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Violence in sports has the greatest impact in the media, especially on television. In the case of refereeing, although there are studies that have specifically addressed violence, those performed on female referees have not had the same repercussions. Accordingly, the aim of this paper is to analyse the media coverage of violence against female referees in Brazil and Spain. In parallel, its intention is to reflect the perceptions of female referees in this respect. The methodology employed combined case studies with critical discourse analysis, based on news items and focus groups with female referees. The results reveal that gender violence against female referees is the most widespread type of aggression. Moreover, they highlight the sensationalist nature of the TV coverage of the phenomenon through the incorporation of visual and audio resources. Lastly, the findings of this study show how the prominence that this type of violence has achieved in the media has ended up eclipsing the recognition of the work of female referees. [ABSTRACT FROM AUTHOR]

Sexual abuse oftentimes occurs in institutional settings involving a power imbalance, including churches, sports, schools, and workplaces. Abuse in the Catholic Church was a reoccurring media fixture beginning in 2002 but continues to be a prominent feature even today. On September 30, 2021, The Athletic published an article documenting a coach's sexual coercion, emotional and verbal abuse, and retaliation, exposing a toxic league culture that failed to protect its players. Negative outcomes for assault survivors can be exacerbated when institutions fail to prevent or respond appropriately to sexual assault, a phenomenon known as institutional betrayal. Using institutional betrayal theory as a context for understanding experiences, this paper presents an exploratory analysis of abuse and misconduct experiences from two separate institutions: the National Women's Soccer League (NWSL) and the Catholic Church. This discussion offers insight into how the various dimensions of institutional betrayal appear differently in distinctive institutional settings. [ABSTRACT FROM AUTHOR]

This article presents a biographical narrative of Christy Martin, a former world champion boxer who survived being stabbed and shot by her trainer/husband. Rooted in a sociological imagination, this biographic research chronicles Martin's boxing career and its entanglements with gender-based violence. The boxing industry has a widely acknowledged, yet under-reported, problem with men's violence against women. This article aims to illustrate that women's boxing should be critically examined for the ways in which it functions both as a site of and a sanctuary from gender-based violence. Within this paper, I draw from media coverage of Christy Martin's boxing career, over 700 pages of transcripts from the subsequent criminal trial, an interview with Martin, as well as my own research in women's boxing, including work with survivors of domestic violence. [ABSTRACT FROM AUTHOR]

Better understanding of the causes and circumstances of maltreatment deaths of children is needed to prevent tragedy. The purpose of this article is to facilitate understanding of child maltreatment fatality review processes and their outcomes. A literature review was conducted through searches of the databases PubMed, PsycINFO, and EMBASE and through citations in publications. Over 165 publications were reviewed and 55 were selected for inclusion. Papers were from the United States, England, Ireland, Northern Ireland, Netherlands, France, Canada, Australia, South Africa, Switzerland, Saudi Arabia, Japan, and China. These were included if they described fatality review goals, authority, procedures, and outcomes. Although we searched databases on a continual basis during the preparation of this review, we could have missed publications, particularly those in newspapers and journals that are not included in large-scale databases or cited in other articles. Improvement of fatality review requires diligence by individuals and organizations that provide information to the reviewers. Among challenges to the review process are varying criteria for review, misclassifications of the manner of death, inadequate or incomplete forensic and medical investigations, lack of information about the perpetrator, diversity of the community, concealment of the cause of death by parents or other caregivers, and disagreement among reviewers about the results of their inquiries. Institutional challenges are also present, which include the need for funding, privacy issues on obtaining information, updating reviewer training, lack of follow-up by institutional authorities on the recommendations of the reviews, and research facilitating the review of maltreatment fatalities. [ABSTRACT FROM AUTHOR]

Narrative data analysis aims to understand the stories' content, structure, or function. However narrative data can also be used to examine how context influences self-concepts, relationship dynamics, and meaning-making. This methodological paper explores the potential of narrative analysis to discover and compare the processes by which culture shapes selfhood and meaning making. We describe the development of the Comparative Ethnographic Narrative Analysis Method as an analytic procedure to systematically compare narrators' experiences, meaning making, decisions, and actions across cultures. This analytic strategy seeks to discover shared themes, examine culturally distinct themes, and illuminate meta-level cultural beliefs and values that link shared themes. We emphasize the need for a shared research question, comparable samples, shared non-biased instruments, and high-fidelity training if one uses this qualitative method for cross-cultural research. Finally, specific issues, trouble-shooting practices, and implications are discussed. [ABSTRACT FROM AUTHOR]

Reactive Attachment Disorder (RAD), is characterized by failure to seek and accept comfort in maltreated children. This lack of activation of the attachment system has profound developmental disadvantages yet, in early childhood, usually resolves quickly after placement in nurturing care. Persistence of RAD into middle childhood has been demonstrated in children reared in Romanian Institutions but, in family-reared children older children, there is controversy regarding whether RAD-like behaviors are genuinely attachment-related and stable from early childhood or are, in fact, related to PTSD. We conducted two pieces of research to investigate this: 1. a systematic review to examine persistence/resolution of RAD and 2. a case series of three boys whose RAD symptoms persisted despite living in placements judged by both social and child health services to be of good quality. Our systematic review revealed a paucity of longitudinal data. Except in atypical institutionalized samples, RAD had not been evidenced beyond pre-school. All three boys in the case series met DSM 5 criteria for RAD in late childhood/early adolescence and had stable RAD symptoms since before age 5. Qualitative interviews with their families revealed common themes of family strain, frustration and resentment at the lack of support from services. This paper provides the first opportunity to generate testable hypotheses about environmental circumstances and coexisting symptomatology that may influence RAD trajectories. Persistence of RAD has profoundly negative implications for children and their families. Recognition of RAD symptoms is challenging but crucial in order to improve care of these children and their families. [ABSTRACT FROM AUTHOR]

High performance athletes participate and function in sports systems where exploitative behaviours may become manifest. These behaviours potentially violate an individual athlete's human rights. Using the Capability Approach first outlined by Amartya Sen the paper details how a more precise analysis of human rights, in the context of high performance sport, may be achieved. Using in-depth narrative accounts from high performance athletes, data illustrate how athlete maltreatment is related to individual capabilities and functionings: the loss of individual freedoms infringes accepted notions of human rights. The implications for practice concern how human rights may be protected within and for systems of high performance production. [ABSTRACT FROM AUTHOR]

