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

We describe the assessment and treatment of a mother who was a victim of domestic violence and of her 10-year-old son, both of whom were living in a domestic violence shelter. The Parent-Child Interaction Assessment-II Modifying Attributions of Parents intervention (PCIA-II/MAP; Bohr, 2005; Bohr et al., 2008; Bohr & Holigrocki, 2005) is a structured brief treatment using video recordings from a parent's play with his or her child. The play involves using toy people and animals to complete story stems related to a trip to the zoo (see Holigrocki, Kaminski, & Frieswyk, 1999, 2002). The therapist shows the parent video excerpts of the interaction, invites reflection and commentary, and collaborates with the parent to change how she makes sense of her child's behaviors. The pretreatment assessment revealed a depressed, fearful, highly stressed mother with a harsh parenting style. Her son experienced significant distress; had behavior problems; and viewed adults as harsh, fragile, irresponsible, and unavailable. Posttreatment gains were evident in the parent's reduced depression and greater parenting sensitivity; however, parenting stress and child behavior problems remained elevated. We emphasize the utility and application of a multimodal assessment that integrates rating scales, free response, and video-recorded interactions.
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PMID:Interventional use of the parent-child interaction assessment-II enactments: modifying an abused mother's attributions to her son. 1967 46

Evidence linking alcohol and other drug abuse with child maltreatment, particularly neglect, is strong. But does substance abuse cause maltreatment? According to Mark Testa and Brenda Smith, such co-occurring risk factors as parental depression, social isolation, homelessness, or domestic violence may be more directly responsible than substance abuse itself for maltreatment. Interventions to prevent substance abuse-related maltreatment, say the authors, must attend to the underlying direct causes of both. Research on whether prevention programs reduce drug abuse or help parents control substance use and improve their parenting has had mixed results, at best. The evidence raises questions generally about the effectiveness of substance abuse services in preventing child maltreatment. Such services, for example, raise only marginally the rates at which parents are reunified with children who have been placed in foster care. The primary reason for the mixed findings, say Testa and Smith, is that almost all the parents face not only substance abuse problems but the co-occurring issues as well. To prevent recurring maltreatment and promote reunification, programs must ensure client progress in all problem areas. At some point in the intervention process, say Testa and Smith, attention must turn to the child's permanency needs and well-being. The best evidence to date suggests that substance-abusing parents pose no greater risk to their children than do parents of other children taken into child protective custody. It may be sensible, say the authors, to set a six-month timetable for parents to engage in treatment and allow twelve to eighteen months for them to show sufficient progress in all identified problem areas. After that, permanency plans should be expedited to place the child with a relative caregiver or in an adoptive home. Investing in parental recovery from substance abuse and dependence, the authors conclude, should not substitute for a comprehensive approach that addresses the multiple social and economic risks to child well-being beyond the harms associated with parental substance abuse.
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PMID:Prevention and drug treatment. 1971 26

There has been recent widespread media coverage of events that involve murder-suicide. In this paper, the author does an extensive literature review of studies about murder-suicide. The purpose is to determine whether the incidence of murder-suicide is increasing and what its risk factors are. The results of this review show that the incidence of murder-suicide remains at under 0.001%. Risk factors for murder-suicide are based on relationship between perpetrator and victims, history of domestic violence, sex or perpetrator and victim, age of perpetrator, presence of divorce/separation, use of weapon, and history of mental illness. This paper shows that the incidence of murder-suicide is low, stable, and similar to what has been reported in the past. There are, however, some distinct risk factors for murder-suicide including: substance abuse (not as common), mostly male perpetrators, depression (more common), and older male caregivers are at risk.
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PMID:Murder-suicide: a review of the recent literature. 2038 56

The study looked at 557 women participating in an evaluation of a domestic violence screening intervention in a primary care setting. Depression and anxiety were investigated in relation to seven types of child and adult intimate partner abuse. At the bivariate level, both physical and sexual child abuse were associated with significantly increased risk for all five types of adult abuse as well as depression and anxiety. Multivariate analyses suggested that recent intimate partner violence and high-severity child abuse increased risk for depression, and both recent and past intimate partner violence as well as child abuse increased risk for anxiety. In addition, higher levels of cumulative abuse increased risk for depression and anxiety over the life span even after controlling for other risk factors.
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PMID:Childhood and adult abuse among women in primary health care: effects on mental health. 1976 93

Until recently, the connection between intimate partner violence (IPV) and persistent poverty had been largely ignored. Recent research indicates, however, that the two phenomena cooccur at high rates; produce parallel effects; and, in each other's presence, constrain coping options. Therefore, both external situational, and internal psychological difficulties are missed when women contending with both poverty and IPV are viewed through the lens of just one or just the other. This article describes mental health consequences for women who contend with both partner violence and poverty. It proposes that the stress, powerlessness, and social isolation at the heart of both phenomena combine to produce posttraumatic stress disorder, depression, and other emotional difficulties. The article also introduces the term ''survival-focused coping'' to describe women's methods of coping with IPV in the context of poverty and highlights the role that domestic violence advocates, mental health providers, and researchers can play in addressing these tightly intertwined phenomena.
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PMID:When crises collide: how intimate partner violence and poverty intersect to shape women's mental health and coping? 1977 85

