Acad Med. 2011 Oct; 86(10): 1282-7
Vivian LM, Naidu CS, Keikelame MJ, Irlam J

To elicit South African medical students' experiences of witnessing patient rights abuses and professional lapses during their clinical training in order to inform an appropriate and effective response.During June and July 2009 at the University of Cape Town Faculty of Health Sciences, the authors surveyed 223 fourth-, fifth-, and sixth-year medical students in selected clinical rotations concerning abuses they had observed. Volunteers were later interviewed individually. The authors coded interview transcripts for key themes using a constant-comparative grounded theory approach.Of 223 students surveyed, 183 (82%) responded, 130 (71%) of whom reported witnessing patient rights abuses and professional lapses, including physical abuse (38%), verbal abuse (37%), disrespect for patients' dignity (25%), and inadequately informing patients about their treatment (25%). Students attributed abuse to stressed health workers, overburdened facilities, and disempowered patients. Most students who witnessed abuse (59%) did not actively respond, and 64% of survey respondents felt unprepared or uncertain about challenging abuses in the future. Interviews with 28 students yielded detailed accounts of the abuses witnessed and of students' emotional reactions, coping strategies, and responses. Most students did not report abuses; they feared reprisal or doubted it would make a difference.This study demonstrates the disjunction between what these students were taught about human rights and ethics and what they witnessed in clinical settings. The high prevalence of patient rights abuses experienced by these students highlights the need to align medical ethics and human rights with medico-legal protocols in theory and clinical practice.

J Immigr Minor Health. 2011 Jun 8;
Infante C, Idrovo AJ, Sánchez-Domínguez MS, Vinhas S, González-Vázquez T

Thousands of Mexican and Central American migrants converge at the Mexico-United States border. Undocumented migrants in transit to the United States are vulnerable due to their lack of access to health care and legal assistance. This study attempts to provide evidence on the violent-related consequences that migration has on migrants. A mixed-method study was conducted between April 2006-May 2007 in shelters in Baja California, Mexicali and Tijuana, Mexico. 22 in depth interviews were performed and fifteen hundred and twelve migrants responded a questionnaire. Results from both in-depth interviews and the analysis of the quantitative data shows the different types of violence experiences by migrants which include threats, verbal abuse, and arbitrary detention based on ethnicity, as well as assaults, beatings and sexual violence. It is crucial to stress the importance and the need to evidence the condition in which migrants' transit to the US and to effectively respond to the violence they experience.

Saudi Med J. 2012 Jan; 33(1): 76-82
Algwaiz WM, Alghanim SA

To identify the prevalence, causes, types, and sources of workplace violence among health professionals in public hospitals in the Kingdom of Saudi Arabia.This exploratory cross-sectional survey employed self-administered questionnaires to collect data on aspects of workplace violence against physicians and nurses in Saudi hospitals. The questionnaires were distributed randomly to 600 physicians and nurses, of which 383 (63.8%) completed the questionnaires at 2 public hospitals in Riyadh city between May and July 2011.More than two-thirds (67.4%) of respondents reported they were victims of violence in the previous 12 months. Nurses were more likely to be exposed to violent incidents than physicians (p

Child Abuse Negl. 2011 Aug; 35(8): 601-5
Eslick GD, Koloski NA, Talley NJ

Approximately one third of patients with non cardiac chest pain (NCCP) report a history of abuse, however no data exists on the prevalence of abuse among people with unexplained chest pain in the general population. We aimed to determine if there is a relationship between childhood sexual, physical, emotional abuse and unexplained chest pain, and to identify whether any potential relationship is being driven by an association with psychological distress.Subjects were identified from 2 previous random population surveys that included people with irritable bowel syndrome (IBS) and/or functional dyspepsia (FD) and healthy controls. People in the unexplained chest pain group (n=27) had chest pain in the past 12months that was not heartburn or heart disease. People in the comparison group (n=60) did not have chest pain for more than 12months. Self-reported abuse and psychological variables were assessed using validated measures.Emotional/verbal abuse (20.8% versus 4.4%, P=0.032) and physical abuse (16.7% versus 2.2%, P=0.028) were significantly more common in people with unexplained chest pain versus the comparison group. Only a history of emotional/verbal abuse was a significant independent predictor of meeting criteria for unexplained chest pain (OR=5.66; 95%CI 1.01-31.80, P=0.049) even after controlling for IBS and/or FD (OR=5.45; 95%CI 0.96-30.83, P=.05), but not when depression was controlled for (OR=4.70; 95%CI 0.90-27.61), P=0.08.A history of childhood emotional/verbal abuse is a risk factor for having unexplained chest pain but the association may be moderated by psychological distress, specifically depression.

Nurs Clin North Am. 2011 Dec; 46(4): 457-64, vi
Araujo S, Sofield L

Workplace violence is not a new phenomenon and is often sensationalized by the media when an incident occurs. Verbal abuse is a form of workplace violence that leaves no scars. However, for nurses, the emotional damage to the individual can affect productivity, increase medication errors, incur absenteeism, and decrease morale and overall satisfaction within the nursing profession. This results in staffing turnover and creates a hostile work environment that affects the culture within the organization.

