Adult Abuse Research Articles

Where do we Draw the Line? Perceptions of Abuse of Older Adults and their Association with Ageism.

Violence against older adults is a prevalent global harm and there is evidence that perceptions of violence toward older adults may impact reporting and intervention. The present study examines the perception of violence against older adults in contrast to violence against other age groups and investigates the role of ageism in those perceptions. 290 participants were surveyed and asked to indicate whether they perceived 15 abusive behaviours reflecting physical, psychological, sexual, and financial abuse and neglect to be abuse toward either an older adult (age 60+), adult or child. Ageism was measured using the Ambivalent Ageism Scale. On average, 25% of participants did not consider the abusive behaviours to be abuse. Perceptions of abuse were relatively stable across the five types of abuse examined (range: 25-27%). Perceptions of the 15 abusive behaviours only varied due to older age in three instances, differences were sometimes between older adults and adults and sometimes children. Regression analyses showed increased ageism to be predictive of disagreement that behaviours were abusive in the older age group, explaining 8-14% of the variance in perception. Regression models were not significant in the adult or child groups. Results raise serious concern about the perception of abuse toward older adults. Future studies should investigate the reasons for such perceptions and other contributing factors in order to identify effective mechanisms for change.

Analysis of Underlying Factors in Financial Neglect and Abuse in Older Adults: A Qualitative Content Analysis

Objectives: To analyze underlying factors in financial neglect and abuse to enhance understanding and inform interventions that can protect the financial well-being of older adults. Design: A qualitative content analysis approach. Setting(s): Borujen, Shahrekord, Iran. Participants: A sample of 15 older adults (8 females and 7 males) aged 60 and above was selected through a purposeful sampling method from healthcare centres in Borujen, based on specific inclusion criteria. Outcome measures: Data were collected through semi-structured, in-depth individual face-to-face interviews. Results: The findings displayed one overarching category, which is lost property, along with four subcategories, including forced reluctance to pursue the recovery of lent money, deprivation of financial independence, distress due to an inability to recover lent money, and children’s financial evasions in repaying the lent money. Collectively, these factors contributed to older adults perceiving their property as lost. Conclusions: Addressing the burden imposed by financial neglect and abuse necessitates coordinated efforts from authorities, ensuring that policymakers and planners in the fields of health and aging implement concrete measures to raise awareness among families, older adults, and service providers regarding elder abuse. Ultimately, these efforts should aim to improve the quality of life for older adults.

Impact of cannabis abuse on the occurrence of stroke in young people: a systematic review and meta-analysis.

The occurrence of stroke in young people has risen significantly. This can easily lead to physical disabilities, swallowing difficulties, and cognitive impairment, among other issues, having a profound impact on families and society. Risk factors for stroke in young people differ from those for traditional stroke, with cannabis abuse emerging as a significant high-risk factor. However, the extent of the impact of cannabis abuse on the occurrence of stroke and the rate of disability in young people remains unclear. To clarify this issue and provide evidence supporting the primary prevention of stroke in young people, this systematic review and meta-analysis summarizes the latest findings from previous studies. A systematic search of PubMed, EMBASE, Cochrane Library, and Web of Science databases was conducted until April 2023. The review included observational studies comparing stroke risk estimates between cannabis abusers and non-users. This review included six observational studies focusing on cannabis abuse, involving 119,284,152 participants. A significant association was found between cannabis abuse and an increased risk of stroke [OR = 1.14, 95% CI (1.08, 1.20)]. However, there was substantial heterogeneity among the studies (I 2 = 89%, p < 0.001). After adjusting for confounders such as smoking and alcohol abuse, we found a stronger association between cannabis abuse and stroke in young adults [OR = 1.21, 95% CI (1.12, 1.29)]. Subgroup analyses revealed no significant difference in stroke risk between ischemic and hemorrhagic strokes (p = 0.43). The results of our systematic review and meta-analysis showed that cannabis abuse has a more significant effect on the occurrence of stroke in young people; however, it was not possible to distinguish whether cannabis abuse is more likely to cause ischemic or hemorrhagic stroke. Further research is needed to explore the impact of different drug types, dosages, and behaviors on stroke risk. https://www.crd.york.ac.uk/prospero/, Identifier CRD42023443261.

