Women with disabilities' experience with physical and sexual abuse: review of the literature and implications for the field

The neuropsychological presentation of women with epilepsy: Clinical considerations and future directions

Objective: Cognitive, mood, and behavioral changes are common among persons with epilepsy (PWE), resulting in a complex neuropsychological presentation. Women with epilepsy (WWE) represent a distinct cohort within the broader epilepsy population due to sex and gender-specific factors impacting epilepsy semiology and treatment. However, unique neuropsychological profiles among WWE have not been established. This narrative review aims to further define neuropsychological correlates in WWE and promote meaningful discussion related to enhancing the provision of neuropsychological care within this clinical population. Method: Current literature in PWE examining differences in cognitive function, mental health, and quality of life (QoL) between women and men was critically reviewed, emphasizing considerations for neuropsychological practice. Results: WWE demonstrate a preservation of verbal learning and memory compared to men both pre- and post-surgically, with sex-based, neurobiological mechanisms likely contributing to this association. WWE also have elevated risk for affective disorder psychopathology, suicidality, and traumatic experiences. Epidemiology related to psychotic and bipolar spectrum disorders is less clear, and findings are mixed regarding sex-specific behavioral side effects of antiseizure and psychotropic medication. Finally, hormonal and obstetric factors are highlighted as important contributors to neuropsychological symptoms in WWE, with elevated risk for low QoL and increased stigma associated with greater medical and psychiatric comorbidities compared to men. Conclusions: While emerging literature has begun to characterize the neuropsychological presentation of WWE, future research is needed to define sex and gender differences in neuropsychological sequalae among PWE to ensure consistency and quality of care for WWE.

Through an Intersectional Lens: Prevalence of Violence Against Disabled Women in Iceland

Using an intersectional lens, this study analyses data from a nationally representative sample in Iceland, examining violence among marginalized groups of different social locations. The results highlight the precarious position of disabled women and show a significant increase of risk of violence with each marginalized social location women inhabit. Results illustrate how precarity and exposure increases for multiply marginalized women, demonstrating the importance of considering the social dimensions of violence. The article argues for the importance of advancing critical dialogue and research on violence, using an intersectional frame and including factors such as disability, gender, sexual orientation, and financial strain.

Experiences of gender based violence and help seeking trends among women with disabilities: an analysis of the demographic and health surveys

Women with disabilities are more likely to experience violence than women without disabilities and there is a critical gap in research regarding this topic. This study uses Demographic and Health Survey (DHS) data to analyse the association between disability and experiences of gender-based violence (GBV) and help-seeking behaviour among women in Haiti, Pakistan, Timor Leste, and Uganda. These countries were chosen because they are representative of the regions where the DHS is conducted and include questions about GBV and disability. The data was analysed based on recommendations from the Washington Group using a disability severity indicator. Logistic regression was the primary method of analysis. Generally, we found women with disabilities had the same or greater odds of experiencing GBV and had the same or lower odds of help-seeking. Given women with disabilities are at least at equal risk of experiencing GBV, it is imperative that programs be developed that are accessible to all women regardless of functional limitations. Also, additional research is needed to determine if there are differences by disability type, if intersectionality is relevant, and to include more unmarried women.

A Latent Class Analysis of Reproductive Coercion Experiences Based on Victim-Survivors' Acknowledgment and Disclosure Patterns

Reproductive coercion (RC) is a form of violence involving behavior that interferes with an individual's contraceptive and reproductive decisions. Like other forms of violence perpetrated by intimate partners, victims of RC do not necessarily identify it as such. Similarly, victim-survivors do not readily disclose their experiences or seek support and treatment. This study identifies patterns of acknowledgment and formal and informal disclosure of RC experiences in a community sample of 317 participants. Latent classes are then compared with respect to characteristics of victims/survivors, RC consequences, and associated contexts. Participants completed measures to assess experiences of RC and violence perpetuated by intimate partners as well as social support, posttraumatic stress symptoms, and consequences for psychological and sexual health. Latent class analysis was performed to identify acknowledgment and disclosure patterns. An optimal three-class solution was selected: High unacknowledgment with ambivalence, High disclosure (41%); High acknowledgment, High disclosure (30%); and Hesitant acknowledgment, No disclosure (29%). Classes were identified according to the presence of social support, living with a disability, victimization experiences, and mental and sexual health consequences. Future studies should explore the relationship between RC acknowledgment and disclosure, which can influence victims' search trajectories for support and services.

Systematic Review Overview: Violence Against Adults with Disabilities

This study aimed to conduct an overview of systematic reviews in the field of violence against adults with disability. Eight electronic databases as well as gray literature from January 2022 to April 2023 were searched to identify systematic reviews that focused on violence against adults with disabilities. A total of 13 high-quality systematic reviews were included in the overview. Findings show that adults with disabilities experience a higher rate of emotional and physical violence than the general population. Sociodemographic, financial, and cultural risk factors, prevention, and treatment approaches were discussed. Although the large body of studies on disability and violence have explored different aspects of the issue, there are some limitations and gaps in the literature that need further attention. The most important gap in the literature is the lack of attention to diversity. Accordingly, there is little knowledge about disability and violence in a variety of geographical locations. In addition, studies on violence based on ethnicity/race, age, gender identifications, and some types of disabilities such as hearing impairments or severe disabilities were scarce. There is a need to reach diverse populations of adults with disabilities, through employing a variety of data collection methods and qualitative research methodology. Prevention and treatment programs should be developed with attention to types of disability, and they should be culturally and linguistically sensitive.

Systematic review of healthcare interventions for reducing gender-based violence impact on the mental health of women with disabilities

PURPOSE

Women with disabilities are more exposed to violence. The health sector has a key role in all three levels of prevention of violence against women. The objective of this paper was to review the interventions for preventing gender-based violence and reducing its impact on the mental health of women with any form of disability.

METHOD

Relevant studies were identified through conducting searches in PubMed, Scopus, CINAHL, PsyInfo, Social Services Abstracts, and PILOTS. Two reviewers analyzed and selected studies. A qualitative synthesis was made.

RESULTS

3149 references were obtained, among which eight articles describing nine interventions from the USA and the UK. Most were intended for women with mental/intellectual disability and assessed intimate partner or sexual violence. Only one study showed high methodological quality. They were found to be particularly effective as regards improvement of the skills acquired by participants, but the results as regards improved mental health are not consistent.

CONCLUSION

Our review shows very little evidence of effective interventions. Further studies are required with higher internal validity and female sample groups with diverse disabilities.

CLINICAL RELEVANCE

Gender-based violence is a highly prevalent problem for women with disabilities, and in addition to being a public health challenge is a violation of human rights. Health care systems and policymakers should take a key role in all three levels of prevention of violence against women with disabilities. Interventions with longer follow-up times are required. It is also important for interventions to be designed in consultation with people with disabilities.

Self-reported sexual coercion among in-school young people with disabilities in Ghana

BACKGROUND

Sexual coercion is one of the major public health concerns globally. This is even more worrying among young people with disabilities (YPWDs). This study assessed the prevalence and factors associated with sexual coercion among in-school young people with disabilities in Ghana.

METHODS

Using a cross-sectional study design, pre-tested questionnaires were used to collect data from 979 YPWDs in 15 special schools for the visually and hearing impaired in Ghana. Sexual coercion was the outcome variable. Both descriptive (frequencies and percentages) and inferential analysis (binary logistic regression) were conducted.

RESULTS

About 68% reported that they had been sexually coerced at some point in their lifetime. This was higher among males (69.9%) compared to females (66.8%). Those aged 15-19 (72.19%) had the highest prevalence compared to those aged 20-24 (61.74%). YPWDs in Junior High School [JHS] [aOR = 1.722; CI = 1.227,2.417], and those in the coastal zone [aOR = 1.616; CI = 1.068,2.443] had higher odds of being coerced. However, those belonging to the Islamic religion [aOR = 0.266; CI = 0.0764,0.928] and the visually impaired [aOR = 0.477; CI = 0.318,0.716] had lower odds of being coerced compared to those with no religion, and the hearing impaired, respectively.

