual interest.
Collapse
Affiliation(s)
- Emilie H Picard
- Department of Psychiatry, University of Virginia Medical Center, West Complex, Rm. 4472, 1300 Jefferson Park Ave., Charlottesville, VA, 22903, USA.
| | - Lillian L Bopp
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Barry Rosenfeld
- Department of Psychology, Fordham University, New York, NY, USA
| |
Collapse
|
21
|
Kuo JYC. Responses of Early Childhood Educators to Children's Interpersonal Sexual Behaviors. Arch Sex Behav 2024; 53:383-394. [PMID: 37700211 DOI: 10.1007/s10508-023-02686-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 08/01/2023] [Accepted: 08/04/2023] [Indexed: 09/14/2023]
Abstract
There is a considerable amount of evidence in the literature that children engage in a wide range of sexual behaviors before puberty. How early childhood educators (ECEs) respond to children's interpersonal sexual behaviors (ISBs) is especially important during the early childhood stage not only due to their roles as educators, but also protector due to their legal obligation to report suspected cases of child sexual abuse. Considering the pivotal responsibilities ECEs have in addressing ISBs, it becomes imperative to gain a comprehensive understanding of the experiences they encounter in managing such behaviors. Surprisingly, the current body of research provides limited insights into how ECEs respond to children's ISBs. To address this gap, the present study aims to explore these topics by conducting a qualitative investigation to examine the experiences of Taiwanese ECEs who encountered ISBs among children and how they responded to these behaviors. Four themes emerged from an analysis of the stories shared by 36 ECEs: (1) being silent versus supporting children's healthy sexuality development, (2) protect yourself versus respect others, (3) punishments versus exploring strategies to address children's ISBs and (4) insensitivity to boundaries and bodily autonomy. This study provides guidelines for understanding the experiences of Taiwanese ECEs who encounter children's ISBs and contributes to the training needs of ECEs about children's sexuality development.
Collapse
Affiliation(s)
- Janet Yeh-Chen Kuo
- Department of Early Childhood and Family Education, National Taipei University of Education, No. 134, Sec. 2, Heping E. Rd., Da-an District, Taipei City, 106, Taiwan.
| |
Collapse
|
22
|
Nasrazadani A, Ruda M, Girardet R, Campbell J, Breeden K, Torres B. Gonorrheal and chlamydia yield for genital and extragenital testing in children evaluated for sexual abuse. Child Abuse Negl 2024; 147:106525. [PMID: 37948873 DOI: 10.1016/j.chiabu.2023.106525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 09/09/2023] [Accepted: 10/22/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVE Texas Forensic Nurse Examiners (TXFNE) performs routine testing of genital and non-genital sites for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG), and further testing for other sexually transmitted pathogens. The current Centers for Disease Control and Prevention (CDC) guidelines recommend that testing be based primarily on patient history of type of sexual contact, patient age, community prevalence of sexually transmitted infections (STIs), perpetrator risk factors for STIs, and patient symptoms (Centers for Disease Control and Prevention, 2021). In this study, we were interested in determining whether our practice of testing all sites in all prepubertal patients presenting for sexual abuse for CT and NG resulted in identification of infections that would have been missed if testing had been limited to disclosed sites of sexual contact. METHODS We conducted a retrospective chart review of all children younger than 14 years who presented to a clinical or hospital site for evaluation by TXFNE in Harris County or surrounding counties during the period January 2020-December 2021. RESULTS Of the 675 patients tested, 61 patients (9 %) had genital injuries and 45 patients (7 %) had either reported symptoms or examination findings consistent with possible STI infection. There were 11 patients who had positive gonorrhea and/or chlamydia results. Of the 11 patients with a positive result, 10 patients' reported history of type of contact did not fully match sites that tested positive. Diagnosis of STI infection would have been missed for 5 patients if testing had been limited to the disclosed sites of sexual contact. CONCLUSION Positive results for CT and NG at undisclosed body sites in children presenting with concern for sexual abuse most likely represent infection from sexual contact. Limiting STI testing based on disclosed contact may lead to missed NG and CT infections in prepubertal patients with concern for sexual abuse. This can lead to delayed treatment of the infection and a missed opportunity to ensure the safety of the child.
Collapse
Affiliation(s)
- Arezo Nasrazadani
- The John P. and Kathrine G. McGovern Medical School, Department of Pediatrics, 6410 Fannin St Ste 1425, Houston, TX 77030, USA; Texas Forensic Nurse Examiners, 2990 Richmond Ste 180, Houston, TX 77098, USA.
| | - Michelle Ruda
- The John P. and Kathrine G. McGovern Medical School, Department of Pediatrics, 6410 Fannin St Ste 1425, Houston, TX 77030, USA; Texas Forensic Nurse Examiners, 2990 Richmond Ste 180, Houston, TX 77098, USA.
| | - Rebecca Girardet
- The John P. and Kathrine G. McGovern Medical School, Department of Pediatrics, 6410 Fannin St Ste 1425, Houston, TX 77030, USA; Texas Forensic Nurse Examiners, 2990 Richmond Ste 180, Houston, TX 77098, USA.
| | - Jamie Campbell
- The John P. and Kathrine G. McGovern Medical School, Department of Pediatrics, 6410 Fannin St Ste 1425, Houston, TX 77030, USA; Texas Forensic Nurse Examiners, 2990 Richmond Ste 180, Houston, TX 77098, USA.
| | - Khara Breeden
- The John P. and Kathrine G. McGovern Medical School, Department of Pediatrics, 6410 Fannin St Ste 1425, Houston, TX 77030, USA; Texas Forensic Nurse Examiners, 2990 Richmond Ste 180, Houston, TX 77098, USA.
| | - Brookley Torres
- The John P. and Kathrine G. McGovern Medical School, Department of Pediatrics, 6410 Fannin St Ste 1425, Houston, TX 77030, USA; Texas Forensic Nurse Examiners, 2990 Richmond Ste 180, Houston, TX 77098, USA.
| |
Collapse
|
23
|
Tsang VMW, Verlinden E, Brilleslijper-Kater SN, van Duin EM, Twisk JWR, Verhoeff AP, Lindauer RJL. A Longitudinal Study in Worrisome Sexual Behavior Following Sexual Abuse in Infancy or Early Childhood: The Amsterdam Sexual Abuse Case. J Child Adolesc Trauma 2023; 16:1053-1063. [PMID: 38045842 PMCID: PMC10689610 DOI: 10.1007/s40653-023-00539-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/23/2023] [Indexed: 12/05/2023]
Abstract
Worrisome sexual behavior (WSB) is often described as an outcome specific to child sexual abuse (CSA). Therefore, it is highly relevant to study WSB in relation to sexual abuse, especially in very young children, as it is hard to recognize sexual abuse in children who have limited verbal capacities of disclosing. Over time, literature describing WSB following CSA has gradually broadened. However, a gap remains regarding the long-term development of WSB in children who were sexually abused during infancy or very early childhood. To our knowledge, our study is the first to examine developmentally-related sexual behavior versus sexual abuse-specific behavior longitudinally in children who were sexually abused at a very young age. In total, we examined the sexual behavior, as reported by parents of 45 children who experienced early-age sexual abuse for a period of more than five years. Overall, we found that WSB is likely to be a CSA-specific and potentially long-term outcome for children who were sexually abused at a very young age. Despite the decrease in sexual abuse-specific behavior over time, the level of this behavior was still significantly high 8 years after the sexual abuse. This finding supports long-term monitoring and assessment and intervention for WSB over time. Despite these findings, it is important to note that WSB does not serve as proof of sexual abuse in children; likewise, when a child does not present with WSB, it does not indicate the absence of a substantiated history of sexual abuse.
