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1.
Eur. j. psychol. appl. legal context (Internet) ; 12(2): 53-60, jul.-dic. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-190649

RESUMO

Intimate partner sexual violence has countless consequences for women suffering it. This research analyse the effect of the type of sexual coercion tactic and partner dependence on both the attribution of responsibility and the probability of leaving a relationship. In Study 1, six scenarios for different sexual tactics were presented (coaxing, coercion, and aggression) to 5 experts in order to select those with better evidence of content validity regarding the construct evaluated. In Study 2, the three selected scenarios were presented to 304 Spanish participants from the general population, analysing the effect of the type of tactic and dependence on attributed responsibility and the probability of leaving a relationship. Results showed that in the sexual aggression scenario, participants assigned the highest responsibility to the aggressorand showed the strongest likelihood of leaving the relationship. Further, results revealed that in the coaxing scenario, dependence had an indirect effect on the probability of leaving the relationship through a lower responsibility attributed to the aggressor. As a conclusion, this study emphasises the importance of the sexual tactic used by aggressors in individuals' perception about sexual coercion, contributing to increasing the visibility of this unacceptable action, especially in its more subtle and normalised form


La violencia sexual en las relaciones de pareja tiene innumerables consecuencias para las mujeres que la sufren. Esta investigación analiza el efecto del tipo de táctica de coerción sexual y la dependencia de la pareja en la atribución de responsabilidad y la probabilidad de dejar la relación. En el Estudio 1 se presentaron seis escenarios sobre diferentes tácticas sexuales(persuasión, coerción y agresión) a 5 expertos con la finalidad de seleccionar a aquellos que mostraran una mayor validez de contenido con respecto al constructo evaluado. En el Estudio 2, 304 participantes leyeron los tres escenarios seleccionados y se analizó el efecto del tipo de táctica y la dependencia en la responsabilidad atribuida y en la probabilidad de dejar la relación. Los resultados mostraron que los participantes responsabilizaban más al agresor y dejarían con más probabilidad la relación en la condición de agresión sexual que en la condición de coerción sexual o persuasión sexual. Además, los resultados revelan que en el escenario más sutil (persuasión) la dependencia tiene un efecto indirecto sobre probabilidad de dejar la relación a través de una menor responsabilidad atribuida al agresor. Como conclusión, esta investigación enfatiza la importancia que tiene la táctica sexual utilizada por el agresor en la percepción de la coerción sexual, contribuyendo a aumentar la visibilidad de este acto inaceptable, especialmente en su forma más sutil y normalizada


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Delitos Sexuais/psicologia , Violência por Parceiro Íntimo/psicologia , Dependência Psicológica , Manobra Psicológica , Fatores de Risco
2.
Rev Saude Publica ; 54: 97, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33146302

RESUMO

OBJECTIVE: To identify the prevalence of violence during pregnancy and the association with the socioeconomic, behavioral and clinical characteristics of pregnant women. METHODS: Cross-sectional study in a low-risk maternity hospital in the municipality of Cariacica, Espírito Santo. A total of 330 puerperal women were interviewed from August to October 2017. Information on socioeconomic, behavioral, reproductive and clinical characteristics, as well as life experiences, was collected through a questionnaire. To identify the types of violence, the proper World Health Organization instrument was used. Gross bivariate and multivariate analysis was performed and adjusted for Poisson regression with robust variance. RESULTS: Prevalence was 16.1% (95%CI 2.5-20.4) for psychological violence, 7.6% (95%CI 5.1-11.0) for physical violence and 2.7% (95%CI 1.4-5.2) for sexual violence. Psychological violence remained associated with age, family income, beginning of sexual life, disease in pregnancy, desire to interrupt pregnancy and number of partners. Physical violence was associated with schooling, beginning of sexual life and disease in pregnancy. Sexual violence remained associated with marital status and desire to interrupt pregnancy (p < 0.05). CONCLUSIONS: Psychological violence by an intimate partner was the most prevalent among pregnant women. Women that were younger, had lower income and less schooling, who started their sexual life before the age of 14 and who wished to interrupt pregnancy, experienced violence more frequently during pregnancy.


Assuntos
Violência por Parceiro Íntimo/estatística & dados numéricos , Saúde Mental/estatística & dados numéricos , Abuso Físico/estatística & dados numéricos , Delitos Sexuais/estatística & dados numéricos , Parceiros Sexuais/psicologia , Maus-Tratos Conjugais/estatística & dados numéricos , Adulto , Brasil/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Feminino , Humanos , Violência por Parceiro Íntimo/psicologia , Abuso Físico/psicologia , Gravidez , Prevalência , Fatores de Risco , Delitos Sexuais/psicologia , Fatores Socioeconômicos , Maus-Tratos Conjugais/psicologia
3.
J Womens Health (Larchmt) ; 29(10): 1239-1242, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33006492

RESUMO

Intimate partner violence (IPV)-defined as physical, psychological, sexual, and/or economic violence typically experienced by women at home and perpetrated by their partners or expartners-is a pervasive form of violence that destroys women's feelings of love, trust, and self-esteem, with important negative consequences on physical and psychological health. Many reports from several countries have underlined a remarkable increase in the cases of IPV during the COVID-19 emergency. In this opinion article, we discussed the hypothesis that such an increase may be related to the restrictive measures enacted to contain the pandemic, including women's forced cohabitation with the abusive partner, as well as the exacerbation of partners' pre-existing psychological disorders during the lockdown. In addition, we retrospectively analyzed some data derived from our practice in a public Italian referral center for sexual and domestic violence (Service for Sexual and Domestic Violence [SVSeD]). These data interestingly revealed an opposite trend, that is, a decrease in the number of women who sought assistance since the beginning of the COVID-19 outbreak. Such a reduction should be interpreted as a negative consequence of the pandemic-related restrictive measures. Although necessary, these measures reduced women's possibilities of seeking help from antiviolence centers and/or emergency services. Owing to the COVID-19 outbreak, there is an urgent need for developing and implementing alternative treatment options for IPV victims (such as online and phone counseling and telemedicine), as well as training programs for health care professionals, especially those employed in emergency departments, to facilitate early detection of IPV.