South African adolescents experience a high prevalence of violence victimization alongside the health and economic burdens of HIV/AIDS and poverty. Polyvictimization is a useful theory and framework that allows for a nuanced understanding of lived adolescent experience patterns. Polyvictimization examinations are further enriched by person-centered analytical approaches. This study used latent class analysis to differentiate a sample of South African adolescents from highly deprived communities by their polyvictimization profiles and contextual violence risk and protective factors. Adolescents were sampled twice (2010/2011; 2011/2012), and data reflected their lifetime (sexual abuse) or recent (all other forms of assessed abuse/violence) violence victimizations, as well as individual, household, and community characteristics. Model fit indices supported a seven-class model with adolescents in high, moderate, and low polyvictimization classes. Adolescents in the high polyvictimization classes experienced a heavy burden of poverty and multiple forms of violence across contexts and were distinguished by HIV/AIDS and disability. Adolescents in the low polyvictimization class experienced relatively little violence, despite living in violent communities, and low household and individual burdens of HIV/AIDS and disability. Findings emphasize the importance of considering adolescent violence through a contextually sensitive polyvictimization lens to understand the complex web of violence that adolescents experience. This work supports previous research in low-resource South African settings highlighting the interconnected nature of violence, poverty, disability, and HIV/AIDS. Future research should explore these complex violence patterns and their effects, while program and policy actions must target and prevent adolescent violence especially for those impacted by poverty, disability, and HIV/AIDS. [ABSTRACT FROM AUTHOR]

Background: Emerging evidence notes increased depression, anxiety, and stress among the general population during the COVID-19 pandemic. However, little is known about populations at increased risk for emotional distress as the pandemic continues. Persons with adverse childhood experiences (ACE) are one group that may be at higher risk for emotional distress. Aim: The aim of this study is to examine whether young adults, particularly Black young adults, with histories of ACEs report more emotional distress during the pandemic than those with no ACE exposure. Method: Using a cross-sectional, quota sampling approach, 100 Black and 100 White young adults were recruited using online sources (e.g., University website, Facebook). Due to the pandemic, participants were screened via Zoom and, if eligible, completed a demographic questionnaire, emotional distress measures (i.e., anxiety, depression, stress), and the ACE Questionnaire online via a Qualtrics survey. Structural equation modeling (SEM) analysis examined the ACE and emotional distress relationship, and multigroup SEM assessed racial differences. Results: High levels of both emotional distress and ACEs were observed. Black young adults reported significantly more ACEs than Whites. ACEs were significantly associated with each measure of emotional distress regardless of race or other covariates. Conclusions: Findings reveal that during the pandemic, persons exposed to ACEs reported greater emotional distress than those with no ACE exposure. Nurses must screen patients for both emotional distress and ACE to target those at higher risk for early intervention and initiate treatment as needed to mitigate long-term mental health consequences. [ABSTRACT FROM AUTHOR]

Lesbian, gay, bisexual, trans, queer, and asexual (LGBTQA+) young people with disability are known to experience higher rates of harassment or abuse than LGBTQA+ young people without disability. This study focused on participants in Australia and identified factors associated with harassment or abuse among LGBTQA+ adolescents and young adults who reported a disability as well as associations with mental health outcomes. Analyses were conducted from a national survey that included 2,500 LGBTQA+ people who reported a disability and were aged 14 to 21 years. Measures included experiences in the past 12 months of verbal and physical harassment or abuse due to one's sexual orientation or gender identity, sexual harassment or abuse, mental health, suicidality, and sociodemographic traits. Overall, 48.4% of participants with disability reported experiencing verbal harassment or abuse, 12.4% physical harassment or abuse, and 29.7% sexual assault or harassment. In multivariable regression analyses, verbal harassment or abuse was significantly more likely among trans men, participants with an intellectual disability, and those who were "out" to most or all of their family. Physical harassment or abuse was significantly more likely among participants with a physical or sensory disability. Sexual harassment or abuse was significantly more likely among trans women and participants with a physical or sensory disability. Participants who experienced harassment or abuse were also significantly more likely to have attempted suicide in the past 12 months. These findings will assist policymakers and practitioners in identifying contexts linked to a heightened risk of abuse among LGBTQA+ young people with disability and further underscore an immediate need to address and prevent harm in this population. [ABSTRACT FROM AUTHOR]

This study explored the relation between guilt and identification with the aggressor (IWA) and the moderating role of IWA in the relation between intimate partner violence (IPV) and guilt. An online survey was conducted among a convenience sample of 700 women. IPV survivors demonstrated elevated guilt, and IWA was related to guilt. Furthermore, IWA moderated the relation between IPV and guilt: Among participants with low IWA levels, IPV was unrelated to guilt, but among participants with high IWA levels, IPV was related to guilt. These findings suggest that IWA may be a key element in explaining guilt among IPV survivors. [ABSTRACT FROM AUTHOR]

Child sexual abuse (CSA) is a pervasive public health problem. If left undetected, CSA can result in immediate and long-term health problems, which can be mitigated through early identification. Schools are an ideal environment to implement screening measures, and school nurses (SN) are uniquely poised to intervene and respond early. The aim of this review was to systematically examine and synthesize the international evidence related to screening for early identification of CSA in schools. Themes emerging from the analysis were SN behaviors relative to screening, potential instruments or approaches for screening, and SN and school professionals' beliefs about CSA screening practices. This review found little evidence that CSA screening is occurring in schools. However, SNs are aware that screening falls within their scope of practice and many SNs feel they should be screening for it. A constant proactive approach by SNs is necessary to improve early identification and subsequent intervention. [ABSTRACT FROM AUTHOR]

Coercive control has been shown to be far more damaging for victims psychologically than physical violence. Linked to this, domestic violence perpetrators are increasingly turning to the online world to enact control and abuse. Women are most likely to be killed once they have separated from their abusers, and perpetrators harness the online realm to continue the abuse long after a relationship has ended, with devastating consequences. This article draws on a subsection of data from a qualitative study as it relates to survivor accounts of online and technological abuse (via social media, mobile phones, Global Positioning Systems [GPS] tracking, etc.) as it is enacted by cisgender men against cisgender women. We reveal crucial evidence of the ways in which intimate partner abuse via the technological realm serves to exacerbate harm and prevent victims from fully recovering from their trauma. [ABSTRACT FROM AUTHOR]

