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Guerschom MM, Alexandre AB, Armelle A. Individual and contextual determinants of early access to post-rape care: A retrospective cohort study of 4048 women in the Democratic Republic of Congo from 2014 to 2019. JOURNAL OF EPIDEMIOLOGY AND POPULATION HEALTH 2024; 72:202534. [PMID: 38908328 DOI: 10.1016/j.jeph.2024.202534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 04/02/2024] [Accepted: 04/03/2024] [Indexed: 06/24/2024]
Abstract
BACKGROUND Armed conflict in the eastern Democratic Republic of Congo (DRC) has significantly increased the incidence of sexual violence against women. Victims who manage to access health care within 72 h of experiencing rape can receive critical preventive care to mitigate the consequences of such violence. Despite this, a disproportionately small number of victims are able to obtain medical care within this crucial time frame. This study aimed to identify both individual and contextual factors that influence the likelihood of accessing post-rape care within 72 h in the eastern DRC. METHODS This retrospective cohort study utilized patient records from Panzi Hospital along with contextual data provided by the South Kivu Provincial Ministry of Health. It encompassed rape victims residing in South Kivu province who sought post-rape care between 2014 and 2019. To identify individual and contextual factors influencing timely access to care (within 72 h), multilevel logistic regression analysis was employed. RESULTS The study included a total of 4,048 women, with 30 % being under 18 years old and 40 % married. Around 13 % accessed care within 72 h of rape. Multivariate analysis revealed that timely access to care (within 72 h) was negatively influenced by factors such as the isolation of the victim's health zone of residence (aOR = 0.29 [0.14-0.63], p = 0.002), the distance between the home health zone and the hospital (aOR = 0.75 [0.54-0.99], p = 0.041), instances of rape occurring in 2015 or earlier (aOR = 0.44 [0.34-0.57], p < 0.001), and referrals to the hospital from other health facilities or organizations (aOR = 0.78 [0.61-1.00], p = 0.049). Conversely, being single was positively associated with access to care within this critical period (aOR = 1.29 [1.03-1.61], p = 0.024). Furthermore, statistical trends indicate that the presence of Panzi partner NGOs in the victim's health zone might facilitate access to care (aOR = 1.33 [0.99-1.80], p = 0.057), highlighting an area of interest, while being internally displaced at the time of rape was associated with a trend towards reduced access to care (aOR = 0.78 [0.59-1.02], p = 0.068), underscoring the need for further research and targeted interventions. CONCLUSION To enhance access to post-rape care, our study highlights the need for strengthened collaboration with all partnering organizations and focused efforts on raising awareness, particularly among married women and their husbands. Enhancing security measures, constructing or upgrading roads to better connect major cities with currently inaccessible or isolated areas, bolstering the efforts of both local and international NGOs, and offering comprehensive reproductive health services to internally displaced women and those residing in the victims' health zones, are crucial steps toward ensuring access to post-rape care within the critical 72-hour window.
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Affiliation(s)
- Mugisho-Munkwa Guerschom
- Demography Institute, Paris 1 Panthéon-Sorbonne University (CRIDUP), Ecole des Hautes Etudes en Démographie, France; Université Evangélique en Afrique-DRC, Bukavu, Democratic Republic of the Congo (DRC).
| | - Ali Bitenga Alexandre
- ICART Research Center, Panzi Hospital and Foundation - DRC, Bukavu, Democratic Republic of the Congo (DRC)
| | - Andro Armelle
- Demography Institute, Paris 1 Panthéon-Sorbonne University (CRIDUP), Ecole des Hautes Etudes en Démographie, France
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Turgumbayev M, Shopabayev B, Dzhansarayeva R, Izbassova A, Beaver K. An examination of associations between sexual assault and health problems, depression or suicidal ideation in a large nationally representative cohort of male and female 20-30-year-olds. CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2023; 33:196-212. [PMID: 36884372 DOI: 10.1002/cbm.2280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 02/14/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND A long line of research has examined whether being the victim of sexual assault is associated with negative and maladaptive outcomes, but has mainly focused on women and girls. AIMS To replicate and extend prior research by examining whether various measures of sexual assault are related to physical ill-health, depression and/or suicidal ideation, regardless of sex or age of victim. Our research questions were (1) is sexual assault related to health problems, depression and suicidal ideation and (2) do these associations differ between men and women? METHOD We analyse data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), a longitudinal study of a US nationally representative sample of nearly 21,000 young people recruited for the first wave of interviews when most of the participants were between ages 12 and 18 years. We used Wave 4 data, collected for participants who were in their 20s and 30s, on experience of both physical sexual assault and non-physical sexual assault and mental state, allowing for some characteristics measured in Wave 1. Allowing for missing data, sample sizes were between 6868 and 10,489 for the women and 6024 and 10,263 for the men. RESULTS Statistically significant associations were revealed between the physical and non-physical measures of sexual assault and the health problems scale, the depression scale and the measure of suicidal ideation. These associations remained statistically significant even after controlling for key covariates measured at Wave 1, including exposure to delinquent peers, poverty and demographic characteristics. CONCLUSIONS Sexual assault at some time and of whatever kind, although more commonly reported by women than men, is similarly associated with serious physical and mental health problems during their 20s and 30s. More sequencing detail is required for better prevention of harms.
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Affiliation(s)
- Marlen Turgumbayev
- Department of Criminal Law, Criminal Procedural Law and Criminalistics, Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Batir Shopabayev
- Department of Criminal Law, Criminal Procedural Law and Criminalistics, Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Rima Dzhansarayeva
- Department of Criminal Law, Criminal Procedural Law and Criminalistics, Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Assel Izbassova
- Department of Criminal Law, Criminal Procedural Law and Criminalistics, Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Kevin Beaver
- College of Criminology and Criminal Justice, Florida State University, Tallahassee, Florida, USA
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#metoo? The association between sexual violence history and parturients' gynecological health and mental well-being. Arch Gynecol Obstet 2021; 304:385-393. [PMID: 33527173 DOI: 10.1007/s00404-021-05977-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 01/19/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE Sexual violence is a global health problem. We aimed to evaluate the association between self-reported history of sexual violence and parturients' health behaviors, focusing on routine gynecological care, and mental well-being. METHODS This was a retrospective questionnaire-based study, including mothers of newborns delivered at the "Soroka" University Medical Center (SUMC). Participants were asked to complete three validated questionnaires, including: screening for sexual violence history (SES), post-traumatic stress disorder (PDS) and post-partum depression (EPDS). Additionally, a demographic, pregnancy and gynecological history data questionnaire was completed, and medical record summarized. Multiple analyses were performed, comparing background and outcome variables across the different SES severity levels. Multivariable regression models were constructed, while adjusting for confounding variables. RESULTS The study included 210 women. Of them, 26.3% (n = 57) reported unwanted sexual encounter, 23% (n = 50) reported coercion, 1.8% (n = 4) assault and attempted rape, and 1.4% (n = 3) reported rape. A significant association was found between sexual violence history and neglected gynecological care, positive EPDS screening, and reporting experiencing sexual trauma. Several multivariable regression models were constructed, to assess independent associations between sexual violence history and gynecological health-care characteristics, as well as EPDS score. Sexual violence history was found to be independently and significantly associated with a negative relationship with the gynecologist, avoidance of gynecological care, sub-optimal routine gynecological follow-up, and seeking a gynecologist for acute symptoms (adjusted OR = 0.356; 95% CI 0.169-0.749, adjusted OR = 0.369; 95% CI 0.170-0.804, adjusted OR = 2.255; 95% CI 1.187-4.283, and adjusted OR = 2.113; 95% CI 1.085-4.111, respectively), as well as with the risk of post-partum depression (adjusted OR = 4.46; 95% CI 2.03-9.81). All models adjusted for maternal age and ethnicity. CONCLUSION Sexual violence history is extremely common among post-partum women. It is independently associated with post-partum depression, neglected gynecological care, a negative relationship with the gynecologist, and with reporting of experiencing sexual trauma. Identifying populations at risk and taking active measures, may reduce distress and improve emotional well-being and family function.
