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Sample records for abuse risk factors

  1. Types of abuse and risk factors associated with elder abuse.

    Science.gov (United States)

    Simone, Lacher; Wettstein, Albert; Senn, Oliver; Rosemann, Thomas; Hasler, Susann

    2016-01-01

    Detecting elder abuse is challenging because it is a taboo, and many cases remain unreported. This study aimed to identify types of elder abuse and to investigate its associated risk factors. Retrospective analyses of 903 dossiers created at an Independent Complaints Authority for Old Age in the Canton of Zurich, Switzerland, from January 1, 2008 to October 31, 2012. Characteristics of victims and perpetrators, types of abuse, and associated risk factors related to the victim or the perpetrator were assessed. Bi- and multivariate analysis were used to identify abuse and neglect determinants. A total of 150 cases reflected at least one form of elder abuse or neglect; 104 cases were categorised as abuse with at least one type of abuse (overall 135 mentions), 46 cases were categorised as neglect (active or passive). Psychological abuse was the most reported form (47%), followed by financial (35%), physical (30%) and anticonstitutional abuse (18%). In 81% of the 150 cases at least two risk factors existed. In 13% no associated risk factor could be identified. Compared with neglect, elders with abuse were less likely to be a nursing home resident than living at home (odds ratio [OR] 0.02, 95% confidence interval [CI] 0.00-0.19). In addition, they were more likely to be cohabiting with their perpetrators (OR 18.01, 95% CI 4.43-73.19). For the majority of the reported elder abuse cases at least two associated risk factors could be identified. Knowledge about these red flags and a multifaceted strategy are needed to identify and prevent elder abuse.

  2. Risk factors for bango abuse in upper Egypt.

    Science.gov (United States)

    Yassa, Heba A; Dawood, Abd El-Wahaab A; Shehata, Manal M; Abdel-Hady, Randa H; Abdel-Aal, Khaled M

    2009-11-01

    Cannabis is the most commonly abused drug in the world. In Egypt, the Anti Narcotic General Administration, showed that the narcotics problem costs the Egyptian economy approximately 800 million dollars annually. The present study was designed to determine the risk factors that lead to bango abuse among secondary school students and drivers in Assiut province. Urine samples were taken from 1000 volunteers after filling questionnaires and the risk factors were determined. Ethical consideration and informed consent was taken on. In drivers, the study found that bango abuse was concentrated in age group (21 to abuse concentrated in male students by 100%, and in those with high daily fund. The abused students tend to be more aggressive. Also, tend to be lazy to share in school activities. Abused students present in large family (8-11 persons) and families with troubles between parents (81% in divorced parents). In conclusion, bango abuse leads to deterioration of the academic achievement, and may be associated with antisocial and violent behavior. Copyright © 2009 Elsevier B.V. All rights reserved.

  3. The relative importance of wife abuse as a risk factor for violence against children.

    Science.gov (United States)

    Tajima, E A

    2000-11-01

    To investigate the relative importance of wife abuse as a risk factor for physical child abuse, physical punishment, and verbal child abuse. The study explored the importance of wife abuse relative to blocks of parent, child, and family characteristics and also relative to specific risk factors. This study re-analyzed a sub-sample (N = 2,733) of data from the 1985 National Family Violence Survey. Hierarchical logistic regressions were conducted, using five different criterion variables measuring physical child abuse, physical punishment, and verbal abuse separately and in combination. Blocks of parent, child, and family characteristics were more important predictors of violence towards children than was wife abuse, though the presence of wife abuse in the home was a consistently significant specific risk factor for all forms of violence against children. Of specific risk factors, a respondent's history of having been hit as an adolescent was a larger risk factor for physical child abuse than was wife abuse. Wife abuse was an important predictor of physical punishment. Non-violent marital discord was a greater factor in predicting likelihood of verbal child abuse than was wife abuse. Though this study confirms the association between wife abuse and violence towards children, it cautions us not to overlook the contribution of other factors in our attempts to understand the increased risk attributed to wife abuse.

  4. Risk Factors for Suicide Attempt in Drug Abusers

    OpenAIRE

    farideh faraji; Neda Kakayi; Mohammad Kazem Atef Vahid; Ahmad Sohraby; Samira Purghorbani

    2015-01-01

    Objective: The present study was conducted to identify risk and prediction factors of suicide attempts among drug abusers. Method: This causal-comparative study was conducted on 91 drug abusers that included 42 male and female suicide attempters and 49 male and female counterparts. Millon multi-axial personality inventory-II (MCMI-II), Dass-42 (depression, anxiety, stress), and coping styles inventory were used for data collection purposes. Results: The highest rate of suicide attempt was fou...

  5. Variables and risk factors associated with child abuse in daycare settings.

    Science.gov (United States)

    Schumacher, R B; Carlson, R S

    1999-09-01

    This article was developed to identify the variables associated with abuse of children in daycare centers and homes, and to specify risk factors to guide professionals and parents. The literature regarding child abuse (physical [PA], sexual [SA], and ritual [RA]) was reviewed, with emphasis on identification of variables associated with victims, perpetrators, and settings. Three factors increased the complexity of the review: (1) differences in definition and categorization complicated study comparison; (2) emotional tone affected some reviewers' definitions, methodology, and conclusions; and (3) some aspects of child abuse in daycare homes and centers have not been well researched. PA most frequently occurred in the form of over discipline, was a response to prior conflict with the child, and may have been inadvertently supported by parental permission for corporal punishment. Although SA occurred less frequently in centers than in homes, effects on the victim seemed worse in centers. SA often included PA. A Satanic overtone was frequently associated with RA, and RA coupled with SA was most devastating. Unfortunately, effects were not temporary. Males predominated the perpetrator profile. Multiple perpetrator abuse was worse (e.g., severity of intrusion). Failure of center staff to report suspicion of abuse by fellow staff or parents was cited as a worry by several researchers. Although research regarding abuse in daycare settings is sparse, one cannot wait for more or better research in order to identify risk factors. Based on literature reviewed, the authors provide risk factors for faculty, caregivers, parents, children, and professionals.

  6. Risk factors for mortality in children with abusive head trauma.

    Science.gov (United States)

    Shein, Steven L; Bell, Michael J; Kochanek, Patrick M; Tyler-Kabara, Elizabeth C; Wisniewski, Stephen R; Feldman, Kenneth; Makoroff, Kathi; Scribano, Philip V; Berger, Rachel P

    2012-10-01

    We sought to identify risk factors for mortality in a large clinical cohort of children with abusive head trauma. Bivariate analysis and multivariable logistic regression models identified demographic, physical examination, and radiologic findings associated with in-hospital mortality of children with abusive head trauma at 4 pediatric centers. An initial Glasgow Coma Scale (GCS) ≤ 8 defined severe abusive head trauma. Data are shown as OR (95% CI). Analysis included 386 children with abusive head trauma. Multivariable analysis showed children with initial GCS either 3 or 4-5 had increased mortality vs children with GCS 12-15 (OR = 57.8; 95% CI, 12.1-277.6 and OR = 15.6; 95% CI, 2.6-95.1, respectively, P < .001). Additionally, retinal hemorrhage (RH), intraparenchymal hemorrhage, and cerebral edema were independently associated with mortality. In the subgroup with severe abusive head trauma and RH (n = 117), cerebral edema and initial GCS of 3 or 4-5 were independently associated with mortality. Chronic subdural hematoma was independently associated with survival. Low initial GCS score, RH, intraparenchymal hemorrhage, and cerebral edema are independently associated with mortality in abusive head trauma. Knowledge of these risk factors may enable researchers and clinicians to improve the care of these vulnerable children. Copyright © 2012 Mosby, Inc. All rights reserved.

  7. Risk factors associated with domestic abuse directed at adults with disabilities in South Korea.

    Science.gov (United States)

    Kim, Kyung Mee; Lee, Byung Hwa

    2016-07-01

    Most research on domestic abuse and disability has focused on women with disabilities, while research on abuse against men with disabilities and their risk factors is virtually non-existent. The purpose of this research is to understand domestic abuse experienced by people with disabilities by investigating its prevalence and risk factors. This research used the National Survey on Persons with Disabilities (2011). Using a stratified sampling method, 5259 respondents were identified to make up the final sample. Ordered logistic regression was used to verify risk factors for abuse. Risk factors for women with disabilities are age, educational attainment level, ADL, experiences of discrimination, awareness of disability discrimination, external support, and satisfaction with number of friends. Risk factors for men with disabilities are region, experiences of discrimination, awareness of disability discrimination, external support, and satisfaction with number of friends. For both women and men with disabilities, more experience of discrimination, greater awareness of disability discrimination, less external support, and less satisfaction with number of friends are associated with a higher likelihood of having experiences of abuse. Men with disabilities living in rural areas have a higher risk of abuse than those living in cities. Younger women, women with lower educational attainment, and those with lower physical functioning are more likely to have experienced abuse. Based on these findings, the authors make recommendations designed to protect people with disabilities from domestic abuse. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Risk factor characteristics in carers who physically abuse or neglect their elderly dependants.

    Science.gov (United States)

    Reay, A M; Browne, K D

    2001-02-01

    This study investigates the prevalence of, and differences in, risk factor characteristics in a sample of two select populations of carers, one of which physically abused their elderly dependants and one of which neglected them. Nineteen carers (nine who had physically abused and 10 who had neglected their elderly relatives), who were referred to clinical psychology by either their general practitioner or their psychiatrist, were invited to take part in this study. A detailed history of risk factors was obtained, including history of alcohol dependency, type and history of mental ill health, history of maltreatment earlier in life, who they were caring for, how long they had been a carer and whether they felt isolated as a carer. Subjects were then given five assessments to determine whether there were any differences between the two groups. These were the Conflict Tactic Scale, Strain Scale, Beck Depression Inventory, Beck Anxiety Inventory and Cost of Care Index. An examination of the risk factors suggests that heavy alcohol consumption and past childhood abuse by fathers were likely to lead to physical abuse. Significantly higher conflict and depression scores were also present in the physical abuse group, while the neglect group had significantly higher anxiety scores. It is suggested that these findings should be incorporated into an assessment of future risk of abuse or neglect by the carer.

  9. Risk Factors for Suicide Attempt in Drug Abusers

    Directory of Open Access Journals (Sweden)

    farideh faraji

    2015-06-01

    Full Text Available Objective: The present study was conducted to identify risk and prediction factors of suicide attempts among drug abusers. Method: This causal-comparative study was conducted on 91 drug abusers that included 42 male and female suicide attempters and 49 male and female counterparts. Millon multi-axial personality inventory-II (MCMI-II, Dass-42 (depression, anxiety, stress, and coping styles inventory were used for data collection purposes. Results: The highest rate of suicide attempt was found in young male drug abusers with these characteristics: single, junior school graduate, unemployed, suicide history, sex and physical abuse history during childhood, legal problems, suicide and self-injury witness, and violence and suicide in family members. Compared to non-attempters, suicide attempters obtained higher scores in depressive, obsessive, masochistic, and borderline personality disorders clinical somatoform symptoms, alcohol abuse in addition to drug use, major depressive disorder, and stress. Suicide attempters also used lower levels of task-focused and avoidance-focused strategies and higher levels of emotion-focused strategies to cope with stressors. Conclusion: The findings of this study can contribute to suicide identification and prevention among drug abusers.

  10. Risk factors of abuse of parents by their ADHD children.

    Science.gov (United States)

    Ghanizadeh, Ahmad; Jafari, Peyman

    2010-01-01

    It is interesting that there is scant research of abuse of parents by their children and no study was found on the abuse of parents by their attention deficit hyperactivity disorder (ADHD) children. Seventy-four children and adolescents suffering from ADHD and their parents were interviewed. The diagnoses were made according to DSM-IV diagnostic criteria. A questionnaire was developed to assess the children's abuse toward parents. More than half of the parents are suffering from at least one of the forms of abuse by their ADHD children. Scores of parental abuse were not related to gender. Different types of abuse correlated with oppositional defiant disorder (ODD), tic, and separation anxiety disorder (SAD). Fathers' and mothers' age, the level of education, and type of occupation were not risk factors of the abuse scores. ODD and mother's major depressive disorder were predictors of the abuse. There was a very disturbing high rate of abuse by children against parents. There is an interrelation of different forms of abuse. This study contributes to increasing awareness on the abuse of parents by their ADHD children.

  11. Risk factors for child abuse: levels of knowledge and difficulties in family medicine. A mixed method study.

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    Regnaut, Océane; Jeu-Steenhouwer, Marie; Manaouil, Cécile; Gignon, Maxime

    2015-10-30

    Family physicians (FPs) have a central role in the detection and management of child abuse. According to the literature, only 2-5% of initial reports of child abuse come from the medical profession. The objective of this study was to assess levels of knowledge of risk factors for child abuse by Family Physicians (FPs) and the attention that the physicians pay to these risk factors. We conducted a mixed-method survey based on semi-structured interviews. 50 FPs practicing in the Somme County (northern France) were interviewed with closed and open questions. The FPs' level of knowledge of risk factors for child abuse and obstacles in the detection of child abuse were assessed. The FPs' level of knowledge of risk factors for child abuse was similar to that reported in the literature. However, FPs knew little about the significant role of prematurity. Likewise, the FP's training did not seem to influence their knowledge of risk factors. Fear of an incorrect diagnosis was the main obstacle to reporting a suspected case. The FPs considered that they were often alone in dealing with a difficult situation and considered that the judicial system and the social services were not sufficiently active. Few FPs had actually received specific training in the detection and management of child abuse but many stated their need for this type of training. FPs encounter many obstacles in the detection of child abuse, which sometimes make the FP reluctant to report a suspected or potential case. Medical education need to be improved in this field.

  12. Adolescent Substance Abuse: Risk Factors and Prevention Strategies. Maternal & Child Health Technical Information Bulletin.

    Science.gov (United States)

    Werner, Mark J.

    The high prevalence of alcohol and substance abuse by adolescents poses a significant threat to the wellness of youth. Adolescents appear to use drugs for a variety of reasons. In addition to the multiple etiologic and risk factors present for substance abuse, there are many pathways teenagers may follow on their way to substance abuse. The…

  13. Prevalence of and Risk Factors for Male Sexual Abuse: The Case of South Korea

    Science.gov (United States)

    Han, In Young; Lee, Yongwoo; Yoo, Seo Koo; Hong, Jun Sung

    2011-01-01

    This study examined the prevalence of and risk factors for sexual abuse of boys in South Korea by asking a national sample of 1,043 adult males whether they had experienced sexual abuse during childhood. The results indicate that 13.5% experienced at least one of the nine types of child sexual abuse assessed. In addition, the majority of the…

  14. Community and Individual Risk Factors for Physical Child Abuse and Child Neglect: Variations by Poverty Status.

    Science.gov (United States)

    Maguire-Jack, Kathryn; Font, Sarah A

    2017-08-01

    Families are impacted by a variety of risk and protective factors for maltreatment at multiple levels of the social ecology. Individual- and neighborhood-level poverty has consistently been shown to be associated with higher risk for child abuse and neglect. The current study sought to understand the ways in which individual- and neighborhood-level risk and protective factors affect physical child abuse and child neglect and whether these factors differed for families based on their individual poverty status. Specifically, we used a three-level hierarchical linear model (families nested within census tracts and nested within cities) to estimate the relationships between physical child abuse and child neglect and neighborhood structural factors, neighborhood processes, and individual characteristics. We compared these relationships between lower and higher income families in a sample of approximately 3,000 families from 50 cities in the State of California. We found that neighborhood-level disadvantage was especially detrimental for families in poverty and that neighborhood-level protective processes (social) were not associated with physical child abuse and child neglect for impoverished families, but that they had a protective effect for higher income families.

  15. Prevalence and risk factors of abuse among community dwelling elderly of Guwahati City, Assam

    Directory of Open Access Journals (Sweden)

    Anku Moni Saikia

    2015-01-01

    Full Text Available Background: In spite of tremendous impact on health, elder abuse is still an underreported and unrecognized issue. Objectives: To assess the prevalence of abuse among community dwelling elderly and to identify the various risk factors. Materials and Methods: This community-based cross-sectional study was conducted in 10 randomly selected wards of Guwahati city. A total of 331 elderly (60 years and above were interviewed. Abuse was screened by Hwalek-Sengstock Elder Abuse Screening Test (H-S EAST. Results: The study revealed 9.31% prevalence. Neglect was the most common type of abuse reported. Age, sex, socioeconomic status, living status, and functional status were found to be significantly associated with abuse. Conclusion: Abuse is prevalent among elderly population.

  16. Autonomy and intimacy in the family as risk factors for sexual abuse

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    Tanja Repič

    2006-08-01

    Full Text Available The study examined the level of two risk factors (autonomy and intimacy for healthy functional family among sexually abused and sexually non-abused individuals. Autonomy and intimacy were measured with Family-of-Origin Scale (FOS; Hovestadt, Anderson, Piercy, Cochran, & Fine, 1985. 261 participants (194 girls and 67 boys completed the FOS, average age was 25 years (SD = 7. Among all participants 18% were sexually abused (N = 46, approximately every fifth (5.7 girl and every seventh (6.7 boy. There were 78% girls and 22% boys among sexually abused participants. Families of sexually abused participants in comparison with the families of sexually non-abused showed many statistically significant differences in elements of autonomy (clarity of expressing emotions, responsibility, respect for others, openness to others, and acceptance of separation and loss and intimacy (encouraging expression of a range of feelings, creating a warm atmosphere in the home, dealing with conflict resolution without undue stress, promoting empathy among family members, trust and developing trust. In general the sexually abused group had a statistically significantly lower level of autonomy and intimacy in comparison with sexually non-abused group.

  17. Mothers of children with externalizing behavior problems: cognitive risk factors for abuse potential and discipline style and practices.

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    McElroy, Erika M; Rodriguez, Christina M

    2008-08-01

    Utilizing the conceptual framework of the Social Information Processing (SIP) model (Milner, 1993, 2000), associations between cognitive risk factors and child physical abuse risk and maladaptive discipline style and practices were examined in an at-risk population. Seventy-three mothers of 5-12-year-old children, who were identified by their therapist as having an externalizing behavior problem, responded to self-report measures pertaining to cognitive risk factors (empathic perspective taking, frustration tolerance, developmental expectations, parenting locus of control), abuse risk, and discipline style and practices. The Child Behavior Checklist (CBCL) provided a confirmation of the child's externalizing behaviors independent of the therapist's assessment. The results of this study suggest several cognitive risk factors significantly predict risk of parental aggression toward children. A parent's ability to empathize and take the perspective of their child, parental locus of control, and parental level of frustration tolerance were significant predictors of abuse potential (accounting for 63% of the variance) and inappropriate discipline practices (accounting for 55% of the variance). Findings of the present study provide support for processes theorized in the SIP model. Specifically, results underscore the potential role of parents' frustration tolerance, developmental expectations, locus of control, and empathy as predictive of abuse potential and disciplinary style in an at-risk sample.

  18. Are Outness and Community Involvement Risk or Protective Factors for Alcohol and Drug Abuse Among Sexual Minority Women?

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    Feinstein, Brian A; Dyar, Christina; London, Bonita

    2017-07-01

    Sexual minority women (SMW) are at increased risk for substance abuse compared to heterosexual women. Two psychosocial factors that have been implicated in SMW's substance abuse are outness and LGBT community involvement, but findings have been mixed as to whether these are risk or protective factors. One possible explanation is that they may have different consequences for subgroups of SMW (lesbians, bisexual women, and queer women). While being open about one's sexual orientation and involved in the community may be protective for lesbians, discrimination against bisexual women may lead these same factors to contribute to substance abuse for bisexual women. It is unclear how these associations will operate for queer women, given limited research on this subpopulation. The current study examined whether sexual identity moderated the associations between outness and community involvement with alcohol and drug abuse. We also examined whether perceived discrimination would help explain why these associations may be different for subgroups of SMW. A sample of 288 self-identified SMW (113 lesbians, 106 bisexual women, and 69 queer women) completed an online survey. Higher outness was associated with higher alcohol and drug abuse for bisexual women, but not for lesbians or queer women. Similarly, higher community involvement was associated with higher drug abuse for bisexual women, but not for lesbians or queer women. Among bisexual women, the association between community involvement and drug abuse was mediated by perceived discrimination. Further, the association between outness and drug abuse was mediated by both community involvement and perceived discrimination. Findings demonstrate that outness and community involvement function as risk factors for substance abuse for bisexual women, in part due to their associations with discrimination.

  19. Delineating selection and mediation effects among childhood personality and environmental risk factors in the development of adolescent substance abuse.

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    Hicks, Brian M; Johnson, Wendy; Durbin, C Emily; Blonigen, Daniel M; Iacono, William G; McGue, Matt

    2014-01-01

    Utilizing the large, longitudinal Minnesota Twin Family Study (N = 2510; 96 % European American ancestry), we examined the influence of several person-environment transactions on adolescent substance abuse. We focused on the two childhood personality traits found to be most predictive of substance abuse in this sample-socialization (willingness to follow rules and endorse conventional values) and boldness (social engagement and assurance, stress resilience, thrill seeking)-and the environmental variables of antisocial and prosocial peers, academic engagement, parent-child relationship quality, and stressful life events. Path analysis revealed that low socialization had a selection effect for each environmental risk factor, that is, socialization at age 11 predicted environmental risk at age 14, after controlling for the stability of the environmental variables from ages 11 to 14. Antisocial peers and academic engagement at age 14 then mediated some of the risk of low socialization on substance abuse at age 17, but the majority of risk for substance abuse was accounted for by the stability of socialization from age 11 to 14. Boldness at age 11 also increased risk for substance abuse, but did so primarily via a direct effect. The findings help to parse the nature of person-environment transactions across multiple personality traits and contextual risk factors that contribute to adolescent substance abuse.

  20. Delineating Selection and Mediation Effects among Childhood Personality and Environmental Risk Factors in the Development of Adolescent Substance Abuse

    Science.gov (United States)

    Hicks, Brian M.; Johnson, Wendy; Durbin, C. Emily; Blonigen, Daniel M.; Iacono, William G.; McGue, Matt

    2014-01-01

    Utilizing the large, longitudinal Minnesota Twin Family Study (N = 2510; 96% European American ancestry), we examined the influence of several person-environment transactions on adolescent substance abuse. We focused on the two childhood personality traits found to be most predictive of substance abuse in this sample—socialization (willingness to follow rules and endorse conventional values) and boldness (social engagement and assurance, stress resilience, thrill seeking)—and the environmental variables of antisocial and prosocial peers, academic engagement, parent-child relationship quality, and stressful life events. Path analysis revealed that low socialization had a selection effect for each environmental risk factor, that is, socialization at age 11 predicted environmental risk at age 14, after controlling for the stability of the environmental variables from ages 11 to 14. Antisocial peers and academic engagement at age 14 then mediated some of the risk of low socialization on substance abuse at age 17, but the majority of risk for substance abuse was accounted for by the stability of socialization from age 11 to 14. Boldness at age 11 also increased risk for substance abuse, but did so primarily via a direct effect. The findings help to parse the nature of person-environment transactions across multiple personality traits and contextual risk factors that contribute to adolescent substance abuse. PMID:24337735

  1. Alcohol abuse as the strongest risk factor for violent offending in patients with paranoid schizophrenia.

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    Kudumija Slijepcevic, Marija; Jukic, Vlado; Novalic, Darko; Zarkovic-Palijan, Tija; Milosevic, Milan; Rosenzweig, Ivana

    2014-04-01

    To determine predictive risk factors for violent offending in patients with paranoid schizophrenia in Croatia. The cross-sectional study including male in-patients with paranoid schizophrenia with (N=104) and without (N=102) history of physical violence and violent offending was conducted simultaneously in several hospitals in Croatia during one-year period (2010-2011). Data on their sociodemographic characteristics, duration of untreated illness phase (DUP), alcohol abuse, suicidal behavior, personality features, and insight into illness were collected and compared between groups. Binary logistic regression model was used to determine the predictors of violent offending. Predictors of violent offending were older age, DUP before first contact with psychiatric services, and alcohol abuse. Regression model showed that the strongest positive predictive factor was harmful alcohol use, as determined by AUDIT test (odds ratio 37.01; 95% confidence interval 5.20-263.24). Psychopathy, emotional stability, and conscientiousness were significant positive predictive factors, while extroversion, pleasantness, and intellect were significant negative predictive factors for violent offending. This study found an association between alcohol abuse and the risk for violent offending in paranoid schizophrenia. We hope that this finding will help improve public and mental health prevention strategies in this vulnerable patient group.

  2. Relationships and Community Risk Factors for Elder Abuse and Neglect: Findings from the First National Prevalence Study on Elder Maltreatment

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    Dimitrinka Jordanova Peshevska

    2014-06-01

    Full Text Available OBJECTIVES: The objective of the study was to mesaure the 12-months prevalence of elder abuse and neglect in private huousehold and to examine the relationship and community level risk factors for elder abuse and neglect. METHOD: Total of 960 respondents aged 65 years and above in private households, from all eight statistical regions participated in the study.  Nationally stratified quota sampling procedure was applied, through four stages. Information was collected in face-to face interview on socio-demographic, healthy life style, physical and mental health, and abuse and neglect types characteristics of elder population. Data were examined using descriptive statistics, binary logistic regression, and odd ratios (OR. Statistical significance was set up at p < 0.05. RESULTS: The respondents reported prevalence of psychological abuse 25.7%, followed by financial abuse 12 %, neglect 6.6%, physical abuse 5.7%, physical injury 3.1%, and sexual abuse 1.3% (reported only in female respondents in the previous 12-months. Living with close relatives, dissatisfaction with the household income, less equipped households, lacking property of house/flat are associated risk factors for elder maltreatment on relationship level. Living in the northeast, southeast, and Polog region are associated risk for elder maltreatment. CONCLUSION: Study findings emphasised the previous data obtained with regards to the community and relationships risk factors for elder maltreatment.

  3. [Sexual Abuse and Neglect Situations as Risk Factors for Adolescent Pregnancy].

    Science.gov (United States)

    Restrepo Martínez, Miguel; Trujillo Numa, Laura; Restrepo Bernal, Diana; Torres de Galvis, Yolanda; Sierra, Gloria

    In Colombia, one out of five women between the ages of 15 and 19 years have been pregnant. Almost two-thirds (64%) of these pregnancies were unplanned. To examine the socio-demographic, psychosocial and clinical risk factors associated with adolescent pregnancy. An analytical prevalence study was performed using secondary data from the First Demographic Study of Mental Health in Medellin, Colombia. Female adolescents between 13 and 19 years of age were included in the study. The population was evaluated using the Composite International Diagnosis Interview, a structured interview developed by the World Health Organization, which establishes diagnoses according to the DSM-IV and ICD-10 criteria. A sample of 499 female adolescents was obtained, in which 135 adolescent pregnancies were identified, representing a prevalence of 21.5%. The large majority (84.4%) were between 16 and 19 years old. The median age was 17 years, with an interquartile range of 2 years. Almost two-thirds (61.2%) of female adolescents had initiated sexual activity at the age of 15 or later. Almost one-third (31.9%) reported being physically abused during childhood, and 6.7% sexually abused. Of those who were pregnant, 66.7% reported previous sexual abuse. A bivariate analysis showed that sexual abuse (OR=7.68), childhood negligence (OR=4.33), and having a partner (OR=6.31) were factors associated with an adolescent pregnancy. Negligence and sexual abuse in childhood and adolescence can be prevented, and adolescent pregnancies can be decreased. This finding has important implications for clinical management and prognosis, and requires public preventive policies. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  4. Elder Abuse: Global Situation, Risk Factors, and Prevention Strategies.

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    Pillemer, Karl; Burnes, David; Riffin, Catherine; Lachs, Mark S

    2016-04-01

    Elder mistreatment is now recognized internationally as a pervasive and growing problem, urgently requiring the attention of health care systems, social welfare agencies, policymakers, and the general public. In this article, we provide an overview of global issues in the field of elder abuse, with a focus on prevention. This article provides a scoping review of key issues in the field from an international perspective. By drawing primarily on population-based studies, this scoping review provided a more valid and reliable synthesis of current knowledge about prevalence and risk factors than has been available. Despite the lack of scientifically rigorous intervention research on elder abuse, the review also identified 5 promising strategies for prevention. The findings highlight a growing consensus across studies regarding the extent and causes of elder mistreatment, as well as the urgent need for efforts to make elder mistreatment prevention programs more effective and evidence based. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  5. Co-Occurring Risk Factors for Arrest among Persons with Opioid Abuse and Dependence: Implications for Developing Interventions to Limit Criminal Justice Involvement

    Science.gov (United States)

    Fisher, William H.; Clark, Robin; Baxter, Jeffrey; Barton, Bruce; O’Connell, Elizabeth; Aweh, Gideon

    2015-01-01

    Persons who abuse opioids or are dependent on opioids are at elevated risk for arrest. Co-occurring behavioral health problems may exacerbate that risk, although the extent of any such increase has not been described. This study examines such risk factors among 40,238 individuals with a diagnosis of opioid abuse or dependence who were enrolled in the Massachusetts Medicaid program in 2010. Medicaid data were merged with statewide arrest data to assess the effects of co-existing mental illness, substance abuse, and previous arrests on arrest during 2010. Persons with serious mental illnesses (psychotic and bipolar disorders) and those with two or more pre-2010 arrests had significantly increased greater odds of arrest. We believe this to be the first study examining effects of co-occurring risk factors on arrest in a large population with opioid dependency/abuse. These findings identify predictors of arrest that could be used to design interventions targeting specific co-occurring risk factors. PMID:25012550

  6. Development and preliminary validation of the Opioid Abuse Risk Screener

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    Patricia Henrie-Barrus

    2016-05-01

    Full Text Available Prescription opioid drug abuse has reached epidemic proportions. Individuals with chronic pain represent a large population at considerable risk of abusing opioids. The Opioid Abuse Risk Screener was developed as a comprehensive self-administered measure of potential risk that includes a wide range of critical elements noted in the literature to be relevant to opioid risk. The creation, refinement, and preliminary modeling of the item pool, establishment of preliminary concurrent validity, and the determination of the factor structure are presented. The initial development and validation of the Opioid Abuse Risk Screener shows promise for effective risk stratification.

  7. Gene-environment correlation in the development of adolescent substance abuse: selection effects of child personality and mediation via contextual risk factors.

    Science.gov (United States)

    Hicks, Brian M; Johnson, Wendy; Durbin, C Emily; Blonigen, Daniel M; Iacono, William G; McGue, Matt

    2013-02-01

    We used a longitudinal twin design to examine selection effects of personality traits at age 11 on high-risk environmental contexts at age 14 and the extent to which these contexts mediated risk for substance abuse at age 17. Socialization at age 11 (willingness to follow rules and endorse conventional values) predicted exposure to contextual risk at age 14. Contextual risk partially mediated the effect of socialization on substance abuse, though socialization also had a direct effect. In contrast, boldness at age 11 (social engagement and assurance, thrill seeking, and stress resilience) also predicted substance abuse directly but was unrelated to contextual risk. There was substantial overlap in the genetic and shared environmental influences on socialization and contextual risk, and genetic risk in socialization contributed to substance abuse indirectly via increased exposure to contextual risk. This suggests that active gene-environment correlations related to individual differences in socialization contributed to an early, high-risk developmental trajectory for adolescent substance abuse. In contrast, boldness appeared to index an independent and direct genetic risk factor for adolescent substance abuse.

  8. Dataset on psychosocial risk factors in cases of fatal and near-fatal physical child abuse

    Directory of Open Access Journals (Sweden)

    Mary Clyde Pierce

    2017-10-01

    Full Text Available This article presents the psychosocial risk factors identified in the cases of 20 children less than four years of age who were victims of fatal or near-fatal physical abuse during a 12 month period in the Commonwealth of Kentucky. These data are related to the article “History, injury, and psychosocial risk factor commonalities among cases of fatal and near-fatal physical child abuse” (Pierce et al., 2017 [1].

  9. FACTORS CONTRIBUTING TO ELDER ABUSE AND NEGLECT IN THE INFORMAL CAREGIVING SETTING

    Directory of Open Access Journals (Sweden)

    Ananias, Janetta

    2014-11-01

    Full Text Available This article provides an overview of factors contributing to elder abuse and neglect within the informal caregiving setting from the perspective of ecological theory. This theory offers a deeper understanding of the complexity of elder abuse by considering the interactions that take place across a number of interrelated systems as well as the multiple risk factors that contribute to elder abuse and neglect. Researchers, policy makers and practitioners need to develop awareness of the risk factors regarding elder abuse and neglect, and to develop appropriate interventions in response to elder abuse and neglect.

  10. Prevalence of and Risk Factors for Elder Abuse and Neglect in the Community: A Population-Based Study.

    Science.gov (United States)

    Burnes, David; Pillemer, Karl; Caccamise, Paul L; Mason, Art; Henderson, Charles R; Berman, Jacquelin; Cook, Ann Marie; Shukoff, Denise; Brownell, Patricia; Powell, Mebane; Salamone, Aurora; Lachs, Mark S

    2015-09-01

    To estimate past-year prevalence and identify risk and protective factors of elder emotional abuse, physical abuse, and neglect. Cross-sectional, population-based study using random-digit-dial sampling and direct telephone interviews. New York State households. Representative (race, ethnicity, sex) sample (N = 4,156) of English- or Spanish-speaking, community-dwelling, cognitively intact individuals aged 60 and older. The Conflict Tactics Scale was adapted to assess elder emotional and physical abuse. Elder neglect was evaluated according to failure of a responsible caregiver to meet an older adult's needs using the Duke Older Americans Resources and Services (OARS) scale. Caseness thresholds were based on mistreatment behavior frequencies and elder perceptions of problem seriousness. Past-year prevalence of elder emotional abuse was 1.9%, of physical abuse was 1.8%, and of neglect was 1.8%, with an aggregate prevalence of 4.6%. Emotional and physical abuse were associated with being separated or divorced, living in a lower-income household, functional impairment, and younger age. Neglect was associated with poor health, being separated or divorced, living below the poverty line, and younger age. Neglect was less likely in older adults of Hispanic ethnicity. Elder abuse and neglect are common problems, with divergent risk and protective factor profiles. These findings have direct implications for public screening and education and awareness efforts designed to prevent elder mistreatment. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

  11. Men Who Abuse Their Spouses: An Approach to Assessing Future Risk.

    Science.gov (United States)

    Goldsmith, Herbert R.

    1990-01-01

    Studied risk assessment for abuse cases by examining cases (N=20) referred to local spouse treatment center. Focused on woman's perception of mate's personality/behavioral characteristics and relationship plus other situational factors. Confirmed majority of risk factors associated with spouse abuse as reported in the literature. Presents pilot…

  12. Multimethod prediction of child abuse risk in an at-risk sample of male intimate partner violence offenders.

    Science.gov (United States)

    Rodriguez, Christina M; Gracia, Enrique; Lila, Marisol

    2016-10-01

    The vast majority of research on child abuse potential has concentrated on women demonstrating varying levels of risk of perpetrating physical child abuse. In contrast, the current study considered factors predictive of physical child abuse potential in a group of 70 male intimate partner violence offenders, a group that would represent a likely high risk group. Elements of Social Information Processing theory were evaluated, including pre-existing schemas of empathy, anger, and attitudes approving of parent-child aggression considered as potential moderators of negative attributions of child behavior. To lend methodological rigor, the study also utilized multiple measures and multiple methods, including analog tasks, to predict child abuse risk. Contrary to expectations, findings did not support the role of anger independently predicting child abuse risk in this sample of men. However, preexisting beliefs approving of parent-child aggression, lower empathy, and more negative child behavior attributions independently predicted abuse potential; in addition, greater anger, poorer empathy, and more favorable attitudes toward parent-child aggression also exacerbated men's negative child attributions to further elevate their child abuse risk. Future work is encouraged to consider how factors commonly considered in women parallel or diverge from those observed to elevate child abuse risk in men of varying levels of risk. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Social-Relational Risk Factors for Predicting Elder Physical Abuse: An Ecological Bi-Focal Model

    Science.gov (United States)

    von Heydrich, Levente; Schiamberg, Lawrence B.; Chee, Grace

    2012-01-01

    Annually in the United States, 1 to 5 million older adults, 65 and above, are physically or sexually injured or mistreated by their caregivers in family settings. This study examined the prevalence and risk factors involved in elder physical abuse by adult child caregivers, moving from the immediate elderly parent/adult child relationship context…

  14. Risk factors for out-of-home custody child care among families with alcohol and substance abuse problems.

    Science.gov (United States)

    Sarkola, Taisto; Kahila, Hanna; Gissler, Mika; Halmesmäki, Erja

    2007-11-01

    To study the risk of children to mothers with alcohol and/or substance abuse related problems for early childhood out-of-home care in Finland. A population-based cross-sectional retrospective analysis of 526 pregnant women attending special outpatient clinics during 1992-2001 and their 626 offspring, with out-of-home care data until 2003 provided by the National Child Welfare Register. Fifty percent (95% confidence interval 46-54%) were at some point and 38% (34-42%) by the age of two years, in out-of-home care. Out-of-home care was associated with maternal care for substance abuse after delivery, nonemployment, housing, daily smoking during pregnancy, increasing number of previous births, mother in custody in her childhood, maternal education, previous child in custody, drug in urine during pregnancy, unplanned pregnancy, partner with significant abuse, regular health-care contact for abuse, daily alcohol consumption before and/or during pregnancy, newborn not discharged with mother, neonatal abstinence symptoms (NAS), intensified perinatal surveillance or NICU, and delayed discharge from hospital. There is a substantial risk of children born to mothers with significant alcohol and/or substance abuse related problems for out-of-home care during early childhood. Factors identified during the pre- and perinatal period are associated with this risk.

  15. Maternal exposure to childhood abuse is associated with elevated risk of autism

    Science.gov (United States)

    Roberts, Andrea L.; Lyall, Kristen; Rich-Edwards, Janet W.; Ascherio, Alberto; Weisskopf, Marc G.

    2014-01-01

    Context Adverse perinatal circumstances have been associated with increased risk of autism. Women exposed to childhood abuse experience more adverse perinatal circumstances than women unexposed, but whether abuse is associated with autism in offspring is unknown. Objective To determine whether maternal exposure to childhood abuse is associated with risk of autism, and whether possible increased risk is accounted for by higher prevalence of adverse perinatal circumstances among abused women, including gestational diabetes, preeclampsia, selective serotonin reuptake inhibitor use, intimate partner abuse, prior abortion, pregnancy less than 37 weeks, low birth weight, alcohol use, and smoking during pregnancy. Design and Setting Nurses’ Health Study II, a population-based longitudinal cohort of 116,430 women. Patients or Other Participants Participants with data on childhood abuse and child’s autism status (97% White). Controls were randomly selected from among children of women who did not report autism in offspring (N mothers of children with autism = 451; N mothers of children without autism=52,498). Main Outcome Measure Autism spectrum disorder, assessed by maternal report, validated with the Autism Diagnostic Interview-Revised in a subsample. Results Exposure to abuse was associated with increased risk of autism in children in a monotonically increasing fashion. The highest level of abuse was associated with the greatest prevalence of autism (1.8% versus 0.7% in women not abused, P = 0.005) and the greatest risk for autism adjusted for demographic factors (risk ratio=3.7, 95% confidence interval=2.3, 5.8). All adverse perinatal circumstances were more prevalent in women abused except low birth weight. Adjusted for perinatal factors, the association of maternal abuse with autism was slightly attenuated (highest level of abuse, risk ratio = 3.0, 95% confidence interval=1.9, 4.9). Conclusions We identify an intergenerational association between childhood

  16. Elder Abuse by Adult Children: An Applied Ecological Framework for Understanding Contextual Risk Factors and the Intergenerational Character of Quality of Life.

    Science.gov (United States)

    Schiamberg, Lawrence B.; Gans, Daphna

    2000-01-01

    Using an applied ecological model, this study focuses on contextual risk factors of elder abuse. Five levels of environment were used to interpret existing research on risk factors. Configuration of risk factors provides a framework for understanding the intergenerational character of quality of life for older adults, developing recommendations…

  17. [The prevalence and influencing factors of abuse and negligence against elderly in rural areas of Anhui province].

    Science.gov (United States)

    Su, Pu-yu; Hao, Jia-hu; Xiong, Li-ming; Yu, Dan-dan; Cao, Yue-ting; Fang, Yun; Jiang, Xiu-ling; Qian, Qiao-xia; Tao, Fang-biao

    2011-02-01

    To investigate the prevalence and influencing factors related to abuse and negligence against the elderly in the rural areas. 975 elderly over 60 years from 41 counties in Anhui province were included. All participants completed an anonymous questionnaire including items as: educational background, marital condition, income, child-discipline, rude action to parents, daily activities, physical functions, having chronic illness, abuse and negligence against the elderly, etc. In the last year, rates of common physical abuse, serious physical abuse, emotional abuse, financial exploitation, negligence, overall abuse and negligence against the elderly were 4.5%, 1.5%, 26.9%, 4.9%, 7.2%, 29.9% respectively. Among the 281 victims, 80.4% reported that they were suffered more than 3 times of abuse and neglect episodes, and 34.9% reported that they were suffered more than 2 forms of abuse and negligence. The primary sadism was carried out by the daughter-in-law or son-in-law (43.2%) of the elderly. Low activity on daily life and having chronic illness were the risk factors causing common physical abuse while better education was the protective factor to it. Low ability in managing daily activity of living was the risk factor causing serious physical abuse. Less active on daily life and having rude action to parents were the risk factors to emotional abuse, but being strict with their children was the protective factor to emotional abuse. Less active on daily life, often beating their children and having rude action to parents were the risk factors related to financial exploitation. Less active on daily life, having rude action to parents and having bad physical functions were the risk factors causing negligence. Less active on daily life and having rude manner to parents were the risk factors of overall elderly abuse and negligence, but being strict with their children was protective factor to the abuse and negligence against the elderly. High prevalence on abuse and

  18. Risk Factors for Drug Abuse among Nepalese Samples Selected from a Town of Eastern Nepal

    Science.gov (United States)

    Niraula, Surya Raj; Chhetry, Devendra Bahadur; Singh, Girish Kumar; Nagesh, S.; Shyangwa, Pramod Mohan

    2009-01-01

    The study focuses on the serious issue related to the adolescents' and adults' behavior and health. It aims to identify the risk factors for drug abuse from samples taken from a town of Eastern Nepal. This is a matched case-control study. The conditional logistic regression method was adopted for data analysis. The diagnosis cut off was determined…

  19. Childhood Sexual and Physical Abuse as Risk Factors for the Development of Bulimia Nervosa: A Community-Based Case Control Study.

    Science.gov (United States)

    Welch, Sarah L.; Fairburn, Christopher G.

    1996-01-01

    Young women (n=102) with bulimia nervosa were compared with 204 control subjects without an eating disorder and with 102 subjects with other psychiatric disorders. Results suggest that sexual and physical abuse are both risk factors for psychiatric disorders in general, including bulimia nervosa, but are not specific risk factors for bulimia. (DB)

  20. Risk factors of child physical abuse by parents with mixed anxiety-depressive disorder or posttraumatic stress disorder.

    Science.gov (United States)

    Kalebić Jakupčević, Katija; Ajduković, Marina

    2011-02-01

    To determine the risk that parents with mixed anxiety and depressive disorder (MADD) or posttraumatic stress disorder (PTSD) will physically abuse their child and evaluate the specific contribution of mental health, perceived social support, experience of childhood abuse, and attributes of family relations to the risk of child physical abuse. The study conducted in 2007 included men (n = 25) and women (n = 25) with a diagnosis of MADD, men with a diagnosis of PTSD (n = 30), and a control sample of parents from the general population (n = 100, 45 men and 55 women) with children of elementary school age. General Information Questionnaire, Child Abuse Experience Inventory, Perceived Social Support Scale, and the Child Abuse Potential Inventory (CAPI) Clinical Abuse Scale were used. Total results on the Clinical Abuse Scale of the CAPI indicated higher risk of child physical abuse in parents with MADD (273.3 ± 13.6) and in fathers with PTSD (333.21 ± 17.98) than in parents from the general population (79.6 ± 9.9) (F = 110.40, P < 0.001; tPTSD,MADD = 13.73, P < 0.001). A hierarchical regression analysis showed that the greatest predictors in the multivariate model were mental health difficulties, poorer economic status, poor social support, and physical and verbal aggression in partner conflicts. Parents with MADD and PTSD exhibit high risk of child abuse. Since parents with PTSD have significantly higher risk of child abuse than parents with MADD, further large-sample research is needed to clarify the relationship between PTSD intensity and the risk of child abuse.

  1. Evaluating the Risk of Child Abuse: The Child Abuse Risk Assessment Scale (CARAS)

    Science.gov (United States)

    Chan, Ko Ling

    2012-01-01

    The present study developed the Child Abuse Risk Assessment Scale (CARAS), an actuarial instrument for the assessment of the risk of physical child abuse. Data of 2,363 Chinese parents (47.7% male) living in Hong Kong were used in the analyses. Participants were individually interviewed with a questionnaire assessing their perpetration of child…

  2. Vulnerability Risk Index Profile for Elder Abuse in Community-Dwelling Population

    Science.gov (United States)

    Dong, XinQi; Simon, Melissa A.

    2013-01-01

    Objectives Elder abuse is associated with increased morbidity and mortality. This study aims to develop a vulnerability index for elder abuse in a community-dwelling population. Design Population-based study Setting Geographically defined community in Chicago. Participants A population-based study was conducted in Chicago of community-dwelling older adults who participated in the Chicago Health and Aging Project (CHAP). Of the 8,157 participants in the CHAP study, 213 participants were reported to social services agency for suspected elder abuse. Measurements A vulnerability index for elder abuse was constructed from sociodemographic, health-related, and psychosocial factors. The outcomes of interest were reported and confirmed elder abuse. Logistic regression models were used to determine the accuracy of the index with respect to elder abuse outcomes. Results Out of the selected risk index for elder abuse, every one point increase in the 9 item vulnerability index items, there was a two fold increase in the risk for reported elder abuse (OR, 2.19 (2.00–2.40) and confirmed elder abuse (OR, 2.19 (1.94–2.47). Compared to the reference group, older adults with 3–4 vulnerability index items had increased risk for reported elder abuse (OR, 2.98 (1.98–4.49) and confirmed elder abuse (OR, 3.90, (2.07–7.36); and older adults with 5 or more risk index items, there was an 18 fold increase in risk for reported elder abuse (OR, 18.46 (12.15–28.04) and confirmed elder abuse (OR, 26.79 (14.18–50.61). Receiver Operating Characteristic (ROC) statistically derived curves for identifying reported elder abuse ranged between 0.77–0.84 and for predicting confirmed elder abuse ranged between 0.79–0.86. Conclusion The vulnerability risk index demonstrates value for identifying individuals at risk for elder abuse. Additional studies are needed to validate this index in other community dwelling populations. PMID:25180376

  3. Cumulative environmental risk in substance abusing women: early intervention, parenting stress, child abuse potential and child development.

    Science.gov (United States)

    Nair, Prasanna; Schuler, Maureen E; Black, Maureen M; Kettinger, Laurie; Harrington, Donna

    2003-09-01

    To assess the relationship between cumulative environmental risks and early intervention, parenting attitudes, potential for child abuse and child development in substance abusing mothers. We studied 161 substance-abusing women, from a randomized longitudinal study of a home based early intervention, who had custody of their children through 18 months. The intervention group received weekly home visits in the first 6 months and biweekly visits from 6 to 18 months. Parenting stress and child abuse potential were assessed at 6 and 18 months postpartum. Children's mental and motor development (Bayley MDI and PDI) and language development (REEL) were assessed at 6, 12, and 18 months postpartum. Ten maternal risk factors were assessed: maternal depression, domestic violence, nondomestic violence, family size, incarceration, no significant other in home, negative life events, psychiatric problems, homelessness, and severity of drug use. Level of risk was recoded into four categories (2 or less, 3, 4, and 5 or more), which had adequate cell sizes for repeated measures analysis. Repeated measures analyses were run to examine how level of risk and group (intervention or control) were related to parenting stress, child abuse potential, and children's mental, motor and language development over time. Parenting stress and child abuse potential were higher for women with five risks or more compared with women who had four or fewer risks; children's mental, motor, and language development were not related to level of risk. Children in the intervention group had significantly higher scores on the PDI at 6 and 18 months (107.4 vs. 103.6 and 101.1 vs. 97.2) and had marginally better scores on the MDI at 6 and 12 months (107.7 vs. 104.2 and 103.6 vs. 100.1), compared to the control group. Compared to drug-abusing women with fewer than five risks, women with five or more risks found parenting more stressful and indicated greater inclination towards abusive and neglectful behavior

  4. Screening for substance abuse risk in cancer patients using the Opioid Risk Tool and urine drug screen.

    Science.gov (United States)

    Barclay, Joshua S; Owens, Justine E; Blackhall, Leslie J

    2014-07-01

    The use of opioids for management of cancer-related pain has increased significantly and has been associated with a substantial rise in rates of substance abuse and diversion. There is a paucity of data not only on the prevalence of substance abuse in cancer patients, but also for issues of drug use and diversion in family caregivers. This study aimed to evaluate the frequency of risk factors for substance abuse and diversion, and abnormal urine drug screens in cancer patients receiving palliative care. A retrospective chart review was performed for patients with cancer who were seen in the University of Virginia Palliative Care Clinic during the month of September 2012. We evaluated Opioid Risk Tool variables and total scores, insurance status, and urine drug screen results. Of the 114 cancer patients seen in September 2012, the mean Opioid Risk Tool score was 3.79, with 43% of patients defined as medium to high risk. Age (16-45 years old, 23%) and a personal history of alcohol (23%) or illicit drugs (21%) were the most common risk factors identified. We obtained a urine drug screen on 40% of patients, noting abnormal findings in 45.65%. Opioids are an effective treatment for cancer-related pain, yet substantial risk for substance abuse exits in the cancer population. Screening tools, such as the Opioid Risk Tool, should be used as part of a complete patient assessment to balance risk with appropriate relief of suffering.

  5. Child maltreatment and risk patterns among participants in a child abuse prevention program.

    Science.gov (United States)

    Duffy, Jennifer Y; Hughes, Marcia; Asnes, Andrea G; Leventhal, John M

    2015-06-01

    The relationship between risk factors and Child Protective Services (CPS) outcomes in families who participate in home visiting programs to prevent abuse and neglect and who are reported to CPS is largely unknown. We examined the relationship between parental risk factors and the substantiation status and number of CPS reports in families in a statewide prevention program. We reviewed CPS reports from 2006 to 2008 for families in Connecticut's child abuse prevention program. Six risk factors (histories of CPS, domestic violence [DV], mental health, sexual abuse, substance abuse, and criminal involvement) and the number of caregivers were abstracted to create risk scores for each family member. Maltreatment type, substantiation, and number of reports were recorded. Odds ratios were calculated. Of 1,125 families, 171 (15.6%) had at least one CPS report, and reports of 131 families were available for review. Families with a substantiated (25.2%) versus unsubstantiated (74.8%) first report had a high number of paternal risk factors (OR=6.13, 95% CI [1.89, 20.00]) and were more likely to have a history of maternal DV (OR=8.47, 95% CI [2.96, 24.39]), paternal DV (OR=11.23, 95% CI [3.33, 38.46]), and maternal criminal history (OR=4.55; 95% CI [1.32, 15.60]). Families with >1 report (34.4%) versus 1 report (65.6%) were more likely to have >3 caregivers, but this was not statistically significant (OR=2.53, 95% CI [0.98, 6.54]). In a prevention program for first-time families, DV, paternal risk, maternal criminal history, and an increased number of caregivers were associated with maltreatment outcomes. Targeting parental violence may impact child abuse prevention. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. Sexual Risk-Taking among High-Risk Urban Women with and without Histories of Childhood Sexual Abuse: Mediating Effects of Contextual Factors

    Science.gov (United States)

    Mosack, Katie E.; Randolph, Mary E.; Dickson-Gomez, Julia; Abbott, Maryann; Smith, Ellen; Weeks, Margaret R.

    2010-01-01

    This study investigated the mechanisms of risk for urban women at high risk for HIV with and without childhood sexual abuse histories. Childhood sexual abuse survivors reported more unprotected intercourse and sexually transmitted infections (STIs). The association of STI locus of control with frequency of unprotected sex was fully mediated by…

  7. Risk Factors for Opioid-Use Disorder and Overdose.

    Science.gov (United States)

    Webster, Lynn R

    2017-11-01

    Opioid analgesics are recognized as a legitimate medical therapy for selected patients with severe chronic pain that does not respond to other therapies. However, opioids are associated with risks for patients and society that include misuse, abuse, diversion, addiction, and overdose deaths. Therapeutic success depends on proper candidate selection, assessment before administering opioid therapy, and close monitoring throughout the course of treatment. Risk assessment and prevention include knowledge of patient factors that may contribute to misuse, abuse, addiction, suicide, and respiratory depression. Risk factors for opioid misuse or addiction include past or current substance abuse, untreated psychiatric disorders, younger age, and social or family environments that encourage misuse. Opioid mortality prevalence is higher in people who are middle aged and have substance abuse and psychiatric comorbidities. Suicides are probably undercounted or frequently misclassified in reports of opioid-related poisoning deaths. Greater understanding and better assessment are needed of the risk associated with suicide risk in patients with pain. Clinical tools and an evolving evidence base are available to assist clinicians with identifying patients whose risk factors put them at risk for adverse outcomes with opioids.

  8. Child sexual abuse as a risk factor for teen dating violence: Findings from a representative sample of Quebec youth

    Science.gov (United States)

    Hébert, Martine; Moreau, Catherine; Blais, Martin; Lavoie, Francine; Guerrier, Mireille

    2016-01-01

    Child sexual abuse (CSA) is identified as a significant risk factor for later victimization in the context of adult intimate relationships, but less is known about the risk associated with CSA in early romantic relationships. This paper aims to document the association between CSA and teen dating victimization in a large representative sample of Quebec high-school students. As part of the Youths’ Romantic Relationships Project, 8,194 teens completed measures on CSA and psychological, physical and sexual dating violence. After controlling for other interpersonal traumas, results show that CSA contributed to all three forms of dating victimization among both boys and girls. The heightened risk of revictimization appears to be stronger for male victims of CSA. Intervention and prevention efforts are clearly needed to reduce the vulnerability of male and female victims of sexual abuse who are entering the crucial phase of adolescence and first romantic relationships. PMID:29308104

  9. Comparison of the risks of shopping behavior and opioid abuse between tapentadol and oxycodone and association of shopping behavior and opioid abuse.

