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BEATVIC, a body-oriented resilience therapy for individuals with psychosis: Short term results of a multi-center RCT. PLoS One 2022; 17:e0279185. [PMID: 36542671 PMCID: PMC9770373 DOI: 10.1371/journal.pone.0279185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Individuals with a psychotic disorder are at an increased risk of victimization, but evidenced-based interventions are lacking. AIMS A body-oriented resilience therapy ('BEATVIC') aimed at preventing victimization was developed and its effectiveness was assessed in a multicenter randomized controlled trial. METHODS 105 people with a psychotic disorder were recruited from six mental health centers. Participants were randomly allocated to 20 BEATVIC group sessions (n = 53) or befriending group sessions (n = 52). Short term effects on risk factors for victimization (e.g. social cognitive deficits, inadequate interpersonal behavior, low self-esteem, internalized stigma, aggression regulation problems), physical fitness and secondary outcomes were expected. At six-month follow-up, the effect on victimization (either a 50% reduction or an absence of victimization incidents) was examined. RESULTS Intervention-dropout was 28.30% for BEATVIC and 39.62% for befriending. In both conditions the majority of participants (60.5% BEATVIC vs 62.9% befriending) showed a reduction or absence of victimization incidents at six months follow-up, which was not significantly different according to condition. Multilevel analyses revealed no main effect of time and no significant time x group interaction on other outcome measures. Per protocol analyses (participants attending ≥ 75% of the sessions) did not change these results. CONCLUSIONS Although a reduction or absence of victimization was found at short term follow-up for the majority of participants, BEATVIC was not more effective than the active control condition. No short-term additional effects on risk factors of victimization were found. Analysis of the data at 2-year follow-up is warranted to investigate possible effects in the long-term. TRIAL REGISTRATION NUMBER Current Controlled Trials: ISRCTN21423535.
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Gender differences in characteristics of violent and sexual victimization in patients with psychosis: a cross-sectional study. BMC Psychiatry 2021; 21:541. [PMID: 34724909 PMCID: PMC8559367 DOI: 10.1186/s12888-021-03558-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 10/19/2021] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Various studies have demonstrated that individuals with a psychotic disorder are at an increased risk of becoming a victim of crime. Little is known about gender differences in victimization types and in specific characteristics of victimization (e.g., perpetrator, location or disclosure). Knowledge on characteristics of victimization would provide clinicians with more insight which may be especially useful for tailoring interventions. The aim of this study is to examine gender differences in characteristics of violent and sexual victimization in patients with a psychotic disorder. METHODS Information on violent (threats, physical abuse) and sexual victimization (harassment, assault) was assessed in 482 individuals with a psychotic disorder who received mental health care. Patients were recruited through a routine outcome monitoring study and a clinical trial. RESULTS Men reported more threats with violence (20.7% vs. 10.5%, x2 = 7.68, p = 0.01), whereas women reported more sexual assault (13.3% vs. 3.6%, x2 = 15.43, p < 0.001). For violent victimization, women were more likely than men to be victimized by a partner, friend or family member (52.9% vs. 30.6%) as opposed to a stranger (11.8% vs. 40.3%; O.R. = 52.49) and to be victimized at home (60.0% vs. 29.3%) as opposed to on the street or elsewhere (40.0% vs. 70.3%; O.R. = 0.06). For sexual victimization, there was no difference in location and perpetrator between men and women. For sexual victimization and physical violence, no differences in disclosure were found, but women were more likely not to disclose threats with violence or to disclose threats to a professional or police (52.9% vs. 45.2%; O.R. = 30.33). All analyses were controlled for age, diagnosis and employment. DISCUSSION Gender patterns of victimization types and characteristics are similar for individuals with a psychotic disorder in comparison to the general population. Men were at higher risk of violent victimization, whereas women were at higher risk for sexual victimization. Men were more likely to become victimized in the streets or elsewhere by a stranger, whereas women seemed to be more often victimized at home by a partner, friend or a family member. Future studies may tailor interventions preventing victimization in psychosis according to gender.
