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1.
Lancet ; 395(10220): 273-284, 2020 01 25.
Artigo em Inglês | MEDLINE | ID: mdl-31928765

RESUMO

BACKGROUND: Hong Kong has been embroiled in increasingly violent social unrest since June, 2019. We examined the associated population mental health burden, risk factors, and health-care needs. METHODS: In a population-based prospective cohort, adult participants aged 18 years or older were assessed at nine timepoints from 2009. Probable depression was measured using the Patient Health Questionnaire-9 (score ≥10) and suspected post-traumatic stress disorder (PTSD) by the PTSD Checklist-Civilian Version (score ≥14), plus direct exposure to traumatic events related to the ongoing social unrest. We used multivariable logistic regression to identify factors associated with both outcomes, adjusting for doctor-diagnosed depression or anxiety disorders before the unrest. On the basis of routine service statistics and respondents' intention to seek professional care, we projected the number of additional ambulatory specialist psychiatric visits required. FINDINGS: After the two baseline surveys, we followed up random subsets of 1213-1736 adults at each timepoint. Probable depression was reported by 11·2% (95% CI 9·8-12·7) of participants in 2019, compared with 1·9% (1·6-2·1) during 2009-14 and 6·5% (5·3-7·6) in 2017 after the Occupy Central Movement and before the current unrest. Prevalence of suspected PTSD in 2019 was estimated to be 12·8% (11·2-14·4). Age, sex, educational attainment, or household income were not associated with either outcome, whereas heavy social media use (≥2 h per day) was associated with both. Political attitude or protest participation was not associated with probable depression, but neutrality towards the extradition bill approximately halved the risk of suspected PTSD. Family support mitigated against probable depression. We estimated that the mental health burden identified would translate into roughly an excess 12% service requirement to the public sector queue or equivalent. INTERPRETATION: We have identified a major mental health burden during the social unrest in Hong Kong, which will require substantial increases in service surge capacity. Health-care and social care professionals should be vigilant in recognising possible mental health sequelae. In a world of increasing unrest, our findings might have implications for service planning to better protect population mental health globally. FUNDING: Research Grants Council, University Grants Committee of Hong Kong, Hong Kong Jockey Club Charities Trust.


Assuntos
Depressão/epidemiologia , Exposição à Violência/psicologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Adolescente , Adulto , Distúrbios Civis/psicologia , Feminino , Hong Kong , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Estudos Prospectivos , Índice de Gravidade de Doença , Mídias Sociais/estatística & dados numéricos , Inquéritos e Questionários , Adulto Jovem
2.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1047782

RESUMO

Objetivo: desvelar a produção acerca da assistência de enfermagem prestada às crianças/adolescentes vítimas de violência. Método: trata-se de uma revisão sistematizada realizada com consulta nas bases de dados: LILACS, Scielo e BDENF. Foram selecionados 19 artigos para compor este trabalho. A análise de dados deu-se por meio da proposta de Mendes, Silveira e Galvão. Resultados: os dados foram discutidos através dos tópicos: despreparo dos profissionais frente aos casos de violência infantil; sentimentos dos profissionais envolvidos no cuidado à criança/adolescente vítima de violência; notificação, protocolos e rotinas na assistência à criança/ adolescente vítima de violência; estratégias de assistência à criança/adolescente vítima de violência. Conclusão: os profissionais de enfermagem não se sentem preparados para atuarem frente aos casos de violência infantil. Identificou-se a necessidade de protocolos assistenciais que respaldem a assistência profissional. Ademais, é importante o fortalecimento da rede de atenção intersetorial que garanta a assistência adequada às vítimas e suas famílias


Objective: to explore the literature regarding the nursing care provided to children/adolescents victims of violence. Method: it consists of a systematic review performed on databases such as, LILACS, Scielo and BDENF. 19 articles have been selected to compose this study. The data analysis was developed throughout Mendes, Silveira and Galvão's proposal. Results: the data discussion occurred throughout the following topics: professional unpreparedness to deal with cases of child violence; the feelings of professionals involved on the care provided to a child/adolescent victim of violence; notification, protocols and routines regarding the assistance of children/adolescents victims of violence. Conclusion: nursing professionals do not feel prepared to deal with situations of children violence. It was identified the need of protocols that support the nursing assistance. Furthermore, it is important to enhance the intersectoral attention network in order to ensure the appropriate care to the victims and their families