Assuntos
Infecções por Coronavirus/prevenção & controle , Violência por Parceiro Íntimo/estatística & dados numéricos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Quarentena/psicologia , Parceiros Sexuais/psicologia , Maus-Tratos Conjugais/estatística & dados numéricos , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Feminino , Humanos , Violência por Parceiro Íntimo/psicologia , Violência por Parceiro Íntimo/tendências , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Estudos Retrospectivos , Autoimagem , Delitos Sexuais/psicologia , Delitos Sexuais/tendências , Distância Social , Maus-Tratos Conjugais/psicologia , Maus-Tratos Conjugais/tendências
5.
PLoS One ; 15(9): e0239046, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32941496

RESUMO

The increasing recidivism rate of sex offenders indicates potential problems in existing recidivism programs. The present study was conducted to determine whether the polygraph examination is a useful technique to obtain a sex offender's concealed past sexual history. We collected fifty-two sex offenders' data and analyzed it. Among the 52 participants, the court ordered 26 sex offenders to take the psychiatric evaluation and the polygraph test. The other half were prisoners at the hospital who were currently undergoing treatment. The participants in the polygraph group disclosed more deviant sexual behaviors and paraphilia interests/behaviors than the comparison group. Thus, the polygraph examination is a powerful tool that can encourage sex offenders to disclose hidden information to help create suitable psychological therapy programs for preventing recidivism in the future.


Assuntos
Detecção de Mentiras/psicologia , Reincidência/prevenção & controle , Delitos Sexuais/psicologia , Adulto , Criminosos/psicologia , Humanos , Masculino , Transtornos Parafílicos/diagnóstico , Transtornos Parafílicos/psicologia , Prisioneiros/psicologia , Comportamento Sexual/psicologia , Revelação da Verdade/ética
6.
BMC Public Health ; 20(1): 1051, 2020 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-32616007

RESUMO

BACKGROUND: Violence against children is a pervasive public health issue, with limited data available across multiple contexts. This study explores the rarely studied prevalence and dynamics around disclosure, reporting and help-seeking behaviours of children who ever experienced physical and/or sexual violence. METHODS: Using nationally-representative Violence Against Children Surveys in six countries: Cambodia, Haiti, Kenya, Malawi, Nigeria and Tanzania, we present descriptive statistics for prevalence of four outcomes among children aged 13-17 years: informal disclosure, knowledge of where to seek formal help, formal disclosure/help seeking and receipt of formal help. We ran country-specific multivariate logistic regressions predicting outcomes on factors at the individual, household and community levels. RESULTS: The prevalence of help-seeking behaviours ranged from 23 to 54% for informal disclosure, 16 to 28% for knowledge of where to seek formal help, under 1 to 25% for formal disclosure or help seeking, and 1 to 11% for receipt of formal help. Factors consistently correlated with promoting help-seeking behaviours included household number of adult females and absence of biological father, while those correlated with reduced help-seeking behaviours included being male and living in a female-headed household. Primary reasons for not seeking help varied by country, including self-blame, apathy and not needing or wanting services. CONCLUSIONS: Across countries examined, help-seeking and receipt of formal services is low for children experiencing physical and/or sexual violence, with few consistent factors identified which facilitated help-seeking. Further understanding of help seeking, alongside improved data quality and availability will aid prevention responses, including the ability to assist child survivors in a timely manner.


Assuntos
Saúde da Criança/estatística & dados numéricos , Revelação/estatística & dados numéricos , Sobreviventes/psicologia , Violência/psicologia , Adolescente , Camboja/epidemiologia , Criança , Feminino , Haiti/epidemiologia , Humanos , Quênia/epidemiologia , Modelos Logísticos , Malaui , Masculino , Prevalência , Delitos Sexuais/psicologia , Inquéritos e Questionários , Sobreviventes/estatística & dados numéricos , Tanzânia/epidemiologia , Violência/prevenção & controle
7.
Arch Womens Ment Health ; 23(5): 673-679, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32623514

RESUMO

Suicidal ideation and suicidal behavior are common after experiencing a sexual assault. Therefore, it is imperative to assess for and manage suicidal ideation using evidence-based techniques after a sexual assault medical forensic examination (SAMFE). We assessed factors associated with higher suicidal ideation identified in a post-SAMFE mental health screening conducted over the phone and strategies to manage suicide risk. We also discuss three case examples and unique considerations when assessing post-SAMFE suicide risk. It was found that among individuals who completed a post-SAMFE screen, individuals who have been previously hospitalized for a mental health problem, who had higher acute stress symptoms, and who were homeless reported more suicidal ideation than those without those histories or symptom presentations. No matter the risk factors for suicidal ideation post-SAMFE, it is essential to screen all individuals post-SAMFE due to their high risk for suicidal ideation and death by suicide.


