Abuse Screening Research Articles

Relationship between maltreatment and mental health in adolescents: A school-based study in Indonesia.

Maltreatment affects emotional development in adolescents and inhibits social adjustment. This study aimed to analyze the relationship between maltreatment and mental health among adolescents. A cross-sectional study was conducted on adolescents in the first and second grades of middle school (12-14 years old) and high school (15-17 years old) in eight cities and municipalities in the province, selected through several stages of simple random sampling (N = 1837). The International Society for the Prevention of Child Abuse and Neglect (ISPCAN) Child Abuse Screening Tool for Children (ICAST-C) questionnaire for detecting maltreatment was translated, simplified, and validated by an expert based on a theoretical framework that involved pediatricians, public health, and medicolegal perspectives. The Strengths and Difficulties Questionnaire (SDQ) was used to assess emotional states. ICAST-C and SDQ scores were transformed to logit values using Rasch model analysis. Distribution frequency and linear regression were used for data analysis. The results indicated that 85.6% of adolescents aged 12-14 and 83% of those aged 15-17 experienced physical maltreatment, while 89.4% of the 12-14 age group and 82.9% of the 15-17 age group experienced psychological maltreatment. The emotional states of the two groups were 52.8% and 59.2%, respectively. There was a significant correlation between the experience of physical maltreatment and emotions among 12-14 (r1 = 0.148 (0.190-0.257)) and 15-17 years old (r1 = 0.047 (0.084-0.156)). There was a significant correlation between the experience of psychological maltreatment and emotions among 12-14 years old '(r2 = 0.191 (0.270-0.350)) and 15 to 17 years old (r2 = 0.097 (0.167-0.252)). In conclusion, physical and psychological maltreatment were correlated with mental health states among adolescent students in West Java, Indonesia.

Prevalence and correlates of severe problematic cannabis use: analysis of a population-based survey in Jamaica

BackgroundThere is an increasing demand for the treatment of problematic cannabis use (PCU) in low-income and middle-income countries. Jamaica’s historical inclination towards cannabis use underscores the need for research in addressing this issue.ObjectivesTo determine the prevalence and patterns of cannabis use and assess the sociodemographic factors, psychosocial correlates, knowledge and perceptions associated with severe PCU among Jamaicans using nationally representative data.MethodsThis study involved a secondary data analysis of the last Jamaica National Drug Prevalence Survey. It included 786 participants who used cannabis in the past year and completed the Cannabis Abuse Screening Test (CAST). The CAST has been validated against the Diagnostic and Statistical Manual of Mental Disorders (DSM), with a score ≥ 7 meeting the criteria for severe PCU. CAST scores were dichotomized utilizing these thresholds, and data generated were analyzed with SPSS version 25 using Pearson’s χ2 test and logistic regression.ResultsIn the past year, 53.3% of Jamaicans who smoked cannabis had a score of 7 or higher on the CAST and smoked an average of 62.21 joints per month. Male respondents were twice as likely to have severe PCU as females. Additionally, young, middle, and older adults were respectively 3, 5 and 3 times more likely to report severe PCU compared to adolescent respondents. Participants who started cannabis use at 11 years and under, 12-17 years, and 18-25 years were respectively 5, 7 and 7 times more likely to report severe PCU than those at 26 years and older. Moreover, easy access to cannabis, a high perceived need for treatment, belief in increased national drug use prevalence, and awareness of the National Drug Control and Prevention Agency were associated with increased odds of reporting severe PCU.ConclusionOne out of every two Jamaicans who used cannabis in the past year reported severe PCU and smoked an average of two cannabis joints per day. Early initiation increases the risk of severe PCU. Accordingly, a public health approach involving multiple sectors is needed to provide treatment options.

Prevalence and associated factors of intimate partner violence against pregnant women who attend antenatal care in Denmark and Spain: A digital screening approach.