PLoS One. 2011; 6(12): e28852
Teicher MH, Vitaliano GD

Research on the consequences of witnessing domestic violence has focused on inter-adult violence and most specifically on violence toward mothers. The potential consequences of witnessing violence to siblings have been almost entirely overlooked. Based on clinical experience we sought to test the hypothesis that witnessing violence toward siblings would be as consequential as witnessing violence toward mothers. The community sample consisted of unmedicated, right-handed, young adults who had siblings (n = 1,412; 62.7% female; 21.8±2.1 years of age). History of witnessing threats or assaults to mothers, fathers and siblings, exposure to parental and sibling verbal abuse and physical abuse, sexual abuse and sociodemographic factors were assessed by self-report. Symptoms of depression, anxiety, somatization, anger-hostility, dissociation and 'limbic irritability' were assessed by rating scales. Data were analyzed by multiple regression, with techniques to gauge relative importance; logistic regression to assess adjusted odds ratios for clinically-significant ratings; and random forest regression using conditional trees. Subjects reported witnessing violence to siblings slightly more often than witnessing violence to mothers (22% vs 21%), which overlapped by 51-54%. Witnessing violence toward siblings was associated with significant effects on all ratings. Witnessing violence toward mother was not associated with significant effects on any scale in these models. Measures of the relative importance of witnessing violence to siblings were many fold greater than measures of importance for witnessing violence towards mothers or fathers. Mediation and structural equation models showed that effects of witnessing violence toward mothers or fathers were predominantly indirect and mediated by changes in maternal behavior. The effects of witnessing violence toward siblings were more direct. These findings suggest that greater attention be given to the effects of witnessing aggression toward siblings in studies of domestic violence, abuse and early adversity.

Acad Med. 2011 Nov; 86(11): 1374-82
Rees CE, Monrouxe LV

Previous medical student abuse research employed quantitative surveys that failed to explore factors thought to contribute to abuse and students' actions in the face of abuse. This study examined medical student abuse narratives to identify types of perceived abuse, factors cited by students as contributing to abuse, and students' actions at the time of abuse.A qualitative design was adopted employing 22 individual and 32 group interviews to elicit narratives of professionalism dilemmas from 200 medical students at two 5-year undergraduate programs and one 4-year graduate entry program (England, Wales, and Australia) between 2007 and 2009. Thematic analysis of abuse narratives was conducted.Of 833 professionalism dilemma narratives, 86 (10%) involved perceived medical student abuse. Within these narratives, students reported mostly covert, status-related abuse, direct verbal abuse, and sexual harassment and discrimination. Some narrators described multiple factors contributing to abuse (individual, work, and/or organization); most cited factors focusing on individuals. Despite the abuse typically recounted with negative emotion, few participants reported resisting at the time of abuse by challenging or reporting the perpetrator. Participants gave a variety of reasons for this inaction (e.g., anxiety about receiving bad marks from the perpetrator) and for resisting (e.g., the abuse was affecting their education negatively).Although narratives focused predominantly on individual factors contributing to abuse and responses to abuse, educators should focus on the dynamic interplay between individual and organizational factors to combat abuse. Several opportunities to mitigate this continuing blight on the conscience of the profession are described.

Niger J Med. 2011 Jul-Sep; 20(3): 355-9
Jeremiah I, Kalio GB, Oriji VK

Domestic violence is common worldwide. When it occurs in pregnancy it is associated with maternal and perinatal morbidity and mortality. It is a human rights violation with medical implication which is under-diagnosed and under-reported. This study sought to determine the prevalence of domestic violence during pregnancy and the factors that promotes domestic violence at the family unit.A cross sectional study of antenatal clients seen at the antenatal booking clinic of the University of Port Harcourt Teaching Hospital from 1st June to 31st December 2007. Five hundred clients selected from a simple random technique completed an interviewer administered structured questionnaire which sought information on domestic violence. Data collected was entered into a spreadsheet and analyzed using the statistical package SPSS 15.00 for Windows.The prevalence of domestic violence during pregnancy in this group was 7.8%. Those who experienced domestic violence were mainly those with low education and low parity. The commonest form of domestic violence was verbal abuse (shouting, cursing) occurring in 43.5% of those who have been abused in the index pregnancy and 1.2% of the victims of domestic violence suffered physical injuries from domestic violence in previous pregnancies. However, less than one third disclosed the incident. Women whose husbands indulge in substance abuse or are without jobs were more likely to experience domestic violence. Abdominal pain and miscarriage were the commonest obstetric complications following domestic violence-in pregnancy in this group.Eight percent of our antenatal mothers suffer domestic violence and many of them are unlikely to report it. Unemployment and substance abuse in the partners are major associated factors. Domestic violence in pregnancy has far-reaching adverse consequence on the mother and her unborn fetus such as miscarriage especially when it occasions bodily harm.