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van der Stouwe ECD, Pijnenborg GHM, Opmeer EM, de Vries B, Marsman JBC, Aleman A, van Busschbach JT. Neural changes following a body-oriented resilience therapy with elements of kickboxing for individuals with a psychotic disorder: a randomized controlled trial. Eur Arch Psychiatry Clin Neurosci 2021; 271:355-366. [PMID: 31980899 PMCID: PMC7960594 DOI: 10.1007/s00406-020-01097-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 01/13/2020] [Indexed: 11/27/2022]
Abstract
Individuals with a psychotic disorder are at an increased risk of becoming the victim of a crime. A body-oriented resilience therapy (BEATVIC) aimed at preventing victimization by addressing putatively underlying factors was developed. One of these factors is social cognition, particularly facial affect processing. The current study investigated neural effects of BEATVIC on facial affect processing using two face processing tasks. Participants were randomized to either BEATVIC or a 'Befriending' control group. Twenty-seven patients completed an Emotional Faces task and the Wall of Faces task during fMRI, pre- and post-intervention. General linear model analyses yielded no differences between groups over time. Independent component analyses revealed increased activation of the salience network to angry and fearful faces in BEATVIC compared to Befriending. Increased activation of the salience network may suggest an increased alertness for potentially dangerous faces.
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Affiliation(s)
- Elisabeth C D van der Stouwe
- University of Groningen, University Medical Center Groningen, University Center of Psychiatry, Rob Giel Onderzoekcentrum, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
- Department of Neuroscience, Cognitive Neuroscience Center, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 2, 9713 AW, Groningen, The Netherlands.
| | - Gerdina H M Pijnenborg
- Department of Clinical Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
- Department of Psychotic Disorders, GGZ-Drenthe, Dennenweg 9, 9404 LA, Assen, The Netherlands
| | - Esther M Opmeer
- Department of Neuroscience, Cognitive Neuroscience Center, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 2, 9713 AW, Groningen, The Netherlands
- Department of Health and Social Work, Windesheim University of Applied Sciences, Campus 2-6, 8017 CA, Zwolle, The Netherlands
| | - Bertine de Vries
- Department of Clinical Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| | - Jan-Bernard C Marsman
- Department of Neuroscience, Cognitive Neuroscience Center, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 2, 9713 AW, Groningen, The Netherlands
| | - André Aleman
- Department of Neuroscience, Cognitive Neuroscience Center, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 2, 9713 AW, Groningen, The Netherlands
- Department of Clinical Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| | - Jooske T van Busschbach
- University of Groningen, University Medical Center Groningen, University Center of Psychiatry, Rob Giel Onderzoekcentrum, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
- Department of Movement and Education, Windesheim University of Applied Sciences, Campus 2-6, 8017 CA, Zwolle, The Netherlands
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Neural correlates of victimization in psychosis: differences in brain response to angry faces. NPJ SCHIZOPHRENIA 2019; 5:14. [PMID: 31501442 PMCID: PMC6733807 DOI: 10.1038/s41537-019-0082-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 08/02/2019] [Indexed: 11/24/2022]
Abstract
Individuals with psychosis are at an increased risk of victimization. Processing of facial expressions has been suggested to be associated with victimization in this patient group. Especially processing of angry expressions may be relevant in the context of victimization. Therefore, differences in brain activation and connectivity between victimized and nonvictimized patients during processing of angry faces were investigated. Thirty-nine patients, of whom nineteen had experienced threats, assaults, or sexual violence in the past 5 years, underwent fMRI scanning, during which they viewed angry and neutral facial expressions. Using general linear model (GLM) analyses, generalized psychophysiological (gPPI) analysis and independent component analyses (ICA) differences in brain activation and connectivity between groups in response to angry faces were investigated. Whereas differences in regional brain activation GLM and gPPI analyses yielded no differences between groups, ICA revealed more deactivation of the sensorimotor network in victimized participants. Deactivation of the sensorimotor network in response to angry faces in victimized patients, might indicate a freeze reaction to threatening stimuli, previously observed in traumatized individuals.