Daycare maltreatment refers to abusive and/or neglectful acts perpetrated by teachers, directors, non-professionals or volunteers, family members of staff, and peers in a daycare setting. Despite growing evidence of its occurrence, the prevalence and consequences of daycare maltreatment for the child, the parent(s), and their dyad are largely unknown. This qualitative systematic literature review was conducted to synthesize the existing literature referring to daycare maltreatment, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. In order to be included in the analysis, the manuscripts needed to report empirical findings regarding maltreatment in daycare settings, be written in English, be published in a peer-reviewed journal or a dissertation, and be accessible by our research team. In all, 25 manuscripts met the above criteria and were included in the review. Our results indicate that reports of daycare maltreatment are characterized by early age of abused children, inferring mainly to sexual, physical, and emotional abuse. The majority of these manuscripts reported caregivers' and teachers' abuse, while peer victimization was reported much less. In addition, the findings demonstrated a higher representation of female perpetrators compared to abuse in other scenarios. Although some indications of long-term implications are reported in the manuscripts, a well-validated measure for assessment of daycare maltreatment seems to be lacking. These findings contribute to a more nuanced understanding of the complex experience and ramifications of daycare maltreatment, providing insight into its multi-faceted implications. [ABSTRACT FROM AUTHOR]

Bearing witness is a means for trauma survivors to give voice to lived experience. Bearing witness has been used in national and international commissions, inquiries, and tribunals to hear directly from survivors of abuse and trauma. This scoping review examines the documented research on the experience of survivors of trauma bearing witness. In 2021, six electronic data bases were searched—EBSCO, Informit, CINHAL, Clarivate, ProQuest, and Sage—and a search of the gray literature, revealed 1,201 references for studies between 1990 and 2021. After applying the Arksey and O'Malley framework, 21 studies that met inclusion criteria were identified. The inclusion criteria focused on studies where survivors expressed their views on bearing witness to trauma in official processes inclusive of public or private testimony, verbal or written. These studies utilized a range of methodologies and designs that represented the perspectives of 3,192 survivors of trauma who had borne witness. Analysis of the studies resulted in key findings under four themes: healing versus re-traumatization, support and safety of survivors, engaging and involving survivors, and culture and context. The literature indicates that bearing witness is a critical means to give voice to survivors of trauma and to provide them with acknowledgment; however, the literature is inconclusive regarding the impact of bearing witness on survivors. More research is required to better understand how survivors can best benefit and be supported by processes of bearing witness, and not be harmed or re-traumatized. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the prevalence of early life stress (ELS) in a population with inflammatory bowel diseases (IBD) and to estimate its burden on mental, physical, and digestive health. Ninety-three participants with IBD were asked to anonymously complete questionnaires (Childhood Trauma Questionnaire-Short Form, Early Life Event Scale, Perceived Stress Scale, Hospital Anxiety and Depression Scale, Ways of Coping Checklist, Gastro-Intestinal Quality of Life Index questionnaire, and ad hoc questions about symptoms). The prevalence of patients with IBD who were exposed to at least one childhood abuse was 53%. Mental health and quality of life were significantly poorer in patients with IBD who were exposed to early abuse than in those who were not. Patients exposed to ELS had also more digestive perturbations and fatigue. These results suggest that early abuse should be considered a component of IBD care. [ABSTRACT FROM AUTHOR]

Research has suggested highly elevated levels of interpersonal trauma (IPT) among parents with intellectual disabilities (ID), and that such experiences may contribute to the caregiving and child developmental problems often seen in this population. Conflicting results have however been reported, and there is no systematic review on this matter. This study therefore systematically reviewed the empirical evidence concerning (a) prevalence of IPT among parents with ID, and links with (b) caregiving-relevant and (c) child developmental outcomes, in accordance with the PRISMA 2020 guidelines. Searches were conducted in MEDLINE, CINAHL, PsycINFO, and PTSDpubs. Peer-reviewed empirical articles reporting exposure to any form of systematically assessed IPT (unspecified IPT, physical, sexual, and emotional abuse, neglect, prolonged childhood separations from caregivers, witnessing abuse in the family) among parents with ID were included, yielding a final selection of 20 studies. Findings consistently indicated markedly elevated levels of IPT among parents with ID, with a majority (>50%) having experienced some form of IPT. Estimates for both unspecified and specific forms were typically higher than corresponding estimates in other groups at elevated risk, and than meta-analytical general population estimates in comparable countries. Findings regarding caregiving-relevant outcomes were mixed but indicated links with adverse outcomes, particularly regarding parental mental health. Reports pertaining to child developmental outcomes were scant and inconsistent. We highlight important limitations in the extant literature and provide directions for future research and clinical practice. [ABSTRACT FROM AUTHOR]

This study investigates implications of complex control combinations applied in manual, service and professional occupations for expressive, behavioral and emotional aspects of workplace dignity. Qualitative comparative analyses of 154 content-coded workplace ethnographies suggest that professionals encounter persuasive ‘bundles’ of control that enhance expressive and behavioral manifestations of dignity as well as pride. However, these benefits come at the expense of high levels of stress associated with internal drives and externally driven normative orientations and behaviors. Workers in manual and service occupations confront a broader array of approaches, including coercive control combinations that erode pride and effort by dehumanizing workers and inviting abuse. Furthermore, the benefits of persuasive control combinations in these settings are mitigated by supplementary constraints, which promote maintenance of a protective distance from employers that may also help to limit stress. The paper concludes with organizational strategies for curbing abuse in coercive manual and service environments and a discussion of changes necessary to address the problem of stress in the professions. [ABSTRACT FROM AUTHOR]

Objectives: The Internet has created a new communication tool, particularly for young people whose use of electronic communication is exploding worldwide. While there are many benefits that result from electronic-based communication, the Internet is concurrently a potential site for abuse and victimization. Methods: This paper systematically reviews the effectiveness of cyber abuse interventions in increasing Internet safety knowledge and decreasing risky online behavior. Results: Significant results were found between pre- and posttest scores related to Internet safety knowledge. Most results related to risky online behavior were not significant. Conclusions: Results provide evidence that participation in psychoeducational Internet safety interventions is associated with an increase in Internet safety knowledge but is not significantly associated with a change in risky online behavior. [ABSTRACT FROM AUTHOR]

In the most recent edition of Diagnostic and Statistical Manual (DSM) that is DSM-5 many modifications have been made in substance use disorder section. These include changes in terminology; sections and categories; diagnostic criteria; threshold for diagnosis; severity; and specifier. Additionally, there have been certain additions and omissions from the earlier version. Critical evaluation of the changes made to the section on disorders related to use of psychoactive substances in India context has not been published so far. The current paper presents a critique of the changes made to the substance use disorder section in DSM-5. The rationale for these changes put forth by DSM-5 work group on substance related disorders have been discussed. Additionally, attempt has been made to highlight the possible future challenges consequent to the current nosological revision for substance use disorder category. Overall DSM-5 seems to be promising in fulfilling its goal of DSM-ICD harmonisation and movement towards an internationally compatible and practical diagnostic system for mental health disorders. It has increased the scope of addiction by inclusion of behavioural addiction. It has also tried to balance the categorical and dimensional approach to diagnosis. However, the real test of this newer edition of one of the most commonly used nosological systems will be during clinical care and research. This will help address the debatable issues regarding the changes that DSM-5 brings with it. [ABSTRACT FROM AUTHOR]

This section presents abstracts of papers on city planning published from 2007 to 2008, including "Streets, Sounds and Identity in Inter-war Harlem," by Clare Corbould, "(Re)making the Other, Heterosexualising Everyday Space," by Kath Browne, and "Rankings and Reactivity: How Public Measures Recreate Social Worlds," by Wendy Nelson Espeland and Michael Sauder.