Collapse
Affiliation(s)
- Vionna M. W. Tsang
- Amsterdam University Medical Centers, Department of Child and Adolescent Psychiatry, University of Amsterdam, Amsterdam, the Netherlands
- Levvel, Academic Centre for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
| | - Eva Verlinden
- Amsterdam University Medical Centers, Department of Child and Adolescent Psychiatry, University of Amsterdam, Amsterdam, the Netherlands
- Department of Epidemiology, Health Promotion & Healthcare Innovation, Public Health Service of Amsterdam (GGD Amsterdam), Amsterdam, the Netherlands
| | - Sonja N. Brilleslijper-Kater
- Amsterdam UMC, Department of Social Pediatrics, Child Abuse and Neglect Team, University of Amsterdam, Amsterdam, the Netherlands
| | - Esther M. van Duin
- Amsterdam University Medical Centers, Department of Child and Adolescent Psychiatry, University of Amsterdam, Amsterdam, the Netherlands
- Levvel, Academic Centre for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
| | - Jos W. R. Twisk
- Amsterdam UMC, Department of Clinical Epidemiology and Biostatistics, VU University, Amsterdam, the Netherlands
| | - Arnoud P. Verhoeff
- Department of Epidemiology, Health Promotion & Healthcare Innovation, Public Health Service of Amsterdam (GGD Amsterdam), Amsterdam, the Netherlands
- Department of Sociology, University of Amsterdam, Amsterdam, the Netherlands
| | - Ramón J. L. Lindauer
- Amsterdam University Medical Centers, Department of Child and Adolescent Psychiatry, University of Amsterdam, Amsterdam, the Netherlands
- Levvel, Academic Centre for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
| |
Collapse
|
24
|
Habek D. Women's sexual abuse: forensic-gynecologic expertise experiences. Forensic Sci Med Pathol 2023; 19:617-619. [PMID: 37148439 DOI: 10.1007/s12024-023-00626-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2023] [Indexed: 05/08/2023]
Abstract
PURPOSE Women sexual violence as a gynecological, social-criminological and gynecological problem has no declining trend in developing and developed countries, including in Croatia. METHODS From my own 23-year forensic-gynecological expertises practice, along with the results of legally completed examples of sexual abuses, as a contribution to this problem, which is also read from other works. RESULTS Of the cases of sexual abuses (n = 31) with a median age of 37 years, gynecological-forensic expertise proved and confirmed 67.7% of sexual abuses criminal cases with a significant problem of inadequate primary gynecological procedure, most often due to insufficient gynecological examination and medical documentation in high 64.5%, as well as late sexual abuses report in 51.6%. Of all cases of sexual abuses, 6 (19.4%) required primary surgical care due to bleeding and lacerations of the genitals, there were no reported cases of sexual abuses in pregnancy, and no deaths related to sexual abuses. The problems that can affect the forensic-gynecological evaluation of sexual abuses victims are: inadequate and insufficient primary medical documentation immediately after sexual abuses, late reports of sexual abuses, after several days, months and years in the reproductive age of women, with a late primary examination and an almost difficult to prove objective gynecological examination and inadequate education of gynecologists in primary examination. CONCLUSION In conclusion, it should be mentioned that the mentioned medical problems can be solved by constant education of all professional medical participants, permanent court experts with experience, coordination and subordination of expert gynecological and forensic societies in cooperation with the state attorney's office, courts and police, and social service.
Collapse
Affiliation(s)
- Dubravko Habek
- Department of Gynecology and Obstetrics Clinical Hospital Merkur Zagreb, School of Medicine, Catholic University of Croatia Zagreb, Croatian Academy of Medical Sciences, Ilica 242, 10000, Zagreb, Croatia.
| |
Collapse
|
25
|
Rogers MM, Ali P, Thompson J, Ifayomi M. "Survive, learn to live with it … or not": A narrative analysis of women's repeat victimization using a lifecourse perspective. Soc Sci Med 2023; 338:116338. [PMID: 37879132 DOI: 10.1016/j.socscimed.2023.116338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 10/06/2023] [Accepted: 10/11/2023] [Indexed: 10/27/2023]
Abstract
Violence against women is a global public health concern, with high levels of prevalence and debilitating consequences for victims, including a higher risk of revictimization. Quantitative evidence shows a strong association between previous experiences of sexual victimization, particularly in childhood, and future victimization. However, there is limited rigorous qualitative scholarship that advances understanding about revictimization experienced from childhood into adulthood. In this study, we address this gap offering a novel contribution to qualitative insights on revictimization using a life-course perspective. We conducted a rigorous qualitative secondary analysis, adopting a feminist narrative approach, to explore how individuals make sense of their experiences of abuse. Findings showed five main themes about survivors' experiences of repeat victimization across the life-course including: abuse experiences in childhood and adolescence; mental health and 'risky' coping mechanisms; naming abuse in early adulthood; seeking support in adulthood; surviving and a life beyond abuse. Most participants experienced multiple incidents of sexual abuse in childhood, which led to helplessness, shame, blame, and normalization of their experiences, creating a vulnerability to repeat victimization. Childhood abuse had later mental health impacts. Many participants used risky coping mechanisms, such as substance use. Survivors tended to be seen through the lens of their mental health diagnosis and addiction rather than through the lens of how abuse caused complex trauma. To address the impacts of revictimization and complex trauma affecting women across the globe, healthcare policy and services need a narrative and trauma-informed approach, over the short-, medium- or longer-term, enabling survivors to make sense of the connected nature of their experiences and accumulated vulnerability resulting from the abuse by others, rather than factors associated with the individual (their mental ill health, for example, or substance use). This is important as women's individual understanding is critical to processing trauma and abuse, and to longer-term recovery.
Collapse
Affiliation(s)
- Michaela M Rogers
- The University of Sheffield, Elmfield, Northumberland Road, Sheffield, S10 2TU, UK.
| | - Parveen Ali
- The University of Sheffield and Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust, Armthorpe Road, Doncaster, DN2 5LT, UK.
| | - Jill Thompson
- The University of Sheffield, Barber House Annexe, 3 Clarkehouse Road, Sheffield, S10 2HQ, UK.
| | - Moninuola Ifayomi
- The University of Sheffield, Barber House Annexe, 3 Clarkehouse Road, Sheffield, S10 2HQ, UK.
| |
Collapse
|
26
|
Jouriles EN, Sitton MJ, Rancher C, Jackson M, McDonald R. Associations of caregiver-adolescent conflict and caregiver emotional support with adolescent trauma symptoms and adjustment after sexual abuse. Child Abuse Negl 2023; 146:106488. [PMID: 37832247 DOI: 10.1016/j.chiabu.2023.106488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 07/18/2023] [Accepted: 09/26/2023] [Indexed: 10/15/2023]
Abstract
BACKGROUND Emotional support from a caregiver is believed to be important for reducing the likelihood of adolescent trauma symptoms and adjustment problems after sexual abuse. Conflict with a caregiver, another relational dynamic, is very common during adolescence, but little is known about how it might operate in tandem with emotional support to influence adolescent trauma symptoms and adjustment after sexual abuse. OBJECTIVE To better understand how caregiver emotional support and caregiver-adolescent conflict jointly contribute to adolescent trauma symptoms and adjustment after sexual abuse. PARTICIPANTS AND SETTING Participants were 477 adolescents (Mage = 13.59, SD = 1.77) and a non-offending caregiver presenting at a children's advocacy center. METHODS Adolescents completed measures of caregiver-adolescent conflict, caregiver emotional support, and their own trauma symptoms and adjustment. Caregivers completed a measure of adolescent adjustment. RESULTS Caregiver-adolescent conflict and caregiver emotional support each correlated in the expected direction with adolescent trauma symptoms and adjustment (conflict correlations ranged from 0.27 to 0.38, all p values ≤.001; support correlations ranged from -0.15 to -0.21, all p values ≤.01). Regression analyses, which simultaneously considered conflict and support, indicated that conflict related to adolescent trauma symptoms and each of the measures of adolescent adjustment, whereas caregiver emotional support contributed to caregiver reports of adolescent adjustment. Caregiver-adolescent conflict did not moderate any of the relations between caregiver emotional support and adolescent trauma symptoms or adjustment. CONCLUSIONS In the aftermath of sexual abuse, caregiver-adolescent conflict contributes to adolescent trauma symptoms and adjustment.
