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Pinto IV, Pimenta IS, Alves MB, dos Santos AP, de Melo CM, Evangelista JG, Lacerda KAR, Bevilacqua PD. Descriptive study of reported cases of sexual violence and specialized care services in the state of Minas Gerais, Brazil, 2019. Epidemiol Serv Saude 2023; 32:e2022907. [PMID: 37878898 PMCID: PMC10595049 DOI: 10.1590/s2237-96222023000300002.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 07/17/2023] [Indexed: 10/27/2023] Open
Abstract
OBJECTIVE to describe the sociodemographic profile of reported cases of sexual violence (SV) and the distribution of care services for this health condition in the state of Minas Gerais, Brazil, 2019. METHODS this was a descriptive study of the cases of sexual violence reported on the Notifiable Health Conditions Information System and care services registered in the National Health Establishment Registry. RESULTS a total of 4,418 notifications of SV were identified during the study period, representing more than 12 notifications per day; the majority of notifications were among females (87.0%) and among children and adolescents (72.0%); the distribution of care services showed care gaps in four of the 14 health macro-regions of the state of Minas Gerais; the maximum distances traveled to access referral services ranged from 93 to 327 km. CONCLUSION the scarcity of care services for people subjected to sexual violence in the micro-regions and macro-regions of Minas Gerais highlights the need for planning public policies aimed at increasing access to these services. MAIN RESULTS Over 12 notifications of sexual violence were reported per day in the state of Minas Gerais in 2019, with a higher prevalence in females, children and adolescents, mixed-race/Black people. Care gaps were identified in four macro-regions of the state. IMPLICATIONS FOR SERVICES There was a need for victims to travel long distances to receive care in municipalities with referral services for comprehensive care for sexual violence, which may hinder access and timely care. PERSPECTIVES It is expected that the results can contribute to improving public policies, considering the need to strategically plan the location of specialized services for people subjected to sexual violence.
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Affiliation(s)
- Isabella Vitral Pinto
- Instituto René Rachou - Fundação Oswaldo Cruz , Grupo de Pesquisa Violências, Gênero e Saúde, Belo Horizonte, MG, Brasil
| | - Iracy Silva Pimenta
- Prefeitura de Belo Horizonte, Secretaria Municipal de Assistência Social, Segurança Alimentar e Cidadania, Belo Horizonte, MG, Brasil
| | - Maria Bevilacqua Alves
- Universidade Federal de Viçosa, Programa de Pós-Graduação em Engenharia Agrícola – Recursos Hídricos e Ambientais, Viçosa, MG, Brasil
| | - Ana Pereira dos Santos
- Instituto René Rachou - Fundação Oswaldo Cruz , Grupo de Pesquisa Violências, Gênero e Saúde, Belo Horizonte, MG, Brasil
| | | | - Janete Gonçalves Evangelista
- Instituto René Rachou - Fundação Oswaldo Cruz , Grupo de Pesquisa Violências, Gênero e Saúde, Belo Horizonte, MG, Brasil
| | - Kate Aparecida Rocha Lacerda
- Instituto René Rachou - Fundação Oswaldo Cruz , Grupo de Pesquisa Violências, Gênero e Saúde, Belo Horizonte, MG, Brasil
| | - Paula Dias Bevilacqua
- Instituto René Rachou - Fundação Oswaldo Cruz , Grupo de Pesquisa Violências, Gênero e Saúde, Belo Horizonte, MG, Brasil
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Lourenço SDS, Polidoro M, Piloto LM, Martins AB. Notifications of sexual violence against children and adolescents in Rio Grande do Sul, Brazil: a descriptive study, 2014-2018. Epidemiol Serv Saude 2023; 32:e2022853. [PMID: 37466565 PMCID: PMC10355989 DOI: 10.1590/s2237-96222023000200004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 02/06/2023] [Indexed: 07/20/2023] Open
Abstract
OBJECTIVE to describe characteristics of notifications of sexual violence against children and adolescents according to race/skin color and their distribution in the state of Rio Grande do Sul, Brazil, between 2014 and 2018. METHODS this was a descriptive study of data retrieved from the Notifiable Health Conditions Information System (SINAN). Frequency distributions, prevalence and statistical differences were analyzed using Pearson's chi-square test. RESULTS of the 8,716 notifications, most occurred in the state capital (48.2%) and related to female victims (82.2%) aged between 10 and 14 years (38.1%). There was a higher prevalence (370/100,000) and relative frequency of rape (84.5%), sexual exploitation (5.8%) and neglect/abandonment (4.6%) among victims of Black race/skin color (p-value < 0.05). Only 4.6% of notifications occurred in primary health care services. CONCLUSION notifications were more frequent among female pre-adolescents and prevalence was higher among Black people, who should be a priority target for protective measures. Surveillance of this form of violence needs to be strengthened in primary care.
