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Violencia contra la mujer en la pareja y consecuencias en la salud física y psíquica

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Abstract

Intimate partner violence is currently a public health issue of great relevance. The aim of this article is to present through a literature review, the physical and psychological health problems that, beyond physical injuries, can alert health care professionals of the presence of spouse abuse in their care centers. Literature consistently shows that victims of the so called «domestic violence» present, compared with no victims, more chronic health problems like fibromyalgia, gastrointestinal disorders like irritable bowel syndrome, and gynaecological signs including sexually transmitted diseases, as well as post-traumatic stress disorder, anxiety and depression among others. The broad range of pathologies associated with the abuse of a sexual intimate suggests that victims will attend different health care services. These could play a key role to help these women and refer them to the appropriate legal, social and/or community services.

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... Dentro del TEPT puede presentarse junto con el Síndrome de la Mujer Maltratada según Lorente, Lorente, Lorente, Martínez y Villanueva, (1998) dicho Síndrome consta de una serie de lesiones tanto de forma físicas como psicológicas que realiza el hombre que está ligado de forma afectiva a una mujer en repetidas ocasiones y este se caracteriza por criterios como recuerdos perturbadores, hiperexcitación, elevados niveles de ansiedad, conducta elusiva que se expresan con eventos depresivos, disociativos, represión, relaciones interpersonales conflictivas, distorsión de la imagen corporal y afectación en la salud física incluyendo algunos problemas sexuales, también puede presentarse conductas de impotencias y optimismo aprendidos. Por ende, la mujer puede retomar sentimientos de resignación que le permite aceptar la consecución de actos violentos (Cascardi y O'Leary, 1992;Plazaola-Castaño, & Pérez, 2004). ...
... Otros estudios que evidencian esta situación que las mujeres padecen y explican el retorno con su agresor desde este síndrome, como lo hicieron Miramontes y Mañas (2018)que demostraron que el retorno con la pareja es más que por la dependencia económica. En algunos casos se presentan casos de Síndrome General de Adaptación donde las mujeres pueden presentar los tres signos de este síndrome que son alarma, resistencia y agotamiento Plazaola-Castaño, & Pérez, 2004;Moreno, & Ordoño, 2009). ...
... Otro número de víctimas quedan con secuelas no solo de índole psicológico sino también de índole físico, sufriendo daños de diferentes traumas debido a los golpes recibidos, llegando a producir enfermedades dependiendo de donde se produce el daño, como problemas crónicos como fibromialgia, trastornos gastrointestinales, síndrome de colon irritable y ginecológicos, enfermedades de transmisión sexual, trastorno por estrés postraumático, ansiedad y trastornos depresivos, como lo demuestra Plazaola- Castaño & Pérez (2004). Los ataques que el victimario realiza sobre la mujer son en la cabeza directamente o en el vientre en Rodríguez (2018). ...
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Resumen: El feminicidio es considerado como un evento cruel que atenta contra los derechos e integridad física de las mujeres a nivel mundial, detrás feminicidio se genera una serie amplia de consecuencias negativas que se desarrollan y enfrentan de forma directa a víctima, victimario, hijos y familiares, este trabajo de investigación ayuda a comprender y permite reunir las consecuencias del feminicidio desde los diferentes puntos de vista. Este trabajo busca determinar el impacto psicológico, biológico y social que desencadena la problemática del feminicidio desde las perspectivas de la víctima, victimario y familiares que afrontan este evento. Abstract: Feminicide is one of the most malignant human acts that go against human rights and women physical integrity worldwide. Behind feminicide there is a variety of negatives consequences that develop and affects straight victims, aggressors, children and family. This research attempts to broaden our understanding of feminicide consequences from different points of view. This article analizes psychological, biological and social impact that surround the feminicide problematic from the victims, aggressors and relatives who face the event. approaches the issue from psychological, biological and social consequences resulted from feminicide.
... La violencia contra las mujeres tiene graves repercusiones sobre su salud 45 . Distintos trabajos han documentado mayor prevalencia de depresión, ansiedad, insomnio, baja autoestima, ideación suicida, conductas autolesivas, problemas osteomusculares, infecciones de transmisión sexual, tabaquismo y mayor consumo de medicamentos entre las mujeres que padecen situaciones de violencia doméstica en comparación con quienes no la sufren 46,47 . En consecuencia, tienden a tener más contacto con los centros de atención medica que, en muchas situaciones, constituyen el primer recurso al que se acercan para buscar ayuda 47 . ...
... En este punto es importante remarcar que la violencia doméstica suele ser causa subyacente de procesos crónicos, tanto en niños 60 como en mujeres adultas, entre quienes se observan mayores índices de cuadros como fibromialgia, colon irritable, enfermedades de transmisión sexual, trastorno por estrés postraumático, ansiedad y trastornos depresivos, entre otros 46,47 . Todos ellos son motivos de consulta frecuentes en la práctica médica ambulatoria. ...
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La violencia por cuestiones de género es un fenómeno histórico, complejo y prevalente a nivel mundial. Definida por la Organización de las Naciones Unidas como “todo acto de violencia basado en la pertenencia al sexo femenino, que tenga o pueda tener como resultado un daño o sufrimiento físico, sexual o psicológico para la mujer, así como las amenazas de tales actos, la coacción o la privación arbitraria de la libertad, tanto si se producen en la vida pública como en la privada”, la violencia contra la mujer constituye una violación de los derechos humanos y por lo tanto, una cuestión de Estado. Las autoras de este artículo repasan el marco legal que aborda este problema en la Argentina, las dificultades del sistema sanitario (a nivel institucional e individual) en la detección y asistencia de las personas que lo padecen y la necesidad de sensibilización y capacitación de los profesionales de la salud.
... Los estudios previos, en muestras generales evidencian que la VcM genera un daño físico y emocional en las sobrevivientes, en un corto y largo plazo. Las sobrevivientes presentan altos niveles de depresión, angustia emocional, pérdida de memoria, pensamientos de tendencia suicida, ansiedad, trastornos de estrés postraumáticos, disminución de la autoestima, conductas suicidas, abuso de alcohol y de otras sustancias, y trastornos de la personalidad (Castaño & Ruiz, 2004;Solórzano, 2007;Vargas, 2017;Gonzales, 2017;Del Castillo et al., 2015;Constantino et al., 2020). ...
... Muchas*os investigadoras*es han escrito sobre el impacto de la VcM de cualquiera de sus formas: psicológica, económica, física o sexual en la salud mental, en muchos casos el efecto es inmediato y en otros la violencia ejercida tiene efectos al correr el tiempo. Las mujeres agredidas presentan trastornos emocionales como la depresión, ansiedad, estrés, entre otros y puede llegar hasta los intentos de suicidio, sobre todo a largo plazo (Constantino et al., 2020;Castaño et al., 2004;Vargas, 2017;Solórzano M. 2007;Torres et al., 2018). De acuerdo con la literatura en el orden clínico las universitarias corren el riesgo de pasar del estado de estrés a la depresión y llegar hasta intentos de suicidio, situación muy preocupante ya que la salud física o mental es determinante para un buen rendimiento académico. ...
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Se determina cómo la violencia contra las mujeres universitarias por sus parejas (VcM) influye en el abandono de cursos académicos. Se encuestó a una muestra aleatoria representativa de 1,461 estudiantes mujeres, con pareja, de la Universidad Mayor de San Andrés (UMSA), la más grande en relación al número de estudiantes del sistema público de las universidades de Bolivia. La investigación se focalizó en el 19.7% de estudiantes que ha reportado haber abandonado al menos un curso durante el año 2020 (n=285). Mediante un cuestionario estructurado en base a 22 indicadores oficiales del Instituto Nacional de Estadística (INE) para medir violencia contra las mujeres en relaciones de pareja, se determinó que el 57% de mujeres que han abandonado al menos un curso durante el año 2020, ha sido agredidas por sus parejas o exparejas. Se comprobó, efectivamente, que la violencia contra las mujeres aumenta en 21% la probabilidad de abandonar cursos universitarios.
... Varios autores en distintas regiones plantearon que la violencia doméstica y de pareja (VP) trae consigo problemas médicos tales como mayor hospitalización, aumento de posibilidades de cáncer, infecciones de transmisión sexual y abortos provocados (Gibbons, 2011;Plazaola-Castaño & Ruiz Pérez, 2004). ...
... Acorde a la bibliografía consultada, el estudio muestra una alta tasa de depresión entre las mujeres que sufren violencia de pareja. En el mundo, diversas investigaciones observan que la depresión junto a los trastornos de ansiedad son los dos problemas de salud mental más frecuentes entre las víctimas mujeres (Amor, Echeburúa, de Corral, Zubizarreta, & Sarasua, 2002;Plazaola-Castaño, 2004). ...
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Domestic violence against women is a human rights and public health problem that affects between 15 and 71% of women in the world (World Health Organization, 2005). Uruguay has a prevalence of 27.7% of domestic violence against women, predominantly intimate partner violence, but its effects on mental health have not been studied with a clinical method. Objective: to quantify the frequency of depression and suicidal ideation (SI) in women victims of intimate partner violence and to estimate the association with sociodemographic variables, moment of violence and pregnancy, excluding other causes of depressive symptoms. Method: case-control study with users from the Centro de Salud Jardines del Hipódromo in Montevideo, 30 cases and 28 controls. We applied short WAST, clinical interview, Depression Inventory and Beck Suicidal Ideation Scale. Results: 56.7% of cases present depression vs 14.3% of controls. The Odds ratio for depression in cases vs controls is 7,846. The frequency of IS is 20% of the cases and 3.6% in the controls and that of depression + suicidal ideation is 17% of the cases. The presence of depression and IS is independent of the rest of the variables except marital status (x2 = 19,408a, p <0,001). Single, separated and / or divorced women have more cases of depression compared to married or in free union: 81% vs 19%. Conclusions: intimate partner violence is a high risk factor for depression and suicidal behaviors.
... Esto no es cierto, la violencia que soportan puede ser más psicológica, pero también afecta a su identidad como mujeres, causando les un daño muy importante. (10) ...
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This study on psychological violence against women in the canton of Santo Domingo combines qualitative and quantitative approaches, with the objective of making this problem and its legal treatment visible. The research highlights the importance of evidence as a fundamental resource in criminal proceedings, focusing on how this form of violence is applied according to the Organic Integral Criminal Code and the Law to Prevent and Eradicate Violence Against Women. Through inductive-deductive, historical-logical and scientific methodologies, the prevalence of this problem was evidenced. Psychological violence, which includes insults, threats, emotional manipulation and isolation, has serious emotional consequences for the victims. It is crucial to raise awareness and promote social change to eradicate this form of abuse and promote relationships based on respect and equity
... However, due to the persistent stigma surrounding mental health, it can be difficult to detect mental health disorders as a consequence of GBV. Similarly, having multiple pathologies can revictimize some women, especially in those environments where there is insufficient training and awareness to support this type of patient [44]. ...
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Background Violence against women is a serious public health problem. Primary care could be one of the ideal places for the detection of gender-based violence (GBV), since women come into contact with PC at some point in their lives to look after their sexual and reproductive health. The increase in initiatives promoted by the health authorities regarding GBV offers the possibility of observing its evolution over the last few years. Methods A descriptive cross-sectional study of reported cases of GBV in the region of Central Catalonia, during the period from 2017 to 2021, was carried out. All women of legal age, belonging to the specified health region and suffering episodes of GBV, were included. The variables analysed were age, area of residence, health diagnoses related to GBV, whether or not they were pregnant at the time of the attack, and mental health history. Results Of the total number of women studied, 1,467 presented some type of diagnosis of GBV, with a total of 3,452 episodes reported. We found an increase in the detection of cases, although it must be noted that there is an underreporting of cases in PC. The prevalence according to the total number of women assigned per year over the period studied was 0.42% in 2017 and 0.48% in 2021. It has also been observed that the average number of episodes per woman increased from 1.03 in 2017 to 1.15 in 2021. During the 5 years analysed, the minimum number of episodes per woman was 1 and the maximum was 10. In reference to the duration of the episodes, the minimum was 1 day, and the maximum was 32 years. The mean age of the women was 42.10 years, the most frequent nationality was Spanish (46.60%), and 54.15% of them lived in rural areas. Conclusions Despite the established protocols and procedures, it seems that primary health care is not the most frequent place for its detection. It is necessary to continue working to raise awareness and train professionals, and to ensure coordination among all the parties involved in accompanying women in these processes. Trial registration CEIm: 21/278-P.
... El interés por abordar todos los tipos de maltrato radica en que hay numerosos indicios que apuntan a que los distintos tipos de maltrato pueden tener diferentes repercusiones en la salud de la mujer (Plazaola-Castaño y Ruiz-Pérez, 2004). Algunos estudios muestran que todos los tipos de maltrato conllevan en las víctimas un efecto acumulativo, con lo cual aquellas mujeres que sufran varios tipos de maltrato tendrán peores efectos en su salud respecto a las que solo experimenten un tipo (Campbell, 2002). ...