Collapse
Affiliation(s)
- Ernest N Jouriles
- Department of Psychology, Southern Methodist University, P.O. Box 750442, Dallas, TX 75275-0442, USA.
| | - Melissa J Sitton
- Department of Psychology, Southern Methodist University, P.O. Box 750442, Dallas, TX 75275-0442, USA
| | - Caitlin Rancher
- National Crime Victims Research and Treatment Center, Medical University of South Carolina, 67 President Street, 2nd Fl. IOP S., MSC861, Charleston, SC 29425-8610, USA
| | - Mindy Jackson
- Dallas Children's Advocacy Center, 5351 Samuell Blvd., Dallas, TX 75228, USA
| | - Renee McDonald
- Department of Psychology, Southern Methodist University, P.O. Box 750442, Dallas, TX 75275-0442, USA
| |
Collapse
|
27
|
Bennett A, Jackson Y, Gabrielli J. A social network analysis of perpetrators of child maltreatment reported by youth in foster care. Child Abuse Negl 2023; 145:106432. [PMID: 37683404 DOI: 10.1016/j.chiabu.2023.106432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 08/17/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023]
Abstract
OBJECTIVE Prior research on child maltreatment has focused on distinct features of maltreatment (type, severity, chronicity) important for youth outcomes, yet perpetrators of child maltreatment reported by youth have gone largely unstudied. The present study examines connections between perpetrators, the total number and type of perpetrators reported, and the frequency at which each type of perpetrator was reported across 24 relationship types to provide a foundation for future research seeking to provide comprehensive measurement of perpetrator profiles. METHODS Data from 503 youth in foster care (8-21 years old) were collected through the Studying Pathways to Adjustment and Resilience in Kids (SPARK) Project. Youth reported on their history of physical, sexual, and psychological maltreatment. Social Network Analysis (SNA) was used to visualize links between perpetrators within maltreatment type and paired samples t-tests were used to compare differences between network edge weights. RESULTS Full sample SNA results were highly interconnected and variable across maltreatment types. Biological parents and peers were the most common perpetrators of physical and psychological abuse with peers and non-family adults being most common for sexual abuse. Family and community member groupings were most distinct in the physical and psychological abuse networks whereas in the sexual abuse network, ties between perpetrators were more equidistant. CONCLUSIONS Differences exist in perpetrator profiles across maltreatment types, adding a layer of complexity to how maltreatment experiences are captured, and variability in profiles might provide insight to differing youth outcomes. Understanding individual youth perpetrator profiles could be used to inform foster care placements and reduce the risk of revictimization.
Collapse
Affiliation(s)
- Amanda Bennett
- Department of Clinical and Health Psychology, University of Florida, United States of America.
| | - Yo Jackson
- Department of Psychology, Pennsylvania State University, United States of America
| | - Joy Gabrielli
- Department of Clinical and Health Psychology, University of Florida, United States of America
| |
Collapse
|
28
|
Hedén L, Jonsson LS, Fredlund C. The Connection Between Sex as Self-Injury and Sexual Violence. Arch Sex Behav 2023; 52:3531-3540. [PMID: 37640887 PMCID: PMC10703980 DOI: 10.1007/s10508-023-02669-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 07/11/2023] [Accepted: 07/17/2023] [Indexed: 08/31/2023]
Abstract
Nonsuicidal self-injury (NSSI) is a suggested diagnosis recognized by DSM-5 as in need of further research. Recent studies conclude that sex as self-injury (SASI) and NSSI share similar functions, such as being used as emotional regulation. SASI has been associated with earlier sexual abuse, but the understanding of the association between sexual violence and SASI is still limited. The aim of this study was to further investigate the connection between sexual violence and the experience of SASI. How could SASI be related to sexual violence? The study used a qualitative design and was based on an anonymous questionnaire published on the websites of Swedish NGOs, providing help and support to women and youths, such as those in women's shelters. In total, 139 informants with a mean age of 27.9 years (range 15-64 years) were included in the study. Three main themes were found: (1) Normalization of sexual violence and a shift in boundaries could be seen as consequences of earlier experiences of sexual violence leading to SASI; (2) SASI could escalate into sexual violence through increased need of emotional regulation, increased risk-taking, and risk of victimization; (3) SASI could be used to regain control of re-experiences, the body, sexuality, and shame after sexual abuse. In conclusion, a complex connection was identified whereby SASI could escalate into sexual violence, and earlier experiences of sexual violence could lead to SASI in a vicious loop. Hence, SASI should be seen as a risk factor for further victimization and sexual abuse.
Collapse
Affiliation(s)
- Ludwig Hedén
- Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
| | - Linda S Jonsson
- Department of Social Sciences, Marie Cederschiöld University, Stockholm, Sweden
| | - Cecilia Fredlund
- Department of Psychiatry in Linköping, and Department of Biomedical and Clinical Sciences, Linköping University, SE-581 83, Linköping, Sweden.
| |
Collapse
|
29
|
Visioli C, Tondo L, Miola A, Pinna M, Contu M, Baldessarini RJ. Early sexual or physical abuse in female and male mood disorder patients. J Psychiatr Res 2023; 167:125-131. [PMID: 37866326 DOI: 10.1016/j.jpsychires.2023.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 09/08/2023] [Accepted: 10/13/2023] [Indexed: 10/24/2023]
Abstract
Early abuse has been associated with psychiatric morbidity but comparisons of bipolar (BD) and major depressive (MDD) disorder subjects with versus without early sexual or physical abuse are rare. Patients (n = 684) diagnosed with a DSM-5-TR major mood disorder were evaluated and followed for several years at mood disorder centers to compare details of history and clinical status in participants with versus without early sexual or physical abuse. Early history of sexual (16.2%) or physical abuse (11.9%) was prevalent; 5.15% reported both. Both types of abuse were much more prevalent with BD than MDD. Sexual abuse was associated with younger illness-onset and somewhat younger menarche in females; both abuse-types were associated with familial mood disorders, especially BD. Prospective, long-term illness episode-frequency, depressions or [hypo]manias/year and %-time [hypo]manic all were greater following sexual abuse but morbidity measures did not differ following physical abuse. Prevalence of suicidal behavior ranked: double (48.5%) > physical (32.1%) > sexual (30.3%) abuse, and with BD > MDD (OR = 2.31). Recall bias and not using psychometric instruments to define abuse severity or type may limit interpretation of findings. Early sexual (more than physical) abuse, led to greater morbidity and both abuses were strongly associated with familial mood disorders and greater suicidal risk, especially with double-abuse and BD diagnosis. We support a bilateral relationship between abuse and diagnosis of BD: abuse may facilitate early appearance of BD but also may result from the actions of abusive BD family members.
Collapse
Affiliation(s)
| | - Leonardo Tondo
- Lucio Bini Mood Disorder Centers, Cagliari, Rome, Italy; International Consortium for Mood & Psychotic Disorders Research, Mailman Research Center, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Alessandro Miola
- International Consortium for Mood & Psychotic Disorders Research, Mailman Research Center, McLean Hospital, Belmont, MA, USA; Department of Neuroscience, University of Padova, Padua, Italy.
| | - Marco Pinna
- Lucio Bini Mood Disorder Centers, Cagliari, Rome, Italy; Section on Psychiatry, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Martina Contu
- Lucio Bini Mood Disorder Centers, Cagliari, Rome, Italy
| | - Ross J Baldessarini
- International Consortium for Mood & Psychotic Disorders Research, Mailman Research Center, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
30
|
Kassman A, Wollter F, Eriksson M. The selective child welfare funnel. Children's exposure to violence and CWS investigations in Sweden. Child Abuse Negl 2023; 144:106356. [PMID: 37478732 DOI: 10.1016/j.chiabu.2023.106356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/04/2023] [Accepted: 07/10/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND Research indicates that child welfare services reach out to children exposed to violence unequally depending on the child's social background, living conditions and violence type. OBJECTIVE Based on the notion of selective recognition of vulnerability and risk, this study explores which children CWS pursue to a complete child welfare investigation. PARTICIPANTS AND SETTING A register was set up including all children (n = 1764) between 7 and 12 years that were investigated for suspected exposure to violence by CWS in the municipality of the City of Stockholm, Sweden, in 2019. METHODS This cohort was systematically compared to demographic data and national self-report prevalence studies to explore possible biases regarding which children CWS investigates. Descriptive analysis, cluster analysis and logistic regressions were used. RESULTS The results confirm previous research that children exposed to violence have reduced access to material resources and inferior living conditions compared to non-exposed children. Physical abuse is more prevalent among boys of foreign backgrounds in stable, two-parent families residing in higher-status suburbs. Conversely, neglect is more common among children of Swedish backgrounds in low-income, single-parent households living in low-status suburbs. In comparison with self-reported prevalence studies, sexual and psychological abuse seem underrepresented in the study group, while neglect and violence in the family are relatively more frequently investigated compared to self-reported prevalence studies. CONCLUSIONS The results indicate that CWS should develop its methods to reach certain vulnerable groups that are underrepresented for safeguarding and support, for example, girls exposed to sexual abuse.