CONCLUSION

There is a relatively high prevalence of sexual coercion among in- school YPWDs in Ghana. This is significantly associated with level of education, ecological zone, religion, and the type of disability. This calls for a concerted effort by policy makers such as the Ghana Education Service, Ghana Federation of the Disabled, Ministry of Education, Ministry of Gender, Children and Social Protection to intensify sex education and put in pragmatic steps to halt this serious public health issue.

"He Stole My Meds to Get High:" The Mental Health and Well-Being of Women Abused by Intimate Partners and Their Disability Status

While population-based research confirms that women with disabilities abused by their intimate partners experience significant mental health issues, few studies compare this in intimate partner violence (IPV)-specific samples of women with or without disabilities and none analyze possible impacts based on disability type. This secondary mixed methods analysis examined 660 Canadian women (50.6% Indigenous, 43.1% White, and 6.1% visible minority) with respect to whether they reported having a disability that impacted their employability or daily living (291 or 44% yes; 369 or 56% said no). In the 291 women with disabilities, about one-third (30.7%) had a physical disability-only, one-quarter had a mental health disability-only, and 44.1% reported both physical and mental health disabilities. Women with mental health and both physical and mental health disabilities reported significantly more Severe Combined IPV on the Composite Abuse Scale, depression (CES-D-10; Center for Epidemiological Studies-Depression), psychological distress (Symptom Checklist Shortform-10; SCL-10; in the clinical range), PTSD symptoms (PTSD Checklist), and lower quality of life (Quality of Life Questionnaire or QoL-9) than women without disabilities. Education about disabilities is needed for IPV advocates and disability practitioners need education about IPV. Developing services specific to survivors of IPV with disabilities is recommended.

Identifying victimization clusters across people with intellectual disabilities: A latent class analysis

BACKGROUND

Research has shown high rates of victimization among people with intellectual disabilities (ID), but victimization clusters have been barely explored.

OBJECTIVE

We address the gap by examining how reported victimization experiences are grouped into different classes and identifying differences in the characteristics of the individuals in each class.

METHODS

We conducted a cross-sectional self-report study with a sample of adults with an ID diagnosis (n = 260). We gathered data about the participants' victimization experiences and socio-demographics, and then subjected the data to latent class analysis (LCA).

RESULTS

Three different classes were detected: High victimization (n = 27, 10.4 %); medium victimization, low sexual (n = 97, 37.3 %); and low victimization (n = 136, 52.3 %). The results highlight the experiences of sexual and physical victimization among the high-victimization class, in which women are overrepresented, and physical victimization among the medium-victimization class. The study also found that experiences of assault and bias attacks occur to a varying extent across all three classes. The LCA and poly-victimization methods showed substantial agreement but also differences when identifying the most victimized participants. In addition, we detected significant differences between classes in gender, type of school attended, place of residence, legal incapacity, type of support needed, secondary disability and poly-victimization status.

CONCLUSION

We identified distinct underlying ingroup patterns of victimization and sociodemographic inter-class differences that contribute to a better understanding of victimization within the population in question. The results have prevention and intervention implications for caregivers and providers of services for people with ID.

Exploring the Relationships Between Rehabilitation and Survivors of Intimate Partner Violence: A Scoping Review

Intimate partner violence (IPV) is a public health crisis affecting one in three women and one in ten men in their lifetimes. Rehabilitation professionals are highly likely to encounter survivors of IPV in their practice; yet, there exists no formal review assessing the relationship between IPV and rehabilitation. Our objective was to understand the types and contexts of rehabilitation care currently available for survivors of IPV, opportunities identified in the literature for rehabilitation care, and IPV awareness and education among rehabilitation providers. A search strategy related to IPV and four rehabilitation professionals of interest (occupational therapy, physiotherapy, speech-language pathology/therapy, and physiatry) was developed across 10 databases and complemented by a gray literature search. Two reviewers independently assessed articles for inclusion. In all, 44 articles met inclusion criteria, ranging from primary research articles (48%) to clinical newsletters. Included articles predominantly focused on opportunities for rehabilitation care (68%) and occupational therapists as a profession (68%). A minority of studies examined specific interventions for IPV survivors (18%) or assessed for knowledge and attitudes about IPV (16%) among rehabilitation professionals. To our knowledge, this is the first scoping review exploring the rehabilitation literature for IPV survivors. These findings show an awareness of IPV among rehabilitation professionals, the importance of identifying IPV in clients, and the ways in which rehabilitation professionals are uniquely situated to support survivors of IPV. There remains an opportunity to explore interventions designed specifically for IPV survivors.

A Systematic Review of Interventions Addressing the Primary Prevention of Violence Against Women With Disability

Women with disability experience significantly more violence and abuse than their nondisabled peers. Efforts to implement, evaluate, and scale-up strategies to prevent violence against women are rapidly expanding, but we know less about "what works" to prevent violence against women with disability. While secondary and tertiary prevention aim to identify violence early and prevent further occurrence, this review focuses on primary prevention. In the disability services sector, primary prevention is sometimes referred to as safeguarding and covers a range of activities that aim to address the underlying determinants of violence to prevent it from happening in the first place. The aim of this review is to identify and synthesize research on evaluated interventions addressing the primary prevention of violence against women with disability and explore evidence about their quality and effectiveness. A systematic search across the bibliographic databases of Medline, CINAHL, Embase, and PsychInfo for peer-reviewed literature published in English on or after January 1, 2010, yielded 483 papers of potential interest. Twelve studies met the inclusion criteria and were considered for review. Data were extracted and the quality of the studies was assessed using the Quality Assessment Tool for Quantitative Studies. Most studies reported outcomes from pre- and post-test research designs and received a weak rating of quality. Although interventions targeting awareness, knowledge, and skill development showed evidence of effectiveness, there is a distinct lack of program development that draws on known risk factors for violence such as the intersection of ableism and gender inequality.

Child maltreatment among deaf and hard-of-hearing adolescent students: associations with depression and anxiety

Objective

Child abuse and neglect have several short- and long-term consequences for the victim. Though Deaf and Hard-of-Hearing children are at higher risk of being maltreated as compared to hearing children, little research in Saudi Arabia has focused on this population. To determine the prevalence of child maltreatment and to examine its association with depression and anxiety among a sample of Deaf and Hard-of-Hearing students in Saudi Arabia, recruited from secondary schools in southern Saudi Arabia.

Methods

The sample included 186 Deaf and Hard-of-Hearing students aged 14-17 years (M = 15.7 years; SD = 3.41 years). Data were collected using the Child Abuse Self-Report Scale, Center for Epidemiological Studies Depression Scale for Children, and Generalized Anxiety Disorder Questionnaire. Bivariate and Linear regression analyses were conducted using SPSS 20.

Results

About 47.3% of the students were exposed severe to very severe child maltreatment. The severity of maltreatment varied based on parents' educational and income level, number of children in the family, the Deaf and Hard-of-Hearing student's gender, and parents' hearing status. Linear regression analysis indicated that child maltreatment was a significant predictor of depression and anxiety in this sample.

Conclusion

Considering the socio-demographic factors influencing the prevalence of maltreatment in the present study, it seems important to work with parents of Deaf and Hard-of-Hearing children to improve their skills in rearing a child with special needs. Addressing the social stigma and social barriers experienced by DHH individuals through familial, institutional, and community interventions may be a first step toward long-term prevention of maltreatment among DHH children.