Assuntos
Delitos Sexuais/psicologia , Ideação Suicida , Tentativa de Suicídio/psicologia , Adolescente , Adulto , Depressão/psicologia , Feminino , Humanos , Saúde Mental , Pessoa de Meia-Idade , Fatores de Risco , Transtornos de Estresse Pós-Traumáticos/psicologia , Suicídio/psicologia , Estados Unidos , Adulto Jovem
8.
PLoS One ; 15(7): e0236873, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32726368

RESUMO

Individual differences in dispositional coping might influence how ambiguous situations involving interactions of men and women are interpreted and remembered. Specifically, we hypothesized that women with a sensitive coping style actively maintain ambiguously threatening stimuli in their memory, showing so-called sensitive maintenance. As a prerequisite to investigate this hypothesis, two surveys (Studies 1 and 2; N = 151 and N = 252) were conducted to answer the questions whether fear of sexual assault is of relevance for young women in Germany and whether ambiguous (rather than only unambiguously threatening) situations are experienced to a significant extent. After confirming this for our target population, our main hypothesis was tested in Study 3 (N = 192) by combining tasks assessing the appraisal and the forgetting of nonthreatening, threatening, and ambiguous pictures showing interactions of men and women, and by varying the cognitive load during the retention interval. Whereas fear of rape predicted the appraisal of pictures, coping dispositions predicted forgetting of ambiguously and unambiguously threatening pictures in the hypothesized way. Results are discussed from the perspective of adaptivity and functionality of memory.


Assuntos
Rememoração Mental , Delitos Sexuais/psicologia , Adaptação Psicológica/fisiologia , Feminino , Humanos , Inquéritos e Questionários , Adulto Jovem
9.
BMC Public Health ; 20(1): 937, 2020 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-32611321

RESUMO

BACKGROUND: The study aimed to investigate the associations between physical partner violence victimization (IPV) and/or sexual violence victimization and various health risk behaviours and mental health in university students in 25 countries. METHODS: Using a cross-sectional study design, 18,335 university students with a median age of 20 years from 25 countries in Africa, the Americas and Asia, replied to self-reported measures of interpersonal violence, health compromising behaviours, mental health measures and protective factors. RESULTS: In adjusted logistic regression analysis, physical IPV and/or sexual violence victimization was associated, among men and/or among women, with sexual risk behaviours (multiple sexual partners, alcohol use in the context of sex, diagnosed with HIV and pregnancy), violence related behaviour (in a physical fight and carrying a weapon), poor mental health (depression, loneliness, post-traumatic stress disorder, sleeping problem and short sleep), addictive behaviour (binge drinking, tobacco and drug use), and other health risk behaviour (skipping breakfast and frequent salt intake). CONCLUSIONS: We found evidence that physical IPV and/or sexual violence victimization among female and/or male university students was associated with 4 of 5 sexual risk behaviours, 2 violence related behaviours, 5 of 5 poor mental health indicators, 3 of 3 addictive behaviours and 2 of 7 other health risk behaviours.


Assuntos
Vítimas de Crime/psicologia , Comportamentos de Risco à Saúde , Violência por Parceiro Íntimo/psicologia , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Delitos Sexuais/psicologia , Estudantes/psicologia , Adulto , África/epidemiologia , Ásia/epidemiologia , Vítimas de Crime/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Violência por Parceiro Íntimo/estatística & dados numéricos , Masculino , Gravidez , Fatores de Risco , Autorrelato , Delitos Sexuais/estatística & dados numéricos , América do Sul/epidemiologia , Estudantes/estatística & dados numéricos , Universidades , Índias Ocidentais/epidemiologia , Adulto Jovem
10.
PLoS One ; 15(6): e0234201, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32502207

RESUMO

Although survivors of sexual violence have shared their stories with the public on social media and mass media platforms in growing numbers, less is known about how general audiences perceive such trauma stories. These perceptions can have profound consequences for survivor mental health. In the present experimental, vignette-based studies, we anticipated that cultural stigma surrounding sexual violence and cultural preference for positive (redemptive) endings to adversity in the United States (U.S.) would shape perceptions. Four samples of U.S. adults (N = 1872) rated first-person narratives of 6 more stigmatizing (i.e., sexual violence) or less stigmatizing (e.g., natural disaster) traumatic events. Confirming pre-registered hypotheses, sexual violence trauma (versus other types of trauma) stories were perceived as more difficult to tell, and their storytellers less likeable, even when they had redemptive endings. Disconfirming other pre-registered hypotheses, redemptive (versus negative) story endings did not boost the perceived likelihood or obligation to share a sexual violence trauma story. Rather, redemptive (versus negative) story endings only boosted the perceived likelihood, obligation, and ease of telling other, less stigmatizing types of trauma stories. Findings suggest that sexual violence survivors do not benefit, to the same degree as other survivors, from telling their stories with the culturally valued narrative template of redemption. Clinical and societal implications of the less receptive climate for sexual violence stories are discussed.