Intimate partner violence against women is a global health issue. Exposure to intimate partner violence during pregnancy leads to health-related problems for both the mother and the newborn. However, current knowledge on its occurrence varies widely and assessing the problem using standardized tools in different contexts is needed. This study aimed to estimate the prevalence and associated factors of IPV in pregnant women in Denmark and Spain through digital screening tools. A cross-sectional design was used to systematically screen for intimate partner violence among pregnant women attending antenatal care by using standardized digital screening tools, Woman Abuse Screening Tool and Abuse Assessment Screen. A total of 17 220 pregnant women in Denmark and 2222 pregnant women in Spain were invited to participate. The response rate was high in both countries (77.3% and 92.5%, respectively). Overall, 6.9% (n = 913) and 13.7% (n = 282) screened positive in Denmark and Spain, respectively. Logistic regressions estimated crude and adjusted odds ratio with 95% confidence intervals of the relationship between sociodemographic variables and intimate partner violence. In both countries, being unmarried and lacking social support were risk factors of intimate partner violence. Additionally, in Denmark, pregnant women older than 40 years, unemployed or foreign, were at higher risk, while having higher educational levels was a protective factor. In Spain, not having a partner at the time of questionnaire completion and having at least one child prior to the current pregnancy were risk factors of intimate partner violence. Prevalence results and found associated factors contribute to a more comprehensive understanding of the occurrence of intimate partner violence during pregnancy in Denmark and Spain, while highlighting the feasibility of digital systematic screening in antenatal settings.

Codesigning training for health providers to improve detection and response to elder abuse.

Screening for elder abuse can improve detection, but many health providers lack the necessary skills and confidence. To address this, training for health providers on elder abuse screening was co-designed as part of a trial aimed at improving elder abuse detection and response. Between March and April 2023, 7 health providers and 10 older people and family carers participated in two national Australian online codesign workshops. Using the World Café method, discussions focused on what knowledge and skills health providers needed for screening; clinical and social issues affecting screening and referral; and support older people needed throughout the process. Data were thematically analyzed. Participants said health providers should take a trauma-informed, person-centered approach to screening, and explain the limits of confidentiality to older people. Clinical, social, and systemic issues such as dementia, ethnic diversity, and housing availability complicated screening and referrals. To facilitate disclosure, participants said health providers needed to reflect on whether they held ageist views. There were differing opinions on the length of the training and if all health providers or only social workers should screen for abuse. Participants' feedback on trauma-informed care, consent, and cognitive impairment concorded with evidence on best practice responses to elder abuse and were integrated in the training. Given operational constraints in health services, feedback from health providers about the training length and the inclusion of all health providers in screening were prioritized. The training is being evaluated in a national trial.

EFFECTIVENESS OF AN ALTERNATIVE PROTOCOL TO FACE SUBSTANCE USE DISORDER AND SYMPTOMS OF COMORBID DEPRESSION

Introduction: There is scarcity of studies in the national and international literature on alternative protocols to pharmacological and psychotherapeutic intervention for the treatment of Substance Use Disorder (SUD) and symptoms of comorbid depression. This study aimed to develop a protocol based on alternative therapies through mindfulness meditation, reiki, acupuncture and auriculotherapy to improve substance use problems and symptoms of comorbid depression. Method: This is a randomized single-blind controlled study. The final sample consisted of 18 participants randomized divided into two groups of nine participants: experimental and control. Participants were evaluated by four validated instruments during the screening process and after the intervention. The instruments were: Beck Depression Scale (BDI), Depression, Anxiety and Stress Scale (DASS-21), Alcohol Use Disorders Identification Test (AUDIT), Drug Abuse Screening Test (DAST-10) and Brazilian Economic Classification Criteria (CCEB). Results: the results of the analysis indicate a significant reduction in the pattern of alcohol consumption (p <0.001); other drugs related problems (p<0.001); symptoms of depression (p<0.001); anxiety (p<0.001) and stress (p<0.001) between the two distinct groups (experimental and control) after the intervention. Conclusion: The protocol proposed in this study was effective in reducing the pattern of problems related to alcohol and other drugs, in addition to being effective in reducing symptoms of depression, stress and anxiety.

Cariprazine as a maintenance treatment in dual schizophrenia: a 6-month observational study in patients with schizophrenia and cannabis use disorder.

