Covert Abuse Research Articles

The Forms and Causes of Domestic Violence as Depicted in The Burdens and Black Mamba by John Ruganda

This paper examines the forms and causes of domestic violence in John Ruganda’s The Burdens (1972) and Black Mamba (1973). It is set to bring out how domestic violence affects characters in the plays and as well as people in society since it is a prevalent act in the universe. This paper establishes that domestic violence occurs in many forms, including physical aggression or assault (hitting, kicking, biting, shoving, restraining, kidnapping, unlawful imprisonment, trespassing, harassment) or threats thereof; sexual abuse, emotional abuse, controlling or domineering, intimidation, stalking, passive covert abuse (neglect), and economic deprivation. John Ruganda’s The Burdens expresses most forms of violence but physical assault stands out. The second issue is to establish the causes of domestic violence as explored in the two plays by John Ruganda. This paper has discovered that the bit of culture that accentuates domestic violence is inheritance. Black Mamba has a twist as far as the economic factors play a role in the cause of domestic violence. Economic factors are found to play a significant role in the causes of domestic violence. These factors include women’s economic dependence on men, limited access to cash and credit, discriminatory laws regarding inheritance, property rights, use of communal lands and maintenance after divorce or widowhood, limited access to employment in formal and informal sectors, and limited access to education and training for women. The legal causes include lesser legal status of women either by written law or by practice, inheritance, the legal definition of rape and domestic abuse, low level of legal literacy among women, and insensitive treatment of women and girls.

Subtle or covert abuse within intimate partner relationships: a scoping review protocol.

The objective of the review is to understand how academic literature on domestic violence has described or defined subtle, non-physical abuse in intimate heterosexual or same-sex relationships. Academic literature frequently refers to subtle or covert abuse in intimate relationships; however, this kind of abuse, while recognized by therapists who work with victims, has not yet been researched. Without understanding how clients experiencing subtle abuse present in therapy, therapists may misunderstand the cause of their distress and do more harm than good. This scoping review aims to understand how the current literature describes or defines subtle or covert abuse to inform future research to enable therapists to recognize subtle abuse in their clients. Academic work that describes or defines subtle or covert abuse in intimate partner relationships based on primary research or discussion papers published in English will be considered for inclusion. Work will be excluded if it only describes physical or overt non-physical abuse. MeSH terms and keywords relating to domestic violence literature found in preliminary searches were used to design the initial search strategies. Search terms based on these were chosen in discussion with a librarian. The following databases will be searched: PsycINFO (EBSCO), MEDLINE Complete (EBSCO), CINAHL (EBSCO), PsycArticles (EBSCO), and Scopus. Searches will be conducted for studies published between 1950 and 2021.

Undetected Ultracet™ dependence in an adolescent with nonmalignant back pain

Addiction to painkillers or other substances in pediatric and adolescent cases of noncancer chronic pain is an understudied phenomenon, even amidst documented increases in rates of prescription opioid use and misuse. Case studies can inform the training of clinicians in ethically negotiating a balance between optimizing analgesia and mitigating risk of aberrant drug-taking behaviors. This report discusses an 18-year-old woman with idiopathic scoliosis and clinical depression secondary to undertreated refractory chronic back pain who underwent surgery to correct pseudoarthrosis after a prior spinal instrumentation operation. This intervention in conjunction with a course of patient-controlled analgesia, hydromorphone, and outpatient tramadol, naproxen, methadone, and gabapentin was successful in addressing her long-standing lumbar pain. The patient, however, continued to complain to her pain management team of postsurgical discomfort and insisted on being prescribed Ultracet™ (acetaminophen-tramadol) rather than generic tramadol. The patient's eventual disclosure of severe withdrawal discomfort and history of covert abuse of Ultracet™ is discussed with respect to key warning signs, gaps, and contingencies in the screening, surgical, and pain management processes.