Assuntos
Cultura , Narração , Trauma Psicológico/psicologia , Delitos Sexuais/psicologia , Estigma Social , Sobreviventes/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Percepção , Adulto Jovem
11.
Cochrane Database Syst Rev ; 6: CD009829, 2020 06 22.
Artigo em Inglês | MEDLINE | ID: mdl-32572950

RESUMO

BACKGROUND: Around 1 in 1000 adolescents aged 12 to 17 years old display problematic or harmful sexual behaviour (HSB). Examples include behaviours occurring more frequently than would be considered developmentally appropriate; accompanied by coercion; involving children of different ages or stages of development; or associated with emotional distress. Some, but not all, young people engaging in HSB come to the attention of authorities for investigation, prosecution or treatment. Depending on policy context, young people with HSB are those whose behaviour has resulted in a formal reprimand or warning, conviction for a sexual offence, or civil measures. Cognitive-behavioural therapy (CBT) interventions are based on the idea that by changing the way a person thinks, and helping them to develop new coping skills, it is possible to change behaviour. OBJECTIVES: To evaluate the effects of CBT for young people aged 10 to 18 years who have exhibited HSB. SEARCH METHODS: In June 2019, we searched CENTRAL, MEDLINE, Embase, 12 other databases and three trials registers. We also examined relevant websites, checked reference lists and contacted authors of relevant articles. SELECTION CRITERIA: We included all relevant randomised controlled trials (RCTs) using parallel groups. We evaluated CBT treatments compared with no treatment, waiting list or standard care, irrespective of mode of delivery or setting, given to young people aged 10 to 18 years, who had been convicted of a sexual offence or who exhibited HSB. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane. MAIN RESULTS: We found four eligible RCTs (115 participants). Participants in two studies were adolescent males aged 12 to 18 years old. In two studies participants were males simply described as "adolescents." Three studies took place in the USA and one in South Africa. The four studies were of short duration: one lasted two months; two lasted three months; and one lasted six months. No information was available on funding sources. Two studies compared group-based CBT respectively to no treatment (18 participants) or treatment as usual (21 participants). The third compared CBT with sexual education (16 participants). The fourth compared CBT (19 participants) with mode-deactivation therapy (21 participants) and social skills training (20 participants). Three interventions delivered treatment in a residential setting by someone working there, and one in a community setting by licensed therapist undertaking a PhD. CBT compared with no treatment or treatment as usual Primary outcomes No study in this comparison reported the impact of CBT on any measure of primary outcomes (recidivism, and adverse events such as self-harm or suicidal behaviour). Secondary outcomes There was little to no difference between CBT and treatment as usual on cognitive distortions in general (mean difference (MD) 1.56, 95% confidence interval (CI) -11.54 to 14.66, 1 study, 18 participants; very low-certainty evidence), assessed with Abel and Becker Cognition Scale (higher scores indicate more problematic distortions); and specific cognitive distortions about rape (MD 8.75, 95% CI 2.83 to 14.67, 1 study, 21 participants; very low-certainty evidence), measured with the Bumby Cardsort Rape Scale (higher scores indicate more justifications, minimisations, rationalisations and excuses for HSB). One study (18 participants) reported very low-certainty evidence that CBT may result in greater improvements in victim empathy (MD 5.56, 95% CI 0.94 to 10.18), measured with the Attitudes Towards Women Scale, compared with no treatment. One additional study also measured this, but provided no usable data. CBT compared with alternative interventions Primary outcomes One study (59 participants) found little to no difference between CBT and alternative treatments on post-treatment sexual aggression scores (MD 0.09, 95% CI -0.18 to 0.37, very low-certainty evidence), assessed using Daily Behaviour Reports and Behaviour Incidence Report Forms. No study in this comparison reported the impact of CBT on any measure of our remaining primary outcomes. Secondary outcomes One study (16 participants) provided very low-certainty evidence that, compared to sexual education, mean cognitive distortions pertaining to justification or taking responsibility for actions (MD 3.27, 95% CI -4.77 to -1.77) and apprehension confidence (MD 2.47 95% CI -3.85 to -1.09) may be lower in the CBT group. The same study indicated that mean cognitive distortions pertaining to social-sexual desirability may be lower in the CBT group, and there may be little to no difference between the groups for cognitive distortions pertaining to inappropriate sexual fantasies measured with the Multiphasic Sex Inventory. AUTHORS' CONCLUSIONS: It is uncertain whether CBT reduces HSB in male adolescents compared to other treatments. All studies had insufficient detail in what they reported to allow for full assessment of risk of bias. 'Risk of bias' judgements were predominantly rated as unclear or high. Sample sizes were very small, and the imprecision of results was significant. There is very low-certainty evidence that group-based CBT may improve victim empathy when compared to no treatment, and may improve cognitive distortions when compared to sexual education, but not treatment as usual. Further research is likely to change the estimate. More robust evaluations of both individual and group-based CBT are required, particularly outside North America, and which look at the effects of CBT on diverse participants.


Assuntos
Adaptação Psicológica , Terapia Cognitivo-Comportamental/métodos , Delitos Sexuais/prevenção & controle , Adolescente , Atitude , Criança , Transtornos Cognitivos/psicologia , Dessensibilização Psicológica , Fantasia , Humanos , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto , Estupro/psicologia , Reincidência , Autoimagem , Educação Sexual , Delitos Sexuais/psicologia , Habilidades Sociais
12.
PLoS One ; 15(6): e0235203, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32584889

