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Arumugaperumal R, Ravichandhiran G, Agadi S, Muthuchamy V, D R, S S, Maruthupandian J. Evaluation of Intimate Partner Violence and Its Association With Depression Among Women in Chengalpattu District, India: A Cross-Sectional Study. Cureus 2024; 16:e59825. [PMID: 38846205 PMCID: PMC11154078 DOI: 10.7759/cureus.59825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2024] [Indexed: 06/09/2024] Open
Abstract
Background Intimate partner violence is one of the major problems experienced by women all over the world. Almost one in three women have experienced one or more forms of violence at least once in their lifetime. These estimates confirm that physical and sexual intimate partner violence remains pervasive in the lives of women across the globe. Intimate partner violence has been found to have a severe impact on mental health such as depression symptoms. This study aimed to assess the prevalence of intimate partner violence in terms of controlling behavior, sexual, and physical violence, and its association with depression in women of Chengalpattu district, India. Methods It is a community-based cross-sectional study conducted in 12 villages under the field practicing area of the rural health training center of Chettinad Health and Research Institute in Kelambakkam, India, by simple random sampling among 190 women participants ever married or partnered of age ≥18 years. A pre-tested, semi-structured questionnaire was used which included the WHO Violence Against Women Instrument (VAWI) in the English language and Patient Health Questionnaire 9 (PHQ 9). The collected data was entered in Microsoft Office Excel (Microsoft Corporation, Redmond, United States) and analyzed using IBM SPSS Statistics for Windows, Version 21 (Released 2012; IBM Corp., Armonk, New York, United States). A probability value (p-value) of less than 0.05 was considered statistically significant. Results The mean (SD) age of the study participants was 34 (±8) years. Among the 190 participants, 57.4% reported controlling behavior, 31.1% reported physical violence and 7.4% reported sexual violence by the intimate partner at least once in the past 12 months. About 34.7% were found to have mild depression and 21.6% with moderate depression. There was a significant association between intimate partner violence and depression in women (p < 0.001) Conclusion The present study found that there is a huge impact of intimate partner violence on the mental health of women whether it is psychological, physical, or sexual. There is a need for awareness and effective management of violence against women, especially in rural areas. Strategies focusing on women's education, leadership, empowerment, decision-making, and financial independence are very much needed.
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Affiliation(s)
- Rathibala Arumugaperumal
- Department of Community Medicine, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, IND
| | - Gowthamkarthic Ravichandhiran
- Department of Community Medicine, KLE Jagadguru Gangadhar Mahaswamigalu Moorsavirmath Medical College (JGMMMC), KLE Academy of Higher Education and Research, Hubballi, IND
| | - Soumya Agadi
- Department of Community Medicine, PSP Medical College Hospital and Research Institute, Oragadam, IND
| | - Vigneshsamy Muthuchamy
- Department of Community Medicine, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, IND
| | - Raja D
- Department of Community Medicine, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, IND
| | - Suganthi S
- Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, IND
| | - Jasmine Maruthupandian
- Department of Community Medicine, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, IND
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Liu X, Liu R, Sun YX, Wang HL, Wang H, Wang T, Ma YN, Li XX, Wang Q, Su YA, Li JT, Si TM. Dorsal CA3 overactivation mediates witnessing stress-induced recognition memory deficits in adolescent male mice. Neuropsychopharmacology 2024:10.1038/s41386-024-01848-9. [PMID: 38504012 DOI: 10.1038/s41386-024-01848-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 02/18/2024] [Accepted: 03/07/2024] [Indexed: 03/21/2024]
Abstract
Witnessing violent or traumatic events is common during childhood and adolescence and could cause detrimental effects such as increased risks of psychiatric disorders. This stressor could be modeled in adolescent laboratory animals using the chronic witnessing social defeat (CWSD) paradigm, but the behavioral consequences of CWSD in adolescent animals remain to be validated for cognitive, anxiety-like, and depression-like behaviors and, more importantly, the underlying neural mechanisms remain to be uncovered. In this study, we first established the CWSD model in adolescent male mice and found that CWSD impaired cognitive function and increased anxiety levels and that these behavioral deficits persisted into adulthood. Based on the dorsal-ventral functional division in hippocampus, we employed immediate early gene c-fos immunostaining after behavioral tasks and found that CWSD-induced cognition deficits were associated with dorsal CA3 overactivation and anxiety-like behaviors were associated with ventral CA3 activity reduction. Indeed, chemogenetic activation and inhibition of dorsal CA3 neurons mimicked and reversed CWSD-induced recognition memory deficits (not anxiety-like behaviors), respectively, whereas both inhibition and activation of ventral CA3 neurons increased anxiety-like behaviors in adolescent mice. Finally, chronic administration of vortioxetine (a novel multimodal antidepressant) successfully restored the overactivation of dorsal CA3 neurons and the cognitive deficits in CWSD mice. Together, our findings suggest that dorsal CA3 overactivation mediates CWSD-induced recognition memory deficits in adolescent male mice, shedding light on the pathophysiology of adolescent CWSD-induced adverse effects and providing preclinical evidence for early treatment of stress-induced cognitive deficits.