AIDS Educ Prev. 2011 Jun; 23(3): 193-205
Nattabi B, Li J, Thompson SC, Orach CG, Earnest J

HIV-related stigma continues to persist in several African countries including Uganda. This study quantified the burden of stigma and examined factors associated with stigma among 476 people living with HIV (PLHTV) in Gulu, northern Uganda. Data were collected between February and May 2009 using the HIV/AIDS Stigma Instrument-PLWA. Females more than males, respondents aged above 30 years, and those who had been on antiretroviral therapy for a longer time experienced higher levels of stigma. Verbal abuse and negative self-perception were more common forms of stigma. The association between antiretroviral therapy and stigma suggested that organizational aspects of antiretroviral delivery may lead to stigmatization of PLHIV. Interventions such as counseling of PLHIV, education of health workers and the community would lead to reductions in negative self-perception and verbal abuse and in turn improve the quality of life for PLHIV in northern Uganda.

Health Estate. 2011 Jun; 65(6): 47-9
Frith S

Sue Frith, deputy head of the NHS Security Management Service (NHS SMS), explains the organisation's important role in advising, and supporting, security staff at NHS hospitals in dealing with incidents ranging from verbal abuse to serious violence and aggression. Arguing that security in the NHS is "everyone's business", she explains both a range of processes and initiatives,already in place to safeguard people and assets, and discusses recent developments, such as a new incident reporting website, designed to help keep patients, staff, visitors, and property, at healthcare facilities safe and secure.

J Nurs Adm. 2011 Jul-Aug; 41(7-8): 315-23
Hess R, Desroches C, Donelan K, Norman L, Buerhaus PI

: The objective of the study was to compare perceptions of RNs employed in Magnet®, in-process (ie, hospitals seeking Magnet recognition), and non-Magnet hospitals using data from the 2010 National Survey of Registered Nurses (NSRN).: The NSRN is administered biennially and measures nurses' perceptions about their profession, workplace environment, and professional relationships.: Self-administered mail survey to a national sample of 1,500 RNs was used. Bivariate statistical techniques were used to analyze responses from 518 nurses who indicated their employer's Magnet status and to examine associations between Magnet status and the nurses' perceptions of career satisfaction, the nursing shortage, work environment, opportunities to influence the workplace, and professional relationships.: Nurses employed in all 3 groups (Magnet, in-process, and non-Magnet hospitals) were uniformly satisfied with being a nurse, although significantly more Magnet and in-process nurses would recommend nursing as a career than would non-Magnet RNs. Views of workplace safety were similar across groups, with no significant differences in violence, verbal abuse, discrimination, or harassment; however, Magnet nurses reported significantly more musculoskeletal injuries. Magnet and in-process nurses rated opportunities to influence decisions about workplace organization and participate in shared governance and employer-paid continuing education, and relationships with advanced practice nurses and nursing faculty higher than did non-Magnet nurses; relationships with new nurses and physicians were not different across groups.: The Magnet program continues to have a positive influence on nurses, their decision making, and their professional relationships. The paucity of other differences suggests that Magnet, in-process, and non-Magnet organizations are increasingly guided by a shared set of principles that define a positive professional environment derived not only by the Magnet program, but also by other professional organizations and forces.

Behav Ther. 2011 Dec; 42(4): 740-50
Beck JG, McNiff J, Clapp JD, Olsen SA, Avery ML, Hagewood JH

This study explored the association of shame and guilt with PTSD among women who had experienced intimate partner violence (IPV). Sixty-three women were assessed by a research clinic serving the mental health needs of women IPV survivors. Results indicated that shame, guilt-related distress, and guilt-related cognitions showed significant associations with PTSD but global guilt did not. When shame and guilt were examined in the context of specific forms of psychological abuse, moderation analyses indicated that high levels of both emotional/verbal abuse and dominance/isolation interacted with high levels of shame in their association with PTSD. Neither guilt-related distress nor guilt-related cognitions were moderated by specific forms of psychological abuse in their association with PTSD. These data support the conceptualization of shame, guilt distress, and guilt cognitions as relevant features of PTSD. Results are discussed in light of proposed changes to diagnostic criteria for PTSD.

Ment Health Today. 2011 Jul-Aug; 21
Faulkner A

PLoS One. 2011; 6(10): e26814
MacPherson P, Webb EL, Choko AT, Desmond N, Chavula K, Napierala Mavedzenge S, Makombe SD, Chunda T, Squire SB, Corbett EL

HIV/AIDS related stigma is a major barrier to uptake of HIV testing and counselling (HTC). We assessed the extent of stigmatising attitudes expressed by participants offered community-based HTC, and their anticipated stigma from others to assess relationship with HIV test uptake. From these data, we constructed a brief stigma scale for use around the time of HIV testing.Adult members of 60 households in urban Blantyre, Malawi, were selected using population-weighted random cluster sampling and offered HTC with the option to self-test before confirmatory HTC. Prior to HTC a 15-item HIV stigma questionnaire was administered. We used association testing and principal components analysis (PCA) to construct a scale measure of stigma. Of 226 adults invited to participate, 216 (95.6%) completed questionnaires and 198/216 (91.7%) opted to undergo HTC (all self-tested). Stigmatising attitudes were uncommon, but anticipated stigma was common, especially fearing verbal abuse (22%) or being abandoned by their partner (11%). Three questions showed little association or consistency with the remaining 12 stigma questions and were not included in the final scale. For the 12-question final scale, Cronbach's alpha was 0.75. Level of stigma was not associated with previously having tested for HIV (p = 0.318) or agreeing to HTC (p = 0.379), but was associated with expressed worry about being or becoming HIV infected (p = 0.003).Anticipated stigma prior to HTC was common among both men and women. However, the high uptake of HTC suggests that this did not translate into reluctance to accept community-based testing. We constructed a brief scale to measure stigma at the time of HIV testing that could rapidly identify individuals requiring additional support following diagnosis and monitor the impact of increasing availability of community-based HTC on prevalence of stigma.