RESUMO

BACKGROUND: Little is known about violence against HIV-positive adolescents and young adults (AYA) in sub-Saharan Africa. This analysis examines experiences of violence victimization, and the perpetrators of this violence, among AYA living with HIV, aged 15-24 years, in Zambia. METHODS: We analyzed baseline data from 272 AYA (60.1% female, 71.0% perinatally infected) enrolled in Project YES! (Youth Engaging for Success), a randomized controlled trial conducted in four HIV clinics in Ndola, Zambia. Violence measures were adapted from the ICAST-C and the WHO Multi-Country Study on Women's Health and Domestic Violence. Youth could report up to 12 perpetrator types for past-year experiences of violence. We estimated lifetime and past-year prevalence of physical violence, psychological abuse, and forced sex, disaggregated by sex and age group. Estimates were weighted using sex and age data from the 2013-14 Zambian Demographic and Health Survey to be representative of HIV-positive AYA in Zambia. RESULTS: Estimated lifetime prevalence of any violence victimization was 78.2%. Past-year prevalence was 72.0% among males and 74.5% among females. Almost half of AYA (46.1%) had ever experienced polyvictimization (2+ types of violence). Psychological abuse was most common (70.4% lifetime, 65.3% past-year), followed by physical violence (50.8% lifetime, 44.7% past-year) and forced sex (10.4% lifetime, 4.7% past-year). Among past-year victims, males experienced more violence than females from a friend/peer (74.3% vs. 45.1%, p<0.001); females experienced more violence than males from a romantic partner (33.3% vs. 5.0%, p<0.001), parent/caregiver (32.4% vs. 17.6%, p = 0.02), and stranger (19.7% vs. 5.2%, p<0.001). CONCLUSION: The widespread and overlapping prevalence of multiple types of violence highlights the critical need for prevention and response efforts that are tailored to youths' sex and the perpetrator type. Future research should explore violence victimization and HIV outcomes, and the measurement of psychological abuse and sexual violence, among HIV-positive AYA in the region.


Assuntos
Infecções por HIV , HIV-1 , Abuso Físico/psicologia , Delitos Sexuais/psicologia , Parceiros Sexuais , Adolescente , Adulto , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/psicologia , Humanos , Masculino , Prevalência , Adulto Jovem , Zâmbia/epidemiologia
13.
Epidemiol Psychiatr Sci ; 29: e133, 2020 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-32482189

RESUMO

Abstract. AIMS: Intimate partner violence (IPV) is an important risk factor for perinatal depression (PND). But IPV's impact on the natural prognosis of PND symptoms is not well understood. We tested two hypotheses: (1) pregnant women with IPV experiences will exhibit more severe PND symptoms than women without IPV experience; (2) IPV experience will impede the recovery prognosis of PND. We also explored the contribution of IPV to PND comparing with other risk factors. METHOD: The sample is comprised of 813 pregnant women followed through perinatal period in Hunan, China. We assessed IPV experience using items from the Short Form of the Revised Conflict Tactics Scale (CTS2S), and PND symptoms via the Edinburgh Postnatal Depression Scale (EPSD). We conducted Linear Mixed-effects Model to compare the trajectories of PND symptoms between victims and non-victims and a multistage Generalised Estimating Equations Model to explore salient factors on the trajectory of PND symptoms. RESULTS: There were 90 participants (11.07%) who reported IPV experience in the past 12 months. With respect to physical, psychological and sexual violence, the prevalence was 4.55% (37/813), 9.23% (75/813) and 2.34% (19/813). Victims reported more severe PND symptoms (t = 5.30, p < 0.01) and slower decreasing slope of trajectories (t = 28.89, p < 0.01). The PND trajectory was associated with IPV experience (OR = 3.78; 95% CI 1.39-10.26), social support (OR = 0.93; 95% CI 0.88-0.97), positive coping strategies (OR = 0.85; 95% CI 0.80-0.91), negative coping strategies (OR = 1.25; 95% CI 1.14-1.37) and monthly income of $0.15-$298.36 (compared to no income, OR = 0.0075; 95% CI 0.00052-0.11). CONCLUSIONS: The findings suggest the reported prevalence of IPV is lower in Hunan than most of the previous studies during perinatal period in other provinces of China, and IPV victimisation is associated with increased severity and slowed prognosis of PND symptoms. Future studies that screen for victimisation and establish its explicit mechanism to the poorer prognosis of PND symptoms would benefit the prevention and treatment of PND.


Assuntos
Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Vítimas de Crime/psicologia , Depressão Pós-Parto/diagnóstico , Depressão/diagnóstico , Violência por Parceiro Íntimo/psicologia , Violência por Parceiro Íntimo/estatística & dados numéricos , Mães/psicologia , Delitos Sexuais/psicologia , Maus-Tratos Conjugais/psicologia , Adaptação Psicológica , Adulto , China/epidemiologia , Estudos de Coortes , Estudos Transversais , Depressão/epidemiologia , Depressão/psicologia , Depressão Pós-Parto/epidemiologia , Depressão Pós-Parto/psicologia , Feminino , Humanos , Violência por Parceiro Íntimo/etnologia , Pessoa de Meia-Idade , Assistência Perinatal , Pobreza/psicologia , Gravidez , Prevalência , Escalas de Graduação Psiquiátrica , Fatores de Risco , Delitos Sexuais/etnologia , Apoio Social , Adulto Jovem
14.
PLoS One ; 15(5): e0233185, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32413081

