Conceptual model and map of psychological abuse of older adults

Psychological abuse of older adults is a hidden and pervasive problem that is not well conceptualized nor well measured. Goals. The goals were to (a) conceptualize psychological abuse using three-dimensional concept maps, and (b) develop theoretical models. Methods. Statements describing the construct were generated by local and national panels. These were sorted and rated using Concept Systems software whereby the concepts were depicted as a map. Results. The concept maps guided development of theoretical hierarchies. Significance. Theoretical models may help to develop measures to estimate prevalence better and may enable more precise screening for triage into appropriate interventions.     

Examining the Effects of a Service-Trained Facility Dog on Stress in Children Undergoing Forensic Interview for Allegations of Child Sexual Abuse

Disclosure of child sexual abuse can be a stressful experience for the child. Gaining a better understanding of how best to serve the child, while preserving the quality of their disclosure, is an ever-evolving process. The data to answer this question come from 51 children aged 4–16 (M = 9.1, SD = 3.5), who were referred to a child advocacy center in Virginia for a forensic interview (FI) following allegations of sexual abuse. A repeated measures design was conducted to examine how the presence of a service-trained facility dog (e.g. animal-assisted intervention (AAI) may serve as a mode of lowering stress levels in children during their FIs. Children were randomized to one of the two FI conditions: experimental condition (service-trained facility dog present-AAI) or control condition (service-trained facility dog not present- standard forensic interview). Stress biomarkers salivary cortisol, alpha-amylase, immunoglobulin A (IgA), heart rate, and blood pressure, and Immunoglobulin A were collected before and after the FI. Self-report data were also collected. Results supported a significant decrease in heart rate for those in the experimental condition (p = .0086) vs the control condition (p = .4986). Regression models revealed a significant decrease in systolic and diastolic blood pressure in the experimental condition (p = .03285) and (p = .04381), respectively. Statistically significant changes in alpha-amylase and IgA were also found in relation to disclosure and type of offense. The results of this study support the stress reducing effects of a service-trained facility dog for children undergoing FI for allegations of child sexual abuse.     

Associations Between Sexual Abuse and Negative Health Consequences Among High-Risk Men Who Have Sex with Men

This study evaluated whether a history of sexual abuse could differentiate negative health consequences among men who have sex with men (MSM; N = 148) enrolled in a risk counseling program. More than half (51.4%) reported an experience of sexual abuse. A history of sexual abuse was associated with increased psychological distress, increased rates of alcohol (AOR = 2.91; p <.01) and/or drug abuse (AOR = 2; p <.01) treatment, increased risk of housing instability (AOR = 2.13; p <.05), and increased risk for suicidality (AOR = 4.3; p <.001). Findings demonstrate that screening for sexual abuse may be useful in determining the service needs of high-risk MSM.     

The risk factors of abusive relationships for nontraditional students

Objective: To examine the effect of nontraditional student status on abusive relationships, namely emotional, physical, and sexual abuse. Participants: The 2011–2014 American College Health Association National College Health Assessment (ACHA-NCHA) II data (N = 102,563) were utilized for the analysis. Methods: Logistic regression models were employed as the outcome variables were dichotomous. Results: Non-traditional students compared to traditional ones indeed had higher odds ratios of having abusive relationships. Nontraditional students compared to traditional students, however, were more likely to experience emotional and physical abuse, but not sexual abuse. Conclusions: The prevention programs and policies related to abusive relationships need to be address differently based on the results of this study, which is also essential for nontraditional students to adjust and succeed in higher education and further their careers.     

Diagnosing physical abuse using Bayes' Theorem: a preliminary study

Objectives. To perform a preliminary study to compare the patterns of bruises in a physically abused group of children and a control group; to investigate whether these could be modelled statistically to enable probabilities of typical bruise patterns to be calculated; to apply Bayes' Theorem to find the probability that a child with a given bruise pattern has been the subject of physical abuse. Design. An observational study. Setting. Cardiff and Vale of Glamorgan. Subjects. Children who have suffered child physical abuse, 0–14 years. The diagnosis was confirmed at a case conference in all cases. A control group of 289 children who presented to the Accident and Emergency Department at the Cardiff Royal Infirmary after an accidental injury. Main outcome measures. The distribution bruise pattern in three regions of the body. The posterior probability of abuse for a given bruise pattern. Results. The bruise distribution in physically abused and control children was well described by a negative binomial distribution. There was a different distribution for the three different regions of the body in physically abused children. The bruising frequency and distribution for the physically abused group was very different from that of the controls. We were able to use parameters derived from these distributions to calculate posterior probabilities of physical abuse given a particular pattern of bruises using Bayes' Theorem. Conclusions. This preliminary study demonstrates that we can use Bayes' Theorem to combine prior probabilities of physical abuse with observed patterns of bruising in given children to obtain posterior probabilities of abuse. This principle has considerable potential for better diagnosis of the physically abused child. © 1998 John Wiley & Sons, Ltd.     

