Domestic violence and emotional distress among Nicaraguan women: Results from a population-based study.

This study aimed to measure the prevalence of emotional distress among women in León, Nicaragua, and to identify risk factors for emotional distress, with special reference to wife abuse. A survey was performed among a representative sample of women aged 15–49. Among ever-married women, 20% were classified as experiencing emotional distress at the time of the interview, and 52% reported physical partner abuse at some point in their lives. Women reporting abuse were 6 times more likely to experience emotional distress. An estimated 70% of all cases of emotional distress found among ever-married women were attributable to wife abuse. The study underscores the need to improve screening and care for battered women within mental health services in Nicaragua. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Use of a screening instrument in women's health care: detecting relationships among victimization history, psychological distress, and medical complaints

The interactive relationship between psychological distress and physical health is a particularly salient one for women. Routine screening for abuse history and current psychological disturbance is essential in providing comprehensive patient care. The present study examines the utility of a brief screening measure in detecting psychological factors in female patients at a primary care facility. Sixty-nine percent of 108 women screened at a women's health clinic reported a history of trauma and almost half (49%) reported having been sexually harassed. Women presenting to treatment for gynecological problems were more likely to be victims of sexual assault and were more likely to report a history of childhood sexual abuse. In addition, women seeking specialized health care also reported increased rates of stress. Relationships among victimization histories, substance use, and eating disturbances were also found. These data suggest the importance of assessing psychological disturbances and trauma histories as part of a comprehensive medical evaluation.     

Clinically Abusive Relationships in an Unselected Birth Cohort: Men's and Women's Participation and Developmental Antecedents.

In an unselected birth cohort (N=980, age 24-26 years), individuals in abusive relationships causing injury and/or official intervention (9% prevalence) were compared with participants reporting physical abuse without clinical consequences and with control participants who reported no abuse, on current characteristics and prospective developmental risks. In nonclinically abusive relationships, perpetrators were primarily women. In clinically abusive relationships, men and women used physical abuse, although more women needed medical treatment for injury. Women in clinically abusive relationships had childhood family adversity, adolescent conduct problems, and aggressive personality; men had disinhibitory psychopathology since childhood and extensive personality deviance. These findings counter the hibitory assumption that if clinical abuse was ascertained in epidemiological samples, it would be primarily man-to-woman, explained by patriarchy rather than psychopathology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluating domestic partner abuse in a family practice clinic

BACKGROUND AND OBJECTIVES: Although national surveys indicate that approximately 2 million women are victims of severe physical aggression by their partners each year, these women are underidentified by physicians. The assessment by medical personnel of partner abuse is hampered by lack of a simple and reliable instrument that systematically and quickly determines the occurrence and effect of abuse among patients. METHODS: Ninety (58% of an eligible pool) consecutive, consenting, eligible female patients at a suburban family practice clinic at a tertiary university hospital completed the Partner Abuse Interview to evaluate the 1-year prevalence and effect of abuse. RESULTS: The Partner Abuse Interview required as little as 3 minutes to administer. Results obtained with the interview instrument were internally consistent. Interrater reliability was high for the diagnosis of partner relationship problems with physical abuse by males, as reported by females. Approximately 15% of the women reported having sustained injury or being fearful of their partners as a result of their partners' physical aggression in the past year. CONCLUSIONS: The Partner Abuse Interview is a simple and reliable instrument that could be adapted for use by medical personnel to assess incidents of abuse among patients.     

Autobiographical memory functioning in depression and reports of early abuse.

The authors investigated the memory functioning of depressed women patients with and without a reported history of child physical or sexual abuse using J. M. G. Williams and K. Broadbent's (1986) Autobiographical Memory Test. Whereas latency to recall autobiographical memories was not related to reports of abuse, patients who reported childhood sexual abuse produced more overgeneral memories to positive and negative cues. In addition, patients reporting high levels of avoidance of spontaneous memories of childhood physical or sexual abuse in the past week retrieved more overgeneral memories to positive and negative cues. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Determinants of child-abuse reporting among Wisconsin school psychologists.