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Sexual assault as a risk factor for gynaecological morbidity: An exploratory systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2020; 255:222-230. [DOI: 10.1016/j.ejogrb.2020.10.038] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 10/12/2020] [Accepted: 10/14/2020] [Indexed: 12/19/2022]
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Guha A, Luebbers S, Papalia N, Ogloff JRP. Long-term healthcare utilisation following child sex abuse: A follow-up study utilising five years of medical data. CHILD ABUSE & NEGLECT 2020; 106:104538. [PMID: 32438015 DOI: 10.1016/j.chiabu.2020.104538] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 02/22/2020] [Accepted: 05/06/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Limited attention has been paid to the long-term physical health consequences experienced by CSA survivors. Research has found that CSA is often associated with increased health burden in adulthood. However, research in this area is plagued by a range of methodological difficulties, rendering it difficult to draw conclusions regarding the health status of CSA survivors. OBJECTIVE This research sought to investigate associations between child sexual abuse (CSA) victimisation and rates of subsequent healthcare utilisation. METHOD The forensic medical records of 2759 cases of CSA between 1964 and 1995 were linked to commonwealth Australian medical data recorded between 2010 and 2015. Differences in rates of health service utilisation during this five-year period were compared between CSA victims and a age and gender matched comparison cohort without known abuse history. FINDINGS CSA was associated with increased levels of attendance at health professionals (OR = 1.51, p < .001) for medical care and for consultations related to dental (OR = 1.28, p < .001) and chronic disease (OR = 1.23, p <.001). CSA was associated with lower mean rates of attendance at gynaecologists. Gender and age at abuse significantly influenced the relationship between CSA and frequency of health service utilisation. CONCLUSIONS Experiencing CSA was associated with increases in rates of contact with health professionals. Abused females and victims abused after 12 years of age demonstrated the greatest elevations in rates of service utilisation. These findings have significance for both researchers in this field, and medical practitioners providing primary care.
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Affiliation(s)
- Ahona Guha
- Swinburne University of Technology, Australia.
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Lee CG, Kwon J, Sung H, Oh I, Kim O, Kang J, Park JW. The effect of physically or non-physically forced sexual assault on trajectories of sport participation from adolescence through young adulthood. ACTA ACUST UNITED AC 2020; 78:54. [PMID: 32537142 PMCID: PMC7288495 DOI: 10.1186/s13690-020-00435-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 05/28/2020] [Indexed: 12/02/2022]
Abstract
Background Sexual assault is one of potential factors that may greatly affect an individual’s sport participation. The purpose of this study is to investigate the effect of experiencing physically or non-physically forced sexual activity on trajectories of sport participation from adolescence to young adulthood. Methods This study used the National Longitudinal Study of Adolescent Health (Add Health) data. Group-based trajectory modeling was utilized to examine the effect of experiencing sexual assault on trajectories of sport participation from adolescence to young adulthood. Results A three-group trajectory model (high-stable group, high-decreasing group, and low-stable group) best fit sport participation among male participants and a two-group trajectory model (high-decreasing group and low-stable group) best fit sport participation among female participants. Both physically and non-physically forced sexual activity did not have significant effect on trajectories of sport participation among male participants. On the other hand, non-physically forced sexual assault significantly affected sport participation trajectory among female participants. Conclusions Special care is required in developing sport promotion program for women victims of non-physically forced sexual activity. The results of this study also suggest that group-based trajectory modeling is a useful technique to examine distinct trajectories of sport participation from adolescence through young adulthood.
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Affiliation(s)
- Chung Gun Lee
- Department of Physical Education, College of Education, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826 South Korea
| | - Junhye Kwon
- Department of Physical Education, College of Education, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826 South Korea
| | - Hojun Sung
- Department of Physical Education, College of Education, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826 South Korea
| | - Inae Oh
- Department of Physical Education, College of Education, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826 South Korea
| | - Ohsup Kim
- Department of Physical Education, College of Education, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826 South Korea
| | - Jeehyun Kang
- Department of Physical Education, College of Education, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826 South Korea
| | - Ji-Won Park
- Department of Taekwondo, College of Sports Science, Woosuk University, 443 Samnye-ro, Samnye-eup, Wanju-gun, Jeollabuk-do 55338 South Korea
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Pegram SE, Abbey A. Associations Between Sexual Assault Severity and Psychological and Physical Health Outcomes: Similarities and Differences Among African American and Caucasian Survivors. JOURNAL OF INTERPERSONAL VIOLENCE 2019; 34:4020-4040. [PMID: 27754921 PMCID: PMC7019196 DOI: 10.1177/0886260516673626] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
There are well-established associations between sexual assault victimization and deleterious psychological and physical health outcomes. The present study contributes to the emerging health disparities literature by examining similarities and differences in relationships between the severity of the sexual assault and health in a community sample of African American and Caucasian survivors. Although the overall pattern of relationships was expected to be comparable for all survivors, some associations were hypothesized to be stronger for African American survivors as compared with Caucasian survivors based on theories of chronic stress. Single, African American, and Caucasian women were recruited for a study of dating experiences through random digit dialing in one large metropolitan area. Participants who experienced a sexual assault since age 14 were included in this study (121 African American and 100 Caucasian women). Multigroup path analyses indicated that for both African American and Caucasian survivors, sexual assault severity was significantly positively associated with posttraumatic stress disorder (PTSD) symptoms, and depressive symptoms were significantly positively associated with physical health symptoms. Among African American survivors, sexual assault severity affected physical health symptoms indirectly through its impact on depressive symptoms, and assault severity indirectly affected drinking problems through its impact on PTSD symptoms; these relationships were not found for Caucasian survivors. These findings highlight the need for additional research that focuses on health disparities in sexual assault survivors' recovery process, so that treatment programs address culturally relevant issues.
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Simmons ML. Evaluating the legal assumptions of Victoria's Sex Offender Registration Act 2004 from a psychological perspective. PSYCHIATRY, PSYCHOLOGY, AND LAW : AN INTERDISCIPLINARY JOURNAL OF THE AUSTRALIAN AND NEW ZEALAND ASSOCIATION OF PSYCHIATRY, PSYCHOLOGY AND LAW 2019; 26:783-796. [PMID: 31984111 PMCID: PMC6896491 DOI: 10.1080/13218719.2019.1642254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The Sex Offender Registration Act 2004 was introduced in Victoria to decrease recidivism and aid in future investigations and prosecutions. This article reviews literature to evaluate four assumptions inherent to the Act: (a) sexual offenders are more dangerous than non-sexual offenders; (b) sexual offenders who target children are more dangerous than those who target adults; (c) recidivism risk can be accurately assessed for sexual offenders who target adults; and (d) the Act is a useful tool for investigations and prosecutions. The findings suggest that there is little evidence that supports the assumptions. Further, given the relatively narrow scope of the Act, it is unlikely to have a positive impact on the safety of the community.
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Affiliation(s)
- Melanie L. Simmons
- Centre for Forensic Behavioural Science, Swinburne University of Technology, Alphington, VIC, Australia
- Victorian Institute of Forensic Mental Health, Melbourne, VIC, Australia
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Neville HA, Oh E, Spanierman LB, Heppner MJ, Clark M. General and Culturally Specific Factors Influencing Black and White Rape Survivors' Self-Esteem. PSYCHOLOGY OF WOMEN QUARTERLY 2016. [DOI: 10.1111/j.1471-6402.2004.00125.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Grounded in a culturally inclusive ecological model of sexual assault recovery framework, the influence of personal (e.g., prior victimization), rape context (e.g., degree of injury during last assault), and postrape response factors (e.g., general and cultural attributions, rape related coping) on self-esteem of Black and White college women, who were survivors of attempted and completed rape, were examined. As predicted, Black and White women identified similar general variables (e.g., general attributions) as important in the recovery process. Black women, however, identified a cultural factor (i.e., cultural attributions) as more important in influencing their reactions to the last rape compared to their White counterparts. Using path analysis, findings from this cross-sectional study indicated that severity of the last assault and prior victimization were related to lower self-esteem indirectly through avoidance coping strategies, and victim blame attributions for the latter. Results also suggested that the link between cultural attributions and self-esteem was explained through victim blame attributions, primarily for Black participants. The model accounted for 26% of variance in self-esteem.