Exploring the Nature of the Relationship Between Poverty and Substance Abuse

Abstract

Poverty and substance abuse are two serious social problems that are often assumed to be interrelated. This article explores what is currently known about the relationship between these two problems. Four possible models for describing the interrelationship are identified: causal, risk factor, exacerbation, and spurious. The theoretical explanations from both the substance and poverty literature are discussed in light of their implications for these types of models. The public health perspective is selected from the substance abuse theoretical literature as the model that best subsumes and directs thinking about the relationship between poverty and substance abuse, because its focus on agent, host, and environment draws attention to the range of factors that can influence both problems, as well as the ways in which they come together. Findings from the research literature are then discussed within the framework of the public health model. The article concludes by outlining the gaps in knowledge and an agenda for future research.     

Child Sexual Abuse News: A Systematic Review of Content Analysis Studies

Public knowledge and attitudes toward child sexual abuse are shaped through media depictions and coverage. Since the media are the main source of information about child sexual abuse, studies of child sexual abuse news can help us understand how news is created, how child sexual abuse is presented to the public, and what is the possible impact of such presentation and coverage on the audience. A systematic review of content analysis research is conducted using predefined criteria in order to identify quality studies, main findings, research gaps and to develop recommendations for future studies. International databases were systematically searched using keywords in September 2017. A total of 24 original quantitative content analysis studies published in the English language were included in the review and evaluated according to research methodology. The framework of child sexual abuse news media studies is developed and main findings are highlighted: (1) presentation and coverage of child sexual abuse (n = 7); (2) prevalence of coverage of CSA cases reported to the authorities (n = 2); (3) presentation and coverage of child abuse and sexual crimes where child sexual abuse is only a subtopic (n = 9); (4) presentation and coverage of specific child sexual abuse cases or issues (n = 6). Although studies represent valuable contribution, most did not meet content analysis design and reporting standards or both (e.g., calculating intercoder reliability), which seriously compromises validity and replicability requirements. Recommendation for future studies and most common errors in conducting content analysis are emphasized.     

Child Abuse Investigations: Reasons for using Child Advocacy Centers and Suggestions for Improvement

Child protective service (CPS) and child abuse law enforcement (LE) investigators have been required by the majority of states to work together when investigating criminal cases of child abuse. Child Advocacy Centers (CACs) and other^. multidisciplinary models of collaboration have developed across the United States to meet these requirements. This study surveyed 290 CPS and LE investigators who use a CAC in their investigations of criminal cases of child abuse. Reasons given for using, centers, include legal or administrative mandate and protocol, child appropriate environment, support, referrals, capacity for medical exams, expertise of center interviewers and access to video and audio technology. Respondents also identified ways that centers could be more helpful.     

Methodological approaches to the analyses of elder abuse screening measures: Application of latent variable measurement modeling to the WC-RAPS

While several elder abuse screens exist, few measure risk and none target long-term support services. The aims were to examine the psychometric properties of the Weinberg Center Risk and Abuse Prevention Screen (WC-RAPS), comparing approaches to modeling self-reported risk and abuse in relation to reported Adult Protective Services contacts. Methods: The sample (n = 7,035), admissions to managed long-term care (79%) and short-term rehabilitation (20%), was primarily (66%) female, with mean age 77.6 (SD = 9.10); 7% each were African American and Latino and 12% Asian. Latent variable models were used to examine measurement properties of six indicators of abuse and five of risk. Results: Good model fit and stable subscale measurement models were observed across analyses. Reliability was >0.80 across methods, and concurrent criterion validity estimates were as expected. Conclusion: Evidence supported the reliability and concurrent criterion validity of the risk and abuse subscales in an ethnically diverse cohort.     

The prevalence of elder abuse and neglect in Iran: a systematic review and meta-analysis

ABSTRACT

Objective: The aim of this study was to estimate the prevalence of elder abuse and neglect in Iran.

Methods: We searched PubMed, Embase, Scopus, and PsycINFO by the end of 2017. The prevalence was calculated based on the percentage or the amount reported in the studies. Heterogeneity was assessed by the I² statistic, and the data were combined using random effects model. The results were reported as the pooled estimates and the 95% confidence intervals (CIs). The review protocol was registered in PROSPERO (CRD42017070744).