    Science.gov (United States)

    Cepeda, M Soledad; Fife, Daniel; Kihm, Mary A; Mastrogiovanni, Greg; Yuan, Yingli

    2014-12-01

    This study compared the risks of opioid shopping behavior and opioid abuse between tapentadol immediate release and oxycodone immediate release and, to validate the definition of shopping, examined the association between opioid shopping and opioid abuse further. This retrospective cohort study using linked dispensing and diagnosis databases followed opioid-naive patients for development of shopping behavior and/or opioid abuse during 1 year after initial exposure to tapentadol or oxycodone. Shopping was defined by having overlapping opioid prescriptions from >1 prescriber filled at ≥3 pharmacies; abuse by having International Classification of Diseases, 9th revision diagnoses reflecting opioid abuse, addiction, or dependence. To determine their association, we cross-tabulated shopping and opioid abuse and calculated odds ratios. Risks of developing each outcome were estimated using logistic regression. Among 277,401 participants initiating opioid use with tapentadol (39,524) or oxycodone (237,877), 0.6% developed shopping behavior, 0.75% developed abuse. Higher proportions of patients in the oxycodone group developed shopping behavior and abuse than in the tapentadol group (shopping: adjusted odds ratio [95% confidence interval], 0.45 [0.36-0.55]; abuse: 0.44 [0.37-0.54]). Shopping behavior and abuse were associated; of those with shopping behavior, 6.5% had abuse. Age (18 to 64 y), sex (male), prior benzodiazepine use, paying cash, and history (mood disorders, abuse of nonopioid medications, and back pain) were risk factors for developing either outcome. Shopping behavior and abuse measure complementary, but associated, constructs, which further validates the current definition of shopping. The risk of developing either is lower among patients who initiate opioid use with tapentadol than those who initiate opioid use with oxycodone.

  10. Corporal Punishment of Adolescents by Parents: A Risk Factor in the Epidemiology of Depression, Suicide, Alcohol Abuse, Child Abuse, and Wife Beating.

    Science.gov (United States)

    Straus, Murray A.; Kantor, Glenda Kaufman

    1994-01-01

    Studied large national sample of U.S. adults, finding that almost one-half recalled having been corporally punished during adolescence. Data analysis revealed that children who experienced corporal punishment in adolescence had increased risk later in life of depressive symptoms, suicidal thoughts, alcohol abuse, physical abuse of children, and…

  11. Prevalence of Teen Dating Violence and Co-occurring Risk Factors Among Middle School Youth in High-Risk Urban Communities

    Science.gov (United States)

    Niolon, Phyllis Holditch; Vivolo-Kantor, Alana M.; Latzman, Natasha E.; Valle, Linda Anne; Kuoh, Henrietta; Burton, Tessa; Taylor, Bruce G.; Tharp, Andra T.

    2018-01-01

    Purpose This study describes the lifetime prevalence of teen dating violence (TDV) perpetration in a sample of middle school students from high-risk urban communities and examines the relation between TDV and related cognitive and behavioral risk factors. Methods Surveys were administered to 2,895 middle school students in four U.S. cities; 1,673 students (58%) reported having dated and were included in analyses. The sample was 52.3% female, 48.2% non-Hispanic black/African-American, 38.2% Hispanic, 4.8% non-Hispanic white, and 7.6% other race. Six types of TDV perpetration were assessed: threatening behaviors, verbal/emotional abuse, relational abuse, physical abuse, sexual abuse, and stalking. Results Of the students who had dated, 77% reported perpetrating verbal/emotional abuse, 32% reported perpetrating physical abuse, 20% reported threatening a partner, 15% reported perpetrating sexual abuse, 13% reported perpetrating relational abuse, and 6% reported stalking. Girls were more likely than boys to report perpetrating threatening behaviors, verbal/emotional abuse, and physical abuse, and boys were more likely to report perpetrating sexual abuse. Involvement in bullying positively predicted perpetration of TDV, albeit, in different ways for boys and girls. Other risk factors differed by sex. For instance, alcohol use and sex initiation predicted multiple forms of TDV perpetration for boys, whereas weapon carrying and emotional symptoms predicted several forms of TDV perpetration for girls. Conclusions The prevalence of TDV was high in our sample. Important sex differences in rates of perpetration and risk factors emerged. Comprehensive prevention programs that target TDV and related risk factors, such as bullying and other risk factors, seem warranted. PMID:25620454

  12. Examining Physical and Sexual Abuse Histories as Correlates of Suicide Risk Among Firefighters.

    Science.gov (United States)

    Hom, Melanie A; Matheny, Natalie L; Stanley, Ian H; Rogers, Megan L; Cougle, Jesse R; Joiner, Thomas E

    2017-12-01

    Research indicates that physical and sexual abuse are associated with increased suicide risk; however, these associations have not been investigated among firefighters-an occupational group that has been shown to be at elevated suicide risk. This study examined whether physical and sexual abuse histories are associated with (a) career suicide ideation, plans, and attempts; and (b) current suicide risk (controlling for theoretically relevant symptoms) in this occupational group. A sample of 929 U.S. firefighters completed self-report surveys that assessed lifetime history of physical and sexual abuse; career suicide ideation, plans, and attempts; current suicide risk; and theoretically relevant symptoms. Logistic regression analyses revealed that individuals who reported a history of physical abuse were significantly more likely to report career suicide ideation, adjusted odds ratio [AOR] = 6.12, plans, AOR = 13.05, and attempts, AOR = 23.81, than those who did not. A similar pattern of findings emerged for individuals who reported a sexual abuse history, AORs = 7.83, 18.35, and 29.58 respectively. Linear regression analyses revealed that physical and sexual abuse histories each significantly predicted current suicide risk, even after controlling for theoretically relevant symptoms and demographics, pr 2 = .07 and .06, respectively. Firefighters with a history of physical and/or sexual abuse may be at increased risk for suicidal thoughts and behaviors. A history of physical and sexual abuse were each significantly correlated with current suicide risk in this population, even after accounting for the effects of theoretically relevant symptoms. Thus, when conceptualizing suicide risk among firefighters, factors not necessarily related to one's firefighter career should be considered. Copyright © 2017 International Society for Traumatic Stress Studies.

  13. Psychological violence against women: What factors increase the risk of this kind of intimate partner abuse?

    Directory of Open Access Journals (Sweden)

    Ana Safranoff

    2017-12-01

    Full Text Available Using data from Argentina’s National Study on Violence Against Women [Estudio nacional sobre violencias contra las mujeres] carried out in 2015, the article identifies the risk factors that increase women’s vulnerability to psychological abuse. Findings show that women who are more prone to be victims of this kind of partner violence are those who are less educated, older, do not earn a wage for their work, live with children at home, are involved in less “formal” long-term relationships, as well as those whose male partners have a lower educational level than their own and/or have alcohol problems and/or were victims or witnesses of violence during their childhood. The article suggests possible intervention strategies to eradicate abuse, which should be primarily targeted at empowering women and strengthening their independence from their partners.

  14. Fathering by partner-abusive men: attitudes on children's exposure to interparental conflict and risk factors for child abuse.

    Science.gov (United States)

    Salisbury, Emily J; Henning, Kris; Holdford, Robert

    2009-08-01

    A substantial body of research concludes that children in homes marked by intimate partner violence (IPV) and conflict are at increased risk for maladjustment. Although studies often attribute these difficulties to the aggressive acts witnessed, other research and theoretical work suggests that disrupted parenting and co-occurring child maltreatment play an equally critical role in the onset of the children's psychological and behavioral problems. Despite the clear importance of parenting in the context of IPV, relatively little scholarship has been devoted to the topic, particularly when it comes to examining fathers. The current study sought to better understand the paternal relationships of men arrested for spouse/partner abuse, to examine their beliefs about children's exposure to interparental conflict and to identify the specific factors that may place their children at risk for maltreatment. The data consisted of questionnaires administered to 3,824 men attending a court-ordered evaluation after they were convicted of assaulting an intimate partner. Analyses revealed that most of the men had some type of fathering role with underage children (n = 2,508; 65.6%) and in most cases these relationships continued following their arrest. Although the majority of the men acknowledged that their children had been exposed to interparental conflicts, few perceived that their children had been affected by the arguing. Also of concern was the fact that risk factors for child maltreatment were highly prevalent in this population. Implications of these findings and suggestions for those working with domestic offenders are discussed.

  15. Child sexual abuse as a risk factor for teen dating violence: Findings from a representative sample of Quebec youth

    OpenAIRE

    Hébert, Martine; Moreau, Catherine; Blais, Martin; Lavoie, Francine; Guerrier, Mireille

    2016-01-01

    Child sexual abuse (CSA) is identified as a significant risk factor for later victimization in the context of adult intimate relationships, but less is known about the risk associated with CSA in early romantic relationships. This paper aims to document the association between CSA and teen dating victimization in a large representative sample of Quebec high-school students. As part of the Youths’ Romantic Relationships Project, 8,194 teens completed measures on CSA and psychological, physical...

  16. Factors Influencing Substance Abuse among Undergraduate ...

    African Journals Online (AJOL)

    The study investigated the factors influencing substance abuse amongundergraduate students in Osun State; Nigeria. A sample of 1, 200undergraduate students were randomly selected from three tertiaryinstitution in Osun State. Factors Influencing Substance Abuse Questionnaire (FISA) was developed by the researcher ...

  17. Evaluation of factors influencing child abuse leading to oro-facial lesions in Isfahan, Iran: A qualitative approach

    Directory of Open Access Journals (Sweden)

    Firoozeh Nilchian

    2012-01-01

    Conclusion: This study has identified a variety of factors influencing the incidence of child abuse. Therefore, dentists should meticulously pay attention to children who have these risk factors in order to discover child abuse events. Quantitative research would reveal the extent of these factors. Dentists′ knowledge of their roles in managing cases suffering from abuse might need to be assessed to see if dentists need further education in this important area.

  18. Child Sexual Abuse and Negative Affect as Shared Risk Factors for Sexual Aggression and Sexual HIV Risk Behavior in Heterosexual Men.

    Science.gov (United States)

    Peterson, Zoё D; Janssen, Erick; Goodrich, David; Fortenberry, J Dennis; Hensel, Devon J; Heiman, Julia R

    2018-02-01

    Previous research has suggested that sexually aggressive behavior and sexual HIV risk behavior are associated. Childhood sexual abuse (CSA) is a well-established risk factor for both types of problematic sexual behavior. Negative affect (i.e., anxiety, depression, and anger) is a less well-studied risk factor, but it has been theorized to relate to both sexual aggression and HIV risk behavior. Thus, this study sought to (1) confirm the relationship between sexual aggression and HIV risk behavior, (2) establish CSA and negative affect as shared risk factors for sexual aggression and HIV risk behavior, and (3) evaluate whether negative affect mediates the relationship between CSA and sexual aggression and between CSA and HIV sexual risk in a sample of heterosexual men. We recruited 18- to 30-year-old heterosexual men (N = 377) from urban sexually transmitted infection clinics. Men completed measures of sexual HIV risk history (number of partners and condom use), sexual aggression history, CSA history, and trait negative affect (anger, anxiety, and depression). Structural equation modeling was used to examine hypothesized direct and indirect relationships. In the final SEM model, sexual aggression history and sexual HIV risk behavior were correlated. CSA was associated with both types of problematic sexual behavior. Anxiety significantly mediated the relationship between CSA and sexual aggression and between CSA and sexual HIV risk behavior (χ 2 [1300] = 2121.79, p Sexual aggression appears to be part of a constellation of sexual risk behaviors; thus, it may be possible to develop prevention programs that target both sexual HIV risk and sexual aggression. CSA is a shared risk factor for sexual aggression and HIV risk behavior through the pathway of anxiety. Thus, anxiety might be one promising target for intervention.

  19. Interplay between childhood physical abuse and familial risk in the onset of psychotic disorders.

    Science.gov (United States)

    Fisher, Helen L; McGuffin, Peter; Boydell, Jane; Fearon, Paul; Craig, Thomas K; Dazzan, Paola; Morgan, Kevin; Doody, Gillian A; Jones, Peter B; Leff, Julian; Murray, Robin M; Morgan, Craig

    2014-11-01

    Childhood abuse is considered one of the main environmental risk factors for the development of psychotic symptoms and disorders. However, this association could be due to genetic factors influencing exposure to such risky environments or increasing sensitivity to the detrimental impact of abuse. Therefore, using a large epidemiological case-control sample, we explored the interplay between a specific form of childhood abuse and family psychiatric history (a proxy for genetic risk) in the onset of psychosis. Data were available on 172 first presentation psychosis cases and 246 geographically matched controls from the Aetiology and Ethnicity of Schizophrenia and Other Psychoses study. Information on childhood abuse was obtained retrospectively using the Childhood Experience of Care and Abuse Questionnaire and occurrence of psychotic and affective disorders in first degree relatives with the Family Interview for Genetic Studies. Parental psychosis was more common among psychosis cases than unaffected controls (adjusted OR = 5.96, 95% CI: 2.09-17.01, P = .001). Parental psychosis was also associated with physical abuse from mothers in both cases (OR = 3.64, 95% CI: 1.06-12.51, P = .040) and controls (OR = 10.93, 95% CI: 1.03-115.90, P = .047), indicative of a gene-environment correlation. Nevertheless, adjusting for parental psychosis did not measurably impact on the abuse-psychosis association (adjusted OR = 3.31, 95% CI: 1.22-8.95, P = .018). No interactions were found between familial liability and maternal physical abuse in determining psychosis caseness. This study found no evidence that familial risk accounts for associations between childhood physical abuse and psychotic disorder nor that it substantially increases the odds of psychosis among individuals reporting abuse. © The Author 2014. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.

  20. Eliciting change in at-risk elders (ECARE): evaluation of an elder abuse intervention program.

    Science.gov (United States)

    Mariam, Lydia Morris; McClure, Regina; Robinson, J B; Yang, Janet A

    2015-01-01

    The current study evaluated the effectiveness of a community-based elder abuse intervention program that assists suspected victims of elder abuse and self-neglect through a partnership with local law enforcement. This program, Eliciting Change in At-Risk Elders, involves building alliances with the elder and family members, connecting the elder to supportive services that reduce risk of further abuse, and utilizing motivational interviewing-type skills to help elders overcome ambivalence regarding making difficult life changes. Risk factors of elder abuse decreased over the course of the intervention and nearly three-quarters of participants made progress on their treatment goal, advancing at least one of Prochaska and DiClemente's (1983) stages of change (precontemplation, contemplation, preparation, action, and maintenance). Forty-three percent of elders moved into the stages of action and maintenance regarding their goal. The usefulness of eliciting change via longer-term relationships with vulnerable elders in entrenched elder abuse situations is discussed.

  1. Stimulant ADHD medication and risk for substance abuse.

    Science.gov (United States)

    Chang, Zheng; Lichtenstein, Paul; Halldner, Linda; D'Onofrio, Brian; Serlachius, Eva; Fazel, Seena; Långström, Niklas; Larsson, Henrik

    2014-08-01

    There are persistent concerns of long-term effects of stimulant ADHD medication on the development of substance abuse. Using Swedish national registers, we studied all individuals born between 1960 and 1998 and diagnosed with ADHD (26,249 men and 12,504 women). We investigated the association between stimulant ADHD medication in 2006 and substance abuse during 2009. Substance abuse was indexed by substance-related death, crime, or hospital visits. ADHD medication was not associated with increased rate of substance abuse. Actually, the rate during 2009 was 31% lower among those prescribed ADHD medication in 2006, even after controlling for medication in 2009 and other covariates (hazard ratio: 0.69; 95% confidence interval: 0.57-0.84). Also, the longer the duration of medication, the lower the rate of substance abuse. Similar risk reductions were suggested among children and when investigating the association between stimulant ADHD medication and concomitant short-term abuse. We found no indication of increased risks of substance abuse among individuals prescribed stimulant ADHD medication; if anything, the data suggested a long-term protective effect on substance abuse. Although stimulant ADHD medication does not seem to increase the risk for substance abuse, clinicians should remain alert to the potential problem of stimulant misuse and diversion in ADHD patients. © 2013 The Authors. Journal of Child Psychology and Psychiatry © 2013 Association for Child and Adolescent Mental Health.

  2. The Impact of Child, Family, and Child Protective Services Factors on Reports of Child Sexual Abuse Recurrence

    Science.gov (United States)

    Sinanan, Allison N.

    2011-01-01

    This study identified selected child factors (e.g., age, gender, race/ethnicity, disabilities, prior victimization, and relationship to perpetrator of abuse), family risk factors (e.g., substance abuse, domestic violence, inadequate housing, and financial problems), and services provided by child protective services that likely increased reports…

  3. Cumulative childhood risk and adult functioning in abused and neglected children grown up.

    Science.gov (United States)

    Horan, Jacqueline M; Widom, Cathy Spatz

    2015-08-01

    This paper examines the relationship between childhood exposure to cumulative risk and three indicators of psychosocial adjustment in adulthood (educational attainment, mental health, and criminal behavior) and tests three different models (linear, quadratic, and interaction). Data were collected over several time points from individuals who were part of a prospective cohort design study that matched children with documented cases of abuse and/or neglect with children without such histories and followed them into adulthood. Hierarchical multiple regressions compared linear and quadratic models and then examined potential moderating effects of child abuse/neglect and gender. Exposure to a greater number of childhood risk factors was significantly related to fewer years of education, more anxiety and depression symptomatology, and more criminal arrests in adulthood. The relationship between cumulative risk and years of education demonstrated a curvilinear pattern, whereas the relationship between cumulative risk and both mental health and criminal arrests was linear. Child abuse/neglect did not moderate these relationships, although there were direct effects for both child abuse/neglect and gender on criminal arrests, with more arrests for abused/neglected individuals than controls and more for males than females. Gender interacted with cumulative risk to impact educational attainment and criminal behavior, suggesting that interventions may be more effective if tailored differently for males and females. Interventions may need to be multifaceted and designed to address these different domains of functioning.

  4. Childhood abuse, parental warmth, and adult multisystem biological risk in the Coronary Artery Risk Development in Young Adults study.

    Science.gov (United States)

    Carroll, Judith E; Gruenewald, Tara L; Taylor, Shelley E; Janicki-Deverts, Denise; Matthews, Karen A; Seeman, Teresa E

    2013-10-15

    Childhood abuse increases adult risk for morbidity and mortality. Less clear is how this "toxic" stress becomes embedded to influence health decades later, and whether protective factors guard against these effects. Early biological embedding is hypothesized to occur through programming of the neural circuitry that influences physiological response patterns to subsequent stress, causing wear and tear across multiple regulatory systems. To examine this hypothesis, we related reports of childhood abuse to a comprehensive 18-biomarker measure of multisystem risk and also examined whether presence of a loving parental figure buffers against the impact of childhood abuse on adult risk. A total of 756 subjects (45.8% white, 42.7% male) participated in this ancillary substudy of the Coronary Artery Risk Development in Young Adults Study. Childhood stress was determined by using the Risky Families Questionnaire, a well-validated retrospective self-report scale. Linear regression models adjusting for age, sex, race, parental education, and oral contraceptive use found a significant positive relationship between reports of childhood abuse and multisystem health risks [B (SE) = 0.68 (0.16); P childhood was associated with lower multisystem health risks [B (SE) = -0.40 (0.14); P childhood had the highest multisystem risk in adulthood.

  5. Moderating factors in the path from physical abuse to attempted suicide in adolescents: application of the interpersonal-psychological theory of suicide.

    Science.gov (United States)

    Cero, Ian; Sifers, Sarah

    2013-06-01

    Childhood physical abuse is a major risk factor for suicide attempt, but factors that moderate this risk remain largely unexamined. Moderated mediation analysis was used with 186 adolescents who responded to the Profiles of Student Life: Attitudes and Behavior survey. Physical abuse increased risk directly and indirectly through reduced self-esteem. Involvement in youth programs moderated the direct effect. Community service moderated the indirect effect. Results indicate 2 hours per week of involvement in youth programs and 2 hours per week of community service mitigated suicide attempt risk associated with abuse. Providing avenues for youth experiencing abuse to increase their community service and involvement is recommended. © 2013 The American Association of Suicidology.

  6. Hispanic Women’s Experiences With Substance Abuse, Intimate Partner Violence, and Risk for HIV

    Science.gov (United States)

    Gonzalez-Guarda, Rosa Maria; Vasquez, Elias P.; Urrutia, Maria T.; Villarruel, Antonia M.; Peragallo, Nilda

    2011-01-01

    Hispanic females are disproportionately affected by substance abuse, intimate partner violence, and HIV. Despite these disparities, research describing the cultural and gender-specific experiences of Hispanic women with regard to these conditions is lacking. The purpose of this study is to describe the experiences that Hispanic community-dwelling women have with regard to substance abuse, violence, and risky sexual behaviors. Eight focus groups with 81 women were conducted. A bilingual, bicultural moderator asked women open-ended questions regarding the experiences that Hispanic women have with these conditions. Focus groups were audiotaped, transcribed, translated, verified, and then analyzed using qualitative content analysis. Participants discussed substance abuse, violence, and risky sexual behaviors interchangeably, often identifying common risk factors associated with these. Nevertheless, intimate partner violence was the most salient of conditions discussed. Three major themes emerged from the analysis: Transplantadas en otro mundo (Uprooted in another world), El criador de abuso (The breeding ground of abuse), and Rompiendo el silencio (Breaking the silence). This study supports the importance of addressing substance abuse, violence, and risk for HIV in an integrated manner and stresses the importance of addressing associated cultural factors (e.g., acculturation, machismo) in interventions targeting Hispanics. PMID:21191036

  7. Relationship of child abuse with personality features and high risk behaviors in adolescents

    Directory of Open Access Journals (Sweden)

    Mehdi Ghezelseflo

    2015-05-01

    Full Text Available Background: Children are one of the most vulnerable groups of the society and are constantly threatened by different people in their family or society. The aim of this study was investigating the correlation of child abuse with personality features and high risk behavior in high school students of Islamshahr, Iran. Methods: This study cross-sectional analytical was conducted on the high school girls and boys of Islamshahr in spring 2014.528 students were selected by cluster random sampling among 4 high schools (two female and two male high schools. Childhood trauma questionnaire, NEO-Five Factor Inventory and Youth Risk-Taking Scale were used for data collection. Data were analyzed by independence t-test, Pearson's correlation coefficient and multiple linear regression. Results: The results of independence t-test indicated significant differences between girls and boys in terms of child abuse and high risk experience (t=-2.16,p=0.03 and t=-5.03, P=0.001, respectively. Also, the results demonstrated a significant relationship between child abuse and personality characteristics, high risk behavior and all its subscales (P<0.05. The findings of multiple linear regressionindicated that child abuse could explain 14% total risk-taking, 25% neurotic personality feature , 14% extroversion, 10% agreeableness, 1% flexibility and 13% conscientiousness (P<0.05. Conclusion: According to the research findings, appropriate behavior with children is of great importance. Therefore, child abuse would form inappropriate personality features and increase risk behaviors among children.

  8. A prospective examination of the path from child abuse and neglect to illicit drug use in middle adulthood: the potential mediating role of four risk factors.

    Science.gov (United States)

    Wilson, Helen W; Widom, Cathy Spatz

    2009-03-01

    This study examines prostitution, homelessness, delinquency and crime, and school problems as potential mediators of the relationship between childhood abuse and neglect (CAN) and illicit drug use in middle adulthood. Children with documented cases of physical and sexual abuse and neglect (ages 0-11) during 1967-1971 were matched with non-maltreated children and followed into middle adulthood (approximate age 39). Mediators were assessed in young adulthood (approximate age 29) through in-person interviews between 1989 and 1995 and official arrest records through 1994 (N = 1,196). Drug use was assessed via self-reports of past year use of marijuana, psychedelics, cocaine, and/or heroin during 2000-2002 (N = 896). Latent variable structural equation modeling (SEM) was used to test: (1) a four-factor model with separate pathways from CAN to illicit drug use through each of the mediating risk factors and (2) a second-order model with a single mediating risk factor comprised of prostitution, homelessness, delinquency and crime, and poor school performance. Analyses were performed separately for women and men, controlling for race/ethnicity and early drug use. In the four-factor model for both men and women, CAN was significantly related to each of the mediators, but no paths from the mediators to drug use were significant. For women, the second-order risk factor mediated the relationship between CAN and illicit drug use in middle adulthood. For men, neither child abuse and neglect nor the second-order risk factor predicted drug use in middle adulthood. These results suggest that for women, the path from CAN to middle adulthood drug use is part of a general "problem behavior syndrome" evident earlier in life.

  9. [Factors for sexual abuse during childhood and adolescence in students of Morelos, Mexico].

    Science.gov (United States)

    Chavez Ayala, Ruben; Rivera-Rivera, Leonor; Angeles-Llerenas, Angélica; Díaz-Cerón, Eva; Allen-Leigh, Betania; Ponce, Eduardo Lazcano

    2009-06-01

    To estimate the prevalence and factors associated with sexual abuse in childhood and adolescence. Study conducted in a sample of students in the state of Morelos, Mexico, in 2004-2005. Participants (n=1730) were drawn from a cohort of 13,293 students aged 12 to 24 years. Data were collected by means of a questionnaire comprising parts of validated scales. The variables studied were: sociodemographic (gender, living area, socioeconomic status), family (parental education, parental addictions, violence between parents), individual psychological factors (self-esteem assessed using the Coopersmith Self-Esteem Inventory, depression, alcohol consumption), intrafamily violence (assessed through Strauss Scale) and sexual abuse. Multiple logistic regression assessed the risk factors associated. Odds ratios (OR) with 95% confidence intervals were estimated. Of all students studied, 4.7% (n=80) reported attempted sexual abuse and 2.9% (n=50) were victims of consummated sexual abuse. Women had higher prevalence of attempted (6.1%) abuse; 3.6% of females and 1.9% of men were sexually abused. Main perpetrators were boyfriends in women and a stranger in men. Mean age was 12.02 years old among females and 11.71 years old among men. Factors found to be associated with abuse: high parental alcohol consumption (OR = 3.37, 95% CI 1.40;8.07), violence toward the mother (OR = 4.49, 95% CI 1.54;13.10), female gender (OR = 2.47, 95% CI 1.17;5.24), being a victim of great domestic violence (OR = 3.58, 95% CI 1.32;9.67). High self-esteem was a protective factor (OR = 0.27, 95% CI 0.09;0.75). Overall sexual abuse occurs at the age of 12 in both males and females, and it is more frequent among females. Most victims do not report abuse.

  10. Sensation Seeking and Risk-Taking Propensity as Mediators in the Relationship between Childhood Abuse and HIV-Related Risk Behavior

    Science.gov (United States)

    Bornovalova, Marina A.; Gwadz, Marya A.; Kahler, Christopher; Aklin, W. M.; Lejuez, C. W.

    2008-01-01

    Objectives: Although a wealth of literature suggests that childhood physical, emotional, and sexual abuse are related to later-life HIV-related risk behaviors, few studies have explored disinhibition (e.g., impulsivity, risk-taking propensity, and sensation-seeking) as a risk factor in this relationship. Method: This cross-sectional study examined…

  11. Elder abuse in Chinese populations: a global review.

    Science.gov (United States)

    Dong, XinQi

    2015-01-01

    This review focuses on the epidemiology of elder abuse in the global Chinese population with respect to its prevalence, risk factors, and consequences, as well as the perceptions of elder abuse. Evidence revealed that elder abuse and its subtypes are common among the global Chinese population with prevalence ranging from 0.2% to 64%. Younger age, lower income levels, depression, cognitive impairment, and lack of social support were consistently associated with self-reported elder abuse. Caregiver burden was a constant risk factor for the proclivity to elder abuse by caregivers. The adverse health outcomes of elder abuse included suicidal ideation and psychological stress. Some primary research gaps exist: such as, lack of consistency in measurements and recall periods, insufficient studies on the causal relationships between potential risk factors and elder abuse, consequences of elder abuse, and possible interventions. In order to reduce the risk of elder abuse in the global Chinese population, collaboration is encouraged among researchers, health care professionals, social service providers, and policy makers.

  12. Hispanic women's experiences with substance abuse, intimate partner violence, and risk for HIV.

    Science.gov (United States)

    Gonzalez-Guarda, Rosa Maria; Vasquez, Elias P; Urrutia, Maria T; Villarruel, Antonia M; Peragallo, Nilda

    2011-01-01

    Hispanic females are disproportionately affected by substance abuse, intimate partner violence, and HIV. Despite these disparities, research describing the cultural and gender-specific experiences of Hispanic women with regard to these conditions is lacking. Transplantadas en otro mundo (Uprooted in another world), El criador de abuso (The breeding ground of abuse), and Rompiendo el silencio (Breaking the silence). This study supports the importance of addressing substance abuse, violence, and risk for HIV in an integrated manner and stresses the importance of addressing associated cultural factors (e.g., acculturation, machismo ) in interventions targeting Hispanics.

  13. Risk and protective factors for physical and sexual abuse of children and adolescents in Africa: a review and implications for practice.

    Science.gov (United States)

    Meinck, Franziska; Cluver, Lucie D; Boyes, Mark E; Mhlongo, Elsinah L

    2015-01-01

    There is now conclusive evidence of the major and long-lasting negative effects of physical and sexual abuse on children. Within Africa, studies consistently report high rates of child abuse, with prevalence as high as 64%. However, to date, there has been no review of factors associated with physical and sexual child abuse and polyvictimization in Africa. This review identified 23 quantitative studies, all of which showed high levels of child abuse in varying samples of children and adults. Although studies were very heterogeneous, a range of correlates of abuse at different levels of the Model of Ecologic Development were identified. These included community-level factors (exposure to bullying, sexual violence, and rural/urban location), household-level factors (poverty, household violence, and non-nuclear family), caregiver-level factors (caregiver illness in particular AIDS and mental health problems, caregiver changes, family functioning, parenting, caregiver-child relationship, and substance abuse), and child-level factors (age, disability, physical health, behavior, and gender). These findings identify key associated factors that are potential foci of child abuse prevention interventions. In addition, there is a clear need for further rigorous longitudinal research into predictive factors and culturally relevant interventions. © The Author(s) 2014.

  14. Relationship between Risk Factors and Drug Use among Female Prisoners in Semarang Prison between 2012 and 2013

    Directory of Open Access Journals (Sweden)

    Ahmadi NH Ahmadi NH

    2013-06-01

    Full Text Available Drugs abuse is a complex problem facing family and society. Drug abuse cases have long long been recognized. in Indoneisia the cases started to gain public attention in 1969. Today, the similiar cases are increasing in number. There have been more number cases and type of drugs abused (multiple drugs. The Risk factors for drug abuse vary among individuals and involve several factors namely individual, environment and drugs. The interaction of the three factors leads to the drug abuse. To cope with that, a holistic approach is needed. This study was aimed at dinding out the risk factors for drug abuse among women serving in women prison of Semarang due to drug abuse. In this cross-sectional study, chi square test was applied to assess the correlation between the risk factors and the drug abuse. Cooficient contigency was applied to evaluate the degree of correlation among variables. The result showed that out of 273 women prisoners, 176 were drug abusers. The individual factors of enxiety had a normal possitive correlation with drug abuse with a weak correlation (p<0,05, r=0,221.

  15. A within-person approach to risk for suicidal ideation and suicidal behavior: Examining the roles of depression, stress, and abuse exposure.

    Science.gov (United States)

    Miller, Adam Bryant; Eisenlohr-Moul, Tory; Giletta, Matteo; Hastings, Paul D; Rudolph, Karen D; Nock, Matthew K; Prinstein, Mitchell J

    2017-07-01

    This study tests a novel, within-person model that reexamines depression and stress as risk factors for suicidal ideation and behavior among adolescent girls with and without sexual/physical abuse histories. This longitudinal study includes data from 220 adolescent girls between 12 and 16 years of age (M = 14.69 years, SD = 1.37; 61% White). At baseline, adolescents reported the presence or absence of prior abuse as part of a clinical interview. At baseline and every 3 months for 18 months, adolescents completed measures of suicidal ideation and behavior, depressive symptoms, and stress. Multilevel models examined within-person mean, deviations from within-person mean, depression, and stress and their interactions with abuse as predictors of suicidal ideation and behavior. In addition to within-person mean depression, higher-than-usual depression (odds ratio [OR] = 1.99) and higher-than-usual stress (OR = 1.53) predicted greater risk of suicidal ideation at each follow-up assessment. Periods of higher-than-usual stress (1 SD increase) and periods of higher-than-usual depression (1 SD increase) were associated with an 82% and 57% increase in the odds of suicidal behavior, respectively, but only among those with abuse histories. Depression, stress, and abuse are well-known risk factors for suicidal ideation and behavior; however, it has been unclear for whom, and when, these factors have their greatest impact. These results show that depression and stress are potent risk factors among those with a history of abuse and that within-person elevations in these risk factors signal increased short-term risk of suicidal ideation and behavior. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  16. Proposal for a new detection method of substance abuse risk in Croatian adolescents

    Directory of Open Access Journals (Sweden)

    Sanja Tatalovic Vorkapic

    2011-01-01

    Full Text Available One of the most important factors of successful substance abuse treatment is the early start of the same treatment. Recent selection method for identification of Croatian adolescents in the substance abuse risk that has been using drug tests from urine samples, has been simple and exact on the one hand, but on the other, has been very rare and usually guided by the pressure of parents or the court. Besides, such method presented the source of legal and ethical questions. So, the proposal of application of standardized psychological tests during systematic medical exams of Croatian adolescents at the age range of 15-22 years could help with the early detection of those adolescents who were in the substance abuse risk or already had the developed addiction problem.

  17. Clustering of modifiable biobehavioral risk factors for chronic disease in US adults: a latent class analysis.

    Science.gov (United States)

    Leventhal, Adam M; Huh, Jimi; Dunton, Genevieve F

    2014-11-01

    Examining the co-occurrence patterns of modifiable biobehavioral risk factors for deadly chronic diseases (e.g. cancer, cardiovascular disease, diabetes) can elucidate the etiology of risk factors and guide disease-prevention programming. The aims of this study were to (1) identify latent classes based on the clustering of five key biobehavioral risk factors among US adults who reported at least one risk factor and (2) explore the demographic correlates of the identified latent classes. Participants were respondents of the National Epidemiologic Survey of Alcohol and Related Conditions (2004-2005) with at least one of the following disease risk factors in the past year (N = 22,789), which were also the latent class indicators: (1) alcohol abuse/dependence, (2) drug abuse/dependence, (3) nicotine dependence, (4) obesity, and (5) physical inactivity. Housing sample units were selected to match the US National Census in location and demographic characteristics, with young adults oversampled. Participants were administered surveys by trained interviewers. Five latent classes were yielded: 'obese, active non-substance abusers' (23%); 'nicotine-dependent, active, and non-obese' (19%); 'active, non-obese alcohol abusers' (6%); 'inactive, non-substance abusers' (50%); and 'active, polysubstance abusers' (3.7%). Four classes were characterized by a 100% likelihood of having one risk factor coupled with a low or moderate likelihood of having the other four risk factors. The five classes exhibited unique demographic profiles. Risk factors may cluster together in a non-monotonic fashion, with the majority of the at-risk population of US adults expected to have a high likelihood of endorsing only one of these five risk factors. © Royal Society for Public Health 2013.

  18. The power of special friends: addressing the risk of child abuse through mentoring.

    Science.gov (United States)

    Vertermark, P; Russell, J; Mulvey, N

    1995-01-01

    Since 1989 two Saint Paul, Minnesota agencies have carried on a collaborative effort called the Befriender Volunteer Project. This project is designed to address the risk factors associated with child abuse which are often inherent in families headed by an adolescent. Between November of 1993 and October of 1994 a self-study of this project was conducted. An important objective of this study was to determine how the positive elements of a successful relationship affected the risk factors in these young families. Consistent with what we know about the effects of successful helping relationships, most significant improvements in young mothers were found in the areas of hopefulness, self-esteem, and parenting skills. Of significant note was the observation of the various ways the Befriender/young mother relationship enhanced the young mothers' potential for breaking the generational cycle of risk for child abuse and neglect.

  19. Assessing the relationship between child sexual abuse and marginal living conditions on HIV/AIDS-related risk behavior among women prisoners.

    Science.gov (United States)

    Mullings, J L; Marquart, J W; Brewer, V E

    2000-05-01

    There were two aims in this research. First, to examine the relationships between childhood sexual abuse and HIV drug and sexual risk taking behaviors among female prisoners, and second, to examine the relationship between a marginal adult living context and HIV drug and sexual risk taking behavior among female prisoners. The data were collected through face-to-face interviews with a random sample of 500 women at admission to prison in 1994. Differences between women who were sexually abused while growing up (n = 130) were compared to women who reported no sexual abuse (n = 370) along various demographic, and HIV drug and sexual risk taking dimensions. A history of sexual abuse while growing up was associated with increased sexual risk taking behaviors in adulthood. A marginal adult living situation also emerged as an important factor increasing the risk for HIV infection. Examining the co-occurrence of both childhood sexual abuse and adult marginal living context revealed a strong relationship between these two factors and HIV risk taking activities. The findings indicate that childhood sexual abuse may be a predictor for HIV sexual risk taking behaviors among incarcerated women. The marginal and chaotic adult living style of these women was also associated the extent of their HIV drug and sexual risk taking behaviors. Our research suggests that the co-occurrence of sexual victimization and marginality is a stronger predictor of HIV risk than each variable alone.

  20. Exposure to child abuse and risk for mental health problems in women.

    Science.gov (United States)

    Schneider, Renee; Baumrind, Nikki; Kimerling, Rachel

    2007-01-01

    Risk for adult mental health problems associated with child sexual, physical, or emotional abuse and multiple types of child abuse was examined. Logistic regression analyses were used to test study hypotheses in a population-based sample of women (N = 3,936). As expected, child sexual, physical, and emotional abuse were independently associated with increased risk for mental health problems. History of multiple types of child abuse was also associated with elevated risk for mental health problems. In particular, exposure to all three types of child abuse was linked to a 23-fold increase in risk for probable posttraumatic stress disorder (PTSD). Findings underscore relations between child emotional abuse and adult mental health problems and highlight the need for mental health services for survivors of multiple types of child abuse.

  1. School Factors as Moderators of the Relationship between Physical Child Abuse and Pathways of Antisocial Behavior

    Science.gov (United States)

    Klika, J. Bart; Herrenkohl, Todd I.; Lee, Jungeun Olivia

    2013-01-01

    Physical child abuse is a predictor of antisocial behavior in adolescence and adulthood. Few studies have investigated factors that moderate the risk of physical child abuse for later occurring outcomes, including antisocial behavior. This analysis uses data from the Lehigh Longitudinal Study to investigate the prediction of antisocial behavior…

  2. Drugs of abuse and increased risk of psychosis development.

    Science.gov (United States)

    Gururajan, Anand; Manning, Elizabeth E; Klug, Maren; van den Buuse, Maarten

    2012-12-01

    There is considerable evidence to suggest that the abuse of illicit drugs, particularly cannabis and methamphetamine, has aetiological roles in the pathogenesis of psychosis and schizophrenia. Factors that may increase susceptibility to the propsychotic effects of these drugs include the age at which the abuse starts as well as family history of genetic polymorphisms relevant to the pathophysiology of this disorder. However, the neurobiological mechanisms involved in drug abuse-associated psychosis remain largely unclear. This paper presents an overview of the available evidence, including clinical, animal model, and molecular studies, with a focus on brain regions and neurotransmitters systems, such as dopamine and glutamate, previously implicated in psychosis. It is clear that further studies are urgently needed to provide a greater insight into the mechanisms that mediate the long-term and neurodevelopmental effects of cannabis and methamphetamine. A dialogue between basic science and clinical research may help to identify at-risk individuals and novel pathways for treatment and prevention.

  3. Analog assessment of frustration tolerance: association with self-reported child abuse risk and physiological reactivity.

    Science.gov (United States)

    Rodriguez, Christina M; Russa, Mary Bower; Kircher, John C

    2015-08-01

    Although frustration has long been implicated in promoting aggression, the potential for poor frustration tolerance to function as a risk factor for physical child abuse risk has received minimal attention. Instead, much of the extant literature has examined the role of anger in physical abuse risk, relying on self-reports of the experience or expression of anger, despite the fact that this methodology is often acknowledged as vulnerable to bias. Therefore, the present investigation examined whether a more implicit, analog assessment of frustration tolerance specifically relevant to parenting would reveal an association with various markers of elevated physical child abuse risk in a series of samples that varied with regard to age, parenting status, and abuse risk. An analog task was designed to evoke parenting-relevant frustration: the task involved completing an unsolvable task while listening to a crying baby or a toddler's temper tantrum; time scores were generated to gauge participants' persistence in the task when encountering such frustration. Across these studies, low frustration tolerance was associated with increased physical child abuse potential, greater use of parent-child aggression in discipline encounters, dysfunctional disciplinary style, support for physical discipline use and physical discipline escalation, and increased heart rate. Future research directions that could better inform intervention and prevention programs are discussed, including working to clarify the processes underlying frustration intolerance and potential interactive influences that may exacerbate physical child abuse. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Sexual abuse and substance abuse increase risk of suicidal behavior in Malaysian youth.

    Science.gov (United States)

    Chan, Lai Fong; Maniam, T; Saini, Suriati Mohamed; Shah, Shamsul Azhar; Loh, Sit Fong; Sinniah, Aishvarya; Idris, Zawaha Haji; Che Rus, Sulaiman; Hassan Nudin, Siti Sa'adiah; Tan, Susan Mooi Koon

    2013-04-01

    The aim of this study was to determine the association between sexual abuse, substance abuse and socio-demographic factors with suicidal ideation (SI), plans (SP) and deliberate self-harm (DSH) and propose steps to prevent youth suicidal behavior. This was a cross-sectional study of 6786 adolescents aged 17-18 years, selected randomly from all Malaysian adolescents to undergo compulsory youth camps located in Selangor, Malaysia (2008-2009). Participants were assessed using self-administered questionnaires developed to reflect the local cultural setting. However, only 4581 subjects were analyzed after excluding incomplete data. The rates of SI, SP and DSH were 7.6%, 3.2% and 6.3%, respectively. The multivariable-adjusted odds ratio showed that sexual abuse was associated with SI 1.99 (95% CI: 1.56-2.55), SP 1.57 (95% CI: 1.09-2.27) and DSH 2.26 (95% CI: 1.75-2.94); illicit drug use was associated with SI 4.05 (95% CI: 2.14-7.67), SP 2.62 (95% CI: 1.05-6.53) and DSH 2.06, (95% CI: 1.05-4.04); for alcohol use DSH was 1.34 (95% CI: 1.00-1.79). Being female was associated with all suicidal behaviors: SI 2.51 (95% CI: 1.91-3.30), SP 2.07 (95% CI: 1.39-3.08) and DSH 1.59 (95% CI: 1.19-2.11). Given the well-founded concern of increasing risk of suicidal behavior among youth, preventive efforts should adopt a more comprehensive approach in dealing with sexual abuse and substance abuse, and their sequelae, especially in girls. Copyright © 2013 Wiley Publishing Asia Pty Ltd.

  5. A conceptual model of the risk of elder abuse posed by incontinence and care dependence.

    Science.gov (United States)

    Ostaszkiewicz, Joan

    2017-12-08

    To describe and critically analyse the thinking that led to the concept of an association between incontinence, care dependence and elder abuse. Coercive or abusive continence care practices include chastising a person for their incontinence and overriding their attempts to resist continence care. Neglect in continence care is characterised by withholding or delaying responding to requests for help to maintain continence or to manage incontinence, and restricting a person's access to toileting assistance, incontinence aids or hygiene care. Contemporary biomedical understandings about incontinence and influencing concepts from the fields of sociology, psychology and nursing were analysed to inform the design of a conceptual model that elucidates possible associations between incontinence, care dependence and elder abuse. Ideas generated from an analysis of the concepts led to the development of a model termed the "Model of Attributes to Abuse of Dependent Elders in Continence Care" (MADE-CC). The MADE-CC theorises factors that cause and contribute to abuse in continence care. Carer factors include physical and emotional exhaustion, frustration related to the inability to control or predict incontinence, resentment associated with constraints imposed by care dependence, disgust associated with physical contact with urine/faeces, limited knowledge and skills about incontinence and ethical conflicts concerning care. Care recipient factors include frequent and severe incontinence, cognitive impairment and a history of physical or psychological trauma. Social factors that are theorised include the stigmatised nature of incontinence, social taboos and cultural norms and the private nature of continence care. The MADE-CC illuminates the potential risk of elder abuse posed by incontinence and care dependence. It should be used to improve ethical care of older people and stimulate debate about everyday ethics in the care of older people who are care dependent and to optimise

  6. Addressing risk factors for child abuse among high risk pregnant women: design of a randomised controlled trial of the nurse family partnership in Dutch preventive health care

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    Mejdoubi Jamila

    2011-10-01

    Full Text Available Abstract Background Low socio-economic status combined with other risk factors affects a person's physical and psychosocial health from childhood to adulthood. The societal impact of these problems is huge, and the consequences carry on into the next generation(s. Although several studies show these consequences, only a few actually intervene on these issues. In the United States, the Nurse Family Partnership focuses on high risk pregnant women and their children. The main goal of this program is primary prevention of child abuse. The Netherlands is the first country outside the United States allowed to translate and culturally adapt the Nurse Family Partnership into VoorZorg. The aim of the present study is to assess whether VoorZorg is as effective in the Netherland as in the United States. Methods The study consists of three partly overlapping phases. Phase 1 was the translation and cultural adaptation of Nurse Family Partnership and the design of a two-stage selection procedure. Phase 2 was a pilot study to examine the conditions for implementation. Phase 3 is the randomized controlled trial of VoorZorg compared to the care as usual. Primary outcome measures were smoking cessation during pregnancy and after birth, birth outcomes, child development, child abuse and domestic violence. The secondary outcome measure was the number of risk factors present. Discussion This study shows that the Nurse Family Partnership was successfully translated and culturally adapted into the Dutch health care system and that this program fulfills the needs of high-risk pregnant women. We hypothesize that this program will be effective in addressing risk factors that operate during pregnancy and childhood and compromise fetal and child development. Trial registration Current Controlled Trials ISRCTN16131117

  7. Child Physical Abuse and Concurrence of Other Types of Child Abuse in Sweden--Associations with Health and Risk Behaviors

    Science.gov (United States)

    Annerback, E. M.; Sahlqvist, L.; Svedin, C. G.; Wingren, G.; Gustafsson, P. A.

    2012-01-01

    Objective: To examine the associations between child physical abuse executed by a parent or caretaker and self-rated health problems/risk-taking behaviors among teenagers. Further to evaluate concurrence of other types of abuse and how these alone and in addition to child physical abuse were associated with bad health status and risk-taking…

  8. Contributions of Child Sexual Abuse, Self-Blame, Posttraumatic Stress Symptoms, and Alcohol Use to Women's Risk for Forcible and Substance-Facilitated Sexual Assault.

    Science.gov (United States)

    Mokma, Taylor R; Eshelman, Lee R; Messman-Moore, Terri L

    2016-01-01

    Child sexual abuse and adult sexual assault have been linked to increased self-blame, posttraumatic stress symptoms, and alcohol use. The current study aims to examine (a) whether these constructs explain women's risk for later adult sexual assault and revictimization, (b) whether such factors differentially confer risk for specific types of adult sexual assault (i.e., substance-facilitated and forcible), and (c) if self-blame confers risk indirectly through other risk factors. Multiple types of self-blame, posttraumatic stress, and alcohol use were examined among 929 female college students as serial mediators of the relationship between child sexual abuse and adult sexual assault and as risk factors for sexual revictimization among child sexual abuse survivors. In the model predicting risk for substance-facilitated adult sexual assault, child sexual abuse indirectly predicted greater risk for substance-facilitated adult sexual assault mediated through two separate paths: global blame-to-posttraumatic-stress and global blame-to-alcohol use. In the model predicting risk for forcible adult sexual assault, child sexual abuse directly predicted greater risk for forcible adult sexual assault, and this relation was mediated by the global blame-to-posttraumatic-stress path. Among child sexual abuse survivors, child sexual abuse specific characterological and behavioral self-blame directly predicted greater risk for forcible and substance-facilitated revictimization, but the pathways were not mediated by posttraumatic stress or alcohol use. Results emphasize the importance of assessing different types of self-blame in predicting posttraumatic stress symptoms as well as examining risk for sexual victimization and revictimization. Findings did not support hypotheses that increased posttraumatic stress would predict increased alcohol use but did indicate that heightened self-blame is consistently associated with heightened posttraumatic stress and that heightened global self

  9. Risk factors for child maltreatment in an Australian population-based birth cohort.

    Science.gov (United States)

    Doidge, James C; Higgins, Daryl J; Delfabbro, Paul; Segal, Leonie

    2017-02-01

    Child maltreatment and other adverse childhood experiences adversely influence population health and socioeconomic outcomes. Knowledge of the risk factors for child maltreatment can be used to identify children at risk and may represent opportunities for prevention. We examined a range of possible child, parent and family risk factors for child maltreatment in a prospective 27-year population-based birth cohort of 2443 Australians. Physical abuse, sexual abuse, emotional abuse, neglect and witnessing of domestic violence were recorded retrospectively in early adulthood. Potential risk factors were collected prospectively during childhood or reported retrospectively. Associations were estimated using bivariate and multivariate logistic regressions and combined into cumulative risk scores. Higher levels of economic disadvantage, poor parental mental health and substance use, and social instability were strongly associated with increased risk of child maltreatment. Indicators of child health displayed mixed associations and infant temperament was uncorrelated to maltreatment. Some differences were observed across types of maltreatment but risk profiles were generally similar. In multivariate analyses, nine independent risk factors were identified, including some that are potentially modifiable: economic disadvantage and parental substance use problems. Risk of maltreatment increased exponentially with the number of risk factors experienced, with prevalence of maltreatment in the highest risk groups exceeding 80%. A cumulative risk score based on the independent risk factors allowed identification of individuals at very high risk of maltreatment, while a score that incorporated all significant risk and protective factors provided better identification of low-risk individuals. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Predictors of HIV-risk sexual behavior: examining lifetime sexual and physical abuse histories in relation to substance use and psychiatric problem severity among ex-offenders.

    Science.gov (United States)

    Majer, John M; Rodriguez, Jaclyn; Bloomer, Craig; Jason, Leonard A

    2014-01-01

    Lifetime histories of sexual and physical abuse have been associated with increased HIV-risk sexual behavior, and some studies have identified other variables associated with these relationships. However, there is a dearth of literature that has critically examined abuse histories and HIV-risk sexual behavior in relation to these other variables. Predictors of HIV-risk sexual behavior were analyzed among a sample of ex-offenders who were completing inpatient substance dependence treatment to identify factors related to increases in HIV-risk sexual behavior beyond that of abuse histories. Hierarchical linear regression was conducted to examine sociodemographic characteristics, recent substance use, and current psychiatric problem severity in addition to lifetime histories of sexual/physical abuse in a cross-sectional design. Gender, substance use, and psychiatric problem severity predicted increases in HIV-risk sexual behavior beyond what was predicted by abuse histories. Proportionately more women than men reported abuse histories. In addition, significantly more unprotected sexual than safer sexual practices were observed, but differences in these practices based on lifetime abuse histories and gender were not significant. Findings suggest recent substance use and current psychiatric problem severity are greater risk factors for HIV-risk sexual behavior than lifetime abuse histories among persons who have substance use disorders.

  11. Effects of opium consumption on coronary artery disease risk factors and oral health: Results of Kerman Coronary Artery Disease Risk factors Study a population-based survey on 5900 subjects aged 15-75 years.

    Science.gov (United States)

    Najafipour, Hamid; Masoomi, Mohammad; Shahesmaeili, Armita; Haghdoost, Ali Akbar; Afshari, Mahdi; Nasri, Hamid Reza; Kahnooji, Masoomeh; Samadi, Sadra; Mirzazadeh, Ali

    2015-01-01

    Opium abuse as a relatively common behavior among Iranian population may have an association with the other coronary artery disease (CAD) risk factors. Here, we reported the prevalence of opium abuse and its co-exposures with oral health and other CAD risk factors. We recruited 5900 inhabitant aged 15-75 years using a randomized cluster household survey. All were interviewed for level of physical activity (PA), depression, anxiety and opium use and assessed for hypertension, diabetes, hyperlipidemia, and oral health status. Regarding to opium abuse, participants were grouped into: "Non-," "occasional," and "dependent" users. Using logistic regression model for every CAD risk factor, we assessed whether the co-exposure of opium and CAD risk factor is significant. Overall, 10.6% reported ever opium use including 5.6% dependent and 5% occasional users. The prevalence of opium abuse was increased from 2.1% in 15-25 years to 24.5% in 55-64 years group. Opium abuse, in occasional and dependent forms, was associated with depression (adjusted odds ratio [AOR] 1.81 and 2.49) and low PS (AOR 1.43 and 1.71 respectively). Dependents were less obese than nonusers (P Opium abuse had no significant association with hypertension, diabetes, oral health status and lipid profile. Opium abuse was associated with depression and low PA. No ameliorative effect was observed on hypertension, diabetes, and plasma lipid profile. Therefore, positive association of opium with depression and LPA and the incorrectness of belief on its ameliorative effect on three other important risk factors of CAD should be clearly highlighted in public health messages to the community.

  12. Attributional style as a mediator between parental abuse risk and child internalizing symptomatology.

    Science.gov (United States)

    Rodriguez, Christina M

    2006-05-01

    This study examined a model wherein children's attributional style mediates the relationship between parental physical child-abuse risk and children's internalizing problems. Using structural equation modeling, three indices of abuse risk were selected (child abuse potential, physical discipline use, and dysfunctional parenting style) and two indices of children's internalizing problems (depression and anxiety). The sample included 75 parent-child dyads, in which parents reported on their abuse risk and children independently completed measures of depressive and anxious symptomatology and a measure on their attributional style. Findings supported the model that children's attributional style for positive events (but not negative events) partially mediated the relationship between abuse risk and internalizing symptoms, with significant direct and indirect effects of abuse risk on internalizing symptomatology. Future directions to continue evaluating additional mediators and other possible contextual variables are discussed.

