Pharmacy barriers for transgender and gender diverse young adults.

BACKGROUND: Transgender and gender diverse (TGD) individuals face substantial physical and mental health care barriers. Community pharmacies are one of the most accessible healthcare settings; however, concern for discrimination at the pharmacy has been reported. It is important to gain a better understanding of TGD individual's perspectives and experiences at the pharmacy to ensure optimal and inclusive care. OBJECTIVE: To identify TGD individual experiences and barriers at the pharmacy. METHODS: This IRB-approved qualitative study recruited TGD young adults in the United States between ages 18-29 years old for semi-structured focus group discussions. Questions focused on barriers to obtaining medications at the pharmacy and negative or positive experiences with pharmacists. Interviews were recorded, transcribed, and transcripts were analyzed for common themes amongst participants. RESULTS: Nine 1.5-2-hour focus groups were conducted and included 30 participants (2-6 participants in each group). All participants reported having been prescribed medications by a physician or mental health provider. Participants self-reported issues at pharmacies and with pharmacy personnel. Major themes included issues accessing medications and supplies (needles, syringes), questioning of prescription validity and patient identity, and lack of education or understanding of TGD individuals by pharmacy staff. CONCLUSION: TGD individuals experience barriers at the pharmacy and concerning issues with pharmacy staff. Education, structural competency, and improvements in gender-related data management are necessary for pharmacists and pharmacy staff to provide equitable and inclusive care for TGD individuals.

Firearm-related threat exposure and associated factors among men and women entering a supportive housing substance use disorder recovery program.

Background: Exposure to firearm victimization has often been overlooked as a sequela of substance use disorders (SUD).Objectives: The overall objective of this study was to explore firearm-related victimization and associated factors among men and women entering a supportive housing SUD recovery program.Methods: This study used program intake information from men (n = 1,758) and women (n = 1,066) clients entering a SUD recovery program.Results: Results found that almost half (49.3%) of the clients entering the program had ever been threatened with a firearm or held at gunpoint, and one-quarter of those clients had experienced firearm-related threats in the 6 months before entering the program. Economic vulnerability, mental health problems, polysubstance use, interpersonal victimization, and early use of drugs and alcohol were associated with firearm-related threat exposure. Many of the factors associated with firearm-related threat exposure were similar for men and women. Multivariate results found that polysubstance use (OR 1.16 men and 1.13 women), number of adverse childhood events (OR 1.13 men and 1.09 women), and interpersonal victimization (OR 3.41 men and 2.05 women) in the 6 months before program entry were significantly associated with ever being threatened with a firearm. Suicidality (OR 1.53 men and 1.80 women) and interpersonal victimization (OR 6.38 men and 6.08 women) were associated with being threatened with a firearm in the 6 months before program entry for both men and women.Conclusion: Results suggest there is a need for firearm-related risk reduction interventions for individuals in SUD recovery programs.

Should we be paying more attention to firearm threats in ex-partner stalking cases?

This study examined relationship abuse, firearm threats, and threat credibility factors as well as help-seeking for (ex)partner-stalking victims with partners who did (n = 153) and did not own guns (n = 263). Victims with (ex)partners who owned guns experienced increased coercive control and physical violence, a longer duration of stalking, and more threats during the relationship and during the course of stalking. Victims reported that (ex)partner gun owners had more extremist beliefs and other risk factors, and more of them believed their (ex)partner was extremely capable of harming them. Most, regardless of partner gun ownership, turned to informal sources of help, while about one-quarter of victims whose partners did not own guns tried to obtain a protective order or talked to police, compared to about 40% of stalking victims with abusers who owned guns. Fear of harm from guns, coercive control during the relationship, and believing their partner was capable of harming harm them were all associated with an increased number of help-seeking sources whereas being threatened with a firearm and abuser gun ownership were not.

Examining the Influence of Financial Assistance and Employment Services on the Criminal Justice Outcomes of Women on Probation.

Although low income is common across the U.S. probation population, women offenders experience it more than men. However, despite the connection between income and probation outcomes, limited research has been conducted on programs that could improve the financial circumstances of female probationers. This study examined the influence on probation outcomes of receiving government financial assistance programs and employment services. The findings indicated that participants who received Social Security Disability Insurance more often were less likely to become incarcerated. Implications include expanding cash assistance programs to provide more substantial monthly incomes for women probationers, particularly those with disabilities, in order to increase financial stability and improve criminal justice outcomes.