Objetivo: desvelar la producción acerca de la asistencia de enfermería a los niños/adolescentes víctimas de violencia. Método: se trata de una revisión sistematizada realizada con consulta en las bases de datos: LILACS, Scielo y BDENF. Se seleccionaron 19 artículos para componer este trabajo. El análisis de datos se dio através de la propuesta de Mendes, Silveira y Galvão. Resultados: los datos fueron discutidos através de los tópicos: despreparo de los profesionales frente a los casos de violencia infantil; sentimientos de los profesionales envolvidos en el cuidado al niño/ adolescente víctima de violencia; notificación, protocolos y rutinas en la asistencia al niño/adolescente víctima de violencia; estrategias de asistencia al niño/adolescente víctima de violencia. Conclusión: los profesionales de enfermería no se sienten preparados para actuar frente a los casos de violencia infantil. Se identificó la necesidad de protocolos asistenciales que soporten la asistencia profesional. Además, es importante el fortalecimiento de la red de atención intersectorial que promueva la asistencia adecuada a las víctimas y sus familia


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Maus-Tratos Infantis/psicologia , Violência Doméstica , Cuidados de Enfermagem , Maus-Tratos Infantis/terapia , Saúde da Criança , Saúde do Adolescente , Exposição à Violência
3.
Eur. j. psychol. appl. legal context (Internet) ; 11(2): 51-59, jul.-dic. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-183599

RESUMO

In order to examine the literature on the relationship between child-to-parent violence and parent-to-child violence, a meta-analytic review was designed with 26 effect sizes assessing the relationship between child-to-parent and parent-to-child violence in 19 primary studies. Correlational effect sizes were computed and corrected for sampling error, and predictor and criterion unreliability. The results showed a significantly positive, medium magnitude (ρ = .36) mean true effect size for the relationship between child-to-parent violence and parent-to-child violence. Similar results were found for direct and vicarious victimization. The probability of developing child-to-parent violence for children victimized by parents increased 71% as compared to non-victimized children. The child-to parent violence type (physical or psychological), and the population (judicial or community) were analysed as moderators. The results revealed similar effects in both types of child-to-parent violence and in both populations: a significantly positive, medium in magnitude mean true effect size. The theoretical and practical implications for measuring child-to parent violence are discussed


Con el propósito de examinar la literatura sobre la relación entre la violencia de hijos a padres y la violencia de padres a hijos, se diseñó una revisión metaanalítica con 26 tamaños del efecto que evalúan la relación de la violencia entre hijos y padres y padres e hijos en 19 estudios principales. Se calcularon y corrigieron los tamaños del efecto correlacional para el error de muestreo y la predicción y la fiabilidad del criterio. Los resultados mostraron una magnitud media significativamente positiva (ρ = .36), que significa el tamaño verdadero del efecto para la relación entre la violencia de hijos a padres y la violencia de padres a hijos. Se encontraron resultados similares para la victimización directa e indirecta. La probabilidad de desarrollar violencia de hijos a padres para los niños victimizados por los padres aumentó 71% en comparación con los niños no victimizados. El tipo de violencia del niño hacia el padre (física o psicológica) y la población (judicial o comunitaria) se analizaron como moderadores. Los resultados revelaron efectos similares en ambos tipos de violencia entre padres e hijos en ambas poblaciones: un nivel de efecto medio significativamente positivo, de magnitud media. Se discuten las implicaciones teóricas y prácticas para medir la violencia de los hijos hacia sus padres


Assuntos
Humanos , Violência Doméstica/psicologia , Exposição à Violência/psicologia , Agressão/psicologia , Relações Pais-Filho , Maus-Tratos Infantis/psicologia , Vítimas de Crime/psicologia
4.
ABCS health sci ; 44(2): 114-119, 11 out 2019. tab
Artigo em Português | LILACS | ID: biblio-1022349