Results: A total of 16 studies involving 6,461 participants aged 60 years and over were included. The pooled prevalence for overall elder abuse was 45.7% (95% CI: 27.3–64.1, p < .001).

Discussion: The prevalence of elder abuse and neglect is substantial in the Iranian population aged 60 years and over. More research is needed to investigate the actual prevalence of elder abuse at the national level.     

Prevalence of Sexual Trauma History Using Behaviorally Specific Methods of Assessment in First Year College Students

There are several challenges associated with evaluating the prevalence of sexual trauma, including child sexual abuse and adult sexual assault. The aim of this study was to assess sexual trauma prevalence rates among first year college students (N = 954) using behaviorally specific questions and a more representative recruitment sample that did not rely on self-selection. Participants completed a list of sexual trauma questions, including general questions containing labels such as “rape” or “abuse” as well as behaviorally specific questions that describe specific behaviors that qualify as sexual trauma without labels. Results indicated that 6.7% of the sample reported at least one incident of child sexual abuse, with similar rates for men and women. Women were more likely to report a history of adult sexual assault, which was reported by 12.4% of the total sample. Participants were also more likely to endorse a history of sexual trauma when answering behaviorally specific rather than general “label” questions. Women survivors in particular were more likely than men to identify their experiences as abuse/assault (66.7% versus 21.1% for child sexual abuse), which may help explain prevalence differences between men and women in prior research. Men may be less likely than women to label their experiences as abuse and may be underidentified in sexual trauma research without the use of behaviorally specific questions. Overall, the results of this study suggest that the prevalence of sexual trauma is better assessed using behaviorally specific questions and that this is an important topic of study among both men and women.     

Evolving Narratives About Childhood Sexual Abuse: Challenging the Dominance of the Victim and Survivor Paradigm

This research project explored the ongoing process of constructing a narrative, following childhood sexual abuse. Twenty‐two men and women aged 25–70 were interviewed about their childhood sexual experiences with adults using narrative inquiry methodology. These experiences occurred in different social and historical contexts, when the theoretical understandings and treatment of the issue of child sexual abuse were significantly different from the present. Many factors made disclosure even more difficult then than it is now including: respect for authority; rigid gender roles; the taboo surrounding sexual issues; lack of supportive adults; and lack of language to describe what was happening. Participants told four differing narratives about their experiences: narratives of silence; narratives of ongoing suffering; narratives of transformation; and narratives of transcendence. These narratives were examined in relation to the changing social and historical context and the current dominance of the victim and survivor paradigm in the child sexual abuse literature.     

Betrayed and Broken: A Study of the Experiences of Victims of Child Sexual Abuse in the Ga Community in Accra,Ghana

ABSTRACT

Child sexual abuse is increasingly becoming an issue of concern in most societies across the globe, including Ghana. This is a phenomenological study that sought to describe the lived experiences of victims of child sexual abuse in Ghana, using the Ga community as a case study. Purposive and snowball sampling techniques were used to identify 17 sexually abused children in the Ga Community. Using the interpretative phenomenological analysis (IPA), four main themes described the experiences of the victims: (a) forced sex (b) incest (c) joleying and (d) transactional sex. The findings illustrate the different circumstances in which children were sexually abused in the community studied. It also presents socio-cultural factors that normalizes the sexual abuse of children in the Ga Community. These findings underline the need for effective preventive programs and community interventions to protect children and support victims of child sexual abuse.     

Does the mandate make a difference? reporting decisions in emotional abuse

Mandated (N = 57) and non‐mandated (N = 94) reporters were questioned as to their perceptions of the seriousness of 20 vignettes related to child emotional abuse, as well as their willingness to report the actions contained in the vignettes to child protective services. No difference was observed between mandated and non‐mandated reporters on the mean number of vignettes considered reportable. In addition, several psychosocial variables, including perceptions of teasing, political viewpoint, tendencies towards diffuse responsibility, perceptions of child protective services (CPS) and attitude towards helping others, were measured. Separate regression equations for mandated and non‐mandated reporters showed two different models in predicting reporting tendencies. Mandated reporters were most affected by the seriousness of the situation and their willingness to engage in prosocial behaviour, whereas non‐mandated reporters were most motivated by judgements of the seriousness of the abusive situation and their faith in child protective services. Being a male was also observed to be more predictive of reporting for non‐mandated reporters. Copyright © 2006 John Wiley & Sons, Ltd.     