The impact of adverse childhood experiences on adult physical, mental health, and abuse behaviors: A sex-stratified nationwide latent class analysis in Japan

Adverse childhood experiences (ACEs) have been reported to detrimentally impact physical and mental health. While experiencing multiple ACEs is common, previous research primarily assessed ACEs by their total count, neglecting the impacts of different experience types. Furthermore, sex-based differences in ACEs and their influences remain unclear. This study employed Latent Class Analysis (LCA) to uncover patterns of ACEs with consideration for sex differences, aiming to elucidate their effects on adult physical and mental health. A geographically nationally representative dataset from the “Japan COVID-19 and Society Internet Study (JACSIS)” conducted in 2022 was used. 13,715 men and 14,327 women retrospectively reported their experiences across fifteen ACEs. The analysis revealed four distinct ACE patterns for both sexes: a Multiple Adversities class with a wide range of severe ACEs, a Psychological Abuse class experiencing emotional abuse at home and bullying at school, a Poverty class facing economic hardships, and a Low Adversities class with the fewest ACEs. Multinomial logistic regression analysis indicated that more severe patterns of exposure correlated with heightened adverse adult outcomes. However, the extent of these impacts varied by sex and ACE pattern. For instance, men in Multiple Adversities and Psychological Abuse classes exhibited higher tendencies towards conducting physical and psychological abuse behaviors. While ACEs in men were linked to both underweight (in cases of psychological abuse) and obesity (across all classes), women with ACEs generally leaned towards higher body weight. These findings highlight the importance of developing support strategies sensitive to sex differences and the specific content of ACEs.

Predictors of Trauma-Related Self-Blame in Male Survivors of Sexual Violence

ABSTRACT Survivors of adult sexual assault and child sexual abuse – together encompassing sexual violence (SV) – experience a number of adverse consequences. High rates of self-blame can lead to increased symptomatology and treatment resistance. There has been a paucity of studies of men who have experienced SV, particularly about self-blame. For this study, 179 cisgender male survivors of SV completed an online survey to explore the relationships among 10 variables, including trauma-related self-blame, rape myth acceptance, tonic immobility, disclosure experiences, sexual arousal, and substance use. Multiple regression analyses and t-tests were used to test the study hypotheses. Results indicate that 93% of the sample reported some level of self-blame. However, only rape myth acceptance was strongly associated with self-blame. Additionally, participants who used substances within 12 hours prior to their SV had higher rates of self-blame, as did participants who had not previously disclosed their abuse. Exploratory analyses also found a significant difference in self-blame between those who experienced SV in childhood and adulthood versus those who only experienced SV in either childhood or adulthood. The findings of this research highlight the high rates of self-blame and how imperative it is to provide psychoeducation about the variables discussed in this study and to normalize these experiences, especially for less well-known phenomena such as physiological sexual arousal and TI.

Academic achievement among youth in foster care

This disproportionate rate of academic achievement among youth in foster care raises significant concerns given the social and economic benefits that earning a high school diploma provides over the course of an individual’s life. This study examines the relationship between a youth’s foster care experience (removal reason, number of placements, total number of days in foster care, connection to adult mentor, substance abuse, and dual-system involvement) and academic achievement across gender, race, ethnicity, and disabilities using the Adoption and Foster Care Analysis and Reporting (AFCARS) data and the National Youth in Transition Database (NYTD). This study found that several factors including gender, race, ethnicity, disability, connection to adult mentor, substance abuse referral, and dual-system involvement (incarceration) were associated with academic achievement. It is clear from the data that youth involved in the foster care system need increased support during their educational tenure. Low academic achievement rates among youth in foster care need to be addressed with more effectual, balanced, deliberate supportive resources, such as special education/disability services, mentoring programs, and independent living services (ILS) that connect youth in foster care to supports that will help them earn a high school diploma and increased the likelihood that they would go on to postsecondary education opportunity.