RESUMO

INTRODUÇÃO: A violência apresenta várias faces e, nesse contexto, pode ocorrer no cenário das instituições de saúde a violência obstétrica, que pode ser definida por qualquer ato ou conduta que venha a causar morte, sofrimento seja de ordem sexual, física ou psicológica à mulher, que pode ocorrer em instituições públicas ou privadas. OBJETIVO: Analisar as experiências de trabalho de parto e parto de mulheres que sofreram violência obstétrica. MÉTODO: Estudo descritivo, transversal, com abordagem qualitativa. Desenvolveu-se em Unidades Básicas de Saúde (UBS) do município de Juazeiro do Norte, região Sul do Ceará, Brasil. Foram convidadas a participar do estudo mulheres que sofreram violência obstétrica no referido município e que estivessem cadastradas em UBS desta mesma cidade. Os critérios de inclusão, mulheres que foram mães em um período de até seis meses e sofreram violência obstétrica. Para a coleta de dados, realizou-se uma entrevista semiestruturada, utilizando-se do critério de saturação dos dados. Para a interpretação dos resultados foi utilizada a técnica de análise de conteúdo. RESULTADOS: O estudo evidenciou que as mulheres sentiram medo, insegurança e ficaram de fato assustadas em estar no ambiente da maternidade. Revelou que à assistência precisa ser modificada, com maior clareza, até para os profissionais, sobre a violência obstétrica. Notou-se que as mulheres não souberam identificar ao certo o que é violência obstétrica e de que forma sofreu essa violência. E por fim, percebeu-se que essa violência afeta no vinculo do binômio mãe-filho. CONCLUSÃO: É preciso uma assistência humanizada e qualificada a estas mulheres neste momento tão delicado e importante de suas vidas.


INTRODUCTION: Violence has many faces and, in this context, may occur in the setting of health institutions obstetric violence, act or conduct based on gender, causing death, damage or suffering of a physical, sexual or psychological nature to women, both in the public sphere and in private. OBJECTIVE: To analyze the labor and delivery experiences of women who suffered obstetric violence. METHODS: Descriptive, cross-sectional study with qualitative approach, developed at Primary Health Centers (UBS) of the municipality of Juazeiro do Norte, southern region of Ceará, Brazil. Women registered in UBS of this city who suffered obstetric violence were invited to participate in the study. The inclusion criteria were women who were mothers in a period of up to six months and who suffered obstetric violence. Data collection used a semi-structured interview, using the data saturation criterion. The interpretation of the results used the content analysis technique. RESULTS: The study showed that these women felt fear, insecurity and were actually scared to be in the maternity setting. It revealed the need for care change, and the need for more clarity, even for professionals, on obstetric violence. These women do not know for sure what obstetric violence is and the way they suffered this violence. Finally, the study showed that this violence affects the bond of the mother-child binomial. CONCLUSION: It is necessary to provide humanized and qualified assistance to these women at this very delicate and important time in their lives.


Assuntos
Humanos , Feminino , Gravidez , Adolescente , Adulto , Trabalho de Parto , Parto , Exposição à Violência , Relações Mãe-Filho , Obstetrícia
8.
J Trauma Acute Care Surg ; 87(2): 456-462, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31349352

RESUMO

An effective injury prevention program is an important component of a successful trauma system. Maintaining support for a hospital-based injury prevention program is challenging, given competing institutional and trauma program priorities and limited resources. In light of those pressures, the American College of Surgeons Committee on Trauma mandates that trauma centers demonstrate financial support for an injury prevention program as part of the verification process, recognizing that hospital administrators might see such support as discretionary and ripe as a target for expense reduction efforts. This Topical Update from the American Association for the Surgery of Trauma Injury Prevention Committee focuses on strategies to be more effective with the limited resources that are allocated to hospital-based injury prevention programs. First, this review tackles two of the many social determinates of violence, including activities aimed at mitigating the impact of both community violence exposure and intimate partner/domestic violence. Developing or participating in coalitions for injury prevention, both in general with any injury prevention initiative, and specifically while developing a hospital-based violence intervention program, efficiently extends the hospital's efforts by gaining access to expertise, resources, and influence over the target population that the hospital might otherwise have difficulty impacting. Finally, the importance of systematic program evaluation is explored. In an era of dwindling resources for injury prevention, both at the national level and the institutional level, it is important to measure the effectiveness of injury prevention efforts on the target population, and when necessary, make changes to programs to both improve their effectiveness and to assist organizations in making wise choices in the use of their limited resources.