Characteristics and experiences of buprenorphine-naloxone use among polysubstance users.

BACKGROUND: With a rise in overdoses and medical emergencies related to opioids, buprenorphine-naloxone (bup-nx) is seen as a preferred treatment for opioid dependence. However, the research examining experiences with bup-nx among polysubstance users who may or may not be opioid dependent has been limited. OBJECTIVES: The purpose of the study was to examine use, characteristics of users, and experiences of bup-nx use among polysubstance users entering drug-free recovery programs. METHODS: This study examined secondary data on 896 opioid or opiate user individuals (53.4% male) collected by drug-free, self-help-based residential recovery centers during intake. RESULTS: One-quarter of users said bup-nx helped them with their substance use while 75% of bup-nx users reported that bup-nx either had no effect or a negative effect on their drug problems. Of the very few (4%-7%) obtaining bup-nx solely through a prescription, over 90% reported relief from withdrawal. However, over 80% of those who obtained bup-nx through illicit means reported using bup-nx until their preferred drug could be obtained and used it for its euphoriant effect. Three groups of opioid users were created including one group with no bup-nx use, one with lifetime but not recent bup-nx use, and one with recent (past 6 month) use. There were differences in substance use patterns and characteristics of bup-nx experiences between the different groups. CONCLUSIONS: Results suggest that the views of bup-nx by individuals in drug-free recovery centers are varied, with many seeing bup-nx as not unlike other opioids while others report bup-nx as self-medication.

Past-year nonmedical use of prescription drugs among women on probation and parole: A cross-sectional study.

BACKGROUND: Prescription drug-related overdose deaths have increased dramatically in recent years. Women in the justice system experience high rates of drug use, victimization, trauma symptoms, and other health problems and would appear to be at high risk for nonmedical use of prescription drugs (NMUPD). This study will be among the first to describe prevalence and correlates of NMUPD among this population. METHODS: This cross-sectional study collected data from 406 victimized women on probation and parole between 2010 and 2012. In a multiple logistic regression model, we differentiated women who reported past-year NMUPD from those who did not using demographic, health, other drug use, substance use treatment, and trauma symptom severity variables. RESULTS: Past-year NMUPD was reported by 26.8% (n = 109) of the overall sample. Women reporting NMUPD were significantly younger and more likely to be white. Past-year use of alcohol (adjusted odds ratio [AOR]: 3.3; 95% confidence interval [CI]: 1.8-6.1), marijuana (AOR: 3.6; 95% CI: 1.8-7.0), methamphetamines (AOR: 6.1; 95% CI: 1.7-21.3), and heroin (AOR: 8.4; 95% CI: 2.0-35.2) were significantly associated with NMUPD. Additionally, each unit increase in the measure assessing bodily pain was associated with a 40% increase (AOR: 1.4; 95% CI: 1.1-1.7) in the odds of NMUPD. Finally, meeting diagnostic criteria for posttraumatic stress disorder almost doubled (AOR: 1.9; 95% CI: 1.1-3.4) the odds of reporting past-year NMUPD. CONCLUSIONS: Victimized women on probation and parole report high rates of NMUPD, and this behavior intersects with other complex social, behavioral, psychological, and physical needs. The authors recommend increased access to trauma-informed correctional care among women in the justice system.

Dangerous Liaisons: Examining the Connection of Stalking and Gun Threats Among Partner Abuse Victims.

Little is known about the scope and nature of how guns are used to threaten (ex)partners particularly during periods of stalking, which often occurs after victims leave their abusers. This study examines survey results from over 500 women from across the United States who contacted the National Domestic Violence Hotline. Specifically, this study (a) describes the prevalence and characteristics of partner abuse victims who were and were not stalked and who were and were not threatened with guns, (b) compares types of gun threats experienced by partner abuse victims who were and were not stalked, (c) examines worries about gun threats for those who were and were not stalked among partner abuse victims not threatened with a gun, and (d) assesses factors associated with advice to obtain a gun for personal safety. This article also provides open-ended comments selected to highlight themes from the quantitative information around participant fears and worries about gun threats and stalking. Findings from this study show one-third of the participants had experienced threats with guns, and one-fifth of those without gun threats worried their (ex)partner would harm them with a gun. Furthermore, there was a significant association between stalking and gun threats, as three-fourth of those who were threatened with a gun reported being stalked. Victims who experienced stalking were also more likely to report their (ex)partner threatened others with guns and were more likely to carry a firearm on their body or in their car, which suggests stalkers who threatened with guns may pose a significant risk to public safety. Implications for future research are discussed.