Patterns of Sexual Harassment: An Intersectional Approach to Reported Victimization in a Campus Climate Survey of Students at Irish Higher Education Institutions

This study explores how identifying with multiple minority groups relates to sexual harassment victimization (SHV) among students in higher education institutions in Ireland (n = 6,002). Results show that gender nonconforming and female students were more likely than males to experience SHV. Bisexual or queer and gay or lesbian students were more likely than their heterosexual peers to experience SHV. Students with a physical or cognitive disability were more likely to experience SHV than those who reported no disability, and white students were more likely than minority ethnic groups to experience SHV. When controlling for sexual orientation, gender, and disability status, students who identified as both gay and lesbian and reported a cognitive disability were 8.5 times more likely to experience SHV. Victims of SHV reported having lower scores on perceived institutional support items than those who had not experienced SHV.

[Ableist obstetric violence against women with disabilities: An integrative literature review]

Women with disabilities face increased precarity throughout their lives, with one of the most affected areas being their sexual and reproductive health. The aim of this study was to identify and analyze the scientific literature on obstetric violence against women with disabilities. The search was conducted from August to October 2022 in five databases: PubMed, Web of Science, Dialnet, SciELO, and Scopus. A total of 194 articles were retrieved, and after applying selection criteria, ten articles were analyzed. Through thematic analysis, the dimension "ableist obstetric violence towards women with disabilities" emerged. Findings suggest that women with disabilities are marginalized during obstetric care, resulting in untimely attention and cascading interventions. At present, there is scarce literature addressing this phenomenon from a rights-based perspective. Urgent measures are needed to train healthcare teams on the provision of care to people with disabilities. Additionally, it is crucial to critically examine the relationship between healthcare personnel and institutions to women with disabilities within the framework of their sexual and reproductive rights.

Exploring the varied manifestations of structural violence in the lives of children on the autism spectrum and their families: a qualitative longitudinal study in Kurdistan, Iran

BACKGROUND

There are many dimensions regarding autism that are closely connected to social structures, policies, and power dynamics, silently impacting the well-being of individuals within the autism spectrum. This research aims to explore these overlooked aspects using a theoretical framework called "structural violence."

METHODS

The study was conducted in Kurdistan, Iran, and a qualitative longitudinal approach was chosen. A purposive sampling method was employed to select the participants, with 11 parents taking part. The study data comprised 29 interviews using a topic guide conducted over a span of 2 years. Thematic analysis and a matrix-based approach were utilized for data analysis. To enhance the scientific rigor of this research, four criteria, including Guba and Lincoln's principles, were implemented to ensure methodological accuracy.

RESULTS

The research findings highlight four primary forms through which structural violence impacts children on the autism spectrum and their families: access to healthcare, geographic disparities, awareness and stigma, and poverty and financial burden. Additionally, the study identified 11 subthemes related to structural violence in the context of autism and families.

CONCLUSIONS

We illustrated how structural forces create barriers to accessing adequate healthcare services, exacerbate discrimination based on ethnicity and geography, perpetuate stigma, and contribute to poverty and the inability to meet basic needs. These factors not only worsen health issues but also deepen existing disparities in healthcare access and outcomes for children on the autism spectrum and families. We emphasize the urgent need for systemic changes to address these issues. It is essential to promote public awareness, provide better access to health and support services, and address economic and political factors that contribute to these inequalities.

The Use of Chemical Control Within Coercive Controlling Intimate Partner Violence and Abuse

This paper explores the use of chemical control by perpetrators as part of coercive controlling intimate partner violence and abuse, defined as the nonconsenting use of prescribed and nonprescribed medication (including vaccines), and/or other substances to coerce or control, reducing the victim-survivor's capacity for independence, freedom, and health. Based on testimonies of 37 victims-survivors and nine domestic abuse practitioners in the UK we identify varying tactics used to chemically coerce and control, deepening our understanding about the continually changing forms of domestic violence and abuse and enhancing the potential for a more robust response through better informed policy and practice.

Partnership and Motivations for Starting a Family of One's Own in the Opinions of Students with Disabilities

Creating and maintaining stable, happy intimate relationships is a right every individual has. Previous research has shown that people with disabilities are at risk of building unsatisfactory partner relationships. The aim of the study was to ascertain the beliefs of students with disabilities concerning their motives for starting families and, in regard to potential partners, their tolerance for risky life experiences and the personal qualities accepted. A cross-sectional study was conducted with a sample of 2847 university students in southeastern Poland. It was found that the following motives for entering into a permanent relationship were considered more important by students with disabilities than they were by students without disabilities: enhancement of self-esteem (p = 0.001), high economic potential of a partner (p = 0.007) and a shared system of values and interests (p = 0.036). Love (p = 0.031) and the mental qualities (p = 0.010) of a partner were considered less important by students with disabilities than they were by students without disabilities. Moreover, students with disabilities are far more likely than students without disabilities to accept disability (p < 0.001) in potential partners. They are also significantly more willing to enter into relationships with people who have risky life experiences, even in the form of violence against previous life partners (p < 0.015) and children (p = 0.001), addiction to alcohol (p < 0.001) or drugs (p = 0.01) and the resulting treatment, and those having served time in prison (p = 0.034). Educational and institutional support for students with disabilities should be intensified with regard to partner selection being satisfactory to both partners.

Sexual Coercion and Harassment of Students with Disabilities in a Public University in Ghana

There is limited literature on sexual coercion/harassment of university students with disabilities, hence we, explored this phenomenon in Ghana, using a sequential explanatory-mixed method design that involved 119 (62 males and 57 females) students with various disabilities in the quantitative study and 12 (7 females and 5 males) students in the qualitative phase using questionnaire and interview guide for data collection respectively. We found that participants were not aware of the university's sexual coercion/harassment policy nor involved in its formulation/dissemination. Persistently asking for sexual relationships, pressurized for outings, attempted/forced kissing, being sexually looked at, engaging in uncomfortable sexual conversations, and sexually provocative touch were common. The main perpetrators of these acts included physically able people (24.4%), colleagues with disabilities (14.3%), and Lecturers/Administrative staff (10.9%). We recommend policies and programs' strengthening to protect students with disabilities from such unwarranted acts.

BARRIERS TO REPORTING AND LACK OF EQUITABLE SUPPORT: ABORTION ACCESS FOR ADULTS WITH AUTISM EXPERIENCING RAPE-RELATED PREGNANCY POST-ROE

Following the overturning of Roe v. Wade, individuals with autism experience unique barriers to accessing abortion for rape-related pregnancies in states restricting reproductive health care. Barriers to reporting rape include inadequate sex education which contributes to a lack of information about sexual violence (SV), difficulties labeling and recognizing SV, and potential difficulties navigating the role of a caregiver or conservator when reporting SV. Individuals with autism often experience a lack of equitable support from formal SV support services. Both barriers to reporting and lack of equitable support from formal SV support services reflect that individuals with autism are marginalized and often overlooked when receiving sexual and reproductive health care. Suggestions are provided for sexuality educators, SV support services, police, healthcare providers and policymakers, for better supporting individuals with autism experiencing rape-related pregnancy in states with abortion restrictions.

The Measurement of Domestic Abuse - Redeveloping the Crime Survey for England and Wales

Purpose

In 2020 the England and Wales Office for National Statistics commissioned the research reported here to review the current questions on domestic abuse in the Crime Survey for England and Wales (CSEW) and to establish how better data for policy and practice might be produced. The CSEW is a representative population survey that since the early 2000s has provided ongoing measurement of domestic abuse via a dedicated domestic abuse module, with regular publication of headline prevalence and other descriptive data. At the same time the measurement of domestic violence in the CSEW has also been the subject of ongoing debate and critique, in particular whether it is appropriate to use catch-all prevalence measures in the context of policy, practice and commissioning of services.

Method

The research included analysis of CSEW user survey data (N = 39), focus group and individual interviews with male and female victims/survivors (N = 11), consultation with core stakeholders (N = 18), and consideration of international surveys and recent legislation.

Results

Current CSEW questions do not capture domestic abuse accurately or reflect lived experience, coercive control needs to be seen at the core of domestic abuse, and while physical assault is an important part of measuring domestic abuse establishing frequency through counting events is probably impossible.

