Adult Abuse Research Articles

Being silenced, loneliness and being heard: understanding pathways to intimate partner violence & abuse in young adults. a mixed-methods study

BackgroundInternational research shows the significance and impact of intimate partner violence and abuse (IPVA) as a public health issue for young adults. There is a lack of qualitative research exploring pathways to IPVA.MethodsThe current mixed-methods study used qualitative interviews and analysis of longitudinal cohort data, to explore experiences of pathways to IPVA. Semi-structured Interviews alongside Life History Calendars were undertaken to explore 17 young women’s (19–25 years) experiences and perceptions of pathways to IPVA in their relationships. Thematic analysis was undertaken.Based on themes identified in the qualitative analysis, quantitative analysis was conducted in data from 2127 female and 1145 male participants of the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort study. We fitted regression models to assess the association of child maltreatment, parental domestic violence, and peer-to-peer victimisation, by age 12, with loneliness during adolescence (ages 13–14), and the association of loneliness during adolescence with IPVA (age 18–21). Mediation analysis estimated the direct effects of maltreatment on IPVA, and indirect effects through loneliness.FindingsAll women interviewed experienced at least one type of maltreatment, parental domestic violence, or bullying during childhood. Nearly all experienced IPVA and most had been multi-victimised. Findings indicated a circular pathway: early trauma led to isolation and loneliness, negative labelling and being silenced through negative responses to help seeking, leading to increased experiences of loneliness and intensifying vulnerability to further violence and abuse in young adulthood. The pathway was compounded by intersectionality. Potential ways to break this cycle of loneliness included being heard and supported, especially by teachers.Quantitative analysis confirmed an association between child maltreatment and loneliness in adolescence, and an association between loneliness in adolescence and experience of IPVA in young adult relationships.ConclusionIt is likely that negative labelling and loneliness mediate pathways to IPVA, especially among more disadvantaged young women. The impact of early maltreatment on young people’s wellbeing and own relationships is compounded by disadvantage, disability and ethnicity. Participants’ resilience was enabled by support in the community.

An Examination of Conditions Exposing Older Adults to Economic Abuse: Logistic Regression Analysis.

The aim of this study was to determine factors affecting the economic abuse status of older adults. The study was conducted with 385 individuals aged 65years and above, living in the Bahçelievler district of Istanbul. Data were collected using a Sociodemographic Form, and a Determination of Economic Abuse of Older Adults Form. Logistic regression analysis was applied to determine the factors affecting the economic abuse status of the older adults. The study participants comprised 51.4% males and 48.6% females with a mean age of 70.44 ± 6.73years. It was determined that 9.4% of the older adults were exposed to economic abuse. As a result of the logistic regression analysis, the factors found to affect the situations of exposure to economic abuse of the older adults were age, income status, number of children, exposure to emotional abuse, and exposure to physical abuse.

The First 1000 Days of Life and the Risk of Future Drug Consumption

Context: The first 1000 days of life last from the beginning of pregnancy to the age of two, a unique step that shapes the basis for a person’s health over their lifetime. Numerous studies have indicated the relationship between one’s first 1000 days of life and the consequent adverse outcomes in adulthood. However, to the extent that we have reviewed it, not a single study has shown the relationship between various aspects of an individual’s first 1000 days of life and the probability of drug consumption in adult life. Hence, the primary purpose of this narrative review was to understand the role of the first 1000 days of life on vulnerability to drug abuse later in life. Evidence Acquisition: This article is a narrative review that has identified the role of the first 1000 days of life on susceptibility to substance abuse later in life. The articles were extracted from valid databases, including PubMed, Scopus, Science Direct, Web of Science, and Embase. Results: Various significant research has pointed to the mother’s distress and anxiety during pregnancy through embryonic planning, influencing the planning of the hypothalamic-pituitary-adrenal (HPA) axis and epigenetic changes. The intestinal microbiota is a part of a complex link named the microbiota-gut-brain axis that can affect drug abuse through the variety and number of intestinal microbiota. On the other hand, a mother’s drug consumption during pregnancy can function as chronic stress by affecting the enteric nervous system (ENS), which activates the concurrent axis of HPA and dopamine pathways by changing the reward circuit and the subsequent increase in drug abuse. The results indicated that various factors, such as exposure to adverse childhood experiences (ACEs), parental separation, and attachment insecurity, increase the probability of drug abuse in adulthood. Nevertheless, the quality of nurturing care during the first 1000 days of life and the mother’s warm relationship with children may hinder the increase in addiction in society. Conclusions: The first 1000 days of one's life are a crucial and delicate stage. If these days are tainted with unpleasant events, the various mechanisms can reduce a person's resilience to drug abuse in later life. How the first 1000 days of an infant’s life and the quality of this period, such as prenatal stress, substance use during pregnancy, ACEs, maternal-infant bonding, maternal separation (MS), and intestinal microbiota, can affect drug abuse in the future. As a result, focusing on the first 1000 days of life is critical to adapting prevention strategies. Health policymakers can design suitable entries during pregnancy and early childhood to reduce the probability of drug abuse.