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Resumen La violencia de género evidencia la desigualdad, la subordinación y las relaciones de poder de los hombres sobre las mujeres, que podrían generar déficits neuropsicológicos y síntomas psicopatológicos. Con el objetivo de analizar estas consecuencias se realizó una investigación en la que participaron 34 mujeres (17 víctimas de violencia de género, con edades entre los 25 y los 60 años). Las herramientas de evaluación utilizadas se han dividido en 2: por un lado, pruebas neuropsicológicas para medir la velocidad de procesamiento, la atención y la memoria: TMT A, TMT B, letras y números, cubos de Corsi, HVLT y d2; por otro lado, pruebas psicopatológicas para medir la ansiedad, la depresión, el abuso y el estrés postraumático: STAI, BDI-II, ISA y EGEP-5. Los resultados mostraron que el abuso está relacionado con mayores déficits neuropsicológicos y numerosos síntomas psicopatológicos. Además, los niveles altos de estrés se relacionaron con una peor memoria de trabajo. Por otro lado, no se encontraron diferencias significativas en relación con el tipo de abuso en los síntomas psicopatológicos, pero sí en algunas variables neuropsicológicas como la memoria a largo plazo y la memoria visual de trabajo. Los datos obtenidos apuntan a la necesidad de centrar la atención en la causa de estas diferencias que podrían estar relacionadas con el abuso físico y psicológico, así como en los efectos que estos déficits cognitivos y el incremento en los niveles de ansiedad y depresión tienen sobre la calidad de vida de las mujeres maltratadas.
... Not taking into account this type of violence in the intervention of health professionals is a problem that indicates the need for training (Plazaola-Castaño & Ruiz-Pérez, 2004;Salvador, 2015;Valls-Llobet, 2008). At the last CEDAW (2015) convention in Geneva, this issue was highly critical in Spain, highlighting the need for improvements of our work teams in terms of awareness of gender differences. ...
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Gender violence (GV) refers to a structural social problem with important social and psychological implications and consequences on the physical and mental health of the women who suffer from it. GV in this chapter refers solely to men against women in an intimate relationship. Thus, in the literature it is often considered as intimate partner violence against women (IPVAW) to differentiate it from general GV, whichcould occur in different contexts. GV is a multi-causal phenomenon (including but not limited to areas such as education, economy, labor, family, or partners), and the effects of this violence in IPVAW on health requires further research. Moreover, it is necessary to address why some women develop more health problems and more serious issues associated with greater consumption of drugs than other women. Most analyses rely on psychological evaluation and intervention and focus on how to face and overcome the GV episodes. However, they fail to address other variables that could prevent or protect women from suffering these effects. In our chapter, we develop two of the variables that may act as protective factors for women suffering gender violence from their partners: resilience and emotional intelligence. Along these lines, we propose that interventions in both resilience and emotional intelligence could protect women from suffering, and men from using, IPVAW in heterosexual contexts.
... Not taking into account this type of violence in the intervention of health professionals is a problem that indicates the need for training (Plazaola-Castaño & Ruiz-Pérez, 2004;Salvador, 2015;Valls-Llobet, 2008). At the last CEDAW (2015) convention in Geneva, this issue was highly critical in Spain, highlighting the need for improvements of our work teams in terms of awareness of gender differences. ...
Article
Intimate partner violence against women (IPVAW) implicates various psychological health problems in women who suffer from it, often associated with the consumption of drugs. To date, studies mainly focus on quantitate data about psychopathological disorders. However, there are factors (i.e. resilience) preventing women from suffering and also helping to overcome certain psychological alterations and trauma. To analyze how resilient (or not) women face this gender violence situation and how their past events influence their current situation, 60 women from Spain (mean age = 37.03; SD = 10.02; range = 21–61) were in-depth interviewed following the life stories method. Furthermore, once the interviews were processed, we content analyzed data to categorize responses into high and low resilience. Thus, we could analyze the relationship among variables. In particular, women with a higher level of resilience show a less development of psychopathologies and drug consumption. As a result resilience proves to be a key aspect to improve and promote the reduction of mental health problems in victims of gender violence.
... En los últimos años, la violencia en las relaciones de noviazgo, ha generado investigaciones a nivel mundial. Hasta el momento, los estudios (Castro y Riquer, 2003 [7]; Larrain Heiremans, 1994 [8]; Moreno Martín, 1999 [9]; Plazaola-Castaño y Ruíz Pérez, 2004 [10]; Traverso, 2007 [11]; Tuesca-Molina y Borda, 2003 [12]) habían centrado su interés en las relaciones violentas dentro de la pareja conyugal (conviviente o casada), analizando sus diferentes modalidades para poder dar respuestas eficaces, desde la asistencia y la prevención. Estas investigaciones permitieron detectar que esta modalidad de vinculación afectiva (signada por la violencia), se había establecido ya durante el noviazgo; es decir que la presencia de violencia en las relaciones de noviazgo suele ser un predictor de la aparición de tal conducta durante el matrimonio. ...
Article
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Objetivo: describir las características de la violencia psicológica en las relaciones de noviazgo, respecto a su percepción, modalidades y respuesta hacia la misma, en estudiantes de la Facultad de Psicología de la Universidad del Aconcagua. Materiales y métodos: investigación cuantitativa, estudio descriptivo, diseño transversal con encuestas. Muestra intencional de 452 alumnos de las carreras Licenciatura en Psicología y Licenciatura en Niñez, Adolescencia y Familia, ambos sexos, edad promedio de 22 años, que hubieran mantenido o que mantuvieran en ese momento una relación de noviazgo. Instrumento: Cuestionario de Violencia Psicológica en las Relaciones de Noviazgo (Marchiori, Lucientes de Funes, Puente de Camaño y Bordón, 2013). Resultados: presencia, en frecuencias que van desde ocasionalmente hasta siempre, de veintitrés conductas o actitudes de la violencia psicológica en las relaciones de noviazgo. La conducta más frecuente en las relaciones de noviazgo de los participantes fue el Oposicionismo (72,1%) y la menos frecuente la Amenaza de muerte (3,1%). El 56% de los participantes experimentaron angustia ante la ocurrencia de tales conductas o actitudes, el 50% tristeza y el 49% enojo. Se encontraron diferencias entre las emociones más experimentadas por los hombres y mujeres de la muestra; también en lo que respecta a las conductas o actitudes que refieren recibir de parte de sus parejas hacia ellas o ellos. Conclusiones: Las conductas o actitudes de la violencia psicológica en las relaciones de noviazgo han afectado a los participantes; y este tipo de violencia es considerado, mayormente, como un problema de pareja y en menor medida como un problema social.
... Estas repercusiones derivadas del maltrato pueden ser inmediatas o latentes y perdurar en el tiempo (Krug, Dahlberg, Mercy, Zwi y Lozano, 2003), suponiendo una gran interferencia en el funcionamiento cotidiano e inadaptación de la vida diaria (Paz, Labrador, Arinero y Crespo, 2004). Algunas de las consecuencias negativas en la salud de las mujeres maltratadas son los trastornos gastrointestinales y ginecológicos (Plazaola-Castaño y Ruiz, 2004), insomnio, menor autoestima (Matud, 2004), cambios en el estado de ánimo (Sanz-Barbero, Rey y Otero-García, 2014), dolor crónico (Coker, Smith, Bethea, King y McKeown, 2000) y sensación de fatiga crónica (Amor et al., 2006), entre otros. ...
Article
Resumen La violencia sufrida por las mujeres tiene importantes consecuencias en la salud y supone un patrón de comportamiento que se expresa, entre otros, a través de la satisfacción en la pareja o el tipo de amor en la relación. Como consecuencia, los objetivos del estudio han sido analizar la relación entre la violencia, las actitudes amorosas, la satisfacción de la relación y la salud, y estudiar el papel mediador de las actitudes amorosas en la relación entre la violencia y la salud percibida en la mujer. La muestra estuvo conformada por 250 mujeres residentes en la Comunidad Autónoma del País Vasco. La edad media fue de 58.66 años (dt = 10.46). Los resultados mostraron que la salud general muestra una relación positiva con la negociación emocional y cognitiva, y negativa con el abuso psicológico severo y con las actitudes amorosas Ludus y Storge. La satisfacción marital mostró una correlación positiva con la negociación emocional y con el estilo de amor Ludus y una correlación negativa con Eros y Ágape. A su vez, el abuso psicológico se ha relacionado en sentido negativo con el rol físico y el rol emocional. Las actitudes amorosas mostraron un papel mediador en la relación entre el abuso, la satisfacción marital y la salud de las mujeres.
... Murphy, Morrel, Elliott & Neavins (2003) por su parte, identifican la violencia psicológica como única variable capaz de pronosticar la reincidencia de la violencia física de forma significativa y consistente en la pareja. No hay que olvidar que la violencia psicológica parece ser más frecuente y con consecuencias equiparables o más severas que las agresiones físicas (Labrador, Fernández-Velasco & Rincón, 2010) aunque éstas sean más difíciles de predecir (Schumacher, Smith & Heyman, 2001;Street & Arias, 2001) Por otro lado, a pesar de la elevada incidencia de relaciones violentas durante el noviazgo (Kelly, Cheng, Peralez-Dieckmann & Martinez, 2009) y la presencia de investigaciones que han intentado abordar los problemas psicológicos que originan que las víctimas de violencia soliciten ayuda profesional (Alonso & Labrador, 2008;Rincón, Labrador, Arinero & Crespo, 2004;Sarasúa, Zubizarreta, Echeburúa& Corral, 2007), seguimos encontrándonos con un vacío importante en el ámbito científico (Sims, 2008) de trabajos encaminados al estudio del maltrato psicológico como un fenómeno con entidad propia (Domínguez, García, Cuberos, 2008;Ellsberg, Jansen, Heise, Watts & Garcia-Moreno, 2008;Pico, García, Celda, Blasco, Echeburúa & Martínez, 2006;Instituto Andaluz de la Mujer, 2006;Plazaola & Pérez, 2004;Ruiz & Plazaola,2005). ...
... Murphy, Morrel, Elliott & Neavins (2003) por su parte, identifican la violencia psicológica como única variable capaz de pronosticar la reincidencia de la violencia física de forma significativa y consistente en la pareja. No hay que olvidar que la violencia psicológica parece ser más frecuente y con consecuencias equiparables o más severas que las agresiones físicas (Labrador, Fernández-Velasco & Rincón, 2010) aunque éstas sean más difíciles de predecir (Schumacher, Smith & Heyman, 2001;Street & Arias, 2001) Por otro lado, a pesar de la elevada incidencia de relaciones violentas durante el noviazgo (Kelly, Cheng, Peralez-Dieckmann & Martinez, 2009) y la presencia de investigaciones que han intentado abordar los problemas psicológicos que originan que las víctimas de violencia soliciten ayuda profesional (Alonso & Labrador, 2008;Rincón, Labrador, Arinero & Crespo, 2004;Sarasúa, Zubizarreta, Echeburúa& Corral, 2007), seguimos encontrándonos con un vacío importante en el ámbito científico (Sims, 2008) de trabajos encaminados al estudio del maltrato psicológico como un fenómeno con entidad propia (Domínguez, García, Cuberos, 2008;Ellsberg, Jansen, Heise, Watts & Garcia-Moreno, 2008;Pico, García, Celda, Blasco, Echeburúa & Martínez, 2006;Instituto Andaluz de la Mujer, 2006;Plazaola & Pérez, 2004;Ruiz & Plazaola,2005). ...
... [8][9][10] No obstante, aunque existen algunas investigaciones 11-13 que han intentado abordar los problemas psicológicos que originan que las víctimas de violencia soliciten ayuda profesional, seguimos encontrándonos con un vacío importante en el ámbito científico 14 de trabajos encaminados al estudio del maltrato psicológico con entidad propia. [15][16][17][18][19] Esta inmadurez conceptual en la investigación de la violencia psicológica nos plantea cuestiones tales como: ¿cómo intervenir en algo que no sabemos con exactitud qué es? El Instituto Andaluz de la Mujer (2006) 20 define el maltrato psicológico como "cualquier acto o conducta que hiera la dignidad y pueda provocar la desvalorización, humillación, sufrimiento o enfermedad mental (insultos, vejaciones, crueldad mental), así como aquellos actos o conductas que ocasionen un clima de angustia (espía, ignorar, controlar los recursos económicos, amenazas y coacciones)". ...
