Psychometric validation of the identity abuse scale among LGBTQ individuals.

Identity abuse (IA) comprises a set of abuse tactics that exploit discriminatory systems including homophobia, biphobia, and transphobia (Tesch & Berkerian, 2015). This study examined the factorial validity of the IA Scale (Woulfe & Goodman, 2018) with a large independent sample of lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals. Participants included 1,049 LGBTQ-identified participants (Mage  = 27.3, 71.9% White, 52.6% cisgender women, and 18.7% as other nonheterosexual identity in their sexual orientation), recruited through listservs. Participants completed an online survey measuring past-year and adult exposure to identity, physical, and psychological abuse. Confirmatory factor analysis indicated that the measurement model had good fit to the data, and strong factor loadings were found across the seven items, confirming a unidimensional factor structure. Findings demonstrate the IA Scale's validity and reliability, supporting its use to assess the frequency of IA tactics experienced within intimate partnerships among LGBTQ individuals.

Injection Depth in Intradermal Therapy: Update and Correction of Published Data.

BACKGROUND: This paper sought to compare calculated injection depth data with published report claims concerning intradermal therapy and skin rejuvenation of the face, hands, neck, and décolleté. OBJECTIVE: A mathematical formula was employed to assess the injection depth, and data from literature were retrieved and compared with the calculated figures to determine whether the claims about the injection depth proved correct. METHODS: Based on a study by Della Volpe et al., involving 140 skin residues adapted for plastic surgery, we have calculated injection depths from published reports on intradermal therapy and skin rejuvenation while comparing these figures with the published injection depth claims. RESULTS: Most injections were not performed at the claimed depth, with over 70% of them carried out in the fat layer, thus, the hypodermis. This is not the recommended depth for a refined injection technique in the intradermal therapy field. CONCLUSION: Whilst examining our study results, two different possibilities come to mind. We must either: 1) review and correct the existing histological classification; and/or 2) better learn to correctly inject in the superficial-dermis, mid-dermis, and deep-dermis. In other words, a perfect control over the needle penetration angle and implanted part appears urgently required.

J Drugs Dermatol. 2018;17(1):89-96.

Hetero-epitaxial approach by using labile coordination sites to prepare catenated metal-organic frameworks with high surface areas.

A solid-state approach that takes advantage of the ordered 3D arrangement of active secondary building units allows the preparation of new interlocked MOFs that grow hetero-epitaxially on the crystal faces of a precursor phase that acts as a "topological blueprint". The synthetic strategy is exemplified by using rigid acetylene-based ligands to produce highly augmented Cu(II) acetate-based MOFs.

Evaluating the Nature and Prevalence of Economic Empowerment Services Provided to Intimate Partner Abuse Survivors.

Economic empowerment (EE) services promote survivors' economic stability and well-being. A target for intervention and prevention, then, is to offer more effective EE services. The study purpose was to develop a clearer picture of what EE services agencies offer, and how prepared staff are to provide these services. We collected data from 154 providers. Survivors most requested, and agencies most frequently provided, housing services. EE services offered did not differ by agency location, staff size, or number of clients. Providers' confidence was greater if they completed high school; their agency offered more EE services; and they completed voluntary training.

Poverty and mental health practice: within and beyond the 50-minute hour.

Despite the high and increasing prevalence of poverty in the United States, psychologists and allied professionals have done little to develop mental health interventions that are tailored to the specific sociocultural experiences of low-income families. In this article, we describe the sociocultural stressors that accompany the material deprivations of poverty, and the mental health difficulties to which they often give rise. Next, we outline the psychosocial and class-related issues surrounding low-income adults' access to and use of mental health services and suggest a conceptual framework to guide the modification of mental health practice to better accommodate poor peoples' complex needs. This framework describes opportunities for practice modification at three levels of intervention, beginning at the individual level of traditional individual psychotherapy and subsequently targeting increasingly broad contextual elements of poverty.

Coercive Control in the Courtroom: the Legal Abuse Scale (LAS).