The purpose of this study was to evaluate risk factors for antepartum depressive symptoms that can be assessed in routine obstetric care. We evaluated articles in the English-language literature from 1980 through 2008. Studies were selected if they evaluated the association between antepartum depressive symptoms and > or =1 risk factors. For each risk factor, 2 blinded, independent reviewers evaluated the overall trend of evidence. In total, 57 studies met eligibility criteria. Maternal anxiety, life stress, history of depression, lack of social support, unintended pregnancy, Medicaid insurance, domestic violence, lower income, lower education, smoking, single status, and poor relationship quality were associated with a greater likelihood of antepartum depressive symptoms in bivariate analyses. Life stress, lack of social support, and domestic violence continued to demonstrate a significant association in multivariate analyses. Our results demonstrate several correlates that are consistently related to an increased risk of depressive symptoms during pregnancy.
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PMID:Risk factors for depressive symptoms during pregnancy: a systematic review. 2041 71

In this study, we investigated the coping behaviors used by Israeli mothers to manage various sources of stress, including security-related stress, based on a life-course perspective of women's health. A random telephone survey of 302 mothers who had children under age 18 living at home was conducted in the Negev area. Measures of stress such as domestic violence, sources of tension in everyday life, and time pressure were assessed together with indicators of exposure to the Intifada for their relationship to indicators of physiological health and depression. Factor analysis revealed three distinct coping styles: social-leisure style, loosening control style, and a restlessness style which were used by 91.4%, 68.5%, and 69.5% of the sample, respectively. Security-related stress was associated with greater reported health symptoms, particularly gynecological symptoms. A history of child abuse and domestic violence and exposure to the Intifada were associated with greater depressive symptoms, but not with physical health indicators. Other sources of stress particularly affected symptoms related to gynecological function. Most mothers used a variety of coping strategies during times of chronic security stress, some of which are health promoting and others that detract from health.
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PMID:Mothers' coping styles during times of chronic security stress: effect on health status. 2039 Jun 42

Intimate partner violence victimization has been associated with serious health problems among women, including many disorders that involve sleep disturbances. However, there has been only limited examination of sleep duration among women with victimization experiences. A total of 756 women with a domestic violence order (DVO) against a male intimate partner were interviewed about their health, mental health, substance use, and partner violence victimization. Face-to-face interviews were conducted from February 2001 to November 2003 for data collection in three rural and one urban county representing different jurisdictional settings. Because the current analyses focused on understanding intimate partner victimization in the past year and associations with sleep disturbance, 147 participants were excluded for reporting a relationship with the DVO partner for less than 6 months in the past year. The final sample for this article was 609. The women reported an average of a little above 5.5 hours of sleep per night. For women in the current study, significant predictors of sleep disturbance included race, number of children, number of other symptoms of depression in the past 2 weeks excluding sleep criteria, number of other symptoms of PTSD in the past 2 weeks excluding sleep criteria, number of chronic physical health problems, and severity of physical violence by the DVO partner in the past year. Addressing short sleep duration among partner victims in health care settings might enhance safety planning and prevent the development of health/mental health problems that can arise from victimization.
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PMID:Sleep loss and partner violence victimization. 2058 69

The present research examines posttraumatic resilience in extremely exposed children and adolescents based on interviews with 330 former Ugandan child soldiers (age = 11-17, female = 48.5%). Despite severe trauma exposure, 27.6% showed posttraumatic resilience as indicated by the absence of posttraumatic stress disorder, depression, and clinically significant behavioral and emotional problems. Among these former child soldiers, posttraumatic resilience was associated with lower exposure to domestic violence, lower guilt cognitions, less motivation to seek revenge, better socioeconomic situation in the family, and more perceived spiritual support. Among the youth with significant psychopathology, many of them had symptoms extending beyond the criteria for posttraumatic stress disorder, in keeping with the emerging concept of developmental trauma disorder. Implications for future research, intervention, and policy are discussed.
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PMID:Posttraumatic resilience in former Ugandan child soldiers. 2063 84

In 2005, the Enhancing Developmentally Oriented Primary Care (EDOPC) project of the Illinois chapter of the American Academy of Pediatrics and the Illinois Department of Healthcare and Family Services began a project to improve the delivery and financing of preventive health and developmental services for children in Illinois. The leaders of this initiative sought to increase primary care providers' use of validated tools for developmental, social/emotional, maternal depression, and domestic violence screening and to increase early awareness of autism symptoms during pediatric well-child visits in children aged 0 to 3 years. These screenings facilitate identification of children at risk and those who need referral for further evaluation. Primary barriers to such screenings include lack of practitioner confidence in using validated screening tools. In this article we describe the accomplishments of the EDOPC project, which created training programs to address these barriers. This training is delivered by EDOPC staff and peer educators (physicians and nurse practitioners) in medical practices. The EDOPC project enhanced confidence and intent to screen among a large group of Illinois primary health care providers. Among a sample of primary care sites at which chart reviews were conducted, the EDOPC project increased developmental screening rates to the target of 85% of patients at most sites and increased social/emotional screening rates to the same target rate in nearly half of the participating practices.
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PMID:Enhancing developmentally oriented primary care: an Illinois initiative to increase developmental screening in medical homes. 2112 80


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