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A model of women's readiness to terminate an abusive relationship was examined, using cognitive and emotional factors to predict readiness to change as conceptualized in the transtheoretical model. Factors previously identified in the domestic violence literature were selected to represent cognitive predictors (attribution and attachment style) and affective predictors (depression, hopelessness, anxiety, and anger) of readiness to end a domestic violence relationship. Responses by 85 female victims of intimate partner violence indicated that their overall readiness to terminate a relationship was predicted by a preoccupied attachment style and high emotional arousal. However, women's low level of anger predicted their precontemplation of change, the earliest stage of readiness, whereas internalizing emotional difficulties and preoccupation with their batterer predicted maintenance, the final stage of readiness to persist in their decision to leave their abuser. Implications of these findings for working with women considering leaving their partner are discussed.
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PMID:Cognitive-affective predictors of women's readiness to end domestic violence relationships. 1705 60

Domestic violence rates among veterans with posttraumatic stress disorder (PTSD) are higher than those of the general population. Individuals who have been diagnosed with PTSD who seek couples therapy with their partners constitute an understudied population. Self-report measures of domestic violence, relationship satisfaction, and intimacy were administered at intake to 179 couples seeking relationship therapy at a Veterans Affairs clinic. Couples in which the veteran was diagnosed with combat-related PTSD were compared with two other groups based on the veteran's primary diagnosis (depression, adjustment disorder/V-code). Both the PTSD- and depression-diagnosed veterans perpetrated more violence than did those with adjustment/V-code diagnoses. Domestic violence rates among depressed and PTSD-diagnosed veterans were much higher than those found in previous research. Implications for assessment and treatment are discussed.
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PMID:Domestic violence in veterans with posttraumatic stress disorder who seek couples therapy. 1712 May 20

The aims of this study were to investigate acute and subacute post-traumatic reactions in victims of physical non-domestic violence. A Norwegian sample of 138 physically assaulted victims was interviewed and a questionnaire was completed. The following areas were examined: the frequency and intensity of acute and subacute psychological reactions such as peritraumatic dissociation (PD), post-traumatic stress disorder (PTSD) and anxiety and depression; the relationship between several psychological reactions; the relationship between psychological reactions and level of physical injury, perceived life threat, and potential of severe physical injury, and the relationship between psychological reactions and socio-demographic variables. The following distress reactions were measured retrospectively: PD, PTSD, and anxiety and depression. Thirty-three per cent of the victims scored as probable PTSD cases according to the Post Traumatic Symptoms Scale 10 (PTSS-10); the corresponding Impact of Event Scale-15 (IES-15) score identified prevalence of 34% respectively. Forty-four per cent scored as cases with probable anxiety and depression, according to the Hopkins Symptom Check List 25 (HSCL-25). Severity of perceived threat predicted higher scores on all measures of psychological reactions. There were no statistically significant differences between acute and subacute groups on PD, PTSS-10, IES-15, IES-22 and HSCL-25 according to measured means (and standard deviations) and occurrence of probable cases and risk level cases. The results showed no connection between severity of physical injury and caseness. The acute psychological impairment that results from assault violence may have a deleterious effect on the mental health of victims.
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PMID:Acute psychological reactions in assault victims of non-domestic violence: peritraumatic dissociation, post-traumatic stress disorder, anxiety and depression. 1716 53

Accurate estimates of health risk factors and outcomes are difficult to obtain for certain ethnic populations. The health of Jewish individuals is particularly hard to determine because of the small group size and because health data rarely include information on religious affiliation. Furthermore, local level health information (for any population subgroup) is limited. To assess health risk factors and outcomes, as well as issues related to access to care, within a Jewish community in Chicago, a group of community agencies and researchers initiated a unique, population-based health survey. Specifically, a three-stage sampling design was used to select a representative sample of 201 adults and 58 children in the most concentrated Jewish neighborhood in the city. Nearly 500 questions were asked, covering a wide variety of demographic, socioeconomic, and health-related topics. The findings revealed that these Jewish individuals were generally as healthy (or healthier) than the average residents of Chicago and the U.S.; however, many serious health concerns still existed. In particular, health problems such as obesity, depression, disability, and domestic violence were common and, in some cases, more prevalent than in the general population. This local level information provides the first accurate estimates of key health variables for the estimated 23,000 Jewish individuals living in this community. This type of data is essential because it enables the efforts and priorities of health and social service providers to be focused on the most pressing health problems. Moreover, this project provides an example for other population subgroups (based on residence, ethnicity, religious affiliation, country of origin, or other characteristics) who would benefit from local level health information.
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PMID:A local community health survey: findings from a population-based survey of the largest Jewish community in Chicago. 1718 42

Each year, exposure to violent trauma takes its toll on the development of millions of children. When their trauma goes unaddressed, children are at greater risk for school failure; anxiety and depression and other post-traumatic disorders; alcohol and drug abuse, and, later in life, engaging in violence similar to that to which they were originally exposed. In spite of the serious psychiatric/developmental sequelae of violence exposure, the majority of severely and chronically traumatized children and youth are not found in mental health clinics. Instead, they typically are seen as the 'trouble-children' in schools or emerge in the child protective, law enforcement, substance abuse treatment, and criminal justice systems, where the root of their problems in exposure to violence and abuse is typically not identified or addressed. Usually, providers in all of these diverse service systems have not been sufficiently trained to know and identify the traumatic origins of the children's presenting difficulties and are not sufficiently equipped to assist with their remediation. This multiplicity of traumatic manifestations outside the mental health setting leads to the inescapable conclusion that we are dealing with a supra-clinical problem that can only be resolved by going beyond the child's individual clinical needs to enlist a range of coordinated services for the child and the family. This paper will focus on domestic violence as a paradigmatic source of violent traumatization and will (a) describe the impact and consequences of exposure to violence on children's immediate and long-term development; (b) examine the opportunities for, as well as the barriers to, bridging the clinical phenomena of children's violent trauma and the existing systems of care that might best meet their needs; and (c) critique current national policies that militate against a more rational and coherent approach to addressing these needs.
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PMID:In the best interests of society. 1735 3

