Midwifery. 2011 Dec 14;
Baird K, Salmon D

OBJECTIVE: this exploratory work examined and assessed the experiences of participants (n=90) using an interactive drama workshop to facilitate the planning and understanding of multiagency working around domestic violence during pregnancy. DESIGN: a descriptive research design was utilised to collect data from field observations, participant reflective feedback sheets and semi-structured telephone interviews. PARTICIPANTS: participants invited to the workshop originated from a wide range of backgrounds including health and social care, criminal justice and the third sector. All participants were invited to complete the reflective feedback evaluation form. To enhance the comprehensiveness of the enquiry, semi-structured interviews were also conducted with 10 of the participants. FINDINGS: shared themes emerging from the data analysis included improved awareness of the consequences of domestic violence; greater understanding of multiple professional roles including the policy context and enhanced skill development. However, participants questioned the extent to which this approach impacted upon longer term practice and policy development. KEY CONCLUSIONS: by centring attention on the emic perspective of women themselves, the drama approach developed professional's awareness, relationships, understanding and skills. Nevertheless, drama can be an expensive education tool. It is therefore essential that further research explores the longer term impacts on practice and outcomes for women that include cost-benefit analysis.

Public Health Nurs. 2012 Jan; 29(1): 19-26
Martin CT, Keswick JL, Crayton D, Leveck P

ABSTRACT Objective: The study investigates welfare recipients' perceptions of personal self-esteem in relationship with their participation in a welfare-to-wellness-to-work program. Design and Sample: The cross-sectional, mixed-methods design examined a convenience sample of 33 participants who attended a welfare-to-wellness-to-work program called Work Wellness: The Basics that is based in an agency called Wellness Works!. Measures: A demographic survey, Rosenberg's Self-Esteem scale, and qualitative interviews were used. Results: Even with normal self-esteem scores, the participants credited the program with decreasing negative thoughts and improving self-esteem. The themes identified include program, self-esteem, mental health, and domestic violence. Conclusion: Information about the benefits of a holistic wellness program and its relationship with self-reported enhanced self-esteem can be used to assist with health promotion, policy, and the development of innovative programs that assist with transition from public assistance.

J Interpers Violence. 2011 Dec 26;
Clark CJ, Shahrouri M, Halasa L, Khalaf I, Spencer R, Everson-Rose S

Research on domestic violence against women has increased considerably over the past few decades. Most participants in such studies find the exercise worthwhile and of greater benefit than emotional cost; however, systematic examination of participant reaction to research on violence is considerably lacking, especially in the Middle East region. This study begins to fill this gap by examining women's reactions to domestic violence research in Jordan and whether a personal history of violence is associated with unfavorable experiences. This sequential exploratory mixed methods study included 17 focus group discussions (FGD) with women in Amman followed by a survey conducted in reproductive health clinics throughout the country (pilot n = 30; survey n = 517). Open coding was used to identify the theme related to participant reaction in the FGD data. This construct was further examined by the subsequent survey that included dichotomous questions inquiring whether the respondent thought the study questions were important and whether they were angry or felt resentment as a result of the survey. One open-ended question on the survey provided additional qualitative data on the theme that was combined with the FGD data. Themes identified in the qualitative data pertained to expressions of gratitude and comments on the survey's value. Findings of this study indicate that Jordanian women's responses to the research process are similar to women currently represented by the extant literature in that a vast majority of its participants felt that the study was important (95%) and it did not evoke anger or resentment (96%). Many even found the study to be useful to them personally or to society. Among those who had a negative emotional reaction, most still found the research to be important. This study's findings highlight the safety and potential benefits of ethically conducted violence research.

Clin Child Psychol Psychiatry. 2012 Jan 19;
Vetere A

This paper describes an approach to supervision and consultation with practitioners who work therapeutically with individuals, couples, and families where domestic violence is of concern. The approach is rooted in an established and visible safety methodology, developed over the last 16 years in the Reading Safer Families project. We emphasise risk management, responsibility for behaviour, and co-operative practices as an integrated framework for safer therapeutic practices. The paper illustrates how supervision style and process are adapted to pay attention to safety from all perspectives in the family-professional network.