Exploring Posttraumatic Outcomes as a Function of Childhood Sexual Abuse

There is sparse systematic examination of the potential for growth as well as distress that may occur for some adult survivors of childhood sexual abuse. The presented study explored posttraumatic growth and its relationship with negative posttrauma outcomes within the specific population of survivors of childhood sexual abuse (N = 40). Results showed that 95% of the participants experienced clinically significant post-traumatic stress disorder symptomatology related to their childhood sexual abuse. In conjunction with these high levels of negative symptoms, the population evidenced posttraumatic growth levels that were comparable to other trauma samples. This research has clinical relevance in terms of adding to the knowledge base on sexual abuse and the usefulness of this knowledge in therapeutic interventions and relationships.     

Beyond Power and Control: Clinical Interventions with Men Engaged in Partner Abuse

Within the context of agency practice, most programs for abusive men are informed by the Duluth Model, suggesting that male violence against women is influenced by the dictates of patriarchy and sexism. Accordingly, this model promotes the importance of educational groups, which aim to debunk men’s stereotypical beliefs about women. Thus, men’s early abuse history, which also contributes to the use of violence, is omitted from service delivery. In contrast, this article explores the use of clinical interventions with men engaged in partner abuse with particular emphasis on a psychodynamic approach. The premise is that exposure to partner abuse during childhood as well as being the target of child abuse both shape the histories of these men in varying degrees, often manifesting in shame, depression, anxiety, and fear of abandonment, resulting in a poor self-image. Since environmental and socio-cultural influences inhibit them from expressing feelings associated with their experiences, clinical work, in contrast, encourages the development of insight and helps build skills that facilitate adaptive psychosocial functioning. This process unlocks suppression of affect by giving them ways to examine how certain events that occurred earlier in their lives contribute to the ways in which they treat their partners. Attachment, social learning and object relations theories all provide the theoretical frameworks. The case of Tom addresses partner abuse in the context of heterosexual relationships, demonstrating how psychodynamically informed psychotherapy can benefit abusive men.

Parenting in Females Exposed to Intimate Partner Violence and Childhood Sexual Abuse

Child sexual abuse and intimate partner violence may have a significant impact on parenting. The current study expands on existing research by examining the effects of child sexual abuse and intimate partner violence on parenting styles and parenting self-efficacy. In women from a parenting intervention program (n?=?20), child sexual abuse was related to lower parenting self-efficacy and more permissive parenting. In women at a domestic violence shelter (n?=?45), child sexual abuse was related to current sexual coercion of the partner, and authoritative parenting was related to higher parenting self-efficacy. These results indicate that having a history of child sexual abuse should be taken into consideration when dealing with mothers in violent relationships.     

The Effects of Childhood Sexual Abuse and Other Trauma on Drug Court Participants

Within the context of a larger study of drug court participants, this study examined the impact of traumatic experiences on psychiatric distress and on court outcomes. In the analyses, the participants (n = 229) were separated into 3 groups: childhood sexual abuse (CSA; n = 18), other trauma (n = 134), and no trauma (n = 77). The CSA group had higher mean scores on depression, anxiety, panic disorder, social phobia, somatization, and posttraumatic stress disorder than the other trauma group. Path analyses suggest that a history of trauma is a positive predictor of psychiatric distress and negative court events (positive urine screens, sanctions, etc.), with indirect effects on substance abuse severity, and failure in the drug court. These results suggest a need for the initial assessment procedure in drug courts to include a screening for trauma history, including CSA. They also suggest a need for trauma-informed care within drug courts.     

Sexual Dysfunction among Male Patients with Tramadol abuse: A Case-Control Study

Objective: Here we have investigated the association between tramadol abuse and male sexual function. Methods: Eighty-two male tramadol abuse patients and 55 healthy controls (20- to 45-years-old) were included in the study. Data from a sociodemographic questionnaire and the International Index of Erectile Function Questionnaire were collected and analyzed. Results: The tramadol abuse patients were 5 times more likely than their healthy counterparts to have erectile dysfunction. The tramadol abuse patients also had worse scores in the orgasmic, sexual desire, intercourse satisfaction, and overall satisfaction domains compared to the controls. Conclusion: Sexual dysfunctions are common among tramadol abuse patients.     

Ritual,and child sexual abuse,but not ritual child sexual abuse

Central to the controversy over ritual (satanic) child sexual abuse have been claims concerning agency ‘diagnoses’ of cases. Specifically, it has been alleged that agency findings of ritual abuse have been erroneous and are the product of poor practice. There is, though, little systematic information regarding agency assessment of suspected ritual abuse cases. This paper presents two cases where there was evidence both of child sexual abuse and ‘ritual’ but where agencies adjudged that these aspects occurred independently of one another and were not indicative of ritual child sexual abuse. The existence of these cases underlines the need for a broader and more balanced debate in respect of ritual abuse in general and the agency handling of these cases in particular. Copyright © 2000 John Wiley & Sons, Ltd.