Search

It is important to understand the epidemiology of intimate partner violence (IPV) experienced by both males and females. Data were drawn from the U.S. National Comorbidity Survey Replication. The relationships between physical IPV and child abuse, mental disorders, and suicidal ideation and attempts among males and females were examined. The results indicate that child sexual abuse was associated with IPV among males, whereas child physical and sexual abuse was associated with IPV among females. IPV was associated with poor mental health outcomes for males and females, although sex differences are noted. The sex differences indicate that females experience a wider range of poor mental health outcomes compared to males. Knowledge about correlates of IPV can be useful in identifying individuals exposed to violence. Further research is required to identify effective methods to reduce exposure to IPV and to adequately address the specific needs of male and female victims of IPV. Keywords: child abuse; intimate partner violence; mental disorders, suicidal ideation and attempts

The purpose of this study was to use rigorous systematic review methods to summarize the effectiveness of interventions for elder abuse. Only eight studies met our inclusion criteria. Evidence regarding the recurrence of abuse following intervention was limited, but the interventions for which this outcome was reported failed to reduce, and may have even increased, the likelihood of recurrence. Elder abuse interventions had no significant effect on case resolution and at-risk caregiver outcomes, and had mixed results regarding professional knowledge and behavior related to elder abuse. The included studies had important methodological limitations that limit our ability to draw conclusions about the effectiveness of these interventions. KEYWORDS elder abuse, systematic review, intervention studies

Copyright of Canadian Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Intimate partner abuse (IPA) affects women's health, requiring accurate questions to identify the abuse. We investigated the accuracy of three questions about fear of an intimate partner in identifying exposure to IPA. We compared the sensitivity and specificity of these questions with the Composite Abuse Scale (CAS) using secondary data analysis of four existing studies. All studies recruited adult women from clinical settings, with sample sizes ranging from 1,257 to 5,871. We examined associations between demographic factors and fear through multivariate logistic regression, and analysis of the sensitivity and specificity of the questions about fear and IPA (CAS), generating a receiver operating curve (ROC). The prevalence of lifetime fear of a partner ranged from 9.5% to 26.7%; 14.0% of women reported fear in the past 12 months; and current fear ranged from 1.3% to 3.3%. Comparing the three questions, the question "afraid of a partner in the past 12 months" was considered the best question to identify IPA. This question had the greatest area under the ROC (0.80, 95% confidence interval (CI) = [0.78–0.81]) compared with "are you currently afraid" (range 0.57–0.61) or "have you ever been afraid" (range 0.66–0.77); and demonstrated better sensitivity (64.8%) and specificity (94.8%). Demographic factors associated with "fear of a partner in the past 12 months" included being divorced/separated (odds ratio [OR] = 8.49, 95% CI = [6.70–10.76]); having a low income (OR = 4.21, 95% CI = [3.46–5.13]); and having less than 12 years of education (OR = 2.48, 95% CI = [2.04–3.02]). The question "In the last 12 months did you ever feel frightened by what your partner says or does?" has potential to identify a majority of women experiencing IPA, supporting its utilization where more comprehensive measures are not possible. [ABSTRACT FROM AUTHOR]

This study examined the relationship between a self-reported history of child physical and sexual abuse and chronic pain among women (N = 3381) in a provincewide community sample. Chronic pain was significantly associated with physical abuse, education, and age of the respondents and was unrelated to child sexual abuse alone or in combination with physical abuse, mental disorder (anxiety, depression, or substance abuse), or low income. Number of health problems and mental health disorders did not mediate the relationship between physical abuse and chronic pain. Despite considerable evidence from the clinical literature linking exposure to child maltreatment and chronic pain in adulthood, this may well be the first population-based study to investigate this relationship for child physical and sexual abuse independently. The significant association between childhood history of physical abuse and pain in adulthood calls for a greater awareness of the potential for chronic pain problems associated with this type of maltreatment. Further research is needed to understand the mechanism for this complex relationship. Keywords: chronic pain; child physical abuse; child sexual abuse; women