Collapse
Affiliation(s)
- Anders Kassman
- Marie Cederschiöld University, Department of Social Sciences, Folkungagatan 127, Box 11189, SE-100 61 Stockholm, Sweden.
| | - Filip Wollter
- Marie Cederschiöld University, Department of Social Sciences, Folkungagatan 127, Box 11189, SE-100 61 Stockholm, Sweden.
| | - Maria Eriksson
- Marie Cederschiöld University, Department of Social Sciences, Folkungagatan 127, Box 11189, SE-100 61 Stockholm, Sweden.
| |
Collapse
|
31
|
Habek D. Sexual abuse of children - some recommendations from a forensic gynaecologist's expert experience. Med Leg J 2023; 91:136-138. [PMID: 37231708 DOI: 10.1177/00258172231165148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Prompt and better primary examination of victims accompanied by meticulous note-taking in cases of suspected child sexual abuse are needed to improve both conviction rates and to avoid inappropriate criminal investigations and proceedings. The majority of child sexual abuse victims are female. More training is needed for gyaecologists in this field.
Collapse
Affiliation(s)
- Dubravko Habek
- School of Medicine, Catholic University of Croatia, Department of Gynaecology and Obstetrics, Clinical Hospital Merkur, Zagreb, Croatia
| |
Collapse
|
32
|
Coelho N, Neves A, Gregório J. Physicians and nurses professional relationship with criminal investigation in dealing with survivors of sexual abuse: a scoping review. Health Justice 2023; 11:33. [PMID: 37615818 PMCID: PMC10464451 DOI: 10.1186/s40352-023-00235-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 08/07/2023] [Indexed: 08/25/2023]
Abstract
Survivors of sexual abuse and their families seek help from criminal law enforcement agencies and health professionals to obtain justice and health care. Many communities have implemented multi-professional collaborative models so that the victim's well-being is assured and the truth is established. However, there is a general lack of evidence on how to best articulate these teams with the healthcare professionals caring for the survivors.Therefore, this Scoping Review was conducted in order to analyze and to map the barriers and facilitators of the relationship between health professionals and the criminal investigation team in the care of survivors of sexual abuse. The methodology proposed by the Joanna Briggs Institute for Scoping Reviews was used, and the Bronstein five dimension model of interprofessional collaboration served as the basis for the analysis of barriers and facilitators. Quantitative, qualitative and mixed studies, primary and secondary sources, text and opinion documents were included. Content analysis was performed on the main findings of the collected studies. Twelve articles were identified and analyzed. Collaboration, communication, hierarchy, skills, confidentiality, and leadership emerged as key themes. Multidisciplinary Sexual Assault Nurse Examiner (SANE) and Sexual Assault Response Teams (SARTs) were implemented to coordinate care, but conflicting goals and values among professionals posed challenges. Communication failures and inadequate information sharing hindered collaboration. Neutral leaders who coordinate teams, minimize groupthink, and improve decision-making were found to be valuable. Engaging across disciplinary boundaries and addressing power dynamics were challenging but could be addressed through facilitation and conflict resolution. This review highlights the importance of effective collaboration and interaction within teams and with other professionals in the care of sexual abuse survivors.
Collapse
Affiliation(s)
- Nuno Coelho
- Instituto de Polícia Judiciária e Ciências Criminais (Institute for Judiciary Police and Criminal Science), Loures, Portugal.
- Center for Research in Biosciences and Health Technologies, CBIOS. Lusófona University, Lisbon, Portugal.
- Health Sciences PhD Program, U Alcalá, Madrid, Spain.
| | - Anabela Neves
- Instituto Nacional de Medicina Legal e Ciências Forenses (National Institute of Forensic Medicine and Forensic Science), Coimbra, Portugal
- Medical and Forensic Office of North Lisbon Area, Lisbon, Portugal
| | - João Gregório
- Center for Research in Biosciences and Health Technologies, CBIOS. Lusófona University, Lisbon, Portugal
| |
Collapse
|
33
|
Lyon TD. Child Maltreatment, the Law, and Two Types of Error. Child Maltreat 2023; 28:403-406. [PMID: 37196319 PMCID: PMC10914389 DOI: 10.1177/10775595231176454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
|
34
|
Gebremichael MW, Gebremariam B, Mitiku M, Hadush Z, Tesfay B, Gerezgiher A, Alemu MG. Rape survivors' experience in Tigray: a qualitative study. BMC Womens Health 2023; 23:372. [PMID: 37443028 PMCID: PMC10347821 DOI: 10.1186/s12905-023-02502-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 06/22/2023] [Indexed: 07/15/2023] Open
Abstract
INTRODUCTION As consequences of war, women and girls are the most likely segment of society to be impacted by violence. War also affects the critical facilities and makes the situation worse as victims cannot get the vital basic services. According to media and unpublished reports, Tigrayan women have been victimized by gang rape and sexual violence. Furthermore, there is substantive evidence of intentional destruction and vandalization of health facilities due to the one-year-old-armed conflict. This study aimed to explore experiences of rape survivors in areas hit by armed conflict in the Tigray region of Ethiopia. METHODS In this qualitative study, a phenomenological study design was employed among Tigrayan sexual assault survivors in a war-ravaged of Tigray. Survivors were selected purposively and included in the study for an in-depth interview. An interview guide was used to collect the data. Audio records from the in-depth interviews in Tigrigna were transcribed verbatim and then translated into English for analysis. Atlas-ti 7 software was used to code the interview transcripts of the qualitative data, and categorizations and thematizing of the codes were done. Direct quotes were used to describe categories or themes. RESULTS Ten women who were survivors of sexual violence and rape related to the war in Tigray participated in the interview. The age of the women ranged between 16 and 30 years with a mean age of 21.7. Among the participants, five were teenagers, six were single and/or economically dependent on their family or husband, and two did not attend any school and were not able to read and write. This study has generated five major thematic areas: (1) infliction of long-lasting trauma on children (2) effects of the rape (3) means of escaping from rape and killings (4) home remedies as means of life saving in war affected areas, and (5) beyond rape. CONCLUSIONS Rape in war-stricken Tigray has been widespread which includes teenagers and it caused immense psychological and physical damage to the survivors and their families. Damage of critical facilities such as the absence of safe houses for survivors and health services was an added complexity to the victims of rape. Hence, a coordinated effort by the government of Tigray and international partners is required to heal, support and rehabilitate the victims and rebuild the damaged health institutions and reequip the health facilities.
Collapse
Affiliation(s)
| | | | - Mengistu Mitiku
- College of Health Sciences, Mekelle University, P.O.Box: 1871, Mekelle City, Tigray, Ethiopia
| | - Znabu Hadush
- College of Health Sciences, Mekelle University, P.O.Box: 1871, Mekelle City, Tigray, Ethiopia
| | - Bisrat Tesfay
- College of Health Sciences, Mekelle University, P.O.Box: 1871, Mekelle City, Tigray, Ethiopia
| | - Alemseged Gerezgiher
- Institute of Population Studies, Mekelle University, Mekelle City, Tigray, Ethiopia
| | | |
Collapse
|
35
|
Stea TH, Steigen AM, Dangmann CR, Granrud MD, Bonsaksen T. Associations between exposure to sexual abuse, substance use, adverse health outcomes, and use of youth health services among Norwegian adolescents. BMC Public Health 2023; 23:1330. [PMID: 37434128 DOI: 10.1186/s12889-023-16261-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 07/07/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND A strong association between sexual abuse and adverse health outcomes has been reported among adolescents. The present study aimed to provide more information about adverse health outcomes associated with sexual abuse and substance use, and to examine the use of youth health services among Norwegian adolescents. METHODS National representative cross-sectional study among 16-19-year-old Norwegian adolescents (n = 9784). Multivariable regression analyses, adjusted for socioeconomic status and age, were used to examine the association between exposure to sexual abuse, substance use and health risk factors, and the use of youth health services. RESULTS Adolescents exposed to sexual abuse had higher odds of depressive symptoms (males: OR:3.8; 95% CI:2.5-5.8, females: 2.9;2.4-3.5), daily headache (males: 5.3;2.8-10.1, females:1.9; 1.5-2.4), high medication use (males: 3.2;1.7-6.0, females: 2.0;1.6-2.6), self-harm (males: 3.8;2.4-6.0, females:3.2; 2.6-3.9), suicidal thoughts (males: 3.3; 2.2-5.0, females:3.0; 2.5-3.6) and suicide attempts (males: 9.5;5.6-16.0, females:3.6;2.7-4.9). Furthermore, exposure to sexual abuse was associated with higher odds of using school health services (males: 3.9;2.6-5.9, females: 1.6;1.3-1.9) and health services for youth (males: 4.8;3.1-7.6, females: 2.1;1.7-2.5). In general, substance use was associated with increased odds of adverse health related outcomes and use of youth health services, but the strength of the relationships varied according to sex. Finally, results indicated a significant interaction between sexual abuse and smoking that was associated with increased odds of having suicidal thoughts for males (2.6;1.1-6.5) but a decreased odds of having suicidal thoughts and have conducted suicide attempts once or more for females (0.6;0.4-1.0 and 0.5;0.3-0.9, respectively). CONCLUSIONS The present study confirmed a strong relationship between exposure to sexual abuse and health risks, especially among males. Moreover, males exposed to sexual abuse were much more likely to use youth health services compared to sexually abused females. Substance use was also associated with adverse health outcomes and use of youth health services, and interactions between sexual abuse and smoking seemed to influence risk of suicidal thoughts and attempts differently according to sex. Results from this study increase knowledge about possible health related effects of sexual abuse which should be used to identify victims and provide targeted treatment by youth health services.