Objective: From the early 1990s there has been a growing awareness in Australia of dissociative processes and dissociative disorders. The objective in this paper is to provide a selective overview of the context and process of treatment based on the substantive dissociative disorders literature, ongoing clinical experience and research, and over 8 years as director of a trauma and dissociation unit at Belmont Hospital, Brisbane.Conclusions: The construct of individual selfhood is of direct relevance in illustrating the psychological damage sustained by patients who have relied on dissociative defences to survive, and in highlighting issues and areas that are a particular focus of informed treatment. [ABSTRACT FROM AUTHOR]

Background: Violence during childbirth indirectly contributes to maternal and neonatal morbidity and mortality. It also causes intrapartum health consequences such as prolonged labor, postpartum hemorrhage, and postpartum psychological problems, including postpartum depression, post-traumatic stress disorder, and other negative feelings that lead to a decreased desire for facility delivery and increase the events of home deliveries which reduce the quality of life. In Tanzania, several efforts have been made to promote respectful maternity care. However, violence during childbirth continues to create a critical barrier for facility-based delivery and is in need of considerable attention throughout the health system. Objectives: This study aimed to assess types of intrapartum violence and its determinants among postnatal women in the Dodoma Region, Tanzania. Design: A cross-sectional study using a questionnaire to interview postnatal women at the exit point after being discharged from the health facility to assess intrapartum violence and its determinants. Methods: This study was conducted in Dodoma Region involving 307 postnatal women from April to June 2022. A simple random method was used to select respondents. The Chi-square and Fisher's exact tests were used to assess the association between the categorical variables. The predictors of intrapartum violence were determined using binary logistic regression analysis. Statistical analysis was performed using Statistical Package for Social Science version 25.0. P < 0.05 was considered to be significant. Results: Overall, 307 postnatal women participated in the study. Among them, 158 (51.5%) postnatal women experienced at least one form of intrapartum violence. The most common forms of intrapartum violence included breach of confidentiality 205 (66.8%), undignified care/verbal abuse 178 (58%), physical abuse 139 (45.3%), and denial or neglected care by midwives 113 (36.8%). Husband employment, urban residence, and being referred from primary hospitals were significant determinants associated with intrapartum violence (adjusted odds ratio = 0.233, 95% confidence interval = 0.057–0.952, p = 0.043, adjusted odds ratio = 2.67, 95% confidence interval = 1.13–10.93, p = 0.026 and adjusted odds ratio = 3.673, 95% confidence interval = 1.131–11.934, p = 0.030, respectively). Conclusion: Violence during childbirth was highly prevalent in this study. Understanding the prevalence and types of intrapartum violence is important in order to promote changes in all levels of the health system. This study reveals the need for key interventions to effect change at many levels; including an interventional study to educate women and birth partners on client rights, and strengthening the health system to meet the needs of women during labor and childbirth. Policies and systems that support respectful maternity care are urgently needed in this setting, including universal training of health professionals in respectful maternity care [ABSTRACT FROM AUTHOR]

There has been limited research on the quality of inpatient psychiatry, yet policies to expand access have increased, such as the use of Medicaid Section 1115 waivers for treatment in "Institutions for Mental Disease" (IMD). Using data from public records requests, we evaluated complaints, restraint, and seclusion from inpatient psychiatric facilities in Massachusetts occurring from 2008 to 2018, and compared differences in the rates of these events by IMD status. There were 17,962 total complaints, with 48.9% related to safety and 19.9% related to abuse (sexual, physical, verbal), and 92,670 episodes of restraint and seclusion. On average, for every 30 census days in a given facility, restraint, and seclusion occurred 7.47 and 1.81 times, respectively, and a complaint was filed 0.94 times. IMDs had 47.8%, 68.3%, 276.9%, 284.8%, 183.6%, and 236.1% greater rates of restraint, seclusion, overall complaints, substantiated complaints, safety-related complaints, and abuse-related complaints, respectively, compared to non-IMDs. This is the first known study to describe complaints from United States inpatient psychiatric facilities. Policies should strengthen the implementation of patients' rights and patient-centeredness, as well as external critical-incident-reporting systems. [ABSTRACT FROM AUTHOR]

There is limited information on the scale and cause of abuse of older people in residential care and nursing homes. It is reasonable to assume a significant level of abuse, given the regularity of proven abuse and investigation. This paper stresses the need for an agreement on the definition of 'abuse' so that future studies allow for comparison. Concern is expressed that the proper wish to minimise abuse may lead to procedures which discourage warm and personal care. Reference is made to the developing literature on organisational systems which encourage staff to express concerns, rather than to be afraid to report on others. [ABSTRACT FROM PUBLISHER]

Pregnant Hispanic women are at increased risk for posttraumatic stress disorder (PTSD) in part due to greater risk of childhood maltreatment, intimate partner violence (IPV), and pregnancy-related vulnerabilities. However, PTSD, is a highly heterogenous diagnosis with numerous presentations. Individual PTSD symptoms may be differentially associated with specific types of maltreatment, IPV. Determining how IPV exposure across the lifespan is associated with specific symptoms of PTSD in pregnant Hispanic women is necessary to develop group-relevant models of this disorder and targeted interventions. The present study examined a network model of PTSD symptoms, childhood maltreatment, and adulthood IPV in a sample of pregnant Hispanic women (N = 198). Childhood emotional abuse and adulthood psychological distress had the highest bridge centrality. These types of exposures were most strongly associated with social isolation. Childhood emotional abuse was associated with more individual PTSD symptoms than any IPV type. These findings suggest that associations between PTSD symptoms and different types of IPV exposure vary. In addition, robust associations between childhood emotional abuse and PTSD symptoms suggest that this domain may be particularly important for the clinical assessment and intervention for pregnant women. [ABSTRACT FROM AUTHOR]