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.socscimed.2006.04.015 Byline: Betty Tang (a), Ellen Jamieson (a), Michael Boyle (a), Anne Libby (b), Amiram Gafni (c), Harriet MacMillan (a) Keywords: Child abuse; Health care expenditures; Canada; Health utilization; Women Abstract: Childhood maltreatment is a common and serious problem for women, particularly in relation to impairment in adulthood. To our knowledge, no system-wide study has addressed the influence of childhood maltreatment on the cost of these women's adult health service utilization. This paper examines this relationship. The 1990 Ontario Health Survey (OHS) gathered information regarding determinants of physical health status and the use of health services. The 1991 Ontario Mental Health Supplement (OHSUP) examined a variety of childhood experiences as well as the prevalence of psychiatric disorders from a sample of OHS respondents. These were province-wide population health surveys of a probability-based sample of persons aged 15 years and older living in household dwellings in Ontario. The OHSUP randomly selected one member from each participating OHS household to be interviewed regarding personal experiences and mental health. This analysis used data from women aged 15-64 who participated in both the OHS and OHSUP. Self-reported health service utilization was collected in four groups of women -- those who reported no history of child abuse, those with a history of physical abuse only, those who reported sexual abuse only, and those who reported both physical and sexual (combined) abuse. We hypothesized that a history of child abuse would result in greater adult health care costs. The results indicated that having a history of combined abuse nearly doubles mean annual ambulatory self-reported health care costs to $775 (95% CI $504-$1045) compared to a mean cost of $400 with no abuse (95% CI $357-$443). Median annual ambulatory self-reported health care costs were also increased in the combined abuse group, to $314 (95% CI $220-$429), compared to $138 (95% CI $132-$169) in those with no abuse. We conclude that child abuse in women is significantly associated with increased adult self-reported health care costs. Author Affiliation: (a) Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Ont., Canada L8N 3Z5 (b) Department of Psychiatry, University of Colorado Health Sciences Centre, USA (c) Centre for Health Economics and Policy Analysis, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ont., Canada L8N 3Z5

A cluster randomized trial was conducted to determine the optimal method for screening for intimate partner violence (IPV) in health care settings. It was observed that in screening for IPV, women preferred self-completed approaches over face-to-face questioning, computer-based screening did not increase prevalence and written screens had fewest missing data.

Community-based population survey data were used to explore whether remaining in school, independent of achievement status, was associated with lower rates of psychopathology in adulthood among participants self-reporting exposure to child physical and/or sexual abuse. Remaining in school, independent of one's achievement status, was significantly associated with a lower probability of experiencing externalizing but not internalizing disorders. Theoretical and educational implications of these results are discussed. Keywords: physical/sexual abuse, school, protective, achievement

Objective: This exploratory study examined the discriminant validity of 10 human-figure features commonly used by many proponents of the draw-a-person (DAP) projective technique as evidence of childhood sexual abuse. Two exploratory features were also examined. Method: Rather than drawing human figures, 64 children (M= 8 years, 9 months), including 19 sexually abused children, 26 nonsexually abused but emotionally/behaviourally troubled children, and 19 nonabused, nonclinical children, were instructed to build male and female figures using groups of prefabricated pieces of human-figure body parts. Unbeknownst to the children, each group of parts contained a potential sexual abuse feature (or features). Results: None of the human-figure features under examination, either individually, or in combination, distinguished the sexually abused group from the other two groups of children. Conclusions: In accordance with years worth of DAP projective technique research, no support for the validity of the human-figure features under examination as evidence of childhood sexual abuse, was found. Keywords: BAP technique; Childhood sexual abuse

The goal of this study was to examine the association of physical and sexual abuse in childhood, poverty, parental substance abuse problems, and parental psychiatric problems with disability due to physical health problems in a community sample of women. We included 4,243 women aged 15-64 years from the Ontario Mental Health Supplement in the analysis. The associations were tested by multiple logistic regression. Ten percent of women had a disability due to physical health problems. Among women with a disability, approximately 40% had been abused while growing up. After controlling for income and age, disability showed the strongest association with childhood physical abuse, parental education less than high school, and parental psychiatric disorder. The association with child sexual abuse was not significant. Given the high correlation between abuse and disability due to physical health problems, it is important to investigate approaches to identify women who are at increased risk of subsequent impairment. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800HAWORTH. E-mail address: Website: KEYWORDS. Childhood sexual abuse, childhood physical abuse, functional disability, physical health

Objective: This study uses results from a large community survey to examine the relationship between a history of child maltreatment and self-reports of contact with Child Protection Services (CPS). Methods: The Ontario Health Supplement was a province-wide, probability-based survey of household dwellings in the province of Ontario, Canada. A random sample of residents aged 15 and older participated in the Ontario Health Supplement (N = 9,953). A face-to-face interview included a question about contact with Child Protection Services (CPS), and the Child Maltreatment History Self-Report, a self-administered questionnaire, was used to assess history of child physical and sexual abuse. Results: Only a very small percentage of respondents with a history of child abuse reported contact with CPS; 5.1% of those with a history of physical abuse, and 8.7% of those with a history of sexual abuse. Contact with CPS was associated with younger age of respondent for both types of abuse and female gender for physical abuse. In the case of sexual abuse, younger respondents whose parental employment classification was in the lower socioeconomic group were more likely to have contact with CPS. Conclusions: Interventions that target only those who come in contact with CPS will not reach most persons exposed to child abuse. Keywords: Child maltreatment; Reporting; Services