132 Wisconsin school psychologists responded to a questionnaire that included background information items and 1 scenario depicting an incident of legally reportable child abuse. Ss indicated whether they would report the abuse and rated the importance of 10 different reasons for reporting or not reporting. The content of the scenarios varied along 3 dimensions: (1) type of abuse, (2) when the abuse occurred, and (3) whether the child asked the psychologist not to disclose the information. Results indicate that conditions surrounding the child abuse, in particular the nature or type of abuse and time of occurrence, were related to reporting. School psychologists were more likely to report physical or sexual abuse than neglect or emotional abuse; they were also more likely to report abuse occurring in the present than in the past. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Routine inquiry into sexual victimization: A survey of therapists' practices.

Surveyed therapists regarding their practices in assessing clients' sexual abuse history. Of the 105 respondents, 51% reported that they routinely ask all clients or most clients about sexual abuse at some time during the course of therapy; 19% reported that they had asked only a few clients or that they never ask clients directly about sexual abuse. Therapists who were younger, who had been in practice for a shorter period of time, and whose current caseload included a high percentage of sexually abused women were most likely to have asked all or most of their clients about having been sexually abused. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relation of low-severity violence to women's health

OBJECTIVE: To determine if women who experience low-severity violence differ in numbers of physical symptoms, psychological distress, or substance abuse from women who have never been abused and from women who experience high-severity violence. DESIGN: Cross-sectional, self-administered, anonymous survey. SETTING: Four community-based, primary care, internal medicine practices. PATIENTS: Survey respondents were 1,931 women aged 18 years or older. SURVEY DESIGN: Survey included questions on violence; a checklist of 22 physical symptoms; the Symptom Checklist-22 (SCL-22) to measure depression, anxiety, somatization, and self-esteem; CAGE questions for alcohol use; and questions about past medical history. Low-severity violence patients had been "pushed or grabbed" or had someone "threaten to hurt them or someone they love" in the year prior to presentation. High-severity violence patients had been hit, slapped, kicked, burned, choked, or threatened or hurt with a weapon. MAIN RESULTS: Of the 1,931 women, 47 met criteria for current low-severity violence without prior abuse, and 79 met criteria for current high-severity violence without prior abuse, and 1,257 had never experienced violence. The remaining patients reported either childhood violence or past adult abuse. When adjusted for socioeconomic characteristics, the number of physical symptoms increased with increasing severity of violence (4.3 for no violence, 5.3 for low-severity violence, 6.4 for high-severity violence, p < .0001). Psychological distress also increased with increasing severity of violence (mean total SCL22 scores 32.6 for no violence, 35.7 for low-severity violence, 39.5 for high-severity violence, p < .0001). Women with any current violence were more likely to have a history of substance abuse (prevalence ratio [PR] 1.8 for low-severity, 1.9 for high-severity violence) and to have a substance-abusing partner (PR 2.4 for both violence groups). CONCLUSIONS: In this study, even low-severity violence was associated with physical and psychological health problems in women. The data suggest a dose-response relation between the severity of violence and the degree of physical and psychological distress.     

Relation between sexual abuse in childhood and adult depression: case-control study

OBJECTIVE: To examine the association between sexual abuse in childhood and adult depression in women. DESIGN: Two stage, case detection and case identification design, using the 30-item general health questionnaire and the Beck depression inventory for screening and the affective items relating to current functioning on the schizophrenia and affective disorders schedule to identify depressed cases. Details of sexual abuse in childhood were elicited retrospectively by semistructured interview, and social problems by the social problems questionnaire. SETTING: Three general practices, in middle class suburban, deprived inner city, and rural areas. SUBJECTS: 1189 women were screened and 237 subsequently interviewed; 132 were depressed. RESULTS: 49 (37%) of the depressed interviews and 24 (23%) of the non-depressed interviews reported experience of sexual abuse when they were aged under 16 years. A positive association existed between the more severe abuse and depression--all those who had experienced penetration were depressed as adults. A relation was also found between sexual abuse in childhood and sexual problems, housing problems, and problems with their children at school. CONCLUSION: A positive association between child sexual abuse and depression was confirmed, but this was confined to more severe abuse (penetration or attempted penetration).     