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Nowadays, violence within couples is the most alarming form of interpersonal violence. It could even be considered a public health problem. Nevertheless, although the magnitude is as serious as the repercussions of the aggression suffered by the victims, there is a general tendency to restrict the focus of attention to the physical aspect of the problem. Thus, the study of psychological abuse is relegated to a secondary plane, ignoring those works that demonstrate the presence of psychological aggression with serious consequences, comparable to or even greater than those of a physical nature, even though the former are more difficult to predict. For this reason, there is little consensus concerning the specific behaviour patterns that make up psychological abuse. Nevertheless, among its most evident characteristics, we can point to such manifestations as insults, criticism, humiliations, disparagement or ridicule, both in public and in private, social and economic isolation, repeated threats to either abandon the relationship or to seek a divorce, threats of abuse towards the victims or their loved ones and those related with harming or destroying the victim's cherished belongings, whether they be objects or animals, which may be psychologically traumatic for the victim. On the other hand, such conduct as manipulating information, affective neglect, denial of violence and putting the blame entirely on the victim can be listed as hidden expressions or psychological abuse in couples. Similarly, several works have established a link between a wide range of psychological and behavioural symptoms connected to psychological violence in couples with numerous aspects of emotional intelligence. On an interpersonal level, conflictive couples seem to respond to communicative registers for removed from emotional intelligence or such partner skills as empathy, self-control and co-operation, thus leading to violent relational dynamics. The current research analyses psychological abuse in couples (disparagement, hostility, indifference, intimidation, imposition of behaviour patterns, blaming and apparent kindness) and its connection with the level of emotional competence (emotiveness, efficacy, rigidity and illusion) shown by the individuals that make up the couple. The research was carried out in the context of the University of Extremadura (Spain). The sample was selected randomly and was made up of 1 080 university students, of whom 332 were male and 748 female, aged in four categories covering the range from 17 to 23 years or more. Following the sample selection, the deans and department directors were informed of the aims of the research, their approval was sought to implement the research instruments and to guarantee the collaboration of the lecturers in the various degree subjects chosen. Then, a joint calendar was established to apply the tests. The surveys were carried out during the academic years 2007/2008 and 2008/2009. The tests were collectively administered in single sessions. Copies of the survey were handed out along with instructions. Volunteers were then told to fill in personal data and the instructions were read out aloud, stressing the importance of answering all the questions without exception. Finally, doubts were answered, taking care not to influence the subjects' replies. The confidentiality of the students' answers was guaranteed by coding each questionnaire with a numerical identification. After the questionnaires were handed in, the students' replies were checked for compliance with the protocols, and on the basis of atypical replies and questions left unanswered. Only two questionnaires were eliminated due to protocol and no atypical answers or unanswered questions were found. The order was exactly the same for all the applications: First of all the Inventory of Constructive Thought (15 to 30 minutes), and secondly the Questionnaire on Psychological Abuse (15 to 20 minutes). The main results of the study, with respect to the indicators of psychological abuse in couples, are as follows: the existence of patterns of psychological violence in the relationships of couples of university students is confirmed. Of the most significant sub-factors of psychological abuse, the most frequently used by these young people were those included in (3) Indifference, while the least commonly used were those included in (7) Apparent Kindness. As for the relationship between psychologically abusive behaviour patterns and emotional competence during pre-marital relationships, there are significant differences. Finally, the presence of significant correlations between most factors and sub-factors of psychological abuse in couples and the different emotional skills is confirmed. To conclude, it can be said that the research provides evidence that the indicators of psychological abuse in couples start to appear during pre-marital relationships. An analysis of the results demonstrates that these subjects put into practice such indicators and/or manifestations as: trivializations, reproaches, lack of empathy or support, judging, criticising, correcting, abusive insistence and accusations. The students from the sample show no marked tendency towards the exercise of any form of psychological violence in particular. Rather, they exhibit a heterogeneous behavioural repertory made up of disparagement, confrontation, lack of interest or affection, coercion, attempts to restrict the victim psychologically or socially, and blaming the victim for the aggressor's own violent response. Also worthy of note are such specific manifestations as: the aggressor's interest in disparaging any behaviour or attitude adopted by the partner, showing serious resistance to listening and sharing the partner's reality, unless to chide them. Similarly, the existence of behaviour patterns can be appreciated through which aggressors implacably and strictly censure their partner for not living up to their own expectations, forcing the situation until they can release their anger and personal tension and thus get their way with the victim. In addition, the presence of indifference can also be appreciated as the commonest expression of psychological violence among young people aged between 17 and 23. This demonstrates a lock of affective involvement that makes empathy, support and respect towards the individuality of the victim impossible. In turn, it promotes behaviour patterns of monopolising by the aggressor, at the same time as it generates problems for establishing effective communicative links within the couple and destroys the principles of mutuality and equality that are at the heart of any relationship. On the other hand, in this pre-marital interaction, there are significant differences and relationships between the considered manifestations of psychological violence. There are certainly such behaviour patterns as disparagement, hostility, lack of affection, coercion, unreasonable demands, blaming and manipulative attitudes present in the relationships of the students studied. There is also the development of such skills as the subject's capacity to face potentially stressful situations ("emotiveness"), to adopt objective, optimistic and functional thought patterns ("efficacy"), to show tolerance when faced with frustration ("rigidity") and to avoid making judgements about reality based on optimism without objective reasons ("illusion"). However, such data are indicative of such revealing results as the existence of a greater tendency towards psychological violence in its different manifestations by those students with more precarious emotional resources, become even more consistent when the many related studies that act as empirical support are reviewed. With this work, we aim to contribute to the scientific analysis of psychological violence in the relationships of couples, as well as in the design of primary prevention programmes focused on the development of emotional education as a key tool for establishing full and healthy relationships between couples.
... Concretamente, en España, el 12.5% de las mujeres han sufrido alguna vez violencia física y/o sexual de carácter moderado (3.9%) o severo (6.9%) por parte de un compañero sentimental; y más del 25% han sufrido violencia psicológica (Ministerio de Sanidad, Servicios Sociales e Igualdad, 2015). Experimentar de manera frecuente situaciones de victimización tiene efectos negativos sobre la salud, tanto física, como psicoemocional de las víctimas (Plazaola-Castaño y Pérez, 2004;Velasco, Seijo, y Vilariño, 2013). Además, uno de los puntos significativos que señala la Macroencuesta de Violencia contra la Mujer (Ministerio de Sanidad, Servicios Sociales e Igualdad, 2015), es la referida a la victimización sufrida por adolescentes y mujeres jóvenes. ...
Chapter
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Intimate partner violence is a major social issue widely spread in our society that comprises the death of a substantial number of women. The aim of research on IPV has significantly changed over time. Social and political factors have outlined different perspectives and approaches in research, from prevention to detection, including typologies and intervention, regarding both victims and batterers. These studies have had a great impact and dissemination in the scientific community. In recent years due to the widespread use of technology, new kind of violence as that occurring among young couples and based on stereotypes, myths and biased ideas have raised. This has led to the normalization of violence and its acceptance. Although remarkable advances in intimate partner violence have been reached, these new forms of violence require redefining the aims of research on this matter. This may allow researchers to recognize these new forms of violence and its risk factors, so it can be early stopped. This study aims to analyse scientific literature regarding IPV to characterise main research lines, most interesting topics and new trends of research.
... [8][9][10] No obstante, aunque existen algunas investigaciones 11-13 que han intentado abordar los problemas psicológicos que originan que las víctimas de violencia soliciten ayuda profesional, seguimos encontrándonos con un vacío importante en el ámbito científico 14 de trabajos encaminados al estudio del maltrato psicológico con entidad propia. [15][16][17][18][19] Esta inmadurez conceptual en la investigación de la violencia psicológica nos plantea cuestiones tales como: ¿cómo intervenir en algo que no sabemos con exactitud qué es? El Instituto Andaluz de la Mujer (2006) 20 define el maltrato psicológico como "cualquier acto o conducta que hiera la dignidad y pueda provocar la desvalorización, humillación, sufrimiento o enfermedad mental (insultos, vejaciones, crueldad mental), así como aquellos actos o conductas que ocasionen un clima de angustia (espía, ignorar, controlar los recursos económicos, amenazas y coacciones)". ...
Article
Full-text available
Nowadays, violence within couples is the most alarming form of interpersonal violence. It could even be considered a public health problem. Nevertheless, although the magnitude is as serious as the repercussions of the aggression suffered by the victims, there is a general tendency to restrict the focus of attention to the physical aspect of the problem. Thus, the study of psychological abuse is relegated to a secondary plane, ignoring those works that demonstrate the presence of psychological aggression with serious consequences, comparable to or even greater than those of a physical nature, even though the former are more difficult to predict. For this reason, there is little consensus concerning the specific behaviour patterns that make up psychological abuse. Nevertheless, among its most evident characteristics, we can point to such manifestations as insults, criticism, humiliations, disparagement or ridicule, both in public and in private, social and economic isolation, repeated threats to either abandon the relationship or to seek a divorce, threats of abuse towards the victims or their loved ones and those related with harming or destroying the victim's cherished belongings, whether they be objects or animals, which may be psychologically traumatic for the victim. On the other hand, such conduct as manipulating information, affective neglect, denial of violence and putting the blame entirely on the victim can be listed as hidden expressions of psychological abuse in couples. Similarly, several works have established a link between a wide range of psychological and behavioural symptoms connected to psychological violence in couples with numerous aspects of emotional intelligence. On an interpersonal level, conflictive couples seem to respond to communicative registers far removed from emotional intelligence or such partner skills as empathy, self-control and co-operation, thus leading to violent relational dynamics. The current research analyses psychological abuse in couples (disparagement, hostility, indifference, intimidation, imposition of behaviour patterns, blaming and apparent kindness) and its connection with the level of emotional competence (emotiveness, efficacy, rigidity and illusion) shown by the individuals that make up the couple. The research was carried out in the context of the University of Extremadura (Spain). The sample was selected randomly and was made up of 1 080 university students, of whom 332 were male and 748 female, aged in four categories covering the range from 17 to 23 years or more. Following the sample selection, the deans and department directors were informed of the aims of the research, their approval was sought to implement the research instruments and to guarantee the collaboration of the lecturers in the various degree subjects chosen. Then, a joint calendar was established to apply the tests. The surveys were carried out during the academic years 2007/2008 and 2008/2009. The tests were collectively administered in single sessions. Copies of the survey were handed out along with instructions. Volunteers were then told to fill in personal data and the instructions were read out aloud, stressing the importance of answering all the questions without exception. Finally, doubts were answered, taking care not to influence the subjects' replies. The confidentiality of the students' answers was guaranteed by coding each questionnaire with a numerical identification. After the questionnaires were handed in, the students' replies were checked for compliance with the protocols, and on the basis of atypical replies and questions left unanswered. Only two questionnaires were eliminated due to protocol and no atypical answers or unanswered questions were found. The order was exactly the same for all the applications: First of all the Inventory of Constructive Thought (15 to 30 minutes), and secondly the Questionnaire on Psychological Abuse (15 to 20 minutes). The main results of the study, with respect to the indicators of psychological abuse in couples, are as follows: the existence of patterns of psychological violence in the relationships of couples of university students is confirmed. Of the most significant sub-factors of psychological abuse, the most frequently used by these young people were those included in (3) Indifference, while the least commonly used were those included in (7) Apparent Kindness. As for the relationship between psychologically abusive behaviour patterns and emotional competence during pre-marital relationships, there are significant differences. Finally, the presence of significant correlations between most factors and sub-factors of psychological abuse in couples and the different emotional skills is confirmed. To conclude, it can be said that the research provides evidence that the indicators of psychological abuse in couples start to appear during pre-marital relationships. An analysis of the results demonstrates that these subjects put into practice such indicators and/or manifestations as: trivializations, reproaches, lack of empathy or support, judging, criticising, correcting, abusive insistence and accusations. The students from the sample show no marked tendency towards the exercise of any form of psychological violence in particular. Rather, they exhibit a heterogeneous behavioural repertory made up of disparagement, confrontation, lack of interest or affection, coercion, attempts to restrict the victim psychologically or socially, and blaming the victim for the aggressor's own violent response. Also worthy of note are such specific manifestations as: the aggressor's interest in disparaging any behaviour or attitude adopted by the partner, showing serious resistance to listening and sharing the partner's reality, unless to chide them. Similarly, the existence of behaviour patterns can be appreciated through which aggressors implacably and strictly censure their partner for not living up to their own expectations, forcing the situation until they can release their anger and personal tension and thus get their way with the victim. In addition, the presence of indifference can also be appreciated as the commonest expression of psychological violence among young people aged between 17 and 23. This demonstrates a lack of affective involvement that makes empathy, support and respect towards the individuality of the victim impossible. In turn, it promotes behaviour patterns of monopolising by the aggressor, at the same time as it generates problems for establishing effective communicative links within the couple and destroys the principles of mutuality and equality that are at the heart of any relationship. On the other hand, in this pre-marital interaction, there are significant differences and relationships between the considered manifestations of psychological violence. There are certainly such behaviour patterns as disparagement, hostility, lack of affection, coercion, unreasonable demands, blaming and manipulative attitudes present in the relationships of the students studied. There is also the development of such skills as the subject's capacity to face potentially stressful situations (" emotiveness" ), to adopt objective, optimistic and functional thought patterns (" efficacy" ), to show tolerance when faced with frustration (" rigidity" ) and to avoid making judgements about reality based on optimism without objective reasons (" illusion" ). However, such data are indicative of such revealing results as the existence of a greater tendency towards psychological violence in its different manifestations by those students with more precarious emotional resources, become even more consistent when the many related studies that act as empirical support are reviewed. With this work, we aim to contribute to the scientific analysis of psychological violence in the relationships of couples, as well as in the design of primary prevention programmes focused on the development of emotional education as a key tool for establishing full and healthy relationships between couples.
... Con respecto al nivel de estudios, los casos se dan en mayor medida en personas con estudios primarios o secundarios y casi un 16% tenía estudios universitarios, estas cifras son superiores a otros estudios revisados en los que la cifra de media de mujeres con estudios universitarios es inferior (Plazaola-Castaño, 2004). ...
... Thus, although there is some research work in Spain that has tried to deal with the psychological problems pertaining to the victims of domestic violence (mainly women) (Alonso & Labrador, 2008;Rincón, Labrador, Arinero & Crespo, 2004;Sarasúa, Zubizarreta, Echeburúa & Corral, 2007), there is still an important void where work aimed at the study of psychological abuse as a form of violence in itself is concerned (Domínguez, García & Cuberos 2008;Ellsberg, Jansen, Heise, Watts & Garcia-Moreno, 2008;Pico, García, Celda, Blasco, Echeburúa & Martínez, 2006;Plazaola & Pérez, 2004;Ruiz & Plazaola, 2005). It is a form of violence that has such serious consequences as to be comparable with those of a physical nature, or even worse, even though they are more difficult to predict (Sackett & Saunders, 1999;Schumacher, Smith & Heyman, 2001;Street & Arias, 2001). ...
Article
Full-text available
This research analyzes the variable ‘length of relationship between couples’ and the evidence for psychological abuse in university students, providing further knowledge concerning the possible connection between the length of a relationship and evidence of psychological abuse appearing within it. The presence of the different components that make up coercive interaction in couples (disparagement, hostility, indifference, intimidation, imposition of behavior patterns, blaming and apparent kindness) is also analyzed. The study shows that relationships, as they get longer, have a greater chance of violent psychological conduct becoming evident through such indicators as trivialization, reproaches, indifference, intimidation, judging, criticizing, correcting, destructive behavior, abusive insistence and accusations. Similarly, the results indicate that there is a greater frequency of “destructive behavior” and “reproaches” the longer the relationship of the young people lasts. The research has been carried out in the context of the University of Extremadura (Spain), the sample being made up of 1.080 university students aged between 17 and 23 years or more. The findings show the need to document and raise awareness of this largely unknown form of abuse.