Collapse
Affiliation(s)
- T H Stea
- Department of Health and Nursing Science, University of Agder, Kristiansand, Norway.
| | - A M Steigen
- Department of Health and Nursing Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
| | - C R Dangmann
- Department of Social Sciences and Guidance, Faculty of Social and Health Science, Inland Norway University of Applied Sciences, Elverum, Norway
| | - M D Granrud
- Department of Social Sciences and Guidance, Faculty of Social and Health Science, Inland Norway University of Applied Sciences, Elverum, Norway
| | - T Bonsaksen
- Department of Health and Nursing Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
- Department of Health, Faculty of Health Studies, VID Specialized University, Stavanger, Norway
| |
Collapse
|
36
|
Allen B, Pistone LF. Psychometric evaluation of a single-item screening tool for the presence of problematic sexual behavior among preteen children. Child Abuse Negl 2023; 143:106327. [PMID: 37390590 DOI: 10.1016/j.chiabu.2023.106327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 06/12/2023] [Accepted: 06/19/2023] [Indexed: 07/02/2023]
Abstract
BACKGROUND Preteen children with problematic sexual behavior (PSB) are increasingly coming to the attention of mental health professionals. However, efforts to provide clinical care to these children are hampered by the limited dissemination and implementation of effective screening procedures. OBJECTIVE A single-item screening tool designed for implementation in mental health settings was developed and tested for psychometric quality. PARTICIPANTS Participants included caregivers of children receiving clinical services as a result of displaying PSB and/or subsequent to disclosure of child maltreatment (n = 341). METHODS Caregivers completed the single-item tool at the onset of services and approximately 15 days later. In addition, caregivers completed the Child Sexual Behavior Inventory, the Strengths and Difficulties Questionnaire, and the Child Stress Disorder Checklist-Short Form at the initial assessment. RESULTS Analyses demonstrated acceptable test-retest reliability of the tool (phi = 0.70-0.74, p < .001). Validity was established by showing that caregivers providing a positive response on the single-item tool scored children significantly higher on a full-length measure assessing PSB than caregivers denying such concerns on the single-item tool (t = 7.28-9.8, p < .001). However, scores on measures of internalizing concerns and posttraumatic stress symptoms were not distinguished by caregiver responses to the single item tool. CONCLUSIONS The newly developed single-item tool appears to offer an efficient, reliable, and valid method of screening preteen children for the presence of PSB.
Collapse
Affiliation(s)
- Brian Allen
- Department of Pediatrics, Penn State College of Medicine, Hershey, PA, USA; Department of Psychiatry & Behavioral Health, Penn State College of Medicine, Hershey, PA, USA; Center for the Protection of Children, Penn State Children's Hospital, Hershey, PA, USA.
| | | |
Collapse
|
37
|
Nuwabaine L, Kawuki J, Amwiine E, Asiimwe JB, Sserwanja Q, Gatasi G, Donkor E, Atwijukiire H. Sexual violence and associated factors among women of reproductive age in Rwanda: a 2020 nationwide cross-sectional survey. Arch Public Health 2023; 81:112. [PMID: 37331931 PMCID: PMC10278278 DOI: 10.1186/s13690-023-01109-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 05/15/2023] [Indexed: 06/20/2023] Open
Abstract
BACKGROUND Sexual violence against women is a global public health issue with both short- and long-term effects on the physical and mental health of women. This study aimed to determine the prevalence of sexual violence and its associated factors among women of reproductive age in Rwanda. METHODS We used secondary data from the 2020 Rwanda Demographic and Health Survey of 1,700 participants, who were selected using multistage stratified sampling. Multivariable logistic regression was conducted to explore factors associated with sexual violence using SPSS (version 25). RESULTS Of the 1,700 women of reproductive age, 12.4% (95%CI: 11.0-14.1) had experienced sexual violence. Justified beating (AOR = 1.34, 95%CI: 1.16-1.65), not having health insurance (AOR = 1.46, 95%CI: 1.26-2.40), not being involved in healthcare decision-making (AOR = 1.64, 95%CI: 1.99-2.70), having a husband/partner with primary (AOR = 1.70, 95%CI: 5.47-6.21) or no education (AOR = 1.84, 95%CI: 1.21-3.37), as well as having a husband/partner who sometimes (AOR = 3.37, 95%CI: 1.56-7.30) or often (AOR = 12.87, 95%CI: 5.64-29.38) gets drunk were positively associated with sexual violence. However, women from male-headed households (AOR = 0.52, 95%CI: 0.29-0.92) were less likely to experience sexual violence. CONCLUSIONS There is a need to demystify negative culturally-rooted beliefs favouring sexual violence, such as justified beating, as well as increase efforts to promote women's empowerment and healthcare access. Moreover, engaging men in anti-sexual violence strategies is paramount to addressing male-related issues that expose women to sexual violence.
Collapse
Affiliation(s)
- Lilian Nuwabaine
- School of Nursing and Midwifery, Aga Khan University, Kampala, Uganda
| | - Joseph Kawuki
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Earnest Amwiine
- Faculty of Medicine, Mbarara University of Science & Technology, Mbarara, Uganda
| | | | | | - Ghislaine Gatasi
- Key Laboratory of Environmental Medicine Engineering, School of Public Health, Southeast University, 210009 Nanjing, Jiangsu Province China
| | - Elorm Donkor
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | | |
Collapse
|
38
|
Grady MD, Yoder J, Deblinger E, Mannarino AP. Developing a trauma focused cognitive behavioral therapy application for adolescents with problematic sexual behaviors: A conceptual framework. Child Abuse Negl 2023; 140:106139. [PMID: 36965434 DOI: 10.1016/j.chiabu.2023.106139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 02/07/2023] [Accepted: 03/08/2023] [Indexed: 05/06/2023]
Abstract
Sexual abuse (SA) perpetration is a significant public health problem; SA perpetration is most likely to emerge during adolescence and youth ages 13 to 17 account for a significant portion of all child sexual abuse. While research shows that these youth have high rates of adversity, once they have engaged in problem sexual behavior (PSB), their own trauma histories are often ignored with treatment primarily focused on reducing risk for reoffending. Although sexual re-offense rates among adolescents with PSB are very low, the rates of non-sexual recidivism are considerably higher; with almost half of known youth have reoffended non-sexually, requiring development, implementation, and testing of therapeutic interventions responsive to the indicated risks and unmet needs of adolescents who have engaged in a range of problematic sexual behaviors (PSB-A) and their families. Yet, there are no empirically supported interventions designed specifically to address PSB-A with trauma histories. This article introduces how Trauma-Focused Cognitive Behavioral Therapy can be applied to PSB-A and provides implications for practice and future research.