  13. Parents' perceptions about child abuse and their impact on physical and emotional child abuse: A study from primary health care centers in Riyadh, Saudi Arabia.

    Science.gov (United States)

    Al Dosari, Mohammed N; Ferwana, Mazen; Abdulmajeed, Imad; Aldossari, Khaled K; Al-Zahrani, Jamaan M

    2017-01-01

    To determine perceptions of parents about child abuse, and their impact on physical and emotional child abuse. Two hundred parents attending three primary health care centers (PHCCs) in Riyadh serving National Guard employes and their families, were requested to participate in this survey. Data was collected by self administered questionnaire. Five main risk factors areas/domains were explored; three were parent related (personal factors, history of parents' childhood abuse, and parental attitude toward punishment), and two were family/community effects and factors specific to the child. SPSS was used for data entry and analysis. Descriptive analysis included computation of mean, median, mode, frequencies, and percentages; Chi-square test and t -test were used to test for statistical significance, and regression analysis performed to explore relationships between child abuse and various risk factors. Thirty-four percent of the parents reported a childhood history of physical abuse. Almost 18% of the parents used physical punishment. The risk factors associated significantly with child abuse were parents' history of physical abuse, young parent, witness to domestic violence, and poor self-control. Child-related factors included a child who is difficult to control or has attention deficit hyperactivity disorder (ADHD). Parents who did not own a house were more likely to use physical punishment. Abusive beliefs of parent as risk factors were: physical punishment as an effective educational tool for a noisy child; parents' assent to physical punishment for children; it is difficult to differentiate between physical punishment and child abuse; parents have the right to discipline their child as they deem necessary; and there is no need for a system for the prevention of child abuse. The causes of child abuse and neglect are complex. Though detecting child abuse may be difficult in primary care practice, many risk factors can be identified early. Parents' attitudes can

  14. Child Abuse and Neglect: Screening for Risks During the Perinatal Period

    Science.gov (United States)

    Besier, T.; Pillhofer, M.; Botzenhart, S.; Ziegenhain, U.; Kindler, H.; Spangler, G.; Bovenschen, I.; Gabler, S.; Künster, A. K.

    2012-01-01

    Purpose: Currently, there is a claim for earlier interventions for families in order to prevent child maltreatment. Here, a screening instrument to assess risk indicators for child abuse and neglect already in the context of maternity clinics is introduced. The present study is the first report on the psychometric properties of this instrument, the “short questionnaire for risk indices around birth” (RIAB). Material and Methods: Data were collected in the context of three different studies conducted at Ulm University Hospital. To examine interrater reliability eight case vignettes were rated by n = 90 study participants (50 students and 40 experts working at a maternity clinic). Criterion validity was examined in two studies applying the German version of the child abuse potential inventory CAPI (n = 96 families at risk and n = 160 additional families). Results: Both laymen and experts were able to understand and use the screening instrument correctly, leading to a high agreement with the sample solutions given. A high concordance was found between parentsʼ and expertsʼ ratings: In case of no reported risk factors applying the screening instrument RIAB, parents themselves reported significantly less stressors and burdens, compared to those parents with an indication for a thorough examination as pointed out in the RIAB. Conclusion: In the context of maternity clinics the RIAB is a useful, broadly applicable instrument, screening for existing risk factors at the earliest and thus allowing for the initiation of specific interventions when needed. PMID:25298543

  15. The Intersection of Stalking and the Severity of Intimate Partner Abuse.

    Science.gov (United States)

    Brady, Patrick Q; Hayes, Brittany E

    2018-04-01

    Using data from the Chicago Women's Health Risk Study (N = 464), this study examined the intersection of stalking and the severity of intimate partner abuse while controlling for previously identified risk factors of intimate partner homicide. Findings indicate that (a) victims of life-threatening abuse by an intimate partner were significantly more likely to experience stalking than victims of nonlethal abuse; (b) after controlling for key risk factors, stalking increased the risk of life-threatening abuse; and (c) threats to kill the victim if she left was the only significant stalking-related behavior that increased the risk for life-threatening abuse. In addition, an offender's prior record and a higher number of previous abusive incidents increased the risk of life-threatening abuse. Implications for prevention and future directions for research are discussed.

  16. Comparison of childhood sexual histories in subjects with pedophilia or opiate addiction and healthy controls: is childhood sexual abuse a risk factor for addictions?

    Science.gov (United States)

    Cohen, Lisa J; Forman, Howard; Steinfeld, Matthew; Fradkin, Yuli; Frenda, Steven; Galynker, Igor

    2010-11-01

    Given the recent interest in the concept of sexual addictions, it is instructive to study subjects with pedophilia alongside chemically addicted individuals and non-addicted controls in order to help identify which factors may determine the objects of people's respective addictions, as well as any factors that may predispose people to developing an addictive disorder. In this study, we considered whether childhood sexual abuse (CSA) is a specific risk factor for pedophilia as opposed to other types of addictive disorders by comparing the childhood sexual histories of 48 pedophilic sex offenders, 25 subjects with opiate addiction in remission, and 61 healthy controls. CSA was assessed with The Sexual History Questionnaire and the Child Trauma Questionnaire (CTQ). Compared with both opiate addicted subjects and healthy controls, subjects with pedophilia were more likely to report experiencing adult sexual advances when they were children and a first sexual contact by age 13 with a partner at least 5 years older. Although both subjects with pedophilia and those with opiate addiction first had sex at a younger age than healthy controls, opiate addicted subjects, compared with healthy controls, reported neither increased reception of sexual advances as children nor increased rates of first sexual contact before age 13 with a partner at least 5 years older. Further, subjects with pedophilia but not those with opiate addiction scored significantly higher than healthy controls on the CTQ. Sexual abuse in childhood may be a specific risk factor for sexual addictions such as pedophilia but may not be a specific risk factor for chemical addictions.

  17. Elder Abuse: Systematic Review and Implications for Practice.

    Science.gov (United States)

    Dong, Xin Qi

    2015-06-01

    This article is based on the lecture for the 2014 American Geriatrics Society Outstanding Scientific Achievement for Clinical Investigation Award. Elder abuse is a global public health and human rights problem. Evidence suggests that elder abuse is prevalent, predictable, costly, and sometimes fatal. This review will highlight the global epidemiology of elder abuse in terms of its prevalence, risk factors, and consequences in community populations. The global literature in PubMed, MEDLINE, PsycINFO, BIOSIS, Science Direct, and Cochrane Central was searched. Search terms included elder abuse, elder mistreatment, elder maltreatment, prevalence, incidence, risk factors, protective factors, outcomes, and consequences. Studies that existed only as abstracts, case series, or case reports or recruited individuals younger than 60; qualitative studies; and non-English publications were excluded. Tables and figures were created to highlight the findings: the most-detailed analyses to date of the prevalence of elder abuse according to continent, risk and protective factors, graphic presentation of odds ratios and confidence intervals for major risk factors, consequences, and practical suggestions for health professionals in addressing elder abuse. Elder abuse is common in community-dwelling older adults, especially minority older adults. This review identifies important knowledge gaps, such as a lack of consistency in definitions of elder abuse; insufficient research with regard to screening; and etiological, intervention, and prevention research. Concerted efforts from researchers, community organizations, healthcare and legal professionals, social service providers, and policy-makers should be promoted to address the global problem of elder abuse. © 2015, Copyright the Author Journal compilation © 2015, The American Geriatrics Society.

  18. Can opium abuse be a risk factor for carotid stenosis in patients who are candidates for coronary artery bypass grafting?

    Science.gov (United States)

    Shirani, Shapour; Shakiba, Madjid; Soleymanzadeh, Maryam; Esfandbod, Maryam

    2010-01-01

    Over the centuries, opium has been the most frequent substance abused in the Middle East. There are many controversial aspects about the effects of opioids on the atherosclerosis process, which is still unclear. All patients who were candidates for coronary artery bypass graft in Tehran Heart Center were registered and evaluated for risk factors such as diabetes mellitus, hypertension, smoking status and duration, opium abuse, involved coronary arteries and left main branch lesion > 50%, carotid stenosis > or = 70%. A total of 1,339 patients were enrolled in the study, of whom 400 (29.9%) were female and the other 939 (70.1%) male. Female patients were omitted from analysis due to the low numbers of female opium addicts. Our study revealed that in the addicted population, the risk of diabetes and hypertension was lower than in the non-addicted group (p 50% and extent of carotid stenosis was not significantly different between the two groups. Our investigations demonstrate that opium is not cardioprotective, as has been claimed by some previous studies, and does not even decelerate atherosclerosis of carotid arteries in opium-addicted patients, but more evidence is still needed to completely prove the case.

  19. Perceived social risk in medical decision-making for physical child abuse: a mixed-methods study.

    Science.gov (United States)

    Keenan, Heather T; Campbell, Kristine A; Page, Kent; Cook, Lawrence J; Bardsley, Tyler; Olson, Lenora M

    2017-12-22

    The medical literature reports differential decision-making for children with suspected physical abuse based on race and socioeconomic status. Differential evaluation may be related to differences of risk indicators in these populations or differences in physicians' perceptions of abuse risk. Our objective was to understand the contribution of the child's social ecology to child abuse pediatricians' perception of abuse risk and to test whether risk perception influences diagnostic decision-making. Thirty-two child abuse pediatrician participants prospectively contributed 746 consultations from for children referred for physical abuse evaluation (2009-2013). Participants entered consultations to a web-based interface. Participants noted their perception of child race, family SES, abuse diagnosis. Participants rated their perception of social risk for abuse and diagnostic certainty on a 1-100 scale. Consultations (n = 730) meeting inclusion criteria were qualitatively analyzed for social risk indicators, social and non-social cues. Using a linear mixed-effects model, we examined the associations of social risk indicators with participant social risk perception. We reversed social risk indicators in 102 cases whilst leaving all injury mechanism and medical information unchanged. Participants reviewed these reversed cases and recorded their social risk perception, diagnosis and diagnostic certainty. After adjustment for physician characteristics and social risk indicators, social risk perception was highest in the poorest non-minority families (24.9 points, 95%CI: 19.2, 30.6) and minority families (17.9 points, 95%CI, 12.8, 23.0). Diagnostic certainty and perceived social risk were associated: certainty increased as social risk perception increased (Spearman correlation 0.21, p < 0.001) in probable abuse cases; certainty decreased as risk perception increased (Spearman correlation (-)0.19, p = 0.003) in probable not abuse cases. Diagnostic decisions changed

  20. Factors That Influence Mandatory Child Abuse Reporting Attitudes of Pediatric Nurses in Korea.

    Science.gov (United States)

    Lee, In Sook; Kim, Kyoung Ja

    This study aimed to identify knowledge of child abuse, awareness of child abuse reporting, factors that influence attitudes toward mandatory reporting, and professionalism among a sample of pediatric nurses in Korea. One hundred sixteen pediatric nurses working at two university hospitals in Korea took part in the study and completed self-administered questionnaires. The data were analyzed using descriptive statistics, t tests, analysis of variance, Pearson correlation coefficients, and hierarchical regression analysis. Knowledge of child abuse, awareness of child abuse reporting, and attitudes toward mandatory reporting were low. Regarding nursing professionalism, social perceptions had the lowest mean score and nursing autonomy had the highest mean score. Attitudes toward mandatory reporting significantly correlated with professionalism. In the hierarchical regression model, the influences of nursing autonomy and intentions to report child abuse on attitudes toward mandatory reporting were statistically significant (F = 2.176, p = .013), explaining 32% of the variation in attitudes toward mandatory reporting. The results of this study could be used to improve systems and policies addressing child abuse and to further develop reporting procedures for identifying children at risk of abuse, to ensure their protection as a professional responsibility.

  1. Childhood Risk Factors in Substance Abuse Among a Group of Abuser 20-30 Year-Old Group in Tehran

    Directory of Open Access Journals (Sweden)

    A.R. Zahiredin

    2004-01-01

    Full Text Available Substance use disorder is the second most common psychiatric disorders and is far more prevalent among young adults (ages;18-34y/0. Because of its importance and main effect in society, this study performed for evaluation of association fourteen childhood and adoleseence pathologic factors with substance use disorder among a group of abuser (20-30/0that referred to five addiction center in Tehran . The sample consist 100 patient: including 50 case and 50 control who were selected by DSM- IV based semi-structured diagnostic interviews for decrease memory biases in this retrospective cohart study. The patient’s parents also evaluated by DSM- IV based Semi-structured diagnostic interviews. The analysis showed significant relation between: parents control on the siblings, addiction in relatives of pt (except parents, addicted peers and friends, to be affected with the peers and friends and substance use disorder at the ages (20-30y/o. There wasn’t any association between: Disruptive childhood behaviors (under 11y/o, diagnosed medical illness (under 11y/o diagnosed Psychiatric illness (under 6 mo , family size, socio economic state and substance use disorder at the age(20-30y/0 . Finally some childhood and adolescence pathologic factors has association with Substance use disorder at the ages ( 20-30y/5 that these can be used for education all planning , prevention , design high risk group and remedical plans.

  2. Etiology of Drug Abuse: A Narrative Analysis

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    Nadjme Jadidi

    2014-01-01

    Full Text Available Introduction and Aim. Further gains in the prevention of drug abuse disorders require in-depth and holistic understanding of the risk factors of addiction from different perspectives. Lay persons and experts have different concepts of risk which could complement each other. The purpose of this study was to elaborate drug abuse risk factors through the story of individuals who had become drug dependent. Design and Methods. In this qualitative research, 33 individuals attending treatment centres for drug abuse were interviewed about the story of their addiction in Kerman, Iran. Interview questions were around the story of the participants. Results. All participants were male and in the age range of 18–40 years. Narrative analysis identified five themes as the main risk factors: family factors, peer pressure, the effect of gateway drugs (especially waterpipe, individual characteristics, and the community factors. More emphasis was placed upon the role of family factors, peer influence, and gateway effect. Discussion and Conclusion. This study elicited information from drug dependent subjects regarding the risk factors of drug abuse. According to drug dependent individuals’ views, more attention should be devoted to family and peer influences by policy makers, in developing culture-based preventive strategies.

  3. Factors associated with alcohol intake and alcohol abuse among women in Belo Horizonte, Minas Gerais State, Brazil

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    Ísis Eloah Machado

    2013-07-01

    Full Text Available The main objective of this cross-sectional study was to analyze factors associated with alcohol consumption among adult women living in Belo Horizonte, Minas Gerais State, Brazil, in 2011. Data for Belo Horizonte were obtained from the VIGITEL system (Telephone-Based Surveillance of Risk and Protective Factors for Chronic Diseases. Alcohol use was defined as self-reported intake of at least one dose in the previous 30 days; alcohol abuse was defined as four or more doses on at least one occasion during the same period. Polytomous logistic regression was used to evaluate factors associated with alcohol use and abuse. Alcohol use was more prevalent among women 25 to 34 years of age. Alcohol abuse was associated with age, schooling, health status, and smoking. The results suggest the need for policies to prevent alcohol abuse among women, especially targeting those who are younger, single, smokers, and with more education.

  4. Abuso físico infantil: avaliando fatores de risco psicológicos em cuidadores notificados Child physical abuse: evaluating psychological risk factors in accused caregivers

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    Lilian Paula D. Bérgamo

    2012-01-01

    Full Text Available Verificou-se em que medida variáveis cognitivas e afetivas/emocionais diferenciariam cuidadores notificados por abusos físicos (G1 de cuidadores sem esse histórico (G2. O Child Abuse Potential Inventory (CAP foi utilizado para avaliar fatores de risco psicológicos em cuidadores. Um Questionário de Caracterização sócio-demográfica e outro econômico também foram empregados para equiparar os grupos. G1 apresentou um potencial de risco superior a G2, e maiores níveis de Angústia, Rigidez, Problemas com a Criança e Consigo, Problemas com os Outros, e um menor nível de Força do Ego. Essas variáveis se articulam para compor o risco de abuso físico, pois segundo o Modelo do Processamento da Informação Social, remeteriam a processos básicos cognitivos/afetivos subjacentes a percepções e avaliações/interpretações, associados ao comportamento parental abusivo.It was verified to what extent cognitive and affective/emotional variables could distinguish caregivers accused of committing physical abuse (G1 from those without physical abuse records (G2. The Child Abuse Potential Inventory (CAP, which is an instrument designed to assess psychological risk factors in caregivers, was used. A questionnaire on socio-demographic characterization and another on economic classification were also employed to equate the groups. G1 presented a greater potential risk than G2, higher levels of Distress, Rigidity, Problems with the Child and with Themselves, Problems with Others, and a lower level of Ego Strength. These variables contribute with the composition of physical abuse risk, since, in agreement with the Social Information Processing Model, they would be related to cognitive and affective basic processes which are veiled to the perceptions and evaluation/interpretations, associated to abusive parental behavior.

  5. Pathways from Childhood Abuse and Neglect to HIV-Risk Sexual Behavior in Middle Adulthood

    Science.gov (United States)

    Wilson, Helen W.; Widom, Cathy Spatz

    2011-01-01

    Objective: This study examines the relationship between childhood abuse and neglect and sexual risk behavior in middle adulthood and whether psychosocial factors (risky romantic relationships, affective symptoms, drug and alcohol use, and delinquent and criminal behavior) mediate this relationship. Method: Children with documented cases of…

  6. Alcohol Abuse Increases Rebleeding Risk and Mortality in Patients with Non-variceal Upper Gastrointestinal Bleeding.

    Science.gov (United States)

    Kärkkäinen, Jussi M; Miilunpohja, Sami; Rantanen, Tuomo; Koskela, Jenni M; Jyrkkä, Johanna; Hartikainen, Juha; Paajanen, Hannu

    2015-12-01

    No current data are available on rebleeding and mortality risk in patients who use alcohol excessively and are admitted for non-variceal upper gastrointestinal bleeding (NVUGIB). This information could help in planning interventions and follow-up protocols for these patients. This study provides contemporary data on the long-term outcome after first-time NVUGIB in alcohol abusers (AAs) compared to non-abusers (NAs). Consecutive patients hospitalized for their first acute gastrointestinal bleeding from 2009 through 2011 were retrospectively recorded and categorized as AA or NA. Risk factors for one-year mortality and rebleeding were identified, and patients were further monitored for long-term mortality until 2015. Alcohol abuse was identified in 19.7% of patients with NVUGIB (n = 518). The one-year rebleeding rate was 16.7% in AAs versus 9.1% in NAs (P = 0.027). Alcohol abuse was associated with a twofold increase in rebleeding risk (P = 0.025); the risk especially increased 6 months after the initial bleeding. The study groups did not differ significantly in 30-day (6.0%) or one-year mortality rates (20.5%). However, there was a tendency for higher overall mortality in AAs than NAs after adjustment of comorbidities. AAs with NVUGIB are at high risk of rebleeding, and mortality is increased in AA patients. A close follow-up strategy and long-term proton pump inhibitor therapy are recommended for AA patients with peptic ulcer or esophagitis.

  7. Factors protecting against the development of adjustment difficulties in young adults exposed to childhood sexual abuse.

    Science.gov (United States)

    Lynskey, M T; Fergusson, D M

    1997-12-01

    The aims of this study were to identify the factors which discriminated young people exposed to childhood sexual abuse (CSA) who developed psychiatric disorder or adjustment difficulties in young adulthood from those young people exposed to CSA who did not develop psychiatric disorder or adjustment difficulties by age 18. Data were gathered on a birth cohort of 1,025 New Zealand children studied from birth to the age of 18 on (a) exposure to CSA; (b) patterns of psychiatric disorder and adjustment difficulties at age 18 years; (c) factors that may have influenced responses to CSA including characteristics of the abuse, parental bonding, parental characteristics, and adolescent peer affiliations. Just over 10% of the cohort reported CSA. Those reporting CSA were at increased risks of a range of difficulties at age 18 (depression, anxiety, conduct disorder, alcohol abuse/dependence, other substance abuse/dependence, post sexual abuse trauma, attempted suicide). However, not all of those exposed to CSA developed difficulties and approximately a quarter of those exposed to CSA did not meet criteria for any adjustment difficulty. Further analysis suggested that the extent of adjustment difficulties in those exposed to CSA was influenced by two additional factors: (a) the extent of affiliations with delinquent or substance using peers in adolescence; and (b) the extent of paternal care or support in childhood. The findings of this study suggest that while young people exposed to CSA are at increased risks of psychiatric disorder and adjustment difficulties in young adulthood, not all individuals exposed to CSA will develop adjustment difficulties. Important factors protecting against the development of adjustment difficulties in young people experiencing CSA appear to be the nature and quality of peer and family relationships.

  8. Epidemiology and risk factors of schizophrenia.

    Science.gov (United States)

    Janoutová, Jana; Janácková, Petra; Serý, Omar; Zeman, Tomás; Ambroz, Petr; Kovalová, Martina; Varechová, Katerina; Hosák, Ladislav; Jirík, Vitezslav; Janout, Vladimír

    2016-01-01

    Schizophrenia is a severe mental disorder that affects approximately one percent of the general population. The pathogenesis of schizophrenia is influenced by many risk factors, both environmental and genetic. The environmental factors include the date of birth, place of birth and seasonal effects, infectious diseases, complications during pregnancy and delivery, substance abuse and stress. At the present time, in addition to environmental factors, genetic factors are assumed to play a role in the development of the schizophrenia. The heritability of schizo- phrenia is up to 80%. If one parent suffers from the condition, the probability that it will be passed down to the offspring is 13%. If it is present in both parents, the risk is more than 20%. The opinions are varied as to the risk factors affecting the development of schizophrenia. Knowing these factors may greatly contribute to prevention of the condition.

  9. A systematic review of risk and protective factors associated with family related violence in refugee families

    DEFF Research Database (Denmark)

    Timshel, Isabelle; Montgomery, Edith; Dalgaard, Nina Thorup

    2017-01-01

    and protective factors an ecological model was used to structure the findings. At the individual level, parental trauma experiences/mental illness, substance abuse and history of child abuse were found to be risk factors. Family level risk factors included parent-child interaction, family structure and family...... families is a result of accumulating, multiple risk factors on the individual, familial, societal and cultural level. The findings suggest that individual trauma and exile related stress do not only affect the individual but have consequences at a family level. Thus, interventions targeting family related...

  10. Risk evaluation and mitigation strategies for drugs with abuse liability: public interest, special interest, conflicts of interest, and the industry perspective.

    Science.gov (United States)

    Wright, Curtis; Schnoll, Sidney; Bernstein, David

    2008-10-01

    Risk evaluation and mitigation strategies (REMS) formerly known as Risk Minimization Action Plans (RiskMAPs) are a regulatory technique for dealing with anticipated risks of new medications and are especially important for new drugs with abuse potential. This paper describes the origin and history of risk-management plans for drugs that might be abused, the proper use of these plans in minimizing the risk to the public, and the special difficulties inherent in managing risks for drugs with abuse potential. Drugs with abuse liability are distinctive since the risks inherent in manufacture and distribution include not only risks to patients prescribed the medications, but also risks to the general public including subgroups in the population not intended to get the drug and who receive no medical benefit from the medication. The crafting of risk-management plans intended to protect nonpatient populations is unique for these products. The content, extent, and level of intensity of these plans affect areas of medical ethics, civil liability, and criminal prosecution. The need for risk-management plans for drugs with abuse liability can potentially act as a deterrent to investment and is a factor in decisions concerning the development of new medications for the treatments of pain, ADHD, anxiety disorders, and addictions. This paper provides a framework for moving the process of REMS development forward and criteria for evaluating the probity and adequacy of such programs.

  11. Veterans Experiencing Elder Abuse: Improving Care of a High-Risk Population About Which Little Is Known.

    Science.gov (United States)

    Makaroun, Lena K; Taylor, Laura; Rosen, Tony

    2018-02-01

    At least 10% of older adults experience abuse, neglect, or exploitation annually in the United States, and this problem is expected to grow as our population ages. Little is known about the prevalence and characteristics of elder abuse of veterans, but it is likely that this population is at high risk based on established elder abuse risk factors. Veterans who receive their care through the Veterans Health Administration (VHA) have a higher prevalence of poor psychological health, poor physical health, functional impairment, cognitive impairment, and social isolation than the general population. As the largest integrated healthcare system in the United States, the VHA has long been a leader in the development of innovative, integrated care programs for older adults. The VHA has another opportunity to lead by promoting research, clinical care, and education on elder abuse, furthering their mission of serving those who served. This article outlines the rationale for developing a research agenda for elder abuse in the VHA, as well as potential first steps toward understanding more about this complex problem affecting veterans. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  12. Nurse case management for pregnant women experiencing or at risk for abuse.

    Science.gov (United States)

    Curry, Mary Ann; Durham, Laurel; Bullock, Linda; Bloom, Tina; Davis, Jan

    2006-01-01

    To determine whether individualized nursing case management can decrease stress among pregnant women at risk for or in abusive relationships. A multisite randomized controlled trial. Two prenatal clinics in the Pacific Northwest and rural Midwest. 1,000 women who spoke English and were 13 to 23 weeks pregnant at time of recruitment. All intervention group women (N = 499) were offered an abuse video and had access to a nurse case manager 24/7. Additionally, participants at risk for or in abusive relationships received individualized nursing care management throughout the pregnancy. The most frequent nursing care management activities were providing support (38%) and assessing needs (32%). The nursing care management group received an average of 22 contacts, most (80%) by telephone and had a significant reduction in stress scores as measured by the Prenatal Psychosocial Profile. Compared to the control group, the differences were in the predicted direction, but not statistically different. A major finding was the choice by abused women to focus on basic needs and their pregnancies rather than the abuse, although all received safety planning. Pregnant women at risk for or in abusive relationships experience very stressful and complex lives. Nurses need to focus on the needs they identify, which may not be the abusive relationship.

  13. Factors associated with depression and suicide attempts in patients undergoing rehabilitation for substance abuse.

    Science.gov (United States)

    Ortíz-Gómez, L D; López-Canul, B; Arankowsky-Sandoval, G

    2014-12-01

    Comorbidity of major depression with substance abuse increases the risk of committing suicide. The objective of this work was to determine the psychological and socio-demographic factors associated with depression and suicide attempts in patients rehabilitating for drug consumption. 57 Patients attending a center for drug abuse treatment answered the following instruments: the Mini-international neuropsychiatric interview, a questionnaire of general information and background data on consumption of substances, depression and suicide attempts, and the Spanish adaptation of the Holmes and Rahe scale for the assessment of life events. Chi-square and logistic regression tests were used to establish associations between variables. 68.4% of the Patients had current major depression, of these, 75.4% experienced it before the onset of substance abuse. Patients attempting suicide before drug use corresponded to 26%, whilst 28.1% attempted suicide within the last year. Current depression-related variables were receiving a diagnosis of depression prior to the consumption of drugs and the first used drugs, which were alcohol or marijuana. The adverse life event "Familial drug abuse history", was also significantly related to depression (p=0.02). Variables associated with current suicide attempts were: receiving a diagnosis of depression prior to the consumption of drugs (p=0.02), and suicide attempts previous to drug use (psuicide prior to the use of drugs also experienced these conditions during the rehabilitation process. Substance use in the family was a risk factor for both, underscoring the need of actions aimed at preventing addictions in the household environment. Copyright © 2014. Published by Elsevier B.V.

  14. Substance Abuse and Psychiatric Co-morbidity as Predictors of Premature Mortality in Swedish Drug Abusers: A Prospective Longitudinal Study 1970-2006

    DEFF Research Database (Denmark)

    Nyhlén, Anna; Fridell, Mats; Bäckström, Martin

    2011-01-01

    Background Few longitudinal cohort studies have focused on the impact of substances abused and psychiatric disorders on premature mortality. The aim of the present study was to identify predictors of increased risk of drug related death and non drug related death in substance abusers of opiates...... with a decreased risk. Neurosis, mainly depression and/or anxiety disorders, predicted drug related premature death while chronic psychosis and personality disorders did not. Chronic alcohol addiction was associated with increased risk of non drug related death. Conclusions The cohort of drug abusers had...... and barbiturate abusers over the observed period of 37 years, while stimulant abuse did not have any impact. Alcohol contributed to non drug related death. Keywords: drug related death; risk factor; gender; competing risks Cox regression; cohort study; Predictors...

  15. ABUSE OF ANABOLIC ANDROGENIC STEROIDS

    Directory of Open Access Journals (Sweden)

    Abbas Yavari

    2009-09-01

    Full Text Available According to the International Olympic Committee, the abuse of anabolic androgenic steroids (AASS is found in over 50% of positive doping tests. AASS abuse is not restricted to the organized sports andwidespread use. It remains as an unsolved public-health problem.Lower black market price, easier access to AASS, bodybuilding clubs and internet advertising are factors of this increasingly misuse. There is not real data about the prevalence of AASS abuse in various populations or countries, because most of athletes or students, due to their prohibition or ethical aspects do not admit to AASS abuse. Often they are aware of the risks of their choice and yet, are eager to put themselves at risk without deeper consideration. The abusers use them to improve their physical fitness and appearance.Present article has been collected to elucidate the risks and adverse effects of AASS and explanation of mechanisms of these events.

  16. Factors associated with child sexual abuse confirmation at forensic examinations

    Directory of Open Access Journals (Sweden)

    Welington dos Santos Silva

    Full Text Available Abstract The aim of this study is identify potential factors associated with child sexual abuse confirmation at forensic examinations. The forensic files of children under 12 years of age reporting sexual abuse at the Nina Rodrigues Institute of Forensic Medicine in Salvador, Bahia, Brazil between January 2008 and December 2009 were reviewed. A multivariate analysis was conducted to identify factors associated with finding evidence of sexual abuse in forensic examinations. The proportion of cases confirmed by the forensic physician based on material evidence was 10.4%. Adjusted analysis showed that the variables place of birth, type of abuse reported, family relationship between the child and the perpetrator, and the interval between the reported abuse and the forensic examination were not independently associated with finding forensic evidence of sexual abuse. A report of penetration was associated with a five-fold greater likelihood of confirmation, while the victim being 10-11 years of age was associated with a two-fold of abuse confirmation than younger children. These findings should be taken into consideration when drawing up guidelines for the multidisciplinary evaluation of children suspected of being victims of sexual abuse and in deciding whether to refer the child for forensic examination.

  17. Psychosocial Risk Factors for Child Welfare among Postpartum Mothers with a History of Childhood Maltreatment and Neglect.

    Science.gov (United States)

    Koenig, A M; Schury, K; Reister, F; Köhler-Dauner, F; Schauer, M; Ruf-Leuschner, M; Gündel, H; Ziegenhain, U; Fegert, J M; Kolassa, I-T

    2016-03-01

    Background: Childhood maltreatment (CM) can increase the risk of psychosocial risk factors in adulthood (e. g. intimate partner violence, financial problems, substance abuse or medical problems). The transition to parenthood presents those affected by CM with particular challenges, in addition to usual birth-related stressors. Methods: In this cross-sectional study a total of 240 women were interviewed in the puerperium with respect to CM experiences, using the German version of the Childhood Trauma Questionnaire (CTQ). Current psychosocial risk factors (e. g. financial concerns, maternal mental illness, single parent) were assessed using the Constance Index (KINDEX) for early childhood risk factors. Associations between CM experience and psychosocial risk factors were calculated using simple correlation. Results: The average age of participants was 33 years. On the CTQ 13.8 % of participants reported emotional abuse, 6.7 % physical abuse and 12.5 % sexual abuse, while 32.1 % reported emotional neglect and 7.5 % physical neglect during childhood. With rising severity of CM, more psychosocial risk factors (KINDEX) were present. Conclusions: This study shows a clear association between experiences of maltreatment during childhood and the presence of psychosocial stressors among women in the puerperium. Regular screening for a history of CM and parental psychosocial stressors should be conducted early, i.e. during pregnancy, to avoid negative consequences for the child.

  18. Iudicium: An Educational Intervention for addressing Risk Perception of Alcohol Abuse in Adolescents.

    Science.gov (United States)

    Bajac, Héctor; Feliu-Soler, Albert; Meerhoff, Diana; Latorre, Laura; Elices, Matilde

    2016-03-02

    Negative consequences of alcohol abuse during adolescence have been extensively described. Consequently, different interventions have been developed to address this issue. This article describes the implementation and evaluation of Iudicium, an educational drama-based intervention designed to increase risk perception of alcohol abuse. In this activity, high school students judge a case in which alcohol consumption had negative consequences (e.g., fights, unwanted pregnancy, and car accident). A trial is simulated and after that, a debriefing takes place during which the activity is discussed and informational materials on the effects of alcohol is provided and commented. A total of 318 students (55.7% females and 44.3% males) from five high schools participated in the study. Data regarding risk perception of alcohol abuse and adequacy of the activity was collected before and after the intervention. Results suggest that Iudicium was effective in increasing risk perception of abusive drinking, reaching a 34% of increase regarding risk perception. Participants highlighted the experiential component of Iudicium as a strength. The intervention was well-accepted, easy to understand and apparently an effective tool for increasing risk perception of alcohol abuse amongst high school students.

  19. Identifying child abuse and neglect risk among postpartum women in Japan using the Japanese version of the Kempe Family Stress Checklist.

    Science.gov (United States)

    Baba, Kaori; Kataoka, Yaeko

    2014-11-01

    The aims of this study were to determine the rate of women who are high-risk for child abuse and neglect in a perinatal unit in Japan, and to identify the factors associated with risk level. To assess the potential risk for child abuse and neglect the Japanese version of the Kempe Family Stress Checklist (FSC-J) was used to guide interviews with postpartum women. FSC-J uses a three-point scale to score 10 categories, categorizing responses as "no risk=0", "risk=5", and "high risk=10". The range of FSC-J is 0-100. Using an established cutoff point of 25, subjects were divided into high and low risk groups. For both groups, relationships between factors were analyzed. Of the 174 subjects who agreed to participate, 12 (6.9%) scored high-risk, and 162 (93.1%) scored low-risk. Adjusted odds ratio identified three associated factors as important for predicting risk level: past mental illness (OR=341.1), previous experience of intimate partner violence (OR=68.0), and having a partner who was unemployed (OR=14.5). Although this study was on a small sample of women in one hospital in Japan and a larger population would make this study much stronger, these results suggest that some 6.9% of postpartum women in Japan may be at high-risk for child abuse and neglect. It is critical, therefore, to develop a system for screening, intervention, and referral for such women and their children. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Family caregiver mistreatment of the elderly: prevalence of risk and associated factors.

    Science.gov (United States)

    Orfila, Francesc; Coma-Solé, Montserrat; Cabanas, Marta; Cegri-Lombardo, Francisco; Moleras-Serra, Anna; Pujol-Ribera, Enriqueta

    2018-01-22

    The detection of elder mistreatment is emerging as a public health priority; however, abusive behaviors exercised by caregivers are little known and rarely detected among primary health care professionals. This study aims to estimate the prevalence of risk of abuse against community-residing elderly with moderate to severe dependency whose caregivers are relatives. In addition, we aim to describe the association between such a risk and socio-demographic variables, cognitive and dependency state of the victim, and the scale of the caregiver's anxiety, depression, and burden. Cross-sectional study developed in 72 Primary Health Care teams from Barcelona, Spain. Participants were caregivers and their dependent care recipients (N = 829). Home interviews included the Caregiver Abuse Screen (CASE); self-reported abuse from care recipient; activities of daily living and cognitive state of the care recipient; anxiety and depression in caregivers and Caregiver Burden Scale. The relationship prior to the dependency, positive aspects of caregiving, and social support for the caregiver were also assessed. Multivariate analysis was performed using logistic regression with risk of abuse as dependent variable. Caregivers were mainly women (82.8%) with a mean age of 63.3 years. Caregivers and care recipients lived in the same household in 87.4% of cases, and 86.6% had enjoyed a good previous relationship. Care recipients were women (65.6%), with a mean age of 84.2 years, and 64.2% had moderate to severe cognitive impairment. CASE demonstrated a prevalence of 33.4% (95% CI: 30.3-36.7) of abuse risk by the caregiver. Logistic regression showed as statistically significant: caregiver burden (OR = 2.75; 95% CI: 1.74-4.33), caregiver anxiety (OR = 2.06; 95% CI: 1.40-3.02), caregiver perception of aggressive behavior in the care recipient (OR = 7.24; 95% CI: 4.99-10.51), and a bad previous relationship (OR = 4.66; 95% CI: 1.25-17.4). Prevalence of risk of abuse is

  1. The correlation of childhood physical abuse history and later abuse in a group of Turkish population.

    Science.gov (United States)

    Caykoylu, Ali; Ibiloglu, Aslihan O; Taner, Yasemen; Potas, Nihan; Taner, Ender

    2011-11-01

    Domestic violence is passed from one generation to the next, and it affects not only the victim but also the psychological states of the witnesses, and especially the psychosocial development of children. Studies have reported that those who have been the victim of or witnessing violence during their childhood will use violence to a greater extent as adults in their own families. This research examines the relationships between a history of childhood physical abuse, likelihood of psychiatric diagnoses, and potential for being a perpetrator of childhood physical abuse in adulthood among women who received psychiatric treatment and in the healthy population from Turkey. Estimates of the prevalence of childhood physical abuse vary depending on definition and setting. The frequency of witnessing and undergoing physical abuse within the family during childhood is much higher in the psychiatrically disordered group than the healthy controls. Childhood physical abuse history is one of the major risk factors for being an abuser in adulthood. The best indicator of physically abusing one's own children was found to be as physical abuse during the childhood period rather than psychiatric diagnosis. There is a large body of research indicating that adults who have been abused as children are more likely to abuse their own children than adults without this history. This is an important study from the point of view that consequences of violence can span generations. Further studies with different risk factor and populations will help to identify different dimensions of the problem.

  2. Risk factors for adolescents' attempted suicide

    DEFF Research Database (Denmark)

    Christoffersen, Mogens; Poulsen, Henrik Day; Nielsen, Anne

    was also found among adolescents who had psychiatric disorder or a physical handicap, those who had been sentenced, were addicted to drugs, or had unstable education and unemployment records. A common feature of these significant risk factors seemed to be stigmatisation or social exclusion......This paper has been submitted to a journal for consideration, so please do not quote without permission. Adolescents' first-time suicide attempt tends to be characterized by parental psychiatric disorder or suicidal behaviour, family violence, especially child abuse and neglect. An increased risk...

  3. Quantity of documentation of maltreatment risk factors in injury-related paediatric hospitalisations

    Directory of Open Access Journals (Sweden)

    McKenzie Kirsten

    2012-07-01

    Full Text Available Abstract Background While child maltreatment is recognised as a global problem, solid epidemiological data on the prevalence of child maltreatment and risk factors associated with child maltreatment is lacking in Australia and internationally. There have been recent calls for action to improve the evidence-base capturing and describing child abuse, particularly those data captured within the health sector. This paper describes the quantity of documentation of maltreatment risk factors in injury-related paediatric hospitalisations in Queensland, Australia. Methods This study involved a retrospective medical record review, text extraction and coding methodology to assess the quantity of documentation of risk factors and the subsequent utility of data in hospital records for describing child maltreatment and data linkage to Child Protection Service (CPS. Results There were 433 children in the maltreatment group and 462 in the unintentional injury group for whom medical records could be reviewed. Almost 93% of the maltreatment code sample, but only 11% of the unintentional injury sample had documentation identified indicating the presence of any of 20 risk factors. In the maltreatment group the most commonly documented risk factor was history of abuse (41%. In those with an unintentional injury, the most commonly documented risk factor was alcohol abuse of the child or family (3%. More than 93% of the maltreatment sample also linked to a child protection record. Of concern are the 16% of those children who linked to child protection who did not have documented risk factors in the medical record. Conclusion Given the importance of the medical record as a source of information about children presenting to hospital for treatment and as a potential source of evidence for legal action the lack of documentation is of concern. The details surrounding the injury admission and consideration of any maltreatment related risk factors, both identifying their

  4. [Abuse of minors. Clinical considerations on physical abuse, sexual aggression and emotional deprivation].

    Science.gov (United States)

    Loredo-Abdalá, A; Trejo-Hernández, J; Bustos-Valenzuela, V

    1999-01-01

    Physicians and other health personnel dealing with the consequences of child abuse ought to have abroad understanding of the magnitude of this serious medical and social phenomenon. The three main patterns of child mistreatment as observed at a pediatric hospital are reviewed, with emphasis on its medical and juridical aspects. Various pathologic entities are to be taken into account for differential diagnoses when child abuse is suspected. Risk factors regarding the victims, the abusers and the psychosocial environment are noted.

  5. Risk based In Vitro Performance Assessment of Extended Release Abuse Deterrent Formulations

    Science.gov (United States)

    Xu, Xiaoming; Gupta, Abhay; Al-Ghabeish, Manar; Calderon, Silvia N.; Khan, Mansoor A.

    2016-01-01

    High strength extended release opioid products, which are indispensable tools in the management of pain, are associated with serious risks of unintentional and potentially fatal overdose, as well as of misuse and abuse that might lead to addiction. The issue of drug abuse becomes increasingly prominent when the dosage forms can be readily manipulated to release a high amount of opioid or to extract the drug in certain products or solvents. One approach to deter opioid drug abuse is by providing novel abuse deterrent formulations (ADF), with properties that may be viewed as barriers to abuse of the product. However, unlike regular extended release formulations, assessment of ADF technologies are challenging, in part due to the great variety of formulation designs available to achieve deterrence of abuse by oral, parenteral, nasal and respiratory routes. With limited prior history or literature information, and lack of compendial standards, evaluation and regulatory approval of these novel drug products become increasingly difficult. The present article describes a risk-based standardized in-vitro approach that can be utilized in general evaluation of abuse deterrent features for all ADF products. PMID:26784976

  6. Factors associated with child sexual abuse in Tanzania: a qualitative ...

    African Journals Online (AJOL)

    user

    Tanzania Journal of Health Research ... Methods: Key informant interviews were conducted among adults including parents of the ... factors for child sexual abuse, the type of perpetrators and the context into which these abuses take place.

  7. Media Violence and Other Aggression Risk Factors in Seven Nations.

    Science.gov (United States)

    Anderson, Craig A; Suzuki, Kanae; Swing, Edward L; Groves, Christopher L; Gentile, Douglas A; Prot, Sara; Lam, Chun Pan; Sakamoto, Akira; Horiuchi, Yukiko; Krahé, Barbara; Jelic, Margareta; Liuqing, Wei; Toma, Roxana; Warburton, Wayne A; Zhang, Xue-Min; Tajima, Sachi; Qing, Feng; Petrescu, Poesis

    2017-07-01

    Cultural generality versus specificity of media violence effects on aggression was examined in seven countries (Australia, China, Croatia, Germany, Japan, Romania, the United States). Participants reported aggressive behaviors, media use habits, and several other known risk and protective factors for aggression. Across nations, exposure to violent screen media was positively associated with aggression. This effect was partially mediated by aggressive cognitions and empathy. The media violence effect on aggression remained significant even after statistically controlling a number of relevant risk and protective factors (e.g., abusive parenting, peer delinquency), and was similar in magnitude to effects of other risk factors. In support of the cumulative risk model, joint effects of different risk factors on aggressive behavior in each culture were larger than effects of any individual risk factor.

  8. The Impact of Risk Factors on the Treatment of Adolescent Sex Offenders

    Science.gov (United States)

    Kelley, Sharon M.; Lewis, Kathy; Sigal, Janet

    2004-01-01

    The authors investigated the impact that 5 selected risk factors have on the treatment outcome of adolescent male sex offenders. The results indicated that the greatest risk factor among sex offenders was having a mother who had a substance abuse problem. Study participants were 35 adolescent boys in a New Jersey residential facility for…

  9. Elder abuse within the family environment in the Azores Islands

    Directory of Open Access Journals (Sweden)

    Juan Manuel Carmona-Torres

    2017-09-01

    Full Text Available ABSTRACT Objectives: to dimension abuse against vulnerable adults within the family and community environment in the Azores Islands, identify risk factors for abuse and describe the profile of an abused elder. Method: descriptive cross-sectional study. Random sampling. The instruments used were: clinical histories of the users, Mini-Mental State Examination, Index of Independence in Basic Activities of Daily Living, Family APGAR Scale, Elder Abuse Suspicion Index and Social Work Assessment Form. Descriptive statistical analysis was used for qualitative and quantitative variables and multiple logistic regression was used to identify factors associated with elder mistreatment. Results: abuse suspicion was identified in 24.5% of elderly participants. Psychological abuse was the most common type of abuse and sons were the main abusers. Conclusion: being a woman and belonging to a dysfunctional family is associated with an increased risk of becoming a victim of abuse; the high level of domestic violence against the elderly in the Azores Islands is in line with the rest of Portugal.

  10. Substance abuse and HIV risk behaviours amongst primary health ...

    African Journals Online (AJOL)

    Substance abuse and HIV risk behaviours amongst primary health care service users in Cape Town. ... African Journal of Psychiatry ... We assessed substance use with the Alcohol, Smoking and Substance Involvement Screening Test, and HIV risk with items addressing injection drug use, blood-sharing rituals, and sexual ...

  11. The long-term health consequences of child physical abuse, emotional abuse, and neglect: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Rosana E Norman

    Full Text Available BACKGROUND: Child sexual abuse is considered a modifiable risk factor for mental disorders across the life course. However the long-term consequences of other forms of child maltreatment have not yet been systematically examined. The aim of this study was to summarise the evidence relating to the possible relationship between child physical abuse, emotional abuse, and neglect, and subsequent mental and physical health outcomes. METHODS AND FINDINGS: A systematic review was conducted using the Medline, EMBASE, and PsycINFO electronic databases up to 26 June 2012. Published cohort, cross-sectional, and case-control studies that examined non-sexual child maltreatment as a risk factor for loss of health were included. All meta-analyses were based on quality-effects models. Out of 285 articles assessed for eligibility, 124 studies satisfied the pre-determined inclusion criteria for meta-analysis. Statistically significant associations were observed between physical abuse, emotional abuse, and neglect and depressive disorders (physical abuse [odds ratio (OR = 1.54; 95% CI 1.16-2.04], emotional abuse [OR = 3.06; 95% CI 2.43-3.85], and neglect [OR = 2.11; 95% CI 1.61-2.77]; drug use (physical abuse [OR = 1.92; 95% CI 1.67-2.20], emotional abuse [OR = 1.41; 95% CI 1.11-1.79], and neglect [OR = 1.36; 95% CI 1.21-1.54]; suicide attempts (physical abuse [OR = 3.40; 95% CI 2.17-5.32], emotional abuse [OR = 3.37; 95% CI 2.44-4.67], and neglect [OR = 1.95; 95% CI 1.13-3.37]; and sexually transmitted infections and risky sexual behaviour (physical abuse [OR = 1.78; 95% CI 1.50-2.10], emotional abuse [OR = 1.75; 95% CI 1.49-2.04], and neglect [OR = 1.57; 95% CI 1.39-1.78]. Evidence for causality was assessed using Bradford Hill criteria. While suggestive evidence exists for a relationship between maltreatment and chronic diseases and lifestyle risk factors, more research is required to confirm these relationships. CONCLUSIONS: This overview of the evidence

  12. Individual and contextual factors for the child abuse potential of Croatian mothers: The role of social support in times of economic hardship.

    Science.gov (United States)

    Ajduković, Marina; Rajter, Miroslav; Rezo, Ines

    2018-04-01

    The study assessed mothers' risk for abusing their children in middle adolescence in relation to individual and contextual factors during the economic crisis in Croatia. Socioeconomic status of mothers, family economic pressure, and mothers' exposure to stress were measured. Special attention was given to the perceived availability of social support as one of protective factors potentially buffering the negative impact of risks of child abuse. The community sample included 746 mothers (Mage = 42.85; SDage = 5.319). The results showed that the risk of child abuse is higher for mothers with lower education, those who perceive themselves as suffering greater family economic hardship, those who have experienced a higher number of stressful events, and those with lower social support. When the mothers perceive a lower availability of social support, the effects of exposure to cumulative risk, namely the combination of socioeconomic status, economic pressure, and exposure to stress, are stronger. Since social support proved to be one of the key protective factors in the relationship between adverse life circumstances and parenting, the development of effective and non-stigmatized interventions aiming to increase social support, positive social relationships, and adequate parenting practices for parents facing economic hardship is an important direction for future family policy measures. Copyright © 2018 Elsevier Ltd. All rights reserved.

  13. A protective factors model for alcohol abuse and suicide prevention among Alaska Native youth.

    Science.gov (United States)

    Allen, James; Mohatt, Gerald V; Fok, Carlotta Ching Ting; Henry, David; Burkett, Rebekah

    2014-09-01

    This study provides an empirical test of a culturally grounded theoretical model for prevention of alcohol abuse and suicide risk with Alaska Native youth, using a promising set of culturally appropriate measures for the study of the process of change and outcome. This model is derived from qualitative work that generated an heuristic model of protective factors from alcohol (Allen et al. in J Prev Interv Commun 32:41-59, 2006; Mohatt et al. in Am J Commun Psychol 33:263-273, 2004a; Harm Reduct 1, 2004b). Participants included 413 rural Alaska Native youth ages 12-18 who assisted in testing a predictive model of Reasons for Life and Reflective Processes about alcohol abuse consequences as co-occurring outcomes. Specific individual, family, peer, and community level protective factor variables predicted these outcomes. Results suggest prominent roles for these predictor variables as intermediate prevention strategy target variables in a theoretical model for a multilevel intervention. The model guides understanding of underlying change processes in an intervention to increase the ultimate outcome variables of Reasons for Life and Reflective Processes regarding the consequences of alcohol abuse.

  14. A Model Linking Diverse Women's Child Sexual Abuse History with Sexual Risk Taking

    Science.gov (United States)

    Watson, Laurel B.; Matheny, Kenneth B.; Gagne, Phill; Brack, Greg; Ancis, Julie R.

    2013-01-01

    The purpose of our study was to examine the role that child sexual abuse may play in body surveillance and sexual risk behaviors among undergraduate women. First, a measured variable path analysis was conducted, which assessed the relations among a history of child sexual abuse, body surveillance, and sexual risk behaviors. Furthermore, body…

  15. Controlling behaviours and technology‐facilitated abuse perpetrated by men receiving substance use treatment in England and Brazil: Prevalence and risk factors

    Science.gov (United States)

    Canfield, Martha; Radcliffe, Polly; D'Oliveira, Ana Flavia Pires Lucas

    2017-01-01

    'Oliveira AFPL. Controlling behaviours and technology‐facilitated abuse perpetrated by men receiving substance use treatment in England and Brazil: Prevalence and risk factors. Drug Alcohol Rev 2017;36:52–63] PMID:28134494

  16. Trauma Symptoms, Sexual Behaviors, and Substance Abuse: Correlates of Childhood Sexual Abuse and HIV Risks among Men Who Have Sex with Men

    Science.gov (United States)

    Kalichman, Seth C.; Gore-Felton, Cheryl; Benotsch, Eric; Cage, Marjorie; Rompa, David

    2004-01-01

    Childhood sexual abuse is associated with high-risk sexual behavior in men who have sex with men. This study examined psychological and behavioral correlates of HIV risk behavior associated with childhood sexual abuse in a sample of men who have sex with men. Men attending a large gay pride event (N = 647) completed anonymous surveys that assessed…

  17. Risk factors for violent crime in Schizophrenia: a national cohort study of 13,806 patients.

    Science.gov (United States)

    Fazel, Seena; Grann, Martin; Carlström, Eva; Lichtenstein, Paul; Långström, Niklas

    2009-03-01

    To determine risk factors for and prevalence of violent crime in patients with schizophrenia, and in particular, to explore the contribution of familial risk factors. We designed a cohort study that followed up patients with 2 or more hospitalizations for schizophrenia (ICD-8, ICD-9, and ICD-10 criteria) and investigated the risk for a violent conviction using Cox proportional hazards models. All 13,806 patients with 2 hospital discharge diagnoses of schizophrenia from January 1, 1973, through December 31, 2004, in Sweden were followed until violent conviction, emigration, death, or end of follow-up (December 31, 2004), and associations with sociodemographic, individual (substance abuse comorbidity, and previous violence), and familial (parental violent crime and parental alcohol abuse) factors were examined. Over an average follow-up period of 12 years, 17.1% (N = 1519) of the men and 5.6% (N = 273) of the women with 2 or more hospitalizations for schizophrenia had a violent conviction after discharge from hospital. Familial risk factors had moderate effects, increasing the risk for violent convictions by 50% to 150%. After adjustment for sociodemographic and individual risk factors, the associations between parental violent crime and risk of violent convictions remained in men (adjusted hazard ratio [HR] = 1.65, 95% CI = 1.33 to 2.04) and in women (adjusted HR = 1.83, 95% CI = 1.11 to 3.01), whereas parental alcohol abuse was no longer significantly associated with violent crime. Parental violent crime had moderate associations with violent crime in male and female offspring with at least 2 hospitalizations for schizophrenia, which were mostly stronger than the better documented sociodemographic risk factors. This suggests that familial (genetic or early environmental) risk factors have an important role in the etiology of violent offending among individuals with schizophrenia and should be considered in violence risk assessment. ©Copyright 2009 Physicians

  18. Risk factors for methamphetamine use in youth: a systematic review

    Directory of Open Access Journals (Sweden)

    Durec Tamara

    2008-10-01

    Full Text Available Abstract Background Methamphetamine (MA is a potent stimulant that is readily available. Its effects are similar to cocaine, but the drug has a profile associated with increased acute and chronic toxicities. The objective of this systematic review was to identify and synthesize literature on risk factors that are associated with MA use among youth. More than 40 electronic databases, websites, and key journals/meeting abstracts were searched. We included studies that compared children and adolescents (≤ 18 years who used MA to those who did not. One reviewer extracted the data and a second checked for completeness and accuracy. For discrete risk factors, odds ratios (OR were calculated and when appropriate, a pooled OR with 95% confidence intervals (95% CI was calculated. For continuous risk factors, mean difference and 95% CI were calculated and when appropriate, a weighted mean difference (WMD and 95% CI was calculated. Results were presented separately by comparison group: low-risk (no previous drug abuse and high-risk children (reported previous drug abuse or were recruited from a juvenile detention center. Results Twelve studies were included. Among low-risk youth, factors associated with MA use were: history of heroin/opiate use (OR = 29.3; 95% CI: 9.8–87.8, family history of drug use (OR = 4.7; 95% CI: 2.8–7.9, risky sexual behavior (OR = 2.79; 95% CI: 2.25, 3.46 and some psychiatric disorders. History of alcohol use and smoking were also significantly associated with MA use. Among high-risk youth, factors associated with MA use were: family history of crime (OR = 2.0; 95% CI: 1.2–3.3, family history of drug use (OR = 4.7; 95% CI: 2.8–7.9, family history of alcohol abuse (OR = 3.2; 95% CI: 1.8–5.6, and psychiatric treatment (OR = 6.8; 95% CI: 3.6–12.9. Female sex was also significantly associated with MA use. Conclusion Among low-risk youth, a history of engaging in a variety of risky behaviors was significantly associated

  19. Opium addiction as a new risk factor of sphincter of Oddi dysfunction.

    Science.gov (United States)

    Mousavi, Shahrokh; Toussy, Jafar; Zahmatkesh, Mehrdad

    2007-11-01

    Sphincter of Oddi dysfunction (SOD) refers to an abnormality of SO contractility. It is a benign, non-calculus obstruction to the flow of bile or pancreatic juice through the pancreaticobiliary junction. Although morphine can cause an excitatory effect on SO motility, there are no comprehensive data about opium as a risk factor in inducing SOD in chronic opium abusers. The aim of the study was to assess potential risk factors, especially opium addiction (OA), in patients with SOD. In a case-control study, opium addiction, cigarette smoking, cholecystectomy, and periampullary diverticulum in patients with SOD were recorded and compared with healthy subjects. SOD was diagnosed by the Geenen-Hogan classification (type I). OA (p=0.001) and cholecystectomy (p<0.001) were two independent risk factors in patients with SOD. Chronic use of opiates by the oral or inhalational route may induce SOD, but whether chronic use of other morphine derivatives or i.v. drug abuse induce this disorder is not clear and needs further evaluation.

