Impact of the Most Frequently Reported Traumatic Events on Community Mental Health Clients

This survey of 354 community mental health clients examined the relative impact of client self-reported events that they deemed “most traumatic” for predicting posttraumatic stress syndrome (PTSD) symptom severity. Results of the voluntary survey revealed the most traumatic lifetime events to be (in descending order of frequency): sudden death of a loved one, sexual abuse, physical abuse, suicide attempt, and having been in a serious/life-threatening accident. These factors were then tested for gender differences, and regression models were developed to test the predictive power of traumatic events relative to primary diagnosis, psychosocial well-being, other key psychiatric indicators, and drinking to cope with negative emotions. Results demonstrated that sexual abuse was reported to be among the strongest predictors of PTSD symptom severity. Separate regression models also revealed important gender differences. Implications for social work assessment of seriously mentally ill clients are suggested.     

Fiduciary Abuse of the Elderly:

Fiduciary abuse of the elderly is an increasingly recognized social problem. While all seniors are potential victims, the oldest members of society are at greater risk. This article identifies those at risk, profiles those most likely to commit financial abuse, describes indicators of abuse, defines commonly encountered crimes, and explains the roles of service professionals and the criminal justice system in responding to incidents of financial abuse.     

Abuse among rural mentally ill.

Each American adult has the right to make individual decisions. These decisions include preferences in lifestyle, occupation, diet, housing, health-care treatment, and allocations of financial resources. The right to autonomous decision making is not limited to young or middle-aged adults, nor is it limited to those occasions during which the individual has the capacity to personally participate in the decisions (US Congress, 1987). The right also applies to elderly, incapacitated, mentally ill, or dependent adults. Because of this autonomy, no individual must suffer physical, psychological, or financial coercion. Based on these rights, all 50 states have enacted statutes to protect dependent adults and to authorize government intervention in cases of suspected adult abuse (Hunzeker, 1990). Iowa is one of the states that has enacted dependent adult abuse legislation, and in 1988, health-care practitioners in Iowa became mandatory reporters of adult abuse (Iowa Code, 1992). As mandatory reporters, all nurses who treat, counsel, examine, or attend dependent adults must observe the physical status and interpersonal relationships of their clients and significant others to identify potential conflict or injury. Categories of abuse recognized by the Iowa law include physical, sexual, and financial abuse, neglect by self, and neglect by another (Figure).     

Promising practices for delivery of court-supervised substance abuse treatment: perspectives from six high-performing California counties operating Proposition 36

Operative for nearly a decade, California's voter-initiated Proposition 36 program offers many offenders community-based substance abuse treatment in lieu of likely incarceration. Research has documented program successes and plans for replication have proliferated, yet very little is known about how the Proposition 36 program works or practices for achieving optimal program outcomes. In this article, we identify policies and practices that key stakeholders perceive to be most responsible for the successful delivery of court-supervised substance abuse treatment to offenders under Proposition 36. Data was collected via focus groups conducted with 59 county stakeholders in six high-performing counties during 2009. Discussion was informed by seven empirical indicators of program performance and outcomes and was focused on identifying and describing elements contributing to success. Program success was primarily attributed to four strategies, those that: (1) fostered program engagement, monitored participant progress, and sustained cooperation among participants; (2) cultivated buy-in among key stakeholders; (3) capitalized on the role of the court and the judge; and (4) created a setting which promoted a high-quality treatment system, utilization of existing resources, and broad financial and political support for the program. Goals and practices for implementing each strategy are discussed. Findings provide a "promising practices" resource for Proposition 36 program evaluation and improvement and inform the design and study of other similar types of collaborative justice treatment efforts.     

Financial oppression and post-separation child positions in Sweden

The present paper deals with post-separation child positions in two domains of practice in the Swedish welfare state: welfare benefits such as financial aid and child contact. The area of concern is financial oppression in the context of parental separation. Empirically, the study draws upon three types of material: interviews with victimised mothers, court orders in welfare benefit appeals and court orders in contested contact cases. Findings suggest that financial abuse in the context of parental separation is a non-question in the domain of welfare benefits, and in the domain of child contact framed as a conflict between equal parties. Object without voice and with needs ignored was the typical child position in welfare benefits cases, whereas incompetent subject was more prominent in child contact cases. Age order as a form of domination may be reinforced by the practice of both domains.     