Healing the Caregiving System: Working With Parents Within a Comprehensive EMDR Treatment

This article is an excerpt from the book EMDR Therapy and Adjunct Approaches With Children: Complex Trauma, Attachment, and Dissociation. It presents an original model to work with caregivers of children with complex trauma. This model comprises 3 levels of parental involvement within a comprehensive eye movement desensitization and reprocessing (EMDR) treatment: psychoeducation, self-regulation, and memory reprocessing and integration (Gomez, 2009, 2012a, 2012b). Mentalization and reflective function (Fonagy & Target, 1997), mindsight (Siegel, 1999, 2010), mind-mindedness (Meins, Fernyhough, Fradley, & Tuckey, 2002), insightfulness (Koren-Karie, Oppenheim, Dolev, Sher, & Etziom-Carasso, 2002), and metacognitive monitoring (Flavell, 1979; Main, 1991) are all constructs linked to the parent’s capacity to develop infant’s attachment security. However, unresolved trauma and loss appears to impair these capacities in parents. Many children wounded by caregivers lacking such competences had to endure repetitive emotional, physical, and sexual overt and covert abuse; enmeshment and intrusiveness; or on the contrary, detachment and lack of connection. When the caregivers have been the wounding agents, their inclusion and active participation in the overall treatment of their children is fundamental.

Abused Children May Develop Subtle Physiological Changes

Abused Children May Develop Subtle Physiological Changes

Covert outpatient drug abuse. Incidence and therapist recognition.

One hundred ninety-five consecutive psychiatric outpatients were surveyed for covert drug abuse by a standardized technique for determining opiates, cocaine, barbiturates, and amphetamines in urine samples. On the basis of demographic variables, diagnostic information, and treatment course, patterns of abuse were defined for the 13.3 per cent with positive test results. Covert abusers demonstrated a higher incidence of adverse drug reactions and a less favorable therapy course than controls. Covert abuse was meaningfuly related to misdiagnosis, management problems, and therapist's response. Demographic variables and patient reports of previous abuse were not found to be reliable predicators of covert drug abuse. Urine screening for drug use is recommended as an aid to proper diagnosis of psychiatric outpatients that present diagnostic questions.

Covert forms of child abuse: a preliminary study.

Child abuse has generally been recognized only in its more obvious physical manifestations. The possibility of less obvious though serious forms of abuse is considered by offering a more expansive definition of child abuse, which includes a category that the investigators term “covert abuse.” The question is raised as to whether or not these more subtle forms of abuse result in a negative developmental outcome in the child. To answer this question, the investigators hypothesized that in the histories of young adult drug abusers, a high incidence of covert abuse would be found. To test this hypothesis, a self-report questionnaire was designed and administered to the 57 male and female residents (mean age of 20.2 years) in two facilities of a nationally based drug treatment program in the United States. As expected, it was found that the population reported a consistently high incidence of family disruption during childhood. A statistically significant relationship was demonstrated between hard-core drug abuse in the subjects and a lack of parental demonstrativeness toward each other. Results of the study suggest that overt forms of abuse are not the only types of abuse that may be developmentally destructive to a child; covert forms of abuse are possible contributors to a negative developmental outcome as well.

The effect of unrecognized drug abuse on diagnosis and therapeutic outcome.

One-hundred and ninety-five consecutive psychiatric outpatients had urine sampled for the presence of opiates, cocaine, barbiturates, and amphetamines. All patients had demographic variables, diagnostic information, and treatment course analyzed in a blind fashion using preselected criteria. Patterns of abuse were defined for the 13.3% of the total sample who were covert abusers. An analysis of diagnostic accuracy for abusing and nonabusing populations indicated that covert abuse markedly distorted diagnosis and management. The study indicates that demographic variables and previous history were not reliable predicators of covert abuse. Drug abuse was a major factor in distorting the accuracy of diagnosis. Drug abusers were significantly less likely to improve with therapy than were nonabusers. Barbiturate abusers were most likely to suffer from adverse drug reactions. Urine screening for drugs was the single most valuable diagnostic tool and was felt to be indicated in all cases where diagnostic confusion was present. Therapists saw the covert abuser as sick out of proportion to their social behavior, were perplexed and frightened by these patients' dependency, and perceived them as too brittle for therapy. Therapists behaved very differently with these patients than with diagnostically matched controls. They misdiagnosed them four times more often, missed appointments with them seven times more often, and were ten times more likely to refer them to another therapist or agency. Therapist anxiety and "flight from therapy" with covertly abusing patients are discussed.