J Interpers Violence. 2011 Dec 26;
Swanberg JE, Ojha MU, Macke C

Evidence indicates that domestic violence has negative consequences on victims' employment; yet employers lag in recognizing this as a workplace issue. To address the problem, some states have established several policy solutions. To understand the scope of the public sector's response to domestic violence as a workplace issue, a content analysis of state-level employment protection policies for domestic violence victims (N = 369) was conducted. Results indicate three broad policy categories: (a) policies that offer work leave for victims; (b) policies that aim to reduce employment discrimination of domestic violence victims; and (c) policies that aim to increase awareness and safety in the workplace. Subcategories emerged within each of these three categories. Implementation of employment protection policies varies significantly across states. Implications for workplaces, practitioners, and policy leaders are discussed.

J Perinatol. 2012 Feb 2;
Lutgendorf MA, Thagard A, Rockswold PD, Busch JM, Magann EF

Objective:The objective was to estimate the self-reported prevalence of domestic violence in a pregnant military population presenting for emergency care, and to determine the acceptability of domestic violence screening.Study Design:A prospective observational survey of patients presenting for obstetric emergency care. Women were anonymously screened for domestic violence using the Abuse Assessment Screen.Result:A total of 499 surveys were distributed, with 26 duplicate surveys. After excluding the 12 blank surveys, a total of 461 surveys were included in the final analysis. The lifetime prevalence of domestic violence (including physical, emotional and sexual abuse) was 22.6% (95% CI=19.0 to 26.4) with 4.1% (95% CI=2.3-6.0) of women reporting physical abuse in the past year and 2.8% (95% CI=1.3-4.3) reporting abuse since becoming pregnant. The majority of women 91.8% (95% CI=88.7-94.2) were not offended by domestic violence screening and 88.8% (95% CI=82.0-88.9) felt that patients should be routinely screened.Conclusion:The self-reported prevalence of domestic violence in a pregnant military population presenting for emergency care was 22.6%. Most women are not offended by domestic violence screening and support routine screening.Journal of Perinatology advance online publication, 2 February 2012; doi:10.1038/jp.2011.188.

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.

Aust Vet J. 2012 Jan; 90(1-2): 48-53
Tiplady C, Walsh D, Phillips C

Objective  To investigate the effect of intimate partner violence (IPV) on companion animal welfare. Design  Self-selected telephone survey of people meeting the criteria. Methods  Members of the Australian public with experience of IPV and concurrent companion animal ownership were invited to telephone a researcher for a semi-structured interview. Results  In total, 26 Australian women reported one or more companion animals in the household being verbally and/or physically abused by their male partner, usually with prolonged effects on animal behaviour; 92% indicated that they had been unwilling to discuss the animal abuse with a veterinarian. Many were unaware of animal accommodation services for people fleeing violence and those who did know about these were unwilling to use them, citing their bond with the animals as the main reason. Animals targeted for abuse were most likely to be dogs and owned by women rather than men, children or both partners. Conclusion  Animals can be severely affected by domestic violence situations and many people experiencing violence are unwilling to confide in veterinarians or seek help from animal shelters.

J Elder Abuse Negl. 2012 Jan; 24(1): 37-49
Peak T, Ascione F, Doney J

Past research has examined links among animal abuse, child maltreatment, and intimate partner violence and demonstrated the importance of addressing the needs of both human and animal victims. We hypothesized that there might be a similar link between animal abuse and older adult welfare issues. As a first step in the earlier research was the development of a screening protocol that shed light on the link between domestic violence and animal abuse, we decided to follow a similar route to explore this new topic by asking state government representatives about their experiences, if any, with this topic. Here we report the results of a national survey of state Adult Protective Services agencies regarding their protocols for assessing animal welfare issues in the context of older adult maltreatment. We also describe a model assessment protocol we developed in collaboration with the Utah Division of Aging and Adult Services.

J Cult Divers. 2011; 18(4): 120-5
Hodges TA, Cabanilla AS

Research in the area of help-seeking among battered individuals suggests that those in need of such assistance are often reluctant to seek out formal help for domestic violence. Therefore, this study sought to determine how factors of social support, spirituality, coping, and resilience influence help-seeking among battered Black women making a decision in seeking help from social service agencies as a result of domestic violence. Participants included 75 Black women who currently and/or recently resided in a domestic violence shelter. The study participants came from three rural communities located in the regional area of the southern United States. A quantitative approach based on a quasi-experimental survey design was used to investigate data collected from each participant.