Assuntos
Exposição à Violência/prevenção & controle , Violência por Parceiro Íntimo/prevenção & controle , Ferimentos e Lesões/prevenção & controle , Relações Comunidade-Instituição , Hospitais , Humanos , Avaliação de Programas e Projetos de Saúde , Sociedades Médicas , Traumatologia/organização & administração , Estados Unidos , Ferimentos e Lesões/etiologia
9.
Health Care Women Int ; 40(11): 1135-1148, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31274387

RESUMO

In this descriptive study, our aim was to examine the relationship between violence exposure status and personality characteristics among infertile women. The researchers collected data from 315 infertile women at an in vitro fertilization unit of the Woman and Child Disease Training and Research Hospital in Istanbul, Turkey. An introductory information form, the Eysenck Personality Questionnaire Revised-Abbreviated Form (EPQR-A), and the Infertile Women's Exposure to Violence Determination Scale (IWEVDS) were used as data collection tools. When the relationship between the IWEVDS and EPQR-A subdimension scores of the infertile women were examined, a positive relationship was found between the being-forced-into-traditional-practices subdimension of the IWEVDS and the neuroticism subdimension of the EPQR-A. In addition, a weak negative relationship was found between the being-forced-into-traditional-practices subdimension of the IWEVDS and the lying subdimension of the EPQR-A.


Assuntos
Violência Doméstica/psicologia , Exposição à Violência/psicologia , Infertilidade Feminina/psicologia , Transtornos Neuróticos/psicologia , Estresse Psicológico , Adulto , Estudos Transversais , Violência Doméstica/estatística & dados numéricos , Feminino , Humanos , Pessoa de Meia-Idade , Personalidade , Inventário de Personalidade , Escalas de Graduação Psiquiátrica , Qualidade de Vida , Percepção Social , Fatores Socioeconômicos , Estereotipagem , Turquia
10.
Glob Health Action ; 12(1): 1638054, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31290378

RESUMO

Intimate partner violence is a public health problem worldwide. Many children witness intimate partner violence at home and are affected by it. Regardless of the degree of exposure, children growing up in violent homes experience negative effects in the form of externalising behaviour and internalising symptoms which call for targeted interventions for children. The aim of the study is to map i) the available methods of detecting child and adolescent witnesses of intimate partner violence and ii) the interventions to support them. Three databases, PubMed, PsychInfo and Social Services Abstracts, were searched for scientific publications spanning over 20 years (1997-2017). This resulted in 2,406 publications of which 15 were finally selected after screening. Analysis of the articles resulted in three categories. The process of detecting children and adolescents who witnessed IPV in their homes varied in the included studies. The children were most commonly identified through their mother or other caregivers. Very few studies were based on children's own reporting of their experiences, but were rather based on the mothers' proxy reports. Studies distinguishing between the different forms of violence witnessed by children were few. It was uncommon that children were directly identified or screened for witnessing IPV in the family.


Assuntos
Exposição à Violência/psicologia , Violência por Parceiro Íntimo/psicologia , Adolescente , Adulto , Cuidadores/psicologia , Criança , Feminino , Humanos , Masculino , Mães/psicologia , Serviço Social
11.
Dev Cogn Neurosci ; 38: 100666, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31276941

RESUMO

Little is known about how childhood adversity influences the development of learning and memory and underlying neural circuits. We examined whether violence exposure in childhood influenced hippocampus-dependent associative learning and whether differences: a) were broad or specific to threat cues, and b) exhibited developmental variation. Children (n = 59; 8-19 years, 24 violence-exposed) completed an associative learning task with angry, happy, and neutral faces paired with objects during fMRI scanning. Outside the scanner, participants completed an associative memory test for face-object pairings. Violence-exposed children exhibited broad associative memory difficulties that became more pronounced with age, along with reduced recruitment of the hippocampus and atypical recruitment of fronto-parietal regions during encoding. Violence-exposed children also showed selective disruption of associative memory for threat cues regardless of age, along with reduced recruitment of the intraparietal sulcus (IPS) during encoding in the presence of threat. Broad associative learning difficulties may be a functional consequence of the toxic effects of early-life stress on hippocampal and fronto-parietal cortical development. Difficulties in the presence of threat cues may result from enhanced threat processing that disrupts encoding and short-term storage of associative information in the IPS. These associative learning difficulties may contribute to poor life outcomes following childhood violence exposure.