  20. Substance Abuse among High-Risk Sexual Offenders: Do Measures of Lifetime History of Substance Abuse Add to the Prediction of Recidivism over Actuarial Risk Assessment Instruments?

    Science.gov (United States)

    Looman, Jan; Abracen, Jeffrey

    2011-01-01

    There has been relatively little research on the degree to which measures of lifetime history of substance abuse add to the prediction of risk based on actuarial measures alone among sexual offenders. This issue is of relevance in that a history of substance abuse is related to relapse to substance using behavior. Furthermore, substance use has…

  1. Tramadol Abuse Status and Related Factors among Three College Students in Hamadan

    Directory of Open Access Journals (Sweden)

    Y. Fathi

    2012-10-01

    Full Text Available Introduction & Objective: Abuse of prescription drugs is on the rise in Iran and tramadol is not an exception. Tramadol abuse can lead to a wide range of illegal and risky behaviors; therefore, the need to understand the tramadol abuse status among students is necessary. The purpose of this study was to determine the prevalence and related factors of tramadol abuse among college students in Hamadan.Materials & Methods: This cross sectional descriptive study was carried out on 400 college students of Hamadan recruited with a stratified sampling method. The participants completed a self-administered questionnaire. Data analysis was done with the SPSS software (version 16, using χ2 test and logistic regression methods.Results: The result showed that lifetime, past-year and past-month prevalence of tramadol use were 12.5, 11 and 9.5%, respectively. Also, significant relationship between tramadol abuse and demographic variables such as gender, educational status and dwelling of students were showed (P<0.05. Cigarette smoking and illicit drug abuse were other factors associated with tramadol abuse among students (P<0.05. In logistic regression, factors influencing tramadol use were smoking and use of other drugs (P< 0.05.Conclusion: The study concluded that there is a worrying increase in tramadol abuse among students. The results of this study as an introduction to designing effective strategies to prevention of drug abuse, particularly in the colleges play a very effective role.(Sci J Hamadan Univ Med Sci 2012;19(3:23-29

  2. A systematic review of risk and protective factors associated with family related violence in refugee families.

    Science.gov (United States)

    Timshel, Isabelle; Montgomery, Edith; Dalgaard, Nina Thorup

    2017-08-01

    The current systematic review summarizes the evidence from studies examining the risk and protective factors associated with family related violence in refugee families. Data included 15 peer-reviewed qualitative and quantitative studies. In order to gain an overview of the identified risk and protective factors an ecological model was used to structure the findings. At the individual level, parental trauma experiences/mental illness, substance abuse and history of child abuse were found to be risk factors. Family level risk factors included parent-child interaction, family structure and family acculturation stress. At the societal level low socioeconomic status was identified as a risk factor. Cultural level risk factors included patriarchal beliefs. Positive parental coping strategies were a protective factor. An ecological analysis of the results suggests that family related violence in refugee families is a result of accumulating, multiple risk factors on the individual, familial, societal and cultural level. The findings suggest that individual trauma and exile related stress do not only affect the individual but have consequences at a family level. Thus, interventions targeting family related violence should not only include the individual, but the family. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. The complexities of elder abuse.

    Science.gov (United States)

    Roberto, Karen A

    2016-01-01

    Elder abuse is a growing societal concern, affecting at least 1 in 10 older Americans. Researchers and practitioners alike consistently assert that a dramatic discrepancy exists between the prevalence rates of elder abuse and the number of elder abuse cases reported. As a field of study, recognition and understanding of elder abuse is still emerging. Comparing findings of a small, but growing, body of literature on perceived and substantiated cases of elder abuse is challenging because there is no uniform term or agreed-upon definition used among state governments, researchers, health care and service providers, and advocates. This article summarizes current understanding of elder abuse, including what constitutes elder abuse, risk factors for elder abuse, perpetrators of elder abuse, and outcomes of elder abuse. Issues associated with the detection of elder abuse and intervention strategies for victims of abuse are addressed. In the final section, potential roles and contributions of psychologists for advancing elder abuse research, professional practice, and policy development are highlighted. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  4. Exploring the Correlates to Depression in Elder Abuse Victims: Abusive Experience or Individual Characteristics?

    Science.gov (United States)

    Santos, Ana João; Nunes, Baltazar; Kislaya, Irina; Gil, Ana Paula; Ribeiro, Oscar

    2017-09-01

    Depression and depressive symptoms have been studied both as risk factors and consequences of elder abuse, even though the most common cross-sectional design of the studies does not allow inferring cause or consequence relationships. This study estimates the proportion of older adults who screened positive for depressive symptoms among those self-reporting elder abuse and examines whether individual characteristics and/or abusive experience aspects are associated with self-reported depressive symptoms. Participants were 510 older adults self-reporting experiences of abuse in family setting enrolled in the cross-sectional victims' survey of the Aging and Violence Study. Depressive symptoms were assessed through the abbreviated version of the Geriatric Depression Scale (GDS-5). Poisson regression was used to determine the prevalence ratio (PR) of screening depressive symptoms according to individual and abusive experience covariates: sex, age group, cohabitation, perceived social support, chronic diseases, functional status, violence type, perpetrator, and number of conducts. Women (PR = 1.18, 95% confidence interval [CI] = [1.04, 1.35]) individuals perceiving low social support level (PR = 1.36, 95% CI = [1.16, 1.60]) and with long-term illness (PR = 1.17, 95% CI = [1.02, 1.33]) were found to be associated with increased risk for screening depressive symptoms. In regard to abusive experience, only the number of abusive conducts increased the PR (PR = 1.07, 95% CI = [1.05, 1.09]). Routine screening for elder abuse should include psychological well-being assessment. Interventions toward risk alleviation for both mental health problems and elder abuse should target women perceiving low social support level and with long-term illness.

  5. Associations of adversity in childhood and risk factors for cardiovascular disease in mid-adulthood.

    Science.gov (United States)

    Anderson, Emma L; Fraser, Abigail; Caleyachetty, Rishi; Hardy, Rebecca; Lawlor, Debbie A; Howe, Laura D

    2018-02-01

    Studies assessing associations of childhood psychosocial adversity (e.g. sexual abuse, physical neglect, parental death), as opposed to socioeconomic adversity, with cardiovascular disease (CVD) risk factors in adulthood are scarce. The aim of this study is to assess associations of various types of psychosocial adversity and cumulative adversity in childhood, with multiple CVD risk factors in mid-life. At study enrolment, women from the Avon Longitudinal Study of Parents and Children (N=3612) retrospectively reported: lack of maternal care, maternal overprotection, parental mental illness, household dysfunction, sexual abuse, physical and emotional abuse, and neglect in childhood. Approximately 23 years later, body mass index (BMI), waist circumference, systolic and diastolic blood pressure, plasma glucose, insulin, triglycerides, low and high density lipoprotein cholesterol, C-reactive protein, carotid intima-media thickness (cIMT) and arterial distensibility were assessed (mean age 51 years). We examined associations of each specific type of psychosocial adversity and cumulative adversity with CVD risk factors. No specific type of psychosocial adversity was consistently associated with the CVD risk factors. There was evidence that a one standard deviation greater cumulative psychosocial adversity was associated with 0.51cm greater waist circumference (95% confidence interval [CI]: 0.02cm, 1.00cm, p=0.04) and a lower arterial distensibility, even after adjustment for age, ethnicity and childhood and adult socioeconomic position. We found no consistent evidence that any specific type of psychosocial adversity, or cumulative psychosocial adversity in childhood, is associated with CVD risk factors in adult women. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  6. The Great Recession and risk for child abuse and neglect.

    Science.gov (United States)

    Schneider, William; Waldfogel, Jane; Brooks-Gunn, Jeanne

    2017-01-01

    This paper examines the association between the Great Recession and four measures of the risk for maternal child abuse and neglect: (1) maternal physical aggression; (2) maternal psychological aggression; (3) physical neglect by mothers; and (4) supervisory/exposure neglect by mothers. It draws on rich longitudinal data from the Fragile Families and Child Wellbeing Study, a longitudinal birth cohort study of families in 20 U.S. cities (N = 3,177; 50% African American, 25% Hispanic; 22% non-Hispanic white; 3% other). The study collected information for the 9-year follow-up survey before, during, and after the Great Recession (2007-2010). Interview dates were linked to two macroeconomic measures of the Great Recession: the national Consumer Sentiment Index and the local unemployment rate. Also included are a wide range of socio-demographic controls, as well as city fixed effects and controls for prior parenting. Results indicate that the Great Recession was associated with increased risk of child abuse but decreased risk of child neglect. Households with social fathers present may have been particularly adversely affected. Results also indicate that economic uncertainty during the Great Recession, as measured by the Consumer Sentiment Index and the unemployment rate, had direct effects on the risk of abuse or neglect, which were not mediated by individual-level measures of economic hardship or poor mental health.

  7. Understanding the Diverse Needs of Children whose Parents Abuse Substances

    Science.gov (United States)

    Solis, Jessica M.; Shadur, Julia M.; Burns, Alison R.; Hussong, Andrea M.

    2013-01-01

    In this review, we consider the potential service needs of children of substance abusing parents based on what we know about the risk outcomes faced by these children and the parenting deficits often present in these families. Importantly, our review does not address the etiological role of parental substance abuse in children's negative outcomes but instead we discuss the complex inter-related risk factors that often co-occur with and exacerbate risk associated with parental alcohol and drug use. We first review studies showing the elevated risk that children of substance abusing parents face in general for poorer academic functioning; emotional, behavioral, and social problems; and an earlier onset of substance use, faster acceleration in substance use patterns, and higher rates of alcohol and drug use disorders. We then review studies showing contextual risk factors for children of substance abusing parents, including parenting deficits (less warmth, responsiveness, and physical and verbal engagement as well as harsher and more over-involved interaction styles), greater risk for child maltreatment, and less secure attachment patterns. We conclude with a discussion of future directions for research and guidelines for professionals working with children and their families where parental substance abuse is present. PMID:22455509

  8. Substance abuse in anaesthetists.

    Science.gov (United States)

    Garcia-Guasch, Roser; Roigé, Jaume; Padrós, Jaume

    2012-04-01

    Anaesthesiologists have a significantly higher frequency of substance abuse by a factor of nearly 3 when compared with other physicians. This is still a current problem that must be reviewed. Many hypotheses have been formulated to explain why anaesthesiologists appear to be more susceptible to substance abuse than other medical professionals (genetic differences in sensitivity to opioids, stress, the association between chemical dependence and other psychopathology or the second-hand exposure hypothesis). Environmental exposure and sensitization may be an important risk factor in physician addiction. There is a long debate about returning to work for an anaesthetist who has been depending on opioid drugs, and recent debates are discussed. Institutional efforts have been made in many countries and physician health programmes have been developed. As drug abuse among anaesthesiologists has continued, new studies have been conducted to know the theories about susceptibility. Written substance abuse policies and controls must be taken in place and in all countries.

  9. Global Prevalence of Elder Abuse: A Meta-analysis and Meta-regression.

    Science.gov (United States)

    Ho, C Sh; Wong, S Y; Chiu, M M; Ho, R Cm

    2017-06-01

    Elder abuse is increasingly recognised as a global public health and social problem. There has been limited inter-study comparison of the prevalence and risk factors for elder abuse. This study aimed to estimate the pooled and subtype prevalence of elder abuse worldwide and identify significant associated risk factors. We conducted a meta-analysis and meta-regression of 34 population-based and 17 non-population-based studies. The pooled prevalences of elder abuse were 10.0% (95% confidence interval, 5.2%-18.6%) and 34.3% (95% confidence interval, 22.9%-47.8%) in population-based studies and third party- or caregiver-reported studies, respectively. Being in a marital relationship was found to be a significant moderator using random-effects model. This meta-analysis revealed that third parties or caregivers were more likely to report abuse than older abused adults. Subgroup analyses showed that females and those resident in non-western countries were more likely to be abused. Emotional abuse was the most prevalent elder abuse subtype and financial abuse was less commonly reported by third parties or caregivers. Heterogeneity in the prevalence was due to the high proportion of married older adults in the sample. Subgroup analysis showed that cultural factors, subtypes of abuse, and gender also contributed to heterogeneity in the pooled prevalence of elder abuse.

  10. Risk assessment of parents' concerns at 18 months in preventive child health care predicted child abuse and neglect.

    Science.gov (United States)

    Staal, Ingrid I E; Hermanns, Jo M A; Schrijvers, Augustinus J P; van Stel, Henk F

    2013-07-01

    As child maltreatment has a major impact, prevention and early detection of parenting problems are of great importance. We have developed a structured interview which uses parents' concerns for a joint needs assessment by parents and a child health care nurse, followed by a professional judgment on the risk level of future parenting and developmental problems: the Structured Problem Analysis of Raising Kids (SPARK). Previous results have shown that the risk assessment of the SPARK is associated with risk factors for child maltreatment. This study reports the predictive value of the SPARK for reports on high impact parenting problems and child abuse and neglect. Cross-sectional study with a 1.5-year follow-up based on 1,850 18-month old children, living in Zeeland, a province of the Netherlands. Data on the SPARK were obtained in the period of June 2007 to March 2008. Outcomes of the SPARK were in October 2009 compared to reports of the Advice and Reporting Centers for Child Abuse and Neglect (ARCAN) and Youth Care Agency (YCA). Univariate and multivariate logistic regression analysis was done using the risk assessment, parents' concerns, the perceived need for support and known risk factors as predictors. The overall risk assessment of the SPARK is the strongest predictor for reports to ARCAN and YCA in the 1.5 years after completing the SPARK (odds ratio of high versus low risk: 16.3 [95% confidence interval: 5.2-50.8]. Controlling for the risk assessment, only the sum of known risk factors and an unemployed father remained as significant predictors. The reported groups differ significantly from the children without a report with regard to family characteristics, but not with regard to child characteristics. A structured assessment of the concerns and care needs of toddlers' parents by a child health care nurse is a valuable predictor of reports on child abuse and neglect and serious parenting problems in toddlers. Systematically exploring and evaluating parental

  11. Understanding Alcohol Abuse among College Students: Contributing Factors and Strategies for Intervention

    Science.gov (United States)

    Iconis, Rosemary

    2014-01-01

    Alcohol abuse among college students has become a major public health concern. Individual, environmental, and demographic factors have each been associated with alcohol abuse in that population. In response to the enormous physical, emotional, and legal consequences that occur as a result of the abuse, colleges and universities are developing…

  12. Exploring the belief systems of domestic abuse victims using Smallest Space Analysis (SSA)

    OpenAIRE

    Spruin, E.; Alleyne, E.; Baker, R.; Papadaki, I.; Franz, A.

    2017-01-01

    Purpose: Support service provisions for domestic abuse victims has typically focused on the immediate risk and etiological factors associated with abuse. Consequently, there is limited research exploring more persistent and pervasive factors involved in this cycle of abuse, such as subjective experiences and beliefs held by victims of domestic abuse. The current study is a preliminary exploration of the individual experience of domestic abuse including the belief systems of participants. Incr...

  13. [Biperiden abuse as a partial factor in polytoxicomania].

    Science.gov (United States)

    Schulte, R M

    1988-03-01

    We found 16 patients (15%) taking the anticholinergic biperiden because of its psychotropic action, occasionally, rather frequently or regularly, among a subgroup of 120 drug-dependent patients (drugs of the barbiturate and amphetamin types) out of a studied total of 194 imprisoned male addicts. These biperiden abusers suffered without exception from polytoxicomania associated with drug dependence and alcoholism. Most prominent was drug dependence on drugs of the morphine type. We could not prove a case of an isolated "primary" abuse of biperiden. Direct medical prescription was a rather secondary factor in procuring this preparation, in contrast to analgesics, tranquilisers, barbiturates and clomethiazol. Increase of biperiden abuse is due, on the one hand, to a generally noticeable tendency to polytoxicomania, and on the other hand to a change in Federal German drug prescription rules effective 1 August 1986 according to which fenetylline hydrochloride, a sympathomimetic, is now subject to medical prescription. Other centrally acting anticholinergics were unknown among this group of patients and were not abused. The results are discussed on the basis of available literature.

  14. Association of Cognitive Function and Risk for Elder Abuse in a Community-Dwelling Population

    Science.gov (United States)

    Dong, XinQi; Simon, Melissa; Rajan, Kumar; Evans, Denis A.

    2011-01-01

    Aim This study aimed to examine the cross-sectional association between cognitive function and elder abuse. Methods The Chicago Health and Aging Project (CHAP) is a population-based study conducted in a geographically defined community (n = 8,932). We identified 238 CHAP participants who had elder abuse reported to a social services agency. Cognitive function was assessed using the Mini-Mental State Examination (MMSE), the Symbol Digit Modalities Test (perceptual speed), and both immediate and delayed recall of the East Boston Memory Test (episodic memory). An index of global cognitive function scores was derived by averaging the z-scores of all tests. Logistic regression models were used to assess the association of cognitive function domains and risk of elder abuse. Results After adjusting for confounders, lowest tertiles of global cognition (odd's ratio, OR 4.18, 95% confidence interval, 95% CI 2.44–7.15), MMSE (OR 2.97, 95% CI 1.93–4.57), episodic memory (OR 2.27, 95% CI 1.49–3.43) and perceptual speed (OR 2.37, 95% CI 1.51–3.73) were associated with increased risk of elder abuse. The lowest levels of global cognitive function were associated with an increased risk of physical abuse (OR 3.56, 95% CI 1.08–11.67), emotional abuse (OR 3.02, 95% CI 1.41–6.44), caregiver neglect (OR 6.24, 95% CI 2.68–14.54), and financial exploitation (OR 3.71, 95% CI 1.88–7.32). Conclusion Lower levels of global cognitive function, MMSE, episodic memory and perceptual speed are associated with an increased risk of elder abuse. PMID:22095098

  15. Laterality of Brain Activation for Risk Factors of Addiction.

    Science.gov (United States)

    Gordon, Harold W

    2016-01-01

    Laterality of brain activation is reported for tests of risk factors of addiction- impulsivity and craving-but authors rarely address the potential significance of those asymmetries. The purpose of this study is to demonstrate this laterality and discuss its relevance to cognitive and neurophysiological asymmetries associated with drug abuse vulnerability in order to provide new insights for future research in drug abuse. From published reports, brain areas of activation for two tests of response inhibition or craving for drugs of abuse were compiled from fMRI activation peaks and were tabulated for eight sections (octants) in each hemisphere. Percent asymmetries were calculated (R-L/R+L) across studies for each area. For impulsivity, most activation peaks favored the right hemisphere. Overall, the percent difference was 32% (Χ2 = 16.026; p laterality into consideration is a missed opportunity in designing studies and gaining insight into the etiology of drug abuse and pathways for treatment.

  16. Personal and couple level risk factors: Maternal and paternal parent-child aggression risk.

    Science.gov (United States)

    Tucker, Meagan C; Rodriguez, Christina M; Baker, Levi R

    2017-07-01

    Previous literature examining parent-child aggression (PCA) risk has relied heavily upon mothers, limiting our understanding of paternal risk factors. Moreover, the extent to which factors in the couple relationship work in tandem with personal vulnerabilities to impact PCA risk is unclear. The current study examined whether personal stress and distress predicted PCA risk (child abuse potential, over-reactive discipline style, harsh discipline practices) for fathers as well as mothers and whether couple functioning mediated versus moderated the relation between personal stress and PCA risk in a sample of 81 couples. Additionally, the potential for risk factors in one partner to cross over and affect their partner's PCA risk was considered. Findings indicated higher personal stress predicted elevated maternal and paternal PCA risk. Better couple functioning did not moderate this relationship but partially mediated stress and PCA risk for both mothers and fathers. In addition, maternal stress evidenced a cross-over effect, wherein mothers' personal stress linked to fathers' couple functioning. Findings support the role of stress and couple functioning in maternal and paternal PCA risk, including potential cross-over effects that warrant further inquiry. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Modeling risk for child abuse and harsh parenting in families with depressed and substance-abusing parents.

    Science.gov (United States)

    Kelley, Michelle L; Lawrence, Hannah R; Milletich, Robert J; Hollis, Brittany F; Henson, James M

    2015-05-01

    Children with substance abusing parents are at considerable risk for child maltreatment. The current study applied an actor-partner interdependence model to examine how father only (n=52) and dual couple (n=33) substance use disorder, as well as their depressive symptomology influenced parents' own (actor effects) and the partner's (partner effects) overreactivity in disciplinary interactions with their children, as well as their risk for child maltreatment. Parents completed the Center for Epidemiologic Studies Depression Scale (CES-D; Radloff, 1977), the overreactivity subscale from the Parenting Scale (Arnold, O'Leary, Wolff, & Acker, 1993), and the Brief Child Abuse Potential Inventory (Ondersma, Chaffin, Mullins, & LeBreton, 2005). Results of multigroup structural equation models revealed that a parent's own report of depressive symptoms predicted their risk for child maltreatment in both father SUD and dual SUD couples. Similarly, a parent's report of their own depressive symptoms predicted their overreactivity in disciplinary encounters both in father SUD and dual SUD couples. In all models, partners' depressive symptoms did not predict their partner's risk for child maltreatment or overreactivity. Findings underscore the importance of a parent's own level of depressive symptoms in their risk for child maltreatment and for engaging in overreactivity during disciplinary episodes. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. A classification of risk factors in serious juvenile offenders and the relation between patterns of risk factors and recidivism.

    Science.gov (United States)

    Mulder, Eva; Brand, Eddy; Bullens, Ruud; Van Marle, Hjalmar

    2010-02-01

    There has been a lot of research on risk factors for recidivism among juvenile offenders, in general, and on individual risk factors, but less focus on subgroups of serious juvenile offenders and prediction of recidivism within these. To find an optimal classification of risk items and to test the predictive value of the resultant factors with respect to severity of recidivism among serious juvenile offenders. Seventy static and dynamic risk factors in 1154 juvenile offenders were registered with the Juvenile Forensic Profile. Recidivism data were collected on 728 of these offenders with a time at risk of at least 2 years. After factor analysis, independent sample t-tests were used to indicate differences between recidivists and non-recidivists. Logistic multiple linear regression analyses were used to test the potential predictive value of the factors for violent or serious recidivism. A nine-factor solution best accounted for the data. The factors were: antisocial behaviour during treatment, sexual problems, family problems, axis-1 psychopathology, offence characteristics, conscience and empathy, intellectual and social capacities, social network, and substance abuse. Regression analysis showed that the factors antisocial behaviour during treatment, family problems and axis-1 psychopathology were associated with seriousness of recidivism. The significance of family problems and antisocial behaviour during treatments suggest that specific attention to these factors may be important in reducing recidivism. The fact that antisocial behaviour during treatment consists mainly of dynamic risk factors is hopeful as these can be influenced by treatment. Consideration of young offenders by subgroup rather than as a homogenous population is likely to yield the best information about risk of serious re-offending and the management of that risk.

  19. Factores de riesgo asociados al uso de drogas en estudiantes adolescentes Fatores de riscos associados ao uso de drogas entre estudantes adolescentes Risk factors associated with drugs abuse among adolescent students

    Directory of Open Access Journals (Sweden)

    Ever Agustín Osorio Rebolledo

    2004-04-01

    moderados são: a recreação, conduta e escola; e as de baixos riscos, pares, habilidades sociais e o uso de drogas. A pontuação da escala de Índice de Severidade Total é alta, podendo indicar que os adolescentes venezuelanos apresentam maiores riscos para o uso de drogas lícitas e ilícitas, ao mesmo tempo apresentam menores índices de uso de drogas, ou seja, a presença dos fatores de proteção interatuam com os fatores de riscos para modificá-los.This study aims to identify risk factors associated with licit and illicit drugs abuse among adolescent students in various public institutions. Methods: a descriptive study was carried out in Naguanagua, Carabobo, Venezuela and applied the Test Drug Use Screening Inventory questionnaire to an age-stratified sample, involving students between 12 and 17 years old. Results: high-risk areas associated with drugs abuse were family and mental health, while recreation, behavior and school are considered moderate risks. Peers, social abilities and drugs use were identified as low-risk factors. The Total Severity Score is high, which may indicate that Venezuelan adolescents present higher risks for licit and illicit drugs abuse. At the same time, they present lower drugs use rates, that is, the presence of protective factors interact with and modify the risk factors.

  20. Adult functioning of mothers with traumatic brain injury at high risk of child abuse: a pilot study.

    Science.gov (United States)

    van Vliet-Ruissen, Cora; McKinlay, Audrey; Taylor, Annabel

    2014-01-01

    There is little information regarding the impact that traumatic brain injury (TBI) has on the functioning of mothers at risk of child abuse. This study evaluated adult functioning (e.g. child abuse, substance use, criminal convictions, and mental health problems) of mothers, at high risk for child abuse, who also had a history of TBI compared with those without TBI. It was hypothesised that mothers with a history of TBI would engage in higher rates of dysfunctional behaviour compared to those with no history of TBI. Participants were 206 women engaged in a child abuse prevention programme for mothers who are highly socially disadvantaged, and at high risk for child abuse. Using historical data collected as part of the referral, and self report intake process, this study compared child abuse, mental health problems (depression, anxiety, substance use) and rates of criminal offending for mothers with a history of TBI versus those with no history of TBI. Mothers with TBI were no more likely than those without TBI to have engaged in child abuse. However, mothers with a history of TBI were significantly more likely to have one or more mental health problems, engage in substance use and have a history of criminal offending. Parents with TBI who have been identified as high risk for engaging in child abuse have increased risk for mental health problems and criminal offending. These issues need to be considered when designing parenting programmes in order for intervention strategies to be effective.

  1. Elevated Risk of Posttraumatic Stress in Sexual Minority Youths: Mediation by Childhood Abuse and Gender Nonconformity

    Science.gov (United States)

    Rosario, Margaret; Corliss, Heather L.; Koenen, Karestan C.; Austin, S. Bryn

    2012-01-01

    Objectives. We examined whether lifetime risk of posttraumatic stress disorder (PTSD) was elevated in sexual minority versus heterosexual youths, whether childhood abuse accounted for disparities in PTSD, and whether childhood gender nonconformity explained sexual-orientation disparities in abuse and subsequent PTSD. Methods. We used data from a population-based study (n = 9369, mean age = 22.7 years) to estimate risk ratios for PTSD. We calculated the percentage of PTSD disparities by sexual orientation accounted for by childhood abuse and gender nonconformity, and the percentage of abuse disparities by sexual orientation accounted for by gender nonconformity. Results. Sexual minorities had between 1.6 and 3.9 times greater risk of probable PTSD than heterosexuals. Child abuse victimization disparities accounted for one third to one half of PTSD disparities by sexual orientation. Higher prevalence of gender nonconformity before age 11 years partly accounted for higher prevalence of abuse exposure before age 11 years and PTSD by early adulthood in sexual minorities (range = 5.2%–33.2%). Conclusions. Clinicians, teachers, and others who work with youths should consider abuse prevention and treatment measures for gender-nonconforming children and sexual minority youths. PMID:22698034

  2. Risks for abuse against pregnant Hispanic women: Morelos, Mexico and Los Angeles County, California.

    Science.gov (United States)

    Castro, Roberto; Peek-Asa, Corinne; García, Lorena; Ruiz, Agustín; Kraus, Jess F

    2003-11-01

    Although violence against women is gaining international attention as a prevention priority, little is known about how risks differ across countries. A comparative study of violence against pregnant Mexican women in Morelos, Mexico, and Latina women in Los Angeles County, California, United States. In 1998 and 1999, women in prenatal clinics were interviewed about psychological abuse and sexual and physical violence by their partner, during and the 1 year prior to the index pregnancy. The overall response rate for Morelos was 99%, with a sample size of 914; Los Angeles County had a response rate of 96.9%, with a sample size of 219. Women in Morelos reported a higher prevalence of violence compared to women in the California (14.8% v 11.9%, respectively). A partner aged child were more than 25 times more likely to be abused during pregnancy than women not reporting this type of abuse. The identification of factors associated with violence against women, especially as they differ by culture and ethnicity, will help clinicians to better identify victims and to design and implement culturally appropriate prevention programs.

  3. Comparing cardiovascular factors in opium abusers and non-users candidate for coronary artery bypass graft surgery.

    Science.gov (United States)

    Aghadavoudi, Omid; Eizadi-Mood, Nastaran; Najarzadegan, Mohammad Reza

    2015-01-01

    In some opinions, opium consumption has traditionally been considered to be a means to lower blood lipids and to put off heart diseases. In this study, the relationship between opium consumption and risk factors of coronary artery diseases, hemodynamic factors and cardiac related functions before and after surgery was evaluated. In a cross-sectional study 325 patient's candidate for elective coronary artery bypass grafting were enrolled in a period of 6 months. Opium addicted patients were recognized based on taking history from the patients by an anaesthesiologist. Serum lipid profile was determined at the beginning of the study. Frequency and distribution of coronary artery diseases were assessed according to the pre-operative coronary angiography. From 325 patients, 117 patients were opium abusers and 208 patients were not. Mean duration of opium abuse was 12.6 ± 7.7 years. Mean total serum cholesterol levels were not significantly different in abusers and non-users patients (185 ± 47 vs. 190 ± 49, P > 0.05). Mean level of low-density lipoprotein cholesterol was significantly higher in addicted group (121 ± 27 vs. 81 ± 22, P opium addicted cases. Mean body mass index was also lower in addicted patients significantly (25.3 ± 3.7 vs. 27.5 ± 4.1, P opium abuse and aggravating lipid profile and hypercholesterolemia and coronary artery disease.

  4. Risk and Protective Factors for Suicide in Patients with Alcoholism

    Directory of Open Access Journals (Sweden)

    Leo Sher

    2006-01-01

    Full Text Available Alcoholism is associated with a high risk for suicidal behavior. Up to 40% of persons with alcoholism attempt suicide at some time and 7% end their lives by committing suicide. Risk factors include being male, older than 50 years of age, living alone, being unemployed, poor social support, interpersonal losses, continued drinking, consumption of a greater amount of alcohol when drinking, a recent alcohol binge, previous alcohol treatment, a family history of alcoholism, a history of comorbid substance abuse (especially cocaine, a major depressive episode, serious medical illness, suicidal communication, and prior suicidal behavior. Suicidal behavior is especially frequent in patients with comorbid alcoholism and major depression. However, all patients with alcoholism should be evaluated for suicide risk. Understanding of risk and vulnerability to suicidal behavior in alcoholism still outweighs our knowledge of protective factors and resilience. Knowledge of protective factors for suicide may help to prevent and/or predict suicidal behavior. Protective factors for suicide in alcoholism are quite varied and include an individual's biological and behavioral characteristics, as well as attributes of the environment and culture. Protective factors include effective clinical care for psychiatric (including alcoholism and drug abuse and physical disorders, easy access to a variety of clinical interventions and support for seeking help, restricted access to highly lethal means of suicide, strong connections to family and community support, skills in problem solving and conflict resolution, cultural and religious beliefs that discourage suicide and support self-preservation. Future studies are necessary to determine which interventions may reduce suicidal behavior in alcoholism.

  5. Canine diabetes mellitus risk factors: A matched case-control study.

    Science.gov (United States)

    Pöppl, Alan Gomes; de Carvalho, Guilherme Luiz Carvalho; Vivian, Itatiele Farias; Corbellini, Luis Gustavo; González, Félix Hilário Díaz

    2017-10-01

    Different subtypes of canine diabetes mellitus (CDM) have been described based on their aetiopathogenesis. Therefore, manifold risk factors may be involved in CDM development. This study aims to investigate canine diabetes mellitus risk factors. Owners of 110 diabetic dogs and 136 healthy controls matched by breed, sex, and age were interviewed concerning aspects related to diet, weight, physical activity, oral health, reproductive history, pancreatitis, and exposure to exogenous glucocorticoids. Two multivariate multivariable statistical models were created: The UMod included males and females without variables related to oestrous cycle, while the FMod included only females with all analysed variables. In the UMod, "Not exclusively commercial diet" (OR 4.86, 95%CI 2.2-10.7, Pdiet" (OR 4.14, 95%CI 1.3-12.7, P=0.01), "Table scraps abuse" (OR 3.62, 95%CI 1.1-12.2, P=0.03), "Overweight" (OR 3.91, 95%CI 1.2-12.6, P=0.02), and "Dioestrus" (OR 5.53, 95%CI 1.9-16.3, P=0.002) were statistically significant. The findings in this study support feeding not exclusively balanced commercial dog food, overweight, treats abuse, and diestrus, as main CDM risk factors. Moreover, those results give subside for preventive care studies against CDM development. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Elder Abuse in the African Diaspora: A Review.

    Science.gov (United States)

    Mouton, Charles P; Southerland, Janet H

    2017-01-01

    As with many other populations, abuse of older adults is a growing problem across the Africa Diaspora. Modernization and urbanization are eroding the traditional values of respect for older adults. Also, older adults living in environments with limited social and economic resources, and having no means of economic support create a recipe for elder abuse and neglect. This article reviews the current literature on the epidemiology, risk factors, and interventions used for elder abuse across the African Diaspora. Reports of elder abuse range from 24.9% to 81.1% across the Diaspora. Risk factors include cognitive and physical impairment, social isolation, lack of resources and widowhood. Community-based programs using the unique social networks of older populations of African descent can provide a venue to improve caregiver training and support, reinforce traditional filial and informal caregiving practices, increase the utilization of available governmental and institutional. Copyright © 2017 National Medical Association. Published by Elsevier Inc. All rights reserved.

  7. The contribution of stress, cultural factors, and sexual identity on the substance abuse, violence, HIV, and depression syndemic among Hispanic men.

    Science.gov (United States)

    González-Guarda, Rosa Maria; McCabe, Brian E; Leblanc, Natalie; De Santis, Joseph P; Provencio-Vasquez, Elias

    2016-10-01

    The purpose of this study was to confirm the substance abuse, violence, HIV, and depression syndemic among Hispanic men, and to test whether stress and sociocultural factors, including acculturation, family support, and sexual orientation, predict this syndemic. A cross-sectional survey was administered to 164 Hispanic men using standardized measures for Hispanic Stress (Cervantes, Padilla, & Salgado de Snyder, 1991), substance abuse (Kelly et al., 1994), violence (Peragallo et al., 2005), risk for HIV (González-Guarda, Peragallo, Urrutia, Vasquez, & Mitrani, 2008), and depression (Center for Epidemiologic Studies Scale, CES-D; Radloff, 1977). Results from Structural Equation Modeling (SEM) supported the syndemic factor among Hispanic men. While family/cultural stress and homosexual identity were risk factors for the syndemic factor, family support was protective. More longitudinal research is needed to identify influences on the syndemic factor among diverse Hispanic communities. Interventions that address stress and enhance family supports may show promise in addressing and preventing syndemics among Hispanic men. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  8. Risk factors of suicide attempts by poisoning: review

    Directory of Open Access Journals (Sweden)

    Maria Cláudia da Cruz Pires

    2014-04-01

    Full Text Available Introduction: Suicide, a complex and universal human phenomenon, is a major public health problem. This study reviewed the literature about the major risk factors associated with suicide attempts by poisoning. Methods: An integrative review of the literature was performed in databases (LILACS, PubMed and MEDLINE to search for studies published between 2003 and 2013, using the following keywords: suicide, attempted; poisoning; risk factors. Inclusion criteria were: original study with abstract, sample of adults, and attempted suicide by poisoning in at least 50% of the study population. Results: Two hundred and nineteen studies were retrieved and read by two independent examiners, and 22 were included in the study. The main risk factors for suicide attempts by poisoning were female sex, age 15-40 years, single status, little education, unemployment, drug or alcohol abuse or addiction, psychiatric disorder and psychiatric treatment using antidepressants. Conclusion: Further prospective studies should be conducted to confirm these risk factors or identify others, and their findings should contribute to planning measures to prevent suicide attempts.

  9. Factors influencing children to self-disclose sexual abuse.

    Science.gov (United States)

    Paine, Mary L; Hansen, David J

    2002-03-01

    Self-disclosure by victims of child sexual abuse (CSA) is critical to initiate legal and therapeutic intervention. Unfortunately, research indicates that lengthy delays in disclosure and even nondisclosure are common. A comprehensive review of the clinical and research literature on CSA and an overview of related bodies of literature was conducted. Areas addressed include the context of sexual abuse as it relates to disclosure, the context and elements of children's disclosures, motivational factors inhibiting disclosure, and models of the disclosure process. Ancillary and analogue research on secrecy and disclosure are also reviewed. Implications for future research and practice are discussed.

  10. Factors associated with multidisciplinary case conference outcomes in children admitted to a regional hospital in Hong Kong with suspected child abuse: a retrospective case series with internal comparison.

    Science.gov (United States)

    Lo, W C; Fung, G Pg; Cheung, P Ch

    2017-10-01

    In all cases of suspected child abuse, accurate risk assessment is vital to guide further management. This study examined the relationship between risk factors in a risk assessment matrix and child abuse case conference outcomes. Records of all children hospitalised at United Christian Hospital in Hong Kong for suspected child abuse from January 2012 to December 2014 were reviewed. Outcomes of the hospital abuse work-up as concluded in the Multi-Disciplinary Case Conference were categorised as 'established', 'high risk', or 'not established'. All cases of 'established' and 'high risk' were included in the positive case conference outcome group and all cases of 'not established' formed the comparison group. On the other hand, using the Risk Assessment Matrix developed by the California State University, Fresno in 1990, each case was allotted a matrix score of low, intermediate, or high risk in each of 15 matrix domains, and an aggregate matrix score was derived. The effect of individual matrix domain on case conference outcome was analysed. Receiver operating characteristic curve analysis was used to examine the relationship between case conference outcome and aggregate matrix score. In this study, 265 children suspected of being abused were included, with 198 in the positive case conference outcome group and 67 in the comparison group. Three matrix domains (severity and frequency of abuse, location of injuries, and strength of family support systems) were significantly associated with case conference outcome. An aggregate cut-off score of 23 yielded a sensitivity of 91.4% and specificity of 38.2% in relation to outcome of abuse categorisation. Risk assessment should be performed when handling suspected child abuse cases. A high aggregate score should arouse suspicion in all disciplines managing child abuse cases.

  11. Psychosocial Factors that Shape Substance Abuse and Related Mental Health of Women Military Veterans who Use Community-Based Services.

    Science.gov (United States)

    Evans, Elizabeth A; Glover, Dawn L; Washington, Donna L; Hamilton, Alison B

    2018-02-27

    Women Veterans who use the Veterans Health Administration (VA) have high rates of substance abuse and poorer health than non-Veteran women. Less is known about the psychosocial needs of women Veterans who seek care in non-VA settings. We provide a grounded description of factors that impact substance abuse, mental health, and related quality of life of women Veterans who use non-VA community-based health and social services. Utilizing a mixed methods design, we conducted semi-structured in-person interviews with 22 women Veterans in Los Angeles in 2013-2015. The current health of these women Veterans was shaped by substance abuse and several other factors, including: histories of trauma (in childhood, during military service) and discrimination, and associated mental health conditions; post-military socio-economic stressors; shifting social roles and adverse social support; and lost personal identity after military service. Psychosocial factors collectively underscore areas in which delivery of health and social services to women Veterans being treated in non-VA settings could be improved: (1) diffuse, implement, and sustain evidence-based gender-sensitive substance abuse treatment; (2) address traumas contributing to poor health; (3) recognize stress proliferation processes erode women's capacity to access healthcare or cope with stressors in healthy ways; (4) champion women Veterans who embody resilience and thereby can help others to form empowered personal identities of health and wellness. Findings can inform interventions and services that ameliorate vulnerability to substance abuse and other health risks among women Veterans.

  12. Personality traits and childhood trauma as correlates of metabolic risk factors: the Netherlands Study of Depression and Anxiety (NESDA).

    Science.gov (United States)

    van Reedt Dortland, Arianne K B; Giltay, Erik J; van Veen, Tineke; Zitman, Frans G; Penninx, Brenda W J H

    2012-01-10

    Personality and childhood trauma may affect cardiovascular disease (CVD) risk. However, evidence for an association with metabolic risk factors for CVD is limited and ambiguous. Moreover, despite their interrelatedness, personality and childhood trauma were not yet studied simultaneously. Therefore, we aimed to explore whether personality and childhood trauma are correlates of metabolic risk factors. Among 2755 participants of the Netherlands Study of Depression and Anxiety (NESDA), we investigated through linear regression models whether Big Five personality traits (i.e., extraversion, openness, agreeableness, neuroticism and conscientiousness) and childhood trauma type (i.e., emotional neglect, and psychological, physical and sexual abuse) were correlates of metabolic risk factors (i.e., lipids, waist circumference (WC), glucose and blood pressure). Basic covariates (i.e., age, sex and income level), lifestyle, severity of depressive symptoms and years of education were taken into account. Openness was the most robust favorable correlate, and sexual abuse was the most robust unfavorable correlate of lipids and WC, and of overall metabolic risk (β=-.070; pchildhood sexual abuse are at higher risk of dyslipidemia and abdominal obesity. Copyright © 2011 Elsevier Inc. All rights reserved.

  13. Parents' perceptions about child abuse and their impact on physical and emotional child abuse: A study from primary health care centers in Riyadh, Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Mohammed N Al Dosari

    2017-01-01

    CONCLUSION: The causes of child abuse and neglect are complex. Though detecting child abuse may be difficult in primary care practice, many risk factors can be identified early. Parents' attitudes can be measured, and prevention initiatives, such as screening and counseling for parents of children at risk, can be developed and incorporated into primary care practice.

  14. Risk factors for suicide completion in major depression: a case-control study of impulsive and aggressive behaviors in men.

    Science.gov (United States)

    Dumais, A; Lesage, A D; Alda, M; Rouleau, G; Dumont, M; Chawky, N; Roy, M; Mann, J J; Benkelfat, C; Turecki, Gustavo

    2005-11-01

    Major depression is a major risk factor for suicide. However, not all individuals with major depression commit suicide. Impulsive and aggressive behaviors have been proposed as risk factors for suicide, but it remains unclear whether their effect on the risk of suicide is at least partly explained by axis I disorders commonly associated with suicide, such as major depression. With a case-control design, a comparison of the level of impulsive and aggressive behaviors and the prevalence of associated psychopathology was carried out with control for the presence of primary psychopathology. One hundred and four male suicide completers who died during an episode of major depression and 74 living depressed male comparison subjects were investigated with proxy-based interviews by using structured diagnostic instruments and personality trait assessments. The authors found that current (6-month prevalence) alcohol abuse/dependence, current drug abuse/dependence, and cluster B personality disorders increased the risk of suicide in individuals with major depression. Also, higher levels of impulsivity and aggression were associated with suicide. An analysis by age showed that these risk factors were more specific to younger suicide victims (ages 18-40). A multivariate analysis indicated that current alcohol abuse/dependence and cluster B personality disorder were two independent predictors of suicide. Impulsive-aggressive personality disorders and alcohol abuse/dependence were two independent predictors of suicide in major depression, and impulsive and aggressive behaviors seem to underlie these risk factors. A developmental hypothesis of suicidal behavior, with impulsive and aggressive behaviors as the starting point, is discussed.

  15. Lost in transition? Substance abuse and risk of labour market exclusion from youth to adulthood

    Directory of Open Access Journals (Sweden)

    Torild Hammer

    2011-03-01

    Full Text Available Despite low levels of youth unemployment in Norway, concerns have been raised about the high numbers of youth in inactivity, receiving health related social security benefits. It is argued that parts of the system of social security may work as welfare traps. OECD recommends welfare policies with the overall aim of fostering youth employability, not benefit dependency. In this article we use a unique combination of register data and survey data from the panel survey “work, lifestyle and health”. This survey follows a representative sample of the cohorts born between 1965 and 1968 from 1985 through follow-ups in 1987, 1989, 1993 and 2003. This allows us to follow individual life trajectories from ages 17-20 to 35-39. The aim of the article is first to study the impact of substance abuse upon risk of receiving social assistance, since previous research has found that receiving social assistance increases the probability of labour market exclusion in adulthood. Second, we analyse the impact of receiving social assistance, to have mental health problems and substance abuse in youth and consequences for labour market integration in adulthood. Analyses reveal that neither cannabis use nor alcohol consumption in youth have a direct effect on the risk of labour market exclusion in adulthood. However, cannabis use increases the probability of receiving social assistance, which in turn increases risk of labour market exclusion in adulthood. Mental health problems in youth increase risk for later labour market exclusion, but these effects are mediated through factors like problem behaviour related to alcohol abuse and the use of illegal drugs other than cannabis. Receiving social assistance in youth has long time effects on the risk of labour market exclusion, especially for individuals from the lower socioeconomic groups.

  16. Online sexual behaviours among Swedish youth: associations to background factors, behaviours and abuse.

    Science.gov (United States)

    Jonsson, Linda S; Bladh, Marie; Priebe, Gisela; Svedin, Carl Göran

    2015-10-01

    Sexual activity online may result in positive experiences for young people, or lead them to engage in risky behaviours possibly resulting in sexual assault or abuse. The aim of our study was to investigate associations between online sexual behaviours among Swedish youth and background factors as well as aspects of well-being. The behaviours investigated were: having sex online with a contact met online, having sex with an online contact offline, posting sexual pictures online, and selling sex online. We used data from a representative sample of 3,432 Swedish youth who were asked about their lifetime experiences as well as their experiences within the previous year. We hypothesized that more advanced online sexual behaviours were associated with more problematic background factors, worse psychosocial well-being and riskier behaviours in general. Bivariate relationships were evaluated followed by a multiple logistic regression model. Our data suggested that most Swedish youth do not perform any of the assessed online sexual behaviours. Young people who reported online sexual behaviour showed a more problematic background, rated their health as poorer, had a more sexualized life and had experienced more sexual or physical abuse. Professionals who work with young people need to help them better evaluate potential risks online and offer support when needed. Youths who sell sex online are especially at risk and need extra attention, as they might be in greater need of protection and therapeutic support.

  17. Modifiable risk factors of ecstasy use: risk perception, current dependence, perceived control, and depression

    Science.gov (United States)

    Leung, Kit Sang; Ben Abdallah, Arbi; Cottler, Linda B.

    2009-01-01

    Risk perception, perceived behavioral control of obtaining ecstasy (PBC-obtaining), current ecstasy dependence, and recent depression have been associated with past ecstasy use, however, their utility in predicting ecstasy use has not been demonstrated. This study aimed to determine whether these four modifiable risk factors could predict ecstasy use after controlling for socio-demographic covariates and recent polydrug use. Data from 601 ecstasy users in the National Institute on Drug Abuse funded TriCity Study of Club Drug Use, Abuse and Dependence were analyzed using multivariate logistic regression. Participants were interviewed twice within a 2-week period using standardized instruments. Thirteen percent (n=80) of the participants reported using ecstasy between the two interviews. Low risk perception, high PBC-obtaining (an estimated ecstasy procurement time ecstasy dependence were statistically associated with ecstasy use between the two interviews. Recent depression was not a significant predictor. Despite not being a target predictor, recent polydrug use was also statistically associated with ecstasy use. The present findings may inform the development of interventions targeting ecstasy users. PMID:19880258

  18. Elder abuse within the family environment in the Azores Islands

    OpenAIRE

    Carmona-Torres, Juan Manuel; Carvalhal-Silva, Rosa María; Viera-Mendes, Maria Helena; Recio-Andrade, Beatriz; Goergen, Thomas; Rodríguez-Borrego, María Aurora

    2017-01-01

    ABSTRACT Objectives: to dimension abuse against vulnerable adults within the family and community environment in the Azores Islands, identify risk factors for abuse and describe the profile of an abused elder. Method: descriptive cross-sectional study. Random sampling. The instruments used were: clinical histories of the users, Mini-Mental State Examination, Index of Independence in Basic Activities of Daily Living, Family APGAR Scale, Elder Abuse Suspicion Index and Social Work Assessment ...

  19. Malaysian adolescent students' needs for enhancing thinking skills, counteracting risk factors and demonstrating academic resilience

    Science.gov (United States)

    Kuldas, Seffetullah; Hashim, Shahabuddin; Ismail, Hairul Nizam

    2015-01-01

    The adolescence period of life comes along with changes and challenges in terms of physical and cognitive development. In this hectic period, many adolescents may suffer more from various risk factors such as low socioeconomic status, substance abuse, sexual abuse and teenage pregnancy. Findings indicate that such disadvantaged backgrounds of Malaysian adolescent students lead to failure or underachievement in their academic performance. This narrative review scrutinises how some of these students are able to demonstrate academic resilience, which is satisfactory performance in cognitive or academic tasks in spite of their disadvantaged backgrounds. The review stresses the need for developing a caregiving relationship model for at-risk adolescent students in Malaysia. Such a model would allow educators to meet the students' needs for enhancing thinking skills, counteracting risk factors and demonstrating academic resilience. PMID:25663734

  20. Child maltreatment in the "children of the nineties" a longitudinal study of parental risk factors.

    Science.gov (United States)

    Sidebotham, P; Golding, J

    2001-09-01

    To identify and validate factors within the parental background affecting risk of child maltreatment. A nested case-control study based on the Avon Longitudinal Study of Parents and Children ("Children of the Nineties"), a cohort of children born in Avon in 1991 through 1992. Data on the childhood and psychiatric histories of the parents, along with other data on the social and family environments, have been collected through postal questionnaires from early antenatal booking onwards. Out of 14,138 participating children, 162 have been identified as having been maltreated. Using logistic regression analysis, significant risk factors within the mothers' backgrounds were age factors in the fathers' backgrounds were age factors on univariate, but not multivariate analysis included a parental history of childhood physical abuse; divorce or separation of the mother's parents; a maternal history of having been in care, or separated from her mother; parental alcohol or drug abuse; and a maternal history of depression. This study, the first of its kind in the UK, supports the findings of others that parental age, educational achievement, and a history of psychiatric illness are of prime importance in an understanding of child maltreatment. With the exception of maternal sexual abuse, a history of abuse in childhood is not significant once adjusted for other background factors. The study suggests that psychodynamic models are inadequate to explain child maltreatment, and wider models incorporating other ecological domains are needed.

  1. Factors affecting visualization of posterior rib fractures in abused infants

    International Nuclear Information System (INIS)

    Kleinman, P.K.; Adams, V.I.; Blackbourne, B.D.; Marks, S.C.

    1987-01-01

    Rib fractures in abused infants commonly occur in the posterior rib arcs. Fractures occurring near the costovertebral articulations are usually identified radiographically only once callus has formed. To assess the factors influencing the visibility of fractures near the costovertical articulations, the authors studied 103 posterior rib fractures occurring in 16 abused infants. Radiologic findings were correlated with CT findings and pathologic material from nine ribs in four patients. The limited visibility of fractures relates to (1) the frequent superimposition of the transverse process over the rib fracture site, (2) a fracture line that crosses at an obliquity to the x-ray beam, and (3) nondisplacement of rib fragments due to preservation of the posterior periosteum. Fresh rib fractures invisible on a frontal projection may be clearly defined on axial CT scans, or on postmortem radiographs. A knowledge of the factors influencing the visibility of these important injuries is useful in planning an appropriate diagnostic evaluation of suspected infant abuse

  2. The Relationship of Social Problem-Solving Skills and Dysfunctional Attitudes with Risk of Drug Abuse among Dormitory Students at Isfahan University of Medical Sciences.

    Science.gov (United States)

    Nasrazadani, Ehteram; Maghsoudi, Jahangir; Mahrabi, Tayebeh

    2017-01-01

    Dormitory students encounter multiple social factors which cause pressure, such as new social relationships, fear of the future, and separation from family, which could cause serious problems such as tendency toward drug abuse. This research was conducted with the goal to determine social problem-solving skills, dysfunctional attitudes, and risk of drug abuse among dormitory students of Isfahan University of Medical Sciences, Iran. This was a descriptive-analytical, correlational, and cross-sectional research. The research sample consisted of 211 students living in dormitories. The participants were selected using randomized quota sampling method. The data collection tools included the Social Problem-Solving Inventory (SPSI), Dysfunctional Attitude Scale (DAS), and Identifying People at Risk of Addiction Questionnaire. The results indicated an inverse relationship between social problem-solving skills and risk of drug abuse ( P = 0.0002), a direct relationship between dysfunctional attitude and risk of drug abuse ( P = 0.030), and an inverse relationship between social problem-solving skills and dysfunctional attitude among students ( P = 0.0004). Social problem-solving skills have a correlation with dysfunctional attitudes. As a result, teaching these skills and the way to create efficient attitudes should be considered in dormitory students.

  3. Emotional Awareness Moderates the Relationship Between Childhood Abuse and Borderline Personality Disorder Symptom Factors.

