Nonsuicidal Self-injury as a Risk Factor for Purging Onset: Negatively Reinforced Behaviours that Reduce Emotional Distress.

Both nonsuicidal self-injury (NSSI) and purging behaviour are thought to involve harm to the self. The acquired capability for self-harm model holds that engaging in one self-harming behaviour increases the capability to tolerate harm to the self, thus increasing risk for engaging on other such behaviours. In addition, both behaviours are thought to serve the similar function of relief from distress. We thus tested whether engagement in one of these behaviours predicts the subsequent onset of the other. In a longitudinal design, 1158 first-year college women were assessed for purging and NSSI at two time points. Engagement in NSSI at time 1 predicted the college onset of purging behaviour 9 months later (OR = 2.20, p < .04, CI = 1.07-4.19) beyond prediction from time 1 binge behaviour, and purging behaviour at time 1 predicted the subsequent onset of NSSI (OR = 6.54, p < .01, CI = 1.71-25.04). These findings are consistent with the acquired capability for harm model and with the possibility that the two behaviours serve a similar function.

Vaccinia virus infections in martial arts gym, Maryland, USA, 2008.

Vaccinia virus is an orthopoxvirus used in the live vaccine against smallpox. Vaccinia virus infections can be transmissible and can cause severe complications in those with weakened immune systems. We report on a cluster of 4 cases of vaccinia virus infection in Maryland, USA, likely acquired at a martial arts gym.

Mandatory Reporting of Domestic Violence: What Do Abuse Survivors Think and What Variables Influence Those Opinions?

For decades, states have passed legislation to mandate reporting of criminal conduct and the abuse of vulnerable persons. Four types of mandatory reporting laws have been enacted, including laws that require reports of injuries associated with crime or due to use of certain weapons, abuse of children, abuse of vulnerable adults, and reporting of domestic violence. While studies have been conducted to evaluate the effectiveness of mandatory reporting laws in domestic violence cases, methodological weaknesses in this body of literature make it difficult to make broad statements about whether mandatory reporting laws advance women's protection or actually place them at additional risk. This study's sample is based on 388 surveys administered in-person to women who had sought services from one of Kentucky's 15 regional domestic violence shelters. In addition to querying women regarding their own experience with mandatory reporting laws, the survey explored the factors that influenced women's views. The study advances research into women's decisions to access shelters, medical, or mental health services and how they are influenced by advance knowledge that their case would be reported if they disclosed abuse. A new and troubling finding was that almost two in five women reported they would have been less likely to contact a domestic violence shelter if they knew in advance that a mandatory report would be made. Future research on mandatory reporting is needed with an eye toward changing state policies and laws to ensure that women feel free to seek the type of assistance they need for themselves and their children.

Violence and women's mental health: the impact of physical, sexual, and psychological aggression.

The reach of violence against women (VAW) has been profoundly felt by women across the United States and around the globe. VAW has been documented for decades as a legal and social justice problem, but as illuminated in this review, it is also a substantial mental health concern. A full understanding of the phenomenon must include discussion of how often it occurs, in what forms, and to whom. This review defines violence against women in its variant forms and examines the literature on the mental health effects associated with these abuse experiences. The effectiveness of the mental health system's response to the complex needs of women suffering battering, rape, stalking, and psychological aggression is also examined. The future of research and the important role of the discipline of psychology in the future of this field of study are discussed.

Childhood maltreatment, intervening variables, and adult psychological difficulties in women: an overview.

This article reviews the complex relationship between child maltreatment and later psychosocial difficulties among adult women. Specifically addressed are (a) the various forms of childhood maltreatment, (b) the range of potential long-term psychological outcomes, and (c) important contextual variables that mediate or add to these maltreatment-symptom relationships. Among the latter are characteristics of the abuse and/or neglect; effects of impaired parental functioning; premaltreatment and postmaltreatment psychobiology; qualities of the parent-child attachment; abuse and/or neglect-related affect dysregulation that may lead to further symptomatology; the extent to which the child responds with significant emotional or behavioral avoidance; and whether later traumas are also present. Also relevant are sociocultural contributors to both child maltreatment and maltreatment effects, especially poverty and marginalization. Clinical and research implications are considered.

Advancing the study of violence against women: evolving research agendas into science.

Decades of research produced by multiple disciplines has documented withering rates of violence against women in the United States and around the globe. To further an understanding of gendered violence, a field of research has developed, but recent critiques have highlighted weaknesses that inhibit a full scientific exploration of these crimes and their impacts. This review extends beyond prior reviews to explore the field's unique challenges, its community of scientists, and the state of its written knowledge. The review argues for moving beyond "research agendas" and proposes creation of a transdisciplinary science for the field of study of violence against women.

The denial of emergency protection: factors associated with court decision making.