"If I Can't Have You Nobody Will": Explicit Threats in the Context of Coercive Control.

Physical assault is only one tool in partner abuse characterized by coercive control. Coercive control creates an ongoing state of fear and chronic stress. Explicit threats are an important component of coercive control yet have received limited research attention. This study examined 210 women with protective orders (POs) against abusive (ex)partners and their experiences of explicit threats including threats of harm and death, threats about harming friends and family, and actual threats to friends and family. There are 4 main findings from this study: (a) explicit threats of harm and death, threats about harming others, and actual threats to others are common both in the history of the abusive relationship as well as within 6 months prior to obtaining a PO but are only moderately correlated with each other; (b) the high-frequency threats of harm group had the highest rates of concurrent abuse, violence, distress, and fear; (c) the prevalence and frequency of threats changed over time for all 3 types of threats examined in this study; and (d) understanding the variety of threats partner abuse victims experience, especially threats of third-party harm, may be important in understanding the larger context and consequences of partner abuse. This study is an interim step toward a better understanding of the role of explicit threats in abusive relationships. Future research is needed to examine the prevalence, frequency, trajectory, features, context, and types of explicit threats that victims of partner abuse experience. This information may be especially key to understanding more about future risk of harm, risk of harm to others, victim distress and fear, and safety planning.

Childhood Victimization, Attachment, Coping, and Substance Use Among Victimized Women on Probation and Parole.

Justice-involved women report high rates of victimization across their life span, and these experiences contribute to their involvement in the criminal justice (CJ) system. Within this population, research has identified an overlap among victimization and substance use, a high-risk coping mechanism. Furthermore, research indicates attachment style is related to coping and high-risk behaviors. Research is needed to understand the relationship among these mechanisms as they relate to intimate partner violence (IPV). To address this gap, this study investigated the relationship between attachment, coping, childhood victimization, substance use, and IPV among 406 victimized women on probation/parole. Results of 6 multivariate regression analyses were statistically significant, accounting for 8%-13% of the variance in IPV. Particularly, childhood sexual victimization and negative coping were significant in all analyses. Findings provide practitioners, administrators, and policymakers information about the specific needs of justice-involved women.

Risk Factors in Arrest of Rural and Urban Female Victims of Intimate Partner Violence.

This study used a sample of women who obtained protective orders (N = 709) from urban and rural communities and identified risk factors in arrest for victims of intimate partner violence 12 months after the protective order was obtained. Lower social support, higher loneliness, living in a rural community, substance abuse/dependency, a history of prior arrest, engaging in illegal behavior, and younger age were all identified as significant predictors of arrest at follow-up. The findings highlight the need for support and resources in vulnerable populations to reduce the risk of offending and recidivism. Implications for reentry programs and services for victimized women at risk are discussed.

Police Officers' Attitudes and Challenges With Charging Stalking.

This study examined 2 groups of police officers on perceived barriers and attitudes related to charging stalking. Police officers who categorized into groups based on if they had (n=73) or had not (n=90) previously charged stalking. Results indicated that officers who had never charged stalking viewed stalking as less dangerous, believed that officers do not file reports when called for stalking, and perceived all barriers related to charging stalking as more challenging than officers who had previously charged stalking. Officers who charged stalking had greater comprehension of the stalking statute and identified specific problems within the statute. The results have implications related to improving specialized police training in an effort to better protect victims of stalking and increase stalking charges.

Substance use among victimized women on probation and parole.

Victimized women within the criminal justice system are an important group and understanding their substance use is critical. Substance use was examined among 406 victimized women on probation and parole in an urban community from 2010 to 2013. Ninety-three percent reported lifetime use of an illicit substance, whereas 58% and 45% reported use of at least one illicit substance in the past 2 years and 12 months, respectively. Among probationers, having been in a controlled environment was associated with a higher prevalence of illicit substance use as compared to parolees. Implications for practice, policy, and future research are discussed.