Conclusion

A fundamental rethink of the current CSEW self-completion module is required, with a wider set of questions about domestic abuse and impact. A revised module should identify and provide estimation of prevalence for different 'abuse profiles' that would complement improved headline measures and better inform policy and practice.

MeTooMS: Sexual, physical, and emotional abuse experience among women with multiple sclerosis

BACKGROUND

Sexual and physical violence against disabled individuals is widespread and linked to negative public health and social outcomes. The real-world prevalence of abuse in women with multiple sclerosis (MS) has not been well studied.

OBJECTIVES

To explore abuse prevalence in a real-world cohort of females with MS attending an academic MS Center.

METHODS

Prospective and retrospective abuse data were confidentially collected during neurology clinic visits and extracted from medical records for women attending an academic MS Center. Self-reported and provider-documented prevalence of abuse experiences were correlated with socio-economic and disease-specific factors.

RESULTS

In total, 200 women completed prospective questionnaires, and 121 non-overlapping independent health records were retrospectively reviewed. Mean age (SD) was 49.055 (11.39). Seventy-six (38%) reported lifetime abuse incidents; 15% were abused within the previous year. Intimate partners were the most likely verbal (p ⩽ 0.01)) and physical (p = 0.04) abuse perpetrators. Neurologic disability correlated with greater likelihood of verbal abuse (p = 0.021) in prospective cohort. There was no billing or encounter documentation for any form of abuse.

CONCLUSION

Intimate partner violence is common in women with MS, correlates with neurologic disability, and is underreported by the health system. Future research needs to focus on abuse detection and mitigation strategies.

Intimate partner violence, substance use, and health comorbidities among women: A narrative review

Exposure to intimate partner violence (IPV), including physical, sexual, and psychological violence, aggression, and/or stalking, impacts overall health and can have lasting mental and physical health consequences. Substance misuse is common among individuals exposed to IPV, and IPV-exposed women (IPV-EW) are at-risk for transitioning from substance misuse to substance use disorder (SUD) and demonstrate greater SUD symptom severity; this too can have lasting mental and physical health consequences. Moreover, brain injury is highly prevalent in IPV-EW and is also associated with risk of substance misuse and SUD. Substance misuse, mental health diagnoses, and brain injury, which are highly comorbid, can increase risk of revictimization. Determining the interaction between these factors on the health outcomes and quality of life of IPV-EW remains a critical need. This narrative review uses a multidisciplinary perspective to foster further discussion and research in this area by examining how substance use patterns can cloud identification of and treatment for brain injury and IPV. We draw on past research and the knowledge of our multidisciplinary team of researchers to provide recommendations to facilitate access to resources and treatment strategies and highlight intervention strategies capable of addressing the varied and complex needs of IPV-EW.

The prevalence of intimate partner violence against women with disabilities: a systematic review of the literature

PURPOSE

Although systematic reviews have already been conducted on violence and disability, the evidence is not conclusive in Intimate Partner Violence (IPV). This study examined the prevalence of IPV in women with disabilities, taking account of the different types of violence and disability.

METHODS

We performed a search in five databases. We included observational studies that analysed the frequency of IPV in women with disabilities compared to women without. Two independent reviewers selected and assessed studies. We made a qualitative synthesis according to the type of IPV analysed in relation to disability.

RESULTS

We identified 26 articles. The frequency and risk of IPV were greater in women with disabilities than in those without. All of the articles that studied financial violence, 81.3% of those that studied physical violence, 78.5% of those that studied psychological violence, 75% of those that studied physical/sexual violence, 73.3% of those that studied sexual violence and 50% of those that studied any type of violence found a significant association whit disability.

CONCLUSIONS

Women with disabilities are at higher risk of IPV. Rehabilitation centers and its professionals must have a leading role in the identification of these situations and this should be considered in IPV prevention plans.Implications for rehabilitationPeople with disabilities are at higher risk of multiple types of violence.Violence against women with disabilities therefore involves two public health issues interacting simultaneously.Rehabilitation centers and its professionals should have a leading role in the identification of IPV in women with disabilities.IPV prevention plans should consider rehabilitation centers and its professionals as a main component of interventions in women with disabilities.

Burden of and risk factors for sexual violence among women with and without disabilities in two sub-Saharan African countries

Background

Available data suggest that women with disabilities have an increased risk of sexual violence, but little is known about the situation of those women living in resource-limited settings.

Objectives

To assess the burden and examine the drivers of sexual violence among women with disabilities.

Methods

This is a pooled analysis of two population-based surveys conducted in Cameroon and Burundi. Adults with and without disabilities were randomly recruited from the general population. Structured interviews were conducted at both sites to collect data on participants’ functional limitations, life-course history of sexual violence, education, employment, and resources. Only women with disabilities whose impairments started before the age of 10 years (n = 359) and women without disabilities (n = 720) are included in this analysis. The age-adjusted prevalence of violence was computed, and risk factors were assessed using a discrete survival regression and mediation analysis.

Results

At both sites, the participants with disabilities had a lower education level and had an increased risk of food insecurity. The pooled age-adjusted prevalence of lifetime sexual violence was 19.8% (95%CI:15.3–24.3) among women with disabilities and 11.7% (95%CI:9.3–14.1) among those without disabilities (OR_ap: 2.0, 95%CI:1.4–2.8). Women with cognitive limitations and those with visual impairments had the highest risk of sexual violence (OR_ap: 3.5 (95%CI:2.0–6.3) and 2.7 (95%CI:1.4–5.0), respectively). Over the life course, the risk of sexual violence was especially high among women with disabilities who had lived with an intimate partner before the age of 25 years (p < 0.001). Education level mediated approximately one-third of the total association between disability and sexual violence (p = 0.001). There was no evidence of an indirect effect through food insecurity.

Conclusion

This study provides evidence of the high burden of sexual violence among women with disabilities who live in urban African contexts. The social environment and access to education may be key contributors to this vulnerability.

Impact of childhood maltreatment on psychosomatic outcomes among men and women with disabilities

PURPOSE

This project examined the impact of childhood maltreatment types on psychosomatic outcomes among adults with a range of self-reported disabilities.

MATERIALS AND METHODS

Participants (n = 643) were recruited using Amazon Mechanical Turk and Cloud Research. Single-item questions assessed sociodemographic information. The Childhood Trauma Questionnaire measured childhood maltreatment types (emotional, physical, and sexual abuse, and emotional and physical neglect) and the RAND-36 Item Health Survey evaluated physical functioning, pain, and energy/fatigue. Logistic regressions determined associations between childhood trauma and psychosomatic outcomes; stratified models compared men and women.

RESULTS

Multivariate-adjusted models indicated physical abuse was positively associated with poor physical functioning (OR: 2.03; 95%CI: 1.35-3.06) with this relationship being stronger for men (OR: 3.25; 95%CI: 1.42-7.43) than women (OR: 1.91; 95%CI: 1.17-3.13). Adjusted models showed that physical neglect was protective against fatigue (OR: 0.58; 95% CI: 0.36-0.94), while emotional neglect increased the risk of fatigue (OR: 1.74; 95%CI: 1.02-2.95). Lastly, physical abuse was positively associated with pain (OR: 1.53; 95%CI: 1.01-2.33). This relationship was stronger in men (OR: 4.99; 95%CI: 1.91-12.99).

CONCLUSIONS

Results improve our understanding of risk factors for poor physical health outcomes and can guide the development of trauma-sensitive rehabilitation services.Implications for RehabilitationIndividuals with disabilities who report childhood maltreatment may experience poor psychosomatic outcomes in adulthood.Consequences of experiencing childhood maltreatment may manifest differently between men and women over the course of the lifespan.It is essential to integrate trauma-informed principles into treatment plans for individuals with poor psychosomatic health.Rehabilitation professionals should screen for abuse and refer individuals to the appropriate mental and physical health services.