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de Vries B, Pijnenborg GHM, van der Stouwe ECD, Visser E, de Jong S, Bartels-Velthuis AA, Bruggeman R, Castelein S, Jörg F, Veling W, Aleman A, van Busschbach JT. "Please tell me what happened": A descriptive study on prevalence, disclosure and characteristics of victimization in people with a psychotic disorder. PLoS One 2019; 14:e0219056. [PMID: 31318903 PMCID: PMC6638995 DOI: 10.1371/journal.pone.0219056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 06/16/2019] [Indexed: 11/18/2022] Open
Abstract
Introduction Although people with a psychotic disorder are approximately four to six times more often victimized than the general population, victimization is not routinely assessed in mental healthcare. This study investigates prevalence, context and risk factors of victimization in patients with a psychotic disorder in the Northern, relatively rural region of the Netherlands. Moreover, disclosure rates and awareness of psychiatrists are examined. Method Information on personal crime (threats, assaults and sexual violence), property and other forms of crime, the context of victimization and disclosure was routinely assessed in 353 patients with a psychotic disorder who received care at a mental health facility. In addition, involved psychiatrists reported on last year’s victimization incidents in their patients. Results One third of the patients reported victimization in the previous year. More than half of the crimes were committed by someone acquainted and took place in the victim’s own home or a place familiar to the victim. Younger age, having a comorbid disorder, drug use and perpetration of a crime were all positively associated with victimization. Approximately half of the reported personal crimes were disclosed to a health care professional but only in 16% of the cases the involved psychiatrist report to know about the incident. Conclusion This study confirms that people with a history of psychosis have an increased risk of becoming the victim of a crime. Although our results suggest that in fifty percent of cases the patients did share the information with professionals, a substantial proportion of incidents appear to go still unnoticed.
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Affiliation(s)
- Bertine de Vries
- University of Groningen, Department of Clinical Psychology, Groningen, the Netherlands
- * E-mail:
| | - Gerdina H. M. Pijnenborg
- University of Groningen, Department of Clinical Psychology, Groningen, the Netherlands
- GGZ Drenthe, Department of Psychotic Disorders, Assen, the Netherlands
| | - Elisabeth C. D. van der Stouwe
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Groningen, the Netherlands
- University of Groningen, University Medical Center Groningen, Department of Neuroscience, Groningen, the Netherlands
| | - Ellen Visser
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Groningen, the Netherlands
| | - Steven de Jong
- Lentis Psychiatric Institute, Groningen, the Netherlands
| | | | - Agna A. Bartels-Velthuis
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Groningen, the Netherlands
- Lentis Psychiatric Institute, Groningen, the Netherlands
| | - Richard Bruggeman
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Groningen, the Netherlands
| | - Stynke Castelein
- University of Groningen, Department of Clinical Psychology, Groningen, the Netherlands
- Lentis Psychiatric Institute, Groningen, the Netherlands
| | - Frederike Jörg
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Groningen, the Netherlands
- GGZ Friesland Mental Health Institution, Leeuwarden, the Netherlands
| | - Wim Veling
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Psychosis Department, Groningen, the Netherlands
| | - André Aleman
- University of Groningen, Department of Clinical Psychology, Groningen, the Netherlands
- University of Groningen, University Medical Center Groningen, Department of Neuroscience, Groningen, the Netherlands
| | - Jooske T. van Busschbach
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Groningen, the Netherlands
- Windesheim University of Applied Sciences, Department of Human Movement and Education, Zwolle, the Netherlands
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de Vries B, van Busschbach JT, van der Stouwe ECD, Aleman A, van Dijk JJM, Lysaker PH, Arends J, Nijman SA, Pijnenborg GHM. Prevalence Rate and Risk Factors of Victimization in Adult Patients With a Psychotic Disorder: A Systematic Review and Meta-analysis. Schizophr Bull 2019; 45:114-126. [PMID: 29547958 PMCID: PMC6293237 DOI: 10.1093/schbul/sby020] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Psychotic disorders often have been linked with violence. However, studies have shown that people with a psychotic disorder are more often victim than perpetrator of violence. The objective of this meta-analysis was to review prevalence rates for different types of victimization and to identify risk factors associated with victimization. Based on a search in MEDLINE, PsycINFO, and Web of Science, 27 studies were found