Schizophrenia is often associated with substance use disorders, particularly cannabis use disorder (CUD). However, treatments frequently fail to address both conditions simultaneously. This study aimed to evaluate the antipsychotic effectiveness of cariprazine in patients with both schizophrenia and CUD in a real-world setting. A 6-month observational study was conducted on 58 patients diagnosed with schizophrenia and CUD, treated with cariprazine. Antipsychotic effectiveness was measured using the Positive and Negative Syndrome Scale and the Clinical Global Impression-Schizophrenia Scale, along with the Improvement and Severity scales. Cannabis consumption and addiction severity were assessed using the Cannabis Abuse Screening Test and the Severity of Dependence Scale, while functioning was evaluated with the Sheehan Disability Inventory. Cariprazine treatment resulted in significant improvements in schizophrenia symptoms (Positive and Negative Syndrome Scale change: -47.88 points, P < 0.0001; Clinical Global Impression-Schizophrenia Scale change: -8.26 points, P < 0.0001). Cannabis use and dependence also decreased (Cannabis Abuse Screening Test change: -7.0 points, P < 0.0001; Severity of Dependence Scale change: -7.88 points, P < 0.0001), alongside improvements in functioning (Sheehan Disability Inventory change: -9.48 points, P < 0.0001). These results suggest that cariprazine is effective for both schizophrenia and CUD, though further research is needed to confirm these findings.

“Eco-friendly HPLC method for analysis of dipyrone and hyoscine in different matrices with biomonitoring”

A selective, precise, and accurate reversed HPLC method has been developed and validated for simultaneous separation and determination of two veterinary drugs, dipyrone and hyoscine, in their combined dosage form in the presence of their official impurities, namely 4-aminoantipyrine and tropic acid, in addition to the formulated preservative: phenol. The linearity range was found to be (1.00–35.00 µg/mL) for dipyrone and (2.50–50.00 µg/mL) for hyoscine. It exhibited a satisfactory linearity regression R (0.9999) for both drugs with LOD 0.22 µg/mL and 0.72 µg/mL and LOQ 0.65 µg/mL and 2.19 µg/mL for dipyrone and hyoscine, respectively. Additionally, the two cited drugs were also determined in the presence of dipyrone active metabolite 4-aminoantipyrine using diclofenac as an internal standard in bovine urine. The linearity range was found to be (15–75 µg/mL) for dipyrone, (2.5–60 µg/mL) for hyoscine, and (2.5–60 µg/mL) for 4-aminoantipyrine with linearity regression R (0.9999–0.9998). The LLOQ (15, 2.5, 2.5 µg/mL), LQC (45, 7.5, 7.5 µg/mL), MQC (55, 25, 25 µg/mL), and HQC (60, 50 50 µg/mL) were determined for dipyrone, hyoscine and 4-aminoantipyrine, respectively. UV detection was carried out at 220 nm. The method was validated according to the ICH guidelines, as well as according to FDA guidelines for determining both drugs in bioanalytical matrices and both proved accuracy and precision. A statistical comparison was made between the results obtained and those obtained by the reported method, showing no significant difference in accuracy and precision at p = 0.05. The suggested method was proved eco-friendly through a greenness assessment using two different tools (The analytical eco-scale scored 83, and the AGREE-Analytical Greenness Metric approach scored 0.83). The suggested method can be used in the routine work of quality control labs, screening for drug abuse, and ensuring clean sport for horse racing.

Bioinformatics-driven untargeted metabolomic profiling for clinical screening of methamphetamine abuse.