RESUMO

BACKGROUND: People with a history of interpersonal trauma, including intimate partner violence, sexual assault, and adverse childhood experiences, are disproportionately affected by the current opioid epidemic. Interpersonal trauma has been shown to increase risk for chronic pain conditions, prescription opioid use, and opioid misuse. Stress, cognition, and affective function have been examined as potential mechanisms that may influence opioid misuse among individuals with a history of interpersonal trauma. However, no studies have examined these factors simultaneously, despite their interrelatedness. OBJECTIVE: The purpose of this study was to 1) examine perceived stress, perceived cognitive function, depressive symptoms, and PTSD symptoms as potential mechanisms of opioid misuse among individuals with a history of interpersonal trauma, 2) examine the types of interpersonal trauma that are associated with opioid misuse, and 3) assess the mediating role of pain and opioid prescription. METHODS: A cross-sectional, observational study design was conducted. Data were collected through a confidential self-report online survey using validated instruments (n = 230). A series of regression analyses were conducted to identify mechanistic factors and interpersonal trauma types associated with opioid misuse, opioid prescription, and pain intensity. Structural equation modeling was used to examine mediating effects of pain intensity and opioid prescription. RESULTS: Opioid prescription, depressive symptoms, and intimate partner violence increased the odds of reporting opioid misuse. Pain intensity and adverse childhood experiences increased the odds of opioid prescription. Higher levels of perceived stress and depressive symptoms were associated with increased pain intensity. Pain intensity emerged as a mediator of the relationship between depressive symptoms and opioid misuse. CONCLUSIONS: Our work shows that there are likely several pathways through which interpersonal trauma can lead to opioid misuse. Interventions aimed at improving depressive symptoms and coping with traumatizing events should be included as part of comprehensive trauma-informed pain management practices.


Assuntos
Violência por Parceiro Íntimo/estatística & dados numéricos , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Uso Indevido de Medicamentos sob Prescrição/estatística & dados numéricos , Trauma Psicológico , Adulto , Analgésicos Opioides/uso terapêutico , Ciências Biocomportamentais , Dor Crônica/psicologia , Cognição/fisiologia , Estudos Transversais , Depressão/epidemiologia , Depressão/etiologia , Depressão/psicologia , Feminino , Humanos , Masculino , Transtornos Relacionados ao Uso de Opioides/etiologia , Autorrelato , Delitos Sexuais/psicologia , Delitos Sexuais/estatística & dados numéricos , Estresse Psicológico/epidemiologia , Estresse Psicológico/etiologia , Inquéritos e Questionários , Adulto Jovem
15.
J Med Internet Res ; 22(5): e16702, 2020 05 14.
Artigo em Inglês | MEDLINE | ID: mdl-32406863

RESUMO

BACKGROUND: Owing to increasing access to Web-based pornography and concerns about its impact on viewers, many researchers have attempted to systematically analyze the content of pornography. OBJECTIVE: We aimed to systematically review the results of quantitative content analyses of video-based pornography and identify the degree to which the following behaviors are depicted: (1) sexual behaviors and themes, (2) condom use during sexual behaviors, and (3) aggression and violence. METHODS: Inclusion criteria for article eligibility were (1) peer-reviewed publications, (2) articles in the English language, (3) articles describing a quantitative content analysis of video pornography, and (4) articles quantitatively examining at least one variable of interest. RESULTS: A total of 23 studies met the eligibility criteria. Studies varied in scope and definitions of behavioral variables. Condom use was rare, although more commonly depicted in gay male pornography (36%-64% videos) compared with heterosexual pornography (2%-3% videos). Normative sexual behaviors were most frequently depicted in pornography samples (eg, vaginal intercourse in 48%-90% and fellatio in 52%-90% of heterosexual videos; fellatio in 66%-100% and anal intercourse in 70%-80% of gay male videos). Extreme acts of violence (1%-3% videos) and rape (0%-6% videos) were relatively rare. However, more subtle forms of aggression, such as spanking (5%-75% videos), were more common, and unequal sexual relations (eg, domination) were also common. Although estimates varied by study, dominating and violent behaviors were nearly always directed toward women. CONCLUSIONS: Condom nonuse and gender inequalities are common in pornography, which has implications for the development of healthy sexual relationships among pornography viewers. Higher quality research, including study replication and consistent methodological choices, is needed.


Assuntos
Literatura Erótica/psicologia , Delitos Sexuais/psicologia , Comportamento Sexual/psicologia , Gravação em Vídeo/normas , Adulto , Feminino , Humanos , Masculino
16.
PLoS One ; 15(4): e0231644, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32315332

RESUMO

OBJECTIVES: Gender-based violence is a global public health crisis, which has health, social, and economic impacts on survivors. In Ghana, responding to and preventing sexual violence on university campuses, has become a priority area. However, data are lacking on the healthcare provider response to students who have experienced sexual violence. The purpose of this study was to conduct a situational analysis to better understand the healthcare provider response to sexual violence in Cape Coast, Ghana. METHODS: First, an observational facility assessment about healthcare services for survivors of sexual violence was conducted at two hospitals serving university students in Cape Coast, Ghana. Next, healthcare providers at the two hospitals completed: 1) a 113-item questionnaire about healthcare services, knowledge, and attitudes related to sexual violence and 2) in-depth semi-structured interviews describing their experiences providing healthcare to survivors of sexual violence. Descriptive statistics and frequencies were computed, and thematic analysis was used to analyze the qualitative data. RESULTS: Both sites lacked supplies, including pre-packed rape kits, post-exposure HIV prophylaxis, and informational handouts on medications and support services for survivors. Further, healthcare providers lacked training on gender-based violence, including best practices for caring for survivors and evidence collection procedures. Providers described the clinical management for survivors of sexual violence, including providers' role in reporting sexual violence to authorities, medical forensic exams, reproductive and sexual health services, and referral for mental healthcare. Finally, providers described a number of barriers to survivors accessing post-assault healthcare, including stigma and structural barriers, such as cost of medical supplies and lack of privacy within the healthcare facilities. CONCLUSIONS: The current healthcare response to sexual violence in Ghana is limited by lack of supplies, knowledge, and training for healthcare providers. Personal and structural barriers may prevent survivors from accessing needed healthcare following sexual violence.