... [8][9][10] No obstante, aunque existen algunas investigaciones 11-13 que han intentado abordar los problemas psicológicos que originan que las víctimas de violencia soliciten ayuda profesional, seguimos encontrándonos con un vacío importante en el ámbito científico 14 de trabajos encaminados al estudio del maltrato psicológico con entidad propia. [15][16][17][18][19] Esta inmadurez conceptual en la investigación de la violencia psicológica nos plantea cuestiones tales como: ¿cómo intervenir en algo que no sabemos con exactitud qué es? El Instituto Andaluz de la Mujer (2006) 20 define el maltrato psicológico como "cualquier acto o conducta que hiera la dignidad y pueda provocar la desvalorización, humillación, sufrimiento o enfermedad mental (insultos, vejaciones, crueldad mental), así como aquellos actos o conductas que ocasionen un clima de angustia (espía, ignorar, controlar los recursos económicos, amenazas y coacciones)". ...
Article
Full-text available
La violencia contra la pareja constituye, actualmente, la forma más alarmante de violencia interpersonal. Sin embargo, a pesar de la magnitud del fenómeno, existe una tendencia general a restringir el foco de interés a la dimensión física del mismo.
... The findings allowed corroborating the reports offered by other research studies (Calvete et al., 2007;Pico-Alfonso et al., 2006;Plazaola-Castaño & Ruiz-Pérez, 2004;Paz et al., 2004;Amor et al., 2002;Arroyo, 2002;Domínguez et al., 2008) by identifying the significant relationship between the scores from both variables, which indicates that a high tendency to experience PTSD manifestations is associated with a high level of psychosocial maladjustment in individuals who have been victimized by their partners. ...
Article
Full-text available
El objetivo de este artículo fue identificar la relación existente entre estrés postraumático y la capacidad de adaptación en un grupo de víctimas de violencia por parte de la pareja residentes en la ciudad de Medellín (Colombia). La muestra estuvo conformada por 26 personas de ambos sexos, seleccionadas en diferentes centros de atención clínica. Los instrumentos utilizados fueron la Escala de Gravedad de Síntomas de Estrés Postraumático y la Escala de Inadaptación. Para el análisis de los datos se utilizaron los estadísticos descriptivos y el Coeficiente de Correlación de Pearson. Los resultados refuerzan la iniciativa de considerar el TEPT como una categoría diagnóstica inequívocamente asociado a la violencia de pareja; 84.2% de la muestra reportó sintomatología de estrés postraumático, y sobresalieron las manifestaciones de evitación e hiperactivación y la presencia de manifestaciones somáticas. Los niveles de inadaptación fueron elevados promedios de 93.2%; las áreas con peor capacidad de adaptación fueron la vida de pareja y familiar, mientras que el nivel de inadaptación mostró asociaciones significativas con el estrés postraumático global y la hiperactivación (p< 0.01). En general, los participantes reflejaron aflicción emocional en sus respuestas, caracterizada por lapresencia de ansiedad somática, un miedo intenso de volver a experimentar las situaciones de abuso y una respuesta notable de aumento de la excitación.
... This lack of precision may be due to the scarcity of work aimed at clarifying the phenomenon of psychological abuse as a separate form of violence (Domínguez, García, & Cuberos, 2008;Echeburúa, 1994; Blázquez, García-Baamonde, & Guerrero, 2011;Pico, et al. 2006;Plazaola & Pérez, 2004;Ruiz & Plazaola, 2005;Sims, 2008) in relationships between young couples (Ferrer, Bosch, Navarro, Ramis, & García, 2008). ...
Article
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This article explores the relationship between abuse in young couples and its severe and chronic nature later on in the relationship, as well as the severity of the consequences of this type of violence and the influence exercised by the gender factor. Therefore, this research analyzes the phenomenon of psychological abuse with respect to the gender factor in young dating couples. The sample is made up of 1,080 students aged 17 to 23 years old at a major university in Spain. The results show the presence of all studied manifestations of psychological abuse, with the highest rate of these manifestations occurring in the 17- to 18-year-old age range. There is evidence of a greater rate of psychological abuse behavior patterns among men. The evidence would suggest the need for future research aimed at making socializing educational practices more dynamic and directed toward the teaching of emotional intelligence as an alternative to combat psychological violence in couples and encourage equality and well-being in relationships. Directions for future research are suggested
Article
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Violence is commonly considered a social problem whose approach is restricted only to public policies, so its impact on health has been seldom studied compared to the magnitude of the problem. However, in the case of violence against women, it has been identified that it can harm their physical health, thereby promoting the emergence of various mental, chronic and infectious diseases. Given this scenario, the objective of this article was to analyze the impact of violence against women in the development of the diseases mentioned above.
Chapter
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El fenómeno de la violencia de pareja hacia las mujeres es un problema multifacético que puede llegar a presentarse en función del contexto en el que se desarrolla la víctima y el perpetrador. Por lo antes expuesto, a lo largo de este capítulo se abordan los diferentes tipos de violencia según su uso, el contexto y tipo de manifestación, considerando aspectos específicos como la edad, el tipo de relación afectiva, etc. Asimismo, se resalta la importancia de abordar otros tipos de violencias emergentes las cuales se manifiestan a través de conductas o en entornos que hasta hace poco fueron ignorados; por ejemplo, el control de la pareja a través de medios electrónicos. Abordando cada uno de estos aspectos también se pretende evidenciar que, en aspectos generales, este problema afecta de manera significativa la salud e integridad de sus víctimas debido a que las conductas violentas ejercidas hacia las mujeres les generan daño y sufrimiento de tipo físico, psicológico, sexual e incluso la muerte. Lo anterior, además de demostrar las diversas caras del fenómeno, recomienda que tanto la comunidad científica como las y los profesionales de la salud desarrollen habilidades y estrategias para la prevención y atención de todos estos tipos de violencia con el objetivo de mejorar la calidad de vida de las víctimas, así como identificar factores intrínsecos que no habían sido tomados en cuenta en estudios anteriores para poder trabajar con los perpetradores de una forma efectiva.
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Este estudio identifica aspectos sociodemográficos y del tiempo de uso del internet que se asocian a la violencia digital de pareja, así como las diferencias sobre los tipos de violencia digital y las redes sociales donde ocurre. A través de un estudio observacional de alcance correlacional, se seleccionaron 340 casos de la base de datos de la Primera Evaluación de la Violencia Digital en Yucatán y se tomaron reactivos que medían las variables de interés. En los resultados se encontró que la vigilancia (α: <.001; OR: 1.607), el correo electrónico (α: .033; OR: 2.787) y usar internet 1 o 2 días a la semana (α: .02; OR: 1.5217), se relacionan a la violencia digital de pareja. El flaming (α: .013; OR: .405) y las burlas y acoso (α: .001; OR: .371) se asociaron a otros ámbitos de violencia digital. También se observó que la comunidad LGBTTIQ, las mujeres y quienes pasan menos tiempo en internet, viven más violencia digital de pareja que sus contrapartes. Se concluye que la violencia digital presenta elementos particulares y diferencias según el tipo de violencia experimentada. La elevada prevalencia en ambas modalidades sugiere patrones de interacción violenta en esta población, resaltando la necesidad de intervenciones que atiendan esta problemática.
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Con el objetivo de determinar los factores asociados a la capacidad resolutiva de establecimientos de salud en la detección de la violencia de género, se desarrolló un estudio descriptivo-transversal-correlacional. La muestra conformada por 256 prestadores de salud que laboran en dos hospitales y cinco centros de salud cabeceras de microrredes, fue determinada por la fórmula de proporciones para poblaciones finitas y seleccionadas por estratificación proporcional. Los instrumentos de recolección de datos fueron un cuestionario de características sociodemográficas, un test de conocimientos sobre las normas legales y protocolos en la prevención y atención de la violencia de género de Siendonés, la escala de actitud frente a la violencia de Chuquimajo (confiabilidad de 0,91 y 0,81, respectivamente) y una lista de cotejo que verifica el número de indicadores de capacidad resolutiva del establecimiento de salud. Los datos fueron procesados en el programa SPSS versión 23,0. Los resultados muestran el perfil de los prestadores de salud: edad promedio 38,1 ± 9,0 años, siendo en su mayoría adultos intermedios de sexo femenino, 43,0% son casados, con un tiempo laboral promedio de 9,68 ± 8 años. El nivel de conocimiento de los prestadores de salud fue alto y muy alto (39,8% y 15,6%, respectivamente), seguido de conocimiento medio (33,6%) y bajo (10,9%). El 83,6% de los prestadores tiene una actitud neutra frente a la violencia de género, y solo el 4,7% tiene una actitud favorable. El conocimiento sobre violencia de género correlacionó en forma positiva con la actitud del prestador para detectar violencia de género (p < 0,05). A mayor capacidad de detección de violencia física, mayor capacidad de detección de violencia sexual, mayor capacidad de referencia de casos de VG (p < 0,05). A mayor número de casos de VG referidos por el prestador de salud, mayor conocimiento del protocolo y flujograma de atención (p < 0,05).
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Intimate partner violence against women (IPVAW) is a serious and overwhelming public concern. Neuroimaging techniques have provided insights into the brain mechanisms underlying IPVAW perpetration. The purpose of this study is to examine the resting-state functional connectivity (rsFC) involving the process of social decision-making of male perpetrators. Twenty-six male perpetrators convicted for an IPVAW crime were compared to 29 men convicted for crimes other than IPVAW (other offenders) and 29 men with no criminal records (non-offenders) using a seed-based approach. Seeds were located in areas involved in reflective (prefrontal), impulsive (amygdala and striatum) and interoceptive (insula) processing. Then, as an exploratory analysis, the connectivity networks on male perpetrators were correlated with measures of executive functions and socioemotional self-report measures. Male perpetrators in comparison to other offenders and non-offenders, presented higher rsFC between prefrontal, limbic, brainstem, temporal and basal ganglia areas. Also male perpetrators showed higher rsFC between insula, default mode network and basal ganglia, while lower rsFC was found between prefrontal and motor areas and between amygdala, occipital and parietal areas. Exploratory correlations suggest that the specific rsFC in male perpetrators might be more related to socioemotional processes than to executive functions. These results showed that male perpetrators present a specific rsFC in brain systems that are essential for an adaptive social decision-making.
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La violencia de pareja hacia la mujer es un fenómeno global que impacta directamente en su integridad física, emocional, psicológica y sexual, así como en su calidad de vida. A pesar del creciente interés por la investigación de este problema, la evidencia científica aún parece ser limitada para delimitar integralmente perfiles tanto de víctimas como de perpetradores. No obstante, la literatura es más prolífica en cuanto a los factores asociados y las consecuencias de la violencia. Por ello, este trabajo busca describir las principales características de estos aspectos centrándose en la situación de México y en el estado de Puebla, a través de una revisión narrativa que integró algunos elementos sistemáticos en la búsqueda, recolección e inclusión de diversos trabajos científicos y no especializados sobre la materia y disponibles a través de internet. Entre los principales resultados, se hallaron diversas características psicológicas que podrían definir a la figura de la víctima y el agresor. Además, se delimitaron algunos de los principales factores de riesgo y de protección, resaltando el papel que podría jugar la familia en ambos. Por otro lado, también se establecieron las consecuencias más importantes a nivel físico y psicológico en las víctimas. Finalmente, se sugiere profundizar en estos elementos para lograr un mejor diagnóstico, atención y tratamiento.
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Referencia de la obra general: Rojas-Solís, J. L. (Ed.). (2022). Investigación, prevención e intervención en la violencia de pareja hacia la mujer (1ª Ed.). Puebla, México: Consejo de Ciencia y Tecnología del Estado de Puebla (CONCYTEP). Disponible en: https://bit.ly/3tGYic3?fbclid ISBN: 978-607-8839-00-1
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Revisión bibliográfica sobre la violencia intregénero (violencia en las parejas homosexuales) en España. Literature review about intimate partner violence in homosexual relationships in Spain.
Article
Este artículo presenta un estado del arte sobre violencia de la pareja íntima durante el embarazo y sus implicaciones en la salud mental de la madre, partiendo de 13 artículos publicados entre 2000 y 2014, obtenidos mediante búsqueda en bases de datos (Pubmed, Medline, Nursing Consult, sCielo, Dialnet, Redalyc, Lilacs, Index y Bireme), utilizando como palabras clave: embarazo, violencia de la pareja íntima, salud mental e implicaciones. Los hallazgos de este estudio, muestran que la violencia de la pareja íntima durante el embarazo incrementa la depresión y depresión posparto, así como el malestar emocional en la gestante. PALABRAS CLAVE: embarazo, género, salud mental, violencia doméstica. Intimate partner violence during pregnancy and its impact on the mental healthABSTRACTThis article presents a state of the art on intimate partner violence during pregnancy and its implications for the mental health of the mother, based on 13 articles published between 2000 and 2014, they were gotten by looking for databases (PubMed, Medline, Nursing Consult, SciELO, Dialnet, Redalyc, Lilacs, Index and Bireme), using as keywords: pregnancy, intimate partner violence, mental health and implications. The findings of this study show that intimate partner violence during pregnancy increases depression and postpartum depression, and emotional distress in pregnant women. KEYWORDS: pregnancy, gender, mental health, domestic violence. Violência por parceiro íntimo durante a gravidez e seu impacto sobre a saúde mental RESUMOEste artigo apresenta um estado da arte sobre a violência por parceiro íntimo durante a gravidez e suas implicações para a saúde mental da mãe, com base em 13 artigos publicados entre 2000 e 2014, obtidos através de pesquisa bases de dados (PubMed, Medline, Enfermagem Consult, SciELO, Dialnet, Redalyc, Lilacs, Índice e Bireme), usando como palavras-chave: gravidez, violência por parceiro íntimo, saúde mental e implicações. Os resultados deste estudo mostram que a violência por parceiro íntimo durante a gravidez aumenta a depressão e depressão pós-parto, e problemas emocionais em mulheres grávidas.PALAVRAS-CHAVE: gravidez, género, saúde mental, violência doméstica.