Amphetamine-type stimulants are very common, and their usage is becoming a very big social problem all over the world. Thousands of addicts encounter several health problems including mental, metabolic, behavioral and neurological disorders. In addition to these, there are several reports about the elevated risk of tendency on committing criminal cases by addicted persons. Hence, methamphetamine addiction is not only an individual health problem but also a social problem. In our study, we aimed to investigate the pathogenesis of chronic usage of methamphetamine via untargeted metabolomics approach. 38 plasma samples were carefully collected and extracted for untargeted metabolomics assay. A liquid-liquid extraction was performed to get as much metabolite as possible from the samples. After the extraction procedure, samples were transferred into vials and they were evaluated via time of flight mass spectrometry instrument. Significantly, altered metabolites were identified by the fold analysis and Welch's test between the groups. 42 different compounds were annotated regarding to data-dependent acquisition method. Pathway analysis were also performed to understand the hazardous effect of methamphetamine on human body. It has been reported that drug exposure may affect several metabolic pathways for amino acids, fats, energy metabolism and vitamins. An alternative bioinformatic model was also developed and validated in order to predict the chronic methamphetamine drug users in any criminal cases. This generated model passes the ROC curve analysis and permutation test and classify the controls and drug users correctly by evaluating the metabolic alterations between the groups.

Sexual Dysfunction, Marital Adjustment, and Quality of Life Among Male Persons with Alcohol Dependence Syndrome Attending Tertiary Healthcare Institution in Northeast India: A Cross-Sectional Study

Background: Sexual dysfunction is one of the major problems associated with the chronic use of alcohol. Sexual dysfunction is also significantly associated with marital adjustment and quality of life. Aim and objectives: To determine the prevalence of sexual dysfunction and its association with marital adjustment and quality of life among persons with alcohol dependence syndrome (ADS) and to compare with the healthy control group. Materials and methods: The present study used a cross-sectional, comparative, and descriptive research design. A purposive sampling technique was used to select the sample of 128 (64 patients with ADS and 64 healthy control persons) between the ages of 21 and 50, from the Department of Addiction Medicine, LGB Regional Institute of Mental Health (LGBRIMH), Tezpur, Assam. Sociodemographic and clinical data sheet, the Arizona Sexual Experience Scale (ASEX), the Severity of Alcohol Dependence Questionnaire (SDAQ), the Alcohol Use Disorders Identification Test (AUDIT), the International Index of Erectile Dysfunction (IIED), and The Drug Abuse Screening Test scales (DAST) were used. Results: The study revealed a higher prevalence of sexual dysfunction in the ADS group (64%) compared to the healthy control group (35.9%) (Chi-square = 46.916; p &lt; .001). Marital satisfaction was significantly lower in the ADS group than in the healthy control group (Fisher’s exact test = 76.932; p &lt; .001). Quality of life was also diminished in the ADS group, particularly in the physical ( t = −5.310; p &lt;.001), social ( t = −4.481; p &lt; .001), and environmental domains ( t = −4.250; p &lt; .001). Furthermore, sexual dysfunction exhibited a significant negative correlation with marital adjustment ( r = −0.676; p &lt; .01) and all domains of quality of life [physical domain ( r = −0.235; p &lt; .001), social domain ( r = −0.383; p &lt; .001), and environmental domain ( r = −0.383; p &lt; .001)]. Conclusion: The prevalence of sexual dysfunction and erectile dysfunction was high in persons with alcohol dependence syndrome as compared to the healthy control group and it has a relationship with marital adjustment and quality of life. The findings highlight the importance of screening and evaluating sexual dysfunction in individuals with alcohol dependence. Comprehensive pharmacological and nonpharmacological services are warranted to address the unique needs of this population, promoting both recovery from alcohol dependence and improvement in overall quality of life.

Evidence of Internal Structure Validity, Measurement Invariance, Convergent Validity, Clinical Validity, and Reliability of the Woman Abuse Screening Tool in Peruvian Women.