    Science.gov (United States)

    Westbrook, John; Berenbaum, Howard

    2017-07-01

    To examine pathways to borderline personality disorder (BPD), focusing on childhood abuse and emotional attention and clarity. Among 293 community residents (mean age = 43.1; 53.9% female), measured associations between the BPD symptom factors of disturbed relatedness, affective dysregulation, and behavioral dysregulation and (a) childhood abuse (emotional, physical, and sexual); (b) emotional attention and clarity; and (c) negative affect, using structured interviews, the Schedule for Non-Adaptive and Adaptive Personality-2, the Trait Meta Mood Scale, and the Positive and Negative Affect Scale, respectively. All forms of childhood abuse were associated with BPD symptom factors. Emotional attention and clarity moderated the effects of childhood physical and emotional abuse on behavioral dysregulation and disturbed relatedness. All results held when controlling for negative affect. The relations between childhood abuse and BPD are robust. Emotional attention and clarity may help elucidate the links between childhood abuse and BPD. © 2016 Wiley Periodicals, Inc.

  4. Prior childhood sexual abuse in mothers of sexually abused children.

    Science.gov (United States)

    Oates, R K; Tebbutt, J; Swanston, H; Lynch, D L; O'Toole, B I

    1998-11-01

    To see if mothers who were sexually abused in their own childhood are at increased risk of their children being sexually abused and to see if prior sexual abuse in mothers affects their parenting abilities. Sixty-seven mothers whose children had been sexually abused by others and 65 control mothers were asked about sexual abuse in their own childhood. The sexually abused children of mothers who had been sexually abused in their own childhood were compared with the sexually abused children of mothers who had not suffered child sexual abuse as children. Comparisons were made on self-esteem, depression and behavior in the children. Thirty-four percent of mothers of sexually abused children gave a history of sexual abuse in their own childhoods, compared with 12% of control mothers. Assessment of the sexually abused children for self-esteem, depression and behavior at the time of diagnosis, after 18 months and after 5 years showed no difference in any of these measures at any of the three time intervals between those whose mothers had suffered child sexual abuse and those whose mothers had not been abused. In this study, sexual abuse in a mother's own childhood was related to an increased risk of sexual abuse occurring in the next generation, although prior maternal sexual abuse did not effect outcome in children who were sexually abused.

  5. The interplay of trait anger, childhood physical abuse, and alcohol consumption in predicting intimate partner aggression.

    Science.gov (United States)

    Maldonado, Rosalita C; Watkins, Laura E; DiLillo, David

    2015-04-01

    The current study examined three well-established risk factors for intimate partner aggression (IPA) within Finkel and Eckhardt's I(3) model, including two impellance factors-trait anger and childhood physical abuse history-and the disinhibiting factor of alcohol consumption. Participants were 236 male and female college students in a committed heterosexual dating relationship who completed a battery of self-report measures assessing childhood physical abuse, trait anger, alcohol consumption, and IPA perpetration. Results revealed a significant three-way interaction showing that as the disinhibition factor alcohol consumption increased, the interaction of the two impelling factors, trait anger and childhood physical abuse, became increasingly more positive. Individuals who had high levels of childhood physical abuse and alcohol consumption were at greater risk of IPA perpetration when trait anger was high. Consistent with the I(3) model, these findings suggest that trait anger and a history of childhood physical abuse may increase tendencies to aggress against one's partner, whereas alcohol consumption may reduce individuals' abilities to manage these aggressive tendencies. The importance of interplay among these risk factors in elevating IPA risk is discussed, as are the implications for clinicians working with male and female IPA perpetrators. © The Author(s) 2014.

  6. More than Poverty—Teen Pregnancy Risk and Reports of Child Abuse Reports and Neglect

    Science.gov (United States)

    Lara, Gerassi; Melissa, Jonson-Reid; Katie, Plax; Brett, Drake

    2015-01-01

    Purpose To compare risk for teen pregnancies between children living in poverty with no Child Protection Services (CPS) report history, and those in poverty with a history of CPS report. Methods Children selected from families in poverty, both with and without CPS report histories were prospectively followed from 1993–2009 using electronic administrative records from agencies including child protective services, emergency departments, Medicaid services and juvenile courts. A total of 3281 adolescent females were followed until age 18. Results For teens with history of poverty only, 16.8% had been pregnant at least once by age 17. In teens with history of both poverty and report of child abuse or neglect, 28.9% had been pregnant at least once by age 17. While multivariate survival analyses revealed several other significant factors at the family and youth services levels, a report of maltreatment remained significant (about a 66% higher risk). Conclusions Maltreatment is a significant risk factor for teen pregnancy among low income youth even after controlling for neighborhood disadvantage, other caregiver risks and indicators of individual emotional and behavioral problems. PMID:26206437

  7. Behavioral Couples Treatment for Substance Use Disorder: Secondary Effects on the Reduction of Risk for Child Abuse.

    Science.gov (United States)

    Kelley, Michelle L; Bravo, Adrian J; Braitman, Abby L; Lawless, Adrienne K; Lawrence, Hannah R

    2016-03-01

    Risk for child abuse was examined prior to and after behavioral couples treatment (BCT) among 61 couples in which one or both parents were diagnosed with substance use disorder (SUD). All couples were residing with one or more school-age children. Mothers and fathers completed pretreatment, post-intervention, and 6-month post-intervention follow-up assessments. Results of piecewise latent growth models tested whether the number of BCT sessions attended and number of days abstinent from drugs and alcohol influenced relationship satisfaction and its growth over time, and in turn if relationship satisfaction and change in relationship satisfaction influenced risk for child abuse. For both mothers and fathers, attending more BCT sessions lead to a direct increase in relationship satisfaction, which in turn led to stronger reductions in risk for child abuse. This effect was maintained from the post-intervention through the 6-month post-intervention follow-up. For fathers, number of days abstinent significantly influenced reduction in child abuse potential at post-intervention via relationship satisfaction. This indirect effect was not present for mothers. The overall benefits of BCT on mothers' and fathers' risk for child abuse suggest that BCT may have promise in reducing risk for child abuse among couples in which one or both parents have SUD. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Childhood sexual abuse and attachment: An intergenerational perspective.

    Science.gov (United States)

    Kwako, Laura E; Noll, Jennie G; Putnam, Frank W; Trickett, Penelope K

    2010-07-01

    Childhood sexual abuse (CSA) is a recognized risk factor for various negative outcomes in adult survivors and their offspring. We used the Dynamic-Maturational Model of attachment theory as a framework for exploring the impact of maternal CSA on children's attachment relationships in the context of a longitudinal sample of adult survivors of CSA and non-abused comparison mothers and their children. Results indicated that children of CSA survivors were more likely to have extreme strategies of attachment than the children of non-abused mothers. However, because both groups were at socioeconomic risk, both were typified by anxious attachment. Explanations for findings and implications for children's development are explored.

  9. Gender differences in substance abuse, PTSD and intentional self-harm among veterans health administration patients.

    Science.gov (United States)

    Gradus, Jaimie L; Leatherman, Sarah; Curreri, Andrew; Myers, Lisa G; Ferguson, Ryan; Miller, Matthew

    2017-02-01

    Epidemiologic studies have reported substance abuse and posttraumatic stress disorder (PTSD) diagnoses as risk factors for suicide among Veterans Health Administration (VHA) patients. Research on risk factors for suicide may not generalize to our understanding of non-fatal intentional self-harm (ISH), given the evidence that these outcomes have unique risk factors. The aims of this study were to examine (1) gender-stratified rates of non-fatal ISH in VHA patients with alcohol abuse/dependence, drug abuse/dependence, and PTSD and (2) gender-stratified interaction between alcohol abuse and dependence and drug abuse and dependence and PTSD in predicting non-fatal ISH. Participants include all VHA care users who received a PTSD diagnosis in Massachusetts from 2000 to 2008 (n=16,004) and an age- and gender-matched comparison group (n=52,502). Data were obtained from the VHA administrative registries. We found evidence of stronger interactions between substance abuse diagnoses and PTSD in predicting non-fatal ISH for females than for males. The interaction contrast (IC) for alcohol abuse and dependence and PTSD in predicting non-fatal ISH among female VHA patients was 62.35/100,000 person-years; for male VHA patients the comparable IC was 21.49/100,000 person-years. For female VHA patients the IC for drug abuse and dependence and PTSD predicting ISH was 256.33/100,000 person-years; no interaction was observed for male VHA patients. This study contributes to the scant literature on gender differences in substance abuse and PTSD among VHA patients. The findings highlight comorbid diagnoses as particularly important risk factors for non-fatal ISH among female VHA patients. Published by Elsevier B.V.

  10. Teen birth rates in sexually abused and neglected females.

    Science.gov (United States)

    Noll, Jennie G; Shenk, Chad E

    2013-04-01

    Prospectively track teen childbirths in maltreated and nonmaltreated females and test the hypothesis that child maltreatment is an independent predictor of subsequent teen childbirth over and above demographic characteristics and other risk factors. Nulliparous adolescent females (N = 435) aged 14 to 17 years were assessed annually through age 19 years. Maltreated females were referred by Child Protective Services agencies for having experienced substantiated sexual abuse, physical abuse, or neglect within the preceding 12 months. Comparison females were matched on race, family income, age and family constellation. Teen childbirth was assessed via self-report during annual interviews. Births were confirmed using hospital delivery records. Seventy participants gave birth during the study, 54 in the maltreated group and 16 in the comparison group. Maltreated females were twice as likely to experience teen childbirth after controlling for demographic confounds and known risk factors (odds ratio = 2.17, P = 0.01). Birth rates were highest for sexually abused and neglected females. Sexual abuse and neglect were both independent predictors of teen childbirth after controlling for demographic confounds, other risk factors and alternative forms of maltreatment occurring earlier in development. Results provide evidence that sexual abuse and neglect are unique predictors of subsequent teen childbirth. Partnerships between protective service providers and teen childbirth prevention strategists hold the best promise for further reducing the US teen birth rate. Additional research illuminating the pathways to teen childbirth for differing forms of maltreatment is needed so that tailored interventions can be realized.

  11. A population-based Swedish Twin and Sibling Study of cannabis, stimulant and sedative abuse in men.

    Science.gov (United States)

    Kendler, Kenneth S; Ohlsson, Henrik; Maes, Hermine H; Sundquist, Kristina; Lichtenstein, Paul; Sundquist, Jan

    2015-04-01

    Prior studies, utilizing interview-based assessments, suggest that most of the genetic risk factors for drug abuse (DA) are non-specific with a minority acting specifically on risk for abuse of particular psychoactive substance classes. We seek to replicate these findings using objective national registry data. We examined abuse of cannabis, stimulants (including cocaine) and sedatives ascertained from national Swedish registers in male-male monozygotic (1720 pairs) and dizygotic twins (1219 pairs) combined with near-age full siblings (76,457 pairs) to provide sufficient power. Modeling was performed using Mx. A common pathway model fitted better than an independent pathway model. The latent liability to DA was highly heritable but also influenced by shared environment. Cannabis, stimulant and sedative abuse all loaded strongly on the common factor. Estimates for the total heritability for the three forms of substance abuse ranged from 64 to 70%. Between 75 and 90% of that genetic risk was non-specific, coming from the common factor with the remainder deriving from substance specific genetic risk factors. By contrast, all of the shared environmental effects, which accounted for 18-20% of the variance in liability, were non-specific. In accord with prior studies based on personal interviews, the large preponderance of genetic risk factors for abuse of specific classes of psychoactive substance are non-specific. These results suggest that genetic variation in the primary sites of action of the psychoactive drugs, which differ widely across most drug classes, play a minor role in human individual differences in risk for DA. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. Risk Factors and Prevention Strategies for Suicide among the Elderly

    Science.gov (United States)

    Franks, Rebecca; Burnett, Donna O.; Evans, Retta R.

    2012-01-01

    Suicide is a preventable public health concern affecting the nation as the 10th leading cause of death. The prevalence of suicide among the elderly is higher than any other group. Risk factors attributed to this phenomenon are depression, social isolation, substance abuse, poor physical health or function, financial stress, and access to lethal…

  13. [Association between supporting child and elder abuse in China].

    Science.gov (United States)

    Wen, X; Hu, Y K; He, P; Wang, Z J; Zheng, X Y

    2017-04-10

    Objective: To examine the association between child-supporting from their folks and elder abuse in China so as to provide evidence for prevention and control of elder abuse. Methods: Based on the third survey on the Status of Chinese women, organized by the All-China Women's Federation and the National Bureau of Statistics, 7 159 residents aged 65 and older were included and general information on supporting child and elder abuse were gathered. Chi-square test and logistic regression were used to investigate the association between supporting child from elderly and elder abuse. Results: The overall prevalence of elder abuse was 6.71 % . Risks of elder people being abused by family numbers varied from different supporting child situations. After adjusting for potential confounding factors, ORs for the elderly appeared as follows: OR =1.99 (95 %CI : 1.56-2.54) for those who only providing support to male children; OR =2.07 (95 %CI : 1.51-3.79) for those only providing support to the female offspring and OR =2.32 (95 % CI : 1.72-3.13) for those who did not support their children regardless of their sex identity. Elderly who provided support to their children on both sexes were exposed to lower risk of being abused than those who only supporting their male offspring. There was no significant difference appearing on the risk of elder abuse between those elderly who only supporting the male ( OR =1.00) or the female offspring ( OR =1.04, 95 % CI : 0.63-1.71), among all the participants in our study. However, such associations were different in urban and rural areas. Conclusions: High prevalence of abuse was seen in China. The pattern of supporting child was associated with risk of elder abuse. Elderly who showed poor support to their children were under higher risk of being abused by their family members.

  14. Prescription Drug Abuse

    Science.gov (United States)

    ... drug abuse. And it's illegal, just like taking street drugs. Why Do People Abuse Prescription Drugs? Some people abuse prescription drugs ... common risk of prescription drug abuse is addiction . People who abuse ... as if they were taking street drugs. That's one reason most doctors won't ...

  15. Association between alcohol, cannabis, and other illicit substance abuse and risk of developing schizophrenia: a nationwide population based register study.

    Science.gov (United States)

    Nielsen, S M; Toftdahl, N G; Nordentoft, M; Hjorthøj, C

    2017-07-01

    Several studies have examined whether use of substances can cause schizophrenia. However, due to methodological limitations in the existing literature (e.g. selection bias and lack of adjustment of co-abuse) uncertainties still remain. We aimed to investigate whether substance abuse increases the risk of developing schizophrenia, addressing some of these limitations. The longitudinal, nationwide Danish registers were linked to establish a cohort of 3 133 968 individuals (105 178 673 person-years at risk), identifying 204 505 individuals diagnosed with substance abuse and 21 305 diagnosed with schizophrenia. Information regarding substance abuse was extracted from several registers and did not include psychotic symptoms caused by substance abuse in the definition. This resulted in a large, generalizable sample of exposed individuals. The data was analysed using Cox regression analyses, and adjusted for calendar year, gender, urbanicity, co-abuse, other psychiatric diagnosis, parental substance abuse, psychiatric history, immigration and socioeconomic status. A diagnosis of substance abuse increased the overall risk of developing schizophrenia [hazard ratio (HR) 6.04, 95% confidence interval (CI) 5.84-6.26]. Cannabis (HR 5.20, 95% CI 4.86-5.57) and alcohol (HR 3.38, 95% CI 3.24-3.53) presented the strongest associations. Abuse of hallucinogens (HR 1.86, 95% CI 1.43-2.41), sedatives (HR 1.68, 95% CI 1.49-1.90), and other substances (HR 2.85, 95% CI 2.58-3.15) also increased the risk significantly. The risk was found to be significant even 10-15 years subsequent to a diagnosis of substance abuse. Our results illustrate robust associations between almost any type of substance abuse and an increased risk of developing schizophrenia later in life.

  16. Growth recovery lines are more common in infants at high vs. low risk for abuse

    International Nuclear Information System (INIS)

    Zapala, Matthew A.; Tsai, Andy; Kleinman, Paul K.

    2016-01-01

    Growth recovery lines, also known as growth arrest lines, are transverse radiodense metaphyseal bands that develop due to a temporary arrest of endochondral ossification caused by local or systemic insults. To determine if growth recovery lines are more common in infants at high risk versus low risk for abuse. Reports of American College of Radiology compliant skeletal surveys (1999-2013) were reviewed with clinical records. Infants at low risk for abuse had a skull fracture without significant intracranial injury, history of a fall and clinical determination of low risk (child protection team/social work assessment). Infants at high risk had significant intracranial injury, retinal hemorrhages, other skeletal injuries and clinical determination of high risk. There were 52 low-risk infants (mean: 4.7 months, range: 0.4-12 months) and 21 high-risk infants (mean: 4.2 months, range: 0.8-9.1 months). Two blinded radiologists independently evaluated the skeletal survey radiographs of the knees/lower legs for the presence of at least one growth recovery line. When growth recovery lines are scored as probably present or definitely present, their prevalence in the low-risk group was 38% (standard deviation [SD] = 8%; reader 1 = 17/52, reader 2 = 23/52) vs. 71% (SD = 7%; reader 1 = 16/21, reader 2 = 14/21) in the high-risk group (P < 0.001; odds ratio 4.0, 95% CI: 1.7-9.5). Growth recovery lines are encountered at a significantly higher rate in infants at high risk vs. low risk for abuse. This suggests that abused infants are prone to a temporary disturbance in endochondral ossification as a result of episodic physiological stresses. (orig.)

  17. Is the cluster risk model of parental adversities better than the cumulative risk model as an indicator of childhood physical abuse?: findings from two representative community surveys.

    Science.gov (United States)

    Fuller-Thomson, E; Sawyer, J-L

    2014-01-01

    Screening strategies for childhood physical abuse (CPA) need to be improved in order to identify those most at risk. This study uses two regionally representative community samples to examine whether a cluster or cumulative model of risk indicators (i.e. parental divorce, parental unemployment, and parental addictions) explains a larger proportion of the variation in CPA. Data were drawn from Statistics Canada's National Population Health Survey (1994-1995) and Canadian Community Health Survey 3.1 (2005). Response rates were greater than 80% in both samples. Each survey had approximately 13,000 respondents aged 18 and over who answered questions about the above adverse childhood experiences. A gradient was shown with similar outcomes in each data set. Only 3.4% of adults who experienced none of the three risk indicators reported they had been physically abused during childhood or adolescence. The prevalence of CPA was greater among those who experienced parental divorce alone (8.3%-10.7%), parental unemployment alone (8.9%-9.7%) or parental addictions alone (18.0%-19.5%). When all three risk indicators were present, the prevalence of CPA ranged from 36.0%-41.0% and the age-sex-race adjusted odds were greater than 15 times that of individuals with none of the three risk indicators. The cluster model explained a statistically significantly larger proportion of the variation than the cumulative model although the difference between the two models was modest. For the purposes of parsimony, the cumulative model may be the better alternative. Adults who were exposed to two or more childhood risk indicators were much more likely to report that they were physically abused during their childhood than those with only one or no risk factors. Medical professionals may use this information on cumulative risk factors to more effectively target screening for potential CPA. Future research should include prospective studies. © 2012 John Wiley & Sons Ltd.

  18. ANOTHER "LETHAL TRIAD"-RISK FACTORS FOR VIOLENT INJURY AND LONG-TERM MORTALITY AMONG ADULT VICTIMS OF VIOLENT INJURY.

    Science.gov (United States)

    Laytin, Adam D; Shumway, Martha; Boccellari, Alicia; Juillard, Catherine J; Dicker, Rochelle A

    2018-04-14

    Mental illness, substance abuse, and poverty are risk factors for violent injury, and violent injury is a risk factor for early mortality that can be attenuated through hospital-based violence intervention programs. Most of these programs focus on victims under the age of 30 years. Little is known about risk factors or long-term mortality among older victims of violent injury. To explore the prevalence of risk factors for violent injury among younger (age < 30 years) and older (age 30 ≥ years) victims of violent injury, to determine the long-term mortality rates in these age groups, and to explore the association between risk factors for violent injury and long-term mortality. Adults with violent injuries were enrolled between 2001 and 2004. Demographic and injury data were recorded on enrollment. Ten-year mortality rates were measured. Descriptive analysis and logistic regression were used to compare older and younger subjects. Among 541 subjects, 70% were over age 30. The overall 10-year mortality rate was 15%, and was much higher than in the age-matched general population in both age groups. Risk factors for violent injury including mental illness, substance abuse, and poverty were prevalent, especially among older subjects, and were each independently associated with increased risk of long-term mortality. Mental illness, substance abuse, and poverty constitute a "lethal triad" that is associated with an increased risk of long-term mortality among victims of violent injury, including both younger adults and those over age 30 years. Both groups may benefit from targeted risk-reduction efforts. Emergency department visits offer an invaluable opportunity to engage these vulnerable patients. Copyright © 2018 Elsevier Inc. All rights reserved.

  19. A within-person approach to risk for suicidal ideation and suicidal behavior : Examining the roles of depression, stress, and abuse exposure

    NARCIS (Netherlands)

    Miller, Adam Bryant; Eisenlohr-Moul, Tory; Giletta, M.; Hastings, Paul D.; Rudolph, Karen D.; Nock, Matthew K.; Prinstein, Mitchell J.

    Objective: This study tests a novel, within-person model that reexamines depression and stress as risk factors for suicidal ideation and behavior among adolescent girls with and without sexual/physical abuse histories. Method: This longitudinal study includes data from 220 adolescent girls between

  20. Internal and external factors in professional burnout of substance abuse counsellors in Croatia.

    Science.gov (United States)

    Tatalović Vorkapić, Sanja; Mustapić, Jelena

    2012-01-01

    In this study, burnout and its internal and external factors were investigated among substance abuse counsellors (no. = 68) who worked in Centres for Prevention and Substance Abuse Treatment (no. = 18) in Croatia. Maslach Burnout Inventory was used which measured three burnout dimensions: emotional exhaustion, depersonalization and personal accomplishment; and questionnaire of internal and external burnout factors. The higher levels of emotional exhaustion and depersonalization, and the higher level of personal accomplishment were determined. Factors such as work conditions, emotions about us and work, work organization and certain personality traits showed significant relationship with three burnout dimensions. Overall, findings implicated a certain specificity of professional burnout in substance abuse counsellors, and the need for specific design of mental health care for them.

  1. Factors from Durkheim's Family Integration Related to Suicidal Ideation among Men with Histories of Child Sexual Abuse

    Science.gov (United States)

    Easton, Scott D.; Renner, Lynette M.

    2013-01-01

    Men who were sexually abused during childhood represent a highly stigmatized, marginalized population at risk for a variety of long-term mental health problems. Using the family integration dimension of Durkheim's theory of suicide, factors associated with suicidal ideation among a purposive sample of 487 men with histories of child sexual…

  2. Family and Individual Factors in the at Risk Population

    Directory of Open Access Journals (Sweden)

    Masoud Mohammadi

    2005-04-01

    Full Text Available Objective: Based on the past studies in the filed of substance abuse, this study is to compare at risk populations regarding to familial and individual factors. Materials & Methods: this study have been done on 716 at risk individual in 11 city of Fars province. Research tools includes:1- locus of control inventory 2- Attachment styles scale 3- Parental Bonding Instrument 4- Resilience Scale 5- Coping Skills Inventory 6- Self Esteem scale. Results: there was a significant difference between normal and user and abuser groups. In resiliency, self esteem, problem oriented coping skills, caring and secure attachment normal group had a higher scores. But in ambivalent attachment style, external locus of control, emotion oriented and less benefit coping skills, normal group had a lower scores. In resiliency, ambivalent attachment style, problem oriented coping skills, and less benefit coping skills there was significant differences between user and abuser groups. But this was not true for caring, overprotection, secure attachment, locus of control, self esteem, and emotion oriented coping skills. Conclusion: according to these finding and in order to development and promotion of resiliency for substance abuse, preventive intervention should focus on educating parents and caregivers in the field of caring, enough protection, developing secure attachment, strategies for development and maintenance of self esteem, internal locus of control, and use of problem oriented coping skills. Psychological interventions also can use these finding in order to focus their therapy goals.

  3. The Relationship between Prenatal Care, Personal Alcohol Abuse and Alcohol Abuse in the Home Environment

    Science.gov (United States)

    Grekin, Emily R.; Ondersma, Steven J.

    2009-01-01

    Aims: Nearly one-fourth of African-American women receive no prenatal care during the first trimester of pregnancy. The aim of the current study is to identify factors that underlie inadequate prenatal care among African-American women. Maternal alcohol abuse has been examined as one risk factor for inadequate prenatal care, but findings have been…

  4. Elder abuse within the family environment in the Azores Islands 1

    OpenAIRE

    Carmona-Torres, Juan Manuel; Carvalhal-Silva, Rosa María; Viera-Mendes, Maria Helena; Recio-Andrade, Beatriz; Goergen, Thomas; Rodríguez-Borrego, María Aurora

    2017-01-01

    ABSTRACT Objectives: to dimension abuse against vulnerable adults within the family and community environment in the Azores Islands, identify risk factors for abuse and describe the profile of an abused elder. Method: descriptive cross-sectional study. Random sampling. The instruments used were: clinical histories of the users, Mini-Mental State Examination, Index of Independence in Basic Activities of Daily Living, Family APGAR Scale, Elder Abuse Suspicion Index and Social Work Assessment ...

  5. The role of child sexual abuse in the etiology of substance-related disorders.

    Science.gov (United States)

    Maniglio, Roberto

    2011-01-01

    To elucidate the role of child sexual abuse in the etiology of substance-related disorders, a systematic review of the several articles on the childhood sexual abuse-related risk for developing substance problems in adolescence or adulthood is provided. Seven databases were searched, supplemented with hand-search of reference lists. Six reviews, including 200 studies, were included. Results indicate that child sexual abuse is a statistically significant, although general and nonspecific, risk factor for substance problems. Other biological and psychosocial variables contribute to substance-related disorders, with sexual abuse conferring additional risk, either as a distal, indirect cause or as a proximal, direct cause. Recommendations for future research are provided.

  6. Internal and external factors in professional burnout of substance abuse counsellors in Croatia

    Directory of Open Access Journals (Sweden)

    Sanja Tatalović Vorkapić

    2012-06-01

    Full Text Available AIM: In this study, burnout and its internal and external factors were investigated among substance abuse counsellors (no. = 68 who worked in centres for Prevention and Substance Abuse Treatment (no. = 18 in Croatia. METHODS: Maslach Burnout Inventory was used which measured three burnout dimensions: emotional exhaustion, depersonalization and personal accomplishment; and questionnaire of internal and external burnout factors. RESULTS: The higher levels of emotional exhaustion and depersonalization, and the higher level of personal accomplishment were determined. Factors such as work conditions, emotions about us and work, work organization and certain personality traits showed significant relationship with three burnout dimensions. CONCLUSIONS: Overall, findings implicated a certain specificity of professional burnout in substance abuse counsellors, and the need for specific design of mental health care for them.

  7. Interpersonal violence: an important risk factor for disease and injury in South Africa

    Directory of Open Access Journals (Sweden)

    Abrahams Naeemah

    2010-12-01

    Full Text Available Abstract Background Burden of disease estimates for South Africa have highlighted the particularly high rates of injuries related to interpersonal violence compared with other regions of the world, but these figures tell only part of the story. In addition to direct physical injury, violence survivors are at an increased risk of a wide range of psychological and behavioral problems. This study aimed to comprehensively quantify the excess disease burden attributable to exposure to interpersonal violence as a risk factor for disease and injury in South Africa. Methods The World Health Organization framework of interpersonal violence was adapted. Physical injury mortality and disability were categorically attributed to interpersonal violence. In addition, exposure to child sexual abuse and intimate partner violence, subcategories of interpersonal violence, were treated as risk factors for disease and injury using counterfactual estimation and comparative risk assessment methods. Adjustments were made to account for the combined exposure state of having experienced both child sexual abuse and intimate partner violence. Results Of the 17 risk factors included in the South African Comparative Risk Assessment study, interpersonal violence was the second leading cause of healthy years of life lost, after unsafe sex, accounting for 1.7 million disability-adjusted life years (DALYs or 10.5% of all DALYs (95% uncertainty interval: 8.5%-12.5% in 2000. In women, intimate partner violence accounted for 50% and child sexual abuse for 32% of the total attributable DALYs. Conclusions The implications of our findings are that estimates that include only the direct injury burden seriously underrepresent the full health impact of interpersonal violence. Violence is an important direct and indirect cause of health loss and should be recognized as a priority health problem as well as a human rights and social issue. This study highlights the difficulties in measuring

  8. Interpersonal violence: an important risk factor for disease and injury in South Africa.

    Science.gov (United States)

    Norman, Rosana; Schneider, Michelle; Bradshaw, Debbie; Jewkes, Rachel; Abrahams, Naeemah; Matzopoulos, Richard; Vos, Theo

    2010-12-01

    Burden of disease estimates for South Africa have highlighted the particularly high rates of injuries related to interpersonal violence compared with other regions of the world, but these figures tell only part of the story. In addition to direct physical injury, violence survivors are at an increased risk of a wide range of psychological and behavioral problems. This study aimed to comprehensively quantify the excess disease burden attributable to exposure to interpersonal violence as a risk factor for disease and injury in South Africa. The World Health Organization framework of interpersonal violence was adapted. Physical injury mortality and disability were categorically attributed to interpersonal violence. In addition, exposure to child sexual abuse and intimate partner violence, subcategories of interpersonal violence, were treated as risk factors for disease and injury using counterfactual estimation and comparative risk assessment methods. Adjustments were made to account for the combined exposure state of having experienced both child sexual abuse and intimate partner violence. Of the 17 risk factors included in the South African Comparative Risk Assessment study, interpersonal violence was the second leading cause of healthy years of life lost, after unsafe sex, accounting for 1.7 million disability-adjusted life years (DALYs) or 10.5% of all DALYs (95% uncertainty interval: 8.5%-12.5%) in 2000. In women, intimate partner violence accounted for 50% and child sexual abuse for 32% of the total attributable DALYs. The implications of our findings are that estimates that include only the direct injury burden seriously underrepresent the full health impact of interpersonal violence. Violence is an important direct and indirect cause of health loss and should be recognized as a priority health problem as well as a human rights and social issue. This study highlights the difficulties in measuring the disease burden from interpersonal violence as a risk factor

  9. Risk factors for repetition of self-harm: a systematic review of prospective hospital-based studies.

    Directory of Open Access Journals (Sweden)

    Celine Larkin

    Full Text Available BACKGROUND: Self-harm entails high costs to individuals and society in terms of suicide risk, morbidity and healthcare expenditure. Repetition of self-harm confers yet higher risk of suicide and risk assessment of self-harm patients forms a key component of the health care management of self-harm patients. To date, there has been no systematic review published which synthesises the extensive evidence on risk factors for repetition. OBJECTIVE: This review is intended to identify risk factors for prospective repetition of self-harm after an index self-harm presentation, irrespective of suicidal intent. DATA SOURCES: PubMed, PsychInfo and Scirus were used to search for relevant publications. We included cohort studies which examining factors associated with prospective repetition among those presenting with self-harm to emergency departments. Journal articles, abstracts, letters and theses in any language published up to June 2012 were considered. Studies were quality-assessed and synthesised in narrative form. RESULTS: A total of 129 studies, including 329,001 participants, met our inclusion criteria. Some factors were studied extensively and were found to have a consistent association with repetition. These included previous self-harm, personality disorder, hopelessness, history of psychiatric treatment, schizophrenia, alcohol abuse/dependence, drug abuse/dependence, and living alone. However, the sensitivity values of these measures varied greatly across studies. Psychological risk factors and protective factors have been relatively under-researched but show emerging associations with repetition. Composite risk scales tended to have high sensitivity but poor specificity. CONCLUSIONS: Many risk factors for repetition of self-harm match risk factors for initiation of self-harm, but the most consistent evidence for increased risk of repetition comes from long-standing psychosocial vulnerabilities, rather than characteristics of an index episode

  10. The abuse potential of medical psilocybin according to the 8 factors of the Controlled Substances Act.

    Science.gov (United States)

    Johnson, Matthew W; Griffiths, Roland R; Hendricks, Peter S; Henningfield, Jack E

    2018-06-05

    This review assesses the abuse potential of medically-administered psilocybin, following the structure of the 8 factors of the US Controlled Substances Act (CSA). Research suggests the potential safety and efficacy of psilocybin in treating cancer-related psychiatric distress and substance use disorders, setting the occasion for this review. A more extensive assessment of abuse potential according to an 8-factor analysis would eventually be required to guide appropriate schedule placement. Psilocybin, like other 5-HT2A agonist classic psychedelics, has limited reinforcing effects, supporting marginal, transient non-human self-administration. Nonetheless, mushrooms with variable psilocybin content are used illicitly, with a few lifetime use occasions being normative among users. Potential harms include dangerous behavior in unprepared, unsupervised users, and exacerbation of mental illness in those with or predisposed to psychotic disorders. However, scope of use and associated harms are low compared to prototypical abused drugs, and the medical model addresses these concerns with dose control, patient screening, preparation and follow-up, and session supervision in a medical facility. (1) psilocybin has an abuse potential appropriate for CSA scheduling if approved as medicine; (2) psilocybin can provide therapeutic benefits that may support the development of an approvable New Drug Application (NDA) but further studies are required which this review describes; (3) adverse effects of medical psilocybin are manageable when administered according to risk management approaches; and (4) although further study is required, this review suggests that placement in Schedule IV may be appropriate if a psilocybin-containing medicine is approved. Copyright © 2018. Published by Elsevier Ltd.

  11. Cognitive and Emotional Differences between Abusive and Non-Abusive Fathers

    Science.gov (United States)

    Francis, Karen J.; Wolfe, David A.

    2008-01-01

    Objective: Abusive fathers perpetrate a substantial portion of child physical abuse. Despite this, little is known about how they differ from non-abusive fathers. This study compared a broad range of cognitive and affective factors between physically abusive and non-abusive fathers. Methods: Abusive (n = 24) and non-abusive (n = 25) fathers…

  12. Factors associated with child sexual abuse in Tanzania: a qualitative ...

    African Journals Online (AJOL)

    Factors associated with child sexual abuse in Tanzania: a qualitative study. Mangi J. Ezekiel, Felix Kisanga, Idda H. Mosha, Amani Anaeli, Switbert R. Kamazima, Rose Mpembeni, Eustace P. Muhondwa ...

  13. The relationship between adolescent depressive symptomology and substance abuse

    Directory of Open Access Journals (Sweden)

    L.G. Blore

    2004-09-01

    Full Text Available The research aimed to investigate the phenomena of adolescent depressive symptomology, substance abuse and the relationship between the two phenomena in a South African context. The influence of moderator variables was also examined. Another objective was to determine risk factors for the before mentioned. This was done by using a questionnaire with a sample of 1298 conveniently selected adolescents in a South African high school. It was determined that adolescents become progressively unhappier from 13 to 17 years of age. Girls are more depressed than boys. This research also revealed that adolescent depressive symptomology is significantly and positively correlated with earlier age of onset of substance abuse as well as frequency of usage. There appear to be no gender differences in substance abuse but teenagers from different ethnic and language groups differ in their use of substances. Risk factors for depression and substance abuse included a conflict relationship with parents, the experience of major stressful events, dissatisfaction with school grades and friends’ use of substances.

  14. Risk assessment for drugs of abuse in the Dutch watercycle.

    NARCIS (Netherlands)

    van der Aa, M.; Bijlsma, L.; Emke, E.; Dijkman, E.; van Nuijs, A.L.N.; van de Ven, B.M.; Hernández, F.; Versteegh, A.; de Voogt, P.

    2013-01-01

    A screening campaign of drugs of abuse (DOA) and their relevant metabolites in the aqueous environment was performed in the Netherlands. The presence of DOA, together with the potential risks for the environment and the possible human exposure to these compounds through consumption of drinking water

  15. Validation of the Italian Version of the Caregiver Abuse Screen among Family Caregivers of Older People with Alzheimer's Disease.

    Science.gov (United States)

    Melchiorre, Maria Gabriella; Di Rosa, Mirko; Barbabella, Francesco; Barbini, Norma; Lattanzio, Fabrizia; Chiatti, Carlos

    2017-01-01

    Introduction . Elder abuse is often a hidden phenomenon and, in many cases, screening practices are difficult to implement among older people with dementia. The Caregiver Abuse Screen (CASE) is a useful tool which is administered to family caregivers for detecting their potential abusive behavior. Objectives . To validate the Italian version of the CASE tool in the context of family caregiving of older people with Alzheimer's disease (AD) and to identify risk factors for elder abuse in Italy. Methods . The CASE test was administered to 438 caregivers, recruited in the Up-Tech study. Validity and reliability were evaluated using Spearman's correlation coefficients, principal-component analysis, and Cronbach's alphas. The association between the CASE and other variables potentially associated with elder abuse was also analyzed. Results . The factor analysis suggested the presence of a single factor, with a strong internal consistency (Cronbach's alpha = 0.86). CASE score was strongly correlated with well-known risk factors of abuse. At multivariate level, main factors associated with CASE total score were caregiver burden and AD-related behavioral disturbances. Conclusions . The Italian version of the CASE is a reliable and consistent screening tool for tackling the risk of being or becoming perpetrators of abuse by family caregivers of people with AD.

  16. Community Poverty and Child Abuse Fatalities in the United States.

    Science.gov (United States)

    Farrell, Caitlin A; Fleegler, Eric W; Monuteaux, Michael C; Wilson, Celeste R; Christian, Cindy W; Lee, Lois K

    2017-05-01

    Child maltreatment remains a problem in the United States, and individual poverty is a recognized risk factor for abuse. Children in impoverished communities are at risk for negative health outcomes, but the relationship of community poverty to child abuse fatalities is not known. Our objective was to evaluate the association between county poverty concentration and rates of fatal child abuse. This was a retrospective, cross-sectional analysis of child abuse fatalities in US children 0 to 4 years of age from 1999 to 2014 by using the Centers for Disease Control and Prevention Compressed Mortality Files. Population and poverty statistics were obtained from US Census data. National child abuse fatality rates were calculated for each category of community poverty concentration. Multivariate negative binomial regression modeling assessed the relationship between county poverty concentration and child abuse fatalities. From 1999 to 2014, 11 149 children 0 to 4 years old died of child abuse; 45% (5053) were poverty concentration had >3 times the rate of child abuse fatalities compared with counties with the lowest poverty concentration (adjusted incidence rate ratio, 3.03; 95% confidence interval, 2.4-3.79). Higher county poverty concentration is associated with increased rates of child abuse fatalities. This finding should inform public health officials in targeting high-risk areas for interventions and resources. Copyright © 2017 by the American Academy of Pediatrics.

  17. Childhood abuse and late-life depression: Mediating effects of psychosocial factors for early- and late-onset depression.

    Science.gov (United States)

    Wielaard, Ilse; Hoyer, Mathijs; Rhebergen, Didi; Stek, Max L; Comijs, Hannie C

    2018-03-01

    Childhood abuse makes people vulnerable to developing depression, even in late life. Psychosocial factors that are common in late life, such as loneliness or lack of a partner, may explain this association. Our aim was to investigate whether the association between childhood abuse and depression in older adults can be explained by psychosocial factors. Cross-sectional data were derived from the Netherlands Study of Depression in Older Persons (aged 60-93), including 132 without lifetime depression, 242 persons with an early-onset depression (Childhood abuse (yes/no) and a frequency-based childhood abuse index were included. Multinomial regression and multivariable mediation analyses were used to examine the association between childhood abuse and the onset of depression, and the influence of loneliness, social network, and partner status. Multinomial regression analyses showed a significant association between childhood abuse and the childhood abuse index with early- and late-onset depression. Multivariable mediation analyses showed that the association between childhood abuse and early-onset depression was partly mediated by social network size and loneliness. This was particularly present for emotional neglect and psychological abuse, but not for physical and sexual abuse. No psychosocial mediators were found for the association between childhood abuse and late-onset depression. A smaller social network and feelings of loneliness mediate the association between childhood abuse and early-onset depression in older adults. Our findings show the importance of detecting childhood abuse as well as the age at depression onset and mapping of relevant psychosocial factors in the treatment of late-life depression. Copyright © 2018 John Wiley & Sons, Ltd.

  18. Substance abuse and batterer programmes in California, USA: factors associated with treatment outcomes.

    Science.gov (United States)

    Timko, Christine; Valenstein, Helen; Stuart, Gregory L; Moos, Rudolf H

    2015-11-01

    The association between substance abuse and intimate partner violence is quite robust. A promising area to improve treatment for the dual problems of substance abuse and violence perpetration is the identification of client characteristics and organisational and programme factors as predictors of health outcomes. Therefore, we examined associations of client, organisational and programme factors with outcomes in community health settings. Directors of 241 substance use disorder programmes (SUDPs) and 235 batterer intervention programmes (BIPs) reported outcomes of programme completion and substance use and violence perpetration rates at discharge; data collection and processing were completed in 2012. SUDPs having more female, non-white, younger, uneducated, unemployed and lower income clients reported lower completion rates. In SUDPs, private, for-profit programmes reported higher completion rates than public or private, non-profit programmes. SUDPs with lower proportions of their budgets from government sources, and higher proportions from client fees, reported better outcomes. Larger SUDPs had poorer programme completion and higher substance use rates. Completion rates in SUDPs were higher when clients could obtain substance- and violence-related help at one location, and programmes integrated violence-prevention contracting into care. In BIPs, few client, organisational and programme factors were associated with outcomes, but the significant factors associated with programme completion were consistent with those for SUDPs. Publicly owned and larger programmes, and SUDPs lacking staff to integrate violence-related treatment, may be at risk of poorer client outcomes, but could learn from programmes that perform well to yield better outcomes. © 2014 John Wiley & Sons Ltd.

  19. Women’s Experience of Abuse in Childhood and Their Children’s Smoking and Overweight

    Science.gov (United States)

    Roberts, Andrea L.; Galea, Sandro; Austin, S. Bryn; Corliss, Heather L.; Williams, Michelle A.; Koenen, Karestan C.

    2014-01-01

    Background Smoking and overweight are principal determinants of poor health for which individual-level interventions are at best modestly effective. This limited effectiveness may be partly because these risk factors are patterned by parents’ experiences preceding the individual’s birth. Purpose To determine whether women’s experience of abuse in childhood was associated with smoking and overweight in their children. Methods In 2012, data were linked from two large longitudinal cohorts of women (Nurses’ Health Study II [NHSII], N=12,666) and their children (Growing Up Today [GUTS] Study, N=16,774), 1989–2010. Odds ratios of children following higher-risk smoking trajectories and risk ratios (RR) of children’s overweight and obesity by their mother’s childhood experience of physical, emotional, and sexual abuse were calculated. The extent to which mother’s smoking and overweight, socioeconomic indicators, family characteristics, and child’s abuse exposure accounted for possible associations was ascertained. Results Children of women who experienced severe childhood abuse had greater likelihood of higher-risk smoking trajectories (OR=1.40, 95% CI=1.21, 1.61), overweight (RR=1.21, 95% CI = 1.11, 1.33), and obesity (RR=1.45, 95% CI=1.21, 1.74) across adolescence and early adulthood compared with children of women who reported no abuse. Mother’s smoking and overweight and children’s abuse exposure accounted for more than half of the elevated risk of following the highest-risk smoking trajectory and overweight in children of women abused. Conclusions These findings raise the possibility that childhood abuse may not only adversely affect the health of the direct victim but may also affect health risk factors in her children decades after the original traumatic events. PMID:24512863

  20. Does Childhood Disability Increase Risk for Child Abuse and Neglect?

    Science.gov (United States)

    Leeb, Rebecca T.; Bitsko, Rebecca H.; Merrick, Melissa T.; Armour, Brian S.

    2012-01-01

    In this article we review the empirical evidence for the presumptions that children with disabilities are at increased risk for child maltreatment, and parents with disabilities are more likely to perpetrate child abuse and neglect. Challenges to the epidemiological examination of the prevalence of child maltreatment and disabilities are…

  1. Abuse and neglect in children with disabilities: risk varies by type of disability

    Directory of Open Access Journals (Sweden)

    Miriam Maclean

    2017-04-01

    Different disabilities are associated with differing risk of child maltreatment and child protection involvement. Groups that are considered at higher risk require services to identify and address the support needs of this group and determine how prevention and early intervention can lower the risk for child abuse and neglect in this vulnerable group.

  2. Syndromes, Disorders and Maternal Risk Factors Associated With Neural Tube Defects (VII

    Directory of Open Access Journals (Sweden)

    Chih-Ping Chen

    2008-09-01

    Full Text Available Neural tube defects (NTDs may be associated with syndromes, disorders and maternal risk factors. This article provides a comprehensive review of the syndromes, disorders and maternal risk factors associated with NTDs, including DK phocomelia syndrome (von Voss-Cherstvoy syndrome, Siegel-Bartlet syndrome, fetal warfarin syndrome, craniotelencephalic dysplasia, Czeizel-Losonci syndrome, maternal cocaine abuse, Weissenbacher-Zweymüller syndrome, parietal foramina (cranium bifidum, Apert syndrome, craniomicromelic syndrome, XX-agonadism with multiple dysraphic lesions including omphalocele and NTDs, Fryns microphthalmia syndrome, Gershoni-Baruch syndrome, PHAVER syndrome, periconceptional vitamin B6 deficiency, and autosomal dominant Dandy-Walker malformation with occipital cephalocele. NTDs associated with these syndromes, disorders and maternal risk factors are a rare but important cause of NTDs. The recurrence risk and the preventive effect of maternal folic acid intake in NTDs associated with syndromes, disorders and maternal risk factors may be different from those of nonsyndromic multifactorial NTDs. Perinatal diagnosis of NTDs should alert doctors to the syndromes, disorders and maternal risk factors associated with NTDs, and prompt thorough etiologic investigation and genetic counseling.

  3. Individual and Parental Risk Factors for Sexual Exploitation Among High-Risk Youth in Uganda.

    Science.gov (United States)

    Self-Brown, Shannon; Culbreth, Rachel; Wilson, Rebecca; Armistead, Lisa; Kasirye, Rogers; Swahn, Monica H

    2018-04-01

    This study examined risk factors to determine associations with commercial sexual exploitation of children and youth (CSEC) in a convenience sample of adolescents living in the slums in Kampala, Uganda. Individual-level factors included demographic, adverse experiences (ever living on the streets; victim of dating violence, parental abuse, or rape), and behavioral risk (social media, alcohol use, age at first intercourse). Parental-risk factors included parent alcohol use and approval attitudes toward youth sex. Analyses included those who self-reported sexually active adolescents ( n = 593) of whom 39% reported CSEC history. CSEC was significantly associated with being female (odds ratio [ OR] = 6.85, 95% confidence interval (CI) = [4.22, 11.12]), living on the streets ( OR = 2.68; 95% CI = [1.65, 4.36]), using social media ( OR = 1.48; 95% CI = [0.94, 2.35]), being a victim of physical dating violence ( OR = 1.74; 95% CI = [1.08, 2.80]), and ever being raped ( OR = 4.03; 95% CI = [2.51, 6.47]). Further analyses suggested differential risk associates among females and males. This study contributes to our knowledge of risk factors for CSEC among adolescents living in high-risk circumstances in low-resource countries and suggests that preventive efforts should prioritize adolescents with a history of living on the streets who engage in social media, use alcohol, and have a history of trauma.

  4. Validation of the Italian Version of the Caregiver Abuse Screen among Family Caregivers of Older People with Alzheimer’s Disease

    Directory of Open Access Journals (Sweden)

    Maria Gabriella Melchiorre

    2017-01-01

    Full Text Available Introduction. Elder abuse is often a hidden phenomenon and, in many cases, screening practices are difficult to implement among older people with dementia. The Caregiver Abuse Screen (CASE is a useful tool which is administered to family caregivers for detecting their potential abusive behavior. Objectives. To validate the Italian version of the CASE tool in the context of family caregiving of older people with Alzheimer’s disease (AD and to identify risk factors for elder abuse in Italy. Methods. The CASE test was administered to 438 caregivers, recruited in the Up-Tech study. Validity and reliability were evaluated using Spearman’s correlation coefficients, principal-component analysis, and Cronbach’s alphas. The association between the CASE and other variables potentially associated with elder abuse was also analyzed. Results. The factor analysis suggested the presence of a single factor, with a strong internal consistency (Cronbach’s alpha = 0.86. CASE score was strongly correlated with well-known risk factors of abuse. At multivariate level, main factors associated with CASE total score were caregiver burden and AD-related behavioral disturbances. Conclusions. The Italian version of the CASE is a reliable and consistent screening tool for tackling the risk of being or becoming perpetrators of abuse by family caregivers of people with AD.

  5. Risk factors and study designs used in research of youths' suicide behaviour-an epidemiological discussion with focus on level of evidence

    DEFF Research Database (Denmark)

    Christiansen, Erik; Larsen, Kim Juul; Agerbo, Esben

    2014-01-01

    to level of evidence (LoE). Methods: We searched PubMed and psycINFO in order to identify relevant individual studies. Results: We included 36 studies of children and youth on suicidal behaviour and ideation-many rank low on LoE. For suicide, cohort design was often used, and mental illness (depression......Introduction: Many different epidemiology study designs have been used to analyse risk factors for suicide behaviour. The purpose of this study was to obtain an insight into the current study design used in research on youths' risk factors for suicide behaviour and to rank the studies according......, substance abuse and severity of mental illness) was the most common risk factor. Cohort studies are ranked 2b, which is high according to LoE. For suicide attempts, survey was often used, and psychopathology, substance abuse and being exposed to suicidal behaviour were the most common risk factors...

  6. Sexual Risk Behavior Among Youth With Bipolar Disorder: Identifying Demographic and Clinical Risk Factors.

    Science.gov (United States)

    Krantz, Megan; Goldstein, Tina; Rooks, Brian; Merranko, John; Liao, Fangzi; Gill, Mary Kay; Diler, Rasim; Hafeman, Danella; Ryan, Neal; Goldstein, Benjamin; Yen, Shirley; Hower, Heather; Hunt, Jeffrey; Keller, Martin; Strober, Michael; Axelson, David; Birmaher, Boris

    2018-02-01

    This study aims to document rates of sexual activity among youth with bipolar spectrum disorder (BD) and to examine demographic and clinical factors associated with first sexual activity and sexual risk behavior during follow-up. The sample was drawn from the Course and Outcome of Bipolar Youth (COBY) study of 413 youth 7 to 17 years at baseline who met criteria for bipolar spectrum disorder according to the Schedule for Affective Disorders and Schizophrenia for School-Aged Children. Psychiatric symptoms during follow-up were assessed using the Adolescent Longitudinal Interview Follow-Up Evaluation (ALIFE). Sexual behavior and level of sexual risk (e.g., unprotected sex, multiple partners, and/or partners with known sexually transmitted infections) were assessed by trained evaluators using the ALIFE Psychosocial Functioning Scale. Analyses were conducted in relation to first sexual behavior during follow-up and then to subsequent sexual behaviors (mean 9.7 years, standard deviation 3.2). Sexually active COBY youth (n = 292 of 413; 71%) were more likely females, using substances, and not living with both parents. Consistent with findings among healthy youth, earlier first sexual activity in the sample was significantly associated with low socioeconomic status, female sex, comorbid disruptive behavior disorder, and substance use. As with healthy youth, sexual risk behavior during follow-up was significantly associated with non-Caucasian race, low socioeconomic status, substance use, and history of sexual abuse. Of those COBY youth who were sexually active, 11% reported sexual assault or abuse, 36% reported becoming pregnant (or the significant other becoming pregnant), and 15% reported having at least 1 abortion (or the significant other having an abortion) during follow-up. Hypomanic symptoms during follow-up were temporally associated with the greatest risk for sexual risk behavior. Demographic and clinical factors could help identify youth with bipolar spectrum

  7. Child Sexual Abuse and HIV-Related Substance Use and Sexual Risk Across the Life Course Among Males and Females.

    Science.gov (United States)

    Scheidell, Joy D; Kumar, Pritika C; Campion, Taylor; Quinn, Kelly; Beharie, Nisha; McGorray, Susan P; Khan, Maria R

    2017-07-01

    Child sexual abuse is associated with substance use and sexual risk behaviors during adolescence and adulthood, but no known studies have documented associations across the life course in a nationally representative U.S. We used the National Longitudinal Study of Adolescent to Adult Health to measure associations between child sexual abuse and substance use and sexual risk behaviors during adolescence, young adulthood, and adulthood among males and females (n = 11,820). Approximately 10% of females and 7% of males reported child sexual abuse. Associations with substance use were strongest during adolescence and lessened over time. Increased odds of sexual risk among those with a history of child sexual abuse remained consistent through the life course. Significant gender differences existed for some associations (e.g., adulthood multiple partners: males adjusted odds ratio (AOR) = 1.73, 95%CI:1.18, 2.53; females AOR = 1.11, 95%CI:0.79, 1.56). Trauma-informed prevention interventions should address child sexual abuse among both males and females to prevent substance use and sexual risk behavior throughout the life course.

  8. The Formation of Marijuana Risk Perception in a Population of Substance Abusing Patients.

    Science.gov (United States)

    Wilkinson, Samuel T; van Schalkwyk, Gerrit I; Davidson, Larry; D'Souza, Deepak C

    2016-03-01

    Risk perception has been shown to be protective with regard to marijuana use. Notably, the risk perception of marijuana in individuals with substance abuse problems varies significantly from that of the general public. Understanding how risk perception is formed in substance users could explain these differences and help predict the consequences of policy changes. Using this framework, we explored risk perception and its formation in a sample of substance abusing veterans. Semi-structured interviews were conducted with veterans who were receiving treatment for substance abuse. Interviews were recorded digitally, transcribed verbatim, and analyzed using inductive thematic analysis. A prominent perspective among the 31 participants was that marijuana is significantly different from other drugs because it is safe, not addictive, not associated with physical withdrawal, and has less overt behavioral effects than other substances. Many of these participants drew upon their own innocuous experiences with the drug in developing this perspective, more so than information from any other source. A contrasting narrative emphasized marijuana's capacity to cause negative social consequences, act as a gateway to the use of other, more harmful substances, and cause paranoia or worsen psychosis. In conclusion, individual experience with marijuana featured more prominently in informing risk perception than any other source of information. Our results and previous literature suggest that the significant disconnect between the individual experiences of substance users and the current clinical and legal policy towards marijuana may weaken the legitimacy of public policy or the authority of the medical community.