Violence, victimization, criminal justice involvement, and substance use among drug-involved men.

This research identified three subgroups of drug-involved men based on severity of self-reported violence perpetration against intimate or nonintimate partners among a sample of 148 men selected from a subsample of participants in the Kentucky National Institute on Drug Abuse (NIDA) AIDS Cooperative Agreement. Men in the No Violence group accounted for approximately 19% of the total respondents, men in the Moderate Violence Severity and Extreme Violence Severity groups comprises 56% and 25% of the sample, respectively. Men in the Extreme Violence Severity group experienced significantly more psychological victimization as children and more frequent physical childhood abuse than did their peers. Men in the Extreme Violence Severity group reported having earlier involvement in the criminal justice system and lawbreaking behavior; they also reported higher frequency of marijuana and crack use. Implications for treatment and future research are presented.

Post-Concussion Symptoms in Women With Head Injury Due to Intimate Partner Violence.

Limited research has examined the symptom sequelae of head injuries in women survivors of intimate partner violence (IPV), despite this community being at increased risk for neurotrauma due to partner abuse. The current study compared post-concussion symptom severity between women with and without IPV-related head injuries. Women were recruited from court jurisdictions in Kentucky, USA, after receiving a protective order for partner abuse. The sample included 268 women with no prior head injuries (age: M[standard deviation (SD)] = 31.8[9.8], 77.2% White) and 251 women with lifetime IPV-related head injuries (age: M[SD] = 31.8[9.8], 88.0% White). Women with IPV-related head injuries were slightly older (t = 2.46, p = 0.014) with lower education (χ2 = 5.81, p = 0.016), were more frequently unemployed (χ2 = 9.23, p = 0.002), and had a higher likelihood of residing in a rural setting (χ2 = 30.16, p < 0.001). Women with IPV-related head injuries were also more often White (χ2 = 10.47, p = 0.001), but this group difference was almost entirely related to rural versus urban residence. Women with IPV-related head injuries reported a higher severity of lifetime physical IPV (t = 7.27, p < 0.001, d = 0.64, 95% confidence interval [CI]: [.46, .82]) and sexual IPV (t = 4.65, p < 0.001, d = 0.41 [0.24, 0.59]). A three-factor model of post-concussion symptoms, inclusive of cognitive, physical, and emotional symptoms, fit well (χ2 = 368.99, p < 0.0001, comparative fit index [CFI] = 0.974, Tucker-Lewis index [TLI] = 0.968, root mean square error of approximation [RMSEA] = 0.079 [0.071, 0.087]), and showed evidence for strong measurement invariance across women with and without IPV-related head injuries. The subscale and total scores each had acceptable reliability: cognitive (ω = 0.88 [0.86, 0.90]), physical (ω = 0.74 [0.70, 0.77]), and emotional (ω = 0.88 [0.86, 0.89]), and total score (ω = 0.93 [0.92, 0.95]). Women with IPV-related head injuries reported all individual post-concussion symptoms at a significantly higher frequency, with medium group differences in cognitive (t = 7.57, p < 0.001, d = 0.67 [0.50, 0.85]) and physical symptoms (t = 7.73, p < 0.001, d = 0.68 [0.51, 0.86]) and large group differences in emotional (t = 8.51, p < 0.001, d = 0.75 [0.57, 0.93]) and total symptoms (t = 9.07, p < 0.001, d = 0.80 [0.62, 0.98]). All sociodemographic characteristics were independently associated with post-concussion symptoms, as were physical IPV (total score: r = 0.28 [0.19, 0.35], p < 0.001) and sexual IPV severity (total score: r = 0.22 [0.13, 0.30], p < 0.001). In hierarchical regression analyses, controlling for sociodemographic characteristics (i.e., age, race/ethnicity, education, unemployment, and rural/urban residence) and physical and sexual IPV severity, IPV-related head injury was independently significant and accounted for significant additional variance when predicting cognitive (ΔR2 = 0.05, p < 0.001), physical (ΔR2 = 0.03, p < 0.001), emotional (ΔR2 = 0.07, p < 0.001), and total symptoms (ΔR2 = 0.06, p < 0.001). Negative-binomial regression resulted in similar findings. This study demonstrates that multiple sociodemographic and IPV history variables are related to post-concussion symptom severity, but IPV-related head injury was independently associated with greater symptom severity. Women with IPV-related head injuries may be at increased risk for unaddressed health problems spanning cognitive, physical, and emotional domains. Future research is needed to psychometrically evaluate assessment instruments for this population and to assess efficacy of interventions to address their unique health care needs.