Suicidal thoughts and behaviours in former sexual abuse victims.

Examined the relationship between childhood sexual abuse and subsequent suicidality in 195 women (mean age 27.4 yrs) presenting to the crisis intervention program of a community health center. As predicted, former sexual abuse victims were considerably more likely to have made at least 1 suicide attempt in the past (55% of the 133 Ss) than were nonabused clients (23% of the 62 Ss) and were more likely to report suicidal ideation upon intake. Sexual abuse was associated with suicide attempts that occurred in childhood or adolescence. Among former sexual abuse victims, greater suicidality was correlated with multiple perpetrators, concurrent physical abuse, and sexual intercourse. Childhood sexual abuse is hypothesized to result in lowered self-esteem, guilt and self-blame, perceived powerlessness, and interpersonal dysfunction—all of which may lead to increased self-destructiveness. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Alcohol abuse in clients presenting with marital problems.

84 women and 56 men seeking marital therapy were assessed for alcohol abuse, current marital disagreements about alcohol abuse, and reported interspousal aggression. More than one-third of the men in the sample met the criterion for alcoholism on a standard alcoholism screening interview, one-fifth of the men self-reported drinking at unsafe levels, and more than four-fifths of the Ss reported marital disagreements about alcohol abuse at least "frequently." 69% of respondents reported the occurrence of physical aggression in their relationship. Reported alcohol problems were associated with more severe marital distress, more steps being taken toward divorce, and greater male aggression. Results suggest that routine screening of marital therapy clients for alcohol abuse is needed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of growth factors on matrix synthesis by human nasal chondrocytes cultured in monolayer and in agar

OBJECTIVES: In this paper we describe the proportion of US adults who report receiving oral cancer screening and tobacco cessation counseling and assistance from dentists and other health professionals. METHODS: Data from the 1992 National Health Interview Survey (NHIS) Cancer Control Supplement, a nationally representative sample of 12,035 adults 18 years of age and older, are analyzed. RESULTS: In 1992, less than 10 percent of adults reported oral cancer screening by a dentist or hygienist within the past three years. White adults (10.1%, 95% CI = 9.3, 10.9) reported an oral cancer screening three times more frequently than black (3.2%, 95% CI = 1.9, 4.5) or Hispanic (3.4%, 95% CI = 2.1, 4.7) adults. About half of adult current smokers had seen a dentist within 12 months, and of those only 24.1 percent (95% CI = 21.7, 26.5) had been advised to quit smoking. Heavy smokers (two or more packs a day) were more likely to have been advised to quit than light (pack or less per day) or occasional smokers. A similar proportion (24.3%, 95% CI = 17.6, 31.0) of white adult men who reported using smokeless tobacco products had been told by a dentist to quit using tobacco. CONCLUSIONS: Results from this population-based survey indicate that cancer screening and tobacco cessation advice are underutilized in the dental practice. Increased patient awareness and implementation of screening and tobacco cessation interventions could improve oral cancer incidence and mortality and have a public health benefit for other tobacco-related morbidity and mortality as well.     