  9. The Protective Effect of Pregnancy on Risk for Drug Abuse: A Population, Co-Relative, Co-Spouse, and Within-Individual Analysis.

    Science.gov (United States)

    Kendler, Kenneth S; Ohlsson, Henrik; Svikis, Dace S; Sundquist, Kristina; Sundquist, Jan

    2017-10-01

    The authors sought to determine whether pregnancy is an intrinsic motivator for cessation of drug abuse. The authors conducted prospective cohort, co-relative, co-spouse, and within-person analyses of registration for drug abuse during pregnancy among Swedish women born between 1980 and 1990 who gave birth between ages 20 and 35 (N=149,512). Drug abuse was assessed from medical, criminal, and pharmacy registries. In the population, rates of drug abuse were lower during pregnancy (unadjusted odds ratio=0.67, 95% CI=0.60, 0.74). Compared with population results, the negative association between pregnancy and drug abuse was moderately stronger in cousins (odds ratio=0.49, 95% CI=0.39, 0.62) and substantially stronger in siblings (odds ratio=0.35, 95% CI=0.24, 0.51) discordant for pregnancy. The estimated odds ratio for drug abuse in pregnancy-discordant monozygotic twins was even stronger, at 0.17 (95% CI=0.10, 0.31). Within individuals, the odds ratio for drug abuse while pregnant compared with an equivalent prepregnancy interval was similar to that seen in pregnancy-discordant monozygotic twins, at 0.22 (95% CI=0.19, 0.26). Compared with cohabiting fathers, mothers had a greater reduction in risk for drug abuse during pregnancy (odds ratio=0.40, 95% CI=0.34, 0.47). Pregnancy was more protective in women with low parental education and without a cohabiting, actively drug-abusing father. Compared with prepregnancy baseline, within-individual analyses indicate that risk for drug abuse is also substantially reduced in the postpartum period, for example, the odds ratio for postpartum days 0-242 was 0.13 (95% CI=0.11, 0.16). Risk for drug abuse in women is substantially reduced during pregnancy. Multiple analyses suggest that this association is largely causal, suggesting that pregnancy is indeed a strong intrinsic motivator for drug abuse cessation. Similar strong protective effects may be present in the immediate postpartum period. Our results have implications for our

  10. Risk and protective factors for bullying victimization among AIDS-affected and vulnerable children in South Africa.

    Science.gov (United States)

    Cluver, Lucie; Bowes, Lucy; Gardner, Frances

    2010-10-01

    To examine whether bullying is a risk factor for psychological distress among children in poor, urban South Africa. To determine risk and protective factors for bullying victimization. One thousand and fifty children were interviewed in deprived neighborhoods, including orphans, AIDS-affected children, streetchildren, and child-headed households. Using standardized scales, children reported on bullying victimization, psychological problems, and potential risk and protective factors at individual, peer, family, and community levels. 34% of children reported bullying victimization. Bullied children showed higher levels of anxiety, depression, suicidal ideation, and post-traumatic stress, as well as higher levels of clinical-level disorder. Risk factors for being bullied were being a victim of physical or sexual abuse or domestic violence at home, living in a high-violence community, and experiencing AIDS-related stigma (independent of sociodemographic cofactors and child psychological disorder). Protective factors were sibling support and support from friends, although findings suggest that friendship groups may also be sources of bullying for AIDS-affected children. Bullying is an independent and important risk factor in child psychological distress in South Africa. Children victimized at home or in the community are more likely to be bullied, suggesting a cycle of violence. Those working with children in Southern Africa should be alert to risk of bullying, especially among abused or AIDS-affected children. Interventions combating community violence and AIDS-related stigma may have additional positive impacts on bullying, and promotion of peer and sibling support may reduce bullying victimization among high-risk children. Copyright © 2010 Elsevier Ltd. All rights reserved.

  11. Assessment of Substances Abuse in Burn Patients by Using Drug Abuse Screening Test

    Directory of Open Access Journals (Sweden)

    Kobra Gaseminegad

    2012-04-01

    Full Text Available There has been an increase in the frequency of substance abuse among hospitalized burn injury patients. However, few studies have investigated substance abuse among burn patients. This study was aimed to identify the incidence of substance abuse in burn injury patients using the "Drug Abuse Screening Test" (DAST-20. We determined the validity of DAST-20 in spring 2010. Subsequently, this descriptive study was performed on 203 burn injury patients who fit the study's inclusion criteria. We chose a score of 6 as the cutoff and thus achieved a sensitivity of 89% and a specificity of 85% for the DAST-20. During the study, we gathered demographic data, burn features and DAST-20 results for all patients. Patients with scores of 6 or more were considered to be substances abusers. A statistical analysis was conducted using SPSS v16 software. According to the DAST-20 results, 33% of the patients were in the user group. The mean score of DAST-20 was significantly higher among users than it was among nonusers (P<0.05. The level of substance abuse was severe in 77% of users. No significant differences were found among the substances, with the exception of alcohol. Substance abuse is an important risk factor for burn patients. In addition, this study showed that DAST-20 is a valid screening measure for studies on burn patients.

  12. Resilience and social support as protective factors against abuse of patients with dementia: A study on family caregivers.

    Science.gov (United States)

    Serra, Lídia; Contador, Israel; Fernández-Calvo, Bernardino; Ruisoto, Pablo; Jenaro, Cristina; Flores, Noelia; Ramos, Francisco; Rivera-Navarro, Jesús

    2018-05-24

    Scientific literature has identified different vulnerability factors associated to abuse in people with dementia (PWD), but little is known about the psychosocial protective variables against abuse. The main objective of this study is to investigate a set of caregiver and patient factors linked to abuse-related behavior of PWD. A total of 326 primary and family caregivers, residents of the Castilla and León community (Spain), were evaluated. All participants filled out a standardized protocol, which assessed the sociodemographic characteristics, patient and care-related variables, as well as the perceived burden, resilience, and social support. Abuse-related behavior was evaluated using the Caregiver Abuse Screen. Results show that the severity of cognitive impairment and behavior disorders of PWD, a greater number of caregiving hours, a worse previous relationship with the caregiver, and perceived burden are positively related with abuse. However, resilience and social support showed a negative relationship with Caregiver Abuse Screen scores, suggesting a protective effect on abuse, even after controlling the effect of a number of covariates. Indeed, resilience was the only variable that remained significant after including the effect of burden. This paper states the role of burden in abuse of PWD, while resilience and social support are abuse protective factors. These variables should be considered in future guidelines for the prevention of abuse against PWD. Copyright © 2018 John Wiley & Sons, Ltd.

  13. Substance abuse and cancer.

    Science.gov (United States)

    Moussas, G I; Papadopoulou, A G

    2017-01-01

    Substance abuse is a health problem with serious psychological and psychiatric dimensions and multiple social and economic consequences. Cancer is a disease that threatens not only life and physical integrity but mental health as well. Oncology patients suffer from mental disorders in high rates, especially from depression and anxiety. The role of substance abuse in the pathogenesis of cancer is studied systematically, since there are research data supporting the mutagenic effects of certain substances. It has been supported that a possible dysregulation of the immune system is linked to the oncogenic processes induced by substances of abuse. Specifically, opioids are the first addictive substances that have been identified as oncogenic factors. However, conflicting results have been offered by experimental animal studies, which showed that opioids, such as morphine, depending on the dosage administered, may not only enhance the process of tumor growth, but also inhibit it. Additionally, research data indicate that the use of cannabis may be associated with cancer, either as an independent factor or in relation to other mutagenics, although it is not yet clear to which extent these effects may be connected to the disease, especially once the consumption of tobacco and alcohol by these patients are taken into account. However, it has been argued that certain cannabinoids may have biological -anticancer- activities which could be used therapeutically without being accompanied by the corresponding 9-tetrahydrocannabinol psychoactive effects. It is well known that alcohol is a risk factor for developing head and neck cancer, and epidemiological studies indicate that the higher the consumption of alcohol, the more mortality due to cancer increases. In addition, it is suggested that there is no safety level for alcohol consumption regarding the risk of developing cancer; that is even a minimum daily consumption is associated with the occurrence of certain types of cancer

  14. Preventing Child Abuse and Neglect with Parent Training: Evidence and Opportunities

    Science.gov (United States)

    Barth, Richard P.

    2009-01-01

    Researchers have identified four common co-occurring parental risk factors--substance abuse, mental illness, domestic violence, and child conduct problems--that lead to child maltreatment. The extent to which maltreatment prevention programs must directly address these risk factors to improve responsiveness to parenting programs or can directly…

  15. Child Sexual Abuse Prevention Opportunities: Parenting, Programs, and the Reduction of Risk.

    Science.gov (United States)

    Rudolph, Julia; Zimmer-Gembeck, Melanie J; Shanley, Dianne C; Hawkins, Russell

    2018-02-01

    To date, child sexual abuse (CSA) prevention has relied largely on child-focused education, teaching children how to identify, avoid, and disclose sexual abuse. The purpose of this article is to explore how prevention opportunities can include parents in new and innovative ways. We propose that parents can play a significant role as protectors of their children via two pathways: (i) directly, through the strong external barriers afforded by parent supervision, monitoring, and involvement; and (ii) indirectly, by promoting their children's self-efficacy, competence, well-being, and self-esteem, which the balance of evidence suggests will help them become less likely targets for abuse and more able to respond appropriately and disclose abuse if it occurs. In this article, we first describe why teaching young children about CSA protective behaviors might not be sufficient for prevention. We then narratively review the existing research on parents and prevention and the parenting and family circumstances that may increase a child's risk of experiencing sexual abuse. Finally, we make a number of recommendations for future approaches to prevention that may better inform and involve parents and other adult protectors in preventing CSA.

  16. Abuse Experiences of Family Members, Child Maltreatment, and the Development of Sex Offending Among Incarcerated Adolescent Males.

    Science.gov (United States)

    McCuish, Evan C; Cale, Jesse; Corrado, Raymond R

    2017-02-01

    Child sexual abuse is considered a risk factor for the development of sexual offending in adolescence. Beyond this, comparisons of the risk factor profiles between adolescent sex offenders (ASOs) and adolescent non-sex offenders (ANSOs) have uncovered minimal differences. However, differences between ASOs and ANSOs in terms of patterns in the abuse histories of their family members have rarely been studied. The aim in the current study was to retrospectively examine histories of abuse among family members of ASOs compared with ANSOs to determine whether and how these were related to youth abuse experiences and sexual offending in adolescence. The current study is based on a sample of 482 incarcerated male adolescents (ASOs = 67, ANSOs = 415). Latent class analysis was conducted to determine multidimensional familial abuse profiles, and a series of logistic regression models were used to examine the relationship between family abuse profiles, youth abuse experiences, and adolescent sexual offending. Overall, familial abuse profiles were related to subsequent youth abuse experiences and sexual offending, and these abuse profiles differentiated ASOs and ANSOs.

  17. Risk Factors for Hepatitis B and C among Military Recruits

    International Nuclear Information System (INIS)

    Azam, N.; Azam, N.; Javed, K.

    2013-01-01

    Objectives: To determine significant risk factors for hepatitis B and C in young military recruits testing positive during pre enrollment screening. Study Design: Case control analytical study. Material and Method: Healthy male recruits during June-December 2005 at Pathology Laboratory, CMH Malir Cantt. Results: The analysis of risk factors among cases and controls has been categorized into two groups according to source of risk. History of previous therapeutic injection administration during the past 5 years, blood donation and sharing toothbrushes and razors in family revealed results which were significant with p-value of 0.002, 0.007 and 0.001 respectively. None of the other risk factors assessed in the comparable groups were found to be significant. Other factors considered plausible by other studies for transmission of hepatitis B and C viruses; like tattooing, ever lived in hostel and injection drug abuse showed OR < 1, this suggested insufficient sample size and frame before any suggestion of direction of association. Conclusion: History of injections for therapeutic purposes, blood donation and sharing toothbrushes and razors among family members were the factors which were significant amongst cases. (author)

  18. Work-related risk factors for workplace violence among Korean employees.

    Science.gov (United States)

    Lee, Hye-Eun; Kim, Hyoung-Ryoul; Park, Jung Sun

    2014-01-01

    The aim of this study was to identify work-related risk factors for workplace violence in a representative sample of Korean employees. We analyzed the associations between work-related factors and workplace violence in 29,171 employees using data from the 2011 Korean Working Conditions Survey. The survey included questions about verbal abuse, unwanted sexual attention, threats and behavior that humiliated the victim, physical violence, bullying/harassment and sexual harassment, and a respondent who answered yes to any of these 6 items was considered a victim of workplace violence. The prevalences of verbal abuse, unwanted sexual attention and threats/behavior that humiliated victims in the month preceding the study were 4.8, 1.0 and 1.5%, respectively. The prevalences of physical violence, bullying/harassment and sexual harassment in the year preceding the study were 0.7, 0.3 and 0.4%, respectively. Service workers had higher prevalences of overall workplace violence. Non-regular workers (OR=2.38, 95% CI=2.01-2.84), working more than 60 hours per week as opposed to 40-48 hours per week (OR=1.83, 95% CI=1.45-2.31) and night shift work (OR=1.88, 95% CI=1.54-2.30) were significant risk factors associated with workplace violence. Long working hours, job insecurity and night shift work were associated with a significant increase in workplace violence among Korean employees.

  19. Patterns of HIV/AIDS, STI, Substance Abuse and Hepatitis Risk among Selected Samples of Latino and African-American Youth in Washington, DC

    Science.gov (United States)

    Edberg, Mark C.; Collins, Elizabeth; Harris, Meredith; McLendon, Hedda; Santucci, Patricia

    2009-01-01

    In order to address evolving risk factors among youth in Washington, DC (District of Columbia), with respect to HIV/AIDS, sexually transmitted infections (STIs), substance abuse, and hepatitis, a targeted, community-needs assessment was conducted through a partnership between the Department of Prevention and Community Health at George Washington…

  20. Dysthymia among Substance Abusers: An Exploratory Study of Individual and Mental Health Factors

    Science.gov (United States)

    Diaz, Naelys; Horton, Eloise G.; McIlveen, John; Weiner, Michael; Nelson, Jenniffer

    2009-01-01

    The purpose of this study was to examine the individual characteristics and mental health factors of dysthymic and nondysthymic substance abusers. Out of a total of 1,209 medical records reviewed to select cases of dysthymic and nondysthymic substance abusers attending a community drug treatment program, 183 medical records were selected, 48% of…

  1. Parental hostility and its sources in psychologically abusive mothers: a test of the three-factor theory.

    Science.gov (United States)

    Lesnik-Oberstein, M; Koers, A J; Cohen, L

    1995-01-01

    A revised version of the three-factor theory of child abuse (Lesnik-Oberstein, Cohen, & Koers, 1982) is presented. Further, we report on a research designed to test three main hypotheses derived from Factor I (1) (a high level of hostility in abusive parents) and its sources. The three main hypotheses are: (1) that psychologically abusive mothers have a high level of hostile feelings (Factor I); (2) that the high level of hostile feelings in abusive mothers is associated with low marital coping skills (resulting in affectionless, violent marriages), a negative childhood upbringing (punitive, uncaring, over controlling), a high level of stress (objective stress), and a high level of strain (low self-esteem, depression, neurotic symptoms, social anxiety, feelings of being wronged); and (3) that maternal psychological child abuse is associated with low marital coping skills, a negative childhood upbringing, a high level of stress and a high level of strain. Forty-four psychologically abusing mothers were compared with 128 nonabusing mothers on a variety of measures and were matched for age and educational level. All the mothers had children who were hospitalized for medical symptoms. The three hypotheses were supported, with the exception of the component of hypothesis 2 concerning the association between objective stress and maternal hostility. The positive results are consistent with the three-factor theory.

  2. More Than Poverty: The Effect of Child Abuse and Neglect on Teen Pregnancy Risk.

    Science.gov (United States)

    Garwood, Sarah K; Gerassi, Lara; Jonson-Reid, Melissa; Plax, Katie; Drake, Brett

    2015-08-01

    The purpose of the study was to compare risk for teen pregnancies between children living in poverty with no child protective services (CPS) report history and those in poverty with a history of CPS report. Children selected from families in poverty, both with and without CPS report histories were prospectively followed from 1993 to 2009 using electronic administrative records from agencies including CPS, emergency departments, Medicaid services, and juvenile courts. A total of 3,281 adolescent females were followed until the age of 18 years. For teens with history of poverty only, 16.8% had been pregnant at least once by the age of 17 years. In teens with history of both poverty and report of child abuse or neglect, 28.9% had been pregnant at least once by the age of 17 years. Although multivariate survival analyses revealed several other significant factors at the family and youth services levels, a report of maltreatment remained significant (about a 66% higher risk). Maltreatment is a significant risk factor for teen pregnancy among low income youth even after controlling for neighborhood disadvantage, other caregiver risks and indicators of individual emotional and behavioral problems. Copyright © 2015. Published by Elsevier Inc.

  3. Risk factors for workplace violence in clinical registered nurses in Taiwan.

    Science.gov (United States)

    Pai, Hsiang-Chu; Lee, Sheuan

    2011-05-01

    The purpose of this study was to determine the risk factors and mental health consequences of physical and psychological violence for clinical nurses working in healthcare settings in Taiwan. Registered nurses working in hospitals in Taiwan report high incidences of workplace violence. However, previous studies rarely report psychological abuse among nursing staff, while the relationships between personal factors and workplace violence remain unclear. This is a cross-sectional study. Participants were invited to complete the Workplace Violence Questionnaire, an instrument designed to assess types of workplace violence (physical violence, verbal abuse, bullying/mobbing and sexual harassment), the characteristics of perpetrators and victims and victims' reactions to their abuse. A total of 521 nurses completed the questionnaire. Of the participants, 102 (19.6%) indicated that they had experienced physical violence, 268 (51.4%) had experienced verbal abuse, 155 (29.8%) had experienced bullying/mobbing and 67 (12.9%) had experienced sexual harassment. Multiple logistic analyses indicated that age under 30 years (odds ratio = 2.4; 95% confidence interval = 1.34-4.46) and anxiety (odds ratio = 4.7; 95% confidence interval = 1.24-18.12) increased the odds of verbal abuse, while bullying was associated with anxiety (odds ratio = 2.7, 95% confidence interval = 1.09-6.93). Night work shift increased the odds of experiencing sexual harassment (odds ratio = 2.3, 95% confidence interval = 1.29-4.16), while physical violence was associated with bachelor's degree (odds ratio = 2.8, 95% confidence interval = 1.20-6.73). The most serious psychological harm was post-traumatic stress disorder.   Exposure to psychological violence often has a great impact on clinical nurses. For violence prevention, interventions should be sensitive to personal factors. Healthcare institutions should initiate counselling programs to help nurses cope with the stress related to workplace violence.

  4. Tobacco use and substance abuse in students of Karaj Universities

    Directory of Open Access Journals (Sweden)

    Kourosh Kabir

    2016-01-01

    Full Text Available Background: It is clear that tobacco smoking and substance abuse have negative consequences on adolescent and youth′s health. Tobacco smoking especially hookah smoking has increased worldwide especially among university students. This study aimed to determine the prevalence of risk-taking behaviors such as cigarette smoking, hookah smoking, alcohol use, and drug abuse and its predictors in students of Karaj universities. Methods: This cross-sectional study took place in Karaj in January and February 2014. The randomly selected sample consisted of 1959 college students. A self-administered questionnaire was used to measure risk-taking behaviors as well as demographic and related risk factors. Logistic regression model was performed in data analysis. Results: The prevalence of cigarette smoking was 9.3%. The prevalence of hookah smoking was 9.3%. 7% of students used illegal drugs and 9.5% of students used alcohol at least once in last 30 days. After adjustment for other factors, being male, living without parents, having smoker friends, and presence any smoker in the family were factors associated with students′ risk-taking behaviors. The results showed the co-occurrence of risk-taking behaviors. Conclusions: The prevalence of tobacco smoking and substance abuse, particular in males, are high. It seems that planning preventive interventions for this part of the population are necessary. This study emphasized the co-occurrence of risky behaviors, so, it is better high-risk behaviors simultaneously targeted at reducing or preventing interventions.

  5. Child sex tourism - prevalence of and risk factors for its use in a German community sample.

    Science.gov (United States)

    Koops, Thula; Turner, Daniel; Neutze, Janina; Briken, Peer

    2017-04-20

    To investigate the prevalence of child sex tourism (CST) in a large German community sample, and to compare those who made use of CST with other child sexual abusers regarding established characteristics and risk factors for child sexual abuse. Adult German men were recruited through a German market research panel and questioned by means of an anonymous online survey. Group assignment was accomplished based on information on previous sexual contacts with children and previous use of CST. Characteristics and risk factors were compared between the groups using t- and Chi-square tests. Binary logistic regression analysis was performed to predict CST. Data collection was conducted in 2013, data analysis in January 2015. Out of 8718 men, 36 (0.4%) reported CST use. The CST group differed from the nonCST group (n = 96; 1.1%) with regard to pedophilic sexual and antisocial behaviors as well as own experiences of sexual abuse. Social difficulties, pedophilic sexual interests, and hypersexuality were not distinct features in the CST group. Own experiences of sexual abuse, child prostitution use, and previous conviction for a violent offense predicted CST in a logistic regression model. This study is a first step to gain insight into the prevalence and characteristics of men using CST. Findings could help to augment prevention strategies against commercial forms of sexual abuse in developed as well as in developing countries by fostering the knowledge about the characteristics of perpetrators.

  6. Emergence of Sex Differences in the Development of Substance Use and Abuse during Adolescence

    Science.gov (United States)

    Kuhn, Dr. Cynthia

    2015-01-01

    Substance use and abuse begins during adolescence. Male and female adolescent humans initiate use at comparable rates, but males increase use faster. In adulthood, more men than women use and abuse addictive drugs. However, some women progress more rapidly from initiation of use to entry into treatment. In animal models, adolescent males and females consume addictive drugs similarly. However, reproductively mature females acquire self-administration faster, and in some models, escalate use more. Sex/gender differences exist in neurobiologic factors mediating both reinforcement (dopamine, opioids) and aversiveness (CRF, dynorphin), as well as intrinsic factors (personality, psychiatric co-morbidities) and extrinsic factors (history of abuse, environment especially peers and family) which influence the progression from initial use to abuse., Many of these important differences emerge during adolescence, and are moderated by sexual differentiation of the brain. Estradiol effects which enhance both dopaminergic and CRF-mediated processes contribute to the female vulnerability to substance use and abuse. Testosterone enhances impulsivity and sensation seeking in both males and females. Several protective factors in females also influence initiation and progression of substance use including hormonal changes of pregnancy as well as greater capacity for self-regulation and lower peak levels of impulsivity/sensation seeking. Same sex peers represent a risk factor more for males than females during adolescence, while romantic partners increase risk for women during this developmental epoch. In summary, biologic factors, psychiatric co-morbidities as well as personality and environment present sex/gender-specific risks as adolescents begin to initiate substance use. PMID:26049025

  7. Postoperative delirium in patients with history of alcohol abuse.

    Science.gov (United States)

    Sousa, G; Pinho, C; Santos, A; Abelha, F J

    2017-04-01

    Postoperative delirium (POD) is an acute confusional state characterized by changes in consciousness and cognition, which may be fluctuating, developing in a small period of time. The aim of this study was to evaluate the relationship between alcohol abuse and the development of POD. We prospectively evaluated consecutively all postoperative patients admitted in the Post-anesthesia Care Unit over a 1-month period for delirium, using the Portuguese versions of the the Nursing Delirium Screening Scale. Before surgery, alcohol consumption was inquired and alcohol abuse was assessed by the CAGE (Cutting Down, Annoyance, Guilt and Eye-opener) questionnaire; a score ≥2 defined alcohol abuse. Fischer exact test or chi-square was applied for comparisons. Risk factors were analyzed in a multivariate analysis using a logistic regression with odds ratios (OR) and 95% confidence intervals (95%CI). Two hundred twenty-one patients were enrolled. Delirium was seen in 11% patients. The incidence of alcohol abuse was 10%. Patients with alcohol abuse were more frequently men (P<.001) and had a higher ASA physical status III/IV (P=.021). POD was more frequent in patients with alcohol abuse (30% vs. 9%; P=.002). Age (OR: 5.9; 95%CI: 2.2-15.9; P<.001 for patients ≥65years), ASA physical statusIII/IV (OR: 4.2; 95%CI: 1.7-10.7; P=.002) and alcohol abuse (OR: 4.2; 95%CI: 1.4-12.9; P=.013) were found to be independent predictors for POD. Older patients, higher ASA physical status and alcohol abuse were more frequent in patients with POD. Alcohol abuse was considered an independent risk factor for POD. Copyright © 2016 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Does Child Abuse and Neglect Increase Risk for Perpetration of Violence Inside and Outside the Home?

    Science.gov (United States)

    Milaniak, Izabela; Widom, Cathy Spatz

    2014-01-01

    Objective: To examine the extent to which abused and neglected children perpetrate three different types of violence within and outside the home: criminal, child abuse, and intimate partner violence and determine whether childhood maltreatment leads to an increased risk for poly-violence perpetration. Method: Using data from a prospective cohort design study, children (ages 0-11) with documented histories of physical and sexual abuse and/or neglect (n = 676) were matched with children without such histories (n = 520) and assessed in young adulthood (average age 29). Official criminal records in conjunction with self-report data were used to assess violent outcomes. Results: Compared to the control group, individuals with histories of child abuse and/or neglect were significantly more likely to be poly-violence perpetrators, perpetrating violence in all three domains (relative risk = 1.26). All forms of childhood maltreatment (physical and sexual abuse and neglect) significantly predicted poly-violence perpetration. Conclusions: These findings expand the cycle of violence literature by combining the distinct literatures on criminal violence, child abuse, and partner violence to call attention to the phenomenon of poly-violence perpetration by maltreated children. Future research should examine the characteristics of maltreated children who become poly-violence perpetrators and mechanisms that lead to these outcomes. PMID:26191459

  9. Mental health/psychiatric issues in elder abuse and neglect.

    Science.gov (United States)

    Cooper, Claudia; Livingston, Gill

    2014-11-01

    Elder abuse may be defined as a violation of a vulnerable older person's human and civil rights. Psychiatric illness is an important cause of vulnerability to abuse, especially when it is comorbid with other risk factors, such as physical frailty, sensory impairment, social isolation, and physical dependency. Health care providers are likely to encounter elder abuse regularly, and therefore have an important role in its detection and management, and in the treatment of subsequent psychiatric illness. This article reviews the relationships between psychiatric illnesses and elder abuse and neglect, examines the psychiatric consequences, and discusses how these may be treated. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. Association between Elder Abuse and Metabolic Syndromes: Findings from the Chicago Health and Aging Project.

    Science.gov (United States)

    Dong, XinQi; Simon, Melissa

    2015-01-01

    Elder abuse and metabolic syndromes are both important public health issues and are associated with increased morbidity and mortality. This study aimed to examine the associations between elder abuse and risk for metabolic syndromes. The Chicago Health and Aging Project (CHAP) cohort is a population-based study (n = 4,586). We identified 676 participants with some form of elder abuse reported to a social services agency. The primary independent variable was elder abuse reported to a social services agency. Outcomes were metabolic syndrome as categorized by World Health Organization (WHO), American Heart Association (AHA) and International Diabetes Federation (IDF) criteria. Bivariate and logistic regression analyses were used to assess the association between elder abuse and different definitions of metabolic syndromes. In the bivariate analyses, elder abuse victims were more likely than those without elder abuse to have metabolic syndromes [22.4 vs. 10.7% (WHO), 50.7 vs. 40.0% (AHA) and 47.7 vs. 33.5% (IDF)]. After adjusting for potential confounding factors, elder abuse was associated with an increased risk for metabolic syndromes according to WHO [OR, 3.95 (2.86-5.47)], AHA [OR, 2.03 (1.56-2.64)] and IDF [OR, 2.55 (1.97-3.29)] criteria. Interaction term analyses indicate that the association between elder abuse and metabolic syndromes may be moderated by sociodemographic characteristics but not by health-related or psychosocial factors. Elder abuse is associated with an increased risk for metabolic syndromes. Research is needed to examine the association between elder abuse and cardiovascular disease.

  11. Identifying and assessing the risk of opioid abuse in patients with cancer: an integrative review

    Directory of Open Access Journals (Sweden)

    Carmichael AN

    2016-06-01

    Full Text Available Ashley-Nicole Carmichael,1 Laura Morgan,1 Egidio Del Fabbro2 1School of Pharmacy, 2Division of Hematology, Oncology, and Palliative Care, Virginia Commonwealth University, Richmond, VA, USA Background: The misuse and abuse of opioid medications in many developed nations is a health crisis, leading to increased health-system utilization, emergency department visits, and overdose deaths. There are also increasing concerns about opioid abuse and diversion in patients with cancer, even at the end of life. Aims: To evaluate the current literature on opioid misuse and abuse, and more specifically the identification and assessment of opioid-abuse risk in patients with cancer. Our secondary aim is to offer the most current evidence of best clinical practice and suggest future directions for research. Materials and methods: Our integrative review included a literature search using the key terms “identification and assessment of opioid abuse in cancer”, “advanced cancer and opioid abuse”, “hospice and opioid abuse”, and “palliative care and opioid abuse”. PubMed, PsycInfo, and Embase were supplemented by a manual search. Results: We found 691 articles and eliminated 657, because they were predominantly noncancer populations or specifically excluded cancer patients. A total of 34 articles met our criteria, including case studies, case series, retrospective observational studies, and narrative reviews. The studies were categorized into screening questionnaires for opioid abuse or alcohol, urine drug screens to identify opioid misuse or abuse, prescription drug-monitoring programs, and the use of universal precautions. Conclusion: Screening questionnaires and urine drug screens indicated at least one in five patients with cancer may be at risk of opioid-use disorder. Several studies demonstrated associations between high-risk patients and clinical outcomes, such as aberrant behavior, prolonged opioid use, higher morphine-equivalent daily dose

  12. Evaluation of a child sexual abuse prevention program.

    Science.gov (United States)

    Chasan-Taber, L; Tabachnick, J

    1999-10-01

    A half-million children are believed to be sexually abused each year in the United States. In 1995, the American Medical Association declared sexual assault "a silent violent epidemic." The majority of efforts to stop child sexual abuse have focused on punishing abusers and treating victims and their families; prevention programs are uncommon and rely on educating children to report sexual abuse. This case study describes the evaluation of the first public health campaign designed to target adults for prevention. A baseline assessment of attitudes, awareness, knowledge, and policies was conducted in Vermont to identify facilitators and barriers to adult prevention of child sexual abuse. These included predisposing factors (50% of Vermont residents did not know the characteristics of an abuser), enabling factors (60% of Vermont residents did not know where to refer someone who may have sexual behavior problems), and reinforcing factors (when focus group participants knew an abuser, they were less likely to take action). This process guided the intervention, which included a broad-based media campaign targeting adults; a one-to-one communications strategy that provided information to agencies working with families at risk and a toll-free helpline for adults in an abuse situation; and a systems change strategy designed to educate decision-makers and leaders. Program evaluation measures included a random-digit dial survey, focus groups, a survey of Vermont decision-makers, and other data sets. The successes and limitations of these interventions, both as strategies in themselves and as data sources for evaluation, are discussed.

  13. Tooth Decay in Alcohol Abusers Compared to Alcohol and Drug Abusers

    Directory of Open Access Journals (Sweden)

    Ananda P. Dasanayake

    2010-01-01

    Full Text Available Alcohol and drug abuse are detrimental to general and oral health. Though we know the effects of these harmful habits on oral mucosa, their independent and combined effect on the dental caries experience is unknown and worthy of investigation. We compared 363 “alcohol only” abusers to 300 “alcohol and drug” abusers to test the hypothesis that various components of their dental caries experience are significantly different due to plausible sociobiological explanations. After controlling for the potential confounders, we observe that the “alcohol and drug” group had a 38% higher risk of having decayed teeth compared to the “alcohol only” group (<.05. As expected, those who belonged to a higher social class (OR=1.98; 95%  CI=1.43–2.75 and drank wine (OR=1.85; 95%  CI=1.16–2.96 had a higher risk of having more filled teeth. We conclude that the risk of tooth decay among “alcohol only” abusers is significantly lower compared to “alcohol and drug” abusers.

  14. Sexual Abuse, Violence And Hiv Risk Among Adolescents In South ...

    African Journals Online (AJOL)

    The aim of the study is to investigate sexual abuse, violence and HIV risk among a sample of South African adolescents. The sample included 400 male and 400 female 16 or 17 year-olds; 400 were from rural and 400 from urban areas, and almost all from African descent. Participants were chosen by multi-stage cluster and ...

  15. Sexual dysfunction risk and quality of life among women with a history of sexual abuse.

    Science.gov (United States)

    Carreiro, Andrea V; Micelli, Ligia P; Sousa, Maria H; Bahamondes, Luis; Fernandes, Arlete

    2016-09-01

    To assess scores for sexual dysfunction risk and quality of life in a cohort of women in Brazil who had a history of sexual abuse. The present study was a secondary analysis of a cross-sectional study conducted between February 1, 2011 and May 31, 2012. Women aged 18-49years attending a family planning clinic at the University of Campinas, Brazil, who were in a heterosexual relationship and reported engaging in sexual intercourse in the 4weeks prior to the study were enrolled. Participants were asked to complete the World Health Organization Quality of Life Questionnaire, Abbreviated Version, and the Female Sexual Function Index (FSFI) questionnaire. Data were grouped based on a history of sexual abuse. An FSFI score of no higher than 26.55 was considered the cut off for sexual dysfunction. The prevalence of FSFI-defined sexual dysfunction was higher in participants with a history of sexual abuse (Phistory of sexual abuse had significantly lower scores across all quality of life domains. Increased risk of sexual dysfunction among women with a history of sexual abuse suggests potential problems in the sex lives of individuals in this population. Healthcare professionals should be alert to this diagnosis. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  16. Understanding Child Sexual Abuse by Catholic Priests from a Situational Perspective

    Science.gov (United States)

    Terry, Karen J.; Freilich, Joshua D.

    2012-01-01

    Most sexual offense research focuses on offender motivation and individual risk factors rather than the criminal events themselves. This article provides an analysis of data from two studies on child sexual abuse by Catholic priests to help understand the opportunities clergy had or created to abuse youth. Findings show that situational factors…

  17. A comparison of abused and non-abused women's definitions of domestic violence and attitudes to acceptance of male dominance.

    Science.gov (United States)

    Faramarzi, M; Esmailzadeh, S; Mosavi, S

    2005-10-01

    To examine the effects of women's subjective definitions of wife abuse and of their general attitudes to acceptance of male dominance on the occurrence of domestic violence. A case-control survey was conducted in the public health center of Babol University of Medical Sciences from November 2002 to October 2003. The Abuse Assessment Screen Form was used to identify partner violence, and the Abuse Definition Form and Abuse Attitude Form were applied to measure how the women defined wife abuse and their attitudes to male dominance. Women with positive attitudes to male dominance had experienced more physical and emotional abuse than those with negative attitudes toward male dominance (p family income were important risk factors for domestic violence, the strongest predictor of physical abuse was a positive attitude to male dominance. A positive attitude of women to male dominance increases the acceptance and frequency of partner violence. This finding shows the need to raise the educational levels of women and raise their awareness of their rights. This could convert an attitude of male dominance to equality of men and women.

  18. Risk factors associated with drug use before imprisonment in Peru

    Directory of Open Access Journals (Sweden)

    A Hernández-Vásquez

    Full Text Available Abstract Objective: To assess the prevalence of drug abuse before prison admission and to identify associated sociodemographic and family history risk factors, according to gender, in prisons of Peru. Materials and methods: A secondary analysis was carried out with data from the First National Prisoner Census 2016, using a questionnaire of 173 items that was applied to the whole prison population of Peru. The types of drugs used before admission were analyzed according to characteristics of the penitentiary population, and generalized linear models were used to calculate prevalence ratios with 95% confidence intervals to identify possible factors associated with drug use. Results: Out of a population of 76,180 prisoners, 71,184 (93.4% answered the survey (men 67,071, 94.2%. The overall prevalence of drug consumption before admission was 24.4% (25.3 % in men and 9.1% in women, the highest prevalence in the 18-29 age group (36.3% in men and 14.9% in women. The most commonly used drugs were marijuana (58.2%, coca paste/cocaine or crack (40.3% and inhalants (1%. The factors most strongly associated with consumption were having a family member who consumed drugs (59.8%, history of previous imprisonment (59.1%, unemployment (48.4%, relationships at school with classmates who had problems with the law (46.9%, background of a family member who attended a penitentiary (38.4%, and history of running away from home before age 15 (35.9%. Conclusions: In Peru, drug use is higher in the prison population than in the general population, and there are differences according to sex in the prevalence of drug use and associated factors prior to admission to a prison. The study demonstrated that childhood events, such as child abuse, having a family member imprisoned, having a family member who used drugs, or who previously abused alcohol, are factors associated with drug use in the penitentiary population. Some of these risk factors are modifiable, so it is

  19. State of the science on prevention of elder abuse and lessons learned from child abuse and domestic violence prevention: Toward a conceptual framework for research.

    Science.gov (United States)

    Teresi, Jeanne A; Burnes, David; Skowron, Elizabeth A; Dutton, Mary Ann; Mosqueda, Laura; Lachs, Mark S; Pillemer, Karl

    2016-01-01

    The goal of this review is to discuss the state of the science in elder abuse prevention. Findings from evidence-based programs to reduce elder abuse are discussed, drawing from findings and insights from evidence-based programs for child maltreatment and domestic/intimate partner violence. A conceptual measurement model for the study of elder abuse is presented and linked to possible measures of risk factors and outcomes. Advances in neuroscience in child maltreatment and novel measurement strategies for outcome assessment are presented.

  20. Risk factors for suicide in schizophrenia: systematic review and clinical recommendations.

    Science.gov (United States)

    Popovic, D; Benabarre, A; Crespo, J M; Goikolea, J M; González-Pinto, A; Gutiérrez-Rojas, L; Montes, J M; Vieta, E

    2014-12-01

    To identify risk factors associated with suicide of patients with schizophrenia and provide clinical recommendations, which integrate research findings into a consensus based on clinical experience and evidence. A task force formed of experts and clinicians iteratively developed consensus through serial revisions using the Delphi method. Initial survey items were based on systematic literature review published up to June 2013. Various risk factors were reported to be implicated in suicide in schizophrenia. Our findings indicate that suicide risk in schizophrenia is mainly related to affective symptoms, history of a suicide attempt and number of psychiatric admissions. Other risk factors identified are given by younger age, closeness to illness onset, older age at illness onset, male sex, substance abuse and period during or following psychiatric discharge. Integrating the evidence and the experience of the task force members, a consensus was reached on 14 clinical recommendations. Identification of risk factors for suicide in individuals diagnosed with schizophrenia is imperative to improve clinical management and develop strategies to reduce the incidence of suicide in this population. This study provides the critical overview of available data and clinical recommendations on recognition and management of the above-mentioned risk factors. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. The role of exogenous risk factors of antituberculosis treatment failure.

    Science.gov (United States)

    Lesnic, Evelina; Ustian, Aurelia; Pop, Carmen Monica

    2016-01-01

    The Republic of Moldova reports the highest incidence of tuberculosis and the lowest treatment success rate among European region countries. In most of the patients the antituberculosis treatment failure is correlated with social risk factors (low socio-economical state, epidemiological danger characteristics) and biological factors (young age, male sex, physiological conditions, associated diseases). Clinical factors (advanced forms of tuberculosis, chronic evolution, immune disturbances), therapeutic factors (treatment errors and interruptions, individualized regimens) and administrative factors (drug interruption in supply, suboptimal treatment quality) prevail in regions with defficient in health care delivery. The association of risk factors has a higher impact than the severity of one risk factor. The risk factor assessment is very important before initiation of the treatment, for establishing the plan of risk reduction measures for increasing the success rate. The aim of the study was to determine the impact of exogenous risk factors on antituberculosis treatment failure. The study was conducted on 201 patients with pulmonary tuberculosis and treatment failure and 105 patients with pulmonary tuberculosis who successfully finished the antituberculosis treatment. Selected cases were investigated according national standards. The treatment failure occurred in patients belonging to socially disadvantaged groups, patients with harmful habits (alcohol abuse, drug use, active smoking), patients from infectious clusters. Migration, homelessness and detention releasing imperil the quality of treatment, thus predisposing to the treatment failure. Social, educational support and the substitutive therapy and withdrawal techniques (tobacco, alcohol, psycho-active substances) must be implemented in the high risk groups in order to diminish the risk of treatment failure and to increase the treatment success rate. The study of exogenous risk factors in vulnerable groups

  2. Mood disorder, anxiety, and suicide risk among subjects with alcohol abuse and/or dependence: a population-based study

    Directory of Open Access Journals (Sweden)

    Carolina D. Wiener

    2017-06-01

    Full Text Available Objective: To evaluate the prevalence of alcohol abuse and/or dependence in a population-based sample of young adults and assess the prevalence of comorbid mood disorders, anxiety, and suicide risk in this population. Methods: This cross-sectional, population-based study enrolled 1,953 young adults aged 18-35 years. The CAGE questionnaire was used to screen for alcohol abuse and/or dependence, with CAGE scores ≥ 2 considered positive. Psychiatric disorders were investigated through the structured Mini International Neuropsychiatric Interview (MINI. Results: Alcohol abuse and/or dependence was identified in 187 (9.60% individuals (5.10% among women and 15.20% among men. Alcohol abuse and/or dependence were more prevalent among men than women, as well as among those who used tobacco, illicit drugs or presented with anxiety disorder, mood disorder, and suicide risk. Conclusion: These findings suggest that alcohol abuse and/or dependence are consistently associated with a higher prevalence of psychiatric comorbidities, could be considered important predictors of other psychiatric disorders, and deserve greater public heath attention, pointing to the need for alcohol abuse prevention programs.

  3. Mood disorder, anxiety, and suicide risk among subjects with alcohol abuse and/or dependence: a population-based study.

    Science.gov (United States)

    Wiener, Carolina D; Moreira, Fernanda P; Zago, Alethea; Souza, Luciano M; Branco, Jeronimo C; Oliveira, Jacqueline F de; Silva, Ricardo A da; Portela, Luis V; Lara, Diogo R; Jansen, Karen; Oses, Jean P

    2018-01-01

    To evaluate the prevalence of alcohol abuse and/or dependence in a population-based sample of young adults and assess the prevalence of comorbid mood disorders, anxiety, and suicide risk in this population. This cross-sectional, population-based study enrolled 1,953 young adults aged 18-35 years. The CAGE questionnaire was used to screen for alcohol abuse and/or dependence, with CAGE scores ≥ 2 considered positive. Psychiatric disorders were investigated through the structured Mini International Neuropsychiatric Interview (MINI). Alcohol abuse and/or dependence was identified in 187 (9.60%) individuals (5.10% among women and 15.20% among men). Alcohol abuse and/or dependence were more prevalent among men than women, as well as among those who used tobacco, illicit drugs or presented with anxiety disorder, mood disorder, and suicide risk. These findings suggest that alcohol abuse and/or dependence are consistently associated with a higher prevalence of psychiatric comorbidities, could be considered important predictors of other psychiatric disorders, and deserve greater public heath attention, pointing to the need for alcohol abuse prevention programs.

  4. Treated Mental Illness and the Risk of Child Abuse Perpetration.

    Science.gov (United States)

    Friedman, Susan Hatters; McEwan, Miranda V

    2018-02-01

    Despite a limited empirical literature, parental mental illness is often cited as a major risk factor for violence against children. However, mental illness that is adequately treated would not be expected to lead to increased violence risk. This study compared incidents of violence toward children perpetrated by parents who were newly discharged from inpatient psychiatric treatment with violence perpetrated by other parents in the same communities to determine whether parents with treated mental illness had an elevated risk of child abuse perpetration. A secondary analysis of data from the MacArthur Violence Risk Assessment Study was conducted. Violence toward children reported by parents and by collateral informants at the initial ten-week follow-up interview was analyzed for two groups: study participants discharged from inpatient psychiatric facilities and parents in the community matched by neighborhood. Of the 416 parents in the participant group, 20 (5%) committed violence toward a child in the ten weeks after discharge, compared with 41 (14%) of the 299 parents in the comparison group. In the participant group, diagnostic categories of parents who committed violence toward a child were as follows: serious mental illness only (8% of whom were violent), substance use disorder only (3%), both serious mental illness and substance use disorder (4%), and another issue (7%). This study found that parents with treated serious mental illness were not at higher risk than other parents in their community of perpetrating violence toward children. Parents who were admitted to an acute psychiatric facility and treated appeared to be at lower risk of being violent toward children than other parents in their community.

  5. Decline in Physical Function and Risk for Elder Abuse Reported to Social Services in a Community-Dwelling Population of Older Adults

    Science.gov (United States)

    Dong, XinQi; Simon, Melissa; Evans, Denis

    2012-01-01

    Objectives Elder abuse is an important public health and human rights issue and is associated with increased morbidity and mortality. This study aimed to examine the longitudinal association between decline in physical function and the risk for elder abuse. Design Prospective population-based study Setting Geographically defined community in Chicago. Participants Chicago Health and Aging Project (CHAP) is a population-based study (N=6,159), and we identified 143 CHAP participants who had elder abuse reported to social services agency from 1993–2010. Participants The primary independent variable was objectively assessed physical function using decline in physical performance testing (Tandem stand, measured walk and chair stand). Secondary independent variables were assessed using the decline in self-reported Katz, Nagi, and Rosow-Breslau scales. Outcomes were reported and confirmed elder abuse and specific subtypes of elder abuse (physical, psychological, caregiver neglect and financial exploitation). Logistic regression models were used to assess the association of decline in physical function measures and risk for elder abuse. Results After adjusting for potential confounders, every 1 point decline in physical performance testing (OR, 1.13(1.06–1.19)), Katz impairment (OR, 1.29(1.15–1.45)), Nagi impairment (OR, 1.30(1.13–1.49)) and Rosow Breslau impairment (OR, 1.42(1.15–1.74)) were associated with increased risk for elder abuse. Lowest tertiles of physical performance testing (OR, 4.92 (1.39–17.46), highest tertiles of Katz impairment (OR, 3.99 (2.18–7.31), Nagi impairment (OR, 2.37 (1.08–5.23), and Rosow Breslau impairment (2.85 (1.39–5.84) were associated with increased risk for elder abuse. Conclusion Decline in objectively assessed physical function and self-reported physical function are associated with increased risk for elder abuse. PMID:23002901

  6. Application of Theory of Planned Behavior in Predicting Factors of Substance Abuse in Adolescents

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    Saeid Bashirian

    2012-12-01

    Full Text Available Background and Objective: Adolescence is the most critical period of life as regards commencing drug abuse. The social cost and damage caused by drug abuse in adolescence are enormous, necessitating interventional programs to prevent this behavior. The theory of planned behavior (TPB is perhaps the most influential theory for the prediction of social and health behaviors such as drug abuse.Materials and Methods: In this descriptive analytical study, samples were collected from male students in four high schools in different regions of Hamedan. The survey was carried out via random cluster sampling of 650 students. Data were collected using the standard self-report questionnaires and were analyzed using SPSS16, chi-squared test, correlation coefficient, and logistic regression analysis.Results: Among the adolescents participating in this study, 11.1% had the experience of cigarette smoking, 3.4% had the experience of drug abuse, and 12% had the experience of intention to abuse drugs. There was a significant relationship between drug abuse and the following variables: smoking experience (p value =0.001, OR=27.238; having drug user parents (p value =0.001, OR=8.630; having friends who had experienced drug abuse (p value =0.001, OR=11.060; having best friends who had experienced drug abuse (p value = 0.001, OR=11.931; family with drug abuse (p value = 0.001, OR=4.311; and having a sibling who abused drugs (p value=0.001, OR=15.815. According to the logistic regression analysis, attitude, subjective norms, and perceived behavior control were the most influential predictors of intention to abuse drugs.Conclusion: The use of TPB is beneficial in the predicting and planning for high-risk behaviors. TPB can be used for planning and implementing drug abuse prevention programs in adolescents.

  7. Recreational Viagra Use and Sexual Risk among Drug Abusing Men

    OpenAIRE

    Dennis G. Fisher; Robert Malow; Rhonda Rosenberg; Grace L. Reynolds; Nisha Farrell; Aditya Jaffe

    2006-01-01

    Until recently, the Viagra connection to HIV was anchored in older adults. However, CDC investigation showed stability in 50+ HIV diagnoses on the heels of upward trends in risk indicators among men who have sex with men (MSM) and substance abusing populations. Signs have increasingly pointed to recreational drug use among younger populations, to which Viagra is being added to th...

  8. Child sex tourism – prevalence of and risk factors for its use in a German community sample

    Directory of Open Access Journals (Sweden)

    Thula Koops

    2017-04-01

    Full Text Available Abstract Background To investigate the prevalence of child sex tourism (CST in a large German community sample, and to compare those who made use of CST with other child sexual abusers regarding established characteristics and risk factors for child sexual abuse. Methods Adult German men were recruited through a German market research panel and questioned by means of an anonymous online survey. Group assignment was accomplished based on information on previous sexual contacts with children and previous use of CST. Characteristics and risk factors were compared between the groups using t- and Chi-square tests. Binary logistic regression analysis was performed to predict CST. Data collection was conducted in 2013, data analysis in January 2015. Results Out of 8718 men, 36 (0.4% reported CST use. The CST group differed from the nonCST group (n = 96; 1.1% with regard to pedophilic sexual and antisocial behaviors as well as own experiences of sexual abuse. Social difficulties, pedophilic sexual interests, and hypersexuality were not distinct features in the CST group. Own experiences of sexual abuse, child prostitution use, and previous conviction for a violent offense predicted CST in a logistic regression model. Conclusions This study is a first step to gain insight into the prevalence and characteristics of men using CST. Findings could help to augment prevention strategies against commercial forms of sexual abuse in developed as well as in developing countries by fostering the knowledge about the characteristics of perpetrators.

  9. Risk Psychosocial Factors to School Dropout and Early Teenage Pregnancy

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    Fabián Antonio Dávila Ramírez

    2016-01-01

    Full Text Available To explore the frequency and weight that psychosocial risk factors predispose to outcomes of early pregnancy and scholar dropout, a descriptive review was conducted. Materials and Meth­ods: A search and review of the results reported by observational studies in the PubMed data­base indexed from July 27, 2010 until July 25, 2013 was performed, restricting the search to studies in humans, Spanish or English written, not made in countries in Africa or Asia. Search was widened to LILACS database for the years 2006 to 2013 for Latinamerican countries. For inclusion, all case-control studies comparing different types of interventions and psychosocial risk factors in adolescents were eligible. Results: The review suggests violence experienced dur­ing adolescence, sexual abuse, belonging to a low socioeconomic status, low self-esteem, eating behavior disorders, smoking, alcoholism and drug addiction, mental disorders, early initiation of sex, poor family ties, lack of access to information, and resources for family planning as main psychosocial factors related to early pregnancy and scholar dropout in adolescents. Conclusions: Both risk factors associated with pregnancy and scholar dropout were described, and interven­tions targeting the described risk factors could potentially contribute to the reduction of these outcomes were described.

  10. [Screening for psychiatric risk factors in a facial trauma patients. Validating a questionnaire].

    Science.gov (United States)

    Foletti, J M; Bruneau, S; Farisse, J; Thiery, G; Chossegros, C; Guyot, L

    2014-12-01

    We recorded similarities between patients managed in the psychiatry department and in the maxillo-facial surgical unit. Our hypothesis was that some psychiatric conditions act as risk factors for facial trauma. We had for aim to test our hypothesis and to validate a simple and efficient questionnaire to identify these psychiatric disorders. Fifty-eight consenting patients with facial trauma, recruited prospectively in the 3 maxillo-facial surgery departments of the Marseille area during 3 months (December 2012-March 2013) completed a self-questionnaire based on the French version of 3 validated screening tests (Self Reported Psychopathy test, Rapid Alcohol Problem Screening test quantity-frequency, and Personal Health Questionnaire). This preliminary study confirmed that psychiatric conditions detected by our questionnaire, namely alcohol abuse and dependence, substance abuse, and depression, were risk factors for facial trauma. Maxillo-facial surgeons are often unaware of psychiatric disorders that may be the cause of facial trauma. The self-screening test we propose allows documenting the psychiatric history of patients and implementing earlier psychiatric care. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  11. Childhood sexual abuse and attachment: An intergenerational perspective

    OpenAIRE

    Kwako, Laura E.; Noll, Jennie G.; Putnam, Frank W.; Trickett, Penelope K.

    2010-01-01

    Childhood sexual abuse (CSA) is a recognized risk factor for various negative outcomes in adult survivors and their offspring. We used the Dynamic-Maturational Model of attachment theory as a framework for exploring the impact of maternal CSA on children’s attachment relationships in the context of a longitudinal sample of adult survivors of CSA and non-abused comparison mothers and their children. Results indicated that children of CSA survivors were more likely to have extreme strategies of...

  12. State-of-the-science on prevention of elder abuse and lessons learned from child abuse and domestic violence prevention: Toward a conceptual framework for research

    Science.gov (United States)

    Teresi, Jeanne A.; Burnes, David; Skowron, Elizabeth A.; Dutton, Mary Ann; Mosqueda, Laura; Lachs, Mark S.; Pillemer, Karl

    2017-01-01

    The goal of this review is to discuss the state-of-the-science in elder abuse prevention. Findings from evidence-based programs to reduce elder abuse are discussed, drawing from findings and insights from evidence-based programs for child maltreatment and domestic/ intimate partner violence. A conceptual measurement model for the study of elder abuse is presented, and linked to possible measures of risk factors and outcomes. Advances in neuroscience in child maltreatment and novel measurement strategies for outcome assessment are presented. PMID:27676289

  13. A prospective investigation of borderline personality disorder in abused and neglected children followed up into adulthood.

    Science.gov (United States)

    Widom, Cathy Spatz; Czaja, Sally J; Paris, Joel

    2009-10-01

    Child abuse has been implicated as a risk factor for borderline personality disorder (BPD), yet few prospective longitudinal studies exist. The current study examined whether 500 individuals with documented cases of childhood physical and sexual abuse and neglect were at elevated risk of BPD in adulthood, compared to 396 demographically similar control children. Results indicated that significantly more abused and/or neglected children overall met criteria for BPD as adults, compared to controls, as did physically abused and neglected children. Having a parent with alcohol/drug problems and not being employed full-time, not being a high school graduate, and having a diagnosis of drug abuse, major depressive disorder, and posttraumatic stress disorder were predictors of BPD and mediated the relationship between childhood abuse/neglect and adult BPD. These results call attention to a heightened risk of BPD in physically abused and neglected children and the need to consider multiple pathways to BPD.