Collapse
Affiliation(s)
- Melissa D Grady
- The Catholic University of America, National School of Social Service, United States of America.
| | - Jamie Yoder
- Colorado State University, Department of Social Work, United States of America
| | - Esther Deblinger
- Child Abuse Research Education Service (CARES) Institute Rowan University, School of Osteopathic Medicine, United States of America
| | - Anthony P Mannarino
- Center for Traumatic Stress in Children and Adolescents Psychiatry and Behavioral Health Institute, Allegheny Health Network, Drexel University College of Medicine, United States of America
| |
Collapse
|
39
|
Rechenberg T, Schomerus G. The stronger and the weaker sex - gender differences in the perception of individuals who experienced physical and sexual violence in childhood. A scoping review. Child Abuse Negl 2023; 140:106131. [PMID: 36934639 DOI: 10.1016/j.chiabu.2023.106131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 02/14/2023] [Accepted: 03/02/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND Violence against children is an issue of serious concern. Stigma impacts coping with childhood trauma. A central aspect regarding disclosing trauma and seeking help is the social perception of the victim and survivor's gender. OBJECTIVE This review aims to synthesize qualitative and quantitative research about the impact of the victim and survivor gender on the societal perceptions of individuals who have experienced sexual and/or physical violence in childhood. PARTICIPANTS AND SETTING This review considered both society's and victims and survivors' perspectives on gender-linked perceptions concerning individuals with childhood trauma. METHODS The initial search was conducted in November 2021 and involved the databases Web of Science, PubMed, and PsychInfo. All studies, published in English or German, that reported study design, sample characteristics, and gender-linked perceptions of individuals with a history of sexual and/or physical violence in childhood were included. RESULTS A total of 10,373 studies were identified, of which 20 studies were eligible for review. Six studies reported no significant victim gender effect. However, when significant victim gender effects were present, males were characterized with considerably more stigmatizing attributes regarding the blame category while females were exposed to considerably more stigmatizing attributes regarding the harm category. CONCLUSIONS Females and males experience stigmatization reflecting typical stereotypes of femininity and masculinity. Thus, females are perceived as more vulnerable, more burdened, and with a higher need for security than males. Males are seen as more blameworthy and less trustworthy than females due to their presumed capability to physically resist or escape abuse.
Collapse
Affiliation(s)
- Theresia Rechenberg
- Department of Psychiatry and Psychotherapy, University of Leipzig, Medical Center, Leipzig, Germany.
| | - Georg Schomerus
- Department of Psychiatry and Psychotherapy, University of Leipzig, Medical Center, Leipzig, Germany
| |
Collapse
|
40
|
Yıldız M, Orak U, Aydoğdu R. Enduring Effects of Early Life Traumas on Adult Suicidal Ideation. J Child Adolesc Trauma 2023; 16:297-307. [PMID: 37234841 PMCID: PMC10205958 DOI: 10.1007/s40653-022-00482-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/15/2022] [Indexed: 05/28/2023]
Abstract
Exposure to traumas early in life has been found to have a range of negative health effects later in adulthood, including a higher risk for suicidal behavior. Using data from the Waves I (1994/95) and IV (2008) of the National Longitudinal Study of Adolescent to Adult Health (N = 14,385; 49.35% female; Mage in Wave IV = 29), this study examines the effects of exposure to three different types of early life traumas-emotional abuse, physical abuse, and sexual abuse before the age of 18-on adult suicidal ideation. Guided by the stress process model incorporated with a life-course perspective, potential mediating roles of psychological distress, subjective powerlessness, and perceived social rejection were also investigated. A series of regression and Karlson-Holm-Breen (KHB) mediation analyses were performed using Stata 14 to assess the total, direct, and indirect effects. All three early life trauma measures were found to be significantly and independently associated with a higher risk of suicidal ideation in adulthood. A substantive portion (between 30 and 50%) of the effects was mediated by psychological distress (i.e., depression and anxiety), subjective powerlessness, and perceived social rejection. The general policy implications of this study include evaluating suicidal individuals for prior childhood abuse experiences and assessing abuse survivors for suicidality.
Collapse
Affiliation(s)
- Muhammed Yıldız
- Applied Sociology and Criminal Justice Department, Utah Tech University, 232 McDonald Center, 84770 St. George, UT USA
| | - Uğur Orak
- Department of Sociology and Anthropology, Middle Tennessee State University, Murfreesboro, TN USA
| | - Ramazan Aydoğdu
- General Education & Health Sciences Department, Baptist Health Sciences University, Memphis, TN USA
| |
Collapse
|
41
|
Das I, Bhattacharjee A. Examining the Roles of Prior Victimization, Perpetrator Identity and the Correlates of Female Rape Myth Acceptance Among Indian Females. Arch Sex Behav 2023; 52:1855-1868. [PMID: 36752952 DOI: 10.1007/s10508-023-02547-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 01/13/2023] [Accepted: 01/16/2023] [Indexed: 06/18/2023]
Abstract
This research attempts to address a widely under-explained phenomenon of female rape myth acceptance (RMA) among the female population. A total number of 500 literate women from India with a mean age of 28.89 years were selected to examine the different determinants of their RMA. The research explored the important correlates of RMA among women, where the stepwise regression model revealed the significant impact of sexual desires, rejection sensitivity, loneliness, and neuroticism/emotional stability on their RMA. This further implied that women high on these four constructs run a 17.7% chance of endorsing female rape myths. The model eliminated the construct of online pornography usage, owing to its non-significant impact on RMA. Further, it was revealed that the history of prior victimization had a significant effect on the rape myths endorsed by the women. The study also reflected on the identity of the perpetrators of the women with a prior victimization history, where 55.43% reported it was perpetrated by a "known" person in their last experienced assault (and 44.57% "stranger" perpetrator). Whereas most women were victimized by "known" perpetrators, there was no significant difference in the sample's RMA, between the perpetrator identity groups (known and stranger perpetrators). The research concretely adds novel knowledge on identifying and predicting the female rape supportive attitudes among females.
Collapse
Affiliation(s)
- Ivan Das
- Department of Psychology, Tripura University, Suryamaninagar, Tripura, 799022, India.
| | - Anjana Bhattacharjee
- Department of Psychology, Tripura University, Suryamaninagar, Tripura, 799022, India
| |
Collapse
|
42
|
Oğuztüzün Ç, Koyutürk M, Karakurt G. Systematic Investigation of Meta-Analysis Data on Treatment Effectiveness for Physical, Psychological, and Sexual Intimate Partner Violence Perpetration. Psychosoc Interv 2023; 32:59-68. [PMID: 37383644 PMCID: PMC10294456 DOI: 10.5093/pi2023a6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 02/18/2023] [Indexed: 06/30/2023]
Abstract
Intimate partner violence can lead to physical, economical, mental, and sexual well-being issues, and even death, and it is most commonly experienced by women. There exist a number of treatment models for the prevention and treatment of intimate partner violence (IPV). In this study, we provided a comprehensive meta-regression analysis of the effectiveness of batterer treatment programs, with a view to characterizing the interplay between different forms of IPV (physical, psychological, and sexual). Using meta-regression, we explore the effect sizes and whether IPV treatment methods have distinct impacts on the outcomes. We use the difference normalized by pretreatment mean and variance foldchange to uncover the relationship between different violence subtypes and how they drive each other. Specifically, our study found that studies with more pre-treatment psychological and/or sexual violence, lead to less favorable outcomes while the studies that start with more physical violence are able to demonstrate their effects more effectively. Results of this study can be used to help the clinician effectively select the treatment for the perpetrator based on the violence type and severity of violence in order to more effectively treat the needs for each specific relationship.
Collapse
Affiliation(s)
- Çerağ Oğuztüzün
- Case Western Reserve University ClevelandOhio USA Case Western Reserve University, Cleveland, Ohio, USA
| | - Mehmet Koyutürk
- Case Western Reserve University ClevelandOhio USA Case Western Reserve University, Cleveland, Ohio, USA
| | - Günnur Karakurt
- Case Western Reserve University ClevelandOhio USA Case Western Reserve University, Cleveland, Ohio, USA
| |
Collapse
|
43
|
Neiva-Silva L, Gomes JR, Goulart-Peres T, Demenech LM, Paludo SS, Carvalho FT, Koller SH, Corrêa ML. Street scars: Suicide ideation and suicide attempt among street-involved adolescents and youth in southern Brazil. Child Abuse Negl 2023; 139:105490. [PMID: 35086723 DOI: 10.1016/j.chiabu.2022.105490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 12/20/2021] [Accepted: 01/09/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To measure the prevalence of suicidal ideation and attempts as well as suicide attempts' associated factors among street-involved youth in southern Brazil. PARTICIPANTS AND SETTING Cross-sectional study was conducted with street-involved adolescents and children from Porto Alegre and Rio Grande, Brazil. METHODS A respondent-driven sampling strategy was used to access this hard-to-reach population quickly and efficiently. Descriptive, bivariate, and multivariate analyses were conducted, with the latter being binary logistic regression. RESULTS The prevalence of suicide attempts was 16.3%, while the frequency of suicidal ideation was 30.9%. Most participants were male, aged between 16 and 18 years, with no ties to school and family. Almost half of the sample had been in a street situation for five years or more, and two-thirds reported spending more than seven hours a day on the streets. Variables independently associated with suicide attempts were aged 19-21 years old, with reduced ties with school and family, having had an experience of sexual abuse, and lifetime use of crack. CONCLUSIONS Public policies targeting the strengthening ties of street-involved children, adolescents, and youth with school and family might reduce their vulnerability to threats, such as sexual abuse and use of crack, and hence focus on decreasing suicide attempts.