Risk Indicators of Elder Mistreatment in the Community

ABSTRACT

This study examined risk indicators of chronic verbal aggression, physical aggression, and financial mistreatment in a population-based sample of 1,797 independently living elderly in Amsterdam, The Netherlands. Included were socio-demographic characteristics, physical and psychological health, and functional capacity. The data were collected using standardized interviews that took place in the homes of the respondents. The results showed that chronic verbal aggression was associated with an elder living with a partner or other(s) and in poor or bad health. Physical aggression was associated with an elder living with a partner or other(s) and having depressive symptoms. Finally, financial mistreatment was associated with being male, living alone, being partially dependent in instrumental activities of daily living and having depressive symptoms. The results indicate that the risk indicators of victims of financial mistreatment differ from those of chronic verbal aggression and physical aggression, suggesting that financial mistreatment may occur more often as a single form of abuse whereas verbal and physical aggression may more frequently occur together.     

Feasibility of Integrating Mental Health Screening and Services Into Routine Elder Abuse Practice to Improve Client Outcomes

This study examined law enforcement and prosecution involvement in 71 cases of elder abuse where pure financial exploitation (PFE), physical abuse (PA), neglect (Neglect), or hybrid financial exploitation (HFE) (financial exploitation co-occurring with physical abuse and/or neglect) occurred in a domestic setting. Victims of elder abuse and assigned Adult Protective Services (APS) caseworkers were systematically interviewed. Law enforcement officials were involved in 54% of the cases, and 18% of the cases were prosecuted. PA was significantly more likely to trigger a law enforcement response and to be prosecuted than Neglect or PFE. HFE involved prosecution for assault rather than financial exploitation. Generally, the victims of elder abuse were not receptive to criminal justice involvement, which appears to have a significant impact upon the level of this involvement. The reasons for this reluctance are discussed, as well as the challenges and limitations of criminal justice system involvement and related implications for policy and practice.     

Definitions of elder abuse in an Italian sample

The purpose of this exploratory qualitative study was to analyze definitions of elder abuse in an Italian convenience sample. Fifty-three Italian participants (15 males, 38 females) provided examples of mild, moderate, and extreme mistreatment of older individuals by their adult children. Analyses were conducted to identify frequently mentioned types of abuse and to determine how severe they were judged to be. Also examined was the extent to which gender and age contributed to response patterns. Most examples of extreme elder abuse made reference to physical abuse and neglect, while references to psychological aggression and neglect predominated as examples of moderate and mild abuse. Examples of neglect appeared with equal frequency at all levels of severity, but physical aggression was mentioned primarily as a form of extreme abuse, and psychological aggression was mentioned more frequently in examples of moderate and mild abuse. The most frequently identified types of specific abuse were abandonment, verbal abuse, emotional abuse, and psychological neglect. When giving examples of extreme abuse, females mentioned more instances of financial exploitation than males. They also gave more examples of verbal aggression and lack of respect as instances of moderate abuse and behaviors reflecting power or control as examples of mild abuse. A statistically significant negative relationship was found between age and the number of examples given of particular types of mistreatment at each of the levels of severity of abuse.     

Addressing substance abuse treatment needs of parents involved with the child welfare system

The goal of this paper is to synthesize available data to help guide policy and programmatic initiatives for families with substance abuse problems who are involved with the child welfare system, and identify gaps in the research base preventing further refinement of practices in this area. To date, Family Treatment Drug Court and newly developed home-based substance abuse treatment interventions appear the most effective at improving substance abuse treatment initiation and completion in child welfare populations. Research is needed to compare the efficacy of these two approaches, and examine cost and child well-being indicators in addition to substance abuse treatment and child welfare outcomes.     

Definitions of Elder Abuse in an Italian Sample

ABSTRACT

The purpose of this exploratory qualitative study was to analyze definitions of elder abuse in an Italian convenience sample. Fifty-three Italian participants (15 males, 38 females) provided examples of mild, moderate, and extreme mistreatment of older individuals by their adult children. Analyses were conducted to identify frequently mentioned types of abuse and to determine how severe they were judged to be. Also examined was the extent to which gender and age contributed to response patterns. Most examples of extreme elder abuse made reference to physical abuse and neglect, while references to psychological aggression and neglect predominated as examples of moderate and mild abuse. Examples of neglect appeared with equal frequency at all levels of severity, but physical aggression was mentioned primarily as a form of extreme abuse, and psychological aggression was mentioned more frequently in examples of moderate and mild abuse. The most frequently identified types of specific abuse were abandonment, verbal abuse, emotional abuse, and psychological neglect. When giving examples of extreme abuse, females mentioned more instances of financial exploitation than males. They also gave more examples of verbal aggression and lack of respect as instances of moderate abuse and behaviors reflecting power or control as examples of mild abuse. A statistically significant negative relationship was found between age and the number of examples given of particular types of mistreatment at each of the levels of severity of abuse.     