Interpersonal Violence Against Women With Spinal Cord Injury: Adding Insult to Injury

Background

Mounting empirical evidence suggests that, compared to women without disabilities, women with disabilities are more likely to experience interpersonal violence (IPV). However, there is extremely limited research attention on IPV against women with spinal cord injury (SCI), a particularly understudied and underserved population.

Objectives

To conduct the first known examination of lifetime IPV experience in women with SCI, to explore demographic and disability-related correlates of IPV, and to examine the health impacts of IPV.

Methods

The sample included 175 women with traumatic SCI from across the United States who enrolled in a randomized controlled trial of an online psychological health promotion intervention. The data, which included a brief measure of lifetime abuse, were collected as part of the baseline survey administered prior to randomization to the intervention or control conditions.

Results

The majority (55%) of the women described experiencing some abuse in their lifetime, with 43% reporting physical abuse, 32% reporting sexual abuse, and 23% reporting disability-related abuse. Sixteen percent of the women indicated that they had experienced all three (physical, sexual, disability) types of abuse. Few demographic and disability characteristics were related to overall lifetime IPV experience; however, disability characteristics were associated with disability-related IPV victimization. In addition, those with a history of IPV had poorer self-reported health and greater depression.

Conclusion

This study suggests that IPV is common among women with SCI. More research is needed to understand the prevalence, risk factors, and consequences of IPV against women with SCI to help inform policy and practice.

Disability and intimate partner violence: a cross-sectional study from Mwanza, Tanzania

BACKGROUND

Women with disabilities are at heightened risk of experiencing intimate partner violence [IPV], although the mechanisms through which disability acts as a risk factor for IPV are not clear.

OBJECTIVE

We analyzed cross-sectional data (n = 867) from Wave 3 of the MAISHA longitudinal study, conducted in Mwanza, Tanzania, to i) describe the levels of disability and IPV amongst women, and ii) to assess the association between level and type of disability and IPV experience.

METHODS

IPV was assessed using the WHO Multi-Country study instrument. Levels of disability (none, mild and severe) were categorized based on responses to the Washington Group Short Set questions. We fitted logistic regression models to determine the risk of experiencing each type of IPV according to disability level and type of disability.

RESULTS

We found significant associations between mild and severe disability and different types of IPV. For example, in multivariate analyses controlling for socio-demographic variables, women reporting severe disability were significantly more likely to report physical and/or sexual IPV, sexual IPV. controlling behaviors, economic IPV, and severe IPV, whereas for mild disability compared to no disability, physical and/or sexual IPV, sexual IPV, and economic IPV were significantly more likely to be reported. Cognitive disability was a significant correlate of all forms of IPV apart from physical IPV.

CONCLUSIONS

Our findings that specific types of disability and not others were associated with an elevated risk of IPV exposure indicate the need for nuanced measurement and analysis of the association between disability and IPV.

Intimate partner violence against women with intellectual disability: A relational framework for inclusive, trauma-informed social services

Women with intellectual disability experience intimate partner violence at higher rates and tend to remain in abusive relationships longer than non-disabled women. The purpose of this inquiry was to generate a preliminary set of principles and delineate domains of support as a general guide for social service workers supporting women with intellectual disability through the difficult, often stop-start process of ending an abusive relationship and creating a desired future. Taking a pragmatic inquiry approach, guiding principles and domains of support were generated through a triangulated engagement with relational theory, relevant published research, and original data gathered through interviews with five experienced social service workers. The results comprise a relational framework for inclusive, trauma-informed services aimed at fostering the relational autonomy of women with intellectual disability. Enacting relational principles of reflexivity, recognition, solidarity and safety, social service workers can support women with intellectual disability with safety planning, securing basic life needs, strengthening social relationships, acquiring new skills and nurturing self-affective attitudes of self-respect, self-efficacy and self-esteem.

Sexual Violence Against Persons With Disabilities: A Meta-Analysis

A growing number of large-scale studies suggest that people with disabilities are at greater risk of sexual victimization than nondisabled individuals. However, certain results are inconsistent and whether potential moderators explain this variability in previous findings remain to be considered. This meta-analysis aimed to determine the magnitude of the difference in risk of being sexually victimized based on the presence of a disability. An additional objective was to evaluate the relative influence of gender, age, type of disability, type of sexual violence, and relationship with the perpetrator on the association between the presence of a disability and sexual victimization. Studies were searched using pertinent databases and retained if they included a group with a disability, provided data that quantify the occurrence of abuse, indicated the type of sexual violence, and was published between 1970 and 2018 in French or English. A total of 68 studies, allowing 84 independent samples and 12,427 participants, were included. Individuals with disabilities were at significantly higher risk of sexual victimization than persons without disabilities (odds ratio = 2.27). The risk of sexual victimization among individuals with a disability was significantly higher in adult participants compared with the risk in minor participants. Sensory impairment was the type of disability associated with the highest risk of sexual victimization. Odds of sexual victimization among individuals with a disability were significantly higher in African countries compared with all others, and odds in Western Europe were significantly lower than in the United States. No significant differences emerged across eras.

Disparities in intimate partner violence among women at the intersection of disability and HIV status in South Africa: a cross-sectional study

OBJECTIVE

Previous research suggests a significant relationship between intimate partner violence (IPV) and HIV infection in women and that the risk of IPV is heightened in women with disabilities. Women with disabilities, particularly those residing in low-income and middle-income countries, may experience additional burdens that increase their vulnerability to IPV. We aimed to examine the association between having disability and HIV infection and the risk of IPV among women in South Africa.

DESIGN

Using the 2016 South Africa Demographic and Health Survey, we calculated the prevalence of IPV and conducted modified Poisson regressions to estimate the unadjusted and adjusted risk ratios of experiencing IPV by disability and HIV status.

PARTICIPANTS

Our final analytical sample included 1269 ever-partnered women aged 18-49 years, who responded to the IPV module and received HIV testing.

RESULTS

The prevalence of IPV was twice as high in women with disabilities with HIV infection compared with women without disabilities without HIV infection (21.2% vs 50.1%). Our unadjusted regression analysis showed that compared with women without disabilities without HIV infection, women with disabilities with HIV infection had almost four times higher odds (OR 3.72, 95% CI 1.27 to 10.9, p<0.05) of experiencing IPV. It appeared that women with disabilities with HIV infection experience compounded disparity. The association was compounded, with the OR for the combination of disability status and HIV status equal to or more than the sum of each of the individual ORs.

CONCLUSIONS

Women with disabilities and HIV infection are at exceptionally high risk of IPV in South Africa. Given that HIV infection and disability magnify each other's risks for IPV, targeted interventions to prevent IPV and to address the complex and varied needs of doubly marginalised populations of women with disabilities with HIV infection are critical.

Characteristics and Prevalence of Lifetime Sexual Victimization Among a Sample of Men and Women with Intellectual Disabilities

This study examines the prevalence and characteristics of sexual victimization experiences suffered by people with intellectual disabilities (ID). The sample consisted of 260 adults with an ID diagnosis (154 men and 106 women), ranging in age from 20 to 71 years (M = 41.69, SD = 12.05). The results showed that 35% of the sample had been sexually victimized at some point in their life. Being a woman, being declared legally incapable, and having comorbid mental health diagnoses were the most relevant characteristics of sexual victims with ID. Fondling was the most reported victimization, and rape showed the greatest gender differences, with a higher risk for women with ID of being raped compared to their male counterparts (odds ratio = 4.28, p < .05). The offender was generally a known male adult, and the percentage of incidents reported to the authorities was very low (7.4%). The psychological consequences of abuse were general distress, anxiety, and depressive symptomatology. Intervention and prevention programs targeting this population, as well as the training of professionals and caregivers, are essential to deal with sexual victimization and to protect and ensure the quality of life of people with ID.