Measurement of tibial torsion

AIM OF STUDY: To investigate the Singaporean doctor's and lawyer's definition of child abuse and neglect, their attitudes towards reporting and their manner of handling suspected cases. METHODS: A self-addressed questionnaire survey was carried out in a population of hospital doctors, family physicians and lawyers. A total of 368 respondents participated in the survey. RESULTS: Most respondents had similar parenting attitudes. The majority felt that child abuse occurred sporadically but 25% of family physicians felt it seldom occurred. Thirty-eight per cent of family physicians had a personal definition of child abuse compared to less than a third of hospital doctors. There was a high consensus among all 3 groups concerning 21 behaviours studied. In all 3 groups, more than 80% agreed that having sex, burning child, tying child and not protecting the child from sexual advances were both unacceptable and abusive. More than 80% of respondents felt that some form of compulsory reporting is necessary in Singapore. Doctors preferred to refer cases of physical abuse to the hospital while lawyers preferred the police. All agreed that sexual abuse is a matter for the police. Respondents were more likely to act in cases of physical abuse and sexual abuse than for cases of emotional abuse and neglect. CONCLUSIONS: There is a need to formalise definitions of child abuse in our society. More education and training in the understanding and handling of child abuse by doctors and lawyers may be necessary.     

Persistent alterations in biological profiles in women with abuse histories: Influence of premenstrual dysphoric disorder.

Objective: To examine dysregulation in biological measures associated with histories of abuse in women and whether women with premenstrual dysphoric disorder (PMDD) differ in their dysregulation. Design: Twenty-five women meeting prospective criteria for PMDD and 42 non-PMDD controls underwent structured interview to determine abuse histories and lifetime Axis I diagnoses, excluding those with current Axis I disorders or using medications. Major Outcome Measures: Plasma cortisol and norepinephrine (NE), heart rate (HR), blood pressure (BP), and vascular resistance index (VRI) were assessed at rest and in response to mental stress. Results: A greater proportion of PMDD women had prior abuse compared with non-PMDD women. Regardless of PMDD status, all abused women had lower plasma NE and higher HRs and tended to have lower plasma cortisol at rest and during stress. Abused women also reported more severe daily emotional and physical symptoms. Greater VRI and BP at rest and during stress were seen only in PMDD women with abuse. Conclusion: There is persistent dysregulation in stress-responsive systems in all abused women that cannot be accounted for by current psychiatric illness or medications, and PMDD women may be differentially more vulnerable to the impact of abuse on measures reflecting α-adrenergic receptor function. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Childhood abuse and parental disorders reported by Navy outpatient mental health patients

OBJECTIVE: To ascertain the number of Navy outpatient mental health patients reporting a history of childhood abuse. To explore the relationships among abuse history, parental/step-parental substance abuse, mental illness, and divorce. METHOD: Review of 134 clinical data forms completed by patients when first seen. RESULTS: Twenty-six percent reported at least one type of childhood abuse (physical, sexual, verbal, emotional). Proportionally more females reported any one type of abuse. Assailants were predominantly males, typically fathers or stepfathers. Verbal abuse significantly affected childhood happiness. Parental substance abuse, mental illness, or divorce before age 19 reduced childhood happiness, and abuse further reduced it. CONCLUSION: Childhood abuse is commonly reported by Navy mental health patients and may affect their adjustment to military life.     

Symptoms of post-traumatic stress disorder in abused women in a primary care setting

Abuse is a major source of trauma to women, and post-traumatic stress disorder (PTSD) results from exposure to extreme trauma. To describe the relationship between symptoms of PTSD and severity of abuse, an ethnically stratified cohort of 131 abused women in a primary care setting was interviewed. Symptoms of PTSD, both intrusion (i.e., trouble falling asleep, strong waves of feelings about the abuse) and avoidance (i.e., trying not to think or talk about the abuse, staying away from reminders of the abuse), were significantly (p < 0.01) correlated to severity of abuse, regardless of ethnicity. When asked about childhood physical or sexual abuse, women reporting physical abuse had significantly (p < 0.05) higher intrusion scores, whereas those reporting sexual abuse had significantly (p < 0.004) higher avoidance scores. Sixty-five percent of the women reported dreams, flashbacks, or terror attacks and had significantly (p < 0.001) higher mean results on both intrusion and avoidance. The need to offer abused women information about the connection between severity of abuse and symptoms of PTSD is discussed. We recommend that clinicians ask all abused women about dreams, flashbacks, or terror attacks to assess for further symptoms of PTSD.     

Systematic review of maintenance of behavior change following physical activity and dietary interventions.

