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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Native Americans appear to be at higher risk than other U.S. ethnic groups for mental health problems, including depression, substance abuse, domestic violence, and suicide. Despite recent increases in the federal budget for mental health services for Native Americans, less than 50 percent of the estimated need for ambulatory services is being met. Initiatives to improve the quantity and quality of mental health services for Native Americans in the 1990s include development of a national mental health plan, increased technical assistance to Native American communities, additional training and research, and continued attention to standards that promote high-quality, culturally relevant care. Tribes themselves are seen as the most appropriate locus for initiation of programs for preventing emotional problems in their communities.
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PMID:An overview of mental health services for American Indians and Alaska Natives in the 1990s. 155 21

Screening for psychosocial risk factors has been limited by lack of a structured approach. The purpose of this study was to assess the utility of a self-administered questionnaire compared with routine history as recorded in the medical record in screening for risk factors for dysfunctional parenting in an urban pediatric clinic. English-speaking parents were offered questionnaires in the waiting room. In addition to routine demographic and medical questions, the questionnaires contained standard screening instruments for substance abuse, depression, self-esteem, and social support, as well as questions about domestic violence, homelessness, and parental history of abuse as a child. Medical records were reviewed separately. Of the 114 mothers who returned questionnaires, the response rate for sensitive questions such as income was greater than or equal to 85%. Compared with the medical record, the questionnaire identified significantly more mothers with possible substance abuse, depression, low self-esteem, and/or history of abuse as a child (P less than .01 for each). Compared with what is usually recorded in the medical record, self-administered questionnaires yield substantial additional information regarding psychosocial risk factors for dysfunctional parenting. Such questionnaires should be considered for routine psychosocial screening in clinics serving high-risk populations.
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PMID:Self-administered questionnaire for structured psychosocial screening in pediatrics. 174 Dec 17

Although nurses may have the necessary skills to plan care of clients in a variety of settings, experience and research demonstrate that nursing interventions with women victims of violence have been consistently inadequate. Of the 243 nursing students included in this study, 8% reported experiencing physical abuse, and 18.9% reported experiencing nonphysical abuse. Difficulties with depression for 26.1% of the students and some level of clinical stress were reported in over half of the group. Specific needs to combat violence and abuse against nurses and nursing students include providing better information on such behavior by incorporating family-violence education into nursing-school curricula, and using this proactively in confronting domestic violence in home and work settings.
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PMID:Partner abuse against female nursing students. 773 66

Presented the 6-month follow-up findings of an experimental intervention designed to provide postshelter advocacy services to women with abusive partners. The intervention involved randomly assigning half the research participants to receive the free services of an advocate, 4 to 6 hours per week, for the first 10 weeks postshelter. One hundred forty-one battered women were interviewed about their experiences immediately upon their exit from a domestic violence shelter: 95% of the sample were interviewed 10 weeks thereafter (postintervention), and 93% were successfully tracked and interviewed 6 months later. At the 6-month follow-up, participants in both groups reported increased social support, increased quality of life, less depression, less emotional attachment to their assailants, and an increased sense of personal power. Although women in both groups reported some decrease in physical abuse over time, there were no statistically significant differences between those with and those without advocates, and abuse continued to be a problem for many women. Those who were still involved with their assailants continued to experience higher levels of abuse and had been more economically dependent upon the men prior to entering the shelter. Women who had worked with advocates continued to report being more satisfied with their overall quality of life than did the women in the control group.
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PMID:An advocacy intervention program for women with abusive partners: six-month follow-up. 794 42

Domestic violence is a widespread problem in our society that has not been extensively studied using psychological assessment tools. In this investigation, the psychological functioning of battered women in transition was examined through the use of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2). Thirty-one women (M age = 30 years, M education = 11.5 years) were evaluated as residents in a confidential shelter operated by Women Against Abuse. All subjects were asked to complete the MMPI-2 as well as information on their history of length, severity, and types of abuse (i.e., physical and/or psychological). Results indicated elevated MMPI-2 profiles in 90% of the subjects with the most frequent code type being a combination of Scales F, 4, 6, and 8. Scales 2 and 7, which are often associated with depression, anxiety, and other forms of subjective distress, were not consistently elevated. Supplementary MMPI-2 scales revealed elevations on scales MAC-R, Mt, PK, and PS. Regression analysis indicated significant relationships between length and severity of psychological forms of abuse and overall levels of psychological distress (i.e., F scale and average clinical T-score). Age and physical forms of abuse were not related to MMPI indices of psychological disturbance. Theoretical issues of domestic violence, intervention strategies with battered women, and the dangers of misdiagnosis are discussed.
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PMID:MMPI-2 profiles of battered women in transition. 843 60