Soc Sci Med. 2012 Jan; 74(2): 103-11
Sobkoviak RM, Yount KM, Halim N

Domestic violence against women is endemic globally and is an important social problem in its own right. A compounding concern is the impact of domestic violence against mothers on the nutritional status of their children. Liberia is an apt setting to examine this understudied topic, given the poor nutritional status of young children, high rate of domestic violence against women, and prolonged period of conflict that included systematic sexual violence against women. We expected that maternal exposure to domestic violence would predict lower anthropometric z-scores and higher odds of stunting, wasting, and underweight in children less than five years. Using data from 2467 mother-child dyads in the 2007 Liberia Demographic and Health Survey (LDHS) undertaken between December 24, 2006 and April 19, 2007, we conducted descriptive and multivariate analyses to examine the total, unadjusted and adjusted associations of maternal exposure to domestic violence with these anthropometric measures in children. Maternal reports of sexual domestic violence in the prior year predicted lower adjusted z-scores for height-for-age and weight-for-height as well as higher odds of stunting and underweight. The findings underscore the needs to (1) enhance and enforce conventional and customary laws to prevent the occurrence of domestic violence; (2) treat maternal survivors of domestic violence and screen their children for nutritional deficits; (3) heighten awareness of the intergenerational implications especially of recent sexual domestic violence; and (4) clarify the biological and behavior pathways by which domestic violence may influence child growth, thereby mitigating early growth failure and its adverse implications into adulthood.

J Interpers Violence. 2011 Dec; 26(18): 3699-719
Schechter DS, Willheim E, McCaw J, Turner JB, Myers MM, Zeanah CH

This study aims to understand if greater severity of maternal posttraumatic stress symptoms (PTSS), related to maternal report of interpersonal violence, mediates the effects of such violence on (a) child PTSS as well as on (b) child externalizing and internalizing symptoms. Study participants were mothers (N = 77) and children 18 to 48 months recruited from community pediatric clinics. Data were analyzed continuously via bivariate correlations and then multiple linear regression. Post hoc Sobel tests were performed to confirm mediation. Paternal violence accounted for 15% of the variance of child PTSS on the PCIP-OR (β = .39, p ≤ .001). While the child's father being violent significantly predicts child PTSS related to domestic violence, as mentioned, when maternal PTSS is included in the multiple regression model, father's being violent becomes less significant, while maternal PTSS remains strongly predictive. Sobel tests confirmed that maternal PTSS severity mediated effects of paternal violence on clinician-assessed child PTSS as well as on maternal report of child externalizing and internalizing symptoms. When presented with a preschool-aged child who is brought to consultation for behavioral difficulties, dysregulated aggression, and/or unexplained fears, clinicians should evaluate maternal psychological functioning as well as assess and treat the effects of interpersonal violence, which otherwise may be avoided during the consultation.

ISRN Nurs. 2011; 2011: 510692
Lawoko S, Sanz S, Helström L, Castren M

We assessed the extent to which healthcare providers at a large healthcare facility in Sweden screen for intimate partner violence against women and the determinants of such screening. Data on frequency of screening, readiness to screen on many dimensions (using the Domestic Violence Healthcare Provider Survey Scale), demographic and occupational characteristics were administered electronically to 217 healthcare providers. We found that only 50% of participants had during the past 3 month screened for IPV at least once, and screening activity was marked with inequalities in measured individual characteristics. Participants of female gender and of doctor/nurse occupation were more likely to screen than male and midwife peers, respectively. Healthcare providers who perceived high efficacy in handling IPV issues, low fears of offending clients, professional preparedness, and with availability of support networks for IPV victims were more likely to screen for IPV. Implications of these findings for interventions are discussed.

J Interpers Violence. 2012 Jan 18;
Robinson AL, Howarth E

Data from the largest study to date of the working practices of British victim support workers (known as Independent Domestic Violence Advisors or IDVAs) are used to provide insight into how "risk judgments" are made in cases of domestic violence. Using data from more than 2,000 victims, this study found a convergence between actuarial data and IDVAs' risk judgments when the risk score was high, but in cases with a lower risk score, IDVAs often used their professional judgment to upgrade risk. Next, we identified the specific factors underpinning IDVAs' risk judgments. Consistent with existing research, we found that IDVAs relied on a subset of available information when forming risk judgments, and characteristics of the abusive situation, such as the escalation of violence, use of weapons, stalking, and significant injuries, were particularly salient to them. Furthermore, IDVAs paid attention to victims' perceptions and when they felt very frightened or afraid of further injury then IDVAs were more likely to label them as high risk. Although we identified some encouraging overlap between the subset of factors informing risk judgments and those associated with victims' reabuse at a later date, some notable differences indicate a need for messages from research about the significance of particular risk factors to be reinforced to frontline practitioners on a regular basis.