The Factors Affecting Substance Use and the Most Effective Mental Health Interventions in Adolescents and Young Adults

Adolescents and young adults are particularly susceptible to substance abuse. They have yet to solidify their sense of self to the degree necessary to effectively resist temptations from negative peer pressure. It is vital for mental health counselors to understand the factors affecting substance abuse in adolescents/young adults and to comprehend the effectiveness of common intervention strategies fully. This paper produces a narrative literature review of 27 international journal publications from 2004 through June 2024 related to causal factors and interventions effective for treating substance abuse in adolescents and young adults. The results indicate that adolescents who idolize antisocial peers and lack a strong sense of self, family attachment, parental monitoring, and role models are more likely to suffer from substance abuse. Successful interventions include those that help strengthen the adolescent’s sense of self, a mental-health-friendly school environment staffed with professional mental health counselors, and interactive programs that engage students in positive behaviors. Positive family and peer role models can also assist in helping adolescents/young adults build a strong self-image and resist substance use. Positive peer influence is another critical factor, but more work must be undertaken to fully assess its effectiveness as an intervention.

Characterizing syndemic HIV risk profiles and mHealth intervention acceptability among patients in the emergency department

ABSTRACT Syndemic theory proposes that co-occurring, mutually reinforcing psychosocial challenges (mental health, substance use, minority stress [discrimination/stigma], abuse, unmet basic needs) drive HIV risk behavior and create barriers to care for marginalized populations. It is thus necessary to address this holistic, complex picture in HIV prevention. Emergency department (ED) visits are a prime opportunity to engage key risk groups, given their low engagement in regular clinic-based care and high utilization of drop-in care via EDs. Yet, EDs are overburdened and under-resourced; mHealth may be a vehicle for intervention delivery in this context. This study aimed to 1) characterize demographics, syndemic profiles, and HIV risk behavior among ED patients and 2) assess the acceptability of addressing syndemic issues, particularly via an mHealth approach, in the ED. A sample of N = 198 ED patients with an indication of HIV risk completed a cross-sectional psychosocial assessment. Descriptive statistics and bivariate correlations between syndemic issues were examined. Patients presenting to the ED reported marginalized identities and complex syndemic profiles including mental health issues (77%), at risk substance use (30%), childhood abuse (35%), adult abuse (31%), minority stress (63%), and unmet basic needs (37%). Over half the sample reported at least three syndemic issues (54%). All syndemic issues were significantly correlated with each other, supporting a synergistic nature. The sample reported indicators of HIV risk including lack of PrEP awareness (33%)/uptake (94%), condomless sex (37%), and not testing for HIV (41%). Majority reported syndemic profiles have never been addressed in the ED (71%), think it would be helpful (88%), and willing to utilize mHealth during an ED visit (76%). The current study provides information to guide next steps for ED-based point-of-care HIV prevention, and more broadly, working towards equitable HIV prevention services reaching those missed by existing interventions.

Patterns of Technology-Based Abuse Among Adult Intimate Partner Violence Survivors and Associations with Offline Abuse.

Research about technology-based abuse (TBA) has primarily relied on youth-focused survey research, leading to gaps in knowledge about the experiences of TBA among adult populations. However, studies among adult intimate partner violence (IPV) survivors suggest that TBA is a pervasive problem warranting attention. This study builds on the limited existing literature about adult experiences of TBA by examining patterns of TBA among adult abuse survivors (n = 377). Latent class analysis showed three distinct patterns of TBA: technology-based emotional abuse, technology-based monitoring, and technology-based control. Multinomial regression analyses demonstrated that TBA co-occurs with offline IPV. Findings reinforce the significant role of TBA in adult IPV survivors' lives and highlight the importance of assessing for TBA among survivors.

Self-Compassion and Psychological Well-Being of Childhood Sexual Abuse Survivors: Emotional Dysregulation and Trauma-Related Shame as Mediators.