with samples consisting of adults with a psychotic disorder and possible victimization occurring during adulthood and data on "violent victimization," "sexual victimization," "non-violent victimization," and/or "victimization not otherwise specified." The median prevalence rate for violent victimization was 20%, for sexual victimization 20%, nonviolent victimization 19%, and for victimization not otherwise specified 19%. Victimization rates were approximately 4-6 times higher than in the general community. Meta-analyses showed the following significant risk factors: delusion (OR = 1.69), hallucinations (OR = 1.70), manic symptoms (OR = 1.66), drugs (OR = 1.90) or alcohol abuse (OR = 2.05), perpetration of a crime (OR = 4.33), unemployment (OR = 1.31), and homelessness (OR = 2.49). Other risk factors like previous victimization, impaired social functioning, personality disorder, and living in a disadvantaged neighborhood were found only in 1 or 2 studies. Based on the results, we conclude that, depending on the examined time period, 1 in 5 (assessment period ≤3 y) or 1 in 3 (assessment period entire adulthood) people with a psychotic disorder was victim of a crime. Clinical, behavioral, and sociodemographic factors were significantly associated with victimization, as well as previous victimization. Prospective research into risk factors is needed to capture causal trajectories of victimization.
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Affiliation(s)
- Bertine de Vries
- Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, the Netherlands
- To whom correspondence should be addressed; Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands; tel: 503-637-779, e-mail:
| | - Jooske T van Busschbach
- University Medical Center Groningen, University Center of Psychiatry, University of Groningen, Groningen, the Netherlands
- Department of Movement and Education, Windesheim University of Applied Sciences, Zwolle, the Netherlands
| | - Elisabeth C D van der Stouwe
- University Medical Center Groningen, University Center of Psychiatry, University of Groningen, Groningen, the Netherlands
- Department of Neuroscience, BCN Neuroimaging Center, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - André Aleman
- Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, the Netherlands
- Department of Neuroscience, BCN Neuroimaging Center, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Jan J M van Dijk
- International Victimology Institute INTERVICT, Tilburg University, Tilburg, the Netherlands
| | - Paul H Lysaker
- Roudebush VA Medical Center, Indianapolis, IN
- Indiana University School of Medicine, Indianapolis, IN
| | - Johan Arends
- Department of Psychotic Disorders, GGZ Drenthe, Assen, the Netherlands
| | - Saskia A Nijman
- University Medical Center Groningen, University Center of Psychiatry, University of Groningen, Groningen, the Netherlands
- Department of Psychotic Disorders, GGZ Drenthe, Assen, the Netherlands
| | - Gerdina H M Pijnenborg
- Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, the Netherlands
- Department of Psychotic Disorders, GGZ Drenthe, Assen, the Netherlands
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BEATVIC, a body-oriented resilience therapy using kickboxing exercises for people with a psychotic disorder: a feasibility study. BMC Psychiatry 2018; 18:384. [PMID: 30537937 PMCID: PMC6288949 DOI: 10.1186/s12888-018-1958-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 11/16/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND People with a psychotic disorder have an increased risk of becoming the victim of a crime. To prevent victimization a body-oriented resilience therapy using kickboxing exercises was developed. This study aims to explore the feasibility of the therapy, to improve the therapy protocol and to explore suitable outcomes for a RCT. METHODS Twenty-four adults with a psychotic disorder received 20 weekly group sessions in which potential risk factors for victimization and strategies for dealing with them were addressed. Sessions were evaluated weekly. During pre and post assessment participants completed questionnaires on, among other, victimization, aggression regulation and social functioning. RESULTS The short recruitment period indicates the interest in such an intervention and the willingness of clients to participate. Mean attendance was 85.3 and 88% of the participants completed fifteen or more sessions. The therapy protocol was assessed as adequate and exercises as relevant with some small improvements to be made. The victimization and aggression regulation questionnaires were found to be suitable outcome measurements for a subsequent RCT. CONCLUSION The results support the feasibility of the BEATVIC therapy. Participants subjectively evaluated the intervention as helpful in their attempt to gain more self-esteem and assertiveness. With some minor changes in the protocol the effects of BEATVIC can be tested in a RCT. TRIAL REGISTRATION The trial registration number (TRN) is 35949 (date submitted 09/11/2018). Retrospectively registered.