Incarcerated girls have disproportionately higher rates of physical, emotional, and sexual abuse compared with their nonincarcerated peers. Failure to address this trauma and abuse can lead to mental health disabilities such as anxiety, depression, post-traumatic stress disorder, and anti-social behaviors. Many girls who experience trauma engage in criminal behaviors as a response to these unresolved issues. The punitive nature of correctional confinement only exacerbates their mental health disabilities. This article examines the correctional confinement experiences for girls with mental health disabilities in the United States, where there is a large population of incarcerated girls, and Costa Rica, a country with fewer incarcerated girls. Policy changes are suggested to minimize the punitive nature of correctional confinement and to enhance the services and support systems available to incarcerated girls with mental health disabilities. [ABSTRACT FROM AUTHOR]

Purpose: The economic downturn due to the Coronavirus Disease 2019 (COVID-19) pandemic initially led to a large increase in the US unemployment rate. Being laid-off or losing a job could cause financial stress and have an impact on the relationship between parents or other adults in the home and children. We aimed to assess the effect of household unemployment on child physical and emotional abuse during the early part of the COVID-19 pandemic, with an older population of children. Methods: Data were from a sample of 7,555 students from 51 schools that participated in a survey administered from October to December 2020. We conducted weighted multivariable logistic regression models and report adjusted odds ratio to estimate associations between recent household unemployment and emotional and physical abuse. Results: Having a parent or other adult in the home with a job loss was associated with higher odds of emotional or physical abuse. Conclusions: The findings are consistent with child maltreatment prevention strategies focused on alleviating economic hardship. [ABSTRACT FROM AUTHOR]

The link between individual experiences in early childhood or adolescence years and future dating violence (DV) perpetration has been well established and explored across various populations. However, little is known on a worldwide scale, about the association between national conditions during childhood, like overall well-being or status of women in that nation, and perpetration of DV in emerging adulthood. Applying life-course theory and a socioecological framework to data from the International Dating Violence Study and country index scores, this study examines whether the overall well-being of a country during childhood affects the perpetration of DV in emerging adulthood. We also examine if the national status of women during childhood moderates the association between overall well-being of a country during childhood and DV perpetration in emerging adulthood, all while controlling for the individual effects of gender, violence approval, criminal history, neglect history, and anger management. The study's sample size included 4,280 people from 19 countries. Men reported less likelihood of perpetrating DV compared to women. Cross national comparative analysis revealed a significant interaction effect between country well-being and women status on DV perpetration (β = 0.69, p <.05) at the national level. When women's status was low or moderate, the well-being status showed an inverse effect on the probability of DV perpetration, but this direction switched in the face of high women's status. Contrary to previous research, higher women status may contribute to increased intimate partner violence (IPV) perpetration. Our findings underscore the existence of context-specific social conditions in relationship to IPV. Broad implications of the findings, potential explanations and directions for future research are discussed. [ABSTRACT FROM AUTHOR]

Background: Agencies and clinical practices are beginning to provide trauma-informed care (TIC) to their clients. However, there are no measures to assess clients' perceptions of and satisfaction with the TIC care they have received. A 20-item questionnaire, the TIC Grade, was developed, based on the National Center for Trauma-Informed Care principles of TIC, to assess the patient or client perception of the TIC provided in settings that serve adolescents and emerging adults. Objective: The goal of this project was to evaluate the psychometric properties of the TIC Grade instrument and to make recommendations for use of the full measure and its short form—an overall letter grade. Study Design: The TIC Grade questionnaire was administered to youth over the age of 18 years from four community partners providing care to vulnerable young adults. Potential participants were offered questionnaires at the end of their visit. Those interested in participating left their completed anonymous questionnaire in a locked box to maintain confidentiality. Questionnaires were collected from 100 respondents; 95 were complete enough to include in analyses for psychometric evaluation. Results: The findings of this project support the reliability and usability of the 20-item TIC Grade measure to assess youth's perceptions of the quality of TIC they received. Conclusions: This TIC-specific, behaviorally worded client report measure can assist service delivery organizations to assess their success at implementing TIC and to identify areas where further staff training and support are needed. [ABSTRACT FROM AUTHOR]

Women who are involved in the correctional system are often neglected and overlooked. Although justice-involved women enter the carceral system with high levels of abuse and trauma, many are exposed to State violence from staff or incarcerated individuals. Criminal victimization in prison presents a significant threat to one's well-being. According to international human rights law, preventing and combatting violence against women is the responsibility of the State in all contexts, including prisons. It is imperative that women be treated humanely while under the custody of the State, which increases odds of post-release success. Policy implications and recommendations are discussed. [ABSTRACT FROM AUTHOR]

The purpose of this study was to validate an original and innovative survey focused on both teens' personal beliefs and how they perceived their peers' beliefs regarding relationship abuse with four research questions: What are the measured constructs in this survey? Is the hypothesized factor structure of the five types of relationship abuse confirmed? Does the validity of constructs vary among racial/ethnic groups and genders? Are there differences between teens' own beliefs on relationship abuse and their perceptions of peers' beliefs? To address these questions, two confirmatory factor analysis (CFA) models were examined with 591 high school students' responses. The first CFA model was created based on the exploratory factor analysis results and the second CFA model was created based on the theoretically hypothesized model of five types of relationship abuse. The results indicate that the 5-factor, 11-item model based on the theoretical hypothesis is the best fit to the data. The multiple group model analysis demonstrated that the identified CFA measurement model was invariant across different gender and racial/ethnic groups. The validated instrument of Teen Beliefs on Relationship Abuse Measure is a reliable and valid way to measure both teens' personal beliefs and their perceptions of peers' beliefs on five types of relationship abuse including emotional, physical, sexual, stalking, and digital abuses. With the validated model, t-test results indicate that teens' own beliefs are significantly more positive than their perceptions of their peers' beliefs for all the five factors. The measure is useful for researchers, educators, and parents to measure and understand teen perceptions of themselves and their peers on different types of relationship abuses to better support them develop healthy, respectful, and nonviolent relationships. [ABSTRACT FROM AUTHOR]