Intimate partner violence (IPV) is the most common type of violence committed against women and results in serious personal, familial, social, and economic consequences; thus, there is a need to detect IPV early. One test for detecting IPV is the Woman Abuse Screening Tool (WAST). The objective of the study was to obtain evidence of the validity of the WAST in terms of its internal structure, measurement invariance, convergent validity, clinical validity, and reliability. A total of 670 women who have or have had a heterosexual relationship participated in the study. The first stage included 513 adult women who partook of health services (M age = 35.5 years, SD age = 10 years). The second stage included 160 women, 80 diagnosed with IPV (M age = 34.2 years, SD age = 11.8 years) and 80 who were not (M age = 31.8 years, SD age = 11.5 years). We used multivariate and receiver operating characteristic curve analyses. We found evidence that the WAST demonstrates a one-dimensional structure; evidence of measurement invariance regarding cohabitation with the partner, length of the relationship, and age; evidence of convergent validity in terms of correlations with emotional dependence, self-compassion, expressive suppression, anxiety, and depression; and evidence of clinical validity in terms of the high probability of detecting positive cases of IPV. These properties support the use of the WAST for detecting possible cases of IPV, which will allow timely intervention. This instrument can also be used in larger studies on IPV in the Spanish-speaking population.

Psychometric Synthesis of the Drug Abuse Screening Test (DAST) Versions

Problem Statement Among individuals aged 12 years or older, 14.3% (40.0 million) reporting the use of an illicit drug in the previous year. Given the prevalence of drug abuse, it is increasingly important to determine effective screening practices, treatment procedures, and best practices among various subpopulations to identify drug use-related consequences. The DAST is one of the most commonly used and accurate drug screening tests. Method This psychometric synthesis of four versions of the Drug Abuse Screening Test (DAST-10, DAST-20, DAST-28, DAST-A) provided aggregated evidence from 346 articles over 40 years of published literature for score reliability, structure, diagnostic, and convergent validity, and descriptive statistics, all with the goal of informing counseling and medical practice and research. Results Results indicated adequate internal consistency (α = 0.81–0.84 across all four versions) and mostly medium to large effect size convergent correlations with comparison measures. Aggregated diagnostic validity data indicate optimal cutoff scores of 7 for DAST-10, 8 for DAST-20, 10 for DAST-28, and 6 for DAST-A. Discussion The DAST-10 appears the best choice for practical and psychometric reasons. Additional studies of the various DAST versions are needed to expand use across participant demographics. Public Statement of Relevance Drug use continues to be a societal problem and mental health practitioners need effective screening practices, treatment procedures, and best practices among various subpopulations to identify drug use-related consequences. This study synthesized 40 years of research on the four versions of the Drug Abuse Screening Test (DAST-10, DAST-20, DAST-28, DAST-A) and found acceptable levels of score reliability and validity for screening purposes.

Screening college athletes for sexual violence: athletes’ experiences and opinions on best practices

ObjectivesCollege athletes are at elevated risk for sexual violence, yet few formally report it and screening for sexual violence is uncommon. This study aimed to evaluate the nature of screening...

The effect of a behavioural intervention package on quality of life of pregnant women experiencing domestic violence: a randomised controlled trial

BackgroundDomestic violence during pregnancy is especially concerning due to its significant detrimental impact on a woman’s health and that of her unborn child. The study aims to evaluate the effects of a behavioural intervention package (BIP) delivered during pregnancy on the quality of life (QOL), domestic violence (DV), and reproductive and child health (RCH) of women experiencing DV.MethodsA randomised controlled trial was conducted on 211 pregnant women recruited between 18 and 20 weeks of pregnancy and randomly assigned to one of two groups: intervention (n = 105) or control (n = 106). The intervention group received BIP and standard care, while the control group received only standard care for 28 weeks. Study tools included socio-demographic variables, a short-form health survey, an abuse assessment screening tool, and an RCH checklist. The tools were completed once before the intervention and again at 6 weeks postnatal. The tools and their subscales were compared pre- and post-intervention using a paired t-test, or Wilcoxon signed test as appropriate to estimate the effect size at baseline and post-intervention.ResultsPost-intervention, the QOL scores were found to be significant, with a positive effect favouring the intervention as compared to the control group. The BIP intervention, which was found to be significantly effective (P ≤ 0.001) in reducing DV for pregnant women experiencing DV, was higher in the intervention group than in the control group.ConclusionThe BIP may be an appropriate method for treating pregnant women experiencing DV from low socioeconomic strata who attend public hospitals in India to improve their QOL. The approach may offer an intervention that healthcare institutions or other organizations in contact with women at risk of violence can implement.Trial registrationIndian Registry of Clinical Trials CTRI/2019/01/017009. Registered on 09/01/2019.