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Affiliation(s)
- Samara da Silveira Lourenço
- Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Saúde Coletiva, Porto Alegre, RS, Brazil
| | | | - Luciane Maria Piloto
- Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Saúde Coletiva, Porto Alegre, RS, Brazil
| | - Aline Blaya Martins
- Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Saúde Coletiva, Porto Alegre, RS, Brazil
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Casas-Muñoz A, Carranza-Neira J, Intebi I, Lidchi V, Eisenstein E, Greenbaum J. Abordaje de la violencia sexual infantil: un llamado a la acción para los profesionales de América Latina. Rev Panam Salud Publica 2023; 47:e54. [PMID: 37008675 PMCID: PMC10065304 DOI: 10.26633/rpsp.2023.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 11/17/2022] [Indexed: 04/03/2023] Open
Abstract
El objetivo de esta comunicación es delinear los elementos clave de la capacitación en violencia sexual infantil (VSI) para profesionales de la salud en diferentes disciplinas medicina, psicología, odontología, enfermería, trabajo social, nutrición, fisioterapia, terapia ocupacional, química, bioquímica y obstetricia incluidas las parteras, entre otras y el desarrollo de protocolos de atención con base en las prácticas basadas en evidencia, así como proporcionar recursos que permitan optimizar ambos procesos. La capacitación sobre la violencia sexual hacia niñas, niños y adolescentes (NNA) es esencial para enfrentar este gran desafío en América Latina y permitir al personal de salud cumplir su función en defensa de la seguridad y el bienestar de NNA. El desarrollo de protocolos ayuda al personal de salud a definir las funciones y responsabilidades de los miembros del personal, resumir los posibles indicadores de VSI y describir las estrategias para identificar y abordar mejor las necesidades de salud y seguridad del paciente y su familia, por lo que deben incluir el enfoque informado sobre el trauma. El trabajo futuro debe centrarse en desarrollar y evaluar estrategias nuevas para aumentar la capacidad del sector de la salud para atender a los NNA que experimentan VSI y optimizar las formas de capacitar al personal. Apunta, también, a mejorar la generación de investigación y evidencia sobre la epidemiología y atención de la VSI en América Latina, incluidos los niños y adolescentes varones, grupos minoritarios y de atención prioritaria (p. ej. NNA migrantes, con discapacidad, en situación de calle, privados de la libertad, pertenecientes a comunidades indígenas y a la comunidad LGBTIQ+).
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Affiliation(s)
- Abigail Casas-Muñoz
- Centro de Estudios Avanzados sobre Violencia – Prevención (CEAVI-P)Instituto Nacional de PediatríaCiudad de MéxicoMéxicoCentro de Estudios Avanzados sobre Violencia – Prevención (CEAVI-P), Instituto Nacional de Pediatría, Ciudad de México, México.
- Abigail Casas-Muñoz,
| | - Julia Carranza-Neira
- Facultad de Ciencias de la SaludUniversidad Peruana de Ciencias AplicadasLimaPerúFacultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas, Lima, Perú.
| | - Irene Intebi
- Consultora independienteArgentinaConsultora independiente, Argentina.
| | - Victoria Lidchi
- Barnet, Enfield and Haringey Mental Health TrustLondresReino UnidoBarnet, Enfield and Haringey Mental Health Trust, Londres, Reino Unido.
| | - Evelyn Eisenstein
- Centro de Estudios IntegradosInfanciaAdolescencia y SaludRío de JaneiroBrasilCentro de Estudios Integrados, Infancia, Adolescencia y Salud, Río de Janeiro, Brasil.
| | - Jordan Greenbaum
- International Centre for Missing and Exploited ChildrenAlexandriaEstados Unidos de AméricaInternational Centre for Missing and Exploited Children, Alexandria, Estados Unidos de América.