Older adult abuse in a service for sexual and domestic violence: Medico-legal implications from the experience of an Italian center

Older adults are subject to vulnerability and abusive behaviors have serious negative health consequences. Since the phenomenon is underestimated, several challenges are faced to prevent, diagnose, and treat abuses on older adults. In this context, clinical forensic medicine practitioners can play a pivotal role. A retrospective monocentric analysis of all the files concerning victims of violence observed in the SVSeD Center in Milan over the age of 65 for a five-year period was performed. For each medical report, data regarding the variables of the victims, the type of violence, and the variables of the perpetrators were analysed. Older adult victims of abuses were 166. Abuses against women were more frequent than against men (less than 6 % of consultations). In one third of cases, subjects also suffered from disabling diseases and reported signs of physical violence. Perpetrators were male known individuals in almost 90 % of cases. Violence was perpetrated by a partner or a family member. The present study may help in identifying risk factors for domestic violence against older adults. Consequently, preventive policies should be designed to interrupt the vicious circle of violence. Older adult abuse deserves additional focus and better education for healthcare professionals and further research should be carried out to better understand the actual epidemiology of the phenomenon and to develop therapeutical and caring strategies.

Correlates of suicidal behaviour among adults in Guyana

This study aimed to determine the prevalence and correlates of suicidal behaviour (SB) among adults in Guyana. Secondary data were analysed from the national cross-sectional 2016 Guyana STEPS survey, which sampled 2 662 adults aged 18-69 years (female = 59.9%; East Indian = 42.3%; median age = 37.4 years). Following logistic regression analyses, results indicated that the prevalence of past 12-month SB was 4.6% (ideation 4.4%, suicide plan 1.5%, and/or suicide attempt 1.1%). Mixed and other ethnicities, childhood physical abuse, childhood sexual abuse, adult sexual abuse, experience of threats, exposure to violent injuries, family history of suicide attempts, and history of heart attack, angina, or stroke were associated with a high risk of SB. Being male sex and higher education were associated with lower risk for SB. In addition to psychosocial distress, considering a history of cardiovascular disorder is essential in devising population-based suicide prevention strategies in Guyana.

Abuse and revictimization in adulthood in multiple sclerosis: a cross-sectional study during pregnancy

BackgroundKnowledge concerning exposure to abuse in adulthood and in pregnancy in people with multiple sclerosis (MS) is sparse.ObjectiveTo determine the occurrence of adult abuse and abuse in relation to pregnancy in women with MS and their risk of revictimization (repeated abuse as adults after childhood abuse).MethodsThis cross-sectional study comprised pregnant women from the Norwegian Mother, Father and Child Cohort study. Information on abuse was acquired through self-completed questionnaires. We used logistic regression to estimate adjusted odds ratios (aORs) with 95% confidence intervals (CIs).ResultsWe identified 106 women with MS at enrollment through linkage with national health registries. The reference group consisted of 77,278 women without MS. Twenty-seven women (26%) with MS reported any adult abuse compared to 15,491 women (20%) without MS, aOR 1.33 (0.85–2.09). Twenty-two (21%) women with MS reported systematic emotional abuse compared to 13% without MS, aOR 1.75 (1.08–2.83). Ten women (10%) with MS reported sexual abuse, compared to 6% without MS, aOR 1.72 (0.89–3.33). More women with MS reported rape as an adult, aOR 2.37 (1.02–5.49). Women with MS had higher risk of revictimization as adults, after childhood abuse, aOR 2.23 (1.22–4.10). The risk of abuse during pregnancy or 6 months preceding pregnancy was similar between the groups.ConclusionsWomen with MS had increased occurrence of systematic emotional abuse, rape, and revictimization as adults, compared to women without MS.