Prevalence and factors associated with the occurrence of sexual violence among people with disabilities in Burkina Faso

A person with a disability regardless of the gender has an increased risk of sexual coercion and violence in various ways. This study aimed to analyze the prevalence and the risk factors associated with lifetime sexual violence among people with disabilities (PWDs) in Burkina Faso. We conducted a secondary analysis of a cross-sectional study carried out in Central, Central-East, Central-West and "Hauts Bassins" regions of Burkina Faso. PWDs were selected during a household survey through a two-stage random sampling technique. The prevalence of sexual violence in people disabilities was 7.4% (95%: CI 5.8-9.4). Females with disabilities were more likely than males with disabilities to report lifetime sexual violence (8.9% vs. 4.9%). The place where the person usually spends time and the disability duration were significantly associated with the occurrence of sexual violence among females with disability. There is no association between the other demographic characteristics and sexual violence among people with disability.

Abuse and revictimization in adulthood in multiple sclerosis: a cross-sectional study during pregnancy

Background

Knowledge concerning exposure to abuse in adulthood and in pregnancy in people with multiple sclerosis (MS) is sparse.

Objective

To determine the occurrence of adult abuse and abuse in relation to pregnancy in women with MS and their risk of revictimization (repeated abuse as adults after childhood abuse).

Methods

This cross-sectional study comprised pregnant women from the Norwegian Mother, Father and Child Cohort study. Information on abuse was acquired through self-completed questionnaires. We used logistic regression to estimate adjusted odds ratios (aORs) with 95% confidence intervals (CIs).

Results

We identified 106 women with MS at enrollment through linkage with national health registries. The reference group consisted of 77,278 women without MS. Twenty-seven women (26%) with MS reported any adult abuse compared to 15,491 women (20%) without MS, aOR 1.33 (0.85–2.09). Twenty-two (21%) women with MS reported systematic emotional abuse compared to 13% without MS, aOR 1.75 (1.08–2.83). Ten women (10%) with MS reported sexual abuse, compared to 6% without MS, aOR 1.72 (0.89–3.33). More women with MS reported rape as an adult, aOR 2.37 (1.02–5.49). Women with MS had higher risk of revictimization as adults, after childhood abuse, aOR 2.23 (1.22–4.10). The risk of abuse during pregnancy or 6 months preceding pregnancy was similar between the groups.

Conclusions

Women with MS had increased occurrence of systematic emotional abuse, rape, and revictimization as adults, compared to women without MS.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00415-022-11249-x.

Sexual Violence Against Women With Disabilities: Experiences With Force and Lifetime Risk

INTRODUCTION

Emerging research suggests that people with disabilities experience an increased risk of sexual violence. However, few studies have examined the relationship between disability types and various forms of sexual violence, involving either physical or nonphysical force.

METHODS

This cross-sectional study used nationally representative data from years 2011-2017 of the National Survey of Family Growth among women aged 18-44 years. Analyses were conducted in March 2020-June 2021. Using binary and multinomial logistic regression models, lifetime risk of sexual violence and experience of physical or nonphysical force at first intercourse were modeled as a function of disability type (sensory, physical, cognitive, or ≥2 disabilities). Models also controlled for relevant demographic confounders.

RESULTS

Women with any type of disability reported experiencing sexual violence in their lifetime approximately double the proportion of that experienced by nondisabled women (∼30% vs 16.9%), with women with multiple disabilities experiencing the greatest prevalence (42.1%) and risk (AOR=2.94, p<0.001) than nondisabled women. Women with cognitive disabilities or multiple disabilities were significantly more likely to experience either physical (cognitive: AOR=1.55, p<0.001; multiple: AOR=1.50, p<0.05) or nonphysical force (cognitive: AOR=2.28, p<0.01; multiple: AOR=2.74, p<0.001) during their first intercourse than nondisabled women.

CONCLUSIONS

Results of this study suggest that future research should focus on the association between various types of disability and sexual violence. The development of inclusive evidence-based violence intervention and prevention programs for girls and women with disabilities is recommended.

Campus Sexual Violence Victims with Disabilities: Disclosure and Help Seeking

Undergraduate students with disabilities represent an important population on college campuses. Yet the incidence of sexual violence and disclosing/reporting of sexual violence among this population is understudied. This exploratory and largely descriptive study uses an intersectional framework to understand the sexual victimization of undergraduate students with disabilities at a large Mid-Atlantic academic institution. The sample consisted of students who completed a sexual violence module (N = 2,929) as part of a larger campus climate survey. Students with disabilities comprised a smaller sample within this group (n = 177) and descriptive and chi-square results from both groups of students are reported. Students with disabilities had a statistically significant higher likelihood of sexual violence victimization before coming to campus and while at the university, with much higher rates for precollege victimization than students with no disabilities. Disclosure rates were not different for students across the two groups, though students with disabilities were more likely to utilize formal sources of support, such as campus Title IX offices and mental health services. This study shows support for a strengths-based approach that recognizes that students with disabilities may be more likely to reach out to campus resources. The findings of the study also underscore the need for culturally relevant victim services for students with disabilities. An evaluation of the culture of a university and its environment of openness, sharing, community, and protection (or lack thereof) can be a key point for future approaches to sexual violence on campus.

Prevalence and factors associated to the occurrence of sexual violence among people with disabilities in Burkina Faso

A person with a disability regardless of the gender has an increased risk of sexual coercion and violence in various ways. This study aimed to analyze the prevalence and the risk factors associated with lifetime sexual violence among people with disabilities (PWDs) in Burkina Faso. We conducted a secondary analysis of a cross-sectional study carried out in four regions (Central, Central-East, Central-West and 'Hauts Bassins' regions) of Burkina Faso. PWDs were selected during a household survey through a two-stage random sampling technique. The prevalence of sexual violence in people disabilities was 7.4% (95%: CI 5.8-9.4). Females with disabilities were more likely than males with disabilities to report lifetime sexual violence (8.9% vs 4.9%). The place where the person usually spends time and the disability duration were significantly associated with the occurrence of sexual violence among female with disability. No significant association was found between different and sexual violence among people with disabilities. Sexual violence is frequent among PWDs in Burkina Faso. Specific policy to protect PWDs particularly women with disabilities from sexual violence is urgently needed.

Applying an Ecological Framework to Factors Associated With Non-Spousal Sexual Assault Among Women in Canada

An ecological framework is useful for understanding how individual, relationship, community, and societal level factors can affect women's vulnerability to sexual assault. However, most studies have focused on examining individual and relationship factors only, due to measurement challenges and a lack of data at the societal level. The purpose of this study was to use data from a nationally representative victimization survey to identify salient predictors of sexual assaults not committed by common-law or marital partners among women across all levels of the ecological framework. Out of 16,738 female respondents, 1.9% (n = 319) experienced one or more incidents of non-spousal sexual assault in the 12 months preceding the survey. Logistic regression modeling indicated that at the individual level, statistically significant factors associated with non-spousal sexual assault included age, Indigenous status, marital status, mental disability, education, main activity, and homelessness or precarious housing. Relationship level predictors of non-spousal sexual assault were a history of child sexual abuse and witnessing violence between parents. Community level predictors were a weak sense of belonging in the local community, low likelihood that neighbors would contact police if they witnessed family violence in the respondents' home, and high likelihood that neighbors would contact police if they witnessed other criminal behavior. Societal level factors were perceptions that local police do a poor job promptly responding to calls, perceptions that local police do a poor job treating people fairly, and having experienced discrimination in the previous 5 years. The results demonstrated that community and societal level factors are critical components of an ecological framework and are important to understanding and addressing the many factors which are independently associated with vulnerability to sexual assault.

A scoping review of measurement of violence against women and disability

INTRODUCTION

Existing evidence indicates that prevalence of violence against women with disability is elevated compared to women without disability. We conducted a scoping review with a focus on measurement to assess the forms of measurement and study design utilized to explore the intersection of violence against women with disabilities, and to identify strengths and limitations in current approaches to measuring violence against women with disabilities. This scoping review is designed to inform current debates and discussions regarding how to generate evidence concerning violence against women with disabilities.

