Trauma, gender, and mental health symptoms in individuals with substance use disorders.

Individuals with substance use disorders are often plagued by psychiatric comorbidities and histories of physical and/or sexual trauma. Males and females, although different in their rates of expressed trauma and psychiatric symptomatology, experience comparable adverse consequences, including poorer substance abuse treatment outcomes, diminished psychosocial functioning, and severe employment problems. The goal of the current study was to examine the relationships between trauma history, lifetime endorsement of psychiatric symptoms, and gender in a sample of individuals participating in outpatient substance abuse treatment. Study participants (N = 625) from six psychosocial counseling and five methadone maintenance programs were recruited as part of a larger study conducted through the National Institute on Drug Abuse Clinical Trials Network (NIDA CTN). Study measures included lifetime trauma experience (yes/no), type of trauma experienced (sexual, physical, both), lifetime depression/anxiety, and lifetime suicidal thoughts/attempts (as measured by the Addiction Severity Index-Lite [ASI-Lite]). Lifetime endorsement of psychiatric symptoms was compared between individuals with and without trauma history. The role of gender was also examined. Results indicated that the experience of trauma was associated with an increase in lifetime report of psychiatric symptoms. Experience of physical and combined physical and sexual trauma consistently predicted positive report of psychiatric symptoms in both males and females, even when controlling for demographic and treatment-related variables. Employment outcomes, however, were not predicted by self-reported history of lifetime trauma.

Minority women victims of recent sexual violence: disparities in incident history.

AIMS: The aims of this descriptive study were to (1) describe assault and care characteristics and (2) determine differences in assault and care characteristics between black women and white women who sought emergency care following sexual violence. METHODS: A retrospective, cross-sectional design was used to examine forensic examination data characterizing the incident history reported by women victims of sexual violence at the time of a forensic nurse examination. Examinations occurred at an urban university-affiliated hospital emergency department (ED) over a 2-year period. RESULTS: Of the women (n = 173) seeking care in the ED, 58.4% were black and 41.6% were white. When compared with white women, black women were more likely to have weapons used in their assaults (42.6% vs. 16.7%, p < 0.00) and to be assaulted in the city rather than the suburbs (82.8% vs. 56.5%, p < 0.00). In general, substance use prior to the assault was reported to have occurred in 49.1% of the victims and 41% of the assailants; however, differences existed in the type and pattern of substance use by race/ethnicity. Black victims were more likely to report use of illicit drugs (28.7% vs. 12.5%, p = 0.01). White women were more likely than black women to report personal alcohol use prior to their assault, with significant differences for drinking by victims (47.2% vs. 23.8%, p = 0.01) or assailant use of alcohol (47.2% vs. 23.8%, p = 0.00). White women were more likely than black women to report both they and the assailant had used some type of substance (38.9 vs. 21.8, p = 0.01). Black women were more likely to arrive to the ED via EMS services (45.5% vs. 29.2%, p = 0.03). There were no reported differences in care characteristics by race. CONCLUSIONS: Findings from this study suggest that differences exist in assault characteristics between black and white women. Use of substances, including alcohol, plays an important role in sexual violence in women and should be a focus of preventive intervention initiatives when conducting a forensic examination. Both coordinated responses and comprehensive, individualized care by specially trained providers are important in the emergency care of minority women who are victims of recent sexual violence.

Domestic violence in the second half of life.

Providing an adequate and effective community response to women age 50 and older who experience domestic violence is complicated by the oftentimes disparate goals and expectations of service providers, emergency responders, and victims themselves. This article shares information provided by participants of focus groups designed to understand and identify what women age 50 and older want and need from agencies that provide services to enhance victim safety.

The Journey Project: a case study in providing health information to mitigate health disparities.

The Journey Project, part of the Virginia Commonwealth University Libraries' Social Work Information Specialist in Context Fellowship, was designed to merge social work and consumer health librarianship skills in order to improve the provision of health information to patients. A resource notebook was created encompassing the many dimensions of cancer health information. A social work informationist distributed the notebooks and provided individualized consultations with respect to patients' health information needs. Areas of congruence as well as key differences between social work and consumer health librarianship emerged during the course of the project. Merging the two professions into the role of a social work informationist increased the ability to attend holistically to clients' health information needs.

Information prescriptions: a barrier to fulfillment.

OBJECTIVES: The aim of this project was to identify and compare physician-perceived versus patient-experienced barriers to filling information prescriptions. METHODS: Physicians participated in a focus group designed to identify any issues linked to the implementation of the project. Telephone interviews were conducted with patients to gather details of the challenges encountered as well as to collect general health information-seeking practices. RESULTS: Although physicians identified several obstacles patients may encounter, it was not possible to identify patient barriers as no patient indicated having received an information prescription. In the focus group, physicians reported not using the term "information prescription," thus undermining one of the intrinsic tenets of the project. CONCLUSIONS: Although designed with the physicians' input, the study results demonstrated a disconnect in the information prescription process. The addition of intervention fidelity measures may have ensured a more positive outcome.