Assuntos
Aprendizagem por Associação/fisiologia , Sinais (Psicologia) , Exposição à Violência/psicologia , Hipocampo/diagnóstico por imagem , Hipocampo/crescimento & desenvolvimento , Adolescente , Criança , Condicionamento Clássico/fisiologia , Exposição à Violência/tendências , Feminino , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Memória/fisiologia , Estimulação Luminosa/métodos , Adulto Jovem
12.
Int J Behav Med ; 26(4): 437-442, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31264100

RESUMO

BACKGROUND: Exposure to violence, which is experienced at disproportionally higher levels by black versus white youth, is associated with disruptions in sleep and elevated cardiovascular risk. Further, poor sleep hygiene is associated with insulin resistance. However, research to date examining disruptions in sleep and cardiovascular risk in African-American adolescents has not taken the impact of exposure to violence into account, nor considered how gender might affect patterns of association. The present study addressed this gap by testing a path model linking exposure to community violence, sleep disruption, and insulin resistance in a sample of African-American adolescents and evaluating model fit across gender. METHOD: African-American adolescents (N = 107; 56% female; Mage = 14.29, SD = 1.17) completed structured interviews at home and provided a blood sample after fasting overnight. RESULTS: The model fit connecting exposure to violence with sleep disruption and insulin resistance, adjusting for depressive symptoms and body mass index z score, was excellent. Multiple group analysis indicated gender differences in model fit. Path analysis revealed significant positive associations between exposure to violence and sleep disruption and sleep disruption and insulin resistance for females but not males. CONCLUSION: These data indicate that low-income, urban African-American female adolescents who witness violence and experience sleep disruptions may already be at elevated risk for health problems compared with their male counterparts. Additional research should attempt to replicate and explicate the underlying reasons for the gender differences observed here, with the goal of improving health and disrupting the path leading to health disparities.


Assuntos
Exposição à Violência/psicologia , Resistência à Insulina , Pobreza/psicologia , Distúrbios do Início e da Manutenção do Sono/psicologia , População Urbana/estatística & dados numéricos , Adolescente , Afro-Americanos/psicologia , Feminino , Humanos , Masculino , Fatores Sexuais , Sono
13.
Int J Gynaecol Obstet ; 146(3): 315-320, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31197830

RESUMO

OBJECTIVE: To compare pregnancy outcomes after exposure to military stress in different trimesters of pregnancy. METHODS: A retrospective study of medical records of deliveries in the Wolfson (WMC) and Barzilai (BMC) medical centers in Israel between July 2014 and April 2015. All parturients were exposed to military stress for 51 days during pregnancy. Pregnancy outcomes were compared between those exposed to military stress in the first or second trimester, and those exposed in the third trimester. Outcomes were also compared between WMC (a new-onset military stress exposure area) and BMC (a chronic military stress exposure area). RESULTS: At WMC, women exposed in the first or second trimester (n=2657) had a higher rate of preterm delivery (<37 weeks) as compared with those exposed in the third trimester (n=2037; 214 [8.1%] vs 121 [5.9%]; P=0.005). At BMC, women exposed in the first or second trimester (n=2208) had a tendency toward lower rates of diabetes mellitus (P=0.055) and macrosomia [103 (4.7%) vs 84 (6.3%); P=0.037], as compared with those exposed in the third trimester (n=1337). CONCLUSION: Exposure to military stress during pregnancy had different impacts on pregnancy outcomes, depending on the time of exposure and whether continuous exposure to stress occurred.