Emotion Dysregulation and Workplace Satisfaction in Direct Care Worker Burnout and Abuse Risk.

Direct care workers frequently encounter difficult interactions with the patients they serve and experience frustration and burnout. The current study tested a hypothesized model in which predictors of caregiver abuse risk (emotional dysregulation, difficulty managing patient behavior, and workplace satisfaction) were mediated by symptoms of burnout. The study used an online cross-sectional survey design. The study was implemented online via Qualtrics. Participants were 206 direct care workers (eg, certified nursing assistants, patient care technicians, home health aides, and medical assistants). All respondents completed the Caregiver Abuse Screen (CASE), Difficulty with Emotional Regulation Scale (DERS-SF), and the Abbreviated Maslach Burnout Inventory. Demographic data and employment history were also collected. Correlational methods, including path analysis, were used to assess associations between study variables. More than half of this heterogenous sample endorsed significant risk for engaging in patient abuse. Path analysis suggested emotional dysregulation and low workplace satisfaction were associated with greater risk of patient abuse, and these associations were partially and simultaneously mediated by burnout facets of depersonalization and emotional exhaustion. This study provided preliminary support for a model of caregiver abuse in which underlying difficulties regulating emotions convey risk for caregiver abuse via burnout facets including emotional exhaustion and depersonalization. Enhancing basic emotion regulation skills and reducing burnout in direct care staff may reduce the risk of abuse for older adults. Thus, providing training necessary to help direct care workers manage their own emotions in order to better recognize, understand, and respond effectively to the needs of older adults may reduce staff burnout and, consequently, lower the risk of abuse for older adults.

THE NEED FOR AUSTRALIAN CRIMINAL LAW REFORM TO PROTECT ELDERLY AUSTRALIANS AGAINST ABUSE

The Australian Bureau of Statistics have reported that Australia’s population is ageing at
 an incremental rate, and a recent National Prevalence Study into elder abuse found that a
 significant proportion of those older Australians are experiencing abuse. While it is
 important to recognise that older people are not inherently vulnerable, it is equally
 important to acknowledge the fact that many instances of abuse are falling through the
 cracks. Older people with distinct vulnerabilities, are at particular risk, and it is the right
 of every older Australian to age with dignity, respect, and to be afforded adequate protection
 from abuse. Despite the existence of criminal laws applicable to abuses including physical,
 social, psychological, and financial, very few matters relating to abuse of older people are
 prosecuted.
 This paper provides an overview of the legal framework in which abuse of older adults
 currently operates in Australia. It proposes that discrete criminal offences should be
 introduced to protect older adults who are reliant on others for their care, and who have a
 distinct vulnerability.

Characterizing Elder Abuse in the UK: A Description of Cases Reported to a National Helpline.

The abuse of older adults by someone in a position of trust—also known as elder abuse (EA)—has a severe impact on victims and society. However, knowledge about EA in the UK is limited in comparison to other types of interpersonal violence and international knowledge. The present study utilized secondary data from a UK national EA helpline to investigate the characteristics of reported cases. Over a one-year period between 2017 and 2018, 1,623 records met inclusion criteria. Descriptive statistics are provided to describe this sample. Most cases reported to the helpline pertained to female victims, suffering from financial or psychological abuse. Co-occurrence of different abuse types was common. Findings provide updated knowledge about the phenomenology of EA cases in the UK. Recommendations are provided for advancing research in this area, including the need for examining cases across longer periods of time with a view to informing practice and policy.