Intimate partner violence (IPV) survivors seeking safety and justice for themselves and their children through family court and other legal systems may instead encounter their partners' misuse of court processes to further enact coercive control. To illuminate this harmful process, this study sought to create a measure of legal abuse. We developed a list of 27 potential items on the basis of consultation with 23 experts, qualitative interviews, and existing literature. After piloting these items, we administered them to a sample of 222 survivor-mothers who had been involved in family law proceedings. We then used both exploratory factor analysis (EFA) and Rasch analysis (RA) to create a final measure. Analyses yielded the 14-item Legal Abuse Scale (LAS). Factor analysis supported two subscales: Harm to Self/Motherhood (i.e., using the court to harm the survivor as a person and a mother) and Harm to Finances (i.e., using the court to harm the survivor financially). The LAS is a tool that will enable systematic assessment of legal abuse in family court and other legal proceedings, an expansion of research on this form of coercive control, and further development of policy and practice that recognizes and responds to it.

Informal Help-Seeking in Moments of Acute Danger: Intimate Partner Violence Survivors' Emergency Outreach Efforts and the Forces That Shape Them.

Heightened attention to police brutality has created momentum for alternative, community-based responses to violence, including that inflicted by an intimate partner. But to build effective alternatives, we must know what survivors already do in moments of acute danger when they do not call the police. This study sought to explore these moments from an ecological perspective. Using a qualitative descriptive methodology, we conducted 25 interviews with a diverse sample of intimate partner violence (IPV) survivors. Each described the first, the worst, and the most recent IPV incident, whom they reached out to and why, the outcomes of their help-seeking, and the individual, interpersonal, and psychosocial influences on the process. Even in the face of severe violence, what participants most wanted was someone who would listen without judgment. Direct interpersonal factors that influenced their help-seeking included their partner's controlling behavior, as well as their network members' capacities, perspectives on IPV, and feelings about the survivor. Broader influential factors included the radiating effects of IPV and other forms of trauma in survivors' networks. Participants offered recommendations on how domestic violence (DV) programs could both strengthen survivors' networks and provide them with targeted community support in moments of grave danger. As we continue to develop community-based alternatives to police intervention, DV programs have a critical opportunity to build on survivors' own recommendations. This process must address the ongoing effects of trauma that hamper the ability of so many network members to support survivors in crisis.

Risk Factors for Intimate Partner Violence in the Context of Disasters: A Systematic Review.

Women are at increased risk for experiencing intimate partner violence (IPV) in the context of disasters. However, the factors that increase this risk are not well understood. The purpose of the current study was to systematically review the literature on IPV in the context of disasters. The first aim was to identify risk factors predicting women's exposure to IPV. The second aim was to identify disaster-specific risk factors for IPV. The third aim was to construct a social ecological framework of risk factors for IPV in disasters at the individual, relationship/household, community, and structural levels. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines (PRISMA; Moher et al., 2009). Articles were identified using keywords in seven ProQuest databases. Of the 67 articles identified for full-text review, 24 were eligible for inclusion. Studies were evaluated based on critical appraisal of methodology using an adapted version of the Mixed Methods Appraisals Tool (MMAT; Hong et al., 2018). Findings suggest that disasters give rise to unique risk factors across social ecologies which interact with pre-existing characteristics of social vulnerability to increase women's risk of IPV. Findings inform violence prevention strategies within the context of disaster response and therefore have implications for research, policy, and practice.

Loneliness and the COVID-19 Pandemic: Implications for Intimate Partner Violence Survivors.

The COVID-19 pandemic has dramatically highlighted the isolation of domestic violence survivors, triggering media coverage and innovative efforts to reach out to those who are trapped in their homes, facing greater danger from their partners than from the virus. But another harmful aspect of this difficult time has received far less attention: survivors' intensified loneliness. Although loneliness can be catalyzed by isolation, it is a distinct psychological phenomenon that is internal and subjective in nature. Loneliness is not only acutely painful in its own right; it also inflicts a range of long lasting, health-related harms, and heightens survivors' vulnerability to violence, creating a vicious cycle that may continue long after strict stay-at-home and physical distancing policies end. This may be particularly true for marginalized survivors, for whom larger structural inequalities and institutional failures compound the negative impact of loneliness. This brief report describes what we know about the nature and costs of survivor loneliness and uses the COVID-19 pandemic as a lens through which to review the ways current DV interventions may help alleviate loneliness (as distinct from isolation), and how these might be expanded to enhance survivor wellbeing, immediately and even after a return to "normal."

From Isolation to Connection: The Practices and Promise of Open Domestic Violence Shelters.

