The prevalence of exposure to domestic violence and the factors associated with co-occurrence of psychological and physical violence exposure: a sample from primary care patients

<p>Abstract</p> <p>Background</p> <p>Since many health problems are associated with abuse and neglect at all ages, domestic violence victims may be considered as a group of primary care patients in need of special attention.</p> <p>Methods</p> <p>The aim of this multi-centre study was to assess the prevalence of domestic violence in primary care patients, and to identify those factors which influence the co-occurrence of psychological and physical violence exposure and their consequences (physical, sexual and reproductive and psychological) as obtained from medical records.</p> <p>A study was carried out in 28 family practices in Slovenia in 2009. Twenty-eight family physicians approached every fifth family practice attendee, regardless of gender, to be interviewed about their exposure to domestic violence and asked to specify the perpetrator and the frequency. Out of 840 patients asked, 829 individuals, 61.0% women (n = 506) and 39.0% men (n = 323) were assessed (98.7% response rate). They represented a randomised sample of general practice attendees, aged 18 years and above, who had visited their physician for health problems and who were given a physical examination. Visits for administrative purposes were excluded.</p> <p>Multivariate binary logistic regression analysis was used to determine the factors associated with exposure to both psychological and physical violence.</p> <p>Results</p> <p>Of 829 patients, 15.3% reported some type of domestic violence experienced during the previous five years; 5.9% reported physical and 9.4% psychological violence; of these 19.2% of men and 80.8% of women had been exposed to psychological violence, while 22.4% of men and 77.6% of women had been exposed to physical violence. The domestic violence victims were mostly women (p < 0.001) aged up to 35 years (p = 0.001). Exposure to psychological violence was more prevalent than exposure to physical violence. Of the women, 20.0% were exposed to either type of violence, compared to 8.0% of male participants, who reported they were rarely exposed to physical violence, while women reported often or constant exposure to physical violence. Their partners were mostly the perpetrators of domestic violence towards women, while amongst men the perpetrators were mostly other family members.</p> <p>In univariate analysis female gender was shown to be a risk factor for domestic violence exposure. Regression modelling, explaining 40% of the variance, extracted two factors associated with psychological and physical violence exposure: the abuse of alcohol in the patient (OR 4.7; 95% CI 1.54-14.45) and their unemployment (OR 13.3; 95% CI 1.53-116.45).</p> <p>Conclusions</p> <p>As far as the study design permits, the identified factors associated with both psychological and physical violence exposure could serve as determinants to raise family physicians' awareness when exploring the prevalence of domestic violence. The results of previous research, showing at least 15% prevalence of exposure to domestic violence among primary care patients in Slovenia, and the female gender as a risk factor, were confirmed.</p

Help-Seeking Barriers Among Sexual and Gender Minority Individuals Who Experience Intimate Partner Violence Victimization

Sexual and gender minority (SGM) individuals experience intimate partner violence (IPV) victimization at disproportionate rates compared to cisgender and heterosexual individuals. Given the widespread consequences of experiencing IPV victimization, intervention and prevention strategies should identify readily accessible and culturally competent services for this population. SGM individuals who experience IPV victimization face unique individual-, interpersonal-, and systemic-level barriers to accessing informal and formal support services needed to recover from IPV. This chapter reviews IPV victimization prevalence rates among SGM individuals in the context of minority stress and highlights unique forms of IPV victimization affecting this population, namely identity abuse. The literature on help-seeking processes among IPV survivors in general and help-seeking patterns and barriers specifically among SGM individuals who experience IPV victimization in the context of minority stress (e.g., discrimination, internalized stigma, rejection sensitivity, identity concealment) are discussed. How minority stressors at individual, interpersonal, and structural levels act as barriers to help-seeking among SGM individuals experiencing IPV victimization is presented. The chapter concludes with a review of emerging evidence for interventions aimed at reducing help-seeking barriers among SGM individuals who face IPV victimization and a discussion of future directions for research on help-seeking barriers in this population

Development and evaluation of a measure of treatment knowledge in guided self-help for eating disorders in a sample of healthcare students and professionals