Article
Fibromyalgia is a known disease, with a prevalence of around 2.5 % of the Spanish population over 20 years old. A significant aspect of the disease is that a certain amount of fibromyalgics declare that their illness appeared soon after suffering a mild or severe trauma. Patients with post-traumatic fibromyalgia show the same signs and symptoms as those with primary fibromyalgia and their prognosis is similar or somewhat worse than the latter. Among other factors determining the agreement with the diagnosis of post-traumatic fibromyalgia, is the specialty of the doctor: rheumatologists seem the most prone to accept it while the majority of orthopedists tend to reject it. According to different publications, the claim for compensation does not modify signs and symptoms or the outcome of these patients. In conclusion, forensic doctors should keep in mind the possibility that the injured patient that does not heal following the usual course of time may suffer from post-traumatic fibromyalgia.
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This article presents a state of the art on intimate partner violence during pregnancy and its implications for the mental health of the mother, based on 13 articles published between 2000 and 2014, they were gotten by looking for databases (PubMed, Medline, Nursing Consult, SciELO, Dialnet, Redalyc, Lilacs, Index and Bireme), using as keywords: pregnancy, intimate partner violence, mental health and implications. The findings of this study show that intimate partner violence during pregnancy increases depression and postpartum depression, and emotional distress in pregnant women.
Article
Domestic violence is a significant health problem and the case prevalence rates are high in emergency departments. The staff of these departments are in an excellent position to detect cases of abuse and intervene early in the process. However, few cases are in fact identified because of certain attitudinal barriers affecting both the women who are victimized and the health care staff who treat them. Attention to signs that should raise suspicion of abuse and even systematic screening are therefore recommended. In all cases it is important to carry out a private interview, to guarantee confidentiality, and to offer help. Victims should be cared for in an individualized way that takes into consideration the woman's situation and preferences and the level of threat to her life. The medical problem that occasioned the visit should be treated and the need for psychiatric care assessed. Appropriate social assistance should be offered and legal requirements met, with particular attention to keeping accurate medical records and notifying authorities when necessary. The problem calls for a multidisciplinary approach, especially by creating good channels of communication between the emergency department, primary care, and social services. Staff training and awareness raising are critical in order to improve the emergency care presently given to women who are victims of domestic violence. [Emergencias 2008;20:269-275]
Article
The study describes the construction of a 12 item scale serving to identify the stage within the process of change lived by battered women. Several tests were conducted to measure reliability and concurrent validity of the instrument in a sample of 199 women consulting 11 out of 17 Family Resource Centers of Medellin, Colombia. Women ranged in age from 16 to 72 years old, mean 35.47, (s = 10.00); 95% of these women had, a low household income. Findings report that most of the women were located in the second stage of the process of change. Up to this moment they realize that have been battered, but they stay in the violent relationship. In order to survive they begin to protect themselves. Cronbach's alpha with the cur-rent sample was 0.80, which indicate that the information collected had internal consistency. The scale contributes to enhance interventions that involve battered women, recognizing that these women live a process of change during their violent relationship and that they work to overcome the abuse. Also they experience different needs depending of the stage of behavioral change where they are located.
Article
Objective: To analyze the frequent use of emergency health services by battered women, risk factors for abuse, detection by health care staff, and referral to social services, with a view to improving quality of care Methods: Prospective, cross-sectional, observational study of battered women receiving emergency care from the municipal health care services (IMAS, Institut Municipal d'Assistencia Sanitaria) in Barcelona. Data were recorded on a standardized data collection sheet Individuals who used the services at least 3 times in 2004 were considered frequent users Results: The emergency services handled 157 482 calls for assistance from patients over the age of 14 years; 79 787 (50.1%) were women. Gender-based violence accounted for 0.76% of the cases. Health care personnel detected gender-based violence in 10.4% Of these, 29.6% women were frequent users. Nonspecific disorders, gynecologic complaints, trauma, psychiatric disorders, digestive complaints, and neurologic symptoms were significantly more frequent (P< 001) than other reasons for seeking care Risk factors for gender-based violence were present in 52.6% of the cases, the most common factors being pregnancy, prior abortions, nonconsensual sex, and escalating violence. Social services were not contacted in 3% of the cases. Conclusions: Nearly a third of women suffering from gender based violence and more were frequent users of emergency services and more than half these women had risk factors. The rate of detection by health care staff was low (10.4%). The committee for assistance to battered women has adopted the following measures to improve quality of care. 1) training courses for first-year residents and continuing professional development courses for members of the staff; 2) computerization of the data collection sheet, including the most common risk factors in our health care area; and 3) routine detection systems. [Emergencias 2010;22:193-198]
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La reincidencia en violencia a la pareja mujer fue evaluada en sus distintas dimensiones en una cohorte de hombres que recibieron intervención psicosocioeducativa especializada. Se determinó el nivel de riesgo de reincidencia y las tácticas de resolución de conflictos con la intención de establecer las posibles correlaciones entre estas variables y los actos de reincidencia. Participaron 24 hombres y 22 mujeres. Los resultados muestran un índice de reincidencia que osciló entre 50% y 59%, según el informante sea el hombre o la pareja mujer. Los datos también muestran que el nivel de riesgo demuestra ser un buen predictor de violencia física, pero no de maltrato psicológico. La reincidencia de violencia psicológica leve se observó como la manifestación más frecuente, por lo que se problematiza su estatus en las intervenciones, y se plantean algunas ideas para aumentar la efectividad de los programas, enfatizando las tácticas de manejo de conflictos basadas en la negociación emocional.
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This study examined the relation between the social construction of gender attributes and stereotypes, and the presence of domestic violence against women. The participants were 1.200 subjects of both sexes, over 18 years of age, residing in different locations in Spain. Participants positively value the gender attributes that constitute the female image. However, they tend to markedly stereotype themselves according to gender. Regarding the transmission of gender attributes in the education of children, there are differences related to the sex of the educator, mothers being more rigid in their parenting. Concerning the assessment of gender attributes in romantic relationships, the subjects tend to prefer strongly stereotyped couples. In relation to the assessment of the gender prototypes broadcast by the media, both sexes agree on their desire to perceive more stereotyped male and female figures. An association between domestic violence and male gender attributes was found, as well as the description of abusive men as violent persons and of women as passive, and the notion of courage as the main characteristic needed to break the cycle of violence.
Article
In 1996 the World Health Organization (WHO) declared the eradication of the violence against women a priority for public health. This violence causes serious consequences, not only physical but also psychological and social, to women and their families. The purpose of this paper is to highlight the importance of a medico-legal assessment of the psychological ill-treatment and abuse in the victims of gender violence, together with the changes in diagnostic method and victim identification depending on the environment. The mental imprint is both the key to cases of psychological violence referred to in the Organic Act 1/2004 on integrated protective measures against gender violence, and also a consequence in the acts of physical violence, threats, coercion or freedom deprivation. In view of this, the mental imprint seems to have been insufficiently considered as proof of charge. It is necessary to develop a comprehensive forensic assessment including forensic psychologists to assess the mental injury and the emotional suffering associated with ill-treatment and abuse.
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Los participantes médicos que cumplimentaron el cuestionario estaban distribuidos más o menos equitativamente por sexo, con una edad media de 49 años, con mucha experiencia en Atención Primaria, siendo una muestra con bastante estabilidad laboral y perteneciente a centros de salud urbanos. El 93,7% consideraba la violencia de género como un problema de salud y al 63,4% no les planteaba incomodidad atender a las pacientes que la sufrían. Los que respondieron que sí les producía incomodidad, destacaban como principal circunstancia de su malestar la impotencia que les generaba el que una mujer no quisiera denunciar a su agresor. El 93,4% de los profesionales encuestados consideraban que estaba entre sus funciones atender a este tipo de pacientes. Algo más de la mitad (55,6%) había recibido formación sobre violencia de género, valorándola como satisfactoria o muy satisfactoria el 80,3%. Tres cuartas partes de los médicos y médicas (73,8%) conocían los recursos sanitarios para atender a las pacientes con violencia de género, reduciéndose el número cuando se trataba del conocimiento de recursos fuera del sistema sanitario (59,9%). Casi la mitad (49,3%) consideraba que había pocos recursos para atender a las víctimas. Un tercio (33,1%) había leído el protocolo común de actuación sanitaria del 2007, y más de la mitad (55,3%) conocía el de su CCAA. El 77,8% de los médicos y médicas conocía las obligaciones legales ante la detección de un caso de violencia de género, el 85% sabía que estaba obligado a denunciar y el 72,3% que el parte de lesiones se tramitaba de forma diferente y más rápido cuando se especifica que es por violencia de género. El 72,3% tenía experiencia de atención a mujeres víctimas de violencia de género. El 81,8% conocían las circunstancias que hacían a las mujeres víctimas de violencia de género más vulnerables, y el 43,8% había detectado en su consulta hombres agresores. La detección de las pacientes se realizaba, principalmente, por comunicación de la misma en la consulta. En los casos identificados el 93,1% lo hacía constar en la historia clínica, el 70,3% realizaba un seguimiento de la paciente y el 82,7% se coordinaba con otros profesionales. Entre los obstáculos para la detección se señalaba el no reconocimiento de la víctima de su situación de maltrato (95,7%), las dificultades idiomáticas y culturales (78,1%), y la falta de tiempo en la consulta que favorezca la comunicación (72,9%). Para valorar adecuadamente el caso muchos médicos y médicas reconocían la necesidad de mejorar sus habilidades para 7 desarrollar la entrevista clínica en los casos de violencia de género (62,2%) y las principales dificultades en las intervenciones que se requerían, se relacionaban con los problemas éticos que surgían cuando la paciente no quería denunciar (90,8%) y el miedo a perjudicarla en las actuaciones socio-sanitarias que se desarrollasen (72,9%). Se destacan como propuestas de la muestra estudiada la necesidad de protocolos claros y sencillos, conocer mejor los recursos especializados en violencia de género, mayor formación en entrevista clínica, mejorar la coordinación con los servicios sociales, mayor tiempo en la atención a las pacientes víctimas de violencia de género, y la coordinación con los equipos de salud mental.
Article
The objective of this research was to evaluate the levels of self-esteem and adaptation in a group of people who have experienced abuse by their partner, in the city of Medellín (Colombia). An ex post facto cross-sectional design was used. It was conducted a non-probability sampling and 50 subjects were selected. The instruments used were a semi structured interview, A Self-Esteem Questionnaire and one of adaptation. In addition, percentages and descriptive analyzes were conducted. The results showed low levels of self-esteem and high levels of maladjustment. It was also found that the most common type of abuse is psychological, which is accompanied by physical, sexual and economic aggression. Furthermore, women were the most reported victims of this situation. In conclusion, people who are victims of abuse by their partner tend to show lower levels of self-esteem and higher levels of maladjustment.
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En La depresión en las mujeres. Una aproximación multidisciplinar desde la perspectiva de género, se lleva a cabo una revisión y un análisis de la salud mental y de sus problemas desde el siglo xix hasta la actualidad desde una perspectiva internacional y se abordan las cuestiones básicas en las vertientes médica, psiquiátrica, psicológica y sociológica. Con este libro se contribuye al conocimiento de la depresión en las mujeres con una investigación cualitativa desde una perspectiva sociológica y también con una visión enfermera. A través de una muestra de mujeres y hombres se indaga en las causas y en las consecuencias que tiene esta dolencia, resaltando las cuestiones culturales y sociales que más han quedado en segundo plano en la generalidad de las investigaciones.
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Los adolescentes presentan conductas transgresoras y conocer este fenómeno puede ayudar en los cuidados de enfermería en esta etapa de la vida. La delincuencia juvenil ha representado una preocupación fundamental de la Criminología histórica y contemporánea y algunas referencias bibliográficas que presentamos se basan en ellas. Según estudios en los jóvenes no existe una distinción entre delincuencia y no delincuencia sino solo hay delincuencia en mayor o menor grado. Objetivo principal: Analizar si existe relación entre el cometer actos delictivos con el tener diferentes valores más tradicionalistas o más hedonistas, con distintos estilos educativos más permisivos o más autoritarios y con otras variables sociodemográficas como la edad, clase social, familia, sexo y consumo de drogas. Metodología: Presentamos un protocolo de investigación en el que realizaremos un estudio cuantitativo con un muestreo estratificado en los diferentes centros de secundaria de una población para resolver los objetivos que nos hemos planteado
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Introducción: Una de las controversias con referencia a la FM es su discapacidad sociolaboral. Se han reportado porcentajes de invalidez muy elevados en la FM, equiparables a los de la artritis reumatoide. Nos proponemos estudiar el impacto de la enfermedad sobre la funcionalidad laboral, en un grupo homogéneo de pacientes de profesión amas de casa, percibido por ellas mismas y por un familiar con quien convivieran, como parámetro de objetivización. Material y método: Muestra de pacientes mujeres afectas de FM atendidas en la consulta de Reumatología y que aceptaron participar, descartando los varones y los que tenían una FM secundaria a otra enfermedad. Se seleccionaron 13 mujeres, de profesión amas de casa, diagnosticadas de FM, que convivían con un familiar que pudiera responder a los tests. Procedimiento: visita médica por el reumatólogo, que realiza el diagnóstico de de FM y verifica los criterios de inclusión y de exclusión, seguida por visita por psicólogo, que administra, por separado, tests al paciente y al familiar.