Collapse
Affiliation(s)
- L Neiva-Silva
- Postgraduate Program in Public Health, Federal University of Rio Grande, Rio Grande, RS, Brazil; Postgraduate Program of Psychology, Federal University of Rio Grande, Rio Grande, RS, Brazil; Center of Studies on Risk and Health, Federal University of Rio Grande, Rio Grande, RS, Brazil.
| | - J R Gomes
- Postgraduate Program in Public Health, Federal University of Rio Grande, Rio Grande, RS, Brazil
| | - T Goulart-Peres
- Postgraduate Program in Public Health, Federal University of Rio Grande, Rio Grande, RS, Brazil
| | - L M Demenech
- Center of Studies on Risk and Health, Federal University of Rio Grande, Rio Grande, RS, Brazil
| | - S S Paludo
- Postgraduate Program in Public Health, Federal University of Rio Grande, Rio Grande, RS, Brazil; Postgraduate Program of Psychology, Federal University of Rio Grande, Rio Grande, RS, Brazil
| | - F T Carvalho
- State Coordination on STI/AIDS, State Secretary of Health of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - S H Koller
- Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - M L Corrêa
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| |
Collapse
|
44
|
Li T, Mao Z, Zhao L, Sun Y, Wang C, Bo Q. Childhood trauma and its influence on the clinical features of bipolar disorder. Child Abuse Negl 2023; 141:106203. [PMID: 37088009 DOI: 10.1016/j.chiabu.2023.106203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 04/03/2023] [Accepted: 04/16/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Childhood trauma is an environmental risk factor for bipolar disorder (BD), But its influence on the clinical features of BD has not been examined sufficiently. OBJECTIVE We compared the childhood trauma between patients with BD and healthy controls (HCs) and determined how childhood trauma impacts clinical features, such as severity, mood episodes, and disease duration. PARTICIPANTS AND SETTING The study population comprised patients with BD (in a state of euthymia or depression, n = 90) and HCs (n = 94). METHODS The Structured Clinical Interview for DSM-IV Axis I Disorders was used to diagnose BD and ascertain its clinical features. The Childhood Trauma Questionnaire (CTQ) was used to assess childhood trauma. RESULTS The total CTQ score and scores for the CTQ subscales emotional abuse, sexual abuse, emotional neglect, and physical neglect, significantly differed between the BD and HC groups. Emotional abuse was correlated with higher Hamilton Anxiety Rating Scale (HARS) score and more frequent mood episodes; emotional neglect was correlated with higher HARS score, longer disease duration, and more mood episodes; and total CTQ score was positively correlated with HARS score, disease duration, and mood episodes. Regression analysis showed that emotional neglect significantly predicted HARS score, Hamilton Depression Rating Scale score, and disease duration in the BD group (P < 0.05). CONCLUSIONS Patients with BD have more serious childhood trauma. General childhood trauma, emotional abuse, and emotional neglect negatively affect the clinical features of BD.
Collapse
Affiliation(s)
- Tian Li
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China
| | - Zhen Mao
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China
| | - Lei Zhao
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China
| | - Yue Sun
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China
| | - Chuanyue Wang
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China
| | - Qijing Bo
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China.
| |
Collapse
|
45
|
Reidy DE, Bhochhibhoya S, Baumler ER, Peskin MF, Emery ST, Shegog R, Temple JR, Markham C. Sexual violence in early adolescence is associated with subsequent teen pregnancy and parenthood. Prev Med 2023; 171:107517. [PMID: 37086860 DOI: 10.1016/j.ypmed.2023.107517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 04/14/2023] [Accepted: 04/16/2023] [Indexed: 04/24/2023]
Abstract
Being a victim of sexual violence (SV) has been associated with risk for teen pregnancy in cross-sectional research. However, longitudinal data are necessary to determine if SV victimization plays a causal role in early pregnancy. To address this gap in research, we test whether experiencing SV victimization in early adolescence is associated with pregnancy and having children by mid-adolescence. The current sample comprised 4594 youth (58% female; 51% Hispanic; 39% Black) attending 44 schools in the southern United States. Self-reported data were collected via audio computer-assisted self-interview (ACASI) when students were in 7th or 8th grade and again approximately 24 months later. Approximately 2.9% of boys and 8.2% of girls reported SV victimization at baseline. At follow-up, 3.4% of boys and 4.0% of girls reported being involved with one or more pregnancies; 1.1% of boys and girls reported having one or more children. Being a victim of SV at baseline was associated with pregnancy and having a child at follow-up for girls. SV was not related to outcomes among boys. The present findings indicate that girls victimized by SV are at risk of becoming pregnant and becoming teen parents. The combined sequelae of SV and teen pregnancy impair health, economic, and social functioning across the lifespan and carry forward into future generations. Future research should explore mechanisms through which victimization confers risk for pregnancy to inform prevention strategies.
Collapse
Affiliation(s)
- Dennis E Reidy
- School of Public Health & Center for Research on Interpersonal Violence, Georgia State University, United States of America.
| | - Shristi Bhochhibhoya
- School of Public Health & Center for Research on Interpersonal Violence, Georgia State University, United States of America
| | - Elizabeth R Baumler
- Center for Violence Prevention, University of Texas Medical Branch, United States of America
| | - Melissa F Peskin
- School of Public Health, University of Texas Health Science Center Houston, United States of America
| | - Susan T Emery
- School of Public Health, University of Texas Health Science Center Houston, United States of America
| | - Ross Shegog
- School of Public Health, University of Texas Health Science Center Houston, United States of America
| | - Jeff R Temple
- Center for Violence Prevention, University of Texas Medical Branch, United States of America
| | - Christin Markham
- School of Public Health, University of Texas Health Science Center Houston, United States of America
| |
Collapse
|
46
|
Buchanan A, Stefanovics E, Rosenheck R. Victimization in schizophrenia and its relation to violence. Schizophr Res 2023; 255:52-58. [PMID: 36963231 DOI: 10.1016/j.schres.2023.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 01/21/2023] [Accepted: 03/08/2023] [Indexed: 03/26/2023]
Abstract
BACKGROUND People with schizophrenia are frequently victims of violence. Previous attempts to examine the reasons for this have mostly used cross-sectional designs that limit the ability to distinguish, among the correlates they identify, potential causes of victimization from its consequences. METHOD We studied patients with schizophrenia participating in the NIMH-funded Clinical Antipsychotic Treatment for Intervention Effectiveness (CATIE) trial. The dependent variable was self-reported victimization during the 18-month CATIE follow-up. Independent variables were assessed at study entry and included demographics, childhood experiences, recent victimization and violent behavior, social circumstances, and mental health symptoms. Bivariate and multivariate analyses examined correlates of victimization and, among those victimized, the correlates of also acting violently oneself. RESULTS Of 1179 participants, 206 (17.5 %) reported one or more incidents where they were victimized over the 18-months. Over a third had been hit with a fist or an object. Most perpetrators were family or acquaintances. Controlling for other variables, victimization was associated with having been recently victimized at baseline as well as with sexual abuse in childhood, frequent interactions with close friends and depressive, but not schizophrenia, symptoms. Victimized participants who reported acting violently themselves (113; 55%) were more likely to report violent behavior at baseline and frequent interactions with close friends. CONCLUSIONS Victimization in schizophrenia is often associated with aggressive behavior by the victim and is more often related to social involvement, past trauma, substance use and depression than to schizophrenia symptoms. Treatments that encourage socialization may incur an unintended risk of victimization.