Objective: In the past decade, there has been no systematic review of the evidence for maintenance of physical activity and/or dietary behavior change following intervention (follow-up). This systematic review addressed three questions: 1) How frequently do trials report on maintenance of behavior change? 2) How frequently do interventions achieve maintenance of behavior change? 3) What sample, methodologic, or intervention characteristics are common to trials achieving maintenance? Design: Systematic review of trials that evaluated a physical activity and/or dietary behavior change intervention among adults, with measurement at preintervention, postintervention, and at least 3 months following intervention completion (follow-up). Main Outcome Measures: Maintenance of behavior change was defined as a significant between-groups difference at postintervention and at follow-up, for one or more physical activity and/or dietary outcome. Results: Maintenance outcomes were reported in 35% of the 157 intervention trials initially considered for review. Of the 29 trials that met all inclusion criteria, 21 (72%) achieved maintenance. Characteristics common to trials achieving maintenance included those related to sample characteristics (targeting women), study methods (higher attrition and pretrial behavioral screening), and intervention characteristics (longer duration [>24 weeks], face-to-face contact, use of more intervention strategies [>6], and use of follow-up prompts). Conclusions: Maintenance of physical activity and dietary behavior change is not often reported; when it is, it is often achieved. To advance the evidence, the field needs consensus on reporting of maintenance outcomes, controlled evaluations of intervention strategies to promote maintenance, and more detailed reporting of interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparison of female and male graduates of southern Appalachian family practice residencies

PURPOSE: One aim of Southern Appalachian family practice residencies is to produce graduates for surrounding physician-needy areas. Some evidence suggests that women are less likely to go to rural areas and that they practice differently than men. This study investigated the practice patterns and location of Appalachian family practice residency female and male graduates. METHODS: Surveys were sent to graduates of seven family practice residencies from 1984 to 1994 in the Southern Appalachian area to determine practice patterns, locations, and reasons for choosing practices. RESULTS: Women were more likely than men to be single and not to have children. More women worked part-time. Women's and men's practice patterns and characteristics were similar except that women were more likely to provide prenatal care and do vaginal deliveries. Women in similar percentages practiced in small towns, and a greater percentage of women practiced in rural areas with populations of less than 2,500. CONCLUSIONS: Female family practice residency graduates from Appalachian residencies are fulfilling the purposes of their residencies as well as male graduates, although more of them are working part-time.     

Recovered memories of abuse in women with documented child sexual victimization histories

This study provides evidence that some adults who claim to have recovered memories of sexual abuse recall actual events that occurred in childhood. One hundred twenty-nine women with documented histories of sexual victimization in childhood were interviewed and asked about abuse history. Seventeen years following the initial report of the abuse, 80 of the women recalled the victimization. One in 10 women (16% of those who recalled the abuse) reported that at some time in the past they had forgotten about the abuse. Those with a prior period of forgetting--the women with "recovered memories"--were younger at the time of abuse and were less likely to have received support from their mothers than the women who reported that they had always remembered their victimization. The women who had recovered memories and those who had always remembered had the same number of discrepancies when their accounts of the abuse were compared to the reports from the early 1970s.     

Childhood abuse and current psychological functioning in a university counseling center population.

84 university counseling center clients (61 women and 23 men) self-reporting childhood physical, sexual, or emotional abuse (n?=?30) or no childhood abuse (n?=?54) completed 3 measures of psychological functioning. Multivariate analysis of variance revealed that clients reporting abuse were more depressed (with the mean Beck Depression Inventory score in the borderline clinical depression range), had more symptomatology (with the mean Global Severity Index of the Brief Symptom Inventory at about the average level of a psychiatric outpatient population), and scored higher on the Borderline Personality scale of the Millon Clinical Multiaxial Inventory (with the mean base-rate score near the cutoff score for presence of borderline personality features). 19 clients reporting emotional abuse only did not differ on any measure from 11 clients reporting sexual or multiple forms of abuse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)