Rev Lat Am Enfermagem. 2011 Dec; 19(6): 1421-8
Lettiere A, Nakano AM

This qualitative study assesses how women, in situations of domestic violence and examined at the Institute of Forensic Medicine, deal with this adversity and identifies protection strategies to cope with it, considering the support required and obtained from their relational and institutional environments. Ten women were interviewed and the data were analyzed using thematic content analysis. Search for help primarily occurs in the women’s social milieu, with family and friends and health and legal services being sought. In such a quest, established bonds may either become an obstacle to coping and make these women vulnerable to violence or protect and strengthen them during coping. In the identification of these women’s social and health needs, the aggravating circumstances of violence are only superficially addressed by professionals. New strategies to implement professional actions should be devised in order to provide integral and humanized care.

Z Psychosom Med Psychother. 2011; 57(4): 325-42
Subic-Wrana C, Beetz A, Wiltink J, Beutel ME

Clinical populations are characterised by a high level of childhood trauma and unresolved attachment status ("U"). Unresolved attachment status indicates the inability to integrate attachment-related dangers. Little is known about the interaction of traumatic childhood experiences and an unresolved attachment status.We administered the Adult Attachment Projective Picture System (AAP) to 45 newly admitted psychosomatic inpatients. Childhood trauma (CTQ) and distress were assessed by self-report questionnaires, and cognitive-emotional development was evaluated with the Levels of Emotional Awareness Scale (LEAS).We explored whether unresolved (U) and resolved (R) attachment status differentiated the sample with regard to childhood trauma, distress and cognitive-emotional development.53 % of the sample was characterized by the attachment status U; physical abuse and neglect as well as emotional neglect were correlated with a diminished ability to integrate trauma indicators in the AAP. A resolved attachment status was related to higher LEAS scores.The level of cognitive-emotional development may mediate the actual integration of attachment-related dangers and the interaction between actual attachment-related anxiety and past traumatic experiences.

Violence Vict. 2011; 26(6): 799-815
Russell BL, Oswald DL, Kraus SW

This study examines the extent to which verdict, guilt, and legal components associated with jury instructions of sexual assault differ as a function of aggressor gender, participant gender, and sexual strategy used (consensual, verbal coercion, alcohol, or physical aggression) to obtain sex. Participants (N = 423; 276 women and 147 men) read a vignette depicting either a couple having consensual sex (control), or a male or female aggressor who initiates sexual intercourse via verbal coercion, use of alcohol, or physical abuse. College students were provided with legal instructions of sexual assault then asked to provide a verdict, degree of guilt, and legal components. Female participants rated guilt and coercion higher than did male participants. Ratings of guilt were highest in the physical assault condition followed by the alcohol, verbal, and control conditions. Female aggressors were rated less guilty than male aggressors. Results are explained in relation to sexual scripts and legal decision making. Lack of significance in verdict decisions and interaction effects suggests male and female aggressors are evaluated similarly using coercive strategies; yet, consent for sex was assumed and attributions of guilt was lower when the aggressor was female. Implications for jury instructions and future research are discussed.

Pain Med. 2012 Feb 1;
Hart-Johnson T, Green CR

Objectives.  Physical and sexual abuses commonly co-occur with chronic pain. We hypothesized that: 1) abuse history questions would form distinct factors that relate differently to pain perceptions and pain outcomes; 2) abuse history consequences on physical and mental health differ by gender; and 3) different abuse types and age of occurrence (childhood vs adolescent/adulthood) predict different negative outcomes. Methods.  Chronic pain patients at a tertiary care pain center provided data (64% women, 50% black) through a confidential survey. Factors were formed for abuse type and age. Linear regression, controlling for socio-demographic information, was used to examine the relationship between abuse and abuse by sex interactions with pain-related outcomes. Results.  Six 3-item abuse factors (α = 0.77-0.91)-sexual molestation, sexual penetration, and physical abuse-were identified in both childhood and adulthood. Lifetime prevalence of abuse was 70% for men and 65% for women. Women experienced lower physical abuse (P = 0.01) in childhood, and higher penetration (P = 0.02) in adulthood. Decreased general health was associated with all abuse types (P 