Collapse
Affiliation(s)
- Alec Buchanan
- Department of Psychiatry, Yale University School of Medicine, New Haven, USA; VA Connecticut Health Care System, 950 Campbell Ave, West Haven, USA.
| | - Elina Stefanovics
- Department of Psychiatry, Yale University School of Medicine, New Haven, USA
| | - Robert Rosenheck
- Department of Psychiatry, Yale University School of Medicine, New Haven, USA; VA Connecticut Health Care System, 950 Campbell Ave, West Haven, USA; Yale University School of Epidemiology and Public Health, New Haven, USA; Child Study Center, Yale University School of Medicine, New Haven, USA
| |
Collapse
|
47
|
Kim J, Lee C, Kang Y, Kang W, Kim A, Tae WS, Ham BJ, Chang J, Han KM. Childhood Sexual Abuse and Cortical Thinning in Adults With Major Depressive Disorder. Psychiatry Investig 2023; 20:255-261. [PMID: 36990669 PMCID: PMC10064205 DOI: 10.30773/pi.2022.0314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 12/27/2022] [Indexed: 03/31/2023] Open
Abstract
OBJECTIVE A growing body of evidence reports on the effect of different types of childhood abuse on the structural and functional architecture of the brain. In the present study, we aimed to investigate the differences in cortical thickness according to specific types of childhood abuse between patients with major depressive disorder (MDD) and healthy controls (HCs). METHODS A total of 61 patients with MDD and 98 HCs were included in this study. All participants underwent T1-weighted magnetic resonance imaging, and the occurrence of childhood abuse was assessed using the Childhood Trauma Questionnaire. We investigated the association between whole-brain cortical thickness and exposure to any type of childhood abuse and specific type of childhood abuse in the total sample using the FreeSurfer software. RESULTS No significant difference was reported in the cortical thickness between the MDD and HC groups nor between the "any abuse" and "no abuse" groups. Compared to no exposure to childhood sexual abuse (CSA), exposure to CSA was significantly associated with cortical thinning in the left rostral middle frontal gyrus (p=0.00020), left (p=0.00240), right fusiform gyri (p=0.00599), and right supramarginal gyrus (p=0.00679). CONCLUSION Exposure to CSA may lead to cortical thinning of the dorsolateral prefrontal cortex, which is deeply involved in emotion regulation, to a greater extent than other types of childhood abuse.
Collapse
Affiliation(s)
- Jinyi Kim
- Department of Psychiatry, Seoul Metropolitan Eunpyeong Hospital, Seoul, Republic of Korea
| | - Changju Lee
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Youbin Kang
- Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea
| | - Wooyoung Kang
- Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea
| | - Aram Kim
- Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea
| | - Woo-Suk Tae
- Brain Convergence Research Center, Korea University, Seoul, Republic of Korea
| | - Byung-Joo Ham
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
- Brain Convergence Research Center, Korea University, Seoul, Republic of Korea
| | - Jisoon Chang
- Department of Psychiatry, Seoul Metropolitan Eunpyeong Hospital, Seoul, Republic of Korea
| | - Kyu-Man Han
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
- Brain Convergence Research Center, Korea University, Seoul, Republic of Korea
| |
Collapse
|
48
|
Allen B. Etiological Perspectives on Problematic Sexual Behavior of Preteen Children: Implications for Treatment. Clin Child Fam Psychol Rev 2023; 26:50-64. [PMID: 36094684 DOI: 10.1007/s10567-022-00412-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2022] [Indexed: 01/31/2023]
Abstract
Problematic sexual behavior (PSB) among preteen children is a poorly understood clinical phenomenon that may leave even the most skilled and knowledgeable of clinicians at a loss when attempting to develop an evidence-based treatment approach. Much of this lack of practical direction can be credited to the relatively scarce clinical trial research examining this outcome. Nonetheless, the etiological research on PSB provides clearer directions and suggests the implementation of already well-established interventions may be effective. This paper reviews the current state of the etiological research pertaining to PSB and places these findings within developmental psychopathology, social learning theory, and post-traumatic stress disorder symptomatology frameworks. Specific treatment directives derived from these three viewpoints are then reviewed, including a review of the current evidence base for the treatment of PSB. Finally, a treatment planning algorithm is specified to help clinicians identify the most beneficial approach to treating PSB in a given case.
Collapse
Affiliation(s)
- Brian Allen
- Department of Pediatrics, Penn State College of Medicine, Hershey, PA, USA.
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, PA, USA.
- Center for the Protection of Children, Penn State Children's Hospital, Hershey, PA, USA.
| |
Collapse
|
49
|
Fitzpatrick SS, Liebman RE, Monson CM, Resick PA. Latent emotion profiles of PTSD and specific emotions predicting differential therapy outcomes in a dismantling study of cognitive processing therapy. J Anxiety Disord 2023; 95:102681. [PMID: 36848714 DOI: 10.1016/j.janxdis.2023.102681] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 01/29/2023] [Accepted: 02/16/2023] [Indexed: 02/19/2023]
Abstract
Posttraumatic stress disorder (PTSD) is theoretically maintained by avoidance of emotions elicited from trauma-related beliefs. Whether PTSD symptom profiles and specific emotions predict treatment response is unknown. This secondary data analysis examined: a) whether individuals with PTSD can be sub-classified based on symptom clusters and specific emotions, and b) if these subgroups predict differential responses to cognitive versus exposure-based PTSD interventions. Women with physical or sexual assault-related PTSD were randomized to CPT (cognitive processing therapy elements only), CPT with written accounts (CPT+A), or written accounts (WA) only (n = 150). Participants completed baseline measures of PTSD, state anxiety, internalized anger, externalized anger, shame, and guilt, and weekly PTSD measures during and 6 months after treatment. Latent profile analyses revealed four subgroups: low symptoms and emotions; moderate-high reexperiencing, low internalized emotions (i.e., moderate-high reexperiencing, moderate avoidance/hyperarousal/guilt, low shame/internalized anger/anxiety); low reexperiencing, moderate emotions (i.e., low re-experiencing, moderate avoidance/hyperarousal/guilt, moderate other emotions); and high symptoms and emotions (high symptoms and emotions except moderate externalized anger). The high symptom and emotion subgroup experienced greater PTSD symptom improvements in cognitive conditions than WA. Other groups did not exhibit differential change across conditions. Cognitive interventions may be well-suited for severe PTSD with high self-directed emotions. CLINICALTRIALS.GOV IDENTIFIER: NCT00245232.
Collapse
Affiliation(s)
| | - Rachel E Liebman
- Department of Psychiatry, University Health Network, Canada; Department of Psychology, Toronto Metropolitan University, Canada
| | - Candice M Monson
- Department of Psychology, Toronto Metropolitan University, Canada
| | - Patricia A Resick
- Department of Psychiatry and Behavioral Sciences, Duke Health, Canada
| |
Collapse
|
50
|
Jojo N, Nattala P, Seshadri S, Krishnakumar P, Thomas S. Knowledge of sexual abuse and resistance ability among children with intellectual disability. Child Abuse Negl 2023; 136:105985. [PMID: 36603444 DOI: 10.1016/j.chiabu.2022.105985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 11/18/2022] [Accepted: 11/27/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Sexual abuse is a global concern among children with intellectual disabilities. Sexual abuse is frequent and long-lasting when the victim is a child with an intellectual disability. Moreover, the rate of sexual abuse is two to eight times the rate in the general population. OBJECTIVE This study aimed to investigate the knowledge of sexual abuse and resistance ability among children with intellectual disabilities. PARTICIPANTS AND SETTING The study was conducted among 120 children with mild or moderate intellectual disabilities attending twelve schools for specific purposes. METHODS We adopted a cross-sectional design to assess knowledge and resistance ability. Personal Safety Questionnaire and Modified What If Situation Test were administered verbally during individual interviews. Institutional Ethics Committee approved our study. RESULTS Current study suggests that children with intellectual disabilities have average knowledge (M = 6.6, SD = 1.6) regarding sexual abuse. More than 90 % of children demonstrated poor reporting skills. Although children exhibited good knowledge in differentiating appropriate from inappropriate touch requests, most children reported they would not disclose this incident to anyone. CONCLUSIONS This study strongly suggests the need for a structured training program for children with intellectual disabilities to prevent sexual abuse.
Collapse
Affiliation(s)
- N Jojo
- Faculty of Health, University of Canberra, Bruce, ACT, Australia.
| | - P Nattala
- Department of Nursing, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - S Seshadri
- Department of Child and Adolescent Psychiatry, NIMHANS, Bangalore, India
| | - P Krishnakumar
- Institute of Mental Health and Neurosciences (IMHANS), Kozhikode, Kerala, India
| | - S Thomas
- Department of Statistics, Christ University, Bangalore, India
| |
Collapse
|