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Christ C, de Waal MM, van Schaik DJF, Kikkert MJ, Blankers M, Bockting CLH, Beekman ATF, Dekker JJM. Prevention of violent revictimization in depressed patients with an add-on internet-based emotion regulation training (iERT): study protocol for a multicenter randomized controlled trial. BMC Psychiatry 2018; 18:29. [PMID: 29394919 PMCID: PMC5797346 DOI: 10.1186/s12888-018-1612-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 01/17/2018] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Psychiatric patients are at high risk of becoming victim of a violent crime compared to the general population. Although most research has focused on patients with severe mental illness, depressed patients have been demonstrated to be prone to victimization as well. Victimization is associated with more severe symptomatology, decreased quality of life, and high risk of revictimization. Hence, there is a strong need for interventions that focus on preventing violent revictimization. Since emotion dysregulation is associated with both victimization and depression, we developed an internet-based Emotion Regulation Training (iERT) to reduce revictimization in depressed patients. This study aims to evaluate the clinical and cost-effectiveness of iERT added to Treatment As Usual (TAU) in reducing incidents of violent revictimization among depressed patients with a recent history of victimization. Furthermore, this study aims to examine secondary clinical outcomes, and moderators and mediators that may be associated with treatment outcomes. METHODS In a multicenter randomized controlled trial with parallel group design, patients with a major depressive disorder and a history of violent victimization over the past three years (N = 200) will be allocated to either TAU + iERT (N = 100) or TAU only (N = 100), based on computer-generated stratified block randomization. Assessments will take place at baseline, 8 weeks, 14 weeks, and 6 months after start of treatment, and 12, 24, and 36 months after baseline. The primary outcome measure is the total number of violent victimization incidents at 12 months after baseline, measured with the Safety Monitor: an adequate self-report questionnaire that assesses victimization over the preceding 12 months. Secondary outcome measures and mediators include emotion dysregulation and depressive symptomatology. An economic evaluation with the societal perspective will be performed alongside the trial. DISCUSSION This study is the first to examine the effectiveness of an intervention aimed at reducing violent revictimization in depressed patients. If effective, iERT can be implemented in mental health care, and contribute to the well-being of depressed patients. Furthermore, the results will provide insight into underlying mechanisms of revictimization. TRIAL REGISTRATION The study is registered at the Netherlands Trial Register ( NTR5822 ). Date of registration: 4 April 2016.
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Affiliation(s)
- Carolien Christ
- Department of Psychiatry, VU University Medical Center/ GGZ inGeest, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands. .,Department of Research, Arkin Mental Health Care, Klaprozenweg 111, 1033 NN, Amsterdam, The Netherlands. .,Amsterdam Public Health research institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| | - Marleen M. de Waal
- Department of Research, Arkin Mental Health Care, Klaprozenweg 111, 1033 NN Amsterdam, The Netherlands ,0000000084992262grid.7177.6Academic Medical Center, Department of Psychiatry, Amsterdam Institute for Addiction Research, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Digna J. F. van Schaik
- 0000 0004 0435 165Xgrid.16872.3aDepartment of Psychiatry, VU University Medical Center/ GGZ inGeest, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands ,0000 0004 0435 165Xgrid.16872.3aAmsterdam Public Health research institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - Martijn J. Kikkert
- Department of Research, Arkin Mental Health Care, Klaprozenweg 111, 1033 NN Amsterdam, The Netherlands
| | - Matthijs Blankers
- Department of Research, Arkin Mental Health Care, Klaprozenweg 111, 1033 NN Amsterdam, The Netherlands ,0000000084992262grid.7177.6Academic Medical Center, Department of Psychiatry, Amsterdam Institute for Addiction Research, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands ,0000 0001 0835 8259grid.416017.5Trimbos Institute – Netherlands Institute of Mental Health and Addiction, Da Costakade 45, 3521 VS Utrecht, The Netherlands