Soc Sci Med. 2012 Feb; 74(4): 490-7
McMahon EM, Reulbach U, Keeley H, Perry IJ, Arensman E

School bullying victimisation is associated with poor mental health and self harm. However, little is known about the lifestyle factors and negative life events associated with victimisation, or the factors associated with self harm among boys who experience bullying. The objectives of the study were to examine the prevalence of bullying in Irish adolescent boys, the association between bullying and a broad range of risk factors among boys, and factors associated with self harm among bullied boys and their non-bullied peers. Analyses were based on the data of the Irish centre of the Child and Adolescent Self Harm in Europe (CASE) study (boys n = 1870). Information was obtained on demographic factors, school bullying, deliberate self harm and psychological and lifestyle factors including negative life events. In total 363 boys (19.4%) reported having been a victim of school bullying at some point in their lives. The odds ratio of lifetime self harm was four times higher for boys who had been bullied than those without this experience. The factors that remained in the multivariate logistic regression model for lifetime history of bullying victimisation among boys were serious physical abuse and self esteem. Factors associated with self harm among bullied boys included psychological factors, problems with schoolwork, worries about sexual orientation and physical abuse, while family support was protective against self harm. Our findings highlight the mental health problems associated with victimisation, underlining the importance of anti-bullying policies in schools. Factors associated with self harm among boys who have been bullied should be taken into account in the identification of boys at risk of self harm.

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.

Soc Work Health Care. 2012 Jan; 51(1): 36-52
Connolly S

In pediatric hospitals, social work plays a central role in the prevention, identification, and management of child abuse. Children who are suspected of having been abused or neglected require an evaluation of their psychosocial situation. As an integral member of the health care team, the social worker is well placed to undertake comprehensive psychosocial assessments including information on the child's development, parental capacity, family, and community supports. Current practice approaches have seen a shift away from a narrow, "expert" approach to child protection. This article describes the development of an integrated model of social work service delivery to better respond to vulnerable and at-risk children in a pediatric hospital setting. Developing a new model of service required strategic planning, consultation, and endorsement from senior hospital management. The new model aimed to ensure a high quality, responsive social work service to children at risk of physical abuse, neglect, or cumulative harm. The change necessitated understanding of current research evidence, development of best practice guidelines, and effective communication with staff and external stakeholders. Policy development, implementation of practice guidelines, staff training, data collection, and service evaluation are described. The role of social work management and leadership were central in creating change. Visionary leadership is widely regarded as key to successful organizational change. The management approach included consultation with staff, building commitment to the need for change, addressing staff concerns, and providing a vision of enhanced client outcomes as a result of the change process. This article provides a candid overview of challenges and barriers to change. Change strategies described are easily transferable to other social work settings.

J Gerontol Soc Work. 2012 Jan; 55(1): 21-38
Ernst JS, Smith CA

This study compared 2 approaches to the assessment of Adult Protective Services (APS) cases. Using administrative data from 869 cases in 2 counties in Maryland, the differences between a nurse/social worker team and a lone social worker in case disposition, risk reduction, recidivism, and cost effectiveness were examined. Lone social workers were significantly more likely to confirm financial exploitation, physical abuse, and neglect by others; while the team approach resulted in significantly greater risk reduction. No differences were observed in relation to recidivism, self-neglect and cost savings. Given limited resources, research that examines optimal staffing patterns in APS agencies is warranted.

J Clin Psychiatry. 2011 Dec 27;
Newport DJ, Baldessarini RJ, Knight BT, Fernandez SV, Morris NJ, Viguera AC, Stowe ZN