J Occup Health. 2011 Dec 9; 53(6): 455-64
Alameddine M, Kazzi A, El-Jardali F, Dimassi H, Maalouf S

Emergency departments (EDs) workers are at increased risk of exposure to occupational violence. The prevalence of occupational violence is potentially higher and consequences are more serious in areas with poor security conditions.We investigated the prevalence, characteristics and factors associated with the exposure of ED workers to violence at Lebanese hospitals.All ED employees at six tertiary hospitals in Lebanon were surveyed using a cross-sectional design. The survey instrument included four sections collecting demographic/professional information and measuring exposure to violence, degree of job satisfaction and degree of professional burnout. The questionnaire was distributed to all ED employees at participating hospitals and was completed by 256 ED workers (70.3% response rate). Multinomial and binary logistic regressions were used to investigate factors significantly associated with verbal and physical violence. Results: Over the past 12 mo, four in five ED employees were verbally abused and one in four was physically assaulted. Exposure to verbal abuse was associated with serious outcomes including significantly higher levels of occupational burnout and an increased likelihood to quit current job. Exposure to physical violence was associated with increased likelihood-to-quit, nurse status and "public hospital" employment.Violence largely prevails at Lebanese EDs. Most vulnerable are nurses and employees of public hospitals who are disproportionally exposed to violence. ED stakeholders must work collaboratively to investigate the root causes of violence and devise and implement effective antiviolence policies and measures. Such measures will be necessary to protect the well-being and decrease the turnover of ED workers.

* The recent sale of the John Paul II Cultural Center in Washington (NCR, Aug. 19) has at least one thing in common with the sex abuse...

MORE than six out of 10 nurses have been verbally abused over the last two years while working in the community, according to a new poll. The...

Blah blah blah; what to do when words don't work.

Roam, Dan.

Portfolio Pub. Co.

2011

350 pages

...

LAS VEGAS -- UK lone worker specialists, Connexion2, the developer of the award winning Identicom® lone worker device, will...

www.nurseuncut.com.au/forum/ component/option,com_ccboard/ Itemid,24/forum,13/limitstart,240/ topic, 187/view,postlist/#ccbp4069

'I...

New Orleans Saints Coach Sean Payton joins the Verizon Foundation, NFL Players Association and A CALL TO MEN in taking the LIVERESPECT...

WITNESSES are asked to come forward after a racially aggravated assault in South Shields.

The incident happened at 7.30pm on...

MANILA, Philippines - After being chased by controversy pinning her to the purported maltreatment of her helpers, Maricel Soriano seemed to be...

Q) Have you ever witnessed racism as a young person growing up or within football? A) Many, many times. Certainly in my youth racism was much...

Byline: BARRY GIBSON

NEW figures show nearly 100 Kirklees Council staff were attacked this year.

Surprisingly the figures,...

J Clin Nurs. 2011 Dec 12;
Boström AM, Squires JE, Mitchell A, Sales AE, Estabrooks CA

Aim.  To describe the frequency of aggressive acts experienced by frontline staff working in two models of dementia care: Residential Alzheimer's Care Centers and Secured Dementia Units and to explore the associations between aggressive acts experienced by frontline staff and factors related to the work context and care providers. Background.  Aggression towards healthcare providers in residential long-term care settings is well documented. However, few studies have examined associations between aggressive behaviours towards care providers and organisational factors. Design.  A cross-sectional survey. Method.  The survey included demographic items and questions about aggressive acts experienced by staff and contextual factors. Analyses included: (1) descriptive statistics, (2) tests of difference (i.e. Student's t-test, Mann-Whitney U-test, chi-squared test and anova), (3) bivariate associations (i.e. Pearson and Spearman rank order correlations) and (4) multivariate linear regression. Results.  Ninety-one health care aides and licensed practical nurses working in four nursing units using two models of dementia care participated (response rate 81%). The most frequently reported types of aggression were physical assault (50% of staff, n = 45) and emotional abuse (48% of staff, n = 44). Aggressive acts were significantly associated with working in Secured Dementia Units rather than Residential Alzheimer's Care Centers. Conclusions.  Frontline staff working in Secured Dementia Units were exposed to higher frequencies of various types of aggressive acts mainly initiated by residents. Future research needs to explore modifiable workplace factors associated with aggressive acts in a larger sample across a variety of long-term care settings. Relevance to clinical practice.  To prevent staff perceived aggressive acts, leaders and managers in dementia care need to acknowledge the complex topic of workplace aggression and encourage an open discussion among frontline staff without assigning blame. Care provider strategies for dealing with aggressive behaviour have to be implemented in policies and clinical practice.