Assuntos
Exposição à Violência/psicologia , Complicações na Gravidez/psicologia , Resultado da Gravidez/epidemiologia , Nascimento Prematuro/epidemiologia , Guerra/psicologia , Adulto , Parto Obstétrico/estatística & dados numéricos , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Israel/epidemiologia , Gravidez , Primeiro Trimestre da Gravidez , Segundo Trimestre da Gravidez , Terceiro Trimestre da Gravidez , Estudos Retrospectivos
14.
Transl Behav Med ; 9(3): 541-548, 2019 05 16.
Artigo em Inglês | MEDLINE | ID: mdl-31094433

RESUMO

Violence exposure increases teens' risk for emotion dysregulation, anxiety, depression, and aggression towards peers. Teens of color are disproportionately more likely to be exposed to violence and less likely to receive mental health services. Community after-school programs can help reduce disparities by offering opportunities for skills development and mental health promotion to mitigate risk associated with violence exposure. The present study explores the promise of a parks-based after-school paid internship program for black and Latinx teens with weekly, group-based enrichment to promote educational attainment, job skills, and health behaviors. University and park administrators collaborated to design a program comprised of paid work (10 hr/week at US$9.05/hr) and weekly 2 hr enrichment (e.g., job skills, meditation, and sleep health psychoeducation). The sample includes 38 youth (n = 38; 15-17 years old [M = 16.26, SD = .73]; 42.1 per cent female; 95.2 per cent non-Latinx black, 4.8 per cent Latinx white). Data analyses include pre-/post-measures of violent and nonviolent adversity, emotion regulation, anxiety, depression, and self-efficacy to manage peer conflict. There were no significant changes from Time 1 (T1) to Time 2 (T2) in teen-reported cognitive reappraisal, emotion suppression, anxiety, depression, or self-efficacy to resolve peer conflict. Teens with more violence exposure at T1 reported significant reductions in anxiety at T2. Teens with more overall adversity reported significant reductions in anxiety and improvements in self-efficacy to resolve peer conflict. Findings indicate that after-school programs infused with poly-strengths programming can benefit diverse teens at high risk for violence exposure.


Assuntos
Adaptação Psicológica , Afro-Americanos/estatística & dados numéricos , Exposição à Violência , Saúde Mental , Adolescente , Exposição à Violência/etnologia , Exposição à Violência/psicologia , Feminino , Promoção da Saúde , Humanos , Masculino , Instituições Acadêmicas
15.
J Pak Med Assoc ; 69(5): 654-658, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31105283

RESUMO

OBJECTIVE: To explore the experience of violence and its association with symptoms of aggression among medical students. METHODS: The cross-sectional study was conducted from January 5 to 14, 2018, at Dow University of Health Sciences, Karachi, and comprised medical students who were interviewed using a self-reporting questionnaire that had three sections: demographics, the Aggression Questionnaire, and the Exposure to Violence Scale. Data were analysed using SPSS 20.. RESULTS: Of the 192 subjects, 144(75%) were females and 48(25%) were males, with an overall mean age of 21.39+/- 2 years. Total exposure to violence was significantly higher among older male respondents (p<0.05). It was significantly associated with higher severity of physical aggression and hostility (p<0.05). However, it had no significant relationship with verbal aggression and anger (p>0.05).. CONCLUSIONS: A large proportion of medical students reported exposure to violent events, which was also associated with increased aggression among them.


Assuntos
Agressão/psicologia , Exposição à Violência/psicologia , Hostilidade , Estudantes de Medicina/psicologia , Estudos Transversais , Exposição à Violência/estatística & dados numéricos , Feminino , Humanos , Masculino , Paquistão , Estudantes de Medicina/estatística & dados numéricos , Adulto Jovem
16.
An. psicol ; 35(2): 300-313, mayo 2019. graf, tab
Artigo em Inglês | IBECS | ID: ibc-181700