Women with disabilities are at risk of experiencing multiple forms of severe and prolonged violence, yet guidelines for screening this population are unclear, screening rates are historically low, and screening tools may be inadequate to capture disability-related aspects of abuse. We conducted qualitative in-depth interviews with 33 rural women in the United States with diverse disabilities and experiences of violence. They described overarching healthcare provider and system factors that influenced their trust and confidence in healthcare delivery as an avenue to support their safety. Women described interactions with the healthcare system during their experience of violence as a missed opportunity for identifying and responding to their abuse and connecting them with resources. We conclude with policy and practice recommendations based on women with disabilities' perspectives and insights. [ABSTRACT FROM AUTHOR]

Registered professional and advanced practice nurses in the school setting, as a specialized practice entity, are leaders in implementation of evidence-based practice, skilled coordinators of care, advocates for students, and experts in designing systems assisting individuals and communities to reach full potential. Child trafficking (CT) is an emerging public health threat impacting safety and well-being of students present in the school setting. This literature review identified four themes in five studies: (1) training impacts nurses' knowledge, awareness, and attitudes; (2) school nursing is underrepresented in training, education, prevention, response, and research; (3) lack of collaboration exists between school staff and school nurses; and (4) formal education and length of experience impact levels of interventions school nurses are able to provide. School nurses are opportunely situated to intervene as advocates for vulnerable children to develop a coordinated, effective response to CT risk factors, mitigating risk and fostering resiliency with systems-based change. [ABSTRACT FROM AUTHOR]

Although the coronavirus disease 2019 (COVID-19) has amplified risk factors known to increase children's vulnerability to abuse and neglect, emerging evidence suggests declines in maltreatment reporting and responding following COVID-19 social distancing protocols in the United States. Using statewide administrative data, this study builds on the current state of knowledge to better understand the volume of child protection system (CPS) referrals and responses in Colorado, USA before and during the early phase of the COVID-19 pandemic and to determine whether there were differences in referral and response rates by case characteristics. Results indicated an overall decline in referrals and responses during COVID-19 when compared to the previous year. Declines were specific to case characteristics, such as reporter and maltreatment type. Implications regarding the impact of the COVID-19 pandemic on child maltreatment reporting and CPS response are discussed. [ABSTRACT FROM AUTHOR]

This study examined the elevated risk of intimate partner violence (IPV) among persons with mental health-related disabilities (MH-RD) and the extent to which known risk factors accounted for this phenomenon. Data were drawn from a nationally representative sample of 33,127 Canadians collected in 2014 as part of Statistics Canada's General Social Survey. Results showed that respondents with MH-RD had more than three-fold increased odds of both overall and severe IPV victimization. Although females were more likely to possess a MH-RD, males and females with MH-RD reported similarly elevated odds of IPV victimization. Risk factors that contributed to a significant reduction in elevated odds of IPV for respondents with MH-RD were child maltreatment (CM), respondents' nonprescription drug abuse, and perpetrators' jealous, monitoring, and socially isolating behaviors. The inability to test additional risk factors and bidirectionality in the relationship between MH-RD and IPV may have contributed to the failure to fully account for these respondents' elevated odds of IPV. Future research is needed to understand the complex mechanisms contributing to the elevated risk of IPV and enhance prevention and intervention strategies for this underresearched and underserved vulnerable population. [ABSTRACT FROM AUTHOR]

Violence against women is a global issue with estimates indicating that 35% of all women worldwide have experienced either physical and/or sexual intimate partner violence or nonpartner violence in their life time. In Malawi, 42% of ever-married women have experienced some form of violence perpetrated by their current or most recent spouse. A number of studies have investigated intimate partner violence in Malawi within the context of HIV/AIDS, girls' sexual abuse, and psychological distress, and a few studies report on the role of sociocultural factors in influencing gender-based violence. No study has used cluster analysis to systematically analyze different levels of abuse among married women in Malawi. Using the 2015 Malawi Demographic and Health Survey data, we employed cluster analysis and multinomial logistic regression to analyze the distribution of different levels of abuse among married women in Malawi and the key attributes associated with each level of abuse. Correlates of domestic violence significantly differ by levels of abuse and are distributed as follows: controlling behavior (11.8%), general controlling behavior (GCB; 27.1%), moderate physical and emotional abuse (27.2%), and the high and complete abuse (8.5%). Alcohol consumption, ethnicity, and women working status were significantly associated with all four levels of abuse, but age and religion were only associated with controlling behavior and generalized controlling behavior. The strength of association between husband's alcohol consumption, woman's working status, and marriage type and domestic violence increased by level of abuse. On each of these factors, the odds of experiencing violence were lowest in the controlling behavior group and highest in the high physical and emotional abuse group. Policies and programs that are designed to tackle violence against married women in Malawi should incorporate strategies that discourage excessive alcohol consumption, promote messages that women can be bread winners, and discourage polygamous marriage. [ABSTRACT FROM AUTHOR]

The Domestic Violence Enhanced Home Visitation (DOVE) intervention used in the Perinatal Nurse Home Visiting Intervention Enhanced With mHealth Technology (RCT: R01HD071771) is a nurse-lead evidenced-based intervention that has been shown to decrease violence overtime. This summative mixed-methods impact evaluation is intended to provide insight to enhance the DOVE IPV protocol for screening and intervention by (a) identifying which core aspects of DOVE facilitated or inhibited its success and what was most critical to optimal IPV (intimate partner violence) screening and intervention practices, (b) informing how DOVE IPV screening and intervention were influenced by the experiences of home visitor (HV), and (c) identifying policy considerations and best practice recommendations for the DOVE protocol. Participants were HVs and managers (N = 13) in rural/urban home visiting programs delivering DOVE across three states. The sample had a mean age of 48.76. Three fourths were baccalaureate-prepared nurses with an average of 10.5 years of home visiting experience. The method used in this study was one-to-one qualitative in-depth interviews with HVs. Data were interpretively analyzed using Nvivo 10 to generate three themes. Participants endorsed screening women for IPV with DOVE being the approach of choice to facilitate IPV screening and intervening with women. HVs found DOVE helped enhance their IPV knowledge, screening, and intervening capabilities while filling an existing void in this type of preparation of HV nurses. Establishing a relationship with the women before initiating screening was an important aspect in delivering DOVE as was the training, support, and increased comfort level in addressing IPV. The evidence offers an understanding of which core aspects of DOVE contributed to its success and what was most critical to optimal IPV screening and intervention practices. Furthermore, this evaluation provided multilevel insights into how best to advance home visiting practices and policies when screening and intervening with perinatal women exposed to IPV. [ABSTRACT FROM AUTHOR]