Purpose: The current study describes the development of a measure designed to assess treatment-specific competence in guided self-help (GSH) for eating disorders. The aim is to assess healthcare professionals’ understanding of a popular treatment manual and associated material. Methods: After initial item development from a review of relevant literature, a range of healthcare staff and students (N = 127) completed a knowledge questionnaire. From these data, estimates of psychometric properties were made and a subset of the original sample completed the measure again after six weeks. Results: The final questionnaire consists of 40 items, demonstrating acceptable content validity, internal consistency, and reliability. Significant differences in the number of questions answered correctly were observed between experts in GSH and those with less experience. Conclusions: This questionnaire offers a means of assessing therapist knowledge of GSH which demonstrates good psychometric properties. Further testing of this instrument is required in order to establish its full applicability

Stress, the Hippocampus and the Hypothalamic-Pituitary-Adrenal Axis: Implications for the development of psychotic disorders

The experience of stress is commonly implicated in models of the onset of psychotic disorders. However, prospective studies investigating associations between biological markers of stress and the emergence of psychotic disorders are limited and inconclusive. One biological system proposed as the link between the psychological experience of stress and the development of psychosis is the Hypothalamic-Pituitary-Adrenal (HPA) axis. This paper summarizes and discusses evidence supporting a role for HPA-axis dysfunction in the early phase of schizophrenia and related disorders. METHOD A selective review of psychiatric and psychological research on stress, coping, HPA-axis, the hippocampus and psychotic disorders was performed, with a particular focus on the relationship between HPA-axis dysfunction and the onset of psychotic disorders. RESULTS Individual strands of past research have suggested that the HPA-axis is dysfunctional in at least some individuals with established psychotic disorders; that the hippocampus is an area of the brain that appears to be implicated in the onset and maintenance of psychotic disorders; and that an increase in the experience of stress precedes the onset of a psychotic episode in some individuals. Models of the onset and maintenance of psychotic disorders that link these individual strands of research and strategies for examining these models are proposed in this paper. CONCLUSIONS The current literature provides some evidence that the onset of psychotic disorders may be associated with a higher rate of stress and changes to the hippocampus. It is suggested that future research should investigate whether a relationship exists between psychological stress, HPA-axis functioning and the hippocampus in the onset of these disorders. Longitudinal assessment of these factors in young people at 'ultra' high risk of psychosis and first-episode psychosis cohorts may enhance understanding of the possible interaction between them in the early phases of illness

Native American Perspectives on Health and Traditional Ecological Knowledge

BACKGROUND: Traditional ecological knowledge (TEK) is a conceptual framework that highlights Indigenous knowledge (IK) systems. Although scientific literature has noted the relevance of TEK for environmental research since the 1980s, little attention has been given to how Native American (NA) scholars engage with it to shape tribal-based research on health, nor how non-Native scholars can coordinate their approaches with TEK. This coordination is of particular importance for environmental health sciences (EHS) research exploring interdisciplinary approaches and the integration of environmental and human health. OBJECTIVE: Our perspective on TEK arose from a series of Health and Culture Research Group (HCRG) workshops that identified gaps in existing EHS methodologies that are based on a reliance on Euro-American concepts for assessing environmental exposures in tribal communities. These prior methods neither take into account cultural behavior nor community responses to these. Our objective is to consider NA perspectives on TEK when analyzing relationships between health and the environment and to look at how these may be applied to address this gap. DISCUSSION: The authors-the majority of whom are NA scholars-highlight two research areas that consider health from a TEK perspective: food systems and knowledge of medicinal plants. This research has yielded data, methods, and knowledge that have helped Indigenous communities better define and reduce health risks and protect local natural food resources, and this TEK approach may prove of value to EHS research. CONCLUSION: NA perspectives on TEK resulting from the HCRG workshops provide an opportunity for developing more accurate Indigenous health indicators (IHI) reflecting the conceptualizations of health maintained in these communities. This approach has the potential to bridge the scientific study of exposure with methods addressing a tribal perspective on the sociocultural determinants of health, identifying potential new areas of inquiry in EHS that afford nuanced evaluations of exposures and outcomes in tribal communities.Smithsonian Institution's Consortia; Western Carolina University; National Institute for Environmental Health Sciences; Recovering Voices program of the Smithsonian InstitutionOpen access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]