RESUMO

Esta revisión bibliográfica sintetiza los resultados de estudios meta analíticos sobre factores de riesgo y protección asociados a la Violencia en el Noviazgo (VN). Se incluyeron 15 meta-análisis publicados entre 1997-2018, N = 1784018, y se clasificaron según el modelo socio-ecológico. Se calcularon las Zr media para cada variable y nivel, incluyendo las diferencias en los tamaños del efecto medio entre victimización y perpetración de VN y, posteriormente, se transformaron a r. Se encontró que los factores de riesgo con mayor peso asociados a VN, según nivel, fueron: (1) individual: consumo de tabaco y embarazo precoz (victimización) y sexo (perpetración/victimización); (2) microsistema: acoso sexual de pares (victimización), VN de los pares, tener amigos con conductas problemáticas y sufrir violencia en familia de origen (perpetración/victimización); (3) exosistema: edad (victimización) y barrio (perpetración/victimización) y (4) macrosistema: minoría cultural y desventaja económica (perpetración/victimización). Factores protectores de VN fueron: apoyo social de pares y parentalidad positiva, pero con menos peso. El tamaño del efecto fue mayor para las variables de nivel exo, frente a las macro, individual y micro respectivamente. Hay diferencias entre los tamaños del efecto totales, siendo en el exosistema mayor en victimización que en perpetración. Delimitar los factores de riesgo y protección con mayor efecto sobre VN resulta fundamental para prevenir este problema


This study summarizes the results of meta-analyses about risk and protective factors related to dating violence (DV). Fifteen studies were included from 1997 to 2018, N = 1784018. The results were classified according to ecological theory. The Zr’s were calculated for each factor and level of analyses, including the differences between victimization and perpetration effect sizes. According to the level of analysis, results showed that the effect sizes were greater for: (1) individual level: cigarette smoking, adolescent pregnancy (victimization) and sex (perpetration/victimization); (2) microsystem: peer sexual harassment, (victimization), peer DV, deviant peers and family violence (perpetration/ victimization); (3) Exosystem: age (victimization) and violent neighborhoods (perpetration/ victimization), and (4) macrosystem: cultural minority and disadvantaged neighborhoods (perpetration / victimization). DV protective factors which had lowest effect sizes were: parental and peers support; and highest effect sizes were in the exo and macro-level, and then in individual and micro-level. Furthermore, statistically significant differences between total effect sizes were found, being higher to victimization than perpetration. Delimiting the most important risk and protective factors on DV have important implications for prevention and intervention


Assuntos
Humanos , Violência por Parceiro Íntimo/psicologia , Violência contra a Mulher , Exposição à Violência/prevenção & controle , Fatores de Risco , Fatores de Proteção , Apoio Social , Características da Família , Delitos Sexuais/psicologia
17.
Dev Psychopathol ; 31(3): 899-915, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30957738

RESUMO

Childhood maltreatment is associated with increased risk for most forms of psychopathology. We examine emotion dysregulation as a transdiagnostic mechanism linking maltreatment with general psychopathology. A sample of 262 children and adolescents participated; 162 (61.8%) experienced abuse or exposure to domestic violence. We assessed four emotion regulation processes (cognitive reappraisal, attention bias to threat, expressive suppression, and rumination) and emotional reactivity. Psychopathology symptoms were assessed concurrently and at a 2-year longitudinal follow-up. A general psychopathology factor (p factor), representing co-occurrence of psychopathology symptoms across multiple internalizing and externalizing domains, was estimated using confirmatory factor analysis. Maltreatment was associated with heightened emotional reactivity and greater use of expressive suppression and rumination. The association of maltreatment with attention bias varied across development, with maltreated children exhibiting a bias toward threat and adolescents a bias away from threat. Greater emotional reactivity and engagement in rumination mediated the longitudinal association between maltreatment and increased general psychopathology over time. Emotion dysregulation following childhood maltreatment occurs at multiple stages of the emotion generation process, in some cases varies across development, and serves as a transdiagnostic mechanism linking child maltreatment with general psychopathology.


Assuntos
Maus-Tratos Infantis/psicologia , Emoções/fisiologia , Exposição à Violência/psicologia , Transtornos Mentais/psicologia , Adolescente , Criança , Mecanismos de Defesa , Feminino , Humanos , Masculino , Ruminação Cognitiva/fisiologia
18.
Lancet ; 393(10182): 1733-1744, 2019 04 27.
Artigo em Inglês | MEDLINE | ID: mdl-30948286