Participation of Mentally Disabled Persons in Experimental Research

Abstract

The need for persons adjudged incompetent is sometimes crucial to performing necessary research. However, this is a complicated proposition since the rights of mentally challenged persons must be protected. There is an acknowledged need to balance the objective requirements of scientific research with the rights and concerns of those who are the subjects of experimentation. This article discusses the role of social workers concerning the participation of mentally challenged persons in experimental research.     

Elder mistreatment in urban India: a community based study

This study examined the extent and correlates of elder mistreatment among 400 community dwelling older adults aged 65 and above in Chennai, India. The prevalence rate of mistreatment was 14%. Chronic verbal abuse was the most common followed by financial abuse and the rate of physical abuse and neglect was similar. Among the mistreated, exactly half of them had experienced more than one type of mistreatment (multifaceted-mistreatment). With the exception of financial abuse, a significantly greater number of women experienced verbal and physical abuse as well as neglect compared to men. Adult children, daughters-in-law, spouses, and sons-in-law were the prominent perpetrators. The mistreated older adults were more depressed and less satisfied with life than those who were not mistreated. Logistic regression analysis revealed gender, social support, and subjective rating of physical health as significant factors associated with abuse.     

Elder abuse and neglect in an urban chinese population

This study aims to investigate the prevalence of elder abuse and neglect in an urban Chinese population. A cross-sectional study was performed in a major urban medical center in NanJing, China. A total of 412 participants completed the survey and 145 (35%) participants screened positive for elder abuse and neglect. The mean age of the victims was 69 years and 59% were male. Caregiver neglect was the most common form of abuse, followed by financial exploitation, psychological abuse, physical abuse, sexual abuse, and abandonment. Thirty-six percent of the victims suffered multiple forms of abuse and neglect. In the logistical regression analyses of the data, female gender, lower education and lower income were demographic risk factors associated with elder abuse and neglect. A better understanding of these and additional risk factors associated with elder abuse and neglect in older Chinese people is needed.     

English perceptions of elder abuse

The purpose of this exploratory study was to investigate an English sample's perceptions on elder abuse, inflicted by adult children against their aging parents. Fifty participants (14 males, 46 females) provided examples of extreme, moderate, and mild elder abuse. As examples of extreme abuse, most participants mentioned neglect and physical aggression. Various forms of neglect and psychological abuse were their most common examples of moderate and mild abuse. References to physical aggression appeared most often as examples of extreme abuse rather than of moderate or mild abuse. Within these main categories, the specific subtypes most frequently mentioned by the sample included physical neglect, psychological neglect, verbal abuse, and deprivation. More females than males provided examples of financial abuse and physical neglect. Females were also more likely than males to list psychological neglect as an extreme form of abuse and disrespect as a form of mild abuse. At the moderate level, males referred to abuse relating to power more often than females. A positive relationship was found between age and the number of examples of physical neglect given at the moderate level and the number of examples of emotional abuse given at the mild level.     

Senator Breaux's Elder Justice Proposal of 2002 Executive Summary

ABSTRACT

The purpose of this exploratory study was to investigate an English sample's perceptions on elder abuse, inflicted by adult children against their aging parents. Fifty participants (14 males, 46 females) provided examples of extreme, moderate, and mild elder abuse. As examples of extreme abuse, most participants mentioned neglect and physical aggression. Various forms of neglect and psychological abuse were their most common examples of moderate and mild abuse. References to physical aggression appeared most often as examples of extreme abuse rather than of moderate or mild abuse. Within these main categories, the specific subtypes most frequently mentioned by the sample included physical neglect, psychological neglect, verbal abuse, and deprivation. More females than males provided examples of financial abuse and physical neglect. Females were also more likely than males to list psychological neglect as an extreme form of abuse and disrespect as a form of mild abuse. At the moderate level, males referred to abuse relating to power more often than females. A positive relationship was found between age and the number of examples of physical neglect given at the moderate level and the number of examples of emotional abuse given at the mild level.     