Head Injury Due to Intimate Partner Violence: Injury Characteristics, Subacute Symptoms, and Receipt of Care.

Women survivors of intimate partner violence (IPV) have increased risk of repetitive neurotrauma in their lifetime but have received less research focus compared with populations of athletes, veterans, and emergency department patients. The current study examined the importance of IPV as a contextual mechanism of injury, by comparing women survivors of IPV based on whether they experienced a head injury due to IPV or a head injury not due to IPV. The analyses involved archival data from in-person interviews conducted with women who received a protective order against an intimate partner in Kentucky from 2001 to 2004 (n = 641). Women were excluded if they reported no head injury history (n = 268), resulting in two groups compared based on a retrospective cohort design: 255 women with at least one self-reported IPV-related head injury (M = 33.8 ± 9.0 years old, range: 19-65; 87.5% White) and 118 women with self-reported head injuries due to reasons other than IPV (M = 32.2 ± 9.1 years old, range: 18-62; 89.0% White). Participants were compared on injury characteristics, lifetime physical and sexual IPV severity, subacute symptoms of head injury, and receipt of care for head injury. Compared with women with head injuries unrelated to IPV, women with IPV-related head injuries reported a higher number of lifetime head injuries (Mdn[range]: IPV-related = 3[1-515] vs. non-IPV-related = 1[1-13], p < 0.001, r = 0.51) and a higher number of head injuries involving loss of consciousness (Mdn[range]: IPV-related = 1[1-35] vs. non-IPV-related = 1[1-4], p < 0.001, r = 0.27), but lower rates of hospitalization (IPV-related = 56.1% vs. non-IPV-related = 73.7%, p = 0.001, odds ratio [OR] = 2.20 [95% confidence interval (CI): 1.36, 3.55]) and formal rehabilitation (IPV-related = 3.2% vs. non-IPV-related = 9.4%, p = 0.011, OR = 3.18 [1.24, 8.13]) following head injury. Women with IPV-related head injuries had greater lifetime severity of physical IPV (p < 0.001, d = 0.64 [0.41, 0.86]) and sexual IPV (p < 0.001, d = 0.38 [0.16, 0.60]). Women with IPV-related head injuries endorsed all symptoms at greater rates than women with non-IPV-related head injuries (ps < 0.001), including physical (e.g., headaches: OR = 3.15 [1.81, 5.47]; dizziness: OR = 2.65 [1.68, 4.16]), cognitive (e.g., trouble problem solving: OR = 2.66 [1.53, 4.64]; inattention: OR = 2.39 [1.52, 3.78]), and emotional symptoms (e.g., depression: OR = 7.39 [4.48, 12.20]; anxiety: OR = 4.60 [2.82, 7.51]). The total count of symptoms endorsed was higher for women with IPV-related head injury than women with head injuries unrelated to IPV (p < 0.001, d = 0.71 [0.49, 0.94]). When controlling for lifetime physical and sexual IPV, IPV-related head injury was independently associated with symptom count (ß = 0.261, p < 0.001) and accounted for additional variance in symptom count (ΔR2 = 0.06, p < 0.001). Among women survivors of IPV, those reporting IPV-related head injuries reported greater subacute symptoms, but a lower likelihood of being hospitalized or receiving rehabilitative care. Women with self-reported IPV-related head injuries represent an underserved population that is often unevaluated following injury and may have many unmet care needs. Future studies should examine persistent symptoms following IPV-related head injuries and interventions that would be most beneficial for this population.

Depression, anxiety, and posttraumatic stress in women with and without brain injuries due to intimate partner violence: Psychometric evaluation of measurement approaches and group comparisons.