METHODS AND RESULTS

We conducted systematic searches of the following databases: PubMed, PsycINFO, Embase, CINAHL, PILOTS, ERIC, Social Work Abstracts, International Bibliography of the Social Sciences, Social Services Abstracts, ProQuest Criminal Justice, and Dissertations & Theses Global, and conducted structured searches of national statistics and surveys and grey literature available on-line. We identified 174 manuscripts or reports for inclusion. n = 113 manuscripts or reports utilized acts-specific measurement of violence. In terms of measurement of disability, we found that amongst the included manuscripts and reports, n = 75 utilized measures of functioning limitations (n = 20 of these were Washington Group questions), n = 15 utilized a single question approach and n = 67 defined participants in the research as having a disability based on a diagnosis or self-report of a health condition or impairment.

DISCUSSION

This scoping review provides a comprehensive overview of measurement of violence against women with disabilities and measurement of violence within disability-focused research. We identified several important gaps in the evidence, including lack of sex and disability disaggregation, limited evidence concerning adaptation of data collection methods to ensure accessibility of research activities for women with disabilities, and limited evidence concerning differential relationships between types of disability and violence exposure. This scoping review provides directions for sub-analyses of the included studies and further research to address gaps in evidence.

"You Should Have Known Better": The Social Ramifications of Victimization-Focused Sexual Assault Prevention Tips

Common sexual assault prevention strategies emphasize individuals' responsibility to protect themselves from victimization. Using a feminist theoretical approach, the present study was the first to assess the unintended, negative consequences that result when taking a victimization-focused approach to sexual assault prevention. Participants (N = 321) were primarily heterosexual, Caucasian undergraduate students from a Western postsecondary institution. A between-participants experimental design was employed, whereby participants were randomly assigned to one of three conditions: (a) victimization-focused prevention tips (n = 114; e.g., "Be alert and aware of your surroundings"); (b) perpetration-focused prevention tips (n = 103; e.g., "Don't slip any unwanted substances into drinks at bars or parties"); or (c) study tips for control purposes (n = 104; e.g., "Take a ten-minute break every hour"). Following prevention tip exposure, participants read a sexual assault vignette and completed measures of victim culpability and several related constructs (i.e., ambivalent sexism, belief in a just world, and rape myth acceptance). Results indicated that participants who received victimization-focused prevention tips attributed significantly more blame to the victimized woman in the vignette than participants in both the control condition and perpetration-focused condition. Based on these results, it is recommended that social institutions further evaluate the efficacy and unintended consequences of prevalent victimization-focused sexual assault prevention strategies. Specifically, institutions should consider the implications of endorsing strategies that are evidenced to enhance victim blame, thereby perpetuating rape culture. Prevention strategies that engage bystanders and seek to prevent perpetration should be considered as an alternative approach.

Physical Disability and Psychedelic Therapies: An Agenda for Inclusive Research and Practice

Over the past decade, there has been an increase in the number of clinical trials for psychedelic therapies as treatments for a wide range of psychiatric conditions. We are concerned that research organizations overseeing these trials have neglected the inclusion of individuals with physical and sensory disabilities. We suggest that psychedelic research organizations should prioritize and plan for the inclusion of individuals with physical and sensory disabilities to address the mental health burdens they confront. Not doing so risks reinforcing structural ableism in healthcare: the discriminatory manifestation of lowered expectations toward people with disabilities on the part of medical providers. Drawing on scholarship from disability studies and medical ethics, we offer four recommendations for disability inclusion in research. We recognize particular populations shoulder significant mental health burdens; these populations deserve priority and should be given a range of accommodations. We emphasize the need for extensive disability awareness training for those facilitating psychedelic therapies and encourage psychedelic researchers and therapists to exercise cultural humility toward individuals with physical and sensory disabilities. This article should be the impetus for further scholarship and debate about how psychedelic research and therapies can be made accessible to members of disability communities who might benefit.

Cumulative Contexts of Vulnerability to Intimate Partner Violence Among Women With Disabilities, Elderly Women, and Immigrant Women: Prevalence, Risk Factors, Explanatory Theories, and Prevention

Some groups of women are more vulnerable to intimate partner violence (IPV) due to particular risks and/or experiences: women with disabilities, elderly women, and immigrant women (DEI). Too often, their reality goes unnoticed, especially for those belonging to more than one of these groups. In this literature review, researchers used an intersectional approach to document the similarities and differences in how DEI women experience IPV, in terms of forms and consequences, as well as related risk factors, explanatory theories, and prevention strategies. Researchers selected 56 articles for review based on the following inclusion criteria: studies on adults living in a situation of IPV, studies on one of the three demographics under study (DEI), studies about one or multiple research questions, and studies based on empirical data relying on research methodology in either French or English. Researchers evaluated each selected article for its quality according to a chart that was specially developed for this review. The results highlight existing "intersections" between these groups to help understand the influence of belonging to more than one vulnerability group on these women's experiences with IPV. The importance to better training social workers and developing policies and programs that target the social determinants of health to prevent IPV experienced by DEI is also discussed.

College Campus Sexual Assault and Female Students With Disabilities

College campus sexual assault is well-documented as a pervasive problem among U.S. colleges and universities, with female college students at the greatest risk. Although more than 30 years of research has been dedicated to uncovering college campus sexual assault and identifying risk factors for victimization, few studies have looked at the relationship between female students with disabilities and college campus sexual assault victimization. The present study uses data from the female respondents (N = 22,828) of the American College Health Association's Fall 2016 National College Health Assessment (ACHA-NCHA) to explore the relationship between female college campus sexual assault victimization and disability status. The analysis finds that disability status produces significantly greater increased odds for sexual assault than other commonly cited risk factors such as binge drinking, drug use, or Greek affiliation. Specifically, female students with disabilities are at increased odds for any type of sexual assault compared with female students without disabilities (odds ratio [OR] = 1.96; p < .001). This increases when looking at specific types of assault. Female students with disabilities were over 100% more likely to experience completed assaults (OR = 2.34; p < .001), attempted assaults, (OR = 2.03; p < .001), and relationship assaults (OR = 2.22; p < .001) compared to female students without disabilities. Analysis also indicates differences in other significant independent variables when sexual assault status is broken down into categories of completed sexual assaults, attempted sexual assaults, and relationship sexual assaults. In addition, the types of disability showing significance vary between the different types of assault. These findings have important policy implications for campus violence prevention and intervention and suggest multiple avenues for further research.

Dialogic Feminist Gathering and the Prevention of Gender Violence in Girls With Intellectual Disabilities

Adolescent gender-based violence prevention and sexuality education is a topic of current concern given the increasing numbers of violence directed at girls. International organizations indicate that one in three girls aged 15 to 19 have experienced gender-based violence in their sexual relationships that this risk may be as much as 3-4 times higher for girls with disabilities. Following the good results obtained in the research project "Free_Teen_Desire" led by the University of Cambridge and funded by the Marie Curie Actions Program in the prevention of gender violence in adolescents through Dialogic Feminist Gatherings (DFG), the aim of study is to analyze Its transfer and impact on adolescent girls with intellectual disabilities. The DFGs are here understood as generators of a more dialogic environment for girls in general and we wonder if and how It is extended to the context of girls with disabilities. Thus, the research takes the form of a case study with a communicative approach on a DFGs. The intervention is carried out in a special school located in Valencia during the 2018-2019 and 2019-2020 academic years with a group of 19 non-mixed female students, female teachers, and the mother of one of the students. The study analyzes which are the transfer criteria to incorporate the DFGs in a special education context and what is their impact on the prevention of gender violence in girls with disabilities. The data collection techniques consist of two in-depth interviews, analysis of the field diary of 24 intervention sessions and a focus group with seven teachers. It is demonstrated that DFGs are successfully transferred to the special education context of the case study. The results show how contexts of safety, solidarity and friendship are generated which protect adolescent girls with disabilities from relationships with gender violence.