Assuntos
Violência de Gênero/prevenção & controle , Infecções por HIV/epidemiologia , Pessoal de Saúde/psicologia , Delitos Sexuais/prevenção & controle , Adulto , Vítimas de Crime/psicologia , Feminino , Violência de Gênero/psicologia , Gana/epidemiologia , Infecções por HIV/psicologia , Hospitais , Humanos , Masculino , Estupro/psicologia , Delitos Sexuais/psicologia , Inquéritos e Questionários , Sobreviventes/psicologia
17.
PLoS One ; 15(4): e0231260, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32275695

RESUMO

BACKGROUND: Specialist sexual assault services, which collect forensic evidence and offer holistic healthcare to people following sexual assault, have been established internationally. In England, these services are called sexual assault referral centres (SARCs). Mental health and substance misuse problems are common among SARC attendees, but little is known about how SARCs should address these needs. This review aims to seek and synthesise evidence regarding approaches to identification and support for mental health and substance misuse problems in SARCs and corresponding services internationally; empirical evidence regarding effective service models; and stakeholders' views and policy recommendations about optimal SARC practice. METHODS: A systematic review was undertaken. PsycINFO, MEDLINE, IBSS and CINAHL were searched from 1975 to August 2018. A web-based search up to December 2018 was also conducted to identify government and expert guidelines on SARCs. Quality assessment and narrative synthesis were conducted. RESULTS: We included 107 papers. We found that identification based on clinical judgement, supportive counselling and referral to other services without active follow-up were the most common approaches. Evaluations of interventions for post-rape psychopathology in attendees of sexual assault services provided mixed evidence of moderate quality. Very little evidence was found regarding interventions or support for substance misuse. Stakeholders emphasised the importance of accessibility, flexibility, continuity of care, in-house psychological support, staff trained in mental health as well as specialist support for LGBT groups and people with learning difficulties. Guidelines suggested that SARCs should assess for mental health and substance misuse and provide in-house emotional support, but the extent and nature of support were not clarified. Both stakeholders and guidelines recommended close partnership between sexual assault services and local counselling services. CONCLUSIONS: This review suggests that there is big variation in the mental health and substance misuse provision both across and within different sexual assault service models. We found no robust evidence about how sexual assault services can achieve good mental health and substance misuse outcomes for service users. Clearer guidance for service planners and commissioners, informed by robust evidence about optimal service organisations and pathways, is required. PROSPERO registration number: CRD42018119706.


Assuntos
Saúde Mental , Delitos Sexuais/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Transtornos Relacionados ao Uso de Substâncias/terapia , Feminino , Governo , Guias como Assunto , Diretrizes para o Planejamento em Saúde , Recursos em Saúde , Humanos , Masculino , Reino Unido
18.
PLoS One ; 15(4): e0231737, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32320405

RESUMO

INTRODUCTION: We sought to estimate the prevalence, severity and identify predictors of violence among adolescent girls and young women (AGYW) in informal settlement areas of Nairobi, Kenya, selected for DREAMS (Determined Resilient Empowered AIDS-free, Mentored and Safe) investment. METHODS: Data were collected from 1687 AGYW aged 10-14 years (n = 606) and 15-22 years (n = 1081), randomly selected from a general population census in Korogocho and Viwandani in 2017, as part of an impact evaluation of the "DREAMS" Partnership. For 10-14 year-olds, we measured violence experienced either in the past 6 months or ever using a different set of questions from those used for 15-22 year-olds. Among 15-22 year-olds we measured prevalence of violence, experienced in the past 12 months, using World Health Organization (WHO) definitions for violence typologies. Predictors of violence were identified using multivariable logit models. RESULTS: Among 606 girls aged 10-14 years, about 54% and 7% ever experienced psychological and sexual violence, respectively. About 33%, 16% and 5% experienced psychological, physical and sexual violence in the past 6 months. The 10-14 year old girls who engaged in chores or activities for payment in the past 6 months, or whose family did not have enough food due to lack of money were at a greater risk for violence. Invitation to DREAMS and being a non-Christian were protective. Among 1081 AGYW aged 15-22 years, psychological violence was the most prevalent in the past year (33.1%), followed by physical violence (22.9%), and sexual violence (15.8%). About 7% experienced all three types of violence. Severe physical violence was more prevalent (13.8%) than moderate physical violence (9.2%). Among AGYW aged 15-22 years, being previously married/lived with partner, engaging in employment last month, food insecure were all risk factors for psychological violence. For physical violence, living in Viwandani and being a Muslim were protective; while being previously married or lived with a partner, or sleeping hungry at night during the past 4 weeks were risk factors. The odds of sexual violence were lower among AGYW aged 18-22 years and among Muslims. Engaging in sex and food insecurity increased chances for sexual violence. CONCLUSIONS: Prevalence of recent violence among AGYW is high in this population. This calls for increased effort geared towards addressing drivers of violence as an early entry point of HIV prevention effort in this vulnerable group.