PURPOSE/OBJECTIVE: The current study examined the psychometric properties of common mental health questionnaires among women survivors of intimate partner violence (IPV) with and without brain injuries due to IPV and evaluated whether women with and without IPV-related brain injuries differed in depression, anxiety, and posttraumatic stress disorder (PTSD) symptom severity. RESEARCH METHOD/DESIGN: Women survivors of IPV with and without IPV-related brain injuries were recruited online through Prolific (N = 205, M = 39.8 ± 11.9 years old, 83.9% non-Hispanic White, 42.4% college-educated). They completed the eight-item Patient Health Questionnaire (PHQ-8), seven-item Generalized Anxiety Disorder scale (GAD-7), and PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders (fifth edition) (PCL-5). Model fit and internal consistency were estimated for each scale. Groups were compared on mental health symptom severity, with and without controlling for age, education, and IPV severity. RESULTS: Both one-factor and multifactor models showed excellent fit for all scales. PHQ-8 (ω = .91), GAD-7 (ω = .94), and PCL-5 total scores (ω = .95) had strong reliability, and all subscale scores had acceptable-to-strong reliability (ω range = .79-.94). Women with IPV-related brain injuries reported greater physical IPV severity, higher rates of depression, and higher somatic anxiety and PTSD symptom severity. No group differences in mental health symptoms were significant after controlling for IPV severity. CONCLUSIONS/IMPLICATIONS: The PHQ-8, GAD-7, and PCL-5 showed evidence for reliability and validity among women survivors of IPV. Women with IPV-related brain injuries had higher PTSD symptom severity, attributable to greater physical violence exposure in general. Brain injury screening among survivors appears warranted for women with extensive physical IPV experiences. Interventions addressing PTSD, violence prevention, and brain injury recovery may best serve this population. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Repetitive Head Injury and Cognitive, Physical, and Emotional Symptoms in Women Survivors of Intimate Partner Violence.

Many women survivors of intimate partner violence (IPV) experience repetitive head injuries in their lifetime, but limited research has examined the cumulative effects of multiple head injuries on post-concussion symptom severity in this population. This study examined how number of lifetime head injuries and episodes of loss of consciousness (LOC) due to head injuries were related to current cognitive, physical, and emotional symptoms among women survivors of IPV. Cisgender women from Kentucky were recruited following a protective order against an intimate partner, including 268 women with no reported lifetime head injuries and 250 women with one or more IPV-related head injuries (mean [M] = 17.2 head injuries, standard deviation [SD] = 50.5, median [Mdn] = 4, range = 1-515; M = 1.8 LOC episodes, SD = 4.3, Mdn = 1, range = 0-35, respectively). Participants underwent in-person interviews about lifetime physical and sexual IPV history, head injury history, and current cognitive, physical, and emotional symptoms. Sociodemographic characteristics, physical and sexual IPV severity, and current symptom severity were examined in relation to number of head injuries and LOC episodes. A higher number of head injuries was associated with greater age, White race, less than high school education, unemployment, and rural residence. No sociodemographic variables differed based on number of LOC episodes. Greater number of lifetime head injuries and LOC episodes correlated significantly with physical IPV severity (rho = 0.35, p < 0.001; rho = 0.33, p < 0.001, respectively) and sexual IPV severity (rho = 0.22, p < 0.001; rho = 0.19, p = 0.003). Greater number of head injuries and LOC episodes correlated significantly with greater cognitive (rho = 0.33, p < 0.001; rho = 0.23, p < 0.001, respectively), physical (rho = 0.36, p < 0.001; rho = 0.31, p < 0.001), emotional (rho = 0.36, p < 0.001; rho = 0.18, p = 0.004), and total symptom severity (rho = 0.39, p < 0.001; rho = 0.26, p < 0.001). In group comparisons, participant groups stratified by number of head injuries (i.e., 0, 1-3, 4+) differed in total symptom severity (p < 0.001, η2 = 0.15), with greater symptom burden associated with more head injuries. Participants with and without LOC differed in symptom severity: cognitive (p < 0.001, d = 0.45), physical (p < 0.001, d = 0.60), emotional (p = 0.004, d = 0.37), and total symptom severity (p < 0.001, d = 0.53). Group differences between participants with and without LOC remained significant after controlling for sociodemographic variables and IPV severity. There was no cumulative effect of LOC, in that participants with 1 LOC episode did not differ from participants with 2 + LOC episodes (p > 0.05). Based on hierarchical regression analyses, only physical symptoms were independently related to number of head injuries (p = 0.008, ΔR2 = 0.011) and number of LOC episodes (p = 0.014, ΔR2 = 0.021) after controlling for sociodemographic characteristics and IPV severity. Among women survivors of IPV, cumulative head injuries appear related to greater symptom severity. Greater head injury history was independently related to worse physical symptoms (e.g., headaches, dizziness, sleep problems), whereas cognitive and emotional symptoms were, in part, attributable to cumulative physical and emotional trauma due to IPV. Women survivors of IPV with repetitive head injuries have unmet neurobehavioral health needs that may benefit from targeted interventions.