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Affiliation(s)
- Helen A. Neville
- Department of Educational Psychology and Afro-American Studies and Research Program, University of Illinois at Urbana-Champaign
| | - Euna Oh
- Department of Educational Psychology, University of Illinois at Urbana-Champaign
| | - Lisa B. Spanierman
- Department of Educational Psychology, University of Illinois at Urbana-Champaign
| | - Mary J. Heppner
- Department of Educational, School, and Counseling Psychology, University of Missouri-Columbia
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Sickel AE, Noll JG, Moore PJ, Putnam FW, Trickett PK. The Long-term Physical Health and Healthcare Utilization of Women Who Were Sexually Abused as Children. J Health Psychol 2016; 7:583-97. [DOI: 10.1177/1359105302007005677] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This article addresses the relationship between childhood sexual abuse and the long-term physical health and healthcare utilization of 148 female participants in an eight-year prospective study. Five factors of physical health emerged: General Health; Vegetative Health Symptoms; Colds and Flu; Gastrointestinal/Gynecological; and Healthcare Utilization. Abused females scored higher on the healthcare utilization and gastrointestinal/gynecological factors than comparison females. Abused females experiencing multiple perpetrators, violence, longer duration and older age at onset endorsed significantly more gastrointestinal/gynecological problems than did the other abused females and the comparison group. Findings suggest that: (1) sexual abuse affects long-term health outcomes and healthcare utilization; and (2) physical health sequelae of abuse may differentially affect females, depending upon the pattern of abuse characteristics.
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11
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Golding JM. Sexual-Assault History and Long-Term Physical Health Problems. CURRENT DIRECTIONS IN PSYCHOLOGICAL SCIENCE 2016. [DOI: 10.1111/1467-8721.00045] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Having a history of sexual assault is associated with both poor general health and limitations in physical functioning, as well as with specific health problems such as chronic pelvic pain, premenstrual disturbance, other gynecologic symptoms, fibromyalgia, headache, other pain syndromes, and gastrointestinal disorders. In studies evaluating the possible role of depression in these associations, depression among sexually assaulted persons did not account for their poorer health. Although there are unanswered questions in the literature on the associations between sexual assault and health, existing findings are consistent with standard criteria for inferring causal relationships from observational data. For example, many assault-health associations are supported by multiple, independent studies, and many demonstrate dose-response relationships (i.e., more incidents of sexual assault, or more severe assaults, are associated with more adverse health outcomes).
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Affiliation(s)
- Jacqueline M. Golding
- Institute for Health & Aging, University of California, San Francisco, San Francisco, California
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Millegan J, Milburn EK, LeardMann CA, Street AE, Williams D, Trone DW, Crum-Cianflone NF. Recent Sexual Trauma and Adverse Health and Occupational Outcomes Among U.S. Service Women. J Trauma Stress 2015. [PMID: 26201507 DOI: 10.1002/jts.22028] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Sexual trauma is prevalent among military women, but data on potential effects are needed. The association of sexual trauma with health and occupational outcomes was investigated using longitudinal data from the Millennium Cohort Study. Of 13,001 U.S. service women, 1,364 (10.5%) reported recent sexual harassment and 374 (2.9%) recent sexual assault. Women reporting recent sexual harassment or assault were more likely to report poorer mental health: OR = 1.96, 95% CI [1.71, 2.25], and OR = 3.45, 95% CI [2.67, 4.44], respectively. They reported poorer physical health: OR = 1.39, 95% CI [1.20, 1.62], and OR = 1.39, 95% CI [1.04, 1.85], respectively. They reported difficulties in work/activities due to emotional health: OR = 1.80, 95% CI [1.59, 2.04], and OR = 2.70, 95% CI [2.12, 3.44], respectively. They also reported difficulties with physical health: OR = 1.55, 95% CI [1.37, 1.75], and OR = 1.52 95% CI [1.20, 1.91], respectively, after adjustment for demographic, military, health, and prior sexual trauma characteristics. Recent sexual harassment was associated with demotion, OR = 1.47, 95% CI [1.12, 1.93]. Findings demonstrated that sexual trauma represents a potential threat to military operational readiness and draws attention to the importance of prevention strategies and services to reduce the burden of sexual trauma on military victims.
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Affiliation(s)
- Jeffrey Millegan
- Directorate of Mental Health, Naval Medical Center, San Diego, California, USA
| | - Emma K Milburn
- Deployment Health Research Department, Naval Health Research Center, San Diego, California, USA
| | - Cynthia A LeardMann
- Deployment Health Research Department, Naval Health Research Center, San Diego, California, USA
| | - Amy E Street
- National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Diane Williams
- Warfighter Performance Department, Naval Health Research Center, San Diego, California, USA
| | - Daniel W Trone
- Deployment Health Research Department, Naval Health Research Center, San Diego, California, USA
| | - Nancy F Crum-Cianflone
- Deployment Health Research Department, Naval Health Research Center, San Diego, California, USA
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Sachs-Ericsson N, Kendall-Tackett KA, Sheffler J, Arce D, Rushing NC, Corsentino E. The influence of prior rape on the psychological and physical health functioning of older adults. Aging Ment Health 2014; 18:717-30. [PMID: 24521090 DOI: 10.1080/13607863.2014.884538] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Older adults who have experienced traumatic events earlier in life may be especially vulnerable to additional challenges associated with aging. In a cross-sectional study of older females, the present study examines whether a history of rape is associated with current psychological and health problems. METHOD This study used existing data from the female respondents (N = 1228) in the National Social Life, Health, and Aging Project (NSHAP), a national probability sample of adults between the ages of 57 and 85 interviewed in their homes. It was determined whether or not the participant experienced forced sexual contact since the age of 18. Measures of psychological health (e.g., scales of depression, anxiety, and loneliness), the presence or absence of a number of serious health problems, and a one-item measure of self-esteem were obtained. RESULTS Adult rape occurred in 7% of the sample. On average, 36 years had elapsed since the rape had occurred. Using structural equation modeling (SEM), rape was associated with lower self-esteem, psychological, and physical health functioning. Self-esteem partially mediated the association between rape and psychological functioning, but not health functioning. These associations were significant even after controlling for participant characteristics and risky health behaviors. CONCLUSIONS Mechanisms linking prior rape to psychological and health problems in older age are discussed, as well as treatment recommendations for symptomatic older adults.
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Sánchez E, Garrido A, Alvaro JL. Un modelo psicosociológico para el estudio de la salud mental. INTERNATIONAL JOURNAL OF SOCIAL PSYCHOLOGY 2014. [DOI: 10.1174/02134740360521750] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Mont JD, White D. Barriers to the effective use of medico-legal findings in sexual assault cases worldwide. QUALITATIVE HEALTH RESEARCH 2013; 23:1228-1239. [PMID: 23935160 DOI: 10.1177/1049732313502396] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Despite the increasing implementation of standardized rape kits across jurisdictions, the medico-legal findings generated by these tools are often not related to positive criminal justice outcomes. Given that there has been no global investigation of the factors that might impede their successful use in cases of sexual assault, we conducted a review of relevant scholarly and "grey" literature from industrialized and less-developed regions. One key theme to emerge from the analysis concerned certain problematic practices and behaviors of professional groups involved in the various stages of the post-sexual assault process. We found that a lack of competence in handling sexual assault cases, contempt for women who have been victimized, and corruption among some forensic examiners, police, scientists, and legal personnel often have shaped the collection, processing, analysis, and use of medico-legal evidence. We discuss recent initiatives and future directions for research that might serve to address these issues.
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Jina R, Thomas LS. Health consequences of sexual violence against women. Best Pract Res Clin Obstet Gynaecol 2013; 27:15-26. [DOI: 10.1016/j.bpobgyn.2012.08.012] [Citation(s) in RCA: 123] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2012] [Accepted: 08/09/2012] [Indexed: 11/26/2022]
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Zinzow HM, Resnick HS, Barr SC, Danielson CK, Kilpatrick DG. Receipt of post-rape medical care in a national sample of female victims. Am J Prev Med 2012; 43:183-7. [PMID: 22813683 PMCID: PMC4084754 DOI: 10.1016/j.amepre.2012.02.025] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Revised: 01/26/2012] [Accepted: 02/29/2012] [Indexed: 11/27/2022]
Abstract
BACKGROUND It is important for rape victims to receive medical care to prevent and treat rape-related diseases and injuries, access forensic exams, and connect to needed resources. Few victims seek care, and factors associated with post-rape medical care-seeking are poorly understood. PURPOSE The current study examined prevalence and factors associated with post-rape medical care-seeking in a national sample of women who reported a most-recent or only incident of forcible rape, and drug- or alcohol-facilitated/incapacitated rape when they were aged ≥14 years. METHODS A national sample of U.S. adult women (N=3001) completed structured telephone interviews in 2006, and data for this study were analyzed in 2011. Logistic regression analyses examined demographic variables, health, rape characteristics, and post-rape concerns in relation to post-rape medical care-seeking among 445 female rape victims. RESULTS A minority of rape victims (21%) sought post-rape medical attention following the incident. In the final multivariate model, correlates of medical care included black race, rape-related injury, concerns about sexually transmitted diseases, pregnancy concerns, and reporting the incident to police. CONCLUSIONS Women who experience rapes consistent with stereotypic scenarios, acknowledge the rape, report the rape, and harbor health concerns appear to be more likely to seek post-rape medical services. Education is needed to increase rape acknowledgment, awareness of post-rape services that do not require formal reporting, and recognition of the need to treat rape-related health problems.