Antidomestic violence advocates have begun to question two essential policies that have long defined domestic violence shelters-strict secrecy regarding shelter location and prohibitions on shelter access to all except staff and residents-both of which serve to increase survivors' social isolation and entail coercive rules that resonate painfully with broader oppressive dynamics. In response a growing number of communities have begun experimenting with open shelters, which break from tradition by making their locations public, and allowing visitors. Although this innovation is a sharp departure from tradition, virtually no research exists to explore its philosophical underpinnings, benefits, and challenges. This study addresses this gap. Study Questions: We used a qualitative descriptive approach to explore the experiences and perspectives of open shelter directors. Participants included 14 open shelter directors from 11 states. We conducted semistructured phone interviews with each participant, focusing on their shelter's (a) nature and history; (b) rationale; (c) policies and programs related to secrecy and openness; (d) benefits and challenges; (e) effects on specific survivor subgroups; and (f) practices used to build or strengthen survivors' relationships. Open shelters: (a) promote physical safety using a broad array of measures; (b) adopt a range of policies that promote varying degrees of location disclosure and visitor accessibility; (c) face challenges, such as the need to gain buy-in from multiple constituents; and (d) Improve survivor outcomes, including decreased shame; improved advocacy relationships; increased access to services and community involvement in shelter life; and deepened relationships with network members; in turn increasing prospects for physical and psychological well-being long after survivors' shelter stays are over. Findings suggest a new path for shelters interested in promoting survivor safety and healing in the context of a web of meaningful relationships.

A Retrospective Evaluation of the Diagnostic Performance of an Interdependent Pairwise MicroRNA Expression Analysis with a Mutation Panel in Indeterminate Thyroid Nodules.

Background: The addition of genetic analysis to the evaluation of thyroid nodule fine-needle aspiration biopsy samples improves diagnostic accuracy of cytologically indeterminate thyroid nodules (ITNs) with Bethesda III or IV cytopathology. We previously reported the performance of a multiplatform molecular test, referred to in this study as MPTXv1, that includes a mutation panel (ThyGeNEXT®) plus an algorithmic microRNA (miRNA) risk classifier (ThyraMIR®). Complex interactions of growth-promoting and -suppressing miRNAs affect the phenotype. We previously demonstrated that accounting for these interactions with pairwise miRNA expression analysis improves the diagnosis of medullary thyroid carcinoma. In this study, we assess the impact of pairwise miRNA expression analysis on risk stratification of ITNs. Methods: Pairwise expression analysis of 11 miRNAs was performed on a training cohort of histopathology-proven benign nodules (n = 50) to define the mean and standard deviation of each pairwise analysis and create a Benign/Malignant Profiler (MPTXv2), deviations from which predicted the malignancy risk. Clinical validation of MPTXv2 was assessed using a cohort of 178 ITN (Bethesda III and IV) samples from a multicentered, blinded retrospective study, previously evaluated by MPTXv1. Results: Compared with MPTXv1, MPTXv2 significantly improved the test performance. The receiver operating characteristic (ROC) areas under the curve (AUC) increased from 0.85 to 0.97 (p < 0.001), and the diagnostic accuracy at the positive threshold increased significantly (p < 0.05) from 83% [95% confidence interval (CI) = 76-88] to 93% [CI = 89-96]. The significant improvement in the ROC AUC and the diagnostic accuracy was due to a strong statistical trend for improvement in specificity at the positive threshold. At the positive threshold, the specificity for MPTXv1 was 90% [CI = 84-95] and improved to 98% [CI = 94-99] for MPTXv2. Using the MPTXv2, the Moderate-Risk cohort decreased from 50 samples (28% of the cohort) to 24 samples (13% of the cohort). This 52% decrease is statistically significant (p < 0.001) and clinically meaningful. Conclusion: As compared with MPTXv1, pairwise miRNA expression analysis used in MPTXv2 significantly improved the diagnostic accuracy of ITN risk stratification and reduced the size of the Moderate-Risk group. Prospective trials are indicated to confirm these findings in a clinical practice setting.

"A Community of Survivors": A Grounded Theory of Organizational Support for Survivor-Advocates in Domestic Violence Agencies.