Beyond American College of Surgeons Verification: Quality Metrics Associated with High Performance at Level I and II Trauma Centers.

The American College of Surgeons (ACS) Committee on Trauma has established a framework for trauma center quality improvement. Despite efforts, recent studies show persistent variation in patient outcomes across national trauma centers. We aimed to investigate whether risk-adjusted mortality varies at the hospital level and if high-performing centers demonstrate better adherence to ACS Verification, Review, and Consultation (VRC) program quality measures. We analyzed data from the 2018-2021 ACS TQIP Participant Use Files, focusing on adult admissions at ACS-verified Level I or II trauma centers for blunt, penetrating, or isolated traumatic brain injury. We used mixed-effects models to assess center-specific risk-adjusted mortality and identified high-performing centers (HPTC), defined as those with the lowest decile of overall risk-adjusted mortality. We compared patient and hospital characteristics, outcomes, and adherence to ACS-VRC quality measures between HPTC and non-HPTC. Over the study period, 1,498,602 patients across 442 Level I and II trauma centers met inclusion criteria: 65.3% presenting with blunt injury, 9.3% with penetrating injury, and 25.4% with isolated TBI. Management at HPTC was associated with lower odds of major complications, failure-to-rescue and takeback. Furthermore, HPTC status was associated with increased odds of adherence to several ACS-VRC quality measures, including balanced resuscitation (Odds Ratio [OR] 1.40, 95%Confidence Interval [CI] 1.29-1.51), appropriate pediatric admissions (OR 1.88, 95%CI 1.07-3.68), and substance abuse screening (AOR 1.14, 95%CI 1.12-1.16). Significant variation in risk-adjusted mortality persists across trauma centers. Given the association between adherence to quality measures and high-performance, multidisciplinary efforts to refine and implement guidelines are warranted.

Assemble and validation of a simulated device of human exhaled breath aerosols for screening of illicit drug abuse by HPLC-TQ-MS/MS detection

Collecting exhaled breath aerosols (EBA) as a sample has a great potential to monitoring illicit drug abuse due to advantages of simple, non-invasiveness and unrestricted sampling. However, scarcity of positive samples has cramped development of more efficient techniques for monitoring illicit drug abuse in EBA. In this work, a simulated human exhaled breath aerosol (SHEBA) generating device based on Venturi jet principle was constructed by integrating nebulizing unit and collection unit to prepare positive EBAs. By means of ultra high-performance hyphenated with triple quadrupole tandem mass spectrometry (HPLC-TQ-MS/MS), using caffeine as a target drug, the device parameters were investigated by studying the effects of flow rates of nebulizing and auxiliary gases, drug concentration and etc., the performance was further validated by commonly abused drugs such as amphetamines (AMP, MAMP, MDA and MDMA). Electret material as adsorbent was used to collect SHEBAs generated by the device, achieving HPLC-TQ-MS/MS detection of the captured drugs at 40.0–2000.0 pg/filter. By this way, caffeine content in EBAs from six volunteers was successfully detected in the range of 51.6 ± 6.8–708 ± 51 pg/filter after drinking the caffeinated beverage. These validation experiments proved that SHEBA generating device could not only meet to the requirement of EBA analysis for illicit drug abuse at trace levels, but also provide the correction factors to calibrate the lower detection value caused by incomplete material adsorption.