Child sexual abuse in African American society

The study is an exploration of the discourse about Child Sexual Abuse in African American society which is a moral, political and social concern that demands an appropriate solution against adult abuse of power. Child Sexual Abuse (CSA) has been part of history since long time but is often neglected as a subject of public discourse and conversation in U.S. hegemonic society. Earlier research focused on the mental health consequences of CSA but not on the prevalence or reasons for its occurrence in African American community in U.S. The study analyses the case of Maya Angelou who was raped at the age of eight by her mother’s live-in boyfriend in her very home, by using her documented experiences from autobiography I Know Why the Caged Bird Sings. The study also examines pertinent questions regarding Child Sexual Abuse (CSA) - the causes, symptoms and effects.

The Loss of the Self—Spiritual Abuse of Adults in the Context of the Catholic Church

Interest in spiritual abuse is a fairly recent phenomenon in research. Originally, it received attention only in the context of child sexual abuse perpetrated by the clergy in the Catholic Church before it was recognized as a specific form of abuse in its own right. In line with Paul Ricœur, I agree that a narrative best describes a person’s identity. I, therefore, give space to the voices of three women who were spiritually abused as adults in France in the context of new religious communities that originated after the Second Vatican Council: Sophie Ducrey, Anne Mardon and Marie-Laure Janssens. The social constructionist method allows the uniqueness of each of their narratives to be recognized, while also accounting for shared experiences such as the dynamics of control, desocialization and intrusion into the private spheres of life. Spiritual abuse, which is at the hinge point between the moral and spiritual and the psychological realms, is perpetrated by a spiritual leader who has power over women. The abuse serves to fulfill the psychological or sexual needs of the leader. Abuse of the conscience, theology and spirituality are the spiritual means used, alongside the psychological ones, to cause the women to become dependent. In the process, their desire for God and the affective needs that some may have are abused. The consequences are many, but the loss of self, of which faith is the core, summarizes it well.

Abuse and Neglect of Community-Dwelling Older Adults: Index Generation, an Assessment of Intensity, and Implications for Ageing in Place

Abuse and Neglect of Community-Dwelling Older Adults: Index Generation, an Assessment of Intensity, and Implications for Ageing in Place

The Long-Term Outcomes of Prepubertal Depression and Internalizing Problems: A Scoping Review.

After participating in this activity, learners should be better able to:• Discuss whether prepubertal depression shows longitudinal continuity with depression in adulthood.• Summarize existing literature on adult emotional and functional outcomes of prepubertal depression and internalizing problems. Adolescent- and young adult-onset depression are common, recurrent, and can cause significant distress and psychosocial impairment across the life span, but recognition of prepubertal internalizing problems and depression, along with their prevalence, clinical course, and long-term outcomes, remains elusive. To examine whether prepubertal depression, which can manifest differently from adult depression, shows longitudinal continuity with depression in adulthood, and to summarize existing literature on adult emotional and functional outcomes of prepubertal depression and internalizing problems. A scoping review was conducted for peer-reviewed cohort articles published between 2000 and 2020 using PubMed and PsycINFO. From 4309 identified references, 17 articles were included. Prepubertal depression confers increased risk of recurrence of depression in adulthood, with similar findings for prepubertal internalizing problems. No studies found prepubertal depression or internalizing problems predicting adult substance abuse, and no studies asked about adult bipolar diagnoses. More research is needed to draw clear conclusions regarding their implications for other psychiatric, medical, or psychosocial outcomes. The reviewed studies provide limited evidence that prepubertal depression onset predicts adult depression. The small evidence base and heterogeneous methodological assessments may limit, however, the ability to draw meaningful conclusions about the long-term course of prepubertal-onset depression. Well-designed studies with longer follow-up and multiple assessments in adulthood are needed to clarify and assess the potential effects of prepubertal depression on adult health and functioning. This information will eventually become available as the samples in recently initiated longitudinal cohort studies of children mature further.