In this study, we explored explanations for the link between self-compassion and psychological well-being among a sample of adult childhood sexual abuse (CSA) survivors in the United States (n = 335). Informed by Neff's self-compassion theory, we hypothesized that the relationship between self-compassion and psychological well-being would be partially explained by a reduction in emotional dysregulation and trauma-related shame. We tested a parallel multiple mediation model with (a) emotion dysregulation and (b) trauma-related shame as the mediators. As hypothesized, we found a significant positive relationship between self-compassion and psychological well-being among the sample of CSA survivors. Emotional dysregulation and trauma-related shame were both significant mediators of this relationship. However, self-compassion had a significant direct effect even after accounting for the two mediators, which suggests partial mediation. Our results provide further support for the link between self-compassion and psychological well-being and identify reductions in both emotional dysregulation and trauma-related shame as potential mechanisms for this relationship. This study also has implications for clinical practice and prevention efforts that integrate self-compassion, emotion regulation, and trauma-related shame as salient areas of focus.

Criminalizing Abuse, Neglect, and Financial Exploitation of Older Adults

The criminalization of abuse, neglect, and financial exploitation of older adults did not begin until the late 1990s in the United States. During this time, a number of states enacted laws criminalizing certain abusive and exploitive behaviors committed against older adults and added punishment enhancements to existing laws if victims were over a certain age. These laws and policies, and the impetus for them, mirrored those enacted decades prior as part of the child welfare movement, with connections drawn between the vulnerability of younger and older victims. Despite passage of these various abuse and exploitation laws for older adults, significant challenges remain in the identification, investigation, and prosecution of crimes committed against this population. Further, the population of older adults has been rapidly expanding along with rates of victimization, elevating the importance of this escalating social problem. This paper identifies limitations in the prior research by describing the past, present, and likely future of U.S. law and policy intended to effectively respond to crimes against older adults and concludes with a research and policy agenda.

The Relationship Between Dominance and Cyber Dating Abuse in Dating as Early Adults

Technology has various applications, including communication with partners. However, cyber dating abuse can negatively impact relationships. This behavior victimizes partners through online media and can stem from dominance in the relationship. Early adulthood is a time when individuals begin to engage in more intimate romantic relationships, which may increase the risk of cyber dating abuse. This correlational quantitative study aims to determine the relationship between dominance and cyber dating abuse in early adults who are dating. The sample consisted of 255 early adults who are dating and was selected using accidental sampling. The study employed the dominance and cyber dating abuse scale instruments for data collection, each comprising of 27 valid items. The reliability coefficient values for the dominance and cyber dating abuse scales were 0.913 and 0.970, respectively. The data was analyzed using Spearman Rho with a significance value (p) of 0.000 and a correlation coefficient (r) of 0.709. The analysis results indicate that dominance falls within the moderate category, while cyber dating abuse falls within the low category. Therefore, we can conclude that the hypothesis stating “There is a relationship between dominance and cyber dating abuse in early adults who are dating” is accepted. In other words, the higher the dominance in the relationship, the higher the cyber dating abuse in early adults who are dating, and vice versa

Older Adult Homicide: Investigating Case, Victim and Perpetrator Characteristics in a National Sample from England and Wales

Abstract Older adult homicide (OAH) is the most severe, yet understudied, form of older adult abuse. This study examined the case, victim and perpetrator characteristics of OAH. A secondary analysis of national data from England and Wales (2008–2019) was conducted where cases of non-stranger OAH (victims aged sixty years and over) were compared to adult homicide (victims aged eighteen to fifty-nine years) at the case, victim (n = 3,274) and perpetrator (n = 2,763) levels. Logistic regression models used to identify characteristics that were OAH risk factors, showed only a slight increase in predictive power but high accuracy in classifying adult homicide cases. Nevertheless, some risk factors known to be predictors of older adult abuse were significant predictors of OAH (e.g. living with the perpetrator, the perpetrator’s mental state). Implications for research, policy and practice are discussed.