Domestic violence from a spouse or an intimate partner has become a public issue as well as criminal justice, since it was known to be a leading cause of death, in the US. Physical therapists (PTs) play a critical role in prevention, treatment, and rehabilitation in health care of a battered patient. This study describes the knowledge of PTs regarding battered women and determines whether PTs recognize these patients in clinical settings. 200 questionnaires were distributed to 25 outpatient PT facilities in northern California. 151 usable questionnaires were returned. Results showed that out of the 151 respondents (121 females, 30 males), 43% dealt with women whom they strongly suspected or identified as being physically battered; however, only 1% of the respondents routinely inquired about physical abuse. Furthermore, 42% correctly identified the neck, head, chest, and abdomen as the most common location of injuries, and having depression as a psychological symptom resulting from the abuse. The results of the survey suggest that the detection of battered patients by a PT was very low. This could be due to the PT's lack of domestic violence education; and reluctance to ask patients whether they were abused; or beliefs that domestic violence was an uncommon occurrence in their patients' lives.
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PMID:Physical therapists' recognition of battered women in clinical settings. 854 89

Domestic violence is a common problem that may affect more than a quarter of women. It is a complex area in which to undertake research. Studies often focus on selected populations and exhibit a diversity of design, making comparison difficult. This review focuses on physical violence by men against women partners or ex-partners, and exemplifies important issues for general practitioners. Domestic violence frequently goes undetected. This may be the result of doctor's fears of exploring an area perceived as time-consuming, where knowledge is lacking and where they feel powerless to 'fix' the situation. Women may not reveal that they are experiencing violence, sometimes because doctors are unsympathetic or hostile. Nevertheless, women wish to be asked routinely about physical abuse and want to receive immediate advice and information about their options if necessary. Women experience a range of health and social problems in association with domestic violence, including depression, anxiety, substance abuse and pregnancy complications. However, none of these features is specific enough to be useful as an indicator of violence. Therefore, doctors should routinely ask all women direct questions about abuse. This recommendation can be incorporated into guidelines, which should be implemented widely in the UK, to improve the care of women experiencing domestic violence. In parallel with this, the educational needs of general practitioners should be addressed. Further research is needed to establish the prevalence of domestic violence in women presenting to general practice and to investigate how the problem is currently being addressed. If progress is to be made in tackling domestic violence, action within primary care is just one part of this: a fundamental change in the attitudes of men towards women is required.
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PMID:Domestic violence: a hidden problem for general practice. 894 4

Empirical evidence suggests that between 33% and 83% of Hawaii women receiving services from programs that serve battered women meet diagnostic criteria for posttraumatic stress disorder (PTSD). In addition, PTSD symptom severity is associated with depression severity, lowered self-esteem, and diminished quality of life. Combined with evidence that domestic violence often goes on for years, these findings provide additional compelling reasons why domestic violence screening should be conducted routinely in medical settings.
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PMID:PTSD among women survivors of domestic violence in Hawaii. 888 21

This study reports on the use of the Brief Symptom Inventory, a shortened version of the Symptom Check List-90-Revised, to measure psychopathological symptoms that predict male domestic violence. A sample of 152 men and their partners reported on the severity of violent behavior present in their relationship. Discriminant analysis indicated variation in men's violent status as a function of psychopathological symptoms. Violent men evidenced higher scores on 7 of the 9 subscales of the Brief Symptom Inventory, namely, Depression, Anxiety, Hostility, Phobia, Paranoid Ideation, Interpersonal Sensitivity, and Psychoticism.
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PMID:Utilization of the Brief Symptom inventory to discriminate between violent and nonviolent male relationship partners. 896 15

Although mental health problems constitute 8.1% of the global burden of disease (GBD), mental health has been largely missing from the international health agenda. The discrepancy between needs and services is likely to increase in the next millennium. Depression alone is currently the fourth leading cause of disability-adjusted life-years (DALYs) the world over and is projected to become the second leading cause by the year 2020. The nations of the world must make a major commitment to upgrade the quality of mental health services, including early detection and prevention of psychiatric problems in childhood and adolescence; to institute the collection of systematic data on the global burden of alcohol and drug abuse and to develop innovative treatment and preventive measures; and to provide substantial support for research on treatment effectiveness. Because hunger, deprivation, and violence affect women disproportionately, there is a pressing need for coordinated efforts to improve state gender policies (including equal educational opportunity and improved health care for women) and to interdict domestic violence. In the words of Boutros Boutros Ghali, the Secretary General of the United Nations: "Medical and social issues which are often viewed separately must be dealt with as a whole...the priority of mental health must be heightened...development policies must...protect and promote mental health."
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PMID:Psychiatry and health in low-income populations. 905 23


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