Assuntos
Abastecimento de Alimentos/estatística & dados numéricos , Infecções por HIV/prevenção & controle , Abuso Físico/estatística & dados numéricos , Avaliação de Programas e Projetos de Saúde/estatística & dados numéricos , Delitos Sexuais/estatística & dados numéricos , Adolescente , Criança , Estudos de Coortes , Feminino , Infecções por HIV/epidemiologia , Humanos , Quênia/epidemiologia , Abuso Físico/prevenção & controle , Abuso Físico/psicologia , Prevalência , Parcerias Público-Privadas/organização & administração , Parcerias Público-Privadas/estatística & dados numéricos , Fatores de Risco , População Rural/estatística & dados numéricos , Delitos Sexuais/prevenção & controle , Delitos Sexuais/psicologia , Fatores Socioeconômicos , População Urbana/estatística & dados numéricos , Adulto Jovem
19.
Psychiatry Res ; 288: 112967, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32339805

RESUMO

The objective of the current study was to assess the association between adverse childhood experiences (ACEs) and irritable bowel syndrome (IBS) in mood disorder patients. Self-report data from the International Mood Disorders Collaborative Project were cross-sectionally analyzed to compare rates of IBS in participants with confirmed diagnoses of major depressive disorder (MDD; n = 279) or bipolar disorder (BD; n = 219). Data was sub-grouped and compared based on history of ACEs. In total, 69 of the 498 participants reported a diagnosis of IBS (13.8%). BD was associated with significantly elevated rates of IBS compared to MDD (18.5% versus 10.1% respectively). After adjusting for age and sex, history of childhood sexual abuse was associated with increased rates of IBS in mood disorder participants [adjusted odds ratio (aOR) = 1.95]. In the MDD subgroup, ACEs (all categories and individual categories) were not associated with increased rates of IBS. In the BD subgroup, history of childhood sexual abuse was associated with significantly increased rates of IBS (38% versus 14%; aOR = 3.7). In summary, BD was associated with a higher prevalence of IBS compared to MDD. Additionally, history of sexual abuse was associated with an increased prevalence of IBS in BD, but not in MDD.


Assuntos
Experiências Adversas da Infância/tendências , Síndrome do Intestino Irritável/diagnóstico , Síndrome do Intestino Irritável/psicologia , Transtornos do Humor/diagnóstico , Transtornos do Humor/psicologia , Adulto , Transtorno Bipolar/diagnóstico , Transtorno Bipolar/psicologia , Criança , Estudos Transversais , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Delitos Sexuais/psicologia , Delitos Sexuais/tendências
20.
PLoS Med ; 17(3): e1003064, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32191701

RESUMO

BACKGROUND: Drought has many known deleterious impacts on human health, but little is known about the relationship between drought and intimate partner violence (IPV). We aimed to evaluate this relationship and to assess effect heterogeneity between population subgroups among women in 19 sub-Saharan African countries. METHODS AND FINDINGS: We used data from 19 Demographic and Health Surveys from 2011 to 2018 including 83,990 partnered women aged 15-49 years. Deviations in rainfall in the year before the survey date were measured relative to the 29 previous years using Climate Hazards Group InfraRed Precipitation with Station data, with recent drought classified as ordinal categorical variable (severe: ≤10th percentile; mild/moderate: >10th percentile to ≤30th percentile; none: >30th percentile). We considered 4 IPV-related outcomes: reporting a controlling partner (a risk factor for IPV) and experiencing emotional violence, physical violence, or sexual violence in the 12 months prior to survey. Logistic regression was used to estimate marginal risk differences (RDs). We evaluated the presence of effect heterogeneity by age group and employment status. Of the 83,990 women included in the analytic sample, 10.7% (9,019) experienced severe drought and 23.4% (19,639) experienced mild/moderate drought in the year prior to the survey, with substantial heterogeneity across countries. The mean age of respondents was 30.8 years (standard deviation 8.2). The majority of women lived in rural areas (66.3%) and were married (73.3%), while less than half (42.6%) were literate. Women living in severe drought had higher risk of reporting a controlling partner (marginal RD in percentage points = 3.0, 95% CI 1.3, 4.6; p < 0.001), experiencing physical violence (marginal RD = 0.8, 95% CI 0.1, 1.5; p = 0.019), and experiencing sexual violence (marginal RD = 1.2, 95% CI 0.4, 2.0; p = 0.001) compared with women not experiencing drought. Women living in mild/moderate drought had higher risk of reporting physical (marginal RD = 0.7, 95% CI 0.2, 1.1; p = 0.003) and sexual violence (marginal RD = 0.7, 95% CI 0.3, 1.2; p = 0.001) compared with those not living in drought. We did not find evidence for an association between drought and emotional violence. In analyses stratified by country, we found 3 settings where drought was protective for at least 1 measure of IPV: Namibia, Tanzania, and Uganda. We found evidence for effect heterogeneity (additive interaction) for the association between drought and younger age and between drought and employment status, with stronger associations between drought and IPV among adolescent girls and unemployed women. This study is limited by its lack of measured hypothesized mediating variables linking drought and IPV, prohibiting a formal mediation analysis. Additional limitations include the potential for bias due to residual confounding and potential non-differential misclassification of the outcome measures leading to an attenuation of observed associations. CONCLUSIONS: Our findings indicate that drought was associated with measures of IPV towards women, with larger positive associations among adolescent girls and unemployed women. There was heterogeneity in these associations across countries. Weather shocks may exacerbate vulnerabilities among women in sub-Saharan Africa. Future work should further evaluate potential mechanisms driving these relationships.


Assuntos
Grupo com Ancestrais do Continente Africano , Secas , Abuso Físico/etnologia , Delitos Sexuais/etnologia , Maus-Tratos Conjugais/etnologia , Saúde da Mulher/etnologia , Adolescente , Adulto , África ao Sul do Saara/epidemiologia , Grupo com Ancestrais do Continente Africano/psicologia , Fatores Etários , Emoções , Feminino , Nível de Saúde , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Abuso Físico/psicologia , Medição de Risco , Fatores de Risco , Fatores Sexuais , Delitos Sexuais/psicologia , Maus-Tratos Conjugais/psicologia , Fatores de Tempo , Desemprego , Adulto Jovem
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