Performing ignorance of state violence in Aotearoa New Zealand

In 2019, the New Zealand government established a Royal Commission of Inquiry into Abuse in Care to investigate the abuse and neglect of children, young people and vulnerable adults in Aotearoa/New Zealand between 1950 and 1999. The public hearings, witness statements and interim reports have charted horrific violence by state and faith-based workers including torture, sexual assaults, serious physical violence, and layers of neglect and discrimination. Māori have been especially targeted as victims of abuse and harms. This article considers the multiple layers of ignorance-making from state representatives. It shows how state agencies have navigated Commission hearings through 10 strategies that demonstrate some acknowledgement of their offending and trauma-making while simultaneously minimising their responsibility and resecuring their institutional legitimacy as protectors of the vulnerable and saviours of Te Tiriti (the Treaty of Waitangi), ethics and integrity. This careful performance stands at odds with the ongoing layers of violence and harms in state care.

Ethical dilemmas: a student reflection on safeguarding in adult domestic abuse

This reflective account discusses a case where a patient refused a safeguarding referral after disclosing domestic abuse to a student paramedic on an MSc programme. The author examines the medical, ethical and legal evidence when determining whether the right path was taken in caring for this patient. It is argued that the care delivered was lawful and ethical but the student paramedic did not have sufficient awareness of the support options available to those experiencing domestic abuse. Their oversimplification of the dilemma to the patient having capacity to refuse referral omitted key aspects of the medico-legal framework, potentially to the detriment of the patient's care. Reflective learning has allowed the author to recognise the limits of his understanding of the complex medico-ethico-legal framework surrounding domestic abuse, consent, coercion and controlling behaviour. In response, he has established a new methodology to assess the underlying reasons for refusing a safeguarding referral.

Substance use among young people during the COVID-19 pandemic

The article discusses issues reflecting the use of psychoactive substances among young people during the COVID-19 pandemic. Adolescence is an important stage of development, during which the foundation is often laid for future patterns of substance use. Both the amount and frequency of use during this period are closely related to the risk of excessive use and substance abuse in adulthood. The use of alcohol, tobacco and other drugs in youth worsens psychological and neurocognitive development and increases the risk of academic failure, chronic and mental illnesses. Thus, the prevention of substance use among young people remains an important public health priority worldwide. Effective strategies should include educational campaigns, psychological support, and access to quality medical care. In addition, it is also necessary to provide youth with opportunities for an active lifestyle so that they can find alternative ways to relax and overcome stress. The support and care provided by parents, family and friends, as well as the structure, supervision and support provided by teachers and school staff, also play an important role.

Sex differences in the association between (sexual) abuse and lower urinary tract symptoms.

To study the possible association between (sexual) abuse and lower urinary tract symptoms (LUTS) in men and women. To study the differences in this association between men and women, and between the timing of the abuse. A Dutch observational population-based cross-sectional study was used, based on self-administered questionnaires. Respondents were included if they had answered all questions about abuse and LUTS. Logistic regression was used to analyse the data. Included were 558 men and 790 women, of whom 29% and 37%, respectively, reported a history of one of more types of abuse. Abuse was significantly associated with LUTS in both men (odds ratio [OR] 1.7; 1.2-2.5) and women (OR 1.4; 1.1-2.1). This association, testing by two-way interaction, was significantly stronger in men. No association was found between childhood abuse or adulthood abuse and LUTS, in men or women. The association of sexual abuse with LUTS was significant in both men (2.7; 1.4-5.2) and in women (1.5; 1.1-2.2), and this association (testing by two-way interaction) was significantly much stronger in men. In men more than in women, a history of any type of abuse is associated with LUTS, regardless of whether the abuse occurred during childhood or adulthood. In both sexes, a history of sexual abuse is also associated with experiencing LUTS, with a much stronger association in men than in women. Patients, in particular male patients, presenting with LUTS should therefore be asked about sexual abuse in the past.

Profiles in neglect of older adult care workers in a long-term care facility: a latent profile analysis.