The Neurobehavioral Symptom Inventory: Psychometric Properties and Symptom Comparisons in Women With and Without Brain Injuries Due to Intimate Partner Violence.

This study psychometrically evaluated the Neurobehavioral Symptom Inventory (NSI) among women survivors of intimate partner violence (IPV) and compared symptoms between women with no brain injury history (n = 93) and women with IPV-related brain injury history (n = 112). Women completed the NSI and questionnaires on traumatic brain injury (TBI), hypoxic-ischemic brain injury (HI-BI), and lifetime IPV history. A four-factor NSI model, including affective, somatosensory, cognitive, and vestibular factors, had the best fit (comparative fit index = 0.970, root mean square error of approximation = 0.064), with strong reliability for the total score (ω = .93) and subscale scores (ω range = .72-.89). In group comparisons, women with IPV-related brain injuries reported greater total, affective, and cognitive symptom severity after adjusting for age and education; however, no group differences were observed after adjusting for IPV severity. When examining lifetime number of brain injuries, HI-BI count was independently predictive of total, cognitive, and vestibular symptom severity after adjusting for age, education, and IPV severity; whereas TBI count did not independently predict any NSI scores after adjusting for these covariates. The NSI had acceptable psychometric properties for measuring neurobehavioral symptoms among women survivors of IPV. The association between HI-BI count and cognitive and vestibular symptoms may indicate the importance of studying repetitive nonfatal strangulation as an injury mechanism in this population.

"Everyone Saw Me Differently Like It Was My Fault or I Wanted It": Acquaintance Stalking Victim Experiences of Sexual Assault, Sexual Harassment, and Sexual Autonomy.

Although the stalking research literature has grown over time, there is more limited research focused on acquaintance stalking victim experiences and harms. The current study used online surveys with women stalked by acquaintances who had (n = 193), and who had not (n = 144), been sexually assaulted by the stalker to examine differences in stalking course of conduct (including jealousy and control, sexual harassment) and victim harms (resource losses, social identity perceptions, sexual autonomy, sexual difficulties, and safety efficacy). Results found that many of the acquaintance stalking victims in the current study experienced all three types of sexual harassment (verbal harassment, unwanted sexual advances, sexual coercion) and had negative social identity perceptions (e.g., how they felt about themselves, how they felt about their ability to be a good partner). More women who were sexually assaulted, compared to those who were not, experienced threats, jealous and controlling behavior, severe physical violence, stalking-related fear, sexual harassment, negative social identity perceptions, and lower sexual autonomy. Multivariate analysis found that sexual assault, more unwanted sexual attention, increased sexual coercion, lower safety efficacy, and more negative social identity perceptions were associated with sexual difficulties while sexual assault, higher safety efficacy, fewer resource losses, and fewer negative social identity perceptions were associated with increased sexual autonomy. Sexual assault, verbal sexual harassment, and resource losses were associated with more negative social identity perceptions. Understanding the full scope of stalking victimization and the negative impacts can inform the recovery journey and safety planning interventions.

Rural and Urban/Suburban Victim Professionals' Perceptions of Gender-Based Violence, Victim Challenges, and Safety Advice During the COVID-19 Pandemic.

This study surveyed a national sample of victim service professionals (N = 222) and compared rural versus urban/suburban participants' perceptions of a variety of issues, such as the impact of the pandemic on gender-based violence victimization and safety advice for isolated victims. Increased interference with victim employment and the abuser monitoring of online activities were reported by participants across all communities. However, urban/suburban participants rated the magnitude of all victim challenges as greater, while more rural participants noted child abuse as a particular problem in their communities. The results highlight the importance of community context for improving coordinated responses to gender-based violence (n = 101).