Psychosom Med. 2012 Jan 27;
Rooks C, Veledar E, Goldberg J, Bremner JD, Vaccarino V

ObjectiveAlthough early trauma (trauma in childhood) has been linked to adult inflammation and adult disease of inflammatory origin, it remains unknown whether this relationship is due to long-term consequences of early life stress or other familial factors.MethodsWe examined 482 male middle-aged twins (241 pairs) born between 1946 and 1956 from the Vietnam Era Twin Registry. Childhood traumatic experiences, before the age of 18 years, were measured retrospectively with the Early Trauma Inventory and included physical, sexual, emotional abuse and general trauma. Lifetime major depressive disorder and posttraumatic stress disorder were assessed with the Structured Clinical Interview for DSM-IV. Traditional risk factors for cardiovascular disease were also assessed. Plasma C-reactive protein and interleukin 6 were measured to determine levels of inflammation. Mixed-effects regression models with a random intercept for pair were used to separate between- and within-twin pair effects.ResultsWhen twins were analyzed as individuals, increasing levels of early trauma were positively related to C-reactive protein (p = .03) but not to interleukin 6 (p = .12). When estimating within- and between-pair effects, only the between-pair association of early trauma with the inflammatory markers remained significant.ConclusionsThe link between early trauma and inflammation is largely explained by familial factors shared by the twins because levels of inflammation were highest when both twins were exposed to trauma. Exposure to early trauma may be a marker for an unhealthy familial environment. Clarification of familial factors associated with early stress and adult inflammation will be important to uncover correlates of stress and disease.

J Forensic Nurs. 2011 Dec; 7(4): 195-202
Clements PT, Holt KE, Hasson CM, Fay-Hillier T

Pregnancy and motherhood traditionally represent evolution of the next generation; yet, contemporary research and analyses confirm that this time can also be manifested in fear by the expectant mother within an environment of battering, cruelty, physical and emotional abuse, and sexual assault. Often to the surprise of many healthcare providers, the Centers for Disease Control and Prevention have consistently reported that Interpersonal Violence (IPV) related homicide is a leading cause of traumatic death among new and expectant mothers. In spite of these staggering statistical and anecdotal findings, universal screening for violence during pregnancy continues to be minimal. Forensic nurses might be prompted to respond to the consequences of violence and its resultant negative effects on expectant mothers by strategically incorporating systematic and consistent assessment into foundational nursing curricula regarding IPV as a leading risk factor for injury or death.

Child Abuse Negl. 2011 Dec 22;
Theoklitou D, Kabitsis N, Kabitsi A

The existence of child abuse is unfortunately a reality of contemporary society. Although various organizations and researchers have been making progress in the struggle against abuse, it has not been decisively dealt with thus far. Most of the research on abuse has focused on the abuse of children in their family environment. OBJECTIVE: The aim of the present study was the investigation of abuse in the school environment and the effects of the gender and school grade of pupils, as well as the gender of teachers on the various forms of abuse. METHODS: The study utilized a questionnaire with a 5-point rating scale, with questions concerning physical abuse, emotional abuse and neglect, which was completed in class by a sample of schoolchildren. The sample consisted of 1,339 pupils in the 4th, 5th, and 6th grade of primary school in the Republic of Cyprus, who lived in both urban and rural areas. Two pilot studies were conducted initially to ensure the appropriateness of the questionnaire. Permission to conduct the study was gained by the headmasters of the schools, and authorization to participate in the study was granted by the students' parents. RESULTS: More than half (52.9%) of the pupils reported neglect, almost a third (33.1%) reported emotional abuse, and almost one tenth (9.6%) reported physical abuse. The results of the statistical analysis revealed statistically significant differences between the 2 genders (p.05). CONCLUSIONS: The gender of the pupils seems to be related to abuse, since more boys than girls reported being victims of abuse, while abuse is not depended on the school grade, or the teacher's gender. The findings from this study may justify some concern on behalf of the Ministry of Education, but also from educators and parents in the Republic of Cyprus.

Psychopathology. 2012; 45(1): 61-6
Jaite C, Schneider N, Hilbert A, Pfeiffer E, Lehmkuhl U, Salbach-Andrae H

Most studies on the relationship between childhood trauma and anorexia nervosa (AN) have focused on the role of childhood sexual and physical trauma in adult patients. Little is known about the role of emotional trauma and eating disorders. The aim of the present study was to examine childhood sexual, physical, and emotional traumatization in adolescents with anorexia nervosa restricting type (AN-R) in comparison to those with anorexia nervosa binge-eating/purging type (AN-BP) and a healthy control group.The sample included 50 patients with AN-R (mean age = 15.8 ± 1.6 years), 27 with AN-BP (mean age = 16.1 ± 1.1 years), and 44 healthy female control participants (mean age = 15.7 ± 1.3 years). AN diagnosis was confirmed by the Structured Inventory for Anorexic and Bulimic Syndromes (SIAB-EX). Childhood sexual, physical, and emotional traumatization was assessed by a self-report questionnaire (Childhood Trauma Questionnaire; CTQ).The results indicated higher rates of sexual, physical, and emotional abuse and physical and emotional neglect in patients with AN-BP than in patients with AN-R and healthy control participants. No significant differences in childhood traumatization were found between patients with AN-R and control participants.Our results underline the importance of detecting the full range of possible childhood traumatic experiences in adolescents with AN, rather than focusing simply on childhood sexual traumatization. Sexual, physical, and emotional childhood traumatization are particularly important in the history of adolescent patients with AN-BP, in contrast to patients with AN-R, and should be screened for in the diagnosis and therapy of eating disorders.