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Affiliation(s)
- Heidi M Zinzow
- Department of Psychology, Clemson University, South Carolina 29634, USA.
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Hart-Johnson T, Green CR. The Impact of Sexual or Physical Abuse History on Pain-Related Outcomes Among Blacks and Whites with Chronic Pain: Gender Influence. PAIN MEDICINE 2012; 13:229-42. [DOI: 10.1111/j.1526-4637.2011.01312.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Smith SG, Breiding MJ. Chronic disease and health behaviours linked to experiences of non-consensual sex among women and men. Public Health 2011; 125:653-9. [PMID: 21855097 DOI: 10.1016/j.puhe.2011.06.006] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2010] [Revised: 04/08/2011] [Accepted: 06/22/2011] [Indexed: 10/17/2022]
Abstract
OBJECTIVES Few studies have examined the association between non-consensual sex and health indicators for both women and men. The current study examined this relationship as part of a large public health survey that collected information on a range of health behaviours and health risks. METHODS The Behavioural Risk Factor Surveillance System (BRFSS) is an annual random-digit-dialled telephone survey providing surveillance of health behaviours and health risks among US adults. In 2005, an optional module on sexual violence was available for use at the discretion of each US state/territory. Over 115,000 respondents in 25 states/territories were administered the sexual violence module within the BRFSS. Logistic regression analyses were conducted from January to December 2008. RESULTS Among both women and men, previous non-consensual sex was associated with health conditions such as high cholesterol, stroke and heart disease, and risk behaviours such as human immunodeficiency virus risk factors, smoking and excessive drinking. Sexually victimized women were more likely to report having had a heart attack or heart disease than non-victims. CONCLUSIONS The experience of non-consensual sex is associated with a number of chronic disease outcomes and risk factors. The development and implementation of effective sexual violence prevention strategies may reduce the risk of chronic conditions among persons who have experienced sexual victimisation.
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Affiliation(s)
- S G Smith
- Centers for Disease Control and Prevention, Atlanta, GA, USA.
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Zimmerman C, Hossain M, Watts C. Human trafficking and health: a conceptual model to inform policy, intervention and research. Soc Sci Med 2011; 73:327-35. [PMID: 21723653 DOI: 10.1016/j.socscimed.2011.05.028] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2010] [Revised: 05/12/2011] [Accepted: 05/14/2011] [Indexed: 11/19/2022]
Abstract
Human trafficking is an international crime renowned for extreme forms of violence against women, men and children. Although trafficking-related violence has been well-documented, the health of trafficked persons has been a largely neglected topic. For people who are trafficked, health risks and consequences may begin before they are recruited into the trafficking process, continue throughout the period of exploitation and persist even after individuals are released. Policy-making, service provision and research often focus narrowly on criminal violations that occur during the period of exploitation, regularly overlooking the health implications of trafficking. Similarly, the public health sector has not yet incorporated human trafficking as a health concern. We present a conceptual model that highlights the migratory and exploitative nature of a multi-staged trafficking process, which includes: 'recruitment', travel-transit', 'exploitation' and 'integration' or 'reintegration', and for some trafficked persons, 'detention' and 're-trafficking' stages. Trafficked persons may suffer from physical, sexual and psychological harm, occupational hazards, legal restrictions and difficulties associated with being marginalised or stigmatised. Researchers and decision-makers will benefit from a theoretical approach that conceptualizes trafficking and health as a multi-staged process of cumulative harm. To address a health risk such as trafficking, which spans geographical boundaries and involves multiple sectors, including immigration and law enforcement, labour, social and health services, interventions must be coordinated between nations and across sectors to promote the protection and recovery of people who are trafficked.
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Affiliation(s)
- Cathy Zimmerman
- Social and Mathematical Epidemiology Group, Department of Global Health & Development, Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK.
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Amstadter AB, McCauley JL, Ruggiero KJ, Resnick HS, Kilpatrick DG. Self-rated health in relation to rape and mental health disorders in a national sample of women. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2011; 81:202-210. [PMID: 21486262 DOI: 10.1111/j.1939-0025.2011.01089.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Overall health status is associated with long-term physical morbidity and mortality. Existing research on the correlates of mental health effects of rape suggests that rape victims are at higher risk for poor overall health status. Little is known, however, about how different rape tactics may relate to health status in rape victims. Our aim was to examine prevalence and correlates of self-rated health in a community sample of women, with particular emphasis on lifetime rape history (distinguishing between rape tactics), psychopathology, and substance use outcomes. A nationally representative sample of 3,001 U.S. women (age range: 18-86 years) residing in households with a telephone participated in a structured telephone interview. Poor self-rated health was endorsed by 11.4% of the sample. Final multivariable models showed that poor self-rated health was associated with older age (p<.001), lower educational attainment (p=.01), African American ethnicity (p=.03), lifetime posttraumatic stress disorder (PTSD; p<.001), lifetime major depressive episode (MDE; p=.01), and history of forcible rape (p=.01). Self-rated health was associated with three potentially modifiable variables (forcible rape, PTSD, and MDE). Therefore, trauma-focused interventions for rape victims should include collaboration on treatment or prevention modules that specifically address both mental and physical health.
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Affiliation(s)
- Ananda B Amstadter
- National Crime Victims Research and Treatment Center, Medical University of South Carolina, USA.
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Zinzow HM, Amstadter AB, McCauley JL, Ruggiero KJ, Resnick HS, Kilpatrick DG. Self-rated health in relation to rape and mental health disorders in a national sample of college women. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2011; 59:588-94. [PMID: 21823953 PMCID: PMC3206265 DOI: 10.1080/07448481.2010.520175] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
OBJECTIVE The purpose of this study was to employ a multivariate approach to examine the correlates of self-rated health in a college sample of women, with particular emphasis on sexual assault history and related mental health outcomes. PARTICIPANTS A national sample of 2,000 female college students participated in a structured phone interview between January and June 2006. METHODS Interview modules assessed demographics, posttraumatic stress disorder, major depressive episode, substance use, rape experiences, and physical health. RESULTS Logistic regression analyses showed that poor self-rated health was associated with low income (odds ratio [OR] = 2.70), lifetime posttraumatic stress disorder (OR = 2.47), lifetime major depressive episode (OR = 2.56), past year illicit drug use (OR = 2.48), and multiple rape history (OR = 2.25). CONCLUSIONS These findings highlight the need for university mental health and medical service providers to assess for rape history, and to diagnose and treat related psychiatric problems in order to reduce physical morbidity.
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Affiliation(s)
- Heidi M Zinzow
- Department of Psychology, Clemson University, Clemson, South Carolina 29634, USA.
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Prevalence and correlates of poor self-rated health in the United States: the national elder mistreatment study. Am J Geriatr Psychiatry 2010; 18:615-23. [PMID: 20220579 PMCID: PMC2893408 DOI: 10.1097/jgp.0b013e3181ca7ef2] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Despite its subjective nature, self-report of health status is strongly correlated with long-term physical morbidity and mortality. Among the most reliable predictors of self-reported poor health is older age. In younger adult populations, the second reliable predictor of reported poor health is the experience of domestic and other interpersonal violence. However, very little research exits on the connection between elder mistreatment and self-reports of poor health. The aim of this study was to examine the level of, and correlates for, poor self-rated health in a community sample of older adults with particular emphasis on elder mistreatment history, demographics, and social dependency variables. DESIGN Random digit dialing telephone survey methodology. SETTING A national representative phone survey of noninstitutionalized U.S. household population. PARTICIPANTS Five thousand seven hundred seventy-seven U.S. adults, aged 60 years and older. MEASUREMENTS Individuals participated in a structured interview assessing elder mistreatment history, demographics, and social dependency variables. RESULTS Poor self-rated health was endorsed by 22.3% of the sample. Final multivariable logistic regression models showed that poor self-rated health was associated with unemployment, marital status, low income, low social support, use of social services, needing help in activities of daily living, and being bothered by emotional problems. Secondary analyses revealed a mediational role of emotional symptoms in the association between physical maltreatment and poor health. CONCLUSIONS Results suggest that poor health is common among older adults. This study also identified correlates of poor health that may be useful in identification of those in need of intervention.