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Introducción La vacunación antigripal ha demostrado su eficacia en la prevención de la gripe y de sus complicaciones. El objetivo de este trabajo es conocer la cobertura vacunal frente a la gripe estacional y pandémica de la Gerencia de Atención Primaria de Talavera de la Reina (Toledo) en las temporadas 2008-2009 y 2009-2010. Material y método Se han analizado todas las administraciones de vacuna de la gripe estacional y pandémica. La cobertura vacunal se calcula dividiendo el número de dosis administradas por el número de Tarjetas Individuales Sanitarias. También se han obtenido los datos de incapacidad laboral temporal para la gripe. Los casos de gripe semanal se han obtenido de la Red de Vigilancia Epidemiológica. Resultados En los años 2008 y 2009 se administraron 30.109 y 34.484 dosis de vacuna antigripal estacional, con una cobertura global vacunal del 19% y el 21,7%. Por zonas básicas de salud, la cobertura vacunal fue del 13,8% (zonas urbanas) al 52,1% (zonas rurales). La cobertura de la vacunación antigripal tipo H1N1 es del 6,3%. El porcentaje de casos que están en incapacidad laboral permanece estable, con cifras del 28,3% y 0,8%; pero el número medio de días ha pasado de 6,34 a 9,25 días por caso de gripe (7,08 días por caso de gripe H1N1). Discusión La cobertura vacunal en el año 2009 ha sido ligeramente superior a la de 2008 y sin embargo, la incidencia de gripe alcanzó cifras mayores, hasta duplicarse. Se constatan las diferencias entre las campañas de gripe estacional y pandémica. Y el porcentaje de personas en situación de incapacidad laboral se ha mantenido estable a los largo de las temporadas. La información aportada por este trabajo supone una aproximación a la caracterización de las dos temporadas de gripe en Talavera de la Reina.
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Violence against women has been an unseen phenomenon for decades. Even today it remains being difficult to identify. Thus, In the Second World Conference about the Status of women celebrated in Copenhagen in 1980 referred this type of abuse as "the most silenced crime in the world." We, as nurses guided by legal, ethical and deontological knowledge, and with other professionals, notice theimmense importance of defending the Human Rights and because of that, this issue is the reason for this study in which we try to summarize the various State Protection Systems in order to get our ultimate goal: to approach the professional nurse who reads these lines to the knowledge of these systems and the knowledge of the context of gender violence. The technique used in this review is a content analysis procedure, within its thematic category which is basedon reading as a tool of data collection; reading that has to be done following the scientific method, i.e. it must be systematic, objective and valid. All these State Protective devices are relevant, but we must remember one important aspect: theinter disciplinary health team which includes among the set of nursing that, realizing of this devices, can become in a prominent ally in women's ensuring security and integrity.
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The role that domestic violence plays in perpetuating poverty is often overlooked as a development issue. Using data from the 2005 Demographic Health Survey, this paper examines the prevalence of intimate partner violence in Colombia. Employing an intrahousehold bargaining framework and a bivariate probit model, it assesses the prevalence of and risk factors for physical and emotional intimate partner violence, including such variables as income, education, gender-based intrahousehold decision making, employment, migration related to armed conflict and child maltreatment. The findings of the study particularly underscore the effects of early childhood maltreatment on domestic violence and the need for policy measures that span the life cycle and include families. Its recommendations for policy makers and researchers take into consideration practical, theoretical and methodological issues.
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This study aimed to measure the prevalence of emotional distress among women in León, Nicaragua, and to identify risk factors for emotional distress, with special reference to wife abuse. A survey was performed among a representative sample of women aged 15–49. Among ever-married women, 20% were classified as experiencing emotional distress at the time of the interview, and 52% reported physical partner abuse at some point in their lives. Women reporting abuse were 6 times more likely to experience emotional distress. An estimated 70% of all cases of emotional distress found among ever-married women were attributable to wife abuse. The study underscores the need to improve screening and care for battered women within mental health services in Nicaragua. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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The aim of this study was to describe the characteristics of domestic violence against women in León, Nicaragua. A survey was carried out among a representative sample of 488 women between the ages of 15-49. The physical aggression sub-scale of the Conflict Tactics Scale was used to identify women suffering abuse. In-depth interviews with formerly battered women were performed and narratives from these interviews were analysed and compared with the survey data. Among ever-married women 52% reported having experienced physical partner abuse at some point in their lives. Median duration of abuse was 5 years. A considerable overlap was found between physical, emotional and sexual violence, with 21% of ever-married women reporting all three kinds of abuse. Thirty-one percent of abused women suffered physical violence during pregnancy. The latency period between the initiation of marriage or cohabitation and violence was short, with over 50% of the battered women reporting that the first act of violence act took place within the first 2 years of marriage. Significant, positive associations were found between partner abuse and problems among children, including physical abuse. Both the survey data and the narrative analysis pointed to extreme jealousy and control as constant features of the abusive relationship. Further, the data indicate that battered women frequently experience feelings of shame, isolation and entrapment which, together with a lack of family and community support, often contribute to women's difficulty in recognizing and disengaging from a violent relationship. These findings are consistent with theoretical conceptualisations of domestic violence developed in other countries, suggesting that, to a large degree, women's experiences of violence transcend specific cultural contexts.
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Objetivo: Estimar la mortalidad y la incidencia de las denuncias por la violencia del compañero íntimo (VCI) por grupos de edad y provincias españolas. Métodos: Estudio epidemiológico, descriptivo, basado en los asesinatos registrados en la base de datos de la Federación de Mujeres Separadas y Divorciadas (1998-2001) y las denuncias por VCI del Ministerio del Interior (1997-2000). Se calculó el porcentaje de incremento producido entre las denuncias y las muertes, el riesgo de una mujer de morir y denunciar por VCI por el método acumulativo simple, las tasas de mortalidad específicas por edad y ajustadas por edad y provincias y las tasas de incidencia bruta por provincias de las denuncias por VCI. También se realizó un análisis de regresión simple para explorar la relación entre mortalidad e incidencia de las denuncias. Resultados: Se observó un incremento del 27% en las denuncias y del 49% en los asesinatos desde el primer año del período al último. Durante el período de estudio una de cada 100.000 mujeres fue asesinada por VCI y u na de cada 200 denunció ser víctima de VCI. Las mujeres de 22-41 años y las de 82-86 presentaron las tasas de mortalidad por VCI más altas. La mortalidad y la incidencia de las denuncias por VCI en las provincias españolas no siguió un patrón geográfico definido. No existe correlación entre la mortalidad y la incidencia de las denuncias por VCI por provincias (r² corregida = -0,016). Conclusiones: La violencia del compañero íntimo es un problema de salud pública creciente en España. Parece existir un patrón bimodal por edad en mortalidad por VCI, pero no un patrón geográfico en mortalidad e incidencia de denuncias, ni tampoco una relación entre las provincias de mayor tasa de incidencia de denuncias y las de mayor tasa de mortalidad.
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Objetivo. Estimar la frecuencia de diferentes formas de violencia sexual y su asociación con sintomatología depresiva, ideación e intento suicida, y uso de alcohol y otras drogas alguna vez en la vida. Material y métodos. Estudio transversal, hecho en un centro de salud oficial de México, D.F., México, entre febrero y marzo de 1998. La muestra estuvo constituida por 345 mujeres usuarias del establecimiento asistencial las cuales, en el momento del estudio, vivían con pareja. Se calcularon proporciones para observar la frecuencia de tres diferentes formas de violencia sexual, y ji cuadrada para compararlas en cuanto a los problemas mencionados. Resultados. De las mujeres, 19% señaló haber sido objeto de tocamientos sexuales contra su voluntad al menos alguna vez en su vida, en tanto 11% habían sido violadas y 5% fueron forzadas a tocar los órganos sexuales de otra persona contra su voluntad. Una de cada cinco mujeres reportó haber experimentado alguna violencia sexual dentro de la relación de pareja. Se encontró una asociación significativa entre algunas formas de violencia sexual y la depresión, la ideación e intento suicida y el uso de psicofármacos. Conclusiones. La violencia sexual es un problema grave de salud pública que requiere implementar programas de capacitación para obtener una respuesta especializada de los proveedores de salud. El texto completo en inglés de este artículo está disponible en: http://www.insp.mx/salud/index.html
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This article reviews and updates major research findings on depressive disorders and gender relationships in the United States and abroad. It also considers some of the World Health Organization's assessment instruments that may clarify the relationship between depression and gender and its cross-cultural ramifications. With psychology converging across national boundaries and with gender being a variable in psychological research both nationally and internationally, gender and its relationship to depressive states is emerging as a focal point of interest and concern.
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Past studies that have addressed the health effects of intimate partner violence (IPV) have defined IPV as violence based on physical blows that frequently cause injuries. To our knowledge, no epidemiologic research has assessed the physical health consequences of psychological forms of IPV. To estimate IPV prevalence by type and associated physical health consequences among women seeking primary health care. Cross-sectional survey. A total of 1152 women, aged 18 to 65 years, recruited from family practice clinics from February 1997 through January 1999 and screened for IPV during a brief in-clinic interview; health history and current status were assessed in a follow-up interview. Of 1152 women surveyed, 53.6% ever experienced any type of partner violence; 13.6% experienced psychological IPV without physical IPV. Women experiencing psychological IPV were significantly more likely to report poor physical and mental health (adjusted relative risk [RR], 1.69 for physical health and 1.74 for mental health). Psychological IPV was associated with a number of adverse health outcomes, including a disability preventing work (adjusted RR, 1.49), arthritis (adjusted RR, 1.67), chronic pain (adjusted RR, 1.91), migraine (adjusted RR, 1.54) and other frequent headaches (adjusted RR, 1.41), stammering (adjusted RR, 2.31), sexually transmitted infections (adjusted RR, 1.82), chronic pelvic pain (adjusted RR, 1.62), stomach ulcers (adjusted RR, 1.72), spastic colon (adjusted RR, 3.62), and frequent indigestion, diarrhea, or constipation (adjusted RR, 1.30). Psychological IPV was as strongly associated with the majority of adverse health outcomes as was physical IPV. Psychological IPV has significant physical health consequences. To reduce the range of health consequences associated with IPV, clinicians should screen for psychological forms of IPV as well as physical and sexual IPV.
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Intimate partner violence (IPV) is associated with a range of adverse physical health outcomes, including chronic and infectious diseases. An emerging literature suggests that partner violence and specifically sexual violence may be associated with an increased risk of cervical neoplasia. To assess the risk of preinvasive and invasive cervical cancer in a cross-sectional study of women screened for IPV by type, frequency and duration, 1152 women ages 18-65 were recruited from family practice clinics in 1997-1998. They were screened for IPV during a brief in-clinic interview, and health history and current status were assessed in a follow-up interview. Of 1152 women surveyed, 14 (1.2%) reported cervical cancer, and 20. 3% (n = 234) reported treatment for cervical neoplasia. Ever experiencing IPV was associated with an increased risk of invasive cervical cancer (adjusted relative risk [aRR] = 4.28; 95% CI 1.94, 18.39) and with preinvasive cervical neoplasia (aRR = 1.47; 95% CI 1. 16, 1.82). This association was stronger for women experiencing physical or sexual IPV than for women experiencing psychological IPV. Women with cervical cancer reported being in violent relationships longer and experiencing more frequent physical and sexual assaults and more IPV-associated injuries than did controls. This exploratory study suggests that IPV may increase a woman's risk of cervical neoplasia. The mechanism by which IPV effects cervical neoplasia may be indirect through psychosocial stress or negative coping behaviors or direct through sexual assaults and transmission of human papillomavirus (HPV).
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We explored the physical and psychological distress of sheltered battered women. A convenience sample of 50 ethnically diverse women was obtained from women who had resided in two shelters for at least 21 days. Participants had experienced multiple traumatic events (8.1+/-4.6); however, only 19 (38.8%) of the participants were diagnosed with posttraumatic stress disorder (PTSD). When we analyzed biopsychosocial variables, we saw beneficial effects of support (financial, social, spiritual). These findings reinforce the need to enhance the resources of battered women, to help them identify existing opportunities, and to fortify self-caring strategies that give them strength.
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Domestic violence results in long-term and immediate health problems. This study compared selected physical health problems of abused and never abused women with similar access to health care. A case-control study of enrollees in a multisite metropolitan health maintenance organization sampled 2535 women enrollees aged 21 to 55 years who responded to an invitation to participate; 447 (18%) could not be contacted, 7 (0.3%) were ineligible, and 76 (3%) refused, yielding a sample of 2005. The Abuse Assessment Screen identified women physically and/or sexually abused between January 1, 1989, and December 31, 1997, resulting in 201 cases. The 240 controls were a random sample of never abused women. The general health perceptions subscale of the Medical Outcomes Study 36-Item Short-Form Health Survey measured general health. The Miller Abuse Physical Symptom and Injury Scale measured abuse-specific health problems. Cases and controls differed in ethnicity, marital status, educational level, and income. Direct weights were used to standardize for comparisons. Significance was tested using logistic and negative binomial regressions. Abused women had more (P<.05) headaches, back pain, sexually transmitted diseases, vaginal bleeding, vaginal infections, pelvic pain, painful intercourse, urinary tract infections, appetite loss, abdominal pain, and digestive problems. Abused women also had more (P< or =.001) gynecological, chronic stress-related, central nervous system, and total health problems. Abused women have a 50% to 70% increase in gynecological, central nervous system, and stress-related problems, with women sexually and physically abused most likely to report problems. Routine universal screening and sensitive in-depth assessment of women presenting with frequent gynecological, chronic stress-related, or central nervous system complaints are needed to support disclosure of domestic violence.