OBJECTIVE: Because bipolar disorder can be difficult to diagnose, we compared characteristics of women with confirmed versus presumably misdiagnosed bipolar disorder. METHOD: This cohort study was conducted from July 2005 to January 2010 in the outpatient clinic of the Emory Women's Mental Health Program, Atlanta, Georgia. Young adult women (mean age = 32 years) who were either pregnant or planning to conceive and who reported having previous clinical diagnoses of bipolar disorder completed 2 independent diagnostic assessments: the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) and an evaluation by a perinatal mood-disorder expert who was masked to the SCID findings. We compared clinical characteristics of women with confirmed versus presumably misdiagnosed bipolar disorder by bivariate testing followed by multivariate logistic regression modeling. RESULTS: Of 199 participants, 141 (70.9%) had confirmed DSM-IV bipolar disorder on the basis of concordant assessments, 23 (11.6%) were considered misdiagnosed, and 35 (17.6%) who had discordant diagnostic assessments were excluded from further analysis. Multivariate modeling indicated that confirmed bipolar disorder was associated with a history of antidepressant-associated mania/hypomania (OR = 13.30; 95% CI, 3.32-53.20; P = .0003), psychotic symptoms (OR = 12.40; 95% CI, 2.14-71.10; P = .005), and sustained euthymia during mood-stabilizer treatment (OR = 4.53; 95% CI, 1.32-15.60; P = .02); presumably misdiagnosed bipolar disorder was associated with childhood physical abuse (OR = 8.73; 95% CI, 2.33-32.70; P = .001) and comorbid obsessive-compulsive disorder (OR = 7.26; 95% CI, 1.86-28.30; P = .004). CONCLUSIONS: Several clinical factors found to distinguish women with confirmed versus presumably misdiagnosed bipolar disorder may help to refine clinical diagnosis.

Dev Psychopathol. 2012 Feb; 24(1): 79-92
Timmer SG, Thompson D, Culver MA, Urquiza AJ, Altenhofen S

The purpose of this study was to investigate the effects of mothers' physical abusiveness on the quality of the mother-child relationship, and note how it further varied by their exposure to interparental violence (IPV). The sample consisted of 232 clinic-referred children, aged 2 to 7 years, and their biological mothers. Slightly more than a quarter of the children (N = 63, 27.2%) had been physically abused by their mothers; approximately half of these children also had a history of exposure to IPV (N = 34, 54%). Investigating effects of physical abuse in the context of IPV history on mothers' and children's emotional availability, we found that physically abused children with no IPV exposure appeared less optimally emotionally available than physically abused children with an IPV exposure. However, subsequent analyses showed that although dyads with dual-violence exposure showed emotional availability levels similar those of nonabusive dyads, they were more overresponsive and overinvolving, a kind of caregiving controllingness charasteric of children with disorganized attachment styles. These findings lend some support to the notion that the effects of abuse on the parent-child relationship are influenced by the context of family violence, although the effects appear to be complex.

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.

J Perinatol. 2012 Feb 2;
Lutgendorf MA, Thagard A, Rockswold PD, Busch JM, Magann EF

Objective:The objective was to estimate the self-reported prevalence of domestic violence in a pregnant military population presenting for emergency care, and to determine the acceptability of domestic violence screening.Study Design:A prospective observational survey of patients presenting for obstetric emergency care. Women were anonymously screened for domestic violence using the Abuse Assessment Screen.Result:A total of 499 surveys were distributed, with 26 duplicate surveys. After excluding the 12 blank surveys, a total of 461 surveys were included in the final analysis. The lifetime prevalence of domestic violence (including physical, emotional and sexual abuse) was 22.6% (95% CI=19.0 to 26.4) with 4.1% (95% CI=2.3-6.0) of women reporting physical abuse in the past year and 2.8% (95% CI=1.3-4.3) reporting abuse since becoming pregnant. The majority of women 91.8% (95% CI=88.7-94.2) were not offended by domestic violence screening and 88.8% (95% CI=82.0-88.9) felt that patients should be routinely screened.Conclusion:The self-reported prevalence of domestic violence in a pregnant military population presenting for emergency care was 22.6%. Most women are not offended by domestic violence screening and support routine screening.Journal of Perinatology advance online publication, 2 February 2012; doi:10.1038/jp.2011.188.