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Van der Feltz-Cornelis CM, de Beurs E. The 10-item Adverse Childhood Experience International Questionnaire (ACE-IQ-10): psychometric properties of the Dutch version in two clinical samples. Eur J Psychotraumatol 2023; 14:2216623. [PMID: 37318018 DOI: 10.1080/20008066.2023.2216623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Childhood trauma has been associated with adult mental disorders, physical illness, and early death. The World Health Organization (WHO) supported the development of the Adverse Childhood Experiences International Questionnaire (ACE-IQ) to explore childhood trauma in adults. We report the psychometric properties of the Dutch version of the Adverse Childhood Experiences International Questionnaire 10 items version (ACE-IQ-10) in the Netherlands. METHODS Confirmatory factor analysis was performed in two convenience samples of consecutive patients presenting at an outpatient specialty mental health setting between May 2015 and September 2018: Sample A (N = 298), patients with anxiety and depressive disorders; and sample B (N = 234), patients with Somatic Symptom and Related Disorders (SSRD). Criterion validity of the scales of the ACE-IQ-10 was explored by their correlation with the PHQ-9, the GAD-7, and the SF-36. The correlation between reporting sexual abuse on the ACE-IQ-10 and in a face-to-face interview was assessed as well. RESULTS We found support for a two-factor structure in both samples: one for directly experiencing childhood abuse and another for household dysfunction, but also support for using the total score. The correlation between reporting a sexual trauma in childhood at face-to-face interview and the sexual abuse item of the ACE-IQ-10 was r = .98 (p < .001). CONCLUSIONS The current study provides evidence on the factor structure, reliability, and validity of the Dutch ACE-IQ-10 in two Dutch clinical samples. It shows clear potential of the ACE-IQ-10 for further research and clinical use. Further studies are needed to assess the ACE-IQ-10 in the Dutch general population.
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Affiliation(s)
- Christina M Van der Feltz-Cornelis
- Department of Health Sciences, University of York, York, UK
- Hull York Medical School, York, UK
- York Biomedical Research Institute (YBRI), University of York, York, UK
- Institute of Health Informatics, University College London, London, UK
| | - Edwin de Beurs
- Social and Behavioral Sciences, Psychology Department, Leiden University, Leiden, the Netherlands
- Arkin GGZ, Amsterdam, the Netherlands
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McElvaney R, McDonnell Murray R, Dunne S. Siblings' Perspectives of the Impact of Child Sexual Abuse Disclosure on Sibling and Family Relationships. Fam Process 2022; 61:858-872. [PMID: 34060077 DOI: 10.1111/famp.12681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Child sexual abuse (CSA) may have significant consequences for siblings; however, limited research has been conducted on the impact of the abuse on sibling and family relationships following the disclosure of CSA. This study sought to investigate sibling responses to disclosures of CSA among a group of adult siblings in Ireland, and the impact on sibling and family relationships through an online survey. A thematic analysis was conducted on a sub-set of participants who responded to open-ended questions (n = 45). Three main themes were identified as follows: (a) intense emotional reactions, (b) relationship support and strain, and (c) managing family dynamics. CSA disclosure may have a substantial impact on sibling and family relationships. Supporting siblings in the aftermath of CSA disclosure is essential, both for the well-being of the individual who was sexually abused and for the wider family.
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Abstract
A child's disclosure of sexual victimization is a difficult experience for parents and has been associated with traumatization, disbelief, denial, self-blame, and clinical difficulties. To date, most studies on parents' responses have been quantitative assessments of the psychological impact of disclosure on parents. A paucity of research has qualitatively explored mothers' experiences of their child's disclosure of child sexual abuse (CSA) and fathers' experiences have been even further neglected. The current study seeks to characterize parents' experiences of their child's disclosure of CSA and to uncover the process-oriented nature of parental responses. This qualitative study, using a grounded theory approach to analysis, involved interviews with 10 mothers and four fathers whose children (3-18 years) had experienced sexual abuse. Three themes emerged from the analysis. The first theme-making sense of the abuse in retrospect-captured the process through which parents sought to make sense of their child's disclosure, focusing on why their child had not disclosed the abuse to them earlier, and how they had noticed something was wrong but misattributed their child's behavior to other factors. The second theme-negotiating parental identity as protector-reflected how parents' identity as a protector was challenged, their perception of their world had been forever altered, and they now experienced themselves as hypervigilant and overprotective. The final theme-navigating the services-pertained to parents' struggle in navigating child protection and police services, and feelings of being isolated and alone. These findings highlight the need for empathy and parental support following child disclosure of sexual victimization.