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Social support for abused women may reduce the impact of abuse on mental health, yet few studies have addressed this issue. We wish to determine associations between intimate partner violence (IPV) and mental health outcomes and to assess the protective role of abuse disclosure and support on mental health among abused women. A cross-sectional survey was conducted of 1152 women, ages 18-65, recruited from family practice clinics from 1997 through 1999. They were screened for IPV during a brief in-clinic interview, and physical and mental health status was assessed in a follow-up interview. IPV, defined as sexual, physical, or psychological abuse, was associated with poor perceived mental and physical health, substance abuse, symptoms of posttraumatic stress disorder (PTSD), current depression, anxiety, and suicide ideation/actions. Among women experiencing IPV and controlling for IPV frequency, higher social support scores were associated with a significantly reduced risk of poor perceived mental health (adjusted relative risk [aRR] 0.5, 95% confidence interval [CI] 0.3, 0.6) and physical health (aRR 0.6, 95% CI 0.5, 0.8), anxiety (aRR 0.3, 95% CI 0.2, 0.4), current depression (aRR 0.6, 95% CI 0.5, 0.8), PTSD symptoms (aRR 0.5, 95% CI 0.4, 0.8), and suicide attempts (aRR 0.6, 95% CI 0.4, 0.9). Healthcare providers can be instrumental in identifying IPV and helping women develop skills, resources, and support networks to address IPV. Physicians, family, or friends may provide needed social support.
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Primary fibromyalgia is regarded as disorder with a complex symptomatology, and no morphological alterations. Findings increasingly point to a dysfunction of the central nervous pain processing. The study aims to discuss vulnerability for fibromyalgia from a developmental psychopathological perspective. We investigated the presence of psychosocial adversities affecting the childhood of adult fibromyalgia patients (FM) and compared them to those of patients with somatoform pain disorders (SOM) and a control group (CG) with medically explained chronic pain. Using the structured biographical interview for pain patients (SBI-P), 38 FM patients, 71 SOM patients, and 44 CG patients were compared on the basis of 14 childhood adversities verified as relevant regarding longterm effects for adult health by prospective studies. The FM patients show the highest score of childhood adversities. In addition to sexual and physical maltreatment, the FM patients more frequently reported a poor emotional relationship with both parents, a lack of physical affection, experiences of the parents' physical quarrels, as well as alcohol or other problems of addiction in the mother, separation, and a poor financial situation before the age of 7. These experiences were found to a similar extent in the SOM patients, but distinctly less frequently in the CG. The results point to early psychosocial adversities as holding a similar etiological meaning in fibromyalgia as well as in somatoform pain disorders. The potential role of these factors as increasing the vulnerability for fibromyalgia is discussed.
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OBJECTIVE: To assess whether being physically abused during pregnancy increases the risk of a low birth weight (LBW) infant. METHODS: We conducted a hospital‐based case‐control study in León, Nicaragua. Cases consisted of 101 newborns with a birth weight under 2500 g, and for each case two controls with a birth weight over 2500 g were selected randomly from infants born the same day. Anthropometry of newborns was done immediately after birth, and background information and data on experiences of violence and potential confounders were obtained through private interviews with mothers. Crude and adjusted odds ratios (ORs) and population‐attributable proportion were calculated for exposure to partner abuse in relation to LBW. Multivariate logistic regression analysis was used to control for potential confounding. RESULTS: Seventy‐five percent of LBW newborns (cases) were small for gestational age and 40% were preterm. Twenty‐two percent of the mothers of LBW infants had experienced physical abuse during pregnancy by their intimate partners compared with 5% of controls. Low birth weight was associated with physical partner abuse even after adjustment for age, parity, smoking, and socioeconomic status (OR 3.9; 95% confidence interval 1.7, 9.3). Given a causal interpretation of the association, about 16% of the LBW in the infant population could be attributed to physical abuse by a partner in pregnancy. CONCLUSION: Physical abuse by a partner during pregnancy is an independent risk factor for LBW.
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A community volunteer sample of 98 battered women was interviewed using a combination of established instruments and in-depth questions over three points in time during a period of 3½ years. An ANOVA change analysis approach was used, dividing the women into three approximately equal groups according to abuse status. Groups 1 and 2, women who indicated a change from abuse to nonabuse status, reported significantly better health as compared to women reporting abuse at all three times. In contrast, depression decreased for all 3 groups from Time 1 to Time 2, with a significant increase at Time 3 with no effect of abuse status. Self-esteem in non-African American women had a similar trajectory. However, for African American women, the means in both self-esteem and self-care agency increased across all three times, regardless of abuse. Depression trajectories also differed between African American and non-African American women.
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Background: Few population-based studies have assessed the physical and mental health consequences of both psychological and physical intimate partner violence (IPV) among women or men victims. This study estimated IPV prevalence by type (physical, sexual, and psychological) and associated physical and mental health. consequences among women and men. Methods: The study analyzed data from the National Violence Against Women Survey (NVAWS) of women and men aged 18 to 65. This random-digit-dial telephone survey included questions about violent victimization and health status indicators. Results: A total of 28.9% of 6790 women and 22.9% of 7122 men had experienced physical, sexual, or psychological IPV during their lifetime. Women were significantly more likely than men to experience physical or sexual IPV (relative risk [RR] =2.2, 95% confidence interval [CI] =2.1, 2.4) and abuse of power and control (RR=1.1, 95% CI=1.0, 1.2), but less likely than men to report verbal abuse alone (RR=0.8, 95% CI=0.7, 0.9). For both men and women, physical IPV victimization was associated with increased risk of current poor health; depressive symptoms; substance use; and developing a chronic disease, chronic mental illness, and injury. In general, abuse of power and control was more strongly associated with these health outcomes than was verbal abuse. When physical and psychological IPV scores were both included in logistic regression models, higher psychological IPV scores were more strongly associated with these health outcomes than were physical IPV scores. Conclusions: Both physical and psychological IPV are associated with significant physical and mental health consequences for both male and female victims.
Article
During an 8-month period a total of 117 battered wives, all seeking emergency surgical care, were identified. Twenty-two of the battered wives were found to have made 82 suicide attempts during the 16-year study period. This corresponds to an incidence more than 8 times that of an unselected population of women being treated because of attempted suicide in the same hospital. The suicide attempts were predominately passive methods. Although conflict with the husband was the most common triggering factor for the attempt, mental disorder of the woman was another main cause. It is concluded that the doctor, when confronted with a patient who has attempted suicide, always should consider the possibility of ongoing physical abuse. Although battering generally is not the only explanation, the physician should remember this possibility and the patient should, if necessary, be referred to proper care services.
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To determine the prevalence of sexual abuse in women diagnosed as having fibromyalgia (FM) compared with controls. A self-administered questionnaire designed to obtain information regarding demographics, health care utilization, and history of sexual and physical abuse was completed by 40 women with FM and by 42 women who had no evidence of connective tissue disease or other major medical condition. Women with FM reported more physical symptoms and were significantly different on multiple indices of health compared with controls. Twenty-six FM subjects (65%) reported sexual abuse, in comparison with 22 controls (52%). The prevalence and type of abuse were not significantly different between groups. Sexually abused FM subjects reported significantly more symptoms than did non-sexually abused FM women, but did not differ in the number of symptoms for which they sought medical treatment. Sexual abuse does not appear to be a specific factor in the etiology of FM, but is correlated with the number and severity of associated symptoms.
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Data on over 20,000 women and men aged 20-59 are analysed from the British General Household Survey for 1991 and 1992, showing the importance of separately analysing educational qualifications, occupational class and employment status for both women and men. Own occupational class and employment status are the key structural factors associated with limiting long-standing illness, but educational qualifications are particularly good predictors of women's self-assessed health. Class inequalities in health are less pronounced among women who are not in paid work. Women's limiting long-standing illness relates solely to their own labour market characteristics, whereas self-assessed health relates to wider aspects of women's everyday lives, including their household material conditions, and for married women, their partner's occupational class and employment status. Men's unemployment has adverse consequences for the health of their wives, which occurs through the mechanism of the family living in disadvantaged material circumstances. Women's labour market position and role in the family have undergone substantial changes since the 1970s. Approaches to measuring inequalities in women's health need to reflect changes in women's employment participation and changes in marital status and living arrangements.
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We examined relationships between perceived physical and emotional trauma that occur prior to, or that initiate, pain onset and health care seeking for fibromyalgia syndrome (FMS). We also assessed associations between perceived trauma and levels of health care usage, symptom severity, functional disability, and receipt of disability compensation among patients with FMS. We evaluated these variables using interviews and standardized instruments in a consecutive series of FMS patients and community residents who met the American College of Rheumatology criteria for FMS but had not sought medical care ("nonpatients"). Emotional trauma was associated with status as an FMS patient independently of demographics, physical trauma, and sexual/physical abuse (P = 0.007). Among patients, emotional trauma was related to a high number of physician visits (P = 0.013), functional disability ratings (P = 0.012), and fatigue (P = 0.029), but physical trauma was associated with receipt of disability compensation (P = 0.019). Trauma history was not related to pain severity or pain thresholds. Perception of physical trauma is a greater determinant of disability compensation for FMS than is perceived emotional trauma, symptom severity, or functional disability. Effort should be devoted to understanding the social and legal factors underlying this observation, as well as to reducing high health care usage among FMS patients with emotional trauma.
Article
To evaluate the relationship between sexual and/or physical abuse and health care usage in patients with fibromyalgia (FM) and identify variables that may influence this relationship. We assessed history of sexual/physical abuse, health care utilization, and medication usage, as well as related variables in 75 women with FM using standardized questionnaires, structured interviews, and laboratory pain perception tasks. Fifty-seven percent of FM patients reported a history of sexual/physical abuse. Compared to non-abused patients, abused patients reported significantly greater utilization of outpatient health care services for problems other than FM and greater use of medications for pain (P < or = 0.025). Consistent with our expectations, abused patients also were characterized by significantly greater pain, fatigue, functional disability, and stress, as well as by a tendency to label dolorimeter stimuli as painful regardless of their intensities (P < or = 0.05). Additional analyses suggested that the high frequency of sexual/physical abuse in our patients was associated primarily with seeking health care for chronic pain rather than the FM syndrome itself or genetic factors. There is an association in FM patients between sexual/physical abuse and increased use of outpatient health care services and medications for pain. This association may be influenced by clinical symptoms, functional disability, psychiatric disorders, stress, and abnormal pain perception. The relationships among these variables should be further tested in prospective, population-based studies.
Article
This longitudinal study aimed to establish a firmer scientific basis for recognition and treatment of post-traumatic psychiatric morbidity associated with domestic violence. The study used a sample of 335 women (mean age 45.5 years) recruited from the Royal Brisbane Hospital Emergency Department. This paper reports baseline data. The outcome measures of lifetime psychiatric diagnoses (DSM-111-R classification), showed that women who reported lifetime adult intimate abuse (n = 162) received significantly more diagnoses of generalised anxiety, dysthymia, depression, phobias, current harmful alcohol consumption and psychoactive drug dependence than those who reported no abuse ever (n = 173). Of the 191 women tested for lifetime post-traumatic stress disorder, those who reported lifetime abuse (n = 115) received significantly more diagnoses than those who reported no abuse (n = 76). Crude prevalence rates of psychiatric diagnoses for women who reported double abuse as child and adult were significantly higher than for women who reported adult intimate abuse only. Adjusted rates showed that doubly abused women had significantly greater risk of current harmful alcohol consumption and lifetime drug dependence than women who reported adult abuse only. A significant independent factor for lifetime psychiatric diagnoses was reporting abuse between a woman's parents. Measurement of the population attributable risk found that one-third of the psychiatric diagnoses were attributable to domestic violence.
Article
Assessment of the prevalence and health consequences of domestic violence among women in Karachi, Pakistan. Confidential interviews were conducted among 150 women randomly selected from health facilities. 34% reported ever being physically abused, 15% ever being physically abused whilst pregnant and 72% of physically abused women were anxious/depressed. Physical abuse was a major predictor of anxiety/depression. The magnitude, physical and mental health consequences of domestic violence represents a serious reproductive health concern for Pakistan.
Article
The purpose of this study was to investigate the presence of emotional abuse and two psychosocial constructs (self-blame and self-silencing) in a sample of women diagnosed with irritable bowel syndrome (IBS) relative to a comparison sample of women diagnosed with inflammatory bowel disease (IBD). Women diagnosed with IBS (N = 25) were compared with women diagnosed with IBD (N = 25) on measures of history of abuse, self-blame, and self-silencing. It was found that women in the IBS sample scored significantly higher on emotional abuse, self-blame, and self-silencing than did women in the IBD sample. These three variables were also found to be significantly intercorrelated in both the IBS and IBD samples. Finally, emotional abuse was significantly higher in IBS patients than in IBD patients beyond the differences accounted for by physical and/or sexual abuse history. These findings empirically demonstrate an association between IBS and emotional abuse, as well as a possible connection with psychosocial variables, that may mediate the connection between emotional abuse and functional bowel symptoms. We suggest that these variables be further evaluated in the context of clinically relevant research on IBS.