The MACE-SCREEN – Screening for Abuse and Neglect Across Developmental Stages

ABSTRACT Few high-quality instruments are available to comprehensively screen for multiple interpersonal traumatic childhood experiences differentiated by developmental stage. One instrument assessing various forms of childhood trauma is the Maltreatment and Abuse Chronology of Exposure (MACE-X, Teicher & Parigger, 2015), which allows for the assessment of age at exposure for every item. The aim of this study is the development of a shorter version, which is suitable for screening. In- and out-patients (n = 719) of a somatic clinic were assessed with the German version of the 75-item MACE. Descriptive statistics, a nonparametric item response theory model (Mokken Scale Analysis), and factor analysis were combined to select items for a screening version. A screener (MACE-SCREEN) with 39 items allocated to five scales was developed. Scales differentiate between abuse types and neglect, direct experience vs. witnessing violence, and the age of the perpetrator (adults vs. peers). The scales showed good internal consistency (Alpha .78 to .91) and the total score a strong correlation with the total score of the long version (r = .96). This screening version is still comprehensive as it assesses exposure to various forms of interpersonal traumatic events, including peer violence and witnessing domestic abuse. As it also allows for the concurrent assessment of age at exposure, it lends itself to assessing exposure across developmental stages.

Intimate Partner Violence and Antenatal Depression Among Underserved Pregnant Women.

Introduction: Few studies have examined the associations of intimate partner violence (IPV) exposure during pregnancy and types of IPV with antenatal depression among underserved pregnant women. Methods: Data came from participants from a Healthy Start program in South Carolina between 2015 and 2019 (n = 1,629). The first two questions in the Woman Abuse Screening Tool (WAST) were used to measure IPV exposure, that is, having a problematic relationship with their partner. Those who had IPV exposure were assessed with six additional questions of the WAST. Principal component analysis was conducted on the 8-item WAST data to identify underlying types of IPV exposure. Antenatal depression was defined as the Center for Epidemiologic Studies Depression scores ≥16. Results: Participants were racially diverse (71% black, 21% white) with 85% Medicaid recipients. Nearly 12% of participants reported IPV exposure and 30% reported antenatal depression. The odds of having IPV exposure were higher among unmarried women, those with less than a high school education, and those who lacked family support. The odds of having antenatal depression were 2.5 times higher (95% CI: 1.9-3.5) among women with IPV exposure. After controlling for covariates, a one-point increase in the scores for psychological IPV (Factor 1) or a problematic relationship (Factor 3) was associated with increased odds of antenatal depression. Conclusion: This is one of the first studies to estimate the prevalence of IPV exposure using a proxy measure (a problematic relationship) among underserved U.S. pregnant women. Its positive association with antenatal depression suggests the utility of screening for a problematic relationship using a two-item WAST and providing assistance to those with IPV exposure.

An Integrative Review Exploring Womens' Experiences of Retraumatization Within Perinatal Services.

Evidence indicates that retraumatization has a detrimental effect for those women who are accessing perinatal services. One in five women worldwide has a history of childhood adversity. Between 18% and 34% of women experience trauma, which is a well-known risk factor for the onset of chronic mental health disorders. There is a lack of evidence on women's experiences on retraumatization in perinatal care settings and how to prevent retraumatization from occurring. The purpose of this study was to conduct an integrative review on women experiences of retraumatization to determine preventive measures within perinatal services. This integrative review followed Whittemore and Knafl's 5-stage framework as it allows for the inclusion and integration of diverse research methodologies into an overall synthesis of the evidence. A systematic search of 5 databases was conducted (Web of Science, MEDLINE, CINAHL, ASSIA, and PsychINFO) with no date, language, or geographical limits set due to the paucity of research published in this subject area. This review was conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Fifteen studies met the inclusion criteria and were included in the thematic synthesis. The review identified that participants across the studies had a history of child sexual abuse, sexual abuse, and rape. Three main themes plus subthemes were identified: (1) activating (subthemes: positions in labor, intimate procedures, communications with health care professionals, loss of control); (2) outcomes (subtheme: emotional responses); and (3) interventions reducing or preventing retraumatization (subthemes: role of the health care professional, screening for abuse and history of trauma). Our findings demonstrate that women are experiencing retraumatization in perinatal services, and there is evidence of formalized approaches being applied in clinical settings to prevent retraumatization from occurring. This study is the first to examine the factors that contribute to retraumatization in perinatal services and make recommendations to reduce the harmful practices in place in perinatal care settings.