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Irish L, Kobayashi I, Delahanty DL. Long-term physical health consequences of childhood sexual abuse: a meta-analytic review. J Pediatr Psychol 2009; 35:450-61. [PMID: 20022919 DOI: 10.1093/jpepsy/jsp118] [Citation(s) in RCA: 237] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE The purpose of the present article was to systematically review the literature investigating the long-term physical health consequences of childhood sexual abuse (CSA). METHODS Literature searches yielded 31 studies comparing individuals with and without a history of CSA on six health outcomes: general health, gastrointestinal (GI) health, gynecologic or reproductive health, pain, cardiopulmonary symptoms, and obesity. Exploratory subgroup analyses were conducted to identify potential methodological moderators. RESULTS Results suggested that a history of CSA was associated with small to moderate group differences on almost all health outcomes assessed, such that individuals with a history of CSA reported more complaints for each health outcome. Suggestive trends in moderating variables of study design and methodology are presented. CONCLUSIONS Results highlight the long-term physical health consequences of CSA and identify potential moderators to aid in the design of future research.
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Affiliation(s)
- Leah Irish
- Department of Psychology, 118 Kent Hall, Kent State University, Kent, OH 44242, USA
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Humphreys J, Lee KA. Interpersonal violence is associated with depression and chronic physical health problems in midlife women. Issues Ment Health Nurs 2009; 30:206-13. [PMID: 19363725 DOI: 10.1080/01612840802498136] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This research describes interpersonal violence (IPV) exposure in a community-based sample of midlife women from three ethnic groups and explores relationships among these exposures and variables associated with health outcomes. IPV, physical health, depression, and social support were measured by self-report questionnaires. More than 33% reported a history of physical abuse or sexual abuse and at least 20% reported both. Approximately 20% experienced sexual harassment in the past year. IPV exposure was associated with more chronic health problems and depressive symptoms. IPV, whenever it occurs, is detrimental to women's health regardless of socioeconomic status or ethnicity.
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Affiliation(s)
- Janice Humphreys
- Department of Family Health Care Nursing, University of California, San Francisco, California 94143-0606, USA.
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Baker CK, Norris FH, Jones EC, Murphy AD. Childhood trauma and adulthood physical health in Mexico. J Behav Med 2009; 32:255-69. [PMID: 19184392 DOI: 10.1007/s10865-009-9199-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2008] [Accepted: 01/05/2009] [Indexed: 10/21/2022]
Abstract
BACKGROUND The present study examined the effect of childhood trauma on adulthood physical health among a randomly selected sample of adults (N = 2,177) in urban Mexico. METHODS Adults were interviewed about their experiences of trauma, post-traumatic stress disorder, depression, and physical health symptoms using Module K of the Composite International Diagnostic Interview, the Center for Epidemiologic Studies Depression Scale, and the Physical Symptoms Checklist. RESULTS Trauma was prevalent, with 35% reporting a traumatic event in childhood. In general, men reported more childhood trauma than women, with the exception of childhood sexual violence where women reported more exposure. For men, childhood sexual violence was related to total and all physical health symptom subscales. For women, childhood sexual violence was related to total, muscular-skeletal, and gastrointestinal-urinary symptoms; hazards/accidents in childhood were related to total, muscular-skeletal, cardio-pulmonary, and nose-throat symptom subscales. Depression mediated the relationship between childhood sexual violence and physical health symptoms for men and women. Among women only, PTSD mediated the relationship between childhood sexual violence and total, muscular-skeletal, and gastrointestinal-urinary symptoms. PTSD also mediated the relationship between hazards/accidents in childhood and total, muscular-skeletal, cardio-pulmonary, and nose-throat symptoms. CONCLUSION These findings can be used to increase awareness among general practitioners, as well as community stakeholders, about the prevalence of childhood trauma in Mexican communities and its impact on subsequent physical health outcomes. With this awareness, screening practices could be developed to identify those with trauma histories in order to increase positive health outcomes among trauma survivors.
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Affiliation(s)
- Charlene K Baker
- Department of Psychology, University of Hawaii, 2430 Campus Road, Gartley 110, Honolulu, HI 96822, USA.
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Sundaram V, Laursen B, Helweg-Larsen K. Is sexual victimization gender specific?: the prevalence of forced sexual activity among men and women in denmark, and self-reported well-being among survivors. JOURNAL OF INTERPERSONAL VIOLENCE 2008; 23:1414-1440. [PMID: 18349345 DOI: 10.1177/0886260508314305] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The present study investigates the prevalence of sexual victimization and correlations between sexual victimization and indicators of poor health in two representative samples of men and women in Denmark. Specifically, the authors explore the prevalence of self-reported victimization among adolescents (N = 5,829) and adults (N = 3,932) and analyze differences in self-reported health outcomes between male and female victims and corresponding controls. Gender differences are found in the reported prevalence of sexual victimization. Significantly more females than males reported forced sexual experiences in both samples. Associations between sexual victimization and poor health outcomes are found for both genders. Comparable patterns of association for men and women are found on a number of variables, particularly those pertaining to risk behavior.
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Suris A, Lind L. Military sexual trauma: a review of prevalence and associated health consequences in veterans. TRAUMA, VIOLENCE & ABUSE 2008; 9:250-269. [PMID: 18936282 DOI: 10.1177/1524838008324419] [Citation(s) in RCA: 222] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
This article reviews the literature documenting the prevalence of military sexual trauma (MST) and its associated mental and physical health consequences. Existing research indicates that prevalence rates of MST vary depending on method of assessment, definition of MST used, and type of sample. Risk factors for MST have been identified as including age, enlisted rank, negative home life, and previous assault history. MST has been associated with increased screening rates of depression and alcohol abuse, in addition to significantly increased odds of meeting criteria for post-traumatic stress disorder. In addition, MST has been associated with reporting increased number of current physical symptoms, impaired health status, and more chronic health problems in veterans. Available research on health care utilization and MST is also discussed. Researchers are encouraged to utilize standardized definitions of MST, employ standardized assessment methodology, and utilize more male veterans in future research. Policy and practice implications are discussed.
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Affiliation(s)
- Alina Suris
- Department of Veterans Affairs, North Texas Health Care System, Dallas, USA
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Knapik GP, Martsolf DS, Draucker CB. Being delivered: spirituality in survivors of sexual violence. Issues Ment Health Nurs 2008; 29:335-50. [PMID: 18382913 PMCID: PMC3155866 DOI: 10.1080/01612840801904274] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
A theoretical framework explaining how survivors of sexual violence use spirituality to respond to or recover from sexual violence is presented. Data were drawn from open-ended interviews of 27 women and 23 men who participated in a larger, ongoing study of women's and men's responses to sexual violence. Grounded theory methodology was used to develop the core category of Being Delivered, reflecting the participants' experiences of being rescued, saved, or set free from the effects of sexual violence by a spiritual being or power. The theoretical framework describing Being Delivered is composed of three dimensions: Spiritual Connection, Spiritual Journey, and Spiritual Transformation. The framework can be used by clinicians to guide discussions of spirituality and healing with survivors of sexual violence.
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Psychological outcomes and measurement of maternal posttraumatic stress disorder during the perinatal period. J Perinat Neonatal Nurs 2008; 22:49-59. [PMID: 18287902 DOI: 10.1097/01.jpn.0000311875.38452.26] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
For many parents, labor, delivery, and/or the perinatal and neonatal periods present significant stressors that result in clinically significant parental feelings of psychological distress or trauma. This review article identifies known preexisting risk, and protective, factors for such distress, focusing on individual variables and familial or other social support networks. Research describing the full range of possible psychological reactions is also presented, loosely categorized as representing psychological outcomes of resiliency or growth, externalized distress, and internalized distress. These outcomes are viewed as neither linear nor mutually exclusive, and specific implications for each outcome are presented. The primary focus of this review is on the most well understood internalizing distress outcome during the perinatal period, maternal posttraumatic stress reactions. The utility of a brief, freely available measure quantifying such distress is also overviewed, including standards for its usage. Healthcare and particularly nursing staff are encouraged to attend to the range of possible psychological outcomes that may emerge during the perinatal period, identifying distressed mothers, so that they may be referred for care. The review concludes by presenting recommended future directions for research regarding the measurement of posttraumatic stress disorder in parents.