Half of today's domestic violence (DV) advocates are survivors of intimate partner violence (IPV) or other forms of abuse. Yet, little is known about the experiences of those who are both survivors and advocates, especially regarding organizational relationships, policies, and culture, and how these factors shape well-being. This grounded theory study of 12 survivor-advocates identified three dimensions of organizational support that contribute survivor-advocates' well-being: acknowledging their trauma-related needs, fostering belonging, and honoring strengths. In each case, these organizational factors contribute to well-being through the mechanism of validating their identities as survivors. Suggestions for organizations to better support survivor-advocates are discussed.

Identity Abuse as a Tactic of Violence in LGBTQ Communities: Initial Validation of the Identity Abuse Measure.

Intimate partner violence (IPV; i.e., physical, sexual, or psychological abuse by a current or former partner) remains a public health concern with devastating personal and societal costs. Lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals are also vulnerable to a dimension of IPV called identity abuse (IA); that is, abuse tactics that leverage systemic oppression to harm an individual. Yet, we know little about its relative prevalence in subgroups of the LGBTQ community. This study developed and evaluated a measure of IA, and explored its prevalence in a sample of 734 sexual minority adults. The sample included women (53.1%), men (27.4%), and transgender or gender nonconforming "TGNC" (19.3%) participants. The majority of participants identified as queer or pansexual (38.7%), then gay (23.6%), lesbian (22.8%), and bisexual (13.6%). Participants completed an online survey that included measures of IA and physical, sexual, and psychological abuse. The IA items formed a unidimensional factor structure with strong internal consistency and construct validity. Nearly one fifth of the sample (16.8%) experienced past year IA and 40.1% reported adult IA. Women experienced greater exposure to IA in adulthood than men, and TGNC participants reported higher rates of IA in adulthood and in the last year compared to their cisgender counterparts. The odds of queer or bisexual participants reporting IA in adulthood were almost three times higher than gay participants, and two times higher than lesbian participants. Findings have implications for advancing assessment of partner abuse in the LGBTQ community, LGBTQ-competent clinical care, and training of practitioners.

Survivor-Centered Practice and Survivor Empowerment: Evidence From A Research-Practitioner Partnership.

In the domestic violence field, a survivor-centered approach to services is a shared ideal, but there is little empirical work demonstrating its importance. This study filled that gap, focusing on a key outcome-safety-related empowerment. We gathered data from 177 intimate partner violence (IPV) survivors seeking community-based services, and after one session with an advocate, results revealed a significant change in two of three subscales of the Measure of Victim Empowerment Related to Safety (MOVERS) measure: Internal Tools and Expectations of Support. There was no change in Trade-Offs (pursuing safety causing new problems). More survivor-defined practice predicted greater changes in empowerment, over and above severity of violence, post-traumatic stress disorder (PTSD), and demographics.

Exploring the Needs and Lived Experiences of Racial and Ethnic Minority Domestic Violence Survivors Through Community-Based Participatory Research: A Systematic Review.

Community-based participatory research (CBPR) is a methodological approach where community-academic teams build equitable relationships throughout the research process. In the domestic violence (DV) field, CBPR may be particularly important when conducting research with racial and ethnic minority DV survivors, as this group faces concurrent oppressions that inform their lived experiences. To our knowledge, no systematic review has synthesized articles using a CBPR approach to explore the needs and lived experiences of racial and ethnic minority DV survivors. Using PRISMA guidelines, we conducted a systematic review of the literature, retrieving articles that used a CBPR approach to understand the needs and/or lived experiences of female racial and ethnic minority DV survivors residing in the United States. Articles were identified from peer-reviewed databases, bibliographies, and experts. Thirteen of the 185 articles assessed for eligibility were included. Articles focused on a variety of racial and ethnic minority groups, the majority identifying as African American or Latina. Collaboration occurred in multiple ways, primarily through equitable decision-making and building team members' strengths. Several needs and lived experiences emerged including gender identity and patriarchal attitudes, racism and discrimination, the immigrant experience informing DV, poverty, shame and stigma, and the need for social support. This is the first systematic review of articles using a CBPR approach to explore the needs and lived experiences of racial and ethnic minority survivors. Implications include promoting community-based dissemination, conducting quantitative studies with larger sample sizes of DV survivors, and encouraging culturally specific services that address DV survivors' intersectional needs.

When crises collide: how intimate partner violence and poverty intersect to shape women's mental health and coping?