Prevalence patterns and associated factors of elder abuse in an urban slum of eastern India

BackgroundThe prevalence of elder abuse in various parts of the world has been reported between 2.2 and 90.4%. According to some studies conducted in India, elder abuse prevalence ranges between 9.6 to 61.7%. Yet, elder abuse is an underreported issue. Most available evidence shows the involvement of close family members and caregivers in the abuse of older adults. Several factors associated with various forms of elder abuse need to be studied further. This study has attempted to capture the prevalence, pattern and associated factors of elder abuse in urban slums.MethodsThis study was a cross-sectional community-based study conducted between August 2019 to August 2020 in an urban field practice area of the All India Institute of Medical Sciences, Bhubaneswar. It covers four wards of the Bhubaneswar Municipal Corporation, served by the Urban Primary Health Centre, IRC Village, Nayapalli. A total of 360 participants aged 60 years and above were included in this study. They were interviewed using various semi-structured interview schedules. Validated study tools such as Activities of Daily Living (ADL- Barthel Index), Hindi Mental Scale Examination (HMSE), Geriatric Depression Scale (GDS), and Vulnerability to Abuse Screening Scale (VASS) were also used to assess various factors.ResultsApproximately one in five (19.4%) older adults reported some form of abuse. The types of elder abuse reported were physical abuse in 12 (3.3%), verbal abuse in 25 (6.9%), emotional abuse in 40 (11.1%), and financial abuse in 15 (4.2%) older adult participants. The sons and daughters-in-law of the older adult participants were the main perpetrators of abuse reported. Depression and past history of abuse were found significantly associated with any type of abuse.ConclusionsThe prevalence of elder abuse in this study was considerably high, with 70 (19.4%) out of the 360 participants reporting some form of abuse. Emotional abuse was the most reported, and physical abuse was the least reported type. The most common perpetrators were those on whom the older adults depended, like their sons and daughters-in-law.

Psychometric Properties of The Five-Item Victimization of Exploitation (FIVE) Scale: A Measure of Financial Abuse of Older Adults.

Elder mistreatment affects at least 1 in 10 older adults. Financial abuse, or exploitation, of older adults is among the most commonly reported forms of abuse. Few validated measures exist to measure this construct. We aim to present a new psychometrically validated measure of financial abuse of older adults. Classical test theory and item response theory (IRT) methodologies were used to examine a five-item measure of financial abuse of older adults, administered as part of the New York State Elder Mistreatment Survey. Factor analysis revealed a single factor best fits the data, which we labeled as financial abuse. Moreover, IRT analyses revealed that these items discriminated well between abused and nonabused persons and provided information at high levels of the latent trait θ, as is expected in cases of abuse. The Five-Item Victimization of Exploitation Scale has acceptable psychometric properties and has been used successfully in large-scale survey research. We recommend this measure as an indicator of financial abuse in elder abuse, or mistreatment prevalence research studies.

Sex Offenses—Offensive Sex: Some Observations on the Recent Reform of Ecclesiastical Penal Law

In recent years, the sexual abuse of minors and vulnerable adults in the Catholic Church has received much attention. This is also true of the related changes to ecclesiastical legislation. Less attention, however, has been paid to other aspects of the reform. The revised penal law of the Code of Canon Law, in any case, demands closer study from the point of critical legal studies. It is striking that while the reform focused on improving the legal protection of minors, it also had rather detrimental effects on the legal standing of women in the church. Reading the revised law, it appears that the reform missed the chance to improve the legal situation of the mostly female adult victims of clerical sex offenses and abuses of power. It rather spotlighted “female” offenses such as abortion in contrast to typical “male” offenses such as homicide, and it moreover criminalized women who attempt ordination. Thus, the regulations of the reformed penal law not only generally leave the systemic causes of abuse untouched, but also establish norms which reinvent or even exacerbate abusive structures. The latter finally sustain clericalism and reinstitutionalize gender inequality, commonly identified as factors fostering abuse.

Interpersonal Trauma and Risk of Incident Cardiovascular Disease Events Among Women.