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Affiliation(s)
- Xiao Liu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Rui Liu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Ya-Xin Sun
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Hong-Li Wang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Han Wang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Ting Wang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Yu-Nu Ma
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Xue-Xin Li
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Qi Wang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Yun-Ai Su
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Ji-Tao Li
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China.
| | - Tian-Mei Si
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China.
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Bravo-Queipo-de-Llano B, Sainz T, Díez Sáez C, Barrios Miras E, Bueno Barriocanal M, Cózar Olmo JA, Fabregas Martori A, Gancedo Baranda A. Violence as a Health Problem. An Pediatr (Barc) 2024; 100:202-211. [PMID: 38431447 DOI: 10.1016/j.anpede.2024.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 02/16/2024] [Indexed: 03/05/2024] Open
Abstract
Violence is a public health problem, and when it affects childhood, it can cause illness throughout the individual's life. Apart from being able to cause damage in the physical, mental and social spheres, it represents a violation of the rights of the affected children, and a high consumption of resources, both economic and social. A multitude of investigations have improved attention to this violence. However, these advances are not consistent with the practical management of victims, both in Primary and Hospital Care. There is a significant area of improvement for paediatric care. Through this article, different professionals from all established paediatric health care facilities develop general lines of knowledge and action regarding violence against children. An overview is taken of the legislation related to childhood, the different types of abuse that exist, their effects, management and prevention. It concludes with an epilogue, through which we aim to move sensibilities. In summary, this work aims to promote the training and awareness of all professionals specialized in children's health, so that they pursue the goal of achieving their patients' greatest potential in life, and in this way, to help create a healthier society, with less disease, and more justice.
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Affiliation(s)
- Blanca Bravo-Queipo-de-Llano
- Servicio de Pediatría y Enfermedades Infecciosas, Hospital Universitario Infantil La Paz, Madrid, Spain; Instituto de Investigación Biomédica Hospital La Paz (IdiPAZ)
| | - Talía Sainz
- Instituto de Investigación Biomédica Hospital La Paz (IdiPAZ); Unidad de Pediatría Social, Servicio de Pediatría y Enfermedades Infecciosas, Hospital Universitario Infantil La Paz, Madrid, Spain; Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC); Universidad Autónoma de Madrid (UAM)
| | - Carmen Díez Sáez
- Servicio de Pediatría, Hospital Universitario de Basurto, Bilbao, Spain
| | - Ester Barrios Miras
- Pediatría de Atención Primaria, Centro de Salud Mejorada del Campo, Mejorada del Campo, Madrid, Spain
| | - Marta Bueno Barriocanal
- Unidad de Urgencias Pediátricas, Servicio de Pediatría, Hospital Universitario Infantil La Paz, Madrid, Spain
| | - Juan Alonso Cózar Olmo
- Unidad de Gestión Clínica (UGC) Pediatría Área Jaén Norte, Hospital Universitario de San Agustín, Jaén, Spain
| | - Anna Fabregas Martori
- Coordinadora Equipo EMMA (Equipo de Atención a las Violencias hacia la Infancia y la Adolescencia), Departamento de Pediatría, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Antonio Gancedo Baranda
- Consulta de Pediatría Social, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain.
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Andrić I, Slović Ž, Todorović M, Čanović V, Mihajlović F, Todorović D, Vitošević K. Beyond the virus: Examining the impact of COVID-19 on violent fatalities. Leg Med (Tokyo) 2024; 67:102392. [PMID: 38215541 DOI: 10.1016/j.legalmed.2024.102392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 01/04/2024] [Indexed: 01/14/2024]
Abstract
INTRODUCTION The COVID-19 pandemic has had a significant impact on various aspects of society, including crime rates. In Serbia, it is important to examine the changes in violent deaths before and during the pandemic to inform public health and safety policies. MATERIALS AND METHODS We conducted a retrospective, epidemiological, cross-sectional analytical study of medico-legal autopsies in the Department of Forensic Medicine and Toxicology at the University Clinical Center of Kragujevac. Our study sample comprises all forensic autopsy cases examined from January 2017 to December 2019 (151 cases), labeled as "Before," and from January 2020 to December 2022 (192 cases), labeled as "During" the pandemic period. Natural deaths, skeletal remains, and undetermined cases were excluded from our sample. RESULTS The data show an increase in the total number of incidents reported from 152 in the "Before" period to 191 in the "During" period. The proportion of incidents involving males remained relatively stable at around 70%, while the proportion of incidents involving females increased. There was no statistically significant change in the proportion of incidents classified as accidental, while the proportion of incidents classified as homicide and suicide increased. The results show a statistically significant association between gender and incident type for both the "Before" and "During" periods. Deaths due to domestic violence have increased by 22.2% during the pandemic, which is cause for concern. In terms of demographic characteristics, males and younger individuals were more likely to be victims of violent deaths both before and during the pandemic. CONCLUSIONS The COVID-19 pandemic had a significant impact on violent deaths in the Šumadija region (Central Serbia), with an overall increase in the number of violent deaths and a major impact on deaths due to domestic violence. Policies to address domestic violence should be prioritized during the pandemic and beyond, and strategies should be developed to mitigate the effects of future pandemics or lockdowns.
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Affiliation(s)
- Ivana Andrić
- University of Kragujevac, Serbia, Faculty of Medical Sciences, Department of Forensic Medicine, Serbia
| | - Živana Slović
- University of Kragujevac, Serbia, Faculty of Medical Sciences, Department of Forensic Medicine, Serbia; University Clinical Center Kragujevac, Department of Forensic Medicine and Toxicology, Serbia.
| | - Miloš Todorović
- University of Kragujevac, Serbia, Faculty of Medical Sciences, Department of Forensic Medicine, Serbia; University Clinical Center Kragujevac, Department of Forensic Medicine and Toxicology, Serbia
| | - Vanja Čanović
- University Clinical Center Kragujevac, Department of Forensic Medicine and Toxicology, Serbia
| | - Filip Mihajlović
- University of Kragujevac, Serbia, Faculty of Medical Sciences, Department of Pharmacy, Serbia
| | - Danijela Todorović
- University of Kragujevac, Serbia, Faculty of Medical Sciences, Department of Genetics, Serbia
| | - Katarina Vitošević
- University of Kragujevac, Serbia, Faculty of Medical Sciences, Department of Forensic Medicine, Serbia; University Clinical Center Kragujevac, Department of Forensic Medicine and Toxicology, Serbia
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Mughal FB, Saint Arnault D. Protective Factors Affecting Trauma Recovery Among Female South Asian Immigrant Intimate Partner Violence Survivors: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2024:15248380241231602. [PMID: 38389397 DOI: 10.1177/15248380241231602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
Intimate partner violence (IPV) is a pressing public health issue affecting women worldwide. Thirty percent of women experience some form of violence throughout their lifetime globally, and South Asian countries have a higher prevalence of IPV (33%-51%). Notably, IPV has detrimental psychological impacts not only on women but also on their children. Despite this, limited empirical attention has explored protective factors for IPV trauma recovery. This review examines protective factors aiding South Asian immigrant IPV survivors' trauma recovery using Joanna Briggs Institute JBI methodology. The study draws on PubMed, Scopus, and PsychINFO data, resulting in 20 articles retrieved using Rayyan software. Protective factor's themes and subthemes revealed in the literature operated at multiple levels, including personal, interpersonal, community, and professional factors. Personal factors were selfhood, collective self, and adaptation, as well as those that enabled the utilization of interpersonal, community, and professional factors; interpersonal factors were family and friends, children as motivators, and religion; and community and professional factors were resources and technology usage. Immigrant status and culture significantly impacted the protective factors, acting as barriers among some IPV survivors. Therefore, future research should focus on exploring the experiences and cultural values of South Asian immigrant women with other influencing factors that may hinder the development and impact of protective factors on IPV trauma recovery. These findings can help design culturally sensitive support services that incorporate the unique needs of female South Asian immigrant IPV survivors.
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Lanchimba C, Díaz-Sánchez JP, Velasco F. Exploring factors influencing domestic violence: a comprehensive study on intrafamily dynamics. Front Psychiatry 2023; 14:1243558. [PMID: 37743993 PMCID: PMC10513418 DOI: 10.3389/fpsyt.2023.1243558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 08/24/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction This econometric analysis investigates the nexus between household factors and domestic violence. By considering diverse variables encompassing mood, depression, health consciousness, social media engagement, household chores, density, and religious affiliation, the study aims to comprehend the underlying dynamics influencing domestic violence. Methods Employing econometric techniques, this study examined a range of household-related variables for their potential associations with levels of violence within households. Data on mood, depression, health consciousness, social media usage, household chores, density, and religious affiliation were collected and subjected to rigorous statistical analysis. Results The findings of this study unveil notable relationships between the aforementioned variables and levels of violence within households. Positive mood emerges as a mitigating factor, displaying a negative correlation with violence. Conversely, depression positively correlates with violence, indicating an elevated propensity for conflict. Increased health consciousness is linked with diminished violence, while engagement with social media demonstrates a moderating influence. Reduction in the time allocated to household chores corresponds with lower violence levels. Household density, however, exhibits a positive association with violence. The effects of religious affiliation on violence manifest diversely, contingent upon household position and gender. Discussion The outcomes of this research offer critical insights for policymakers and practitioners working on formulating strategies for preventing and intervening in instances of domestic violence. The findings emphasize the importance of considering various household factors when designing effective interventions. Strategies to bolster positive mood, alleviate depression, encourage health consciousness, and regulate social media use could potentially contribute to reducing domestic violence. Additionally, the nuanced role of religious affiliation underscores the need for tailored approaches based on household dynamics, positioning, and gender.
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Affiliation(s)
- Cintya Lanchimba
- Departamento de Economía Cuantitativa, Facultad de Ciencias Escuela Politécnica Nacional, Quito, Ecuador
- Institut de Recherche en Gestion et Economie, Université de Savoie Mont Blanc (IREGE/IAE Savoie Mont Blanc), Annecy, France
| | - Juan Pablo Díaz-Sánchez
- Departamento de Economía Cuantitativa, Facultad de Ciencias Escuela Politécnica Nacional, Quito, Ecuador
| | - Franklin Velasco
- Department of Marketing, Universidad San Francisco de Quito USFQ, Quito, Ecuador
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Sójta K, Juraś-Darowny M, Margulska A, Jóźwiak-Majchrzak W, Grażka A, Strzelecki D. Resilience and Strategic Emotional Intelligence as Mediators between the Disconnection and Rejection Domain and Negative Parenting among Female Intimate Partner Violence Victims. Brain Sci 2023; 13:1290. [PMID: 37759891 PMCID: PMC10526309 DOI: 10.3390/brainsci13091290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 08/30/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
(1) Background: The exposure of children to intimate partner violence (IPV) is associated with a wide range of negative effects on children's development, where as parenting practice is considered to be one of the key factors mediating and mitigating this. Studies have found mixed results regarding the impact of female IPV victimization on maternal parenting practice; however, the most frequently tested hypothesis suggests that the cumulative stress of the IPV experience may emotionally deregulate the mother, contributing to an increased risk of neglected and abusive parenting practices. Little is still known about the factors determining the observed differences in maternal parenting practices among IPV victims. Thus, in our study, we use mediation models to provide preliminary results exploring the role of resilience and strategic emotional intelligence in the relationship between women's disconnection and rejection (D/R) schema domain and maternal parenting practice among IPV victims. (2) Methods: A total of 48 female survivors of IPV and 48 age-matched women with no prior experience of IPV completed a set of tests examining parenting practices, the D/R domain, resilience and emotional intelligence. (3) Results: IPV victimization was associated with significantly higher rates of negative parenting practices. The D/R domain was found to be a significant predictor of parental autonomy attitude and level of parental competence, and these relationships were fully mediated by resilience with strategic emotional intelligence and resilience, respectively. (4) Conclusions: The results shed light on the under-researched relationship between early maladaptive schemas and parenting behavior in the context of IPV. The implications for clinical practice and further research can be drawn based on the study findings.
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Affiliation(s)
- Klaudia Sójta
- Department of Affective and Psychotic Disorders, Medical University of Lodz, Czechoslowacka Street 8/10, 92-216 Lodz, Poland; (K.S.); (A.G.)
| | - Małgorzata Juraś-Darowny
- Institute of Psychology, Faculty of Educational Sciences, University of Lodz, Rodziny Scheiblerów 2, 90-128 Lodz, Poland;
| | - Aleksandra Margulska
- Department of Adolescent Psychiatry, Medical University of Lodz, Czechoslowacka Street 8/10, 92-216 Lodz, Poland;
| | - Wioletta Jóźwiak-Majchrzak
- Department of Applied Sociology and Social Work, University of Lodz, Rewolucji 1905 41/43, 90-214 Lodz, Poland;
| | - Anna Grażka
- Department of Affective and Psychotic Disorders, Medical University of Lodz, Czechoslowacka Street 8/10, 92-216 Lodz, Poland; (K.S.); (A.G.)
| | - Dominik Strzelecki
- Department of Affective and Psychotic Disorders, Medical University of Lodz, Czechoslowacka Street 8/10, 92-216 Lodz, Poland; (K.S.); (A.G.)
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Raj A, Wagman J. Expanding knowledge of intergenerational violence in the Philippines. A commentary on Kim et al. (2023). SSM Popul Health 2023; 23:101450. [PMID: 37483391 PMCID: PMC10362346 DOI: 10.1016/j.ssmph.2023.101450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 06/10/2023] [Indexed: 07/25/2023] Open
Affiliation(s)
- Anita Raj
- Newcomb Institute, Tulane University, New Orleans, LA, USA
- Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Jennifer Wagman
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA, USA
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Sójta K, Margulska A, Jóźwiak-Majchrzak W, Grażka A, Grzelczak K, Strzelecki D. Cognitive-Affective Risk Factors of Female Intimate Partner Violence Victimization: The Role of Early Maladaptive Schemas and Strategic Emotional Intelligence. Brain Sci 2023; 13:1118. [PMID: 37509048 PMCID: PMC10377412 DOI: 10.3390/brainsci13071118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/11/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
(1) Background: Intimate partner violence (IPV) is a pervasive and destructive phenomenon. There is a need for an integrated and comprehensive approach to IPV in order to align prevention, support and treatment. Still little is known about the cognitive and affective markers of IPV that are modifiable. Such knowledge, therefore, can support the effectiveness of prevention and intervention programs. In this study, we put forward a hypothesis that, after accounting for the influence of sociodemographic variables, the domains of early maladaptive schemas (EMS) and strategic emotional intelligence would provide additional information for predicting female IPV victimization. (2) Methods: 48 female survivors of IPV and 48 age-matched women with no prior experience of IPV completed the Young Schema Questionnaire-Short Form 3 (YSQ-SF3) and The Emotional Understanding Test (TRE). (3) Results: The domains of disconnection and rejection and impaired limits were significant predictors of IPV victimization, but the results did not support the predictive value for impaired autonomy, other-directedness and strategic emotional intelligence. (4) Conclusions: Our findings add to the emerging evidence of a link between disconnection and rejection domain and IPV victimization. As a consequence, maladaptive beliefs that interpersonal relationships are unstable and insecure and expose to the risk of humiliation and harm, and that basic emotional needs cannot be satisfied in close relationships, are associated with a higher risk of intimate partner violence. In this context, schema therapy appears to be a promising support for IPV victims.
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Affiliation(s)
- Klaudia Sójta
- Department of Affective and Psychotic Disorders, Medical University of Lodz, Czechoslowacka Street 8/10, 92-216 Lodz, Poland
| | - Aleksandra Margulska
- Department of Adolescent Psychiatry, Medical University of Lodz, Czechoslowacka Street 8/10, 92-216 Lodz, Poland
| | - Wioletta Jóźwiak-Majchrzak
- Department of Applied Sociology and Social Work, University of Lodz, Rewolucji 1905 41/43, 90-214 Lodz, Poland
| | - Anna Grażka
- Department of Affective and Psychotic Disorders, Medical University of Lodz, Czechoslowacka Street 8/10, 92-216 Lodz, Poland
| | | | - Dominik Strzelecki
- Department of Affective and Psychotic Disorders, Medical University of Lodz, Czechoslowacka Street 8/10, 92-216 Lodz, Poland
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Ye M, Hessler D, Ford D, Benson M, Koita K, Bucci M, Long D, Harris NB, Thakur N. Pediatric ACEs and related life event screener (PEARLS) latent domains and child health in a safety-net primary care practice. BMC Pediatr 2023; 23:367. [PMID: 37461038 PMCID: PMC10351141 DOI: 10.1186/s12887-023-04163-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 06/27/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Research examining the connections between individual adverse childhood experiences (ACEs) and how groupings of interrelated adversities are linked with subsequent health is scarce, limiting our understanding of risk during a period of rapid expansion of ACE screening in clinical practice. The study objective was to conduct a psychometric analysis to derive latent domains of ACEs and related life events and assess the association between each domain and health outcome. METHODS Participants (3 months-11 years) were recruited from the University of California San Francisco Benioff's Children Hospital Oakland Primary Care Clinic. Children were screened with the Pediatric ACEs and Related Life Events Screener (PEARLS) (n = 340), which assessed 17 total ACEs and related life events, including forms of abuse, household challenges, and social risks. Domains were constructed using confirmatory factor analysis and associations between the three identified domains and 14 health outcomes were assessed using multivariable linear and logistic regression models. RESULTS Three PEARLS domains were identified: Maltreatment (ω = 0.73, ɑ=0.87), Household Challenges (ω = 0.70, ɑ=0.82), and Social Context (ω = 0.55, ɑ=0.70). Measurement invariance was supported across both gender and screening format. All domains were associated with poorer general and behavioral health and stomachaches. Maltreatment and Social Context were additionally associated with eczema while only Social Context was associated with increased odds of reporting headaches and somatic symptoms. CONCLUSION In an underserved, urban west-coast pediatric population, the PEARLS found three adversity domains of Maltreatment, Household Challenges, and Social Context that all had an independent statistically significant association with poorer child health. The results provide a timely and more nuanced representation of risk that can inform clinical practice and policy using more targeted resources and interventions.
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Affiliation(s)
- Morgan Ye
- San Francisco Departments of Medicine and Epidemiology and Biostatistics, University of California, 500 Parnassus Avenue, 94143-0841 San Francisco, CA USA
| | - Danielle Hessler
- San Francisco Department of Family and Community Medicine, University of California, 500 Parnassus Avenue, 94143 San Francisco, CA USA
| | - Derek Ford
- Center for Psychological and Social Health, LLC, 2918 Westover Dr, Danville, VA 24541 USA
| | - Mindy Benson
- San Francisco Department of Pediatrics, University of California, 5220 Claremont Ave, Oakland, CA 94609 USA
| | - Kadiatou Koita
- Center for Youth Wellness, 3450 3rd St, 94124 San Francisco, CA USA
| | - Monica Bucci
- Center for Youth Wellness, 3450 3rd St, 94124 San Francisco, CA USA
| | - Dayna Long
- San Francisco Department of Pediatrics, University of California, 5220 Claremont Ave, Oakland, CA 94609 USA
| | | | - Neeta Thakur
- San Francisco Departments of Medicine and Epidemiology and Biostatistics, University of California, 500 Parnassus Avenue, 94143-0841 San Francisco, CA USA
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Shayestefar M, Saffari M, Gholamhosseinzadeh R, Nobahar M, Mirmohammadkhani M, Shahcheragh SH, Khosravi Z. A qualitative quantitative mixed methods study of domestic violence against women. BMC Womens Health 2023; 23:322. [PMID: 37340321 DOI: 10.1186/s12905-023-02483-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 06/14/2023] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND Violence against women is one of the most widespread, persistent and detrimental violations of human rights in today's world, which has not been reported in most cases due to impunity, silence, stigma and shame, even in the age of social communication. Domestic violence against women harms individuals, families, and society. The objective of this study was to investigate the prevalence and experiences of domestic violence against women in Semnan. METHODS This study was conducted as mixed research (cross-sectional descriptive and phenomenological qualitative methods) to investigate domestic violence against women, and some related factors (quantitative) and experiences of such violence (qualitative) simultaneously in Semnan. In quantitative study, cluster sampling was conducted based on the areas covered by health centers from married women living in Semnan since March 2021 to March 2022 using Domestic Violence Questionnaire. Then, the obtained data were analyzed by descriptive and inferential statistics. In qualitative study by phenomenological approach and purposive sampling until data saturation, 9 women were selected who had referred to the counseling units of Semnan health centers due to domestic violence, since March 2021 to March 2022 and in-depth and semi-structured interviews were conducted. The conducted interviews were analyzed using Colaizzi's 7-step method. RESULTS In qualitative study, seven themes were found including "Facilitators", "Role failure", "Repressors", "Efforts to preserve the family", "Inappropriate solving of family conflicts", "Consequences", and "Inefficient supportive systems". In quantitative study, the variables of age, age difference and number of years of marriage had a positive and significant relationship, and the variable of the number of children had a negative and significant relationship with the total score and all fields of the questionnaire (p < 0.05). Also, increasing the level of female education and income both independently showed a significant relationship with increasing the score of violence. CONCLUSIONS Some of the variables of violence against women are known and the need for prevention and plans to take action before their occurrence is well felt. Also, supportive mechanisms with objective and taboo-breaking results should be implemented to minimize harm to women, and their children and families seriously.
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Affiliation(s)
- Mina Shayestefar
- School of Allied Medical Sciences, Semnan University of Medical Sciences, Semnan, Iran.
| | - Mohadese Saffari
- School of Allied Medical Sciences, Semnan University of Medical Sciences, Semnan, Iran
| | | | - Monir Nobahar
- Department of Nursing, Faculty of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Majid Mirmohammadkhani
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Seyed Hossein Shahcheragh
- Clinical Research Development Unit, Kowsar Educational, Research and Therapeutic Hospital, Semnan University of Medical Sciences, Semnan, Iran
| | - Zahra Khosravi
- Student Research Committee, School of Allied Medical Sciences, Semnan University of Medical Sciences, Semnan, Iran
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12
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Moreira DN, Pinto da Costa M. The role of family doctors in the management of domestic violence cases - a qualitative study in Portugal. BMC Health Serv Res 2023; 23:571. [PMID: 37268919 DOI: 10.1186/s12913-023-09501-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 05/04/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Domestic violence leads to multiple health problems in victims and their families. Family doctors are in a particularly privileged position to detect, follow up, refer and report cases of domestic violence. However, little is known about the perception of these physicians regarding their role in managing domestic violence cases. METHODS We conducted semi-structured interviews with family doctors from all regional health administrations of continental Portugal. Interviews were audio recorded, transcribed, and analysed using thematic analysis. RESULTS Fifty-four family doctors participated in this study (n = 39 women, n = 15 men). The themes and subthemes that emerged from the data analysis translated doctors' broad responsibilities when approaching victims and aggressors. These included: "Implement preventive measures", "Empower the victim leading them to recognize the violent situation", "Detect domestic violence cases", "Treat health problems related to violence", "Provide emotional support", "Refer victims to specialized services", "Register the episode on the victims and/or aggressor clinical records", "Incentivize the victim to report", "Report the case to the authorities", "Intervene with the aggressor", "Protect other individuals" and "Follow up the patient and the process". CONCLUSIONS The results of this study provide an overview of the current practical approaches being adopted by physicians and may provide a base for developing new interventions to support physicians to manage cases of domestic violence.
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Affiliation(s)
- Diana Nadine Moreira
- Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal
| | - Mariana Pinto da Costa
- Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal.
- Institute of Public Health of the University of Porto, Porto, Portugal.
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
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13
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Machado JC, Santos CS, Gomes AMT, Boery RNSDO, Rodrigues VP, Vilela ABA. Female community health agents' structure of social thinking about domestic violence against women. CIENCIA & SAUDE COLETIVA 2023; 28:1663-1673. [PMID: 37255144 DOI: 10.1590/1413-81232023286.14592022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 12/05/2022] [Indexed: 06/01/2023] Open
Abstract
This study aimed at describing community health agents' representational structure on domestic violence against women. A quantitative-qualitative research study based on the Theory of Social Representations in its structural approach and carried out in a municipality from inland Bahia, Brazil. The community health agents participated through free evocation and centrality techniques: choix-par-bloc, constitution of word pairs and mise-en-cause, from May to August 2019. Data analysis was carried out by means of the EVOC software (Ensemble of Programs Permettant I'analyse des Evocations), similarity analysis and mise-en-cause analysis. These professionals' representational structure is organized from the central elements of disrespect and sadness, which attribute negative meanings to the representation regarding their positions and repercussions; the other elements integrate specific information to the structure of the representations, justifying them. It is concluded that the understanding regarding organization of the community agents' social thinking about the phenomenon allows its problematization, as well as the elaboration of prevention and coping strategies for women in situations of violence, the aggressors and the community.
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Affiliation(s)
- Juliana Costa Machado
- Universidade Estadual do Sudoeste da Bahia. Campus de Jequié-BA, Av. José Moreira Sobrinho s/n, Jequiezinho. 45208-091 Jequié BA Brasil.
| | - Charles Souza Santos
- Universidade Estadual do Sudoeste da Bahia. Campus de Jequié-BA, Av. José Moreira Sobrinho s/n, Jequiezinho. 45208-091 Jequié BA Brasil.
| | | | | | - Vanda Palmarella Rodrigues
- Universidade Estadual do Sudoeste da Bahia. Campus de Jequié-BA, Av. José Moreira Sobrinho s/n, Jequiezinho. 45208-091 Jequié BA Brasil.
| | - Alba Benemérita Alves Vilela
- Universidade Estadual do Sudoeste da Bahia. Campus de Jequié-BA, Av. José Moreira Sobrinho s/n, Jequiezinho. 45208-091 Jequié BA Brasil.
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14
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Giezek M, Shpakou A, Zabielska P, Karakiewicz B. The Involvement in Domestic Violence and the Severity of Legal, Moral and Social Consequences for the Perpetrators in the Perceptions of Students in Poland and Belarus. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4947. [PMID: 36981855 PMCID: PMC10049266 DOI: 10.3390/ijerph20064947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/08/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
Domestic violence is sequential, developmental and dynamic. The aim of this study was to examine whether, in the perceptions of students in Poland and Belarus, there is a relationship between involvement in violence and the legal and social consequences for the perpetrators. A total of 482 university students took part in the study, including 251 students from Poland and 231 students from Belarus. Statistically, Polish respondents were more frequently involved in domestic violence as witnesses and victims, which was confirmed by χ2 test. Based on the 95% confidence interval (CI), it can be concluded that the largest number of respondents from both countries surveyed who have been involved in violence as witnesses (85.2-94.8) indicated that an adequate punishment for perpetrators of violence is imprisonment. Students who have never been involved in domestic violence indicated social consequences as appropriate punishment for the use of violence more often than those who have been involved in violence as witnesses, victims or perpetrators. Witnesses and victims were not found to be in favour of more severe punishment or more serious moral and social consequences than perpetrators. The largest number of respondents indicated that the appropriate consequence of using violence should be imprisonment, followed by a restraining order and eviction from the place of residence.
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Affiliation(s)
- Marta Giezek
- Subdepartment of Social Medicine and Public Health, Department of Social Medicine, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland
| | - Andrei Shpakou
- Department of Theory of Physical Culture and Sports Medicine, Faculty of Physical Education, Yanka Kupala State University of Grodno, 230023 Grodno, Belarus
- Department of Integrated Medical Care, Faculty of Health Sciences, Medical University of Bialystok, 15-089 Bialystok, Poland
| | - Paulina Zabielska
- Subdepartment of Social Medicine and Public Health, Department of Social Medicine, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland
| | - Beata Karakiewicz
- Subdepartment of Social Medicine and Public Health, Department of Social Medicine, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland
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15
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Heidari H, Hamidi H, Mardani-Hamooleh M. Psychosocial challenges of married women who have experienced domestic violence: a qualitative study. J Public Health (Oxf) 2023. [DOI: 10.1007/s10389-023-01837-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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16
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Intimate Partner Violence and Children: Essentials for the Pediatric Nurse Practitioner. J Pediatr Health Care 2023; 37:333-346. [PMID: 36682969 DOI: 10.1016/j.pedhc.2022.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 12/16/2022] [Accepted: 12/21/2022] [Indexed: 01/21/2023]
Abstract
Intimate partner violence (IPV) is a public health problem of epidemic proportions. IPV often starts early in adolescence and continues throughout an individual's lifespan. IPV is defined as abuse or aggression occurring in the context of a romantic relationship that is perpetrated by a current or former partner. IPV victims often experience severe psychological trauma, physical injury, and even death. The direct recipient of the violence is often not the only individual impacted. Children are often peripheral victims of IPV. It is vital that pediatric health care providers, including pediatric nurse practitioners, recognize that IPV is indeed a pediatric health care crisis requiring strategies for both identification and intervention. This continuing education article will discuss IPV and its impact on children from conception to adolescence while exploring implications for practice.
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Grzejszczak J, Gabryelska A, Gmitrowicz A, Kotlicka-Antczak M, Strzelecki D. Are Children Harmed by Being Locked up at Home? The Impact of Isolation during the COVID-19 Pandemic on the Phenomenon of Domestic Violence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13958. [PMID: 36360840 PMCID: PMC9657348 DOI: 10.3390/ijerph192113958] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 10/09/2022] [Accepted: 10/24/2022] [Indexed: 06/16/2023]
Abstract
The phenomenon of violence against children is a very complex one. There are many types of child abuse, and they are culturally dependent to a significant degree. Although studies show that children generally only suffer from mild COVID-19 infection, some social restrictions introduced during the pandemic, such as home isolation, may have many severe consequences on the population's mental health. Studies on this topic suggest that violence against children increased during lockdown due to the COVID-10 pandemic. This narrative review summarizes this available literature on the subject and discusses the different forms of violence against children, their cultural aspects, the impact of the COVID-19 pandemic on the phenomenon of violence, the long-term consequences of the above, and forms of assistance for abused minors.
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Affiliation(s)
- Jagoda Grzejszczak
- Department of Child and Adolescent Psychiatry, Medical University of Lodz, 90-151 Lodz, Poland
| | - Agata Gabryelska
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 90-151 Lodz, Poland
| | - Agnieszka Gmitrowicz
- Department of Child and Adolescent Psychiatry, Medical University of Lodz, 90-151 Lodz, Poland
| | | | - Dominik Strzelecki
- Department of Affective and Psychotic Disorders, Medical University of Lodz, 90-151 Lodz, Poland
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18
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Saboury Yazdy N, Talaei A, Ebrahimi M, Ghofrani Ivari A, Pouriran MA, Faridhosseini F, Mohaddes Ardabili H. "Be my Voice" to break social stigma against domestic violence: The underestimated role of smartphone applications in protecting victims in developing countries. Front Psychiatry 2022; 13:954602. [PMID: 35990047 PMCID: PMC9386513 DOI: 10.3389/fpsyt.2022.954602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 07/14/2022] [Indexed: 12/04/2022] Open
Affiliation(s)
- Niloofar Saboury Yazdy
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Talaei
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Ebrahimi
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Aida Ghofrani Ivari
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Amin Pouriran
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farhad Faridhosseini
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hossein Mohaddes Ardabili
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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19
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Barbara G, Collini F, Buggio L, Cattaneo C, Tiso G, Marasciuolo L, Kustermann A. An Italian single-centre retrospective analysis of 1106 consecutive cases of child and adolescent abuse: key elements of effective practices. Minerva Pediatr (Torino) 2021; 74:325-331. [PMID: 34184469 DOI: 10.23736/s2724-5276.21.06459-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Child and adolescent maltreatment refer to several forms of abuse and neglect, with negative and harmful consequences on children's and adolescents' physical and psychological health. METHODS This study aims to provide a wide perspective on child and adolescents maltreatment from a large, public, anti-violence centre located in a university hospital (SVSeD, Sexual and Domestic Violence Service) and to suggest models of tailored therapeutic interventions and proposals for effective clinical practice. RESULTS The sample study was obtained by analyzing 1106 medical records of victims aged 0 to 17 referring to SVSeD for all types of abuse. Our findings confirm that almost in one third (28,2%) of the cases children and adolescents are victims of multiple different types of violence. In our experience, sexual violence plays a leading role (66% of cases), being the most frequent type of child and adolescent abuse. CONCLUSIONS This study confirms that child and adolescent abuse could manifest in many different ways, which are often not so easily detected, as the violence usually occurs inside the family. Institutional educational programs should be implemented to increase the health practitioners' skills and competence for detecting and reporting children and adolescents who are victims of abuse.
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Affiliation(s)
- Giussy Barbara
- Gynecological Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,SVSeD (Service for Sexual and Domestic Violence), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Federica Collini
- SVSeD (Service for Sexual and Domestic Violence), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Section of Legal Medicine, Department of Biomedical and Health Sciences, University of Milan, Milan, Italy
| | - Laura Buggio
- Gynecological Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy -
| | - Cristina Cattaneo
- SVSeD (Service for Sexual and Domestic Violence), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Section of Legal Medicine, Department of Biomedical and Health Sciences, University of Milan, Milan, Italy
| | - Giulia Tiso
- SVSeD (Service for Sexual and Domestic Violence), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Laura Marasciuolo
- SVSeD (Service for Sexual and Domestic Violence), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Section of Legal Medicine, Department of Biomedical and Health Sciences, University of Milan, Milan, Italy
| | - Alessandra Kustermann
- SVSeD (Service for Sexual and Domestic Violence), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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