  14. Orphaned and abused youth are vulnerable to pregnancy and suicide risk☆, ☆☆

    Science.gov (United States)

    Kissin, Dmitry M.; Bogoliubova, Olga; Yorick, Roman V.; Kraft, Joan Marie; Jamieson, Denise J.; Marchbanks, Polly A.; Hillis, Susan D.

    2015-01-01

    Objective Little is known about the magnitude and consequences of violence against children for those living outside family care. We sought to estimate the frequency of childhood abuse and examine its association with lifetime pregnancy involvement (LPI) and past year suicide ideation among orphaned youth. Methods We analyzed data collected via cross-sectional interviewer-administered surveys completed by 293 orphaned youth aged 16–23 years living outside of family care in St. Petersburg, Russia. We used multivariable logistic regression to estimate adjusted odds ratios (AORs) of LPI and past year suicide ideation associated with childhood physical and sexual abuse. Other risk factors were also examined (e.g., social vulnerability, sexual and substance use behaviors), and characteristics of orphaned youth with LPI and past year suicide ideation were described. Results The prevalence of childhood abuse was higher among females than among males (23.3% versus 15.6% for physical abuse, and 20.3% versus 5.6% for sexual abuse), as was the prevalence of LPI and past year suicide ideation among those with histories of abuse. Experiences of childhood abuse were strong risk factors for both LPI and past year suicide ideation, with significant variation by gender. While both types of abuse were significantly associated with LPI and past year suicide ideation among females, physical abuse was significantly associated with LPI and sexual abuse was associated with suicide ideation for males. Of the other characteristics examined, strong modifiable risk factors included having no one to turn to for help and no involvement in activities outside of class. Among those with LPI (n = 36), nearly 20% had been pregnant or gotten someone pregnant ≥2 times, most (61.8%) reported at least one induced abortion, and current use of effective contraception was nearly non-existent. Among those with past year suicide ideation (n = 30), nearly half (44.8%) reported attempting suicide

  15. Substance abuse and child maltreatment.

    Science.gov (United States)

    Wells, Kathryn

    2009-04-01

    Pediatricians and other medical providers caring for children need to be aware of the dynamics in the significant relationship between substance abuse and child maltreatment. A caregiver's use and abuse of alcohol, marijuana, heroin, cocaine, methamphetamine, and other drugs place the child at risk in multiple ways. Members of the medical community need to understand these risks because the medical community plays a unique and important role in identifying and caring for these children. Substance abuse includes the abuse of legal drugs as well as the use of illegal drugs. The abuse of legal substances may be just as detrimental to parental functioning as abuse of illicit substances. Many substance abusers are also polysubstance users and the compounded effect of the abuse of multiple substances may be difficult to measure. Often other interrelated social features, such as untreated mental illness, trauma history, and domestic violence, affect these families.

  16. Child and Family Factors Associated With Child Maltreatment in Vietnam.

    Science.gov (United States)

    Tran, Nhu K; van Berkel, Sheila R; van IJzendoorn, Marinus H; Alink, Lenneke R A

    2018-04-01

    This study aims to explore possible risk factors for child maltreatment in Vietnam by investigating the association of child and family factors with different types of child maltreatment (i.e., sexual abuse, physical abuse, emotional abuse, witnessing parental conflict, and neglect) and the occurrence of multiple types of child maltreatment. Cross-sectional data of 1,851 secondary and high school students aged 12 to 17 years (47.3% boys) in four provinces of Northern Vietnam were obtained using self-report questionnaires. Results indicated that the likelihood of emotional abuse, witnessing parental conflict, and experiencing multiple types of child maltreatment during lifetime increased with age. Boys had a higher risk than girls on lifetime sexual abuse, and past year and lifetime physical abuse. Living in a single parent family was the risk factor related to most types of child maltreatment including lifetime sexual abuse, neglect, and multiple types of child maltreatment, and both past year and lifetime witnessing parental conflict. Interestingly, low socioeconomic status (SES) and parental unemployment were associated with a decreased risk on experiencing emotional abuse in the past year and during lifetime, respectively. "Tiger parenting," a parenting style observed frequently in East Asian parents, may be more common in families with high SES and might explain this finding. This study highlights the importance of prioritizing single parent families in parenting programs and implementing child maltreatment interventions early because of the risk on child maltreatment increased with age. More research on emotional abuse and "Tiger parenting" in Vietnam could clarify the association of emotional abuse with high SES and parental employment. Finally, the underlying mechanisms of the risk factors in Vietnam should be studied more to inform interventions.

  17. Structural Pathways between Child Abuse, Poor Mental Health Outcomes and Male-Perpetrated Intimate Partner Violence (IPV)

    Science.gov (United States)

    Machisa, Mercilene T.; Christofides, Nicola; Jewkes, Rachel

    2016-01-01

    Background Violent trauma exposures, including child abuse, are risk factors for PTSD and comorbid mental health disorders. Child abuse experiences of men exacerbate adult male-perpetrated intimate partner violence (IPV). The relationship between child abuse, poor mental health and IPV perpetration is complex but research among the general population is lacking. This study describes the relationship and pathways between history of child abuse exposure and male-perpetrated IPV while exploring the potentially mediating effect of poor mental health. Methods We analysed data from a randomly selected, two-stage clustered, cross-sectional household survey conducted with 416 adult men in Gauteng Province of South Africa. We used multinomial regression modelling to identify associated factors and Structural Equation Modelling (SEM) to test the primary hypothesis that poor mental health (defined as abusing alcohol or having PTSD or depressive symptoms) mediates the relationship between child abuse and IPV perpetration. Results Eighty eight percent of men were physically abused, 55% were neglected, 63% were emotionally abused and 20% were sexually abused at least once in their childhood. Twenty four percent of men had PTSD symptoms, 24% had depressive symptoms and 36% binge drank. Fifty six percent of men physically abused and 31% sexually abused partners at least once in their lifetime. Twenty two percent of men had one episode and 40% had repeat episodes of IPV perpetration. PTSD symptomatology risk increased with severity of child trauma and other trauma. PTSD severity increased the risk for binge drinking. Child trauma, other trauma and PTSD symptomatology increased the severity of depressive symptoms. PTSD symptomatology was comorbid with alcohol abuse and depressive symptoms. Child trauma, having worked in the year before the survey, other trauma and PTSD increased the risk of repeat episodes of IPV perpetration. Highly equitable gender attitudes were protective

  18. Structural Pathways between Child Abuse, Poor Mental Health Outcomes and Male-Perpetrated Intimate Partner Violence (IPV.

    Directory of Open Access Journals (Sweden)

    Mercilene T Machisa

    Full Text Available Violent trauma exposures, including child abuse, are risk factors for PTSD and comorbid mental health disorders. Child abuse experiences of men exacerbate adult male-perpetrated intimate partner violence (IPV. The relationship between child abuse, poor mental health and IPV perpetration is complex but research among the general population is lacking. This study describes the relationship and pathways between history of child abuse exposure and male-perpetrated IPV while exploring the potentially mediating effect of poor mental health.We analysed data from a randomly selected, two-stage clustered, cross-sectional household survey conducted with 416 adult men in Gauteng Province of South Africa. We used multinomial regression modelling to identify associated factors and Structural Equation Modelling (SEM to test the primary hypothesis that poor mental health (defined as abusing alcohol or having PTSD or depressive symptoms mediates the relationship between child abuse and IPV perpetration.Eighty eight percent of men were physically abused, 55% were neglected, 63% were emotionally abused and 20% were sexually abused at least once in their childhood. Twenty four percent of men had PTSD symptoms, 24% had depressive symptoms and 36% binge drank. Fifty six percent of men physically abused and 31% sexually abused partners at least once in their lifetime. Twenty two percent of men had one episode and 40% had repeat episodes of IPV perpetration. PTSD symptomatology risk increased with severity of child trauma and other trauma. PTSD severity increased the risk for binge drinking. Child trauma, other trauma and PTSD symptomatology increased the severity of depressive symptoms. PTSD symptomatology was comorbid with alcohol abuse and depressive symptoms. Child trauma, having worked in the year before the survey, other trauma and PTSD increased the risk of repeat episodes of IPV perpetration. Highly equitable gender attitudes were protective against single and

  19. An Update on the Epidemiology of Schizophrenia with a Special Reference to Clinically Important Risk Factors

    Science.gov (United States)

    El-Missiry, Ahmed; Aboraya, Ahmed Sayed; Manseur, Hader; Manchester, Johnna; France, Cheryl; Border, Katherine

    2011-01-01

    Schizophrenia is a chronic mental illness which poses a tremendous burden on the families, caregivers and the society. The purpose of this paper is to provide an updated review of the epidemiology of schizophrenia with a special attention to the clinically important risk factors such as drug abuse, hormonal factors and the new advances in genetic…

  20. Nursing Aides' Attitudes to Elder Abuse in Nursing Homes: The Effect of Work Stressors and Burnout

    Science.gov (United States)

    Shinan-Altman, Shiri; Cohen, Miri

    2009-01-01

    Background: Nursing aides' attitudes condoning elder abuse are a possible risk factor for executing abusive behaviors against elder residents of long-term care facilities but have been studied infrequently. Purpose: The purpose of the study was to assess nursing aides' attitudes that condone abusive behaviors toward elderly people, as well as the…

  1. Inhalant and Prescription Medication Abuse among Adolescents: An Inexpensive, Accessible, and Misperceived Trend

    Science.gov (United States)

    Sikes, April; Walley, Cynthia; McBride, Rebecca; Fusco, Angela; Cole, Rebekah F.; Lauka, Justin

    2011-01-01

    Inhalant and prescription medication abuse, particularly among adolescents, are serious problems in our society. Several risk factors associated with inhalant and medication abuse among adolescents have been identified. As a result, adolescents may suffer multiple consequences in a range of developmental areas. The purpose of this article is to…

  2. Understanding Suicide Across the Lifespan: A United States Perspective of Suicide Risk Factors, Assessment & Management.

    Science.gov (United States)

    Steele, Ian H; Thrower, Natasha; Noroian, Paul; Saleh, Fabian M

    2018-01-01

    Suicide is a troubling, preventable phenomenon. Prior to attempts, individuals often seek help, prompting practitioners to perform risk assessments that ideally use evidence-based risk management strategies. A literature review was performed using Harvard Countway Library of Medicine, Google Scholar, PubMed. Key words used were "Forensic Science," "Suicide Risk Management," "Pediatric Suicide Risk Factors," "Adult Suicide Risk Factors," "Geriatric Suicide Risk Factors," "Suicide Risk Assessment." Parameters limited articles to studies/reviews completed in the past twenty years in the United States. Results indicated predictors of suicide in juveniles were insomnia, burdensomeness, and recent conflicts with family or a romantic partner. Adults had greater risk if male, substance abusing, with marital/job loss. Elderly individuals with multiple medical comorbidities, hopelessness, and isolation were at higher risk. Everyone evaluated should be screened for access to firearms. Management of suicide risk involves providing the least restrictive form of treatment which maintains an individual's safety. © 2017 American Academy of Forensic Sciences.

  3. Effects of Community Based Educational Prevention Program of Drug Abuse in Reduction of High Risk Behavior

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    H Aranpour

    2010-08-01

    Full Text Available Introduction: Overcoming social problems requires a participatory approach. This study was performed in order to determine the effect of community based educational prevention program of drug abuse in reduction of high risk behavior. Methods: This study was a community based participatory research. According to planned approach to community health model, "the health companion group" was established with participation of public representatives of villages, researchers, and managers of health sectors. Need assessment and priority setting of health problems was done. Drug abuse was selected as the topmost priority of health problems. By interviewing 10 year olds and older members of households, the questionnaires were completed. By conducting workshops, distributing educational pamphlets and face to face training for six months, the educational program was carried out. After this period, the study population was interviewed again. Data was analyzed by SPSS software, X2, and T tests. Results: The mean score of drug abuse related high risk behavior was 26.8 +/- 2.05 before educational program and 25.2 ±2.3 after the program. The mean score of psychological health was 26.2±5.8 before educational program and 26.4±5.7 after the program. The rate of negative drug abusing related behavior decreased and positive behavior increased after the educational program. Conclusion: The community based participatory research with participation of the public can be a proper pattern to prevent drug abuse and related high risk behaviors and as a result reduce costs and complications of this problem.

  4. Suicide attempts among men with histories of child sexual abuse: examining abuse severity, mental health, and masculine norms.

    Science.gov (United States)

    Easton, Scott D; Renner, Lynette M; O'Leary, Patrick

    2013-06-01

    Men who were sexually abused during childhood are at risk for a variety of long-term mental health problems, including suicidality. However, little is known about which factors are related to recent suicide attempts for this vulnerable, under-researched population. The purpose of this study was to examine the relationship between abuse severity, mental health, masculine norms and recent suicide attempts among men with histories of child sexual abuse (CSA). We analyzed survey data gathered from a purposive sample of 487 men who were sexually abused during childhood. The age of the sample ranged from 19 to 84 years (μ = 50.4 years). Recent suicide attempts served as the dependent variable in the study. Self-reported measures of sexual abuse severity, child physical abuse, mental health, masculine norms, and demographic information (age, race) represented the independent variables. The results from logistic regression modeling found that five variables - duration of the sexual abuse, use of force during the sexual abuse, high conformity to masculine norms, level of depressive symptoms, and suicidal ideation - increased the odds of a suicide attempt in the past 12 months. To improve mental health services for men with histories of CSA, mental health practitioners should incorporate sexual abuse severity, current mental health, and adherence to masculine norms into assessment and treatment planning. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. Association between Physical Abuse, Physical Neglect and Health Risk Behaviours among Young Adolescents: Results from the National Study

    Directory of Open Access Journals (Sweden)

    Dimitrinka Jordanova Peshevska

    2014-06-01

    CONCLUSION: The results demonstrated a relationship between physical abuse and later manifestation of health risk behaviours such as: smoking and early pregnancy. Physical neglect increased the chances for drug abuse, drink-driving, having early sex, having more sexual partners.

  6. [Prescription drug abuse in elderly psychiatric patients].

    Science.gov (United States)

    Wetterling, Tilman; Schneider, Barbara

    2012-08-01

    Due to demographic changes there will be a fraction of elderly patients with substance use disorders. However, only a few data have been published about elderly abusers of prescription drugs. Since substance abuse is frequently comorbid with psychiatric disorders, treatment in a psychiatric hospital is often needed. In this explorative study elderly people with prescription drug abuse who required psychiatric inpatient treatment should be characterized. This study was part of the gerontopsychiatry study Berlin (Gepsy-B), an investigation of the data of all older inpatients (≥ 65 years) admitted to a psychiatric hospital within a period of 3 years. Among 1266 documented admissions in 110 cases (8.7 %) (mean age: 75.7 ± 7.1 years) prescription drug abuse, mostly of benzodiazepines was diagnosed. Females showed benzodiazepine abuse more often than males. In only a small proportion of the cases the reason for admission was withdrawal of prescribed drugs. 85.5 % suffered from psychiatric comorbidity, mostly depression. As risk factors for abuse depressive symptoms (OR: 3.32) as well as concurrent nicotine (OR: 2.69) or alcohol abuse (OR: 2.14) were calculated. Psychiatric inpatient treatment was primarily not necessary because of prescription drug abuse but because of other psychopathological symptoms. © Georg Thieme Verlag KG Stuttgart · New York.

  7. A Comparison of the Structural Factors of the Propensity for Abusiveness Scale for Women and Men in a Domestic Violence Treatment Program.

    Science.gov (United States)

    Allen, Christopher T; Swan, Suzanne C; Maas, Carl D; Barber, Sara

    2015-08-01

    Court-mandated domestic violence (DV) treatment programs across the country have seen a marked increase in female clients. These programs use a variety of measurement tools to assess the needs of their clients. Increased numbers of women in treatment for DV reflect a need to address the measurement of intimate partner violence (IPV) for both males and females. Unfortunately, the reliability and validity of many of measures used to assess IPV and related constructs for women remains unknown. The current study focuses on a particular measure, the Propensity for Abusiveness Scale (PAS). The PAS is not a measure of abusive behavior per se; rather, it assesses risk factors for abuse, including affective lability, anger expression, trauma symptoms, and harsh parenting experienced by the respondent. Specifically, the current study compares the factor structure and the measurement properties of the PAS for males and females in a sample of 885 (647 female, 238 male) participants in a DV treatment program. Findings indicate that the PAS demonstrated configural, metric, and scalar invariance between the female and male samples. These results suggest that it is appropriate for researchers and clinicians to make comparisons between women and men based on PAS factor scores. © The Author(s) 2014.

  8. Risk factors for rape, physical assault, and posttraumatic stress disorder in women: examination of differential multivariate relationships.

    Science.gov (United States)

    Acierno, R; Resnick, H; Kilpatrick, D G; Saunders, B; Best, C L

    1999-01-01

    The National Women's Study, a 2-year, three-wave longitudinal investigation, employed a national probability sample of 3,006 adult women to: (a) identify separate risk factors for rape and physical assault, and (b) identify separate risk factors associated with post-rape posttraumatic stress disorder (PTSD) and post-physical assault PTSD. This investigation differed from previous studies in that it prospectively examined risk factors at the multivariate, as opposed to univariate level. Overall, past victimization, young age, and a diagnosis of active PTSD increased women's risk of being raped. By contrast, past victimization, minority ethnic status, active depression, and drug use were associated with increased risk of being physically assaulted. Risk factors for PTSD following rape included a history of depression, alcohol abuse, or experienced injury during the rape. However, risk factors for PTSD following physical assault included only a history of depression and lower education.

  9. Osteonecrosis - A rare complication of HIV infection. Association with numerous risk factors

    International Nuclear Information System (INIS)

    Meyer, D.; Behrens, G.; Stoll, M.; Schmidt, R.E.

    2000-01-01

    Osteonecrosis is a rare complication of HIV infection. The presumptive cause of the aseptic osteonecrosis is a disturbed blood supply to the bone. Most cases of osteonecrosis are associated with numerous risk factors, such as use of steroids, alcohol abuse, coagulopathies or metabolic derangements. Since conventional X-rays appear unremarkable, early forms often go unrecognized or are diagnosed late. Methods of establishing the diagnosis are MRI and three-phase skeletal scintigraphy. The pathogenesis of osteonecrosis in HIV infection is unclear. So far, about 30 cases have been reported in the literature. We would recommend that in HIV patients with typical symptoms - in particular when classical risk factors are present - osteonecrosis be included in the differential diagnostic considerations. (orig.) [de

  10. Comparing the Central Eight Risk Factors: Do They Differ Across Age Groups of Sex Offenders?

    Science.gov (United States)

    Wilpert, Julia; van Horn, Joan E; Boonmann, Cyril

    2018-02-01

    Following the risk-need-responsivity (RNR) model, cognitive-behavioral therapy is considered most effective in reducing recidivism when based on dynamic risk factors. As studies have found differences of these factors across age, exploring this seems beneficial. The current study investigates the Central Eight (C8) risk factors across six age groups of outpatient sex offenders ( N = 650). Results showed that recidivism rates and age were inversely related from 19 years and up. Half of the C8 did not predict general recidivism at all, substance abuse, antisocial cognition, antisocial associates, and history of antisocial behavior in only one or several age groups. However, factors differed between age groups, with the youngest group demonstrating the most dysfunction in several areas and the oldest group the least. It is concluded that the C8 risk factors seem to lose significance in the older age groups. Results may benefit targeting treatment goals.

  11. Suicide risk and alcohol and drug abuse in outpatients with HIV infection and Chagas disease.

    Science.gov (United States)

    Guimarães, Patrícia M; Passos, Sonia R; Calvet, Guilherme A; Hökerberg, Yara H; Lessa, José L; Andrade, Carlos A de

    2014-01-01

    To evaluate psychiatric comorbidities in outpatients receiving care for HIV and Chagas disease at Instituto de Pesquisa Clínica Evandro Chagas (IPEC), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Brazil. Cross-sectional study with a consecutive sample of 125 patients referred to an outpatient psychiatric clinic from February to December 2010. The Mini International Neuropsychiatric Interview (MINI) was used. Factors associated with more frequent mental disorders were estimated by odds ratios (OR) with 95% confidence intervals (95%CI) by multiple logistic regression. Seventy-six (60.8%) patients with HIV, 40 (32%) patients with Chagas disease, and nine (7.2%) patients with human T-lymphotropic virus were interviewed. The majority were women (64%), with up to 8 years of formal education (56%), and unemployed (81.6%). The median age was 49 years. Suicide risk (n=71) (56%), agoraphobia (n=65) (52%), major depressive episode (n=56) (44.8%), and alcohol/drug abuse (n=43) (34.4%) predominated, the latter being directly associated with lower family income (OR = 2.64; 95%CI 1.03-6.75) and HIV infection (OR = 5.24; 95%CI 1.56-17.61). Suicide risk was associated with non-white skin color (OR = 2.21; 95%CI 1.03-4.75), unemployment (OR = 2.72; 95%CI 1.01-7.34), and diagnosis of major depression (OR = 3.34; 95%CI 1.54-7.44). Measures targeting adverse socioeconomic conditions and psychiatric and psychological monitoring and care should be encouraged in this population, considering the association with abuse of alcohol/other psychoactive drugs and suicide risk.

  12. Child sexual abuse, links to later sexual exploitation/high-risk sexual behavior, and prevention/treatment programs.

    Science.gov (United States)

    Lalor, Kevin; McElvaney, Rosaleen

    2010-10-01

    This paper reviews the literature on the nature and incidence of child sexual abuse, explores the link between child sexual abuse and later sexual exploitation, and reviews the literature on prevention strategies and effective interventions in child sexual abuse services. Our understanding of the international epidemiology of child sexual abuse is considerably greater than it was just 10 years ago, and studies from around the world are examined. Childhood sexual abuse can involve a wide number of psychological sequelae, including low self-esteem, anxiety, and depression. Numerous studies have noted that child sexual abuse victims are vulnerable to later sexual revictimization, as well as the link between child sexual abuse and later engagement in high-risk sexual behaviour. Survivors of child sexual abuse are more likely to have multiple sex partners, become pregnant as teenagers, and experience sexual assault as adults. Various models which attempt to account for this inter-relationship are presented; most invoke mediating variables such as low self-esteem, drug/alcohol use, PTSD and distorted sexual development. Prevention strategies for child sexual abuse are examined including media campaigns, school-based prevention programmes, and therapy with abusers. The results of a number of meta-analyses are examined. However, researchers have identified significant methodological limitations in the extant research literature that impede the making of recommendations for implementing existing therapeutic programmes unreservedly.

  13. Longitudinal study of family factors associated with risk behaviors in Mexican youth

    Directory of Open Access Journals (Sweden)

    Alejandro González-González

    2017-06-01

    Full Text Available Introduction: according to literature, adolescence is a period where the young are more likely to engage in behaviors that could endanger their health. In addition, there is evidence suggesting the impact of some factors of family environment on the presence of risk behaviors. Objetive: the aim of this study was to determine changes in risk behavior and analyze the differences in family factors on these behaviors. Method: we used a longitudinal study on a group of 6,089 students (37.5% men and 62.5% women. Risk behaviors were assessed with 10 indicators. Family factors were evaluated by three scales: support, relationship and substance abuse within the family context. The information was obtained in a previous session prior to the beginning of the scholar semester for each of the three analyzed events. Results: an increase in risk behaviors was observed over time. Further, we also found significant differences in family factors on risk behaviors in the three measurements. Discussion: this evidence will allow the development of prevention and early detection programs to treat several problems related to teenagers during their school career.

  14. Interventions for preventing abuse in the elderly.

    Science.gov (United States)

    Baker, Philip R A; Francis, Daniel P; Hairi, Noran N; Othman, Sajaratulnisah; Choo, Wan Yuen

    2016-08-16

    independently extracted data and assessed the studies' risk of bias. Studies were categorised as: 1) education on elder abuse, 2) programmes to reduce factors influencing elder abuse, 3) specific policies for elder abuse, 4) legislation on elder abuse, 5) programmes to increase detection rate on elder abuse, 6) programmes targeted to victims of elder abuse, and 7) rehabilitation programmes for perpetrators of elder abuse. All studies were assessed for study methodology, intervention type, setting, targeted audience, intervention components and intervention intensity. The search and selection process produced seven eligible studies which included a total of 1924 elderly participants and 740 other people. Four of the above seven categories of interventions were evaluated by included studies that varied in study design. Eligible studies of rehabilitation programmes, specific policies for elder abuse and legislation on elder abuse were not found. All included studies contained a control group, with five of the seven studies describing the method of allocation as randomised. We used the Cochrane 'Risk of bias' tool and EPOC assessment criteria to assess risk of bias. The results suggest that risk of bias across the included body of research was high, with at least 40% of the included studies judged as being at high risk of bias. Only one study was judged as having no domains at high risk of bias, with two studies having two of 11 domains at high risk. One study was judged as being at high risk of bias across eight of 11 domains.All included studies were set in high-income countries, as determined by the World Bank economic classification (USA four, Taiwan one, UK two). None of the studies provided specific information or analysis on equity considerations, including by socio-economic disadvantage, although one study was described as being set in a housing project. One study performed some form of cost-effectiveness analysis on the implementation of their intervention programmes

  15. The Association between Foster Care and Substance Abuse Risk Factors and Treatment Outcomes: An Exploratory Secondary Analysis

    Science.gov (United States)

    Blome, Wendy Whiting; Shields, Joseph; Verdieck, Mary Jeanne

    2009-01-01

    The child welfare and substance abuse systems are integrally linked through the children and families they both serve. There is a dearth of knowledge, however, on how children who have experienced foster care fare when they are treated for substance abuse issues as adults. This article presents an exploratory study using the Alcohol and Drug…

  16. Risk for Suicidal Thoughts and Behavior after Childhood Sexual Abuse in Women and Men

    Science.gov (United States)

    Bedi, Saaniya; Nelson, Elliot C.; Lynskey, Michael T.; McCutcheon, Vivia V.; Heath, Andrew C.; Madden, Pamela A. F.; Martin, Nicholas G.

    2011-01-01

    Earlier studies have found an elevated risk for psychopathology and suicidal behavior associated with childhood sexual abuse (CSA); however, the degree to which risk is mediated by depression and posttraumatic stress disorder (PTSD) in women and men remains unclear. We examined these issues in data from a family study of childhood maltreatment (N…

  17. Physical child abuse potential in adolescent girls: associations with psychopathology, maltreatment, and attitudes toward child-bearing.

    Science.gov (United States)

    Pajer, Kathleen A; Gardner, William; Lourie, Andrea; Chang, Chien-Ni; Wang, Wei; Currie, Lisa

    2014-02-01

    Adolescent mothers are at increased risk of mistreating their children. Intervening before they become pregnant would be an ideal primary prevention strategy. Our goal was to determine whether psychopathology, exposure to maltreatment, preparedness for child-bearing, substance use disorders (SUDs), IQ, race, and socioeconomic status were associated with the potential for child abuse in nonpregnant adolescent girls. The Child Abuse Potential Inventory (CAPI) was administered to 195 nonpregnant girls (aged 15 to 16 years; 54% African American) recruited from the community. Psychiatric diagnoses from a structured interview were used to form 4 groups: conduct disorder (CD), internalizing disorders (INTs; that is, depressive disorder, anxiety disorder, or both), CD + INTs, or no disorder. Exposure to maltreatment was assessed with the Childhood Trauma Questionnaire, and the Childbearing Attitudes Questionnaire measured maternal readiness. CAPI scores were positively correlated with all types of psychopathology, previous exposure to maltreatment, and negative attitudes toward child-bearing. IQ, SUDs, and demographic factors were not associated. Factors associated with child abuse potential interacted in complex ways, but the abuse potential of CD girls was high, regardless of other potentially protective factors. Our study demonstrates that adolescent girls who have CD or INT are at higher risk of perpetrating physical child abuse when they have children. However, the core features of CD may put this group at a particularly high risk, even in the context of possible protective factors. Treatment providers should consider pre-pregnant counselling about healthy mothering behaviours to girls with CD.

  18. The risk factor of domestic violence in India

    Directory of Open Access Journals (Sweden)

    Meerambika Mahapatro

    2012-01-01

    Full Text Available Background: It is over the last decade that research in this field of domestic violence has led to greater recognition of the issue as public health problem. The paper aims to study the prevalence of physical, psychological, and sexual violence and potential risk factors of the women confronting violence within the home in India. Materials and Methods: A multicentric study with analytical cross-sectional design was applied. It covers 18 states in India with 14,507 women respondents. Multistage sampling and probability proportion to size were done. Results: The result shows that overall 39 per cent of women were abused. Women who have a lower household income, illiterate, belonging to lower caste, and have a partner who drinks/bets, etc. found to be important risk factors and place women in India at a greater risk of experiencing domestic violence. Conclusion: As India has already passed a bill against domestic violence, the present results on robustness of the problem will be useful to sensitize the concerned agencies to strictly implement the law. This may lead to more constructive and sustainable response to domestic violence in India for improvement of women health and wellbeing.

  19. Elder abuse and neglect in Bangladesh: understanding issues, associated factors and consequences

    Directory of Open Access Journals (Sweden)

    Shekh Farid

    2017-06-01

    Full Text Available Background. Fewer studies have attempted to address elder abuse and neglect in Bangladesh despite its widespread prevalence and fatal consequences. Objectives. To collect qualitative facts concerning the nature of elder abuse and neglect in Bangladesh and to find out the causes and impacts of this malpractice. Material and methods . The study categorized older people into ten broader classes and selected four old persons purposively under each category for an in-depth case study. In addition, Focus Group Discussion, Key Informants Interview and observational methods were also used to draw supplementary data. Results. The results show that all old persons interviewed, irrespective of socio-economic status, came up against varying degrees of abuse and neglect by their families, relatives and communities that resulted in their physical ill-health and mental distress. Financial and physical abuses were found more frequent among poor and weaker sections, whereas psychological abuse appeared as severe among those belonging to the middle and affluent classes. Families having strong religious practices and a long tradition of taking care of the elderly were less subjected to elder mistreatment. As is revealed, along with various other factors, degradation of moral and religious values, new family structure and the lower socio-economic status of old people were associated with the maltreatment they faced. Conclusions. Socio-economic insecurity and a poor institutional mechanism for old persons cause a higher incidence of elder abuse and neglect in Bangladesh, which calls for immediate action from all levels.

  20. Alcohol abuse and involvement in traffic accidents in the Brazilian population, 2013.

    Science.gov (United States)

    Damacena, Giseli Nogueira; Malta, Deborah Carvalho; Boccolini, Cristiano Siqueira; Souza, Paulo Roberto Borges de; Almeida, Wanessa da Silva de; Ribeiro, Lucas Sisinno; Szwarcwald, Célia Landmann

    2016-12-01

    Abstract This article aims to analyze alcohol abuse and frequent consumption according to sociodemographic characteristics and investigate the risk of greater involvement in traffic accidents, using data from the National Health Survey (PNS), 2013, Brazil. Events investigated were alcohol abuse and frequent consumption and if the individual was involved in a traffic accident and sustained an injury in the last 12 months. We investigated both events according to sociodemographic characteristics and assessed the association among them through multivariate logistic regression. The prevalence of alcohol abuse and frequent consumption was 6.1% for the population aged 18 years and over, 8.9% among men and 3.6% among women. The prevalence of involvement in traffic accidents was 3.1% in the general population and 6.1% among those who reported alcohol abuse. After controlling for sociodemographic factors, alcohol abuse and frequent consumption was significantly associated with traffic accidents. Considering a higher risk of involvement in traffic accidents among individuals who reported alcohol abuse and frequent consumption, monitoring blood alcohol concentration of drivers becomes a strategic possibility of intervention.

  1. Mediators of the childhood emotional abuse-hopelessness association in African American women.

    Science.gov (United States)

    Lamis, Dorian A; Wilson, Christina K; Shahane, Amit A; Kaslow, Nadine J

    2014-08-01

    Although there is an association between experiencing childhood emotional abuse and feeling hopeless as an adult, it is critical to understand the factors that may be protective in this relationship. The goal of this study was to determine if two protective factors, namely spiritual well-being, including both religious and existential well-being, and positive self-esteem, served to mediate the association between childhood emotional abuse and adult hopelessness. The sample for this investigation was low-income African American women suicide attempters who were abused by a partner in the prior year (N=121). A path analysis revealed that in this sample, the childhood emotional abuse-hopelessness link was mediated by existential well-being and positive self-esteem, as well as by the two-mediator path of emotional abuse on existential well-being on self-esteem on hopelessness. Results suggested that existential well-being may be a more salient protective factor for hopelessness than religious well-being among abused, suicidal African American women who experienced childhood emotional abuse. Findings highlight the value of culturally relevant strategies for enhancing existential well-being and self-esteem in this at-risk population to reduce their vulnerability to feelings of hopelessness. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. Alcohol use disorders among people living with HIV/AIDS in Southern Brazil: prevalence, risk factors and biological markers outcomes.

    Science.gov (United States)

    da Silva, Cláudio Moss; Mendoza-Sassi, Raúl Andrés; da Mota, Luisa Dias; Nader, Maíba Mikhael; de Martinez, Ana Maria Barral

    2017-04-11

    Alcohol abuse is an important public health problem, frequently unrecognized among people living with HIV/AIDS (PLWHA), and requires investigation and intervention. It is usually associated with lower adherence to highly active antiretroviral therapy (HAART). It can also produce adverse clinical outcomes, such as changes in certain HIV markers, particularly CD4 cell counts and HIV viral loads (VLs). Thus, this study aimed to evaluate the prevalence of alcohol abuse among PLWHA, its associated risk factors and effects on CD4 cell counts and HIV VLs in southern Brazil. Between December 2012 and July 2013, 343 patients were interviewed at a reference hospital in southern Brazil. The instrument used was the Alcohol Use Disorder Identification Test (AUDIT), and a cutoff of eight points or more was applied. Socioeconomic, demographic, clinical and laboratory data were also collected. The statistical analysis included a Poisson regression to evaluate the factors associated with alcohol use disorder, and a linear regression was performed to assess the relationship between AUDIT scores and CD4 cell counts and HIV VLs. Alcohol abuse was present in 28.6% of the respondents, and possible dependence was present in 5%. The risk factors identified included being male, mixed or black skin color, low education and the use of intravenous or inhaled drugs. A higher AUDIT score was associated with a lower CD4 cell count but was not associated with higher HIV VL values. Our results show the importance of screening for alcohol abuse in this group. The prevalence of alcohol abuse was high, and it was associated with socioeconomic factors and the use of illicit drugs. Moreover, AUDIT score negatively affected CD4 cell counts as well.

  3. Substance abuse In Middle Eastern adolescents living in two different countries: spiritual, cultural, family and personal factors.

    Science.gov (United States)

    Badr, Lina Kurdahi; Taha, Asma; Dee, Vivien

    2014-08-01

    It is estimated that the percentage of students using illicit substances by sixth grade has tripled over the last decade not only in developed countries but in developing countries as well probably due to the transition to a more Western society. Although much has been done to understand the mechanisms underlying substance abuse, few studies have been conducted with minority ethnic and religious groups such as Middle Eastern Youth. The primary goal of this study was to determine whether there are differences in factors contributing to substance abuse in adolescents from Lebanon versus the U.S.A. and to decipher the role of spirituality, religion, and culture among other factors that may influence substance abuse. A correlational cross-sectional design was used with adolescents living in two different countries: Los Angeles, California and Beirut, Lebanon. Muslim adolescents had significantly less rates of alcohol and substance use than Christians in both Lebanon and Los Angeles. More years lived in the U.S.A. increases the likelihood of abuse for both Muslims and Christians. Attachment to God and family was negatively associated with substance abuse. These results among others facilitate a better understanding of the influence of culture, religion, family and personal factors on substance abuse. Culturally sensitive interventions could benefit from the findings of this pilot study.

  4. Stroke And Substance Abuse

    OpenAIRE

    A Chitsaz

    2017-01-01

    Introduction: stroke in recreational substance users can be an indirect complication, like endocarditis and cardio embolism in parenteral drug users. With some drug like cocaine, stroke appear to be the result of a direct effect. In young subjects without other risk factors provide persuasive evidence for causality . OPIATES: Heroine is the most abused opiate drug, which is administered by injection, by snorting or by smoking. Stroke affects heroin users by diverse mechanisms,. Injec...

  5. Effects of opium consumption on coronary artery disease risk factors and oral health: Results of Kerman Coronary Artery Disease Risk factors Study a population-based survey on 5900 subjects aged 15-75 years

    Directory of Open Access Journals (Sweden)

    Hamid Najafipour

    2015-01-01

    Conclusions: Opium abuse was associated with depression and low PA. No ameliorative effect was observed on hypertension, diabetes, and plasma lipid profile. Therefore, positive association of opium with depression and LPA and the incorrectness of belief on its ameliorative effect on three other important risk factors of CAD should be clearly highlighted in public health messages to the community.

  6. Child abuse

    International Nuclear Information System (INIS)

    Dorst, J.P.; Johns Hopkins Medical Institutions, Baltimore, MD

    1982-01-01

    Child abuse is common in most, if not all, Western nations; it probably occurs worldwide. It may be a major factor in the increase in violence throughout much of the world. Radiologists who treat children should think of the possibilitys of abuse whenever they diagnose a fracture, intracranial bleed, ar visceral injury, especially when the history is not compatible with their findings. Metaphyseal 'corner' fractures in infants usually are caused by abuse. Less than 20% of abused children, however, present injuries that can be recognized by radiologic techniques. Consequently normal roentgenograms, nuclear medicine scans, ultrasound studies, and computed tomograms do not exclude child abuse. (orig.)

  7. Child abuse

    Energy Technology Data Exchange (ETDEWEB)

    Dorst, J.P.

    1982-08-01

    Child abuse is common in most, if not all, Western nations; it probably occurs worldwide. It may be a major factor in the increase in violence throughout much of the world. Radiologists who treat children should think of the possibilitys of abuse whenever they diagnose a fracture, intracranial bleeding or visceral injury, especially when the history is not compatible with their findings. Metaphyseal 'corner' fractures in infants usually are caused by abuse. Less than 20% of abused children, however, present injuries that can be recognized by radiologic techniques. Consequently normal roentgenograms, nuclear medicine scans, ultrasound studies, and computed tomograms do not exclude child abuse.

  8. Risk factors for antenatal depression, postnatal depression and parenting stress

    Directory of Open Access Journals (Sweden)

    Milgrom Jeannette

    2008-04-01

    Full Text Available Abstract Background Given that the prevalence of antenatal and postnatal depression is high, with estimates around 13%, and the consequences serious, efforts have been made to identify risk factors to assist in prevention, identification and treatment. Most risk factors associated with postnatal depression have been well researched, whereas predictors of antenatal depression have been less researched. Risk factors associated with early parenting stress have not been widely researched, despite the strong link with depression. The aim of this study was to further elucidate which of some previously identified risk factors are most predictive of three outcome measures: antenatal depression, postnatal depression and parenting stress and to examine the relationship between them. Methods Primipara and multiparae women were recruited antenatally from two major hoitals as part of the beyondblue National Postnatal Depression Program 1. In this subsidiary study, 367 women completed an additional large battery of validated questionnaires to identify risk factors in the antenatal period at 26–32 weeks gestation. A subsample of these women (N = 161 also completed questionnaires at 10–12 weeks postnatally. Depression level was measured by the Beck Depression Inventory (BDI. Results Regression analyses identified significant risk factors for the three outcome measures. (1. Significant predictors for antenatal depression: low self-esteem, antenatal anxiety, low social support, negative cognitive style, major life events, low income and history of abuse. (2. Significant predictors for postnatal depression: antenatal depression and a history of depression while also controlling for concurrent parenting stress, which was a significant variable. Antenatal depression was identified as a mediator between seven of the risk factors and postnatal depression. (3. Postnatal depression was the only significant predictor for parenting stress and also acted as a mediator

  9. Risk factors for antenatal depression, postnatal depression and parenting stress.

    Science.gov (United States)

    Leigh, Bronwyn; Milgrom, Jeannette

    2008-04-16

    Given that the prevalence of antenatal and postnatal depression is high, with estimates around 13%, and the consequences serious, efforts have been made to identify risk factors to assist in prevention, identification and treatment. Most risk factors associated with postnatal depression have been well researched, whereas predictors of antenatal depression have been less researched. Risk factors associated with early parenting stress have not been widely researched, despite the strong link with depression. The aim of this study was to further elucidate which of some previously identified risk factors are most predictive of three outcome measures: antenatal depression, postnatal depression and parenting stress and to examine the relationship between them. Primipara and multiparae women were recruited antenatally from two major hoitals as part of the beyondblue National Postnatal Depression Program 1. In this subsidiary study, 367 women completed an additional large battery of validated questionnaires to identify risk factors in the antenatal period at 26-32 weeks gestation. A subsample of these women (N = 161) also completed questionnaires at 10-12 weeks postnatally. Depression level was measured by the Beck Depression Inventory (BDI). Regression analyses identified significant risk factors for the three outcome measures. (1). Significant predictors for antenatal depression: low self-esteem, antenatal anxiety, low social support, negative cognitive style, major life events, low income and history of abuse. (2). Significant predictors for postnatal depression: antenatal depression and a history of depression while also controlling for concurrent parenting stress, which was a significant variable. Antenatal depression was identified as a mediator between seven of the risk factors and postnatal depression. (3). Postnatal depression was the only significant predictor for parenting stress and also acted as a mediator for other risk factors. Risk factor profiles for

  10. Reliability, Validity and Factor Structure of Drug Abuse Screening Test

    Directory of Open Access Journals (Sweden)

    Sayed Hadi Sayed Alitabar

    2016-05-01

    Full Text Available Background and Objective: According to the increasing of substance use in the country, more researches about this phenomenon are necessary. This Study Investigates the Validity, Reliability and Confirmatory Factor Structure of the Drug Abuse Screening test (DAST. Materials and Methods: The Sample Consisted of 381 Patients (143 Women and 238 Men with a Multi-Stage Cluster Sampling of Areas 2, 6 and 12 of Tehran Were Selected from Each Region, 6 Randomly Selected Drug Rehabilitation Center. The DAST Was Used as Instrument. Divergent & Convergent Validity of this Scale Was Assessed with Problems Assessment for Substance Using Psychiatric Patients (PASUPP and Relapse Prediction Scale (RPS.Results: The DAST after the First Time Factor Structure of Using Confirmatory Factor Analysis Was Confirmed. The DAST Had a Good Internal Consistency (Cranach’s Alpha, and the Reliability of the Test Within a Week, 0.9, 0.8. Also this Scale Had a Positive Correlation with Problems Assessment for Substance Using Psychiatric Patients and Relapse Prediction Scale (P<0.01.Conclusion: The Overall Results Showed that the Drug Abuse Screening Test in Iranian Society Is Valid. It Can Be Said that Self-Report Scale Tool Is Useful for Research Purposes and Addiction.

  11. Parental consanguinity and susceptibility to drug abuse among offspring, a case-control study.

    Science.gov (United States)

    Saadat, Mostafa; Vakili-Ghartavol, Roghayyeh

    2010-11-30

    Consanguineous marriage is the union of individuals having at least one common ancestor. It is well established that consanguinity is a potential risk factor for many adverse health outcome of offspring. In the present case-control study we tested the hypothesis of an association between parental consanguinity marriages and risk of offspring substance abuse. The study was performed in Shiraz (Fars province, Iran). Here 156 male drug abusers (case group) and 264 randomly selected healthy blood donors, matched for age and gender as control group, were included in the study. The prevalence of parental consanguineous marriages in the studied sample was 39.1 and 28.0% among cases and controls, respectively. The difference was statistically significant. The substance abusers were more smokers and drinkers compared with the control group. There was significant negative linear trend between drug abuse and level of education. The participants stratified using drinking habits and then the analysis was carried out separately for drinker and non-drinker subjects. Among drinkers, neither before nor after adjusting for smoking status and educational level, parental consanguinity did not show association with risk of substance abuse. Among non-drinkers, after adjusting for smoking status and educational level, parental consanguineous marriage was significantly associated with increased risk of substance abuse. Our study supports a significant relationship between parental consanguinity and drug abuse among non-drinker subjects. Copyright © 2010 Elsevier Ltd. All rights reserved.

  12. Child and Family Factors Associated With Child Maltreatment in Vietnam

    NARCIS (Netherlands)

    Tran, N.K. (Nhu K.); van Berkel, S.R. (Sheila R.); M.H. van IJzendoorn (Rien); L.R.A. Alink (Lenneke R.A.)

    2018-01-01

    textabstractThis study aims to explore possible risk factors for child maltreatment in Vietnam by investigating the association of child and family factors with different types of child maltreatment (i.e., sexual abuse, physical abuse, emotional abuse, witnessing parental conflict, and neglect) and

  13. Connecting the Dots: State Health Department Approaches to Addressing Shared Risk and Protective Factors Across Multiple Forms of Violence.

    Science.gov (United States)

    Wilkins, Natalie; Myers, Lindsey; Kuehl, Tomei; Bauman, Alice; Hertz, Marci

    Violence takes many forms, including intimate partner violence, sexual violence, child abuse and neglect, bullying, suicidal behavior, and elder abuse and neglect. These forms of violence are interconnected and often share the same root causes. They can also co-occur together in families and communities and can happen at the same time or at different stages of life. Often, due to a variety of factors, separate, "siloed" approaches are used to address each form of violence. However, understanding and implementing approaches that prevent and address the overlapping root causes of violence (risk factors) and promote factors that increase the resilience of people and communities (protective factors) can help practitioners more effectively and efficiently use limited resources to prevent multiple forms of violence and save lives. This article presents approaches used by 2 state health departments, the Maryland Department of Health and Mental Hygiene and the Colorado Department of Public Health and Environment, to integrate a shared risk and protective factor approach into their violence prevention work and identifies key lessons learned that may serve to inform crosscutting violence prevention efforts in other states.

  14. A History of Abuse and Operative Delivery

    DEFF Research Database (Denmark)

    Schei, Berit; Lukasse, Mirjam; Ryding, Elsa Lena

    2014-01-01

    OBJECTIVE: The main aim of this study was to assess whether a history of abuse, reported during pregnancy, was associated with an operative delivery. Secondly, we assessed if the association varied according to the type of abuse and if the reported abuse had been experienced as a child or an adult...... and multinomial regression analysis were used to assess the associations. RESULTS: Among 3308 primiparous women, sexual abuse as an adult (≥ 18 years) increased the risk of an elective CS, Adjusted Odds Ratio 2.12 (1.28-3.49), and the likelihood for a non-obstetrically indicated CS, OR 3.74 (1.24-11.24). Women...... expressing current suffering from the reported adult sexual abuse had the highest risk for an elective CS, AOR 4.07 (1.46-11.3). Neither physical abuse (in adulthood or childhood sexual abuse in childhood increased the risk of any operative delivery among primiparous women. Among 3416...

  15. Child physical and sexual abuse and cigarette smoking in adolescence and adulthood.

    Science.gov (United States)

    Kristman-Valente, Allison N; Brown, Eric C; Herrenkohl, Todd I

    2013-10-01

    Analyses used data from an extended longitudinal study to examine the relationship between childhood physical and sexual abuse (CPA and CSA, respectively) and adolescent and adult smoking behavior. Two questions guided the study: (1) Is there an association between childhood abuse and adolescent and adult smoking behavior? (2) Does the relationship between childhood abuse and later cigarette smoking differ for males and females? A censored-inflated path model was used to assess the impact of child abuse on adolescent and adult lifetime smoking prevalence and smoking frequency. Gender differences in significant model paths were assessed using a multiple-group approach. Results show no significant relation between CPA or CSA and risk of having ever smoked cigarettes in adolescence or adulthood. However, for males, both CPA and CSA had direct effects on adolescent smoking frequency. For females, only CSA predicted increased smoking frequency in adolescence. Adolescent smoking frequency predicted adult smoking frequency more strongly for females compared with males. CPA and CSA are risk factors for higher frequency of smoking in adolescence. Higher frequency of cigarette smoking in adolescence increases the risk of higher smoking frequency in adulthood. Results underscore the need for both primary and secondary prevention and intervention efforts to reduce the likelihood of childhood abuse and to lessen risk for cigarette smoking among those who have been abused. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  16. Sexual abuse during childhood and adolescence as predictors of HIV-related sexual risk during adulthood among female sexual partners of injection drug users.

    Science.gov (United States)

    Klein, H; Chao, B S

    1995-03-01

    This study explores the relationship of sexual abuse during childhood and adolescence with HIV-related sexual risk behaviors during adulthood among female sexual partners of injection drug users. It analyzed data that was gathered between 1990 and 1993, which included a sample of 2794 women from the US, Mexico, and Puerto Rico. 6 HIV-related sexual risk behaviors that occurred during the month prior to interview were examined; namely, number of sexual partners, number of drug-injecting sexual partners, number of sexual intercourse while high on alcohol and/or other drugs, number of times trading sex for drugs and/or money, proportion of all sexual acts involving protection, and overall HIV-related sexual risk. The results showed that more than one-third of the women (36.3%) experienced some form of sexual abuse during childhood, whereas 34.4% reported that they had been abused sexually during adolescence; 1 in 5 women (18.4%) stated being abused during both periods. The results further indicate that there is a strong link between sexual abuse victimization early in life and involvement later in life in HIV-related sexual risk behaviors. It was found out that certain forms of sexual abuse, such as forced exposure and touching of one's sexual parts were more strongly related than other forms of sexual abuse to subsequent involvement in HIV-related sexual behaviors.

  17. Parent abuse by adolescents with first-episode psychosis in Egypt.

    Science.gov (United States)

    Fawzi, Mounir H; Fawzi, Mohab M; Fouad, Amira A

    2013-12-01

    To determine the rate of parent abuse in a sample of Egyptian adolescents with first-episode psychosis (FEP) and to identify the association between parent abuse and a number of sociodemographic and clinical factors of interest in these patients. As yet, the abuse of parents by their children, especially mentally ill children, in contrast to child abuse, has remained a research taboo. In a cross-sectional study in Zagazig (Egypt), a sample of 150 adolescent outpatients (82 boys; 68 girls), presenting with FEP, was assessed for the occurrence of parent abuse using both interview and questionnaire methods (Abused Parent Questionnaire, APQ). Univariate analyses were used to compare parent abusers and nonabusers along a number of sociodemographic and clinical variables. Variables that were associated with parent abuse were entered into a multivariate logistic regression analysis model. We found that 61 patients (40.7%) perpetrated abuse against parents, mostly mothers (55/61; 90.2%). Five significant risk factors for parent abuse were identified by multivariate analysis. These were parent's female gender (95% CI = 7.82-45.56), patient's male gender (95% CI = 3.15-37.14), Childhood Trauma Questionnaire - Short Form total score (95% CI = 1.48-14.91), Positive and Negative Syndrome Scale positive subscale score (95% CI = 1.26-9.59), and duration of untreated psychosis (95% CI = 1.01-4.72). The study indicates that parent abuse, particularly mother abuse, in untreated adolescents with FEP is an issue calling for increased awareness of the problem. The findings may have important implications for parental psychoeducation and support, and earlier access to treatment. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  18. Child Abuse: The Crying Baby at Risk.

    Science.gov (United States)

    Kirkland, John

    The author considers the relationship between uncontrollable infant crying and child abuse. An integrative scheme is offered from evidence of child abuse literature, experimentally induced infant crying effects, attribution theory, and learned helplessness. It is suggested that infant crying often has causes beyond caregiver control, such as birth…

  19. Maternal Risk Factors for Preterm Birth in Murmansk County, Russia: A Registry-Based Study.

    Science.gov (United States)

    Usynina, Anna A; Postoev, Vitaly A; Grjibovski, Andrej M; Krettek, Alexandra; Nieboer, Evert; Odland, Jon Øyvind; Anda, Erik Eik

    2016-09-01

    Globally, about 11% of all liveborn infants are preterm. To date, data on prevalence and risk factors of preterm birth (PTB) in Russia are limited. The aims of this study were to estimate the prevalence of PTB in Murmansk County, Northwestern Russia and to investigate associations between PTB and selected maternal factors using the Murmansk County Birth Registry. We conducted a registry-based study of 52 806 births (2006-2011). In total, 51 156 births were included in the prevalence analysis, of which 3546 were PTBs. Odds ratios with 95% confidence intervals of moderate-to-late PTB, very PTB and extremely PTB for a range of maternal characteristics were estimated using multinomial logistic regression, adjusting for potential confounders. The overall prevalence of PTB in Murmansk County was 6.9%. Unmarried status, prior PTBs, spontaneous and induced abortions were strongly associated with PTB at any gestational age. Maternal low educational level increased the risk of extremely and moderate-to-late PTB. Young (<18 years) or older (≥35 years) mothers, graduates of vocational schools, underweight, overweight/obese mothers, and smokers were at higher risk of moderate-to-late PTB. Secondary education, alcohol abuse, diabetes mellitus, or gestational diabetes were strongly associated with moderate-to-late and very PTB. The observed prevalence of PTB (6.9%) in Murmansk County, Russia was comparable with data on live PTB from European countries. Adverse prior pregnancy outcomes, maternal low educational level, unmarried status, alcohol abuse, and diabetes mellitus or gestational diabetes were the most common risk factors for PTB. © 2016 John Wiley & Sons Ltd.

  20. Community characteristics, conservative ideology, and child abuse rates.

    Science.gov (United States)

    Breyer, Rebekah J; MacPhee, David

    2015-03-01

    Authoritarian ideology, including religious conservativism, endorses obedience to authority and physical punishment of children. Although this association has been studied at the level of the family, little research has been conducted on whether conservativism in the broader community context correlates with the mistreatment of children. The purpose of this study was to determine whether this relation between conservativism and physical punishment of children extends to child abuse rates at the community level. Predictors included county-level religious and political conservativism and demographic variables. Political and religious conservativism covaried, and both were inversely related to child abuse rates. Population density was strongly related to rates of maltreatment and with demographic factors controlled, religious conservativism but not political conservativism continued to predict rates of child abuse. The results suggest that community factors related to social disorganization may be more important than religious or political affiliation in putting children at risk for maltreatment. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Gender differences in pathways from child physical and sexual abuse to adolescent risky sexual behavior among high-risk youth.