Objective: The aims of this study are to (a) provide reliable estimates of prevalence rates of family polyvictimization by synthesizing the findings from the existing literature, (b) examine the effect sizes of the impact of one type of family victimization on other types of family victimization, and (c) investigate the correlates of family polyvictimization. Method: Databases of literature published on or before April 2018 were searched. A total of 59 publications met the inclusion criteria and were included in the analysis for the combined odds ratios (OR s) to estimate the associations among different types of family victimization; 38 of them (99,956 participants) were used for the calculation of the combined prevalence rates of family polyvictimization. Findings: The overall co-occurrence rates of family victimization were 9.7% among the general population and 36.0% among the clinical population. The combined OR of other type(s) of victimization when one was present was 6.01 (p <.001). Longitudinal studies show that, when a family reported intimate partner violence, the odds of child abuse and neglect within the same family at a later stage was 3.64 (p <.001). Depression and post-traumatic stress disorder were two significant correlates associated with family polyvictimization. Conclusion: Family polyvictimization is prevalent across the world. The high co-occurrence rates and strong associations between different types of victimization on different family members warrant the need for the early detection of victims and effective preventions and interventions using a family approach, instead of treating victims from the same family individually. [ABSTRACT FROM AUTHOR]

Opioid misuse, abuse, and diversion continues to be a public health issue. Pharmacists (particularly those who work in the community setting) form the vanguard of health-care providers facing the opioid crisis because they have the opportunity to interact with patients more frequently than primary care or specialty medical providers. These frequent interactions give pharmacists more opportunities to properly counsel patients on prevention and to reinforce appropriate use of opioid medications. Pharmacists should be aware of the strategies for reducing opioid misuse, abuse, and diversion, including understanding mandates on prescription limitations; knowing how to use prescription drug monitoring programs; knowing when drug take-back programs are occurring; educating patients on the risks of opioid abuse, safe storage, and proper disposal of unused medications; identifying "red flag" behavior that may indicate opioid misuse; using assessments that help identify a patient's risk for opioid abuse; interacting with other health-care professionals to discuss a patient's care; understanding how abuse-deterrent opioids work and their limitations; preparing for opioid overdose management and understanding the local regulations on naloxone availability; and knowing when to refer patients to addiction services. Using these strategies, pharmacists have an opportunity to potentially reduce opioid abuse and improve patient outcomes. [ABSTRACT FROM AUTHOR]

Inadequate prenatal care utilization has been proposed as a mechanism between exposure to violence during pregnancy and adverse maternal and fetal obstetric outcomes. Adequate prenatal care is important for identifying and treating obstetric complications as they arise and connecting pregnant women to supports and interventions as needed. There is some evidence that pregnant women experiencing relational violence may delay or never enter prenatal care, though this association has not been systematically or quantitatively synthesized. The present meta-analysis investigates the relationship between interpersonal violence during pregnancy and inadequate prenatal care utilization across two dimensions: (1) no prenatal care during gestation (k = 9) and (2) delayed entry into prenatal care (k = 25). Studies were identified via comprehensive search of 9 social science and health-related databases and relevant reference lists. Studies were included if (1) participants were human, (2) violence occurred in the context of an interpersonal relationship, (3) abuse occurred during pregnancy (including abuse within 12 months before the time of assessment during pregnancy), (4) the study was empirical, peer-reviewed, and included quantitative data, (5) prenatal care utilization data were available, (6) they were in English, and (7) they were not part of an intervention study. Results from random-effects models found that women abused during pregnancy were more likely to never enter care (odds ratio [ OR ] = 2.62, 95% confidence interval [CI] = [1.55, 4.42]) or to delay care (OR = 1.81, 95% CI [1.48, 2.23]). Sociodemographic, abuse-related, and methodological factors emerged as moderators. Practice, policy, and research implications are discussed. [ABSTRACT FROM AUTHOR]

Physical and sexual violence are commonly researched as risk factors for human immunodeficiency virus (HIV). However, psychological violence and its relationship with HIV risk behaviors have received limited attention among African American/Black (Black) women. This study examined (a) the frequency of recent (past 3 months) psychological violence, physical violence, and sexual violence and (b) the association of HIV risk behaviors, including unprotected sex, sex under the influence of alcohol/drugs, and sex exchange for money/drugs/shelter, with psychological violence. Participants included 191 women (89.2% Black), who were recruited through information sessions held at community centers, Parent Teacher Association meetings, substance use and HIV counseling centers, radio public service announcements, and word of mouth. Interested women participated in a multisession HIV and substance use prevention program and completed a self-reported assessment at program baseline. The current study utilized baseline data collected for a longitudinal study. Results from descriptive analysis indicated that the rate of psychological violence was higher than physical violence or sexual violence, and it was strongly associated with physical and sexual violence. Furthermore, hierarchical logistic regression analysis showed that unprotected sex was significantly associated with recent psychological violence after controlling for covariates. Findings suggest that recent psychological violence is more common than physical or sexual violence and it relates to sexual risk behaviors among Black women. Recent psychological violence may indicate psychosocial and sexual vulnerability for HIV and warrants particular attention among Black women. [ABSTRACT FROM AUTHOR]

People with intellectual disability experience disproportionately high rates of interpersonal violence (IPV) due, in part, to disability-related risks that often can be minimized through targeted intervention. In this article, we describe using an academic and community participatory research approach to develop and test the feasibility of an accessible IPV prevention program for people with intellectual disability. The Safety Class, which is an interactive, structured, eight-session, weekly face-to-face group program, was found feasible for implementation in an efficacy study. Working in partnership with the intellectual disability community through all phases of the project helps ensure the relevance, inclusion, and accessibility of The Safety Class. [ABSTRACT FROM AUTHOR]

Summary: Child maltreatment is under-reported despite its high prevalence. It ranges from one-third to one-half lifetime exposure to violence. This points out to the issue of laypersons' perceptions of what is child maltreatment and at what severity should it be reported. The current study sought to examine children and youth versus parents' perceptions of child maltreatment. Following ethical approval, 259 children and youth between the ages 9 and 14 and 229 parents were administered anonymous questionnaire that included demographics and The Perception of Child Maltreatment Severity Scale. Statistically significant differences between children and youth, and adults in perception of child maltreatment in general were observed. Findings: Results indicated that the groups differ in the severity attributed to emotional abuse and sexual abuse. In addition, unlike parents, children and youth perceived exposure of embarrassing photos via Internet and silent treatment by peers to be severe whereas parents perceived sexual molestation to be most severe behavior. Applications: The study findings were discussed in light of the cultural gap between children and parents. Practically, the gap between parents' and children's perceptions of child maltreatment indicates the need for parents and professionals to look beyond their own perceptions and be alert to experiences of victimization a young person may have. This might assist professionals in developing an intervention program to increase children's awareness of violent behaviors and decrease the gap between generations in terms of the perceptions gap. [ABSTRACT FROM AUTHOR]