The effect of a digital intervention on symptoms of depression in pregnant women exposed to Intimate partner violence in Denmark and Spain (STOP study)

Introduction and objectiveIntimate Partner Violence (IPV) during pregnancy is a significant public health concern associated with adverse maternal and fetal health outcomes, including increased risk of depression. This study aimed to assess the effectiveness of a digital empowerment-based intervention in reducing symptoms of depression among IPV-exposed pregnant women. Study designThis intervention study was nested within a cohort study conducted in Denmark and Spain. Pregnant women attending antenatal care were digital screened for IPV using the Abuse Assessment Screen (AAS) and the Women’s Abuse Screening Tool (WAST). Those screening positive were offered a digital intervention comprising 3–6 video consultations with trained IPV counsellors and access to a safety planning app. Changes in depression scores from baseline to follow-up were evaluated using mixed model regression. ResultsFrom February 2021-October 2022, 1,545 pregnant women (9.6 %) screened positive for IPV within our population (8.5 % in Denmark and 17.0 % in Spain) with 485 (31.4 %) meeting the criteria for the intervention. Of those eligible, 104 (21.4 %) accepted the intervention, and 55 completed it (13.1 %). Post-intervention, a significant reduction in Edinburgh Postnatal Depression Scale (EPDS) was found, with a mean difference of −3.9 (95 % CI: −5.3; −2.4), compared to the average pre-intervention score of 11.3. Stratifying the analyses across sociodemographic variables did not alter the overall result, indicating a reduction in EPDS scores irrespective of setting or sociodemographic factors. Notably, the intervention was most effective for women initially presenting with EPDS scores above the depression cut-off. ConclusionThe findings suggest that a brief digital intervention is associated with a reduction in depression symptoms among pregnant women exposed to IPV, particularly among those with high depressive scores. This highlights the potential of digital interventions in delivering counseling and shows efficacy when administered by both midwives and psychologists in diverse settings. However, the absence of a control group underscores the need for caution in interpreting the results.

Psychometric properties of the modified Drug Abuse Screening Test Sinhala version (DAST-SL): evaluation of reliability and validity in Sri Lanka

BackgroundPsychoactive drug use is an important public health issue in Sri Lanka as it causes substantial health, social and economic burden to the country. Screening for substance use disorders in people who use drugs is vital in preventive health care, as it can help to identify problematic use early. Screening can aid in referring those in need, for the most appropriate treatment and care. Thus, preventing them from developing severe substance use disorders with complications. The Drug Abuse Screening Test (DAST-10) is an evidence-based tool widely used to assess the severity of psychoactive drug use. This study aimed to culturally adapt and evaluate the validity and reliability of the Drug Abuse Screening Test (DAST-10) in Sri Lanka.MethodsThe DAST-10 was culturally adapted, and the nine-item Sinhala version (DAST-SL) was validated using exploratory and confirmatory factor analysis. The validation study was conducted in the Kandy district among people who use drugs, recruited using respondent-driven sampling. Criterion validity of the questionnaire was assessed by taking the diagnosis by a psychiatrist as the gold standard. Cut-off values for the modified questionnaire were developed by constructing Receiver Operating Characteristic (ROC) curves. The reliability of the DAST-SL was assessed by measuring its internal consistency and test re-test reliability.ResultsThe validated DAST-SL demonstrated a one-factor model. A cut-off value of ≥ 2 demonstrated the presence of substance use disorder and had a sensitivity of 98.7%, specificity of 91.7%, a positive predictive value of 98.8% and a negative predictive value of 91.3%. The area under the curve of the ROC curve was 0.98. A cut-off score of ≤ 1 was considered a low level of problems associated with drug use. The DAST-SL score of 2–3 demonstrated a moderate level of problem severity, a score of 4–6 demonstrated a substantial level of problems, and a score of ≥ 7 demonstrated a severe level of drug-related problems. The questionnaire demonstrated high reliability with an internal consistency of 0.80 determined by Kuder–Richardson Formula-20 and an inter-class correlation coefficient of 0.97 for test re-test reliability.ConclusionThe DAST-SL questionnaire is a valid and reliable tool to screen for drug use problem severity in people who use drugs in Sri Lanka.