BackgroundTraumatic experiences have been linked to risk for cardiovascular disease (CVD). Interpersonal violence is a trauma that is prevalent in women. Among midlife women followed up for 2 decades, we examined whether interpersonal violence (childhood abuse, adulthood abuse, or intimate partner violence [IPV]) was related to increased risk of subsequent clinical CVD events.Methods and ResultsA total of 2201 women, aged 42 to 52 years at baseline, underwent up to 16 in‐person visits over 22 years. Measures included questionnaires (including of childhood physical/sexual abuse, adult physical/sexual abuse, and IPV), physical measures, phlebotomy, and reported CVD events (myocardial infarction, stroke, heart failure, and revascularization). Death certificates were collected. Relationships between childhood abuse, adult abuse, and IPV with incident fatal/nonfatal CVD were tested in Cox proportional hazards models. Women with a childhood abuse history had increased risk for incident CVD (versus no abuse; hazard ratio [HR] [95% CI], 1.65 [1.12–2.44]; P=0.01; adjusted for demographics and CVD risk factors); associations were strongest for childhood sexual abuse. Adult abuse was not significantly associated with CVD. Women with IPV had a doubling of risk for incident CVD in demographic‐adjusted models (versus no IPV; IPV: HR [95% CI], 2.06 [1.01–4.23]; P=0.04; no partner: HR [95% CI], 1.79 [0.91–3.53]; P=0.09); systolic blood pressure partially mediated relationships between IPV and CVD.ConclusionsChildhood abuse, particularly sexual abuse, was associated with increased risk of CVD in women. IPV was associated with risk for CVD, with the higher systolic blood pressure among IPV‐exposed women important in these associations. Interpersonal violence prevention may contribute to CVD risk reduction in women.

Creating opportunities to improve detection of older adult abuse: a national interRAI study

Despite being recognized as a major global health issue, older adult abuse (OAA) remains largely undetected and under-reported. Most OAA assessment tools fail to capture true prevalence. Follow up of patients where abuse exposure is not easily determined is a necessity. The interRAI-HC (International Resident Assessment Instrument—Home Care) currently underestimates the extent of abuse. We investigated how to improve detection of OAA using the interRAI-HC. Analysis of 7 years of interRAI-HC data from an Aotearoa New Zealand cohort was completed. We identified that through altering the criteria for suspicion of OAA, capture rates of at-risk individuals could be nearly doubled from 2.6% to 4.8%. We propose that via adapting the interRAI-HC criteria to include the "unable to determine" whether abuse occurred (UDA) category, identification of OAA sufferers could be substantially improved. Improved identification will facilitate enhanced protection of this vulnerable population.

Adverse Childhood Experiences and Substance Abuse in Young Adults: A Correlational Study

Adverse Childhood Experiences and Substance Abuse in Young Adults: A Correlational Study

Sexual Assault Is the Biggest Risk Factor for Violence against Women in Taiwan-A Nationwide Population Cohort Study from 2000 to 2015.

Objective: To understand the main types of risk of violence against women in Taiwan. Materials and methods: This study used the outpatient, emergency, and hospitalization data of 2 million people in the National Health Insurance sample from 2000 to 2015. The International Classification of Diseases, Ninth Revision diagnostic N-codes 995.5 (child abuse) and 995.8 (adult abuse) or E-codes E960–E969 (homicide and intentional injury by others) were defined as the case study for this study, and the risks of first violent injury for boys and girls (0–17 years old), adults (18–64 years old), and elders (over 65 years old) were analyzed. Logistic regression analysis was used for risk comparison. A p value of <0.05 was considered significant. Results: The proportion of women (12–17.9 years old) who were sexually assaulted was 2.71 times that of women under the age of 12, and the risk of sexual assault for girls and adult women was 100 times that of men. Girls who were insured as labor insurance, farmers, members of water conservancy and fishery associations, low-income households, and community insured population (public insurance as the reference group) were significantly more likely to seek medical treatment from sexual assault than adult women. Among them, the risk was greatest for girls from low-income households (odds ratio = 10.74). Conclusion: Women are at higher risk of sexual assault than men regardless of whether they are children or adults, and the highest risk is for women in senior high schools, especially for girls from low-income households. Therefore, the protection of women’s personal autonomy is the direction that the government and people from all walks of life need to continue to strive for. Especially for high school students from low-income households, protection must be strengthened through education, social work, and police administration.