    Science.gov (United States)

    Yoon, Susan; Voith, Laura A; Kobulsky, Julia M

    2018-04-01

    This study investigated gender differences in the roles of internalizing and externalizing symptoms and substance use as pathways linking child physical and sexual abuse to risky sexual behavior among youth at risk of maltreatment. Path analysis was performed with 862 adolescents drawn from Longitudinal Studies of Child Abuse and Neglect. Four waves of data collected in the United States were used: childhood physical and sexual abuse experiences (from ages 0-12) were assessed by Child Protective Services reports, internalizing and externalizing symptoms were measured at age 14, substance use was measured at age 16, and risky sexual behavior was measured at age 18. Physical abuse was directly associated with risky sexual behavior in boys but not girls. For girls, physical abuse had a significant indirect effect on risky sexual behavior via externalizing symptoms. Gender-focused preventive intervention strategies may be effective in reducing risky sexual behavior among at-risk adolescents. Copyright © 2018 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  2. Psychiatric symptom typology in a sample of youth receiving substance abuse treatment services: associations with self-reported child maltreatment and sexual risk behaviors.

    Science.gov (United States)

    Oshri, Assaf; Tubman, Jonathan G; Jaccard, James

    2011-11-01

    Latent profile analysis (LPA) was used to classify 394 adolescents undergoing substance use treatment, based on past year psychiatric symptoms. Relations between profile membership and (a) self-reported childhood maltreatment experiences and (b) current sexual risk behavior were examined. LPA generated three psychiatric symptom profiles: Low-, High- Alcohol-, and High- Internalizing Symptoms profiles. Analyses identified significant associations between profile membership and childhood sexual abuse and emotional neglect ratings, as well as co-occurring sex with substance use and unprotected intercourse. Profiles with elevated psychiatric symptom scores (e.g., internalizing problems, alcohol abuse and dependence symptoms) and more severe maltreatment histories reported higher scores for behavioral risk factors for HIV/STI exposure. Heterogeneity in psychiatric symptom patterns among youth receiving substance use treatment services, and prior histories of childhood maltreatment, have significant implications for the design and delivery of HIV/STI prevention programs to this population.

  3. Longitudinal Risk Factors for Intimate Partner Violence among Men in Treatment for Alcohol Use Disorders

    Science.gov (United States)

    Taft, Casey T.; O'Farrell, Timothy J.; Doron-Lamarca, Susan; Panuzio, Jillian; Suvak, Michael K.; Gagnon, David R.; Murphy, Christopher M.

    2010-01-01

    Objective: This study examined static and time-varying risk factors for perpetration of intimate partner violence (IPV) among men in treatment for alcohol use disorders. Method: Participants were 178 men diagnosed with alcohol abuse or dependence and their partners. Most (85%) of the men were European American; their average age was 41.0 years.…

  4. Maternal Risk Factors Associated with the Development of Cleft Lip and Cleft Palate in Mexico: A Case-Control Study.

    Science.gov (United States)

    Angulo-Castro, Emmanuel; Acosta-Alfaro, Luis F; Guadron-Llanos, Alma M; Canizalez-Román, Adrian; Gonzalez-Ibarra, Fernando; Osuna-Ramírez, Ignacio; Murillo-Llanes, Joel

    2017-07-01

    Cleft lip and palate, the most common developmental deformity, is seen worldwide and the etiology involves a combination of genetic and environmental factors. The purpose of this study was to determine the maternal risk factors associated with the development of cleft lip and cleft palate. We conducted a case control study at the Women's Hospital in Culiacan, Mexico. Medical records were analyzed, including patients who delivered babies with and without cleft lip and cleft palate from January 2010 to December 2015. Multiple variables were analyzed, including gestational age, weight at birth, the use of folic acid and multivitamins during pregnancy, smoking, alcohol abuse, the use of recreational drugs, history of sexually transmitted infections, marital status, socioeconomic status, education, and nutritional status. We found that the maternal risk factors with the strongest association for the development of cleft lip and cleft palate were the following: patients who were not taking folic acid during pregnancy [OR 3.27, 95% CI 1.32-8.09], P=0.00; patients who were not taking vitamin supplementation during pregnancy [OR 2.6, 95% CI 1.19-7.27], P=0.02; smoking during pregnancy [OR 2.05, 95% CI 1.23-3.41], P=0.01; and alcohol abuse during pregnancy [OR 1.90, 95% CI 1.17-3.08], P=0.03. The main risk factors associated with the development of cleft lip and cleft palate in a Mexican population at the Women's hospital in Culiacan, Sinaloa, Mexico were smoking, alcohol abuse, and patients not taking folic acid and multivitamins during pregnancy.

  5. Suicide risk and alcohol and drug abuse in outpatients with HIV infection and Chagas disease

    Directory of Open Access Journals (Sweden)

    Patrícia M. Guimarães

    2014-05-01

    Full Text Available Objective: To evaluate psychiatric comorbidities in outpatients receiving care for HIV and Chagas disease at Instituto de Pesquisa Clínica Evandro Chagas (IPEC, Fundação Oswaldo Cruz (Fiocruz, Rio de Janeiro, Brazil. Methods: Cross-sectional study with a consecutive sample of 125 patients referred to an outpatient psychiatric clinic from February to December 2010. The Mini International Neuropsychiatric Interview (MINI was used. Factors associated with more frequent mental disorders were estimated by odds ratios (OR with 95% confidence intervals (95%CI by multiple logistic regression. Results: Seventy-six (60.8% patients with HIV, 40 (32% patients with Chagas disease, and nine (7.2% patients with human T-lymphotropic virus were interviewed. The majority were women (64%, with up to 8 years of formal education (56%, and unemployed (81.6%. The median age was 49 years. Suicide risk (n=71 (56%, agoraphobia (n=65 (52%, major depressive episode (n=56 (44.8%, and alcohol/drug abuse (n=43 (34.4% predominated, the latter being directly associated with lower family income (OR = 2.64; 95%CI 1.03-6.75 and HIV infection (OR = 5.24; 95%CI 1.56-17.61. Suicide risk was associated with non-white skin color (OR = 2.21; 95%CI 1.03-4.75, unemployment (OR = 2.72; 95%CI 1.01-7.34, and diagnosis of major depression (OR = 3.34; 95%CI 1.54-7.44. Conclusion: Measures targeting adverse socioeconomic conditions and psychiatric and psychological monitoring and care should be encouraged in this population, considering the association with abuse of alcohol/other psychoactive drugs and suicide risk.

  6. The Cedar Project: Historical trauma, sexual abuse and HIV risk among young Aboriginal people who use injection and non-injection drugs in two Canadian cities☆

    Science.gov (United States)

    For the Cedar Project Partnership; Pearce, Margo E.; Christian, Wayne M.; Patterson, Katharina; Norris, Kat; Moniruzzaman, Akm; Craib, Kevin J.P.; Schechter, Martin T.; Spittal, Patricia M.

    2016-01-01

    Recent Indigenist scholarship has situated high rates of traumatic life experiences, including sexual abuse, among Indigenous peoples of North America within the larger context of their status as colonized peoples. Sexual abuse has been linked to many negative health outcomes including mental, sexual and drug-related vulnerabilities. There is a paucity of research in Canada addressing the relationship between antecedent sexual abuse and negative health outcomes among Aboriginal people including elevated risk of HIV infection. The primary objectives of this study were to determine factors associated with sexual abuse among participants of the Cedar Project, a cohort of young Aboriginal people between the ages of 14 and 30 years who use injection and non-injection drugs in two urban centres in British Columbia, Canada; and to locate findings through a lens of historical and intergenerational trauma. We utilized post-colonial perspectives in research design, problem formulation and the interpretation of results. Multivariate modeling was used to determine the extent to which a history of sexual abuse was predictive of negative health outcomes and vulnerability to HIV infection. Of the 543 eligible participants, 48% reported ever having experienced sexual abuse; 69% of sexually abused participants were female. The median age of first sexual abuse was 6 years for both female and male participants. After adjusting for sociodemographic variables and factors of historical trauma, sexually abused participants were more likely to have ever been on the streets for more than three nights, to have ever self-harmed, to have suicide ideation, to have attempted suicide, to have a diagnosis of mental illness, to have been in the emergency department within the previous 6 months, to have had over 20 lifetime sexual partners, to have ever been paid for sex and to have ever overdosed. The prevalence and consequences of sexual abuse among Cedar Project participants are of grave concern

  7. Wife Abuse and Its Affecting Factors among the Married Woman

    Directory of Open Access Journals (Sweden)

    Hassan Shams-Esfandabad

    2004-10-01

    Full Text Available Objective: The incindence of wife abuse and its impacts on psychological as well as physical health of the women and in its ultimate negative effects on the health of the family have been presented in many researches. The purpose of the present study was to investigate physical and psychological wife abuse among the married women living in Tehran. Materials & Methods: Study sample (N=1000 consisted of two group of married women (18-45 years: those who did not refere to domestic curts (n= 800, and those who had problem with their husbands and therefore refered to domestic curts (n=200. Moffir et al. (15 Questionnaire has been applied. Results: Data analysis revealed that: psychological and physical wife abuse among subjects in the first group were 87/9 and 47/9 respectively. Psychological and physical wife abuse among subjects in the second group were 99/5 and 91 respectively. Wife abuse was significantly related to the age of the couples and duration of their marriage the older the couples and the longer the marriage, the higher the wife abuse. There was a significant negative relationship between education of the couples and wife abuse. The higher the education, the lesser the wife abuse. Those husbands who consumed alcohol or drug, abused their wives significantly more than those husbands who did not consume alcohol or drug. Husbands with psychological problems abused their wives significantly more than husbands without psychological problems. Psychological and physical wife abuse among the subjects in the second group were higher than psychological and physical wife abuse among the subjects in the first group. Conclusion: Our findings suggested that there are relationships among the variables of age, education, alcohol or drug consumption, husbands psychological disorders and wife abuse. Legislation of a low wich forbids husbands to abuse their wives and increament of the general knowledge about wife abuse by means of mass media may have

  8. Association between childhood abuse and psychiatric morbidities among hospitalized patients

    Directory of Open Access Journals (Sweden)

    Kshirod Kumar Mishra

    2016-01-01

    Full Text Available Background: Childhood abuse has been linked with increased risk of adult psychiatric disorders including major depression, substance abuse, anxiety disorders, posttraumatic stress disorder, and personality disorders. However, only a few from India attempted to study long-term consequences of childhood abuse. Our study aimed to understand the role of physical, sexual, and emotional abuse along with psychiatric co-morbidities in hospitalized patients. Materials and Methods: Patients admitted to psychiatric inpatient services in the age group of 14-45 years for the 1 st time were evaluated for a history of physical, sexual, and emotional abuse on the basis of retrospective chart review. Semi-structured Performa was used to evaluate the patient with a history of child abuse, and they were diagnosed according to International Classification of Diseases-10 diagnostic criteria. Result: The prevalence of child abuse in our inpatient services was 43.29%; emotional abuse (61.9% was most commonly reported among patient followed by physical (21.43% and sexual abuse (16.67%. We observed a significant difference in terms of length of hospital stay between abuse (10.29 ± 6.01 days and nonabuse group (5.90 ± 2.43 days (t = 4.902, df = 95, P < 0.0001. The boys experienced physical abuse at a younger age (7.43 ± 2.50 years than girls (13.50 ± 0.70 years. The sexual abuse and emotional abuse were reported at a younger age in girls than boys. We found high prevalence of substance use disorders (40.47%, psychosis (19.04%, and mood disorder (28.57% among abuse group. Conclusions: The study findings highlight the developing importance of the different forms of abuse on adult psychiatric diagnosis in India. The abused patients are at high risk of the development of psychiatric disorder than the nonabuse group. The increased length of hospitalization among abused group reflects severity and complexity of child abuse. The early detection of social factors

  9. Overcrowding as a possible risk factor for inpatient suicide in a South African psychiatric hospital

    Directory of Open Access Journals (Sweden)

    Christoffel Grobler

    2015-08-01

    Full Text Available About 4% of all suicides are estimated to occur while being an inpatient in a psychiatric facility. Staff generally assume that an inpatient suicide reflects a failure on their part to recognise the patient’s suicidal intent and whether it could have been prevented in any way. Inpatients who commit suicide do not seem to be a homogenous group, but some risk factors have been identified, including being young, single, male, unemployed, abusing substances, schizophrenia and personality- and affective disorders. Number of admissions in the previous month also appears to be a risk factor. When the numbers of inpatients are high, more violent incidents occu. Although literature presently do not suggest an association, overcrowding in psychiatric inpatient wards should be considered a risk factor for inpatient suicide.

  10. ALCOHOL CONSUMPTION AS A RISK FACTOR TO ACQUIRE OVERWEIGHT AND OBESITY

    Directory of Open Access Journals (Sweden)

    José Luis Higuera-Sainz

    2017-07-01

    Full Text Available This chapter describes the epidemiological panorama of overweight, obesity and presents alcohol consumption as a major risk factor for acquiring these health conditions. It also describes the definition of alcohol, its pharmacology, the role of alcohol consumption in overweight and obesity, the combination of alcoholic beverages with sugary drinks and concludes with a series of recommendations to limit alcohol consumption and in consequence to avoid or reduce the overweight and obesity caused in part by the abuse of this substance.

  11. The abuse of nuclear power

    International Nuclear Information System (INIS)

    Hill, J.

    1977-01-01

    Different aspects of possible abuse of nuclear power by countries or individuals are discussed. Special attention is paid to the advantage of nuclear power, despite the risk of weapon proliferation or terrorism. The concepts of some nuclear power critics, concerning health risks in the nuclear sector are rejected as untrue and abusive

  12. Crossing the line from physical discipline to child abuse: how much is too much?

    Science.gov (United States)

    Whipple, E E; Richey, C A

    1997-05-01

    The aim of this paper was to better differentiate physical discipline, corporal punishment, and physical child abuse based on samples drawn from the United States. The American literature was examined to differentiate these three constructs, first on such dimensions as severity, intention, and child effects; and second on key contextual or environmental factors empirically associated with higher rates of violent behavior in families. Third, normative data on parental spanking frequencies were summarized to better operationalize patterns of physical discipline among abusive and nonabusive parents. Five articles that met selection criteria revealed that abusive parents spanked their children more often than did nonabusive parents. Aggregated data from nonabusive parents were used to compute a continuum or "normal range" of daily spanking frequencies from 0 to 5.73 (M = 2.5) times in 24 hours. While further research is needed to address spanking intensity, severity, and context, results of the research suggest that "relative exposure" to spanking may be an additional risk marker for abuse when considered with other known indicators or risk factors.

  13. A prospective study of sex differences in the lifetime risk of posttraumatic stress disorder among abused and neglected children grown up.

    Science.gov (United States)

    Koenen, Karestan C; Widom, Cathy Spatz

    2009-12-01

    In the general population, women's lifetime risk of developing posttraumatic stress disorder (PTSD) is twice that of men's. However, evidence is contradictory as to whether this sex difference is present among child abuse/neglect victims. The authors examined sex differences in PTSD among a sample of 674 individuals with documented child abuse/neglect histories assessed for PTSD in adulthood. Across all types of abuse/neglect, women were more than twice as likely to develop PTSD as men. The sex difference was greatest among sexual abuse victims. Female victims' greater revictimization explained a substantial proportion (39%) of the sex differences in PTSD risk. Future research should identify mechanisms that make female victims particularly vulnerable to revictimization and the development of PTSD.

  14. [Review of risks factors in childhood for schizophrenia and severe mental disorders in adulthood].

    Science.gov (United States)

    Artigue, Jordi; Tizón, Jorge L

    2014-01-01

    To provide scientific evidence, using a literature review on psychosocial risk factors in mental health, that a high exposure to psychosocial stress situations in childhood increases the risk of mental disorders in adulthood,. A literature review up to December 2011 in the electronic databases from Medline, Universitat de Barcelona, and the Universitat Autonoma de Barcelona. The keywords used were: childhood, prenatal, vulnerability, risk, abuse, neglect, child mental disorder, schizophrenia, and prevention. Inclusion criteria for the studies reviewed: 1) designed to investigate childhood risk factors; 2) Comparative studies with persons without risk factors; 3) Studies with sufficient statistical significance; 4) Studies with "n" participants equal to o more than 30 persons. There are a group of easily identifiable mental health risk factors in childhood that can help in the prevention of mental disorders in the adulthood. They can be grouped into four categories: A) Pregnancy, birth and perinatal problems; B) Poor interpersonal relations with parents; C) Adverse life events in the first two years of life; D) Cognitive deficits in primary school, and social isolation during school years. There are life events that may increase the possibilities of suffering some kind of Psychopathology. It is necessary to consider those events as Risk Factors for Mental Health. The accumulation of these Risk Factors increases vulnerability to Mental Disorders. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  15. Modifiable risk factors for prescription medicine sharing behaviours.

    Science.gov (United States)

    Beyene, Kebede; Aspden, Trudi; McNeill, Rob; Sheridan, Janie

    2018-04-06

    Prescription medicine sharing has been defined as giving one's own medicine to someone else (lending) or taking someone else's medicine (borrowing). Medicines can be shared for non-medical purposes (recreational sharing or drug abuse) or for their intended therapeutic benefits (non-recreational sharing, e.g. sharing antibiotics to self-treat); the latter is the focus of this research. Limited research evidence is available about modifiable risk factors for non-recreational medicine sharing and addressing this issue was the main aim of this research. An online, cross-sectional survey design was used. The study population comprised a convenience sample of 233 adults, who were primarily recruited through patient support groups across New Zealand. Principal component analysis was used to develop scales assessing attitudes toward medicine lending and borrowing. Logistic regression was used to examine the relationship between explanatory (demographics, medical conditions, and attitudes towards medicine sharing) and outcome (medicine sharing behaviours) variables. Half of the study participants reported ever borrowing/lending medicines, and approximately a third of participants reported borrowing/lending in the past year. Modifiable risk factors associated with an increased risk of medicine borrowing behaviour were having more difficulty with accessing medicine ('access-related issue'), stronger 'emotional beliefs about borrowing', and greater 'concern about missing doses.' Greater 'concern for the wellbeing of others' and stronger 'beliefs about the benefits and safety of lending' were associated with an increased risk of medicine lending behaviour. Those with a higher 'perceived risk of harm' were less likely to borrow or lend medicines. This research expands the current knowledge of medicine sharing by examining underlying behavioural factors which predict sharing behaviours and that can be modified by interventions. This research suggests using multifaceted

  16. Workplace victimization risk and protective factors for suicidal behavior among active duty military personnel.

    Science.gov (United States)

    Hourani, Laurel L; Williams, Jason; Lattimore, Pamela K; Morgan, Jessica K; Hopkinson, Susan G; Jenkins, Linda; Cartwright, Joel

    2018-04-22

    Workplace victimization is a potential risk factor for suicidal behaviors (SB) among military personnel that has been largely overlooked. This paper examines both the impact of workplace victimization on reported SB and several potential protective factors associated with such suicidal behaviors in a large sample of active duty soldiers. A case-control study was conducted with 71 soldiers who reported SB in the past 12 months, each matched on sociodemographic characteristics to two others without reported suicidal behaviors. A multiple regression model was estimated to assess the effects of risk and protective factors while controlling for other variables. SB was associated with several aspects of victimization, mental health and substance abuse conditions, pain, impulsivity, stressors, negative life events, work-family conflict, active coping behaviors and positive military-related factors. Controlling for other variables, those with SB were more likely to have sought mental health or substance abuse services, to be depressed, anxious, impulsive, and less resilient than non-SB personnel. Study limitations included the use of retrospective self-report data, absence of some known SB predictors, and a population restricted to active duty Army personnel. SB among active duty personnel is associated with victimization since joining the military and is protected by resiliency. These findings suggest that in addition to the usual mental health factors, these additional predictors should be accounted for in SB intervention and prevention planning for active duty personnel. Copyright © 2018 Elsevier B.V. All rights reserved.

  17. Drug Use, the Drug Environment, and Child Physical Abuse and Neglect.

    Science.gov (United States)

    Freisthler, Bridget; Wolf, Jennifer Price; Wiegmann, Wendy; Kepple, Nancy J

    2017-08-01

    Although drug use is considered a risk factor for child maltreatment, very little work has examined how the drug environment may affect physical abuse and neglect by parents. Utilizing information from a telephone survey with 2,597 respondents from 43 cities with valid police data on narcotics incidents, we analyzed the relationship between drug use, drug availability, and child maltreatment using multilevel models. City-level rates of drug abuse and dependence were related to more frequent physical abuse. Parents who use drugs in areas with greater availability of drugs reported more physical abuse and physical neglect. Emotional support was protective of all types of maltreatment. While most child welfare interventions focus on reducing parental drug use in order to reduce child abuse, these findings suggest environmental prevention or neighborhood strengthening approaches designed to reduce the supply of illicit drugs may also reduce child abuse through multiple mechanisms.

  18. Elder abuse as a risk factor for psychological distress among older adults in India: a cross-sectional study.

    Science.gov (United States)

    Evandrou, Maria; Falkingham, Jane C; Qin, Min; Vlachantoni, Athina

    2017-10-22

    This study examines the association between elder abuse and psychological distress among older adults in India and explores whether this association varies by the level of psychosocial and material resources. The study uses a cross-sectional survey design. The data are drawn from a representative sample of 9589 adults aged 60 and above in seven Indian states-Himachal Pradesh, Punjab, West Bengal, Odisha, Maharashtra, Kerala and Tamil Nadu-in 2011. Secondary analysis, using bivariate and multivariate logistic regression models, is conducted using the United Nations Population Fund project Building Knowledge Base on Ageing in India survey. Elder abuse (physical and/or emotional) emanating from family members in the previous month before the survey is examined. Multivariate models are run on the total analytical sample and for men and women separately. The overall prevalence of psychological distress among persons aged 60 and over living in the seven Indian States is 40.6%. Among those older persons who experienced some form of physical or emotional abuse or violence in the last month, the prevalence of psychological distress is much higher than that in the general older population, at 61.6% (pwealth has an inverse relationship with mental health, with the association between experiencing elder abuse and reporting poor mental health being strongest among older people in wealthy households. Elder abuse in India is currently a neglected phenomenon, and greater recognition of the link between abuse and mental health is critical to improve the well-being of vulnerable older adults, some of whom may be 'hidden' within well-off households. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  19. Young female survivors of sexual abuse in Malaysia and depression: what factors are associated with better outcome?

    Science.gov (United States)

    Wahab, Suzaily; Tan, Susan Mooi Koon; Marimuthu, Sheila; Razali, Rosdinom; Muhamad, Nor Asiah

    2013-04-01

    Research in the field of child sexual abuse is lacking in Malaysia. The aims of this study are to identify the association between sociodemographic factors and depression among sexually abused females. A cross-sectional study was conducted among 51 young sexually abused female attendees at the Suspected Child Abuse and Neglect (SCAN) clinic of Hospital Kuala Lumpur, a tertiary referral centre. Upon obtaining informed consent from participant and guardian, participants were screened for depression using the Strength and Difficulty Questionnaire (SDQ) and interviewed using the Schedule for Affective Disorders and Schizophrenia for School Aged Children (K-SADS) for depressive disorders and K-SADS-PL (Present and Lifetime version) to diagnose depression. Sociodemographic data and details of the abuse were also obtained. Of the survivors, 33.3% were depressed. Univariate analysis showed significant association between legal guardianship, living environment and duration of abuse with depression, however, multivariate analyses later showed that the sole predictor for depression was living environment. Respondents who lived with others were 23-times more likely to be depressed as compared to those who lived with their parents. Depression is common among young survivors of sexual abuse. Those who lived with parents appeared to have a better outcome. Thus, further research to explore possible protective factors associated with living with parents is vital. This will help clinicians develop strategies to empower parents and families help these young survivors get back on track with their lives despite the abuse. Copyright © 2013 Wiley Publishing Asia Pty Ltd.

  20. Dental health care providers' views on child physical abuse in Malaysia.

    Science.gov (United States)

    Hussein, A S; Ahmad, R; Ibrahim, N; Yusoff, A; Ahmad, D

    2016-10-01

    To assess the knowledge, attitudes and experience of a group of Malaysian dental health care providers regarding child physical abuse (CPA) cases in terms of frequency of occurrence, diagnosis, risk factors and reporting. A questionnaire was distributed to all dental health care providers attending a national paediatric dentistry conference in Kuantan, Malaysia, and demographical variables, knowledge, attitudes and experience about CPA, risk factors and the reasons for not reporting abuse cases were collected. Descriptive statistics and bivariance analysis were performed. A 5 % level of statistical significance was applied for the analyses (p ≤ 0.05). The response rate was 74.7 %. Half of the respondents (52.8 %) stated that the frequency of occurrence of CPA is common in Malaysia. Full agreement between dental health care providers was not determined concerning the identification of signs of CPA and its risk factors. Although 83.3 % were aware that reporting CPA is a legal requirement in Malaysia, only 14.8 % have reported such cases. Lack of adequate history was the main reason for not reporting. Virtually two-thirds of the respondents (62 %) indicated that they had not received sufficient information about CPA and were willing to be educated on how to diagnose and report child abuse cases (81.5, 78.7 %, respectively). There were considerable disparities in respondents' knowledge and attitudes regarding the occurrence, signs of suspected cases, risk factors and reporting of CPA. Despite being aware of such cases, only a handful was reported. Enhancement in the education of Malaysian dental health care providers on recognising and reporting CPA is recommended.

  1. Suicide risk factors in the professional military personnel in the Army of Serbia

    Directory of Open Access Journals (Sweden)

    Dedić Gordana

    2010-01-01

    Full Text Available Background/Aim. Recognition of suicide risk factors is important in taking adequate suicide preventive measures, Suicide Prevention Program for Professional Military Personnel (PMP implemented in the Army of Serbia in 2003. The aim of our study was to establish suicide risk factors in PMP of the Army of Serbia. Methods. Analysis of suicide risk factors in PMP was carried out on the basis of data obtained by psychological suicide autopsy. The controls were demographically similar psychiatric outpatients with no history of suicidal behavior. A descriptive statistics method was used for risk factors analysis. The t-test was used for testing statistical hypotheses. Results. A total of 30 PMP, aged 22-49 years (30.53 ± 6.24 on average committed suicide within the period 1998-2007. Distal suicide risk factors in PMP were considered to be not being married, psychiatric heredity, having no outpatient psychiatric treatment, gambling, regular physical practice (bodybuilding, less transfer to a different post, low motivation for military service (p < 0.001, not having children, parental loss in early childhood, alcohol abuse (p < 0.005, low salary (p < 0.01 uncompleted military school, debts in the family (p < 0.05. The commonest proximal suicide risk factors were: actual family problems (36.6%, actual mental problems (13.3%, burnout (13.3%, negative balance of accounts (13.3%, professional problems (6.7%, behavioral model while for 10.0% PMP suicide risk factors could not be established. Conclusion. According to the presence of multiple suicide risk factors, Suicide Prevention Program for PMP in the Army of Serbia is directed to the prevention of both proximal and distal suicide risk factors.

  2. Elder Abuse in the Iberian Peninsula and Bolivia: A Multicountry Comparative Study.

    Science.gov (United States)

    Carmona-Torres, Juan Manuel; Carvalhal, Rosa; Gálvez-Rioja, Ruth Mary; Ruiz-Gandara, África; Goergen, Thomas; Rodríguez-Borrego, Mª Aurora

    2017-06-01

    The objective of this study is to determine the prevalence of abuse of vulnerable older persons in the family and community environment in the following regions-Spain (Andalusia-Córdoba), Portugal (Azores), and Bolivia (Santa Cruz de la Sierra)-and to identify risk factors and delineate a profile of abused older persons. For this, a descriptive cross-sectional study was conducted. The sample consisted of people in the age group 65 years plus living in the catchment areas of health centers. The following were used as instruments to collect data: the medical record of the patients of relevant health centers, Mini-Mental State Examination (MMSE), daily activities autonomy test, adaptability, partnership, growth, affection, and resolve (APGAR) familiar test, The Elder Abuse Suspicion Index (EASI) and the Social Work Evaluation Form. Multivariable logistic regression was performed to identify factors associated with abuse. Suspected abuse was identified in 6.9% of the elderly who participated in the study in Spain, 39% in Bolivia, and 24.5% in Azores. In all areas, studied psychological abuse was the most common type of abuse. In conclusion, although the prevalence of abuse to older people in the family and community environment differs in the areas studied, it is present in all countries and the data are comparable with other developing and European countries. The profile of the abused older persons appears to be similar in all countries.

  3. Cognitive vulnerabilities as mediators between emotional abuse and depressive symptoms.

    Science.gov (United States)

    Padilla Paredes, Patricia; Calvete, Esther

    2014-01-01

    This study tested whether childhood parental emotional abuse and peer emotional bullying serve as antecedents of depression in adolescence and identified the cognitive mechanisms involved in this process. It was hypothesized that the experience of emotional abuse would predict depressive symptoms via development of rumination and negative inferences. A 3-wave longitudinal study was carried out with 998 adolescents (471 girls and 526 boys) between 13 and 17 years of age. Results showed that emotional abuse by parents and peers at Time 1 predicted a worsening of several cognitive vulnerabilities at Time 2. In addition, brooding mediated between the experiences of abuse and the increase of depressive symptoms at Time 3. Thus, findings suggest that the experiences of childhood emotional abuse by parents and peers serve as antecedents to develop a negative cognitive style, vulnerability that, once developed, is a risk factor for the onset of depressive symptoms in adolescence.

  4. Predisposing and Precipitating Risk Factors for Suicide Ideations and Suicide Attempts In Young and Adolescent Girls

    Directory of Open Access Journals (Sweden)

    K.S KHUSHABI

    2006-11-01

    Full Text Available Background:To investigate the predisposing and precipitating risk factors for suicide ideations and suicide attempts in young and adolescent females,we tried to introduce a holistic model of suicidal behavior in young and adolescent girls. Methods: This study is based on the survey studies and was cross-sectional. Considering high rates of suicide attempts in provinces of Iran,three provinces (Kermanshah, Hamedan,Ilam which had the highest rates of completed suicide were selected. Then among female high school students (aged 14 to 21 years, in two stages a representative sample was selected by a multi-clusteral and simple randomized sampling methods. The research data were gathered by administering (1 The inventory of predisposing and precipitating factors of suicide, demographic and family characteristics (based on the literature review (2 Symptom Check List (SCL 90-R (3Suicidality Subscale of the Depressive Symptom Index (DSI-SS (4 Center for Epidemiological Studies (CED- SSI (5 Beck Hopelessness Scale (BHS and (6 Child Abuse Self Report Scale (CASRS.Then,subjects were characterized by dividing them in to two categories: at risk,and low risk. The scores of 2 categories were analyzed and discussed. Results: Relationships were found between suicide ideations and psychological problems and disorders (especially depression.Also,the students who reported suicide ideation and suicide attempt had a history of being abused. Based on the results,predisposing and precipitating risk factors and also some protective factors of suicide ideations and suicide attempts were found and a theoretical model was presented.Conclusion: Some predisposing,precipitating and protective factors can predict suicide ideation and suicide attempts significantly.

  5. Risk factors in adolescence: the case of gambling, videogame playing, and the internet.

    Science.gov (United States)

    Griffiths, M; Wood, R T

    2000-01-01

    It has been noted that adolescents may be more susceptible to pathological gambling. Not only is it usually illegal, but it appears to be related to high levels of problem gambling and other delinquent activities such as illicit drug taking and alcohol abuse. This paper examines risk factors not only in adolescent gambling but also in videogame playing (which shares many similarities with gambling). There appear to be three main forms of adolescent gambling that have been widely researched. Adolescent gambling activities and general risk factors in adolescent gambling are provided. As well, the influence of technology on adolescents in the form of both videogames and the Internet are examined. It is argued that technologically advanced forms of gambling may be highly appealing to adolescents.

  6. Parental Alcoholism, Adverse Childhood Experiences, and Later Risk of Personal Alcohol Abuse among Chinese Medical Students

    Institute of Scientific and Technical Information of China (English)

    QIN XIAO; MA-XIA DONG; JIE YAO; WEN-XIAN LI; DONG-QING YE

    2008-01-01

    Objective To determine the status of adverse childhood experiences (ACEs) and the association of multiple ACEs with both parental alcoholism and later personal alcohol abuse among Chinese medical students with a view of improving adolescent health and reducing alcohol abuse among them. Methods In this cross-sectional study, 2073 Chinese medical students completed a survey on ten categories of ACEs in Anhui province of China. The association of parental alcoholism with ACEs and personal lcohol abuse was assessed by logistic regression analyses. Results The adjusted odds ratio (OR) for each category of ACEs in the subjects whose parents (either fathers or mothers or oth) had alcohol abuse was 2 to 14 times higher than that inthose with parental alcoholism (P<0.05). Subjects with i-parental alcoholism had the highest likelihood of ACEs. Compared with the subjects without ACEs, the risk of personal alcohol abuse was increased by 2-4-folds in the subjects with ACEs, irrespective of parental alcoholism (P<0.05). The total number of ACEs (ACE score) had a graded relationship to 4 categories of personal alcohol abuse with or without parental alcoholism. The prevalence of personal alcohol abuse among the subjects with parental alcoholism was higher, which was ndependent of ACE scores. Conclusion The prevalence of ACEs is generally serious in China. Efforts should be made to prevent and treat children with ACEs and subsequently to reduce alcohol abuse and later problems.

  7. Modifiable factors related to abusive behaviors in nursing home residents with dementia

    NARCIS (Netherlands)

    Volicer, L.; Kampen, van J.T.; Frijters, D.H.M.

    2009-01-01

    OBJECTIVES: To determine modifiable factors related to abusive behaviors in nursing home residents with dementia. DESIGN: Analysis of Minimum Data Set (MDS) of the Resident Assessment Instrument (RAI) information. SETTING: We used MDS-RAI data from 8 Dutch nursing homes and 10 residential homes that

  8. Opioid Abuse and Addiction

    Science.gov (United States)

    ... means feeling withdrawal symptoms when not taking the drug. Addiction is a chronic brain disease that causes a person to compulsively seek out drugs, even though they cause harm. The risks of dependence and addiction are higher if you abuse the medicines. Abuse ...

  9. Factors Associated with the Transition from Drug Abuse to Initiation of Injection Drug Use

    Directory of Open Access Journals (Sweden)

    Mosayeb Yarmohamadi Vasel

    2015-06-01

    Full Text Available Objectives: Drug injection carries with it many risks and therefore it is important to understand the initiating factors of injection and its origins. Thus,  the purpose of this study was to identify factors associated with the initiation of injection drug use among substance abusers. Methods:  Study method was a cross-sectional study. The research statistics universe constitutes all people suffering from a substance dependence disorder with a pattern of injection use in Tehran and Hamedan. This study was conducted among 216 individuals with substance dependence disorders who were selected from harm reduction centers in Tehran and Hamedan. The sampling selection method was simply random. The instruments used for data collection included: demographic information, patterns of drug use and initiation of injection scales.  Results: In this study, the average age of initiation to injections was 22.5 years. Factors associated with initiation of drug injection included: acquired more pleasure, easier use, faster effect of injection, ineffective previous use method, curiosity, peer pressure, lack of availability of the drug, poverty, and low quality drugs. Discussion: Results of this study indicate that initiation factors to drug injection are multifaceted (Psychological, Social, Economic and Environmental, therefore, injection interventionists should consider all these factors for prevention, treatment and harm reduction.

  10. Risk behaviors and sexual abuse among men and woman with visual or hearing impairments

    Directory of Open Access Journals (Sweden)

    Silvia Susana Robles Montijo

    2017-06-01

    Full Text Available The present study proposed a descriptive analysis of sociodemographic and family variables, as well as risky sexual behaviors and sexual abuse in a sample of young Mexicans with hearing or visual impairments, examining differences based on gender and type of disability of the participants. 128 young persons (64 hearing impaired and 64 visually impaired of whom, 53.2% were male and 86.6% were single, were included in the study. The instruments used were adapted linguistically to be answered by young people with hearing disabilities, and translated into Braille for visually impaired young people. The results show that participants maintain an active sex life with a risk profile that is characterized by the early onset of sexual intercourse, lack of planning their first sexual encounter, underuse of condoms and victimization of some form of sexual abuse. The risk was higher in women and among those with visual disabilities.

  11. Relation of Childhood Sexual Abuse, Intimate Partner Violence, and Depression to Risk Factors for HIV Among Black Men Who Have Sex With Men in 6 US Cities.

    Science.gov (United States)

    Williams, John K; Wilton, Leo; Magnus, Manya; Wang, Lei; Wang, Jing; Dyer, Typhanye Penniman; Koblin, Beryl A; Hucks-Ortiz, Christopher; Fields, Sheldon D; Shoptaw, Steve; Stephenson, Rob; O'Cleirigh, Conall; Cummings, Vanessa

    2015-12-01

    We assessed the relation of childhood sexual abuse (CSA), intimate partner violence (IPV), and depression to HIV sexual risk behaviors among Black men who have sex with men (MSM). Participants were 1522 Black MSM recruited from 6 US cities between July 2009 and December 2011. Univariate and multivariable logistic regression models were used. Participants reported sex before age 12 years with someone at least 5 years older (31.1%), unwanted sex when aged 12 to 16 years (30%), IPV (51.8%), and depression (43.8%). Experiencing CSA when aged 12 to 16 years was inversely associated with any receptive condomless anal sex with a male partner (adjusted odds ratio [AOR] = 0.50; 95% confidence interval [CI] = 0.29, 0.86). Pressured or forced sex was positively associated with any receptive anal sex (AOR = 2.24; 95% CI = 1.57, 3.20). Experiencing CSA when younger than 12 years, physical abuse, emotional abuse, having been stalked, and pressured or forced sex were positively associated with having more than 3 male partners in the past 6 months. Among HIV-positive MSM (n = 337), CSA between ages 12 and 16 years was positively associated with having more than 3 male partners in the past 6 months. Rates of CSA, IPV, and depression were high, but associations with HIV sexual risk outcomes were modest.

  12. Connecting the Dots: State Health Department Approaches to Addressing Shared Risk and Protective Factors Across Multiple Forms of Violence

    Science.gov (United States)

    Wilkins, Natalie; Myers, Lindsey; Kuehl, Tomei; Bauman, Alice; Hertz, Marci

    2018-01-01

    Violence takes many forms, including intimate partner violence, sexual violence, child abuse and neglect, bullying, suicidal behavior, and elder abuse and neglect. These forms of violence are interconnected and often share the same root causes. They can also co-occur together in families and communities and can happen at the same time or at different stages of life. Often, due to a variety of factors, separate, “siloed” approaches are used to address each form of violence. However, understanding and implementing approaches that prevent and address the overlapping root causes of violence (risk factors) and promote factors that increase the resilience of people and communities (protective factors) can help practitioners more effectively and efficiently use limited resources to prevent multiple forms of violence and save lives. This article presents approaches used by 2 state health departments, the Maryland Department of Health and Mental Hygiene and the Colorado Department of Public Health and Environment, to integrate a shared risk and protective factor approach into their violence prevention work and identifies key lessons learned that may serve to inform crosscutting violence prevention efforts in other states. PMID:29189502

  13. Does Accessibility of Positive and Negative Schema Vary by Child Physical Abuse Risk?

    Science.gov (United States)

    Crouch, Julie L.; Risser, Heather J.; Skowronski, John J.; Milner, Joel S.; Farc, Magdalena M.; Irwin, Lauren M.

    2010-01-01

    Objective: To examine differences in accessibility of positive and negative schema in parents with high and low risk for child physical abuse (CPA). Methods: This study combined picture priming and lexical decision making methods to assess the accessibility of positive and negative words following presentation of child and adult faces. The child…

  14. Xylometazoline abuse induced ischemic stroke in a young adult.

    Science.gov (United States)

    Leupold, Daniela; Wartenberg, Katja E

    2011-01-01

    substance abuse is an important cause of ischemic stroke in the young. This includes over-the-counter dietary supplements and cough and cold remedies, which were reported to be an independent risk factor for hemorrhagic stroke. this article describes a young male patient with acute ischemic infarctions in the posterior inferior cerebellar and posterior cerebral artery territories bilaterally, the right cerebral peduncle, the left pontine tegmentum, and lateral pons following abuse of xylometazoline-containing nasal decongestant for 10 years. this is the first report in the literature of posterior circulation strokes because of chronic xylometazoline abuse. We hope to contribute to increase knowledge and awareness of the public about these serious complications of cough-and-cold remedies as well as dietary supplements containing sympathomimetics.

  15. Physical punishment, abuse, torture or revenge? A case report.

    Science.gov (United States)

    Gharib, Behdad; Esmaeili, Sara; Mazloomi Nobandegani, Narges; Shariati, Golnaz

    2012-01-01

    Child maltreatment happens in all countries and cultures. Children as the vulnerable part of the societies are subject to rage, abuse and maltreatment and need special multidisciplinary attention to get proper protection and care. Appropriate legislation, community education, advocacy in media and attention of care givers and children health providers may alter the trend of child abuse in communities. In order to raise awareness about child abuse for healthcare professionals, in this report we introduce a disastrous case of 4 years old boy who was attacked by his father which presented to Children's Medical Center in Tehran. The living environment of the victim was a dysfunctional family and an addict father as the risk factors of dangerous circumstances for a child.

  16. Physical Punishment, Abuse, Torture or Revenge? A Case Report

    Directory of Open Access Journals (Sweden)

    Behdad Gharib

    2012-08-01

    Full Text Available Child maltreatment happens in all countries and cultures. Children as the vulnerable part of the societies are subject to rage, abuse and maltreatment and need special multidisciplinary attention to get proper protection and care. Appropriate legislation, community education, advocacy in media and attention of care givers and children health providers may alter the trend of child abuse in communities. In order to raise awareness about child abuse for healthcare professionals, in this report we introduce a disastrous case of 4 years old boy who was attacked by his father which presented to Children's Medical Center in Tehran. The living environment of the victim was a dysfunctional family and an addict father as the risk factors of dangerous circumstances for a child.

  17. Do Trauma Symptoms Mediate the Relationship Between Childhood Physical Abuse and Adult Child Abuse Risk?

    Science.gov (United States)

    2010-05-01

    fisico y abuso sexual . Psicothema, 14, 53–62. DiLillo, D., Perry, A. R., & Fortier, M. (2006). Child physical abuse and neglect. In R. T. Ammerman (Ed...Valerie A. Standere, Lex L. Merrill e a Center for the Study of Family Violence and Sexual Assault, Northern Illinois University, DeKalb, IL 60115-2854...recruits (N=5,394) and college students (N=716) completed self-report measures of their history of child abuse (i.e., CPA and child sexual abuse [CSA

  18. Sex Differences in Drug Abuse

    OpenAIRE

    Becker, Jill B.; Hu, Ming

    2007-01-01

    Sex differences are present for all of the phases of drug abuse (initiation, escalation of use, addiction, and relapse following abstinence). While there are some differences among specific classes of abused drugs, the general pattern of sex differences is the same for all drugs of abuse. Females begin regularly self-administering licit and illicit drugs of abuse at lower doses than do males, use escalates more rapidly to addiction, and females are at greater risk for relapse following abstin...

  19. Adult atopic dermatitis and the risk of type 2 diabetes

    DEFF Research Database (Denmark)

    Andersen, Yuki M.F.; Egeberg, Alexander; Gislason, Gunnar H.

    2017-01-01

    While AD is not an independent risk factor for T2D in adjusted analysis, age, smoking, alcohol abuse and use of systemic and topical corticosteroids may increase the risk of T2D in adults with AD.......While AD is not an independent risk factor for T2D in adjusted analysis, age, smoking, alcohol abuse and use of systemic and topical corticosteroids may increase the risk of T2D in adults with AD....

  20. Bayesian spatial models of the association between interpersonal violence, animal abuse and social vulnerability in São Paulo, Brazil.

    Science.gov (United States)

    Baquero, Oswaldo Santos; Ferreira, Fernando; Robis, Marcelo; Neto, José Soares Ferreira; Onell, Jason Ardila

    2018-04-01

    Animal abuse adversely affects animal health and welfare and has been associated with interpersonal violence in studies of individuals. However, if that association also depends on sociocultural contexts and can be detected on a geographic scale, a wider source of data can be used to identify risk areas to support the surveillance of both types of violence. In this study, we evaluated the association between interpersonal violence notifications, animal abuse notifications and an index of social vulnerability in São Paulo City, on a geographic scale, using Bayesian spatial models. The social vulnerability index was a risk factor for the number of interpersonal violence notifications and presented a dose-response pattern. The number of animal abuse notifications was also a risk factor for the number of interpersonal violence notifications, even after controlling for the social vulnerability index. The incorporation of spatial effects produced marked improvements in model performance metrics and allowed the identification of excess risk clusters. Geographical data on notifications on either animal abuse or interpersonal violence should be considered incitement for investigations and interventions of both types of violence. We suggest that notifications of animal abuse be based on an explicit definition and classification, as well as on objective measurements that allow a better understanding of the species and type of abuse involved, the animal health consequences, and the context in which they occurred. Copyright © 2018 Elsevier B.V. All rights reserved.

  1. [Consumption of licit and illicit drugs in students and the factors of protection and risk].

    Science.gov (United States)

    Duvicq, Carmen Gloria Fraile; Pereira, Náyade Riquelme; Carvalho, Ana Maria Pimenta

    2004-01-01

    The aims of the investigation were identify the population that consumes licit and illicit drugs among students of sixth primary, from municipal urban schools of Chiguayante, know the levels of risks and identify risks factors and protection. Descriptive, transversal, correlate study. The instrument applied to 301 students was the Dusy Abreviado. The variables were subjected to a statistic descriptive -- comparative analysis through the test of Chi -- Cuadrado de Pearson and ANOVA. There was 60% of the consumers of licit drugs, that began consumption between 8 and 11 years. The prevalence of use of tobacco and alcohol was 18.7% and 16.3% respectively. The 85% of men showed inclination to the consumption, from which 69% is between 11 and 12 years old. There are mainly abusers of licit drugs. The behaviours associated to the personal risk factor were the most relevant, the ones of protection were mainly associated with the micro-social protective factor. All subjects were submitted to different levels of risk.

  2. Effects of Trauma Intervention on HIV Sexual Risk Behaviors among Women with Co-Occurring Disorders in Substance Abuse Treatment

    Science.gov (United States)

    Amaro, Hortensia; Larson, Mary Jo; Zhang, Annie; Acevedo, Andrea; Dai, Jianyu; Matsumoto, Atsushi

    2007-01-01

    Women in substance abuse treatment often have co-occurring mental health disorders and a history of trauma; they are also at high risk for HIV infection and other sexually transmitted diseases via unprotected sex. A quasi-experimental study evaluated the effectiveness of trauma-enhanced substance abuse treatment combined with HIV/AIDS prevention…

  3. Differences and similarities of risk factors for suicidal ideation and attempts among patients with depressive or bipolar disorders.

    Science.gov (United States)

    Aaltonen, Kari; Näätänen, Petri; Heikkinen, Martti; Koivisto, Maaria; Baryshnikov, Ilya; Karpov, Boris; Oksanen, Jorma; Melartin, Tarja; Suominen, Kirsi; Joffe, Grigori; Paunio, Tiina; Isometsä, Erkki

    2016-03-15

    Substantial literature exists on risk factors for suicidal behaviour. However, their comparative strength, independence and specificity for either suicidal ideation or suicide attempt(s) remain unclear. The Helsinki University Psychiatric Consortium (HUPC) Study surveyed 287 psychiatric care patients with ICD-10-DCR depressive or bipolar disorders about lifetime suicidal behaviour, developmental history and attachment style, personality and psychological traits, current and lifetime symptom profiles, and life events. Psychiatric records were used to confirm diagnosis and complement information on suicide attempts. Multinomial regression models predicting lifetime suicidal ideation and single or repeated suicide attempts were generated. Overall, 21.6% patients had no lifetime suicidal behaviour, 33.8% had lifetime suicide ideation without attempts, and 17.1% had a single and 27.5% repeated suicide attempts. In univariate analyses, lifetime suicidal behaviour was associated with numerous factors. In multivariate models, suicidal ideation was independently predicted by younger age, severe depressive disorder, bipolar disorder type II/nos, hopelessness, and childhood physical abuse. Repeated suicide attempts were independently predicted by younger age, female sex, severe depressive disorder with or without psychotic symptoms, bipolar disorder type II/nos, alcohol use disorder, borderline personality disorder traits, and childhood physical abuse. Cross-sectional and retrospective study design, utilization of clinical diagnoses, and relatively low response rate. Risk factors for suicidal ideation and attempts may diverge both qualitatively and in terms of dose response. When effects of risk factors from multiple domains are concurrently examined, proximal clinical characteristics remain the most robust. All risk factors cluster into the group of repeated attempters. Copyright © 2015 Elsevier B.V. All rights reserved.

  4. Possible inclinations for psychostimulant, toxic agent and drug abuse among youths and students

    Directory of Open Access Journals (Sweden)

    V. G. Ginzburg

    2012-03-01

    Full Text Available Taking into account modern achievements in medicine, psychology and sociology, the attempt at complex research of possible inclinations for psychostimulant, toxic agent and drug abuse among youths and students was made with the subsequent determination of the possible alternates of primary prevention. It is analysed the basic and additional risk factors promoting smoking, drinking, psychostimulant abuse, toxicomania and narcomania among young people. The dynamics of possible influences of medical, psychological and social factors is studied. The attempt of short-term prognostication and ranking was made.

  5. Characteristics of Transgender Individuals Entering Substance Abuse Treatment

    Science.gov (United States)

    Heck, Nicholas C.; Sorensen, James L.

    2014-01-01

    Little is known about the needs or characteristics of transgender individuals in substance abuse treatment settings. Transgender (n=199) and non-transgender (cisgender, n=13440) individuals were compared on psychosocial factors related to treatment, health risk behaviors, medical and mental health status and utilization, and substance use behaviors within a database that documented individuals entering substance abuse treatment in San Francisco, CA from 2007–2009 using logistic and linear regression analyses (run separately by identified gender). Transgender men (assigned birth sex of female) differed from cisgender men across many psychosocial factors, including having more recent employment, less legal system involvement, greater incidence of living with a substance abuser, and greater family conflict, while transgender women (assigned birth sex of male) were less likely to have minor children than cisgender women. Transgender women reported greater needle use and HIV testing rates were greater among transgender women. Transgender men and women reported higher rates of physical health problems, mental health diagnoses, and psychiatric medications but there were no differences in service utilization. There were no differences in substance use behaviors except that transgender women were more likely to endorse primary methamphetamine use. Transgender individuals evidence unique strengths and challenges that could inform targeted services in substance abuse treatment. PMID:24561017

  6. Environmental factors that distinguish between clinical and healthy samples with childhood experiences of abuse and neglect.

    Science.gov (United States)

    Infurna, Maria Rita; Giannone, Francesca; Guarnaccia, Cinzia; Lo Cascio, Maria; Parzer, Peter; Kaess, Michael

    2015-01-01

    Childhood maltreatment is associated with a wide range of problems in adulthood. However, specific environmental factors (either positive or negative) influence mental health outcomes in maltreated children. The present study investigated the effect of environmental factors by comparing a group of clinical participants with experiences of abuse/neglect with a healthy group with similar patterns of experiences. Environmental factors selected were: separation from parents, financial hardship, parental psychiatric disorders, and low social involvement. The study included 55 mixed clinical participants and 23 healthy participants. All participants were investigated using the Childhood Experience of Care and Abuse (CECA) interview. The two groups were specifically matched with regard to patterns of childhood maltreatment. The findings indicated that psychopathological outcome was associated with a greater presence of negative environmental factors (p < 0.001). In particular, lack of social support seemed to be the only one predictor (OR = 27.86). This study is the first to investigate the influence of specific environmental factors in two groups with similar childhood experiences of abuse/neglect but different mental health outcomes. These findings suggest that efforts should be made to incorporate both familial and external sources of social support in promoting mental health for maltreated children. © 2015 S. Karger AG, Basel.

  7. A population-based study of physical function and risk for elder abuse reported to social service agency: findings from the Chicago health and aging project.

    Science.gov (United States)

    Dong, XinQi; Simon, Melissa; Evans, Denis

    2014-10-01

    We examined the association between physical function and the risk for reported elder abuse. In the Chicago Health and Aging Project (N = 8,932), 238 participants had reported elder abuse. The independent variable was objectively assessed physical function using both directly observed physical performance testing and self-reported physical function (Katz activity of daily living scale, Nagi physical activity scale, and Rosow Breslau mobility scales). Outcomes were elder abuse and specific subtypes of elder abuse. After adjusting for confounders, lower levels of physical performance testing (OR, 2.71[1.58-4.64]), Katz impairment (OR, 1.84[1.29-2.59]), Nagi impairment (OR, 1.65[1.15-2.37]) and Rosow Breslau (OR, 1.76[1.26-2.47]) were associated with increased risk for elder abuse. Lowest levels of physical performance testing were associated with increased risk for psychological abuse (OR, 2.69[1.27-5.71]), caregiver neglect (OR, 2.66[1.22-5.79]), and financial exploitation (OR, 2.35 [1.21-4.55]). Our results may have important implications to healthcare professional, social services and other disciplines to prevent and treat elder abuse. © The Author(s) 2012.

  8. Factors Related to Medicaid Payment Acceptance at Outpatient Substance Abuse Treatment Programs

    Science.gov (United States)

    Terry-McElrath, Yvonne M; Chriqui, Jamie F; McBride, Duane C

    2011-01-01

    Objective To examine factors associated with Medicaid acceptance for substance abuse (SA) services by outpatient SA treatment programs. Data Sources Secondary analysis of 2003–2006 National Survey of Substance Abuse Treatment Services data combined with state Medicaid policy and usage measures and other publicly available data. Study Design We used cross-sectional analyses, including state fixed effects, to assess relationships between SA treatment program Medicaid acceptance and (1) program-level factors, (2) county-level sociodemographics and treatment program density, and (3) state-level population characteristics, SA treatment-related factors, and Medicaid policy and usage. Data Extraction Methods State Medicaid policy data were compiled based on reviews of state Medicaid