How to Discuss Sexual Health With Girls and Young Women With Spina Bifida: A Practical Guide for the Urologist

OBJECTIVE

To provide urologists with a practical guide for how to provide sexual health counseling to girls and women with spina bifida.

METHODS

The recommendations and research of several sources were synthesized to create this guidance, including clinical guidance from the Spina Bifida Association and American College of Obstetricians, the current literature on the sexual health of girls and women with spina bifida, and the multidisciplinary experience of the authors.

RESULTS

Sexual health education should be viewed by urologists as a continuous discussion, starting in early childhood and gradually building through adolescence. Developing a plan for when and how to bring it up, utilizing parents as educational partners, identifying who will provide the detailed one-on-one counseling if not the primary urologist, establishing a referral network for specialized care (eg, adolescent gynecologist, physical therapist, or sex therapist), becoming familiar with how spina bifida impacts sexual health, and being prepared for challenges are key to providing these girls and women with competent sexual health education. Urologists should also screen for abuse at each visit and be familiar with reporting and resources for when abuse is identified.

CONCLUSION

This guidance can serve to direct urologists in providing competent sexual health education to girls and women with spina bifida. This will ensure these girls and women receive the basic education they need, and that they can be referred to appropriate sexual health experts as indicated.

Experiences with traumatic events, consequences and care among people with visual impairment and post-traumatic stress disorder: a qualitative study from The Netherlands

OBJECTIVE

Having a visual impairment is known to be associated with an increased vulnerability to (potentially) traumatic events. Little is known about how people with visual impairment experience and process such events. This qualitative study aimed to provide more insight into experiences with traumatic events, consequences of traumatic events and post-traumatic stress disorder (PTSD)-related care among people with visual impairment and PTSD.

METHODS

Eighteen persons with visual impairment and (a history of) PTSD were interviewed. Among them were 14 women and 4 men aged between 23 and 66 years. Recruitment of participants was done through health professionals from two low-vision service centres and a patient association for people with eye diseases and visual impairment in The Netherlands. Interviews focused on experiences with (1) traumatic events, (2) consequences of traumatic events and (3) PTSD-related care. Thematic content analysis of interview data was performed using ATLAS.ti. The COnsolidated criteria for REporting Qualitative research (COREQ) checklist was used to check for completeness and transparency of the study. Data were collected between 2018 and 2020.

RESULTS

The most commonly reported traumatic events were sexual and physical abuse. Many participants experienced that their impairment had negatively affected their acceptance by others, independence and self-esteem, increasing their vulnerability for traumatic events. Additionally, having a visual impairment negatively impacted participants' ability to respond to situations and aggravated post-traumatic stress reactions. Existing treatments seem suitable for people with visual impairment when accommodated to the impairment.

CONCLUSIONS

Having a visual impairment may affect traumatic events and post-traumatic stress reactions, particularly by contributing to low self-esteem, problems in social interactions and a lack of visual information. Insights from this study provide starting points for adapting pretraumatic and post-traumatic care to the needs of people with visual impairment.

The development of posttraumatic stress disorder in individuals with visual impairment: a systematic search and review

PURPOSE

Posttraumatic stress disorder (PTSD) is a mental health problem with a negative impact on quality of life. Little is known about the relationship between PTSD and visual impairment. According to diagnostic criteria for PTSD, vision loss in itself is generally not considered as a traumatic event. PTSD in people with visual impairment is more likely to be the result of traumatic events, which are not directly related, or are only indirectly related to, visual impairment. The purpose of this systematic review was to describe and discuss the literature on the development of PTSD in people with visual impairment.

METHODS

A literature search in PubMed, Embase, PsycINFO and Web of Science was performed up to 15 November 2019 in collaboration with a medical information specialist. Additional search strategies included hand searches of references of retrieved papers and free-text hand searches in Google Scholar. Thematic content analysis of the extracted data was carried out in order to identify main themes and subthemes.

RESULTS

Findings from 13 articles are presented in a narrative manner along three main themes: (1) posttraumatic stress disorder; (2) traumatic events and (3) impact of traumatic events. People with visual impairments may be at higher risk of being exposed to certain potentially traumatic events. Limited/restricted access to situational information during events may contribute to the stressfulness of the experience. Furthermore, visual impairment may shape the impact of traumatic events.

CONCLUSIONS

The current evidence suggests some unique experiences and challenges for people who are visually impaired. PTSD was prevalent in this population, and prevalence rates ranged from 4% to 50%. Future research may focus on gaining insight into the extent and burden of PTSD, and exploring help-seeking behaviour and treatment needs among those with visual impairment and PTSD.

Intimate Partner Violence against Women with Disabilities in Spain: A Public Health Problem

Violence against women with disabilities is a social problem with important consequences for their physical and mental health. The World Health Organization (WHO) declared violence against women as a public health priority issue in 1996 and the fact that violence is used by the intimate partner and upon women with disabilities exacerbates the situation. Therefore, this is an issue that must be addressed from a public health viewpoint. Violence is studied from various aspects: Physical, psychological, sexual, or social control, and its multiple consequences in women's health and the use of health services. In this perspective, with the data from the VI Violence against Women Macro-survey 2019 (VWM-2019) and adjusted to Spain, this study examines the incidence of intimate partner violence and its consequences in the health of women with disabilities and its impact on health services. Using binary logistic regression, the greater vulnerability of this group to these attacks is stated and the need to address this issue to improve the health of these people is brought to light.

Violence and Disability: Experiences and Perceptions of Victimization Among Deaf People

Research on the unique experiences of deaf people is rare, and limited information exists regarding the nature and extent of violence against this population. Existing scholarship highlights the increased vulnerabilities of deaf individuals; however, there remains a paucity of research that examines how deaf and hard of hearing individuals perceive their own victimization. Also lacking is research on the experiences of deaf individuals outside of the United States, where cultural norms and the status of the deaf may be quite different. In this article, we examine the relationship between violence and disability among 60 deaf people from developing countries. Each respondent is seeking legal asylum in the United States, and their asylum depositions provide the data for analysis. Thematic analyses reveal that deaf individuals experience abuse and violence within various social institutions and draw upon social perceptions of disability to explain their negative treatment. Notably, respondents cite their status as "devalued persons" as the driving factor behind institutional and interpersonal experiences of violence and, in some cases, respondents internalize this devalued status. The results suggest social conceptualizations of disability and deafness are important to consider in the context of violence and abuse.

Measurement of violence against women and disability: protocol for a scoping review

INTRODUCTION

Violence against women is a serious threat to women's health and human rights globally. Disability has been associated with increased risk of exposure to different forms of violence, however, there are questions concerning how best to measure this association. Research on understanding the association between violence and disability among women has included incorporating short disability measures into violence against women prevalence surveys. The potential to improve understanding of interconnections between violence and disability by measuring violence within disability-focused research is underexplored. The scoping review described here focuses on three areas of measurement of violence against women and disability: (1) measurement of violence within the context of disability-focused research, (2) measurement in research focused on the intersection of disability and violence and (3) measurement of disability in the context of research focused on violence against women. Specifically, we aim to map definitions, measures and methodologies in these areas, globally.

METHODS AND ANALYSIS

For our scoping review, we will conduct searches for quantitative studies of disability-focused research which use measures of violence against women, and measures of disability in research focused on violence against women, in 11 online databases. Two authors will independently review titles and abstracts retrieved through the search strategy. We will search for grey literature, search the websites of National Statistics Offices for all countries to identify any national or subnational disability research and consult with experts for input. Data extraction will be conducted independently by one author and reviewed by another author, and data will be analysed and synthesised using a thematic synthesis approach.

ETHICS AND DISSEMINATION

Ethics approval was not sought as no primary data is being collected. Findings will be disseminated through a publication in a peer-reviewed journal, through coordinated dissemination to researchers, practitioners, data users and generators and through various working groups and networks on violence against women and disability.