Despite the importance of civil orders of protection as a legal resource for victims of intimate partner violence, research is limited in this area, and most studies focus on the process following a court's initial issuance of an emergency order. The purpose of this study is to address a major gap in the literature by examining cases where victims of intimate partner violence are denied access to temporary orders of protection. The study sample included a review of 2,205 petitions that had been denied by a Kentucky court during the 2003 fiscal year. The study offers important insights into the characteristics of petitioners and respondents to denied orders and outlines individual, contextual, structural, qualitative/perceptual, and procedural factors associated with the denial of temporary or emergency protective orders. Recommendations for statutory changes, judicial education, and future research to remedy barriers to protection are offered.

Pre-Assault Personality Predicts the Nature of Adverse Outcomes Among Sexual Assault Victims.

OBJECTIVE: Exposure to sexual assault results in ongoing harms for women. After an assault, some women engage in higher levels of externalizing behaviors, such as problem drinking, and others experience higher levels of internalizing dysfunction, such as symptoms of anxiety and depression. We sought to understand the role of premorbid factors on the different post-assault experiences of women. METHOD: We studied 1,929 women prospectively during a period of high risk for sexual assault (the first year of college): women were assessed in July before arriving at college and in April near the end of the school year. RESULTS: A premorbid personality disposition to act impulsively when distressed (negative urgency) interacted positively with sexual assault experience to predict subsequent increases in drinking behavior; a premorbid personality disposition toward internalizing dysfunction positively interacted with sexual assault experience to predict increased symptoms of anxiety and depression. CONCLUSIONS: Women with different personalities tend to experience different forms of post-assault consequences.

Adverse impact of a history of violence for women with breast, cervical, endometrial, or ovarian cancer.

OBJECTIVE: The experience of physical and sexual violence (victimization) is common among U.S. women and is associated with adverse health consequences. The study objectives were to estimate the prevalence of victimization in women with cancer and to examine associations with demographics, cancer screening, and cancer stage. METHODS: From 2004 to 2005, 101 women with breast, cervical, endometrial, or ovarian cancer were interviewed to collect demographics, cancer screening history, health care access/use, and violence history. Chi-square and Fisher exact tests were used test risk-factor associations. A multinomial logistic regression model was used for multivariable analysis. RESULTS: The prevalence of a history of violence was 48.5% (49/101 women), and within that group, 46.9% (23/49) had a positive childhood violence screen, 75.5% (37/49) had a positive adult screen, and 55% (27/49) reported sexual violence at any age. Women with a positive violence screen differed significantly from women with a negative screen in that they were younger (P = .031), more often divorced (P = .012), more likely to smoke (P = .010), more often lacked commercial insurance (P = .036), and had more advanced stage of disease (P = .013), but they did not differ with regard to race, cancer type, education level, alcohol or drug use, or cancer screening compliance. Multivariable analysis revealed that only stage remained significant; women with a history of violence had a 2.6-fold increased chance of diagnosis in later stages (odds ratio 2.61, 95% confidence interval 1.03-6.59). CONCLUSION: A history of violence in breast, ovarian, endometrial, and ovarian cancer patients was extremely common and correlated with advanced stage at diagnosis. LEVEL OF EVIDENCE: II-2.

Fear of acquaintance versus stranger rape as a "master status": towards refinement of the "shadow of sexual assault".

Using a sample of 1010 women from a southeastern state university, we explore whether associations between fear of sexual assault and other crime-specific fears vary based on presumed victim-offender relationship. More specifically, we assess the extent to which fear of stranger- and acquaintance-perpetrated sexual assaults differ in the extent to which they are correlated with fear of other crime victimizations. Multivariate logistic regression analysis revealed that both fear of stranger-perpetrated sexual assault and fear of acquaintance-perpetrated sexual assault were positively associated with nearly all other crime-specific fears under examination. However, associations were particularly strong between fear of sexual assault by a stranger and fear of other stranger-perpetrated crimes. Findings have significant implications for how academic institutions should comprehensively address direct and indirect negative influences of violence against college women.

Barriers to services for rural and urban survivors of rape.

A significant proportion of survivors of rape do not utilize formal services to cope with the aftermath of rape. Understanding victimization experiences in environments that differ on resources, such as rural versus urban areas, may be an important dimension to consider in understanding barriers. Thirty women (18 rural and 12 urban) were recruited from rape crisis centers to participate in focus groups. Study results suggest that (a) survivors of rape experience many barriers to service utilization, (b) there were some differences in barriers to service utilization that were mentioned only in rural areas and some that were mentioned only in urban areas that may suggest that community context is important to consider in understanding barriers to service use, and (c) barriers to health and mental health services overlap with barriers to criminal justice system services.

Negative Urgency and Lack of Perseverance: Identification of Differential Pathways of Onset and Maintenance Risk in the Longitudinal Prediction of Nonsuicidal Self-Injury.