Annually an estimated 3 million or more children are exposed to acts of domestic violence between adults in their homes. These children are at risk for abuse themselves as well as other immediate and long-term problems, especially if they have been exposed to repeated episodes of domestic violence. Multiple behavioral manifestations, including anxiety, depression, and posttraumatic stress disorder, may be associated with violence exposure, and it is imperative that school nurses recognize these. All children should be screened for domestic violence exposure at regular intervals, and those who are at risk should have a more thorough health assessment. Planning for the safety of the child, nonoffending caregiver, and siblings and the school nurse involved in the situation is of utmost importance.
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PMID:Silent victims: children exposed to family violence. 1739 77

Antenatal depression is a depressive episode that begins in pregnancy and is often a predictor of postnatal depression. The main aim of this study was to examine the prevalence of antenatal depression and other psychiatric conditions in women referred to a consultation liaison psychiatry service because of positive scores on the Edinburgh Postnatal Depression Scale. The other aim was to review known risk factors in the women and note any significant findings. An audit of all women referred to the psychiatry team because of positive Edinburgh scores during a 2-year period was completed. Information about Edinburgh scores, clinical diagnoses at the time of the psychiatric appointment, and factors such as relationship status, domestic violence, ethnicity, and substance use was noted. According to the Diagnostic and Statistical Manual of Mental Disorders: Fourth Edition criteria: 36.5% of the women had an adjustment disorder, 13% had a major depression, 10% had dysthymia, 8% had a recurrent depressive disorder, 2% had post-traumatic stress disorder, and 2% had a borderline personality disorder. The findings demonstrated the usefulness of using a screening tool such as the Edinburgh Postnatal Depression Scale in detecting women requiring psychiatric intervention and highlighted the importance of a psychiatric interview assessment to interpret the scores of screened patients in terms of clinically relevant syndromes.
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PMID:Analysis of positive Edinburgh depression scale referrals to a consultation liaison psychiatry service in a two-year period. 1753 61

Violence against women is a human rights violation, which is increasingly becoming a serious public health issue. When it occurs in pregnant women, victims are recognised to be at higher risk of complications of pregnancy. A cross-sectional questionnaire survey was carried out over a 3-month period from May to July 2005 to document the prevalence, knowledge and perception of domestic violence (DV) on pregnant women attending the antenatal clinic of the National Hospital, Abuja, Nigeria. The mean age of the respondents was 31.5 +/- 4.25 years, with a range of 20 - 42 years. Most (85.2%) had attained tertiary education. While most (92.9%) were aware of DV in pregnancy, 125 women (37.4%) had experienced DV. Psychological abuse ranked highest with 66.4%, while physical and sexual abuse accounted for 23.4% and 10.2% of the group. Of this group, 21.2% required medical treatment as a result of DV, and all were aware of possible pregnancy complications, such as abortion, premature labour and depression. Most (81.9%) of the respondents felt DV was illegal. A majority (29.7%) kept their DV secret with a few numbers reporting to family, doctors, clergy or close friends. With higher educational status, the experience of DV was greater, although this was not statistically significant (p > 0.05). Similarly with increasing parity, although this tended to reverse after parity of 3. The prevalence of DV found in Abuja, the centrally located capital city of Nigeria is higher than that from the study in Zaria, northern Nigeria (28%). This is cause for concern, and points to a rising trend in the northern region of the country although the centres are different. Similarly, the husband/spouse was the most common offender; responsible here for 74.2% of cases. This may give justification to recent calls for paternal educational classes for spouses. Increasing public awareness remains the key, through education and public enlightenment campaigns, with more emphasis on the identified perpetrator class.
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PMID:Domestic violence on pregnant women in Abuja, Nigeria. 1765 90

This study investigated the relationship between dangerousness in intimate partner relationships and victims' mental health and/or health behavior problems. Health records of 387 women residents in a domestic violence shelter in an urban city on the East coast were reviewed. Of these, 177 women were eligible for this study. Dangerousness was determined by Danger Assessment Score (DA). Higher DA scores were significantly associated with mental health symptoms and health behaviors, including anxiety (p = 0.0024), depression (p = 0.017), difficulty concentrating (p = 0.001), memory loss (p = 0.008), suicidal attempts (p = 0.013), weight gain (p = 0.014), past history of smoking (p = 0.027), and past history of illicit drug use (p = 0.047).
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PMID:Dangerous intimate partner relationships and women's mental health and health behaviors. 1772 69

Estimates of intimate partner violence (IPV) during pregnancy vary by population being studied, measures, and other methodological limitations, hindering the ability to gauge the relationship between IPV and negative birth outcomes. The authors report aggregated data from a subsample (n = 148) of the first three waves of the Women's Employment Study. The authors compared groups of women who did and did not give birth to low birth weight infants on demographic, material deprivation, risk behavior, mental health, and IPV factors. The prevalence of domestic violence was more than twice as high for women with low birth weight infants as those women who had a normal weight infant. When considering additional risk factors, including food insufficiency, substance dependence, and depression and/or posttraumatic stress disorder, IPV remained a significant indicator, but it was most strongly associated with low birth weight among women also experiencing depression and/or posttraumatic stress disorder.
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PMID:Intimate partner violence, depression, and posttraumatic stress disorder as additional predictors of low birth weight infants among low-income mothers. 1776 28


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