Child Abuse Negl. 2012 Jan 21;
Renner LM, Whitney SD

OBJECTIVE: The purpose of this study was to identify common and unique risk factors for intimate partner violence (IPV) among young adults in relationships. Guided by two models of IPV, the same set of risk factors was used to examine outcomes of unidirectional (perpetration or victimization) and bidirectional (reciprocal) IPV separately for males and females. METHODS: The sample included 10,187 young adults, ages 18-27, in relationships from Wave 3 of the National Longitudinal Study of Adolescent Health. The risk factors were primarily related to violent socialization (e.g., childhood maltreatment, youth violence) and personal adjustment (e.g., alcohol use, depression). RESULTS: Approximately 47% of the respondents experienced some form of IPV in romantic relationships, and the majority of respondents reported bidirectional violence. For males, childhood sexual abuse was associated with perpetration and bidirectional IPV, and childhood neglect was associated with bidirectional IPV. For females, childhood neglect was associated with all three IPV outcomes, and childhood physical abuse was associated with bidirectional IPV. Youth violence perpetration during adolescence increased the odds for all IPV outcomes among females, while low self-esteem increased the odds for all IPV outcomes among males. A history of suicide attempts predicted bidirectional IPV across genders. Being married and living with a partner predicted all three IPV outcomes for males and females. CONCLUSIONS: The results revealed more common risk factors for bidirectional IPV than unidirectional IPV and few common risk factors across genders. The results indicate that IPV prevention and intervention strategies should be tailored to the unique risk experiences of males and females rather than focus on a common factors approach. However, child abuse, youth violence, and suicide prevention efforts may reduce incidents of later IPV for males and females, and these strategies should continue to be an emphasis in practice and research.

Pediatr Emerg Care. 2012 Jan; 28(1): 61-3
Sagar M, Shukla S, Bradley-Dodds K

ABSTRACT: Nonaccidental trauma (NAT) is common and presents with varied symptoms. Pleural effusion as a complication of physical abuse has not been described in the past. We report the case of a 10-week-old infant who presented with multiple nonspecific complaints that included respiratory distress, refusal to feed, constipation, and lethargy. Sepsis was the working diagnosis on admission, but a massive pleural effusion and rib fractures seen on chest imaging ultimately led to the diagnosis of nonaccidental trauma. This interesting case highlights the importance of maintaining a high index of suspicion for abuse irrespective of atypical presenting signs.

Eur J Dent Educ. 2012 Feb; 16(1): e158-65
Sonbol HN, Abu-Ghazaleh S, Rajab LD, Baqain ZH, Saman R, Al-Bitar ZB

Background:  Signs of physical abuse often present in the oro-facial region and dentists are in a strategic position to recognise and report suspected cases. The aim of this study was to assess the knowledge, educational experiences and attitudes of Jordanian dentists towards child abuse and to assess their educational needs. Methods:  A cross-sectional survey of a random sample of Jordanian dentists (n = 400) was conducted using an anonymous, self-administered structured questionnaire. Results:  The response rate was 64%. Thirty-four per cent (n = 88) of the respondents reported having formal training in recognising and reporting child abuse, and 42% (n = 106) had post-qualification/continuing education training on the topic. Half of the dentists (127/256) suspected a case of child abuse in the past 5 years, but only 12% (31/256) reported their suspicions. The main reasons for not reporting suspicions of abuse were fear from anger of parents (43%), uncertainty about diagnosis (41%) and uncertainty about referral procedures (41%). Those dentists who had formal training in dental school (P = 0.0001) and post-qualification courses in child abuse (P = 0.006) were significantly more likely to report suspicions. Conclusions:  A significant gap existed between recognising signs of physical child abuse and responding effectively. Improvements in child abuse education and continuing education courses are advised to provide dentists in Jordan with adequate knowledge of indicators of physical child abuse and to inform them on the protocol to follow when suspicions arise.

Violence Vict. 2011; 26(6): 738-57
Jackson SL, Hafemeister TL

Elder abuse research rarely differentiates by the type of elder maltreatment involved when identifying risk factors. The purpose of this study was to compare risk factors across four predominant types of elder maltreatment (financial exploitation, physical abuse, neglect by others, and hybrid financial exploitation [HFE]). Data were collected from two sources: interviews with victims of substantiated elder abuse, responding adult protective services (APS) caseworkers (N = 71), and third-party informants; and a statewide database that contained all substantiated cases over a corresponding 2-year period (N = 2,142). Using chi-square (interview data) and logistic regressions (Adult Services/Adult Protective Services [ASAPS] data), significant differences across the four types of elder maltreatment were found. These two datasets provide converging evidence for the importance of differentiating by type of maltreatment when identifying risk factors for elder maltreatment and for the importance of considering both the elderly victim and the abusive individual when predicting type of elder maltreatment.

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