| | - Claudi L. H. Bockting
- 0000000120346234grid.5477.1Department of Clinical Psychology, Faculty of Social and Behavioural Sciences, University Utrecht, Heidelberglaan 1, 3584 CS Utrecht, The Netherlands
| | - Aartjan T. F. Beekman
- 0000 0004 0435 165Xgrid.16872.3aDepartment of Psychiatry, VU University Medical Center/ GGZ inGeest, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands ,0000 0004 0435 165Xgrid.16872.3aAmsterdam Public Health research institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - Jack J. M. Dekker
- Department of Research, Arkin Mental Health Care, Klaprozenweg 111, 1033 NN Amsterdam, The Netherlands ,0000 0004 1754 9227grid.12380.38Department of Clinical Psychology, Neuro- and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, BT 1081 Amsterdam, The Netherlands
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de Waal MM, Dekker JJM, Kikkert MJ, Kleinhesselink MD, Goudriaan AE. Gender differences in characteristics of physical and sexual victimization in patients with dual diagnosis: a cross-sectional study. BMC Psychiatry 2017; 17:270. [PMID: 28743237 PMCID: PMC5526321 DOI: 10.1186/s12888-017-1413-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 06/30/2017] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Patients with substance use disorders and co-occurring mental health disorders are vulnerable to violent victimization. However, no evidence-based interventions are available to reduce patients' vulnerability. An exploration of the characteristics of physical and sexual violence can provide valuable information to support the development of interventions for these patients. This study aimed to examine gender differences in characteristics of violent victimization in patients with dual diagnosis. METHODS In this cross-sectional survey study recent incidents of physical and sexual assault were examined with the Safety Monitor in 243 patients with dual diagnosis. Chi-square tests were used to examine gender differences in the prevalence of physical and sexual victimization. Fisher's exact tests and Fisher-Freeman-Halton exact tests were used to determine whether there were significant differences between victimized men and women with regard to perpetrators, locations, reporting to the police and speaking about the assault with others. RESULTS There was no significant difference in the prevalence of physical violence in men (35%) and women (47%) with dual diagnosis. There was a significant association between gender of the victim and type of perpetrator (P < .001). Men were most often physically abused by a stranger or an acquaintance, whereas women were most frequently abused by an (ex)partner. Sexual violence was more prevalent in women (29%) compared to men (4%) (P < .001). Patients with dual diagnosis were unlikely to report incidents of physical abuse and sexual assault to the police and to speak about it with caregivers. CONCLUSIONS Characteristics of physical violence are different for men and women with dual diagnosis. Women with dual diagnosis are more often victims of sexual violence compared to men. Interventions aimed at reducing patients' vulnerability for victimization should take gender differences into account.
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Affiliation(s)
- Marleen M. de Waal
- Department of Research, Arkin Mental Health Care, Klaprozenweg 111, 1033 NN, Amsterdam, The Netherlands
- Academic Medical Center, Department of Psychiatry, Amsterdam Institute for Addiction Research, University of Amsterdam, Amsterdam, The Netherlands
| | - Jack J. M. Dekker
- Department of Research, Arkin Mental Health Care, Klaprozenweg 111, 1033 NN, Amsterdam, The Netherlands
- Department of Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Martijn J. Kikkert
- Department of Research, Arkin Mental Health Care, Klaprozenweg 111, 1033 NN, Amsterdam, The Netherlands
| | - Maaike D. Kleinhesselink
- Department of Research, Arkin Mental Health Care, Klaprozenweg 111, 1033 NN, Amsterdam, The Netherlands
| | - Anna E. Goudriaan
- Department of Research, Arkin Mental Health Care, Klaprozenweg 111, 1033 NN, Amsterdam, The Netherlands
- Academic Medical Center, Department of Psychiatry, Amsterdam Institute for Addiction Research, University of Amsterdam, Amsterdam, The Netherlands
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