Int J Psychiatry Clin Pract. 2011 Nov; 15(4): 275-9
Sansone RA, Hahn HS, Dittoe N, Wiederman MW

In this study, we examined relationships between five types of childhood trauma and two measures of borderline personality symptomatology in a non-psychiatric clinical population in order to assess a potential association between these variables in a non-psychiatric-treatment-seeking population.Using a cross-sectional sample and a survey approach in 250 consecutive patients presenting for cardiac stress testing, we explored self-reported histories of five types of childhood trauma (i.e. witnessing violence, physical neglect, emotional abuse, physical abuse, sexual abuse), several aspects of past mental healthcare, and borderline personality symptomatology using two self-report measures (the borderline personality disorder scale of the Personality Diagnostic Questionnaire-4 and the Self-Harm Inventory).All relationships between the individual forms of trauma and total number of childhood traumas, and measures of borderline personality symptomatology, attained statistical significance. Using multiple regression analysis, sexual abuse in childhood was an independent predictor for borderline personality symptomatology in addition to past psychiatric/counseling care, with the latter finding suggesting some inter-drift of psychiatric patients into this cardiac stress test sample.In this non-psychiatric-treatment-seeking population, there appear to be relationships between various forms of trauma (especially sexual abuse) and borderline personality symptomatology, reinforcing the role of childhood trauma in borderline personality disorder.

Compr Psychiatry. 2011 Dec 13;
Zhang T, Chow A, Wang L, Dai Y, Xiao Z

BACKGROUND: There has been no large-scale examination of the association between types of childhood abuse and personality disorders (PDs) in China using standardized assessment tools and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. Hence, this study aimed to explore the relationship between retrospective reports of various types of childhood maltreatments and current DSM-IV PDs in a clinical population in China, Shanghai. METHOD: One thousand four hundred two subjects were randomly sampled from the Shanghai Psychological Counselling Centre. PDs were assessed using the Personality Diagnostic Questionnaire, Fourth Edition Plus. Participants were also interviewed using the Structured Clinical Interview for DSM-IV axis II. The Child Trauma Questionnaire (CTQ) was used to assess childhood maltreatment in 5 domains (emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect). RESULTS: According to Pearson correlations, childhood maltreatment had a strong association with most PDs. Subsequently, using partial correlations, significant relationships were also demonstrated between cluster B PDs and all the traumatic factors except physical neglect. A strongest positive correlation was found between cluster B PD and CTQ total scores (r = .312, P < .01). Using the Kruskal-Wallis rank sum test, significant differences in 4 groups of subjects (clusters A, B, and C PD and non-PD) in terms of emotional abuse (χ(2) = 34.864, P < .01), physical abuse (χ(2) = 14.996, P < .05), sex abuse (χ(2) = 9.211, P < .05), and emotional neglect (χ(2) = 17.987, P < .01) were found. Stepwise regression analysis indicated that emotional abuse and emotional neglect were predictive for clusters A and B PD, and sexual abuse was highly predictive for cluster B PD; only emotional neglect was predictive for cluster C PD. CONCLUSION: Early traumatic experiences are strongly related to the development of PDs. The effects of childhood maltreatment in the 3 clusters of PDs are different. Childhood trauma has the most significant impact on cluster B PD.

J Fam Violence. 2011 Nov; 26(8): 607-615
Jirapramukpitak T, Abas M, Harpham T, Prince M

Evidence suggests that certain migrant populations are at increased risk of abusive behaviors. It is unclear whether this may also apply to Thai rural-urban migrants, who may experience higher levels of psychosocial adversities than the population at large. The study aims to examine the association between migration status and the history of childhood sexual, physical, and emotional abuse among young Thai people in an urban community. A population-based cross-sectional survey was conducted in Northern Bangkok on a representative sample of 1052 young residents, aged 16-25 years. Data were obtained concerning: 1) exposures-migration (defined as an occasion when a young person, born in a more rural area moves for the first time into Greater Bangkok) and age at migration. 2) outcomes-child abuse experiences were assessed with an anonymous self report adapted from the Conflict Tactics Scales (CTS). There were 8.4%. 16.6% and 56.0% reporting sexual, physical, and emotional abuse, respectively. Forty six percent of adolescents had migrated from rural areas to Bangkok, mostly independently at the age of 15 or after to seek work. Although there were trends towards higher prevalences of the three categories of abuse among early migrants, who moved to Bangkok before the age of 15, being early migrants was independently associated with experiences of physical abuse (OR 1.9 95%CI 1.1-3.2) and emotional abuse (OR 2.0, 95%CI 1.3-3.0) only. Our results suggest that rural-urban migration at an early age may place children at higher risk of physical and emotional abuse. This may have policy implications for the prevention of childhood abuse particularly among young people on the move.