Until recently, the connection between intimate partner violence (IPV) and persistent poverty had been largely ignored. Recent research indicates, however, that the two phenomena cooccur at high rates; produce parallel effects; and, in each other's presence, constrain coping options. Therefore, both external situational, and internal psychological difficulties are missed when women contending with both poverty and IPV are viewed through the lens of just one or just the other. This article describes mental health consequences for women who contend with both partner violence and poverty. It proposes that the stress, powerlessness, and social isolation at the heart of both phenomena combine to produce posttraumatic stress disorder, depression, and other emotional difficulties. The article also introduces the term ''survival-focused coping'' to describe women's methods of coping with IPV in the context of poverty and highlights the role that domestic violence advocates, mental health providers, and researchers can play in addressing these tightly intertwined phenomena.

Secondary traumatic stress among domestic violence advocates: workplace risk and protective factors.

This study identified workplace factors associated with secondary traumatic stress (STS) in a sample of 148 domestic violence advocates working in diverse settings. Findings indicate that coworker support and quality clinical supervision are critical to emotional well-being and that an environment in which there is shared power-that is, respect for diversity, mutuality, and consensual decision making-provides better protection for advocates than more traditional, hierarchical organizational models. Furthermore, shared power emerged as the only workplace variable to significantly predict STS above and beyond individual factors. The discussion includes implications for practice and policy as well as directions for future research.

The victim-informed prosecution project: a quasi-experimental test of a collaborative model for cases of intimate partner violence.

The Victim-Informed Prosecution Project (VIP) was designed to amplify the voice of the victim in the prosecution of a battering current or ex-partner through collaboration between the prosecution and victim-centered agencies. This article describes the rationale for and design and implementation of VIP and then explores whether it increased perceived voice. While some VIP services (advocacy and civil protection order representation) were associated with increased perceived voice, the program as a whole was associated with it only in the context of greater contact with prosecutors, when cases were more likely to be felonies. We make specific recommendations for applying this model.

Advocacy With Survivors of Intimate Partner Violence: What It Is, What It Isn't, and Why It's Critically Important.

Survivors of intimate partner violence arrive at the doors of domestic violence (DV) programs with a wide variety of needs, including long-term safety and healing, housing, economic stability, health and well-being, and community connection. Although some DV programs offer holistic approaches to survivors, many focus the vast majority of their attention and resources on providing emotional support and safety planning rather than advocating with survivors for their access to needed resources and opportunities. Although services focused on emotional support and safety planning are important, they alone are not likely to result in the life changes that many survivors are seeking. Programs that provide genuine advocacy for survivors-defined as partnering with them to represent their rights and interests while linking them to concrete resources, protections, and opportunities-have been found to be effective and well received. Although an early pillar of DV programs, this type of advocacy has fallen by the wayside in many agencies. In this article, the authors make a case for re-invigorating advocacy efforts designed to improve the life circumstances of survivors. We argue that such efforts will make DV programs more relevant and sought after by a wider range of survivors and that agencies will see real change occur at both the individual and community levels.

Evaluation of the effects of receiving trauma-informed practices on domestic violence shelter residents.

Domestic violence is a potentially traumatizing experience that has devastating psychological and physical consequences. In response, domestic violence shelter programs have focused increasing attention on helping adult and child survivors understand and heal from this trauma. What have come to be called trauma-informed practices include (a) reflecting an understanding of trauma and its many effects on health and behavior, (b) addressing both physical and psychological safety concerns, (c) using a culturally informed strengths-based approach, (d) helping to illuminate the nature and effects of abuse on survivors' everyday experience; and (e) providing opportunities for clients to regain control over their lives. Despite the proliferation of these practices, little is known about their effects on survivors. In response, the current study explored the extent to which trauma-informed practices, as experienced by shelter residents, related to changes in their levels of self-efficacy, safety-related empowerment, and depressive symptoms over the course of approximately 30 days in shelter. Fifty-seven shelter residents from 4 programs in Ohio completed surveys shortly after arriving in shelter and again before exit. Their perception of the degree to which they received trauma-informed services was associated with significant improvement in their self-efficacy and safety-related empowerment, but had no impact on depressive symptoms. Depressive symptoms decreased over time, regardless of receipt of trauma-informed practice. Implications for policy and practice are discussed. (PsycINFO Database Record