Neglect is a common form of abuse, and long-term care facilities record higher incidences of this abuse. Given that older adult care workers are the main workforce in these facilities, their neglectful behavior requires public health attention. Internal individual characteristics can lead to older adult abuse, and managing workers who abuse older adults may require various methods. This study aimed to identify the profiles of neglect among older adult care workers in long-term care facilities and explore the influencing factors of neglect. In this cross-sectional study, a convenience sample of older adult care workers from 15 long-term care facilities in Shandong Province (N = 421) completed a questionnaire on the characteristics associated with neglect. Latent profile analysis was used to identify distinct neglect profiles and promote the understanding of individual characteristics associated with varying levels of neglect. One-way analysis of variance and multivariate logistic regression analyses were used to examine the population characteristic differences. Older adult care workers exhibited three neglect profiles, namely, the "low-risk group," "medium-risk group," and "high-risk group." Males, participants with no employment qualification certificate, and those who did not attend regular training represented the majority of those in the "high-risk group." Participants with a monthly income of more than ¥ 4,000 and nursing 1-2 older adults simultaneously represented the majority of those in the "low-risk group." Long-term care facility administrators should tailor interventions to individual care worker profiles to reduce neglect behaviors and improve care levels.

Adolescent alcohol exposure modifies adult anxiety-like behavior and amygdala sensitivity to alcohol in rats: Increased c-Fos activity and sex-dependent microRNA-182 expression

Adolescent binge alcohol drinking is a serious health concern contributing to adult alcohol abuse often associated with anxiety disorders. We have used adolescent intermittent ethanol (AIE) administration as a model of binge drinking in rats in order to explore its long-term effect on the basolateral amygdala (BLA) responsiveness to alcohol and anxiety-like behavior. AIE increased the number of BLA c-Fos positive cells in adult Wistar rats and anxiety-like behavior assessed by the open field test (OFT). Additionally, in adult female rats receiving AIE BLA over expression of miR-182 was found. Therefore, our results indicate that alcohol consumption during adolescence can lead to enduring changes in anxiety-like behavior and BLA susceptibility to alcohol that may be mediated by sex-dependent epigenetic changes. These results contribute to understanding the mechanisms involved in the development of alcohol use disorders (AUD) and anxiety-related disorders.

The Relationship of Perceived Emotional Abuse in Adults with Psychological Resilience, Body Image and Beck's Cognitive Triad

Bu araştırmanın amacı yetişkinlerde algılanan duygusal istismarın psikolojik sağlamlık, beden imajı ve Beck’in bilişsel üçlü kavramı ile ilişkisini ortaya koymaktır. Bu çalışma Türkiye genelinde 18 yaş ve üstü yetişkinlerden oluşan 214 kişiyle online ortamda gerçekleştirilmiştir. Demografik Bilgi Formu, Kısa Psikolojik Sağlamlık Ölçeği, Vücut Algısı Ölçeği, Algılanan Duygusal İstismar Ölçeği ve Bilişsel Üçlü Ölçeği kullanılmıştır. Araştırmanın istatistik verileri IBM SPSS Statistics 23.0 programında yapılmıştır. Kullanılan ölçeklerden alınan puanların birbirleriyle olan korelasyon katsayılarına Pearson Korelasyon analizi ile bakılmıştır. İki grubu karşılaştırırken Bağımsız Örneklem T testi, üç ve üzeri grubu karşılaştırırken ise Anova testi yapılmıştır. Araştırma sonucunda algılanan duygusal istismarın vücut algısı, psikolojik sağlamlık ve bilişsel üçlü modelindeki kişinin kendine, geleceğe ve dış dünyaya yönelik algısı ile negatif ilişkisi bulunmuştur. Başka bir ifadeyle, kişinin algılanan duygusal istismar puanı arttıkça psikolojik sağlamlık, vücut algısı, bilişsel üçlü modelindeki kişinin kendine, geleceğe ve dış dünyaya yönelik algısı puanları düşmektedir. Ayrıca, ekonomik durum kötüleştikçe algılanan duygusal istismarın arttığı ve ebeveyn kaybı yaşayan bireylerin yaşamayan bireylere göre duygusal istismar yaşamaları durumunda anlamlı olarak artma tespit edilmiştir. Araştırma sonuçları literatür ışığında tartışılmıştır.