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Rueness J, Myhre MC, Strøm IF, Wentzel-Larsen T, Dyb G, Thoresen S. The mediating role of posttraumatic stress reactions in the relationship between child abuse and physical health complaints in adolescence and young adulthood. Eur J Psychotraumatol 2019; 10:1608719. [PMID: 31143411 PMCID: PMC6522978 DOI: 10.1080/20008198.2019.1608719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 03/20/2019] [Accepted: 04/08/2019] [Indexed: 11/04/2022] Open
Abstract
Background: Child abuse is associated with physical health problems in adolescence and adulthood, but the mechanisms involved are unclear. A possible mediating effect of posttraumatic stress reactions (PTSR) linking child abuse with later physical health complaints has not been fully investigated. Objective: The current study investigated whether PTSR could be a potential mediator in the relationship between child abuse and physical health complaints in adolescents and young adults. If so, we also investigated whether this was the case for different child abuse types alone or in combination. Method: The study sample comprised 506 adolescents and young adult victims of child abuse and 504 unexposed matched controls aged 16-33 from a community sample. We measured child abuse retrospectively and current PTSR at wave 1 (2013), and current physical health complaints at wave 2 (2014/15). We tested a model of PTSR as a possible mediator between child abuse and physical health complaints and conducted causal mediation analysis to estimate direct and indirect pathways. Each child abuse type was studied in isolation and in combination with other abuse types. Results: PTSR had a notable, significant mediating effect on the relationship between child abuse and physical health complaints in our overall model (average causal mediation effect; ACME = 0.14, p < 0.001), accounting for 85% of the total effect. The mediated pathway was also significant in analyses of the different child abuse types. The mediating effect of PTSR was most prominent in individuals reporting exposure to more than one child abuse type. Conclusions: The current study indicates that PTSR may be an important mediator in the relationship between child abuse and physical health complaints. Health professionals should be aware of the important role that PTSR may have in maintaining or exacerbating physical health problems in child abuse victims. However, a reverse model could not be tested in this study and the results need confirmation in future prospective studies.
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Affiliation(s)
- Janne Rueness
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Mia C Myhre
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Ida Frugård Strøm
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Tore Wentzel-Larsen
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway.,Centre for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP), Oslo, Norway
| | - Grete Dyb
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Siri Thoresen
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
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Wagenmans A, Van Minnen A, Sleijpen M, De Jongh A. The impact of childhood sexual abuse on the outcome of intensive trauma-focused treatment for PTSD. Eur J Psychotraumatol 2018; 9:1430962. [PMID: 29441153 PMCID: PMC5804725 DOI: 10.1080/20008198.2018.1430962] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 01/11/2018] [Indexed: 11/06/2022] Open
Abstract
Background: It is assumed that PTSD patients with a history of childhood sexual abuse benefit less from trauma-focused treatment than those without such a history. Objective: To test whether the presence of a history of childhood sexual abuse has a negative effect on the outcome of intensive trauma-focused PTSD treatment. Method: PTSD patients, 83% of whom suffered from severe PTSD, took part in a therapy programme consisting of 2 × 4 consecutive days of Prolonged Exposure (PE) and EMDR therapy (eight of each). In between sessions, patients participated in sport activities and psycho-education sessions. No prior stabilization phase was implemented. PTSD symptom scores of clinician-administered and self-administered measures were analysed using the data of 165 consecutive patients. Pre-post differences were compared between four trauma groups; patients with a history of childhood sexual abuse before age 12 (CSA), adolescent sexual abuse (ASA; i.e. sexual abuse between 12 and 18 years of age), sexual abuse (SA) at age 18 and over, or no history of sexual abuse (NSA). Results: Large effect sizes were achieved for PTSD symptom reduction for all trauma groups (Cohen's d = 1.52-2.09). For the Clinical Administered PTSD Scale (CAPS) and the Impact of Event Scale (IES), no differences in treatment outcome were found between the trauma (age) groups. For the PTSD Symptom Scale Self Report (PSS-SR), there were no differences except for one small effect between CSA and NSA. Conclusions: The results do not support the hypothesis that the presence of a history of childhood sexual abuse has a detrimental impact on the outcome of first-line (intensive) trauma-focused treatments for PTSD.
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Affiliation(s)
| | - Agnes Van Minnen
- Research Department, PSYTREC, Bilthoven, The Netherlands.,Radboud University Nijmegen, Behavioural Science Institute (BSI), Nijmegen, The Netherlands
| | - Marieke Sleijpen
- Department of Social and Behavioral Sciences, Utrecht University, Utrecht, The Netherlands
| | - Ad De Jongh
- Research Department, PSYTREC, Bilthoven, The Netherlands.,Department of Social Dentistry and Behavioural Sciences, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands.,School of Health Sciences, Salford University, Manchester, UK.,Institute of Health and Society, University of Worcester, UK
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