Many researchers have identified impulsivity-related personality traits as correlates of and risk factors for nonsuicidal self-injury (NSSI). Using a longitudinal design, we tested the hypothesis that one such trait, negative urgency (the tendency to act rashly when distressed), predicts the onset of NSSI during the first year of college and a different trait, lack of perseverance (the disposition to fail to maintain focus on tasks that are difficult or boring), predicts the maintenance of NSSI during the first year of college. In a sample of n=1,158 college women (mean age=18.04, 95% of participants were 18 at Time 1), we found support for these hypotheses. Negative urgency, measured prior to college entry, predicted the onset of NSSI behavior across the first year of college (odds ratio=1.58). Lack of perseverance predicted the maintenance of NSSI status across the first year of college, controlling for prior NSSI behavior (odds ratio=1.73). These findings indicate that different impulsivity-related personality traits may play different roles in the risk process for NSSI.

The effect of highly active antiretroviral therapy on dermatologic disease in a longitudinal study of HIV type 1-infected women.

The effect of highly active antiretroviral therapy (HAART) on skin diseases was evaluated in 878 human immunodeficiency virus type 1 (HIV-1)-infected women in the Women's Interagency HIV Study, a multicenter prospective study. HIV-1-infected women receiving HAART were less likely to have eczema, folliculitis, tinea pedis, and xerosis than were women who had not initiated HAART, independent of CD4+ cell count. Participants who had a prior history of a nadir CD4+ cell count of <200 cells/microL and recent CD4+ cell counts of 200-349 cells/microL were more likely to have eczema and xerosis than were women with a nadir CD4+ cell count of >200 cells/microL and recent CD4+ cell counts of >349 cells/microL. An HIV-1 RNA load of >100,000 copies/mL was associated with increased prevalence of herpes zoster infection (odds ratio, 6.10; 95% confidence interval, 2.00-18.65). History of injection drug use was associated with a higher prevalence of onychomycosis, tinea pedis, and xerosis. Molluscum contagiosum was more prevalent among younger women.

An integrative review of separation in the context of victimization: consequences and implications for women.

Given the number of divorces that occur each year as well as the high rates of intimate partner violence, it is critical that divorce/separation and victimization be considered in research and in clinical practice with women. However, the separation/divorce research and victimization research has often been conducted independently, with limited attention to integration. The integration of these two domains is critically important in facilitating the understanding of these issues for women. This article has 5 main purposes: (a) to review the research on the general consequences of separation; (b) to review the research on the consequences of separation when children are involved; (c) to review the research on the consequences of victimization; (d) to integrate the separation and victimization research to examine separation in the context of victimization; and (e) to discuss the implications of separation in the context of victimization for practice and research.

Intimate partner violence and the justice system: an examination of the interface.

Women entering the court system face a challenging experience, in part, because a courtroom can be an intimidating and difficult place for any person, and in part because women victimized by crimes in which the offender is known to them face distinctive difficulties when they seek the court's remedies. The interface is also made more challenging for women as the literature offers disparate findings as to the efficacy of criminal justice responses and civil remedies. This article briefly explores the unique characteristics of intimate partner violence cases that influence the interface of these victims with the court system. Areviewis provided of research on the criminal justice interventions in cases of intimate partner violence; and research on the efficacy of civil protective orders.

Violence against women: outcome complexity and implications for assessment and treatment.

This article reviews the major forms of violence against women, including sexual assault, intimate-relationship violence, and stalking and outlines the known psychological effects of such victimization. Also discussed are a number of variables that combine to determine the effects of such victimization, including type and characteristics of the assault; victim variables such as demographics, psychological reactions at the time of the trauma, previous victimization history, current or previous psychological difficulties, and general coping style; and sociocultural factors such as poverty, social inequality, and inadequate social support. The implications of this complexity are explored in terms of psychological assessment and the frequent need for multitarget, multimodal treatment approaches.

Child custody evaluations and domestic violence: case comparisons.

The literature indicates that witnessing domestic violence is harmful to children, that them is a high overlap between domestic violence and child abuse, and that safety is an important issue for separating women because separation from abusive partners is a particularly dangerous time for victims of domestic violence. Further, child custody is often a contentious issue in domestic violence cases. Child custody evaluations are typically used to assist courts in deciding custody when custody is disputed and when the best interests of the child are unclear. The concept of "best interests of the child" does not specify evaluation techniques or approaches, however, and while custody evaluation standards generally address the best interests of the child, they offer little guidance in high-risk situations such as parental domestic violence. In addition, there has been limited research focused on understanding the custody evaluation process or the degree to which practitioners differ in their procedures and reporting for cases with and without parental domestic violence. This study is one of the first to examine characteristics of disputed custody cases and their custody evaluation reports differences between domestic violence and non-domestic violence cases. This study selected a 60% random sample of cases with custody evaluations in Fiscal Year 1998 and 1999 (n = 82 cases). Out of the 82 cases, 56% (n = 46) met criteria for classification into the domestic violence group and 44% (n = 36) did not. In general, results indicated that although there were some important differences in court records between cases with and without domestic violence, there were only minor differences between custody evaluation reported process and recommendations for the two groups. Implications for research and practice are discussed.