PLoS One. 2011; 6(12): e27738
Uthman OA, Moradi T, Lawoko S

Intimate partner violence against women (IPVAW) is a serious and widespread problem worldwide. Much of the research on IPVAW focused on individual-level factors and attention has been paid to the contextual factors. The aim of this study was to develop and test a model of individual- and community-level factors associated with IPVAW.We conducted a (multivariate) multilevel structural equation analysis on 8731 couples nested within 883 communities in Nigerian Demographic and Health Survey 2008. Variables included in the model were derived from respondents' answers to the experience of IPVAW, attitudes towards wife beating and witnessing physical violence in childhood. We found that women that witnessed physical violence were more likely to have tolerant attitudes towards IPVAW and women with tolerant attitudes were more likely to have reported spousal IPVAW abuse. Women with husbands with tolerant attitudes towards IPVAW were more likely to have reported spousal abuse. We found that an increasing proportion of women in the community with tolerant attitudes was significantly positively associated with spousal sexual and emotional abuse, but not significantly associated with spousal physical abuse. In addition, we found that an increasing proportion of men in the community with tolerant attitudes and an increasing proportion of women who had witnessed physical violence in the community was significantly positively associated with spousal physical abuse, but not significantly associated with spousal sexual and emotional abuse. There was a positive correlation between all three types of IPVAW at individual- and community-level.We found that community tolerant attitudes context in which people live is associated with exposure to IPVAW even after taking into account individual tolerant attitudes. Public health interventions designed to reduce IPVAW must address people and the communities in which they live in order to be successful.

Int J Psychiatry Clin Pract. 2012 Feb 1;
Sansone RA, Chang J, Jewell B, Rock R

Objective. Childhood trauma has been empirically associated with various types of self-regulatory difficulties in adulthood. However, according to the extant literature, no study has examined relationships between various types of childhood trauma and compulsive buying behavior in adulthood. Methods. Using a self-report survey methodology in a cross-sectional consecutive sample of 370 obstetrics/gynecology patients, we examined five types of childhood trauma before the age of 12 years (i.e. witnessing violence, physical neglect, emotional abuse, physical abuse, sexual abuse) in relationship to compulsive buying as assessed by the Compulsive Buying Scale (CBS). Results. All forms of trauma demonstrated statistically significant correlations with the CBS. Using a linear regression analysis, both witnessing violence and emotional abuse significantly contributed to CBS scores. Further analyses indicated that race did not moderate the relationship between childhood trauma and compulsive buying. Conclusions. Findings indicate that various forms of childhood trauma are correlated with compulsive buying behavior, particularly witnessing violence and emotional abuse.

Child Abuse Negl. 2012 Jan 19;
Green HD, Tucker JS, Wenzel SL, Golinelli D, Kennedy DP, Ryan GW, Zhou AJ

OBJECTIVE: Childhood abuse has been linked to negative sequelae for women later in life including drug and alcohol use and violence as victim or perpetrator and may also affect the development of women's social networks. Childhood abuse is prevalent among at-risk populations of women (such as the homeless) and thus may have a stronger impact on their social networks. We conducted a study to: (a) develop a typology of sheltered homeless women's social networks; (b) determine whether childhood abuse was associated with the social networks of sheltered homeless women; and (c) determine whether those associations remained after accounting for past-year substance abuse and recent intimate partner abuse. METHODS: A probability sample of 428 homeless women from temporary shelter settings in Los Angeles County completed a personal network survey that provided respondent information as well as information about their network members' demographics and level of interaction with each other. Cluster analyses identified groups of women who shared specific social network characteristics. Multinomial logistic regressions revealed variables associated with group membership. RESULTS: We identified three groups of women with differing social network characteristics: low-risk networks, densely connected risky networks (dense, risky), and sparsely connected risky networks (sparse, risky). Multinomial logistic regressions indicated that membership in the sparse, risky network group, when compared to the low-risk group, was associated with history of childhood physical abuse (but not sexual or emotional abuse). Recent drug abuse was associated with membership in both risky network groups; however, the association of childhood physical abuse with sparse, risky network group membership remained. CONCLUSIONS: Although these findings support theories proposing that the experience of childhood abuse can shape women's social networks, they suggest that it may be childhood physical abuse that has the most impact among homeless women. PRACTICAL IMPLICATIONS: The effects of childhood physical abuse should be more actively investigated in clinical settings, especially those frequented by homeless women, particularly with respect to the formation of social networks in social contexts that may expose these women to greater risks.

Child Abuse Negl. 2012 Jan 20;
Burns EE, Fischer S, Jackson JL, Harding HG

The present study examined the relationship of child maltreatment to both emotion dysregulation and subsequent eating pathology. In an effort to extend previous research, the authors examined the unique impact of childhood emotional abuse (CEA) on emotion dysregulation and eating disorder (ED) symptoms while controlling for the effects of sexual and physical abuse. Structural equation modeling was utilized to simultaneously examine the effects of all three abuse types on multiple dependent variables as well as examine whether deficits in emotion regulation mediated the relationship between abuse and eating pathology. Results from a survey of 1,254 female college students revealed significant paths from abuse subtypes to specific eating disorder symptoms, with CEA evidencing the strongest association with ED symptoms. Additionally, emotion dysregulation was positively associated with ED symptoms, and mediated the effects of emotional abuse on symptoms. Findings support previous research on the enduring effects of emotional abuse as well as highlight the importance of the assessment of CEA in the treatment of ED symptoms.