Exposure to Economically Abusive Tactics Among Adolescent Girls in the Child Welfare System

Economically abusive tactics (EAT), including financial exploitation, economic control, and employment sabotage, have been increasingly identified in intimate relationships. Negative outcomes include increased material hardship, increased depression, and co-occurrence with physical and emotional abuse. However, there is no known research on adolescent exposure to EATs, or its relationship with other well-being indicators. This exploratory study examined the extent of witnessing EAT among adolescent girls involved in child welfare, along with relationships between witnessing EAT and exposure to physical violence, risk of mental health challenges, and current financial self-efficacy. Interviews were conducted with 105 girls ages 12–19. Results indicated that nearly half witnessed moderate to high EATs. Rates of EATs were significantly higher among girls who witnessed physical violence. At the bivariate level, witnessing EATs was correlated with increased rates of physical and emotional abuse, physical neglect, and number of types of trauma, as well as higher levels of depression and PTSD and decreased financial self-efficacy. Implications include the need for measurement refinement, screening, prevention, and intervention for child welfare-involved girls, and continued research regarding EAT exposure.     

Elder Abuse and Neglect in an Urban Chinese Population

ABSTRACT

This study aims to investigate the prevalence of elder abuse and neglect in an urban Chinese population. A cross-sectional study was performed in a major urban medical center in NanJing, China. A total of 412 participants completed the survey and 145 (35%) participants screened positive for elder abuse and neglect. The mean age of the victims was 69 years and 59% were male. Caregiver neglect was the most common form of abuse, followed by financial exploitation, psychological abuse, physical abuse, sexual abuse, and abandonment. Thirty-six percent of the victims suffered multiple forms of abuse and neglect. In the logistical regression analyses of the data, female gender, lower education and lower income were demographic risk factors associated with elder abuse and neglect. A better understanding of these and additional risk factors associated with elder abuse and neglect in older Chinese people is needed.     

The characteristics and management of elder abuse: evidence and lessons from a UK case study

Despite older people representing a significant majority of victims of abuse in the UK and Europe, evidence about its characteristics and management is limited. This article reports on an analysis of adult protection referrals for older people over an eight year period in two English local authorities. It extends understanding of the characteristics of elder abuse and identifies lessons for its effective management. Findings suggest that older people are at particular risk of multiple and physical abuse. Those living alone are especially vulnerable to financial abuse and those living in a care home to multiple abuse. The most common sites of abuse were the person's own home or a care home. Just two fifths of abuse referrals were confirmed, with the vast majority involving multi-agency consultation and most resulting in ongoing monitoring. Findings also suggest that risk is a product of the intersection of dependency and setting and that information about user and carer need—especially the nature of disability—could enhance the quality of adult protection data and safeguarding responses. The study underscores the need for adult protection legislation and of committing professional resources to the prevention, identification, assessment and management of elder abuse across Europe.     

Financial exploitation of older persons in adult care settings: comparisons to physical abuse and the justice system's response

The current study uses a sample of 242 elder financial abuse cases and 314 elder physical abuse cases handled by fraud control units to shed some light on the dynamics of elder financial exploitation and the way the justice system processes these cases. Attention also is given to the way that the processing of elder financial exploitation cases can be distinguished from the processing of elder physical abuse cases. Results show that a wide range of elder financial exploitations cases are committed, and these cases should be broadly defined. Implications are provided.     

The effect of a family-based intervention with a cognitive-behavioral approach on elder abuse

ABSTRACT

Elder abuse may become a health issue in developing countries, including Iran. The purpose of this investigation was to study the effectiveness of Family-Based Cognitive-Behavioral Social Work (FBCBSW) in reducing elder abuse. In a randomized clinical trial in Iran, 27 elders participated in intervention and control groups. The intervention groups received a five-session FBCBSW intervention and completed the Domestic-Elder-Abuse-Questionnaire (DEAQ), which evaluates elder abuse at baseline and follow-ups. Repeated measures of analysis of variance (ANOVA) and the Wilcoxon test were used to analyze the data. The repeated measures ANOVA revealed that FBCBSW was successful in reducing elder abuse. The Wilcoxon test indicated that emotional neglect, care neglect, financial neglect, curtailment of personal autonomy, psychological abuse, and financial abuse significantly decreased over time, but there was no statistically significant difference in physical abuse before and after the intervention. The findings from this study suggest that FBCBSW is a promising approach to reducing elder abuse and warrants further study with larger samples.