This study explores how typologies of adversity and mental health/substance use disorders impact rule violations during incarceration. Data come from the 2004 cross-sectional Survey of Inmates in State and Federal Correctional Facilities (SI-SFCF). Logistic regression and structural equation modeling were used for analysis. Results link history of adverse experiences to rule violations during incarceration and demonstrate how mental health and substance use disorders mediate this relationship. Incarcerated people with severe histories of adverse experiences had the highest odds of rule violations, relative to people with low adversity, for all typologies. More severe adversity typologies predicted mental health and substance use disorders. Alcohol and substance use disorders predicted drug violations, whereas substance use and mental health disorders predicted major violations. Serious mental illness did not predict rule violations when accounting for adversity. Findings suggest that addressing adverse experiences, mental health, and substance use disorders may prevent rule violations. [ABSTRACT FROM AUTHOR]

Objective: Small clinical samples suggest that psychiatric inpatients report a lifetime history of interpersonal trauma. Since past experiences of trauma may complicate prognosis and treatment trajectories, population-level knowledge is needed about its prevalence and correlates among inpatients.Methods: Using health-administrative databases comprising all adult psychiatric inpatients in Ontario, Canada (2009 to 2016, n = 160,436, 49% women), we identified those who reported experiencing physical, sexual, and/or emotional trauma in their lifetime, 1 year, and 30 days preceding admission. We described the prevalence of each type of trauma, comparing women and men using modified Poisson regression, and identified individual-level characteristics associated with lifetime trauma history using multivariable logistic regression.Results: 31.7% of inpatients reported experiencing trauma prior to admission. Lifetime prevalence was higher in women (39.6% vs. 24.1%; age-adjusted prevalence ratio [aPR] = 1.68; 95% CI, 1.65 to 1.71), including sexual (22.7% vs. 8.4%; aPR = 2.81; 95% CI, 2.73 to 2.89), emotional (33.3% vs. 19.4%; aPR = 1.76; 95% CI, 1.72 to 1.79), and physical trauma (24.2% vs. 14.8%; aPR = 1.68; 95% CI, 1.65 to 1.72). Factors most prominently associated with lifetime trauma were witnessing parental substance use (adjusted odds ratio [aOR] = 8.68; 95% CI, 8.39 to 8.99), female sex (aOR = 2.29; 95% CI, 2.23 to 2.35), and number of recent stressful life events (aOR = 1.62; 95% CI, 1.59 to 1.65).Conclusions: These results suggest that trauma-informed approaches are essential to consider in the design and delivery of inpatient psychiatric services for both women and men. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the efficacy of a newly implemented Child Protection Alert System (CPAS) that utilizes triggering diagnoses to identify children who have been confirmed/strongly suspected as maltreated. We retrospectively reviewed electronic health records (EHRs) of 666 patients evaluated by our institution's child protection team between 2009 and 2014. We examined each EHR for the presence of a pop-up alert, a persistent text-based visual alert, and diagnoses denoting child maltreatment. Diagnostic accuracy of the CPAS for child maltreatment identification was assessed. Of 323 patients for whom child maltreatment was confirmed/strongly suspected, 21.7% (70/323) had a qualifying longitudinal diagnosis listed. The pop-up alert fired in 14% of cases (45/323) with a sensitivity and specificity of 13.9% (95% CI [10.4%, 18.2%]) and 100% (95% CI [98.9%, 100.0%]), respectively. The text-based visual alert displayed in 44 of 45 cases. The CPAS is a novel simple way to support clinical decision-making to identify and protect children at risk of (re)abuse. This study highlights multiple barriers that must be overcome to effectively design and implement a CPAS to protect at-risk children. [ABSTRACT FROM AUTHOR]

We present a review of the international covenants and conventions and U.S. domestic laws and regulations that are designed to protect nursing home residents in the United States. Based on a review of research studies, government reports, and news reports, we found extensive evidence of widespread and systematic abuse and neglect of nursing home residents in the United States that needs urgent government action to protect the basic human rights of residents. [ABSTRACT FROM AUTHOR]

Questions related to violence, vulnerability, and sexual and gender minorities continuing to occupy a focal place in U.S. public discourse. We reviewed findings from 20 years of research on that topic to make recommendations for policy, practice, and future research. This article synthesizes findings from 102 peer-reviewed articles as well as a small number of unpublished studies and grey literature. We found no data to support the idea (widespread in popular discourse) that those in the sexual or gender majority require protection from sexual or gender minority individuals. Instead, this wide body of research indicates that sexual and gender minorities are themselves at elevated risk for physical and sexual assault, harassment, bullying, and hate crime victimization throughout childhood, adolescence, and adulthood. Contradicting the image of hate crimes as perpetrated by strangers or acquaintances, we find that bias-related verbal abuse, physical, and sexual assault by close family members contribute heavily to observed victimization rates. Further, despite the perception that society is becoming more welcoming, victimization disparities appear to be stable or widening since the 1990s. More studies with probabilistic sampling approaches, standardized measures, and larger samples of gender minorities are needed. However, widespread victimization of sexual and gender minorities is clearly an urgent issue, demanding attention from clinicians, program developers, and policy makers. [ABSTRACT FROM AUTHOR]

This qualitative study examines the factors that affect counseling services in structures aimed to provide support to women who are victims of violence. What has created the need to investigate the above issues is the increase in events of violence against women in Greece, and the subsequent development of relevant support and accommodation structures. Despite the clinical experience accumulated, research data from Greece are incomplete. The main research question concerns the factors that affect counseling in violence counseling structures. The participants were 10 professional counselors employed in violence counseling structures. The research data were collected through semi-structured interviews and their analysis followed the interpretative phenomenological method. The results designate two main axes: the personal and that of the others. The main categories of factors on the "personal" axis highlighted the importance of prior as well as continuing training for the counselor's work with the specific population; the crucial role of experience, which is characterized as dense and very rich; and the necessary presence of unfailing supervision. Regarding the axis of "the others," the main categories that emerged are cooperation with colleagues—in the light of interdisciplinarity as well as support—and cooperation with the local authorities and the central responsible body, as an important determinant of the operation of the structure. The results are discussed on the basis of the factors' importance and of possible implications for finding solutions. [ABSTRACT FROM AUTHOR]