Int J Psychiatry Clin Pract. 2011 Sep 13;
Sansone RA, Farukhi S, Wiederman MW

Abstract Objective. In this study, we examined relationships between five types of childhood trauma and 17 disruptive behaviors in the medical setting. Methods. Using a cross-sectional consecutive sample of 394 internal medicine outpatients, we surveyed participants about five types of childhood trauma (i.e. witnessing of violence, physical neglect, emotional abuse, physical abuse, and sexual abuse) and 17 disruptive behaviors in the medical setting (e.g., yelling, cursing, threatening medical personnel). Results. Initial correlations indicated relationships between four of the five forms of childhood trauma and the number of different disruptive behaviors endorsed. However, using multiple regression analysis, only witnessing violence and physical abuse remained independent predictors of disruptive behaviors in the medical setting. Conclusions. Individuals with childhood histories of witnessing violence and/or physical abuse are at-risk for perpetrating various disruptive behaviors in the medical setting.

Br J Psychiatry. 2012 Feb; 200: 107-15
Keyes KM, Eaton NR, Krueger RF, McLaughlin KA, Wall MM, Grant BF, Hasin DS

Previous research suggests that various types of childhood maltreatment frequently co-occur and confer risk for multiple psychiatric diagnoses. This non-specific pattern of risk may mean that childhood maltreatment increases vulnerability to numerous specific psychiatric disorders through diverse, specific mechanisms or that childhood maltreatment engenders a generalised liability to dimensions of psychopathology. Although these competing explanations have different implications for intervention, they have never been evaluated empirically.We used a latent variable approach to estimate the associations of childhood maltreatment with underlying dimensions of internalising and externalising psychopathology and with specific disorders after accounting for the latent dimensions. We also examined gender differences in these associations.Data were drawn from a nationally representative survey of 34 653 US adults. Lifetime DSM-IV psychiatric disorders were assessed using the AUDADIS-IV. Physical, sexual and emotional abuse and neglect were assessed using validated measures. Analyses controlled for other childhood adversities and sociodemographics.The effects were fully mediated through the latent liability dimensions, with an impact on underlying liability levels to internalising and externalising psychopathology rather than specific psychiatric disorders. Important gender differences emerged with physical abuse associated only with externalising liability in men, and only with internalising liability in women. Neglect was not significantly associated with latent liability levels.The association between childhood maltreatment and common psychiatric disorders operates through latent liabilities to experience internalising and externalising psychopathology, indicating that the prevention of maltreatment may have a wide range of benefits in reducing the prevalence of many common mental disorders. Different forms of abuse have gender-specific consequences for the expression of internalising and externalising psychopathology, suggesting gender-specific aetiological pathways between maltreatment and psychopathology.

J Nerv Ment Dis. 2012 Jan; 200(1): 95-8
Buhlmann U, Marques LM, Wilhelm S

ABSTRACT: Individuals with body dysmorphic disorder (BDD) are excessively concerned about perceived defects in their appearance (e.g., blemishes on their skin). BDD is a severe mental disorder often associated with increased suicidality as well as significant social and occupational interference (e.g., J Clin Psychiatry 2005;66:717-725). Recently, investigators have begun to explore variables that might function as risk factors in the development of BDD, such as traumatic experiences (e.g., Child Abuse Negl 2006;30:1105-1115). As such, one of the goals of the current study was to examine the role of early-life sexual, physical, or emotional abuse in BDD. Specifically, the Traumatic Stress Institute Life Event Questionnaire (Treat Abuse Today 1992;2:9-11) was used to examine whether individuals with BDD (n = 18) self-reported having experienced more traumatic events than mentally healthy controls (n = 19). The BDD group reported more retrospective experiences of sexual and physical abuse in childhood or adolescence than did healthy controls. Surprisingly, there was no significant group difference in reports of emotional abuse in early life. This study provides preliminary evidence of the importance of examining abuse as a potential risk factor in the development of BDD.

Understanding disorganized attachment; theory and practice for working with children and adults.

Shemmings, David and Yvonne...

NEWLY-qualified counsellors have celebrated their success.

United Churches Healing Ministry provides accessible counselling and...

Persons with mental retardation face multiple emotional, cognitive and social challenges. Mental health professionals increasingly agree that...

Byline: Hilarie Stelfox

IT WOULD be wonderful if all children were born into caring, loving homes and raised with aspirations and...

New Orleans Saints Coach Sean Payton joins the Verizon Foundation, NFL Players Association and A CALL TO MEN in taking the LIVERESPECT...

In her new memoir, "Memories of Hell; Visions of Heaven" ( www.estherfrancisjoseph.com ), author Esther Francis Joseph shares the story of...

After applying a 12-step program to her life, Teri Johnson experienced freedom from her addiction to alcohol. She realized those same steps...

An intimate relationship with another individual should provide both partners with feelings of satisfaction, belonging, confidence,...

Breaking their will; shedding light on religious child maltreatment.

Heimlich, Janet.

Prometheus Books

2011

...