Objective: This study examined the relationship between reported exposure to child abuse and a history of parental substance abuse (alcohol and drugs) in a community sample in Ontario, Canada. Method: The sample consisted of 8,472 respondents to the Ontario Mental Health Supplement (OHSUP), a comprehensive population survey of mental health. The association of self-reported retrospective childhood physical and sexual abuse and parental histories of drug or alcohol abuse was examined. Results: Rates of physical and sexual abuse were significantly higher, with a more than twofold increased risk among those reporting parental substance abuse histories. The rates were not significantly different between type or severity of abuse. Successively increasing rates of abuse were found for those respondents who reported that their fathers, mothers or both parents had substance abuse problems; this risk was significantly elevated for both parents compared to father only with substance abuse problem. Conclusions: Parental substance abuse is associated with a more than twofold increase in the risk of exposure to both childhood physical and sexual abuse. While the mechanism for this association remains unclear, agencies involved in child protection or in treatment of parents with substance abuse problems must be cognizant of this relationship and focus on the development of interventions to serve these families. Keywords: Physical abuse; Sexual abuse; Substance abuse

Very little research has been done on effective ways to prevent domestic abuse, according to researchers who analyzed 22 studies on this topic. There is some evidence that women who spend at least one night in a shelter and receive advocacy and counseling services have an improved quality of life and a decreased rate of abuse. More research is needed to identify effective interventions for domestic violence.

Objective: Does exposure to prenatal and postnatal adversity have the same long-term effects on brain development in humans? Methods: We examined whether these two types of exposures differed from their demographically matched controls on a frontal EEG alpha/delta ratio score, a proxy of brain maturation. Young adults born at extremely low birth weight (prenatal adversity; N = 64, Mage = 23.14 years, SDage = 1.26 years) had a lower alpha/delta ratio score compared to normal birth weight controls (N = 76, Mage = 23.60 years, SDage = 1.09 years), while youth exposed to child maltreatment (postnatal adversity; N = 39, Mage = 16.18 years, SDage = 1.15) had a higher alpha/delta ratio compared to controls (N = 23, Mage = 16.00 years, SDage = 1.50 years). Our results suggest that being exposed to pre- and post-natal adversity may have different long-term consequences on brain development. We speculate that these differences might be associated with some of the different functional outcomes known to characterize each type of adverse experience. [ABSTRACT FROM AUTHOR]

Introduction: Since the outbreak of COVID-19, numerous studies from around the world have reported declines in mental health. However, most of these studies were of low-to-moderate quality and many were based on convenience samples or used mental health measures with low validity, or both. Consequently, it has been difficult to draw conclusions. Methods: Both the 2020 Survey on COVID-19 and Mental Health (SCMH) and the Canadian Community Health Survey (CCHS) (2015-2019) used the Patient Health Questionnaire-9 to screen for major depressive disorder (MDD) in adults aged 18 or older. The prevalence of MDD was compared between the SCMH and the CCHS. Risk and protective factors for MDD in the SCMH were examined using bivariate and logistic regression analyses. Results: Based on SCMH data, 15.2% (95% CI: 14.2-16.2) of Canadians screened positive for MDD. The prevalence of MDD was more than two times higher in the SCMH (during COVID-19) than in the CCHS (predating COVID-19). In bivariate analysis, Canadians reporting five or more COVID-19-related risk factors were close to 30 times more likely to have MDD than those reporting no risk factors. Mastery and a sense of community belonging were protective factors for MDD. Conclusion: After remaining stable for two decades, the prevalence of depression among Canadians increased substantially with the onset of COVID-19. Ongoing monitoring of this common condition associated with major morbidity is vital to determine if elevated levels of MDD persist as we progress through and beyond future waves of COVID-19. [ABSTRACT FROM AUTHOR]

Objective: The study's goal was to examine the relationship between a history of parental psychiatric disorder and a history of child abuse in a general population sample of Ontario residents. Method: A representative community sample of 8548 respondents who participated in the Ontario Mental Health Supplement (OHSUP) were interviewed about parental psychiatric history and completed a self-report measure of childhood physical and sexual abuse. Results: The lifetime prevalence of either parent with a psychiatric disorder was as follows: 14.1% for depression, 3.7% for manic depression, 2.4% for schizophrenia, 2.4% for antisocial behavior, and 17.3% for any parental psychiatric disorder. Respondents reporting a parental history of depression, mania, or schizophrenia had a two to threefold increase in the rates of physical, sexual, or any abuse. Parental history of antisocial disorder increased the risk of exposure to physical abuse (adjusted odds ratios [OR 6.1] and any abuse [OR 7.5]). There was no statistically significant difference between parental psychiatric disorder and childhood physical or sexual abuse by gender of the respondent. There was a trend for increasing risk associated with father only, mother only, and both parents having any psychiatric disorder. Conclusions: The elevated risk for physical and sexual abuse among respondents reporting a parental history of psychiatric illness highlights the need to examine the mechanism for this association. Such information is important in developing approaches to assist families where the risk of child maltreatment is increased. Keywords: Physical abuse; Sexual abuse; Parental psychopathology