RESUMO

BACKGROUND: Many women are affected by anxiety and depression after armed conflict in low-income and middle-income countries, yet few scalable options for their mental health care exist. We aimed to establish the effectiveness of a brief group psychological intervention for women in a conflict-affected setting in rural Swat, Pakistan. METHODS: In a single-blind, cluster, randomised, controlled trial, 34 community clusters in two union councils of rural Swat, Pakistan, were randomised using block permutation at a 1:1 ratio to intervention (group intervention with five sessions incorporating behavioural strategies facilitated by non-specialists) or control (enhanced usual care) groups. Researchers responsible for identifying participants, obtaining consent, enrolment, and outcome assessments were masked to allocation. A community cluster was defined as neighbourhood of about 150 households covered by a lady health worker. Women aged 18-60 years who provided written informed consent, resided in the participating cluster catchment areas, scored at least 3 on the General Health Questionnaire-12, and at least 17 on the WHO Disability Assessment Schedule were recruited. The primary outcome, combined anxiety and depression symptoms, was measured 3 months after the intervention with the Hospital Anxiety and Depression Scale (HADS). Modified intention-to-treat analyses were done using mixed models adjusted for covariates and clusters defined a priori. The trial is registered with the Australian New Zealand Clinical Trials Registry, number 12616000037404, and is now closed to new participants. FINDINGS: From 34 eligible community clusters, 306 women in the intervention group and 306 women in the enhanced usual care (EUC) group were enrolled between Jan 11, 2016, and Aug 21, 2016, and the results of 288 (94%) of 306 women in the intervention group and 290 (95%) of 306 women in the EUC group were included in the primary endpoint analysis. At 3 months, women in the intervention group had significantly lower mean total scores on the HADS than women in the control group (10·01 [SD 7·54] vs 14·75 [8·11]; adjusted mean difference [AMD] -4·53, 95% CI -7·13 to -1·92; p=0·0007). Individual HADS anxiety scores were also significantly lower in the intervention group than in the control group (5·43 [SD 4·18] vs 8·02 [4·69]; AMD -2·52, 95% CI -4·04 to -1·01), as were depression scores (4·59 [3·87] vs 6·73 [3·91]; AMD -2·04, -3·19 to -0·88). No adverse events were reported in either group. INTERPRETATION: Our group psychological intervention resulted in clinically significant reductions in anxiety and depressive symptoms at 3 months, and might be a feasible and effective option for women with psychological distress in rural post-conflict settings. FUNDING: WHO through a grant from the Office for Foreign Disaster Assistance.


Assuntos
Transtornos de Ansiedade/terapia , Conflitos Armados/psicologia , Transtorno Depressivo/terapia , Psicoterapia Breve/métodos , Adolescente , Adulto , Transtornos de Ansiedade/etiologia , Análise por Conglomerados , Transtorno Depressivo/etiologia , Exposição à Violência/psicologia , Feminino , Humanos , Pessoa de Meia-Idade , Paquistão , Saúde da População Rural , Método Simples-Cego , Resultado do Tratamento , Adulto Jovem
20.
Nat Commun ; 10(1): 1942, 2019 04 26.
Artigo em Inglês | MEDLINE | ID: mdl-31028269

RESUMO

Individuals exposed to community violence are more likely to engage in antisocial behavior, resulting in a dramatic increase in contact with justice and social service systems. Theoretical accounts suggest that disruptions in learning underlie the link between exposure to violence and maladaptive behaviors. However, empirical evidence specifying these processes is sparse. Here, in a sample of incarcerated males, we investigated how exposure to violence affects the ability to learn about the harmfulness of others and use this information to adaptively modulate trust behavior. Exposure to violence does not impact the ability to accurately develop beliefs about agents' harm preferences and predict their choices. However, exposure to violence disrupts the ability to form moral impressions that dissociate between agents with distinguishable harm preferences, and subsequently, the ability to adjust trust behavior towards different agents. These findings reveal a process that may explain the association between exposure to violence and maladaptive behavior.


Assuntos
Exposição à Violência/psicologia , Princípios Morais , Prisioneiros/psicologia , Confiança/psicologia , Violência/psicologia , Adaptação Psicológica , Adolescente , Adulto , Idoso , Antecipação Psicológica , Atitude , Exposição à Violência/ética , Humanos , Masculino , Pessoa de Meia-Idade , Violência/ética
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