Article
This cross-sectional controlled study investigated the association between chronic pain, health care utilization and a history of childhood sexual abuse. Three groups, constituting 80 women in total, were studied (1) attendees at group therapy for individuals who had experienced childhood sexual abuse (n = 26); (2) Two control groups consisting of nonabused (a) psychiatric outpatients (n = 33); and (b) nurses (n = 21). The setting was a university affiliated community and tertiary care hospital in London. Ontario. Each subject voluntarily completed questionnaires documenting history of childhood abuse, pain, psychological symptomatology and medical and surgical history. Sixty-nine percent of the women who had experienced childhood sexual abuse reported a chronic painful condition lasting more than three months, compared to 43% of the combined control groups (p = .026). Women who had experienced childhood sexual abuse reported a greater number of painful body areas (p = .003), more diffuse pain and more diagnoses of fibromyalgia (p = .013). They had more surgeries (p = .037), hospitalizations (p = .0004) and family physician visits (p = .046). Women with a history of childhood sexual abuse reported more chronic pain symptoms and utilized more health care resources compared to nonabused control subjects. Identification of such a history in the patient experiencing persisting pain may be the first step toward a successful combination of medical and psychosocial interventions.
Article
Studies indicate that women abused by their intimate partners are at increased risk for a number of health problems and have increased rates of health care utilization. However, these findings are based mainly on studies using clinic or health plan populations. In this study, we examined the association between intimate partner abuse (IPA) and health concerns and health care utilization in a population-based sample of adult women. We analyzed data on 2043 women aged 18 to 59 who participated in the 1998 Massachusetts Behavioral Risk Factor Surveillance System (BRFSS), a population-based health survey that included questions on IPA. IPA was defined as experiencing physical violence by, fear of, or control by an intimate partner. Consequences of IPA and self-rated health status and health care utilization of women experiencing IPA were examined. A total of 6.3% of Massachusetts women aged 18 to 59 reported IPA during the past year. Women experiencing IPA were more likely than other women to report depression, anxiety, sleep problems, suicidal ideation, disabilities, smoking, unwanted pregnancy, HIV testing, and condom use. Women experiencing IPA were less likely to have health insurance, but received routine health care at similar rates as other women. These results indicate that women in the general population experiencing IPA are at increased risk for several serious emotional and physical health concerns. Most of these women are in routine contact with health care providers. These findings also suggest that the BRFSS may provide a valuable mechanism for tracking state-based IPA prevalence rates over time.
Article
This study examined the health consequences of having experienced both sexual and physical abuse relative to women experiencing physical abuse but not sexual abuse. A cross-sectional study was conducted among 203 women seeking refuge in battered women's shelters. Controlling for sociodemographics, logistic regression analyses were conducted to assess the consequences of experiencing both sexual and physical abuse. Compared to women experiencing physical abuse, women experiencing both sexual and physical abuse were more likely to have a history of multiple sexually transmitted diseases (STDs) in their abusive relationships, have had an STD in the past 2 months, be worried about being infected with HIV, use marijuana and alcohol to cope, attempt suicide, feel as though they had no control in their relationships, experience more episodes of physical abuse in the past 2 months, rate their abuse as more severe, and be physically threatened by their partner when they asked that condoms be used. Given the prevalence of adverse health outcomes, domestic violence shelters could counsel women to avoid using alcohol/drugs as a coping strategy, educate women about alternative healthy coping strategies, counsel women about methods of STD prevention that they can control, and provide STD screening and treatment.
Article
The authors studied the prevalence and characteristics of different forms of victimization in 95 patients suffering from chronic fatigue syndrome (CFS) or fibromyalgia (FM) compared with a chronic disease group, including rheumatoid arthritis (RA) and multiple sclerosis (MS) patients, and a matched healthy control group. The authors assessed prevalence rates, nature of victimization (emotional, physical, sexual), life period of occurrence, emotional impact, and relationship with the perpetrator by a self-report questionnaire on burdening experiences. CFS and FM patients showed significantly higher prevalences of emotional neglect and abuse and of physical abuse, with a considerable subgroup experiencing lifelong victimization. The family of origin and the partner were the most frequent perpetrators. With the exception of sexual abuse, victimization was more severely experienced by the CFS/FM group. No differences were found between healthy control subjects or RA/MS patients, and between CFS and FM patients. These findings support etiological hypotheses suggesting a pivotal role for chronic stress in CFS and FM and may have important therapeutic implications.
Article
In medical settings intimate partner violence (IPV) has been linked to a variety of health problems. However, few population-based studies have assessed the health of abused women, particularly women from low socioeconomic groups such as Mexican Americans. This study examined the association between recent physical or sexual IPV and self-rated health, chronic health conditions, and somatic symptoms among Mexican American women. Participants were women (N = 1155) with current male partners enrolled in a household survey of 3012 Mexican-origin adults, ages 18 to 59 years, living in urban, town, and rural areas of Fresno County, California. Crude and adjusted odds ratios (ORs) were calculated for four self-assessed health measures, seven chronic diseases, and 32 somatic symptoms. In multivariate analyses, women reporting previous-year physical or sexual IPV were more likely to report 1) fair/poor overall health (OR, 1.9; confidence interval [CI], 1.0-3.7), physical health (OR, 2.1; CI, 1.2-3.9), and mental health (OR, 3.4; CI, 1.9-6.1), as well as worse comparative health (OR, 4.4; CI, 2.3-8.3); 2) a history of heart problems (OR, 17.0; CI, 4.3-66.7); 3) persistent health problems (OR, 3.3; CI, 1.5-7.0); and 4) numerous somatic symptoms. Physical or sexual IPV was associated with poorer self-assessed health and many health symptoms among this culturally distinctive Mexican American population.
Article
Major depressive disorder is a significant cause of morbidity among women in the USA. Women are twice as likely as men to be diagnosed with major depressive disorder, yet no known risk factors can account for this sex difference. We aimed to assess violent victimisation as a risk factor for depression in women. We undertook a case-control study to assess the association between violent victimisation early in life and major depressive disorder in women. We randomly selected a population-based sample of women, aged 36-45 years, from the greater Boston area. In 1999, 236 cases and 496 controls (n=732) completed a self-administered questionnaire designed to ascertain a lifetime history of exposure to violent victimisation. Our main outcome measure was major depressive disorder, assessed by structured clinical interview for Diagnostic Statistical Manual IV (DSM-IV) criteria. 363 (50%) of 732 respondents reported experience or fear of abuse as a child or adolescent. 68 were excluded because they reported violence as an adult only. Compared with women who reported no abuse, risk of depression was increased in women who reported any abuse as a child or adolescent (relative risk 2.5, 95% CI 1.9-3.0), physical abuse only (2.4, 1.8-3.0), sexual abuse only (1.8, 1.2-2.8), and both physical and sexual abuse (3.3, 2.5-4.1). Severity of abuse had a linear dose-response relation with depression. Our results suggest a positive association between violent victimisation early in life and major depressive disorder in women.
Article
Victims of intimate partner violence (IPV) often develop psychiatric disorders. We examined the extent and correlates of comorbidity between two of the disorders most frequently linked to trauma--major depressive disorder (MDD) and post-traumatic stress disorder (PTSD)--in a group of 44 women who were victims of IPV within the preceding 2 years. MDD (68.2%) and PTSD (50.0%) were highly prevalent on a lifetime basis in female victims of IPV. On a current basis, MDD (18.2%) and IPV-related PTSD (31.8%) were more frequently comorbid (42.9% of cases of current IPV-related PTSD also had MDD) than would be expected by chance (P<0.001). Most cases of current MDD occurred in persons who also had current IPV-related PTSD. Severity of depressive and PTSD symptoms were highly correlated (r=0.84). Although women with PTSD were significantly more disabled than women without PTSD, persons with comorbid PTSD and MDD were not significantly more disabled than those with PTSD alone. Cross-sectional study; entry criteria for study may limit generalizability. PTSD and MDD symptoms are frequently seen in the aftermath of IPV, and often co-occur. The usefulness of the distinction between PTSD and MDD in this context remains to be determined, both in terms of diagnostic classification and prognostic implications.
Article
Intimate partner violence, which describes physical or sexual assault, or both, of a spouse or sexual intimate, is a common health-care issue. In this article, I have reviewed research on the mental and physical health sequelae of such violence. Increased health problems such as injury, chronic pain, gastrointestinal, and gynaecological signs including sexually-transmitted diseases, depression, and post-traumatic stress disorder are well documented by controlled research in abused women in various settings. Intimate partner violence has been noted in 3-13% of pregnancies in many studies from around the world, and is associated with detrimental outcomes to mothers and infants. I recommend increased assessment and interventions for intimate partner violence in health-care settings.
Article
Previous research suggests that sufferers of irritable bowel syndrome (IBS) report a greater prevalence of sexually and physically abusive experiences than patients with organic gastrointestinal disorders and non-patient populations. This has led to suppositions that previous abusive experiences might predispose to the development of functional gastrointestinal disorders. This study aimed to investigate the hypothesis that the prevalence of previous abuse experiences in patients with functional bowel disorders (FBD) is greater than it is in patients with a painful organic bowel disorder and healthy control subjects. Fifty-three idiopathic constipation patients were compared with matched control groups of 50 IBS patients, 51 Crohn disease patients and 53 non-patient control subjects. Measures of previous abuse experiences were taken using a self-report questionnaire and a semistructured interview. Other questionnaires of psychological distress were also administered. No significant differences were found between all four groups, both for measures of abuse and for psychological distress. However, patients who reported past abuse, irrespective of their FBD status. demonstrated significantly higher levels of current psychological distress. These results challenge the current assumption that past abuse experiences may be significant in the later presentation of functional bowel disorders, but suggest that previous abuse experience might be related to a general level of psychopathology.
Article
Victimization by intimate partner violence (IPV) may play an important role in sexual decision-making, increasing the risk for sexually transmitted diseases (STDs) and HIV. To explore the relationship between IPV and high-risk sexual behaviors, substance abuse, partners who had sex outside the relationship, and history of STD among women attending an STD clinic. A self-administered survey of patients attending a public STD clinic in San Francisco was conducted from October 1996 to March 1997. Topics included STD history, sexual risk behaviors, partner violence history, partner characteristics, and demographics. Logistic regression analysis was used to assess the independent effect of IPV on STD risk factors. Overall, 2115 patients participated, for a response rate of 96%. Data were analyzed for a subgroup of 409 female patients who reported recent male sexual partners. Among these women, 11% reported IPV in the past 12 months; lifetime history of IPV was 24%. A history of IPV was associated with a self-reported history of STD (adjusted odds ratio [OR], 2.15; 95% CI, 1.23-3.77). IPV in the past 12 months was associated with alcohol or drug use before sex (adjusted OR, 2.36; 95% CI, 1.17-4.77) and main partners who had sex outside the relationship (adjusted OR, 3.75; 95% CI, 1.94-7.26). IPV is common among female STD patients and is associated with risk behaviors and partner factors that increase patients' risk of contracting STD and HIV. Screening and referral for IPV should be routinely conducted for female patients attending STD clinics.
Article
To assess whether being physically abused during pregnancy increases the risk of a low birth weight (LBW) infant. We conducted a hospital-based case-control study in León, Nicaragua. Cases consisted of 101 newborns with a birth weight under 2500 g, and for each case two controls with a birth weight over 2500 g were selected randomly from infants born the same day. Anthropometry of newborns was done immediately after birth, and background information and data on experiences of violence and potential confounders were obtained through private interviews with mothers. Crude and adjusted odds ratios (ORs) and population-attributable proportion were calculated for exposure to partner abuse in relation to LBW. Multivariate logistic regression analysis was used to control for potential confounding. Seventy-five percent of LBW newborns (cases) were small for gestational age and 40% were preterm. Twenty-two percent of the mothers of LBW infants had experienced physical abuse during pregnancy by their intimate partners compared with 5% of controls. Low birth weight was associated with physical partner abuse even after adjustment for age, parity, smoking, and socioeconomic status (OR 3.9; 95% confidence interval 1.7, 9.3). Given a causal interpretation of the association, about 16% of the LBW in the infant population could be attributed to physical abuse by a partner in pregnancy. Physical abuse by a partner during pregnancy is an independent risk factor for LBW.
Article
This study set out to examine whether women victimized by domestic violence in a given year subsequently have more health problems measured by amount of hospital contacts due to disease than non-victimized women. A case control study was carried out, based on data in the Danish National Patient Register, which covers all hospital contacts, identified by the unique citizen number. Three age groups were included: 15-19, 20-29, and 30-49 years. Cases were women with any hospital contact as a result of intentional injuries, defined as domestic violence, in 1995, and controls were women with all other reasons for hospital contact in 1995. The Nordic Classification of External Causes of Injuries classified reason for contact, place of occurrence, and mechanism of injury. Domestic violence was defined as intentional injury by blunt force and occurring in a residential area. The rate of subsequent hospital contacts because of any disease, induced abortions, gynaecological diseases, and mental illness among cases and controls in 1996-98 was compared. 1,815 women victimized by domestic violence and 388,366 controls were identified. In the entire period, the victims of violence presented significantly more health problems than the controls, as measured by hospital contacts due to any disease. The rate of contacts due to induced abortions, gynaecological diseases, and mental illness was significantly higher among the victims in all three age groups in the first year following the identified violence. In the entire period, victims of violence aged 20-49 presented a significantly higher rate of contacts due to mental illness, and victims aged 20-29 years a higher rate of induced abortions. Registration practice of all hospital contacts in Denmark facilitates nationally representative analyses of associations between violence and health problems. The observed differences among women victimized by domestic violence and controls point to violence against women as a major public health problem. Proper registration of hospital contacts due to intentional injury may both guarantee adequate follow-up of the individual victim, and serve as a useful tool in the monitoring of general violence prevention.