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Walsh CA, Jamieson E, Macmillan H, Boyle M. Child abuse and chronic pain in a community survey of women. JOURNAL OF INTERPERSONAL VIOLENCE 2007; 22:1536-1554. [PMID: 17993640 DOI: 10.1177/0886260507306484] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
This study examined the relationship between a self-reported history of child physical and sexual abuse and chronic pain among women (N = 3,381) in a provincewide community sample. Chronic pain was significantly associated with physical abuse, education, and age of the respondents and was unrelated to child sexual abuse alone or in combination with physical abuse, mental disorder (anxiety, depression, or substance abuse), or low income. Number of health problems and mental health disorders did not mediate the relationship between physical abuse and chronic pain. Despite considerable evidence from the clinical literature linking exposure to child maltreatment and chronic pain in adulthood, this may well be the first population-based study to investigate this relationship for child physical and sexual abuse independently. The significant association between childhood history of physical abuse and pain in adulthood calls for a greater awareness of the potential for chronic pain problems associated with this type of maltreatment. Further research is needed to understand the mechanism for this complex relationship.
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Hu JC, Link CL, McNaughton-Collins M, Barry MJ, McKinlay JB. The association of abuse and symptoms suggestive of chronic prostatitis/chronic pelvic pain syndrome: results from the Boston Area Community Health survey. J Gen Intern Med 2007; 22:1532-7. [PMID: 17763912 PMCID: PMC2219794 DOI: 10.1007/s11606-007-0341-y] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2006] [Revised: 05/03/2007] [Accepted: 08/09/2007] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To determine the effect of reported sexual, physical, or emotional abuse on the symptoms suggestive of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and to determine the effect of race/ethnicity on these patterns. METHODS The Boston Area Community Health (BACH) survey used a multi-stage stratified cluster sample to randomly sample 5,506 adults aged 30-79 from the city of Boston. BACH recruited 2,301 men (700 Black, 766 Hispanic, and 835 White). Interviewers administered questions approximating the National Institutes of Health chronic prostatitis symptom index (CPSI), and symptoms suggestive of CP/CPPS were measured by the definition of perineal and/or ejaculatory pain and CPSI pain score of 4+. Questions about previous abuse were obtained from a validated self-administered questionnaire during the home visit. Logistic regression was used to determine the effect of abuse on the likelihood of a man having symptoms suggestive of CP/CPPS. RESULTS The prevalence of symptoms suggestive of CP/CPPS was 6.5%. Men who reported having experienced sexual, physical, or emotional abuse had increased odds (1.7-3.3) for symptoms suggestive of CP/CPPS. Previous abuse increased both the pain and urinary scores from the CPSI. CONCLUSION Symptoms suggestive of CP/CPPS are not uncommon in a community-based population of men. For men presenting with symptoms suggestive of CP/CPPS, clinicians may wish to consider screening for abuse.
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Affiliation(s)
- Jim C. Hu
- Division of Urologic Surgery, Brigham and Women’s Hospital, Boston, MA USA
| | | | | | - Michael J. Barry
- General Medicine Division, Massachusetts General Hospital, Boston, MA USA
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Elnashar AM, El-Dien Ibrahim M, Eldesoky MM, Aly OM, El-Sayd Mohamed Hassan M. Sexual abuse experienced by married Egyptian women. Int J Gynaecol Obstet 2007; 99:216-20. [PMID: 17888926 DOI: 10.1016/j.ijgo.2007.05.049] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2007] [Revised: 05/20/2007] [Accepted: 05/24/2007] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess the prevalence of sexual abuse (SA) and associated factors among married women in Lower Egypt. METHODS A cross-sectional clinic- and hospital-based survey was designed for married women aged between 16 and 49 years. The study was conducted with 936 women from the Dakahlia Governorate, which is considered representative of Lower Egypt. Data were collected by personal interview using a questionnaire. RESULTS The response rate was 93.6%. The most commonly reported frequency of sexual intercourse was 2 to 4 times per week. More than one-third of the women (36.2%) thought this was too frequent, and 11.5% reported being sexually abused in addition to other sexual problems. The educational level of the women; the presence of genital mutilation; parity, especially for those who had more than 5 deliveries; number of gynecologic visits; and history of gynecologic interventions were significantly or highly significantly associated with SA. The husbands' educational level and age were highly significantly correlated with their wives reporting SA, particularly when the men were illiterate or were smokers or drug users. CONCLUSION The study's findings demonstrate an immediate need for the prevention of SA in Lower Egypt.
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Surìs A, Lind L, Kashner TM, Borman PD. Mental health, quality of life, and health functioning in women veterans: differential outcomes associated with military and civilian sexual assault. JOURNAL OF INTERPERSONAL VIOLENCE 2007; 22:179-97. [PMID: 17202575 DOI: 10.1177/0886260506295347] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
The present study examined psychiatric, physical, and quality-of-life functioning in a sample of 270 women veterans receiving outpatient treatment at a Veterans Affairs medical center. Participants were interviewed regarding their civilian (CSA) and military sexual assault (MSA) histories, and data regarding quality of life and health outcomes were obtained through structured interviews and questionnaires. Women veterans with CSA histories reported significantly poorer physical, psychiatric, and quality-of-life functioning compared to those without a history of sexual assault. Furthermore, women veterans with an MSA history demonstrated additional negative consequences above and beyond the effects of CSA. The study sample was comparable to a national random sample of women veterans who access care in the Veterans Affairs healthcare system, increasing the generalizibility of the results.
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Affiliation(s)
- Alina Surìs
- North Texas Health Care System, Dallas, TX, USA
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Renck B. Psychological stress reactions of women in Sweden who have been assaulted: Acute response and four-month follow-up. Nurs Outlook 2006; 54:312-9. [PMID: 17142149 DOI: 10.1016/j.outlook.2006.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2005] [Indexed: 10/23/2022]
Abstract
Violence is a global health problem. Women in particular are likely to be targets of violent behavior. This study investigated the reactions of female victims to an individual act of interpersonal violence. A sample of 68 assaulted women registered as injured parties in 2 police districts were assessed for symptoms of acute stress disorder (ASD) and post-traumatic stress disorder (PTSD) at 3 weeks and after 4 months. Risk factors for developing psychological distress in the long-term were explored. High rates of ASD symptoms and distress measured with Post Traumatic Symptom Scale (PTSS-10), Impact of Event Scale (IES), and General Health Questionnaire (GHQ-20) were reported by the women in the acute phase. Four months post-assault, the high rates of stress reactions measured with PTSS-10, IES, and GHQ-20 were significantly reduced, but not for all the women. Dissatisfaction with one's previous life, previous mental health problems, post-assault life events and earlier abuse were risk factors for 4 months post-assault stress reactions.
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Affiliation(s)
- Barbro Renck
- Department of Public Health Sciences, Karlstad University, SE-651 88 Karlstad, Sweden.
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Lang AJ, Laffaye C, Satz LE, McQuaid JR, Malcarne VL, Dresselhaus TR, Stein MB. Relationships among childhood maltreatment, PTSD, and health in female veterans in primary care. CHILD ABUSE & NEGLECT 2006; 30:1281-92. [PMID: 17116330 DOI: 10.1016/j.chiabu.2006.06.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2003] [Revised: 05/25/2006] [Accepted: 06/17/2006] [Indexed: 05/12/2023]
Abstract
OBJECTIVE Women with histories of childhood maltreatment (CM) have higher rates of physical health problems and greater medical utilization compared to women without abuse histories. This study examined whether current post-traumatic stress disorder (PTSD) symptoms mediate the relationship between CM and indicators of physical health and medical utilization in female veterans. METHOD Respondents were 221 female veterans (56% of the potential sample), who received medical care from the San Diego VA Healthcare System during a 12-month period. Respondents provided self-report information about CM, PTSD symptoms, use of pain medication, and physical symptoms and functioning. Additional information about medical utilization was extracted from respondents' medical charts. Regression-based models were conducted to test whether PTSD symptoms mediate the relationships between CM and physical symptoms and between CM and medical utilization. RESULTS Emotional abuse was associated with poorer role-physical functioning, increased bodily pain and greater odds of using pain medication in the past 6 months. Physical abuse was associated with poorer general health. Contrary to prediction, emotional neglect was associated with better role-physical functioning, and CM was not associated with increased healthcare utilization. PTSD was shown to mediate the relationship between emotional and physical abuse and health outcomes. CONCLUSIONS PTSD, or psychopathology more generally, appears to be an important factor in the negative health impact of CM. Given that several empirically supported interventions are available for PTSD, there may be physical health benefits in early identification and treatment of psychopathology related to CM.
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Affiliation(s)
- Ariel J Lang
- VA San Diego Healthcare System, 8810 Rio San Diego Drive (MC116A4Z), San Diego, CA 92108, USA
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Lown EA, Schmidt LA, Wiley J. Interpersonal violence among women seeking welfare: unraveling lives. Am J Public Health 2006; 96:1409-15. [PMID: 16809602 PMCID: PMC1522097 DOI: 10.2105/ajph.2004.057786] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Exposure to violence is a widespread problem among women who receive welfare benefits. Research has focused on partner violence among women with children on Temporary Assistance for Needy Families (TANF), ignoring low-income women without dependent children who are eligible for General Assistance (GA). METHODS We report findings from a survey of 1235 women seeking TANF (N=1095) and GA (N=140) throughout a California county. RESULTS Estimates of recent physical, sexual, and severe violence were high in both populations. However, the highest rates occurred among women without children seeking GA, suggesting that they are at higher risk for sexual violence and more severe forms of physical violence, especially from intimate partners. This increased risk is partly accounted for by the co-occurrence of other serious health and social problems. In multivariate analyses, past-year violence was associated with substance use (adjusted odds ratio [AOR]=2.0, 95% confidence interval [CI] = 1.5, 2.9), recent homelessness (AOR = 1.9, 95% CI = 1.4, 2.6), family fragmentation including divorce or separation (AOR=3.1, 95% CI 1.8, 5.2), or foster care involvement (AOR=2.2, 95% CI=1.1, 4.5) CONCLUSIONS Welfare reform created TANF programs to address domestic violence. Women seeking GA may need similar services because of the high prevalence of violence.
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Affiliation(s)
- E Anne Lown
- Alcohol Research Group, Berkeley, CA 94709, USA.
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The influence of child abuse on the pattern of expenditures in women's adult health service utilization in Ontario, Canada. Soc Sci Med 2006; 63:1711-9. [PMID: 16793185 DOI: 10.1016/j.socscimed.2006.04.015] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2005] [Indexed: 10/24/2022]
Abstract
Childhood maltreatment is a common and serious problem for women, particularly in relation to impairment in adulthood. To our knowledge, no system-wide study has addressed the influence of childhood maltreatment on the cost of these women's adult health service utilization. This paper examines this relationship. The 1990 Ontario Health Survey (OHS) gathered information regarding determinants of physical health status and the use of health services. The 1991 Ontario Mental Health Supplement (OHSUP) examined a variety of childhood experiences as well as the prevalence of psychiatric disorders from a sample of OHS respondents. These were province-wide population health surveys of a probability-based sample of persons aged 15 years and older living in household dwellings in Ontario. The OHSUP randomly selected one member from each participating OHS household to be interviewed regarding personal experiences and mental health. This analysis used data from women aged 15-64 who participated in both the OHS and OHSUP. Self-reported health service utilization was collected in four groups of women--those who reported no history of child abuse, those with a history of physical abuse only, those who reported sexual abuse only, and those who reported both physical and sexual (combined) abuse. We hypothesized that a history of child abuse would result in greater adult health care costs. The results indicated that having a history of combined abuse nearly doubles mean annual ambulatory self-reported health care costs to 775 dollars (95% CI 504 dollars-1045 dollars) compared to a mean cost of 400 dollars with no abuse (95% CI 357 dollars-443 dollars). Median annual ambulatory self-reported health care costs were also increased in the combined abuse group, to 314 dollars (95% CI 220 dollars-429 dollars), compared to 138 dollars (95% CI 132 dollars-169 dollars) in those with no abuse. We conclude that child abuse in women is significantly associated with increased adult self-reported health care costs.
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Tonmyr L, Jamieson E, Mery LS, MacMillan HL. The relationship between childhood adverse experiences and disability due to physical health problems in a community sample of women. Women Health 2006; 41:23-35. [PMID: 16260412 DOI: 10.1300/j013v41n04_02] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The goal of this study was to examine the association of physical and sexual abuse in childhood, poverty, parental substance abuse problems and parental psychiatric problems with disability due to physical health problems in a community sample of women. We included 4,243 women aged 15-64 years from the Ontario Mental Health Supplement in the analysis. The associations were tested by multiple logistic regression. Ten percent of women had a disability due to physical health problems. Among women with a disability, approximately 40% had been abused while growing up. After controlling for income and age, disability showed the strongest association with childhood physical abuse, parental education less than high school and parental psychiatric disorder. The association with child sexual abuse was not significant. Given the high correlation between abuse and disability due to physical health problems, it is important to investigate approaches to identify women who are at increased risk of subsequent impairment.
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Affiliation(s)
- Lil Tonmyr
- Department of Sociology and Anthropology, Carleton University, Ottawa, Canada.
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Campbell R, Lichty LF, Sturza M, Raja S. Gynecological health impact of sexual assault. Res Nurs Health 2006; 29:399-413. [PMID: 16977640 DOI: 10.1002/nur.20155] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
We examined the relationship between sexual assault and gynecological health symptoms (e.g., pelvic pain, painful intercourse) in a sample of predominately African American female veterans. Those who had been sexually victimized experienced significantly more frequent gynecological health symptoms than those who had not been assaulted. Multiple forced penetrations, assault by an intimate partner, having weapons used, physical injury, belief that the victim's life was in danger during the assault, and serving in the military at the time of assault increased the likelihood of reporting particular gynecological health symptoms. Screening women in health care settings for a history of violence can link women to resources and treatment for assault-related health symptoms.
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Affiliation(s)
- Rebecca Campbell
- Michigan State University, East Lansing, Michigan 48824-1116, USA
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Abstract
OBJECTIVE Lifetime history of sexual abuse is estimated to range between 15% and 25% in the general female population. People who are sexually abused are at greater risk for a whole host of physical health disorders that may occur many years after the abusive incident(s). Despite the high prevalence of this trauma and its association with poor health status, abuse history often remains hidden within the context of medical care. The aims of this review are to determine which specific health disorders have been associated with sexual abuse in both women and men, to outline the types of sexual abuse associated with the worst health outcome, to discuss some possible explanations and mediators of the abuse/health relationship, to discuss when and how to talk about abuse within a clinical setting, and to present evidence for which psychological treatments have been shown to improve the mental health of patients with past sexual abuse. METHOD To meet these objectives, we have reviewed a wide literature on the topic of sexual abuse. RESULTS We demonstrate that abuse appears to be related to greater likelihood of headache and gastrointestinal, gynecologic, and panic-related symptoms; that the poor health effects associated with abuse are also seen in men; that abuse involving penetration and multiple incidents appears to be the most harmful, and that exposure-type therapies with and without cognitive behavioral therapy hold promise for those with abuse history. CONCLUSION We need more research examining psychological treatments that might be efficacious in treating the physical health problems associated with sexual abuse history.
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Affiliation(s)
- Jane Leserman
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7160, USA.
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Leserman J, Whetten K, Lowe K, Stangl D, Swartz MS, Thielman NM. How trauma, recent stressful events, and PTSD affect functional health status and health utilization in HIV-infected patients in the south. Psychosom Med 2005; 67:500-7. [PMID: 15911916 DOI: 10.1097/01.psy.0000160459.78182.d9] [Citation(s) in RCA: 143] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE In addition to biological markers of human immunodeficiency virus (HIV) disease progression, physical functioning, and utilization of health care may also be important indicators of health status in HIV-infected patients. There is insufficient understanding of the psychosocial predictors of health-related physical functioning and use of health services among those with this chronic disease. Therefore, the current study examines how trauma, severe stressful events, posttraumatic stress disorder (PTSD), and depressive symptoms are related to physical functioning and health utilization in HIV-infected men and women living in rural areas of the South. METHODS We consecutively sampled patients from 8 rural HIV clinics in 5 southern states, obtaining 611 completed interviews. RESULTS We found that patients with more lifetime trauma, stressful events, and PTSD symptoms reported more bodily pain, and poorer physical, role, and cognitive functioning. Trauma, recent stressful events, and PTSD explained from 12% to 27% of the variance in health-related functioning, over and above that explained by demographic variables. In addition, patients with more trauma, including sexual and physical abuse, and PTSD symptoms were at greater risk for having bed disability, an overnight hospitalization, an emergency room visit, and four or more HIV outpatient clinic visits in the previous 9 months. Patients with a history of abuse had about twice the risk of spending 5 or more days in bed, having an overnight hospital stay, and visiting the emergency room, compared with those without abuse. The effects of trauma and stress were not explained by CD4 lymphocyte count or HIV viral load; however, these effects appear to be largely accounted for by increases in current PTSD symptoms. CONCLUSION These findings highlight the importance of addressing past trauma, stress, and current PTSD within clinical HIV care.
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Affiliation(s)
- Jane Leserman
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7160, USA.
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Abstract
OBJECTIVE To estimates rates and correlates of disclosure of date/acquaintance rape or attempted rape and verbally coercive sex among a diverse sample of adolescent and young adult females. DESIGN Secondary data analysis of cross sectional data. SETTING Urban adolescent healthcare facility. PARTICIPANTS Adolescents who were identified as having experienced rape/attempted rape (n = 86) or verbally coerced sex (n = 68) in the last 12 months from study examining sexual violence. MAIN OUTCOME MEASURES Disclosure of forced sex (logistic regression) and the timing of disclosure (survival analysis). INTERVENTIONS None. RESULTS Almost 60% of victims who experienced rape/attempted rape disclosed this information to one or more individuals, whereas only 47% of those who experienced verbally coerced sex told another person. Multivariate analyses found that drinking by the partner (AOR = 4.6) and shorter dating history (AOR = 6.3) were associated with disclosure of rape/attempted rape; timing of this disclosure was facilitated by Caucasian ethnicity (RR = 3.5), having a dating partner who drank > or = 1 drinks (RR = 2.5), and the perpetrator being someone other than the victim's boyfriend or partner (RR = 2.5). With regards to verbally coerced sex, reporting no pressure to use alcohol (AOR = 10.7) was the only factor associated with disclosure. No significant predictors of timing to disclosure were detected for this type of victimization. CONCLUSIONS Perpetrator's alcohol use and a shorter dating history are important variables associated with disclosure of rape/attempted rape as well as timing to disclosure. Factors affecting the disclosure of verbally coerced sex and the latency associated with disclosure are less well defined.
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Affiliation(s)
- Vaughn I Rickert
- Center for Community Health and Education, Mailman School of Public Health at Columbia University, New York, NY 10032, USA.
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Sachs-Ericsson N, Blazer D, Plant EA, Arnow B. Childhood Sexual and Physical Abuse and the 1-Year Prevalence of Medical Problems in the National Comorbidity Survey. Health Psychol 2005; 24:32-40. [PMID: 15631560 DOI: 10.1037/0278-6133.24.1.32] [Citation(s) in RCA: 120] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In a population sample (N=5,877; ages 15 to 54), the authors found childhood sexual and physical abuse to be associated with the 1-year prevalence of serious health problems for both men and women. The authors also found that participants' psychiatric disorders partially mediated the effects of physical and sexual abuse on adult health. However, childhood abuse continued to independently influence health status after the authors controlled for psychiatric disorders. Contrary to expectations, individuals who experienced a combination of sexual and physical abuse did not have a higher frequency of health problems than those who experienced either type of abuse alone. Implications for these findings are discussed, including possible mechanisms that may account for the association between childhood abuse and adult health problems.
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Chang BH, Skinner KM, Zhou C, Kazis LE. The relationship between sexual assault, religiosity, and mental health among male veterans. Int J Psychiatry Med 2004; 33:223-39. [PMID: 15089005 DOI: 10.2190/nm3d-ewyr-4b59-dfm8] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVES We examine the association between sexual assault, religion and mental health among male veterans. METHODS We used longitudinal data collected from 2,427 male veterans who received VA outpatient care. Sexual assault was self-reported in the questionnaire. Two dimensions of religiosity were used: organizational (frequency of religious service attendance) and subjective religiosity (the extent that religious beliefs are a source of strength or comfort). Mental health was measured by the mental component summary from the Veterans SF-36 and depression was measured by the Center for Epidemiologic Studies-Depression scale. A regression model that uses the generalized estimating equation approach for longitudinal repeated data analysis was used. RESULTS Based on the baseline data, 96 (4%) patients reported ever experiencing sexual assault. These patients have significantly lower levels of mental health status and higher levels of depression (p < .001). The regression results show that this decrement in mental health and increment in depression associated with sexual assault are in lesser degrees for patients who attended religious service more frequently compared to those who never did (p < .05). Similarly, there is a smaller magnitude of increment in depression associated with sexual assault for those who have a higher level of subjective religiosity (p < .05). CONCLUSIONS Although the prevalence of self reported sexual assault is low among male veterans, those who reported sexual assault experiences had lower levels of mental health status and higher levels of depression. Further, religion attenuates this association which highlights the important role religion might have in coping with this stressful life event.
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Affiliation(s)
- Bei-Hung Chang
- Center for Health Quality, Outcomes, and Economic Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, Massachusetts 01730, USA.
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Woods SJ, Wineman NM. Trauma, posttraumatic stress disorder symptom clusters, and physical health symptoms in postabused women. Arch Psychiatr Nurs 2004; 18:26-34. [PMID: 14986288 DOI: 10.1053/j.apnu.2003.11.005] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The purpose of this retrospective, descriptive-correlational research was to examine the relationships between violent and nonviolent trauma, posttraumatic stress disorder (PTSD) and its symptom clusters of avoidance, intrusive/re-experiencing, and hyperarousal, and self-reported physical health symptoms in 50 postabused women. Results indicated: (1) PTSD hyperarousal and avoidance symptom clusters were positively associated with physical health symptoms, and (2) childhood physical abuse accounted for a significant and unique portion of the variance in physical health symptoms. The results highlight the need for health care practitioners in all settings to assess for a history of trauma in a woman's life.
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Dyb G, Holen A, Steinberg AM, Rodriguez N, Pynoos RS. Alleged sexual abuse at a day care center: impact on parents. CHILD ABUSE & NEGLECT 2003; 27:939-950. [PMID: 12951142 DOI: 10.1016/s0145-2134(03)00141-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
OBJECTIVE This report describes the cascade of stressful events and secondary life changes experienced by parents in a case of alleged sexual abuse at a day care program. The study evaluated parents' Posttraumatic Stress Disorder (PTSD) symptoms and general psychological responses to the stressful events 4 years after the alleged abuse, and explored predictive factors of parental distress. METHODS A total of 39 parents were interviewed about stressful events, life changes, and social support. Current distress reactions, psychological wellbeing, and locus of control were assessed with a battery of standardized measures. RESULTS Hearing about the sexual abuse, testifying in court, hearing the verdict, and being exposed in media reports were all rated by the parents as distressing events. The majority of the parents experienced secondary life changes after the alleged sexual abuse. Four years after the alleged sexual abuse, one-third of the parents reported a high level of PTSD Intrusive symptoms and one-fourth reported a high level of PTSD Avoidance symptoms. There was a significant positive correlation between a measure of psychological wellbeing and PTSD. Secondary life changes and locus of control significantly predicted PTSD. CONCLUSION This study demonstrates that the alleged sexual abuse of children in day care and the resulting events in the legal system and the media constitute significant and chronic stressors in the lives of the children's parents. These findings underscore the need to expand the focus of trauma-related sequelae from the child victim to their parents and family.
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Affiliation(s)
- Grete Dyb
- Department of Psychiatry and Behavioural Medicine, Faculty of Medicine, Norwegian University of Science and Technology, MTFS, NO-7489 Trondheim, Norway
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Kerimova J, Posner SF, Brown YT, Hillis S, Meikle S, Duerr A. High prevalence of self-reported forced sexual intercourse among internally displaced women in Azerbaijan. Am J Public Health 2003; 93:1067-70. [PMID: 12835181 PMCID: PMC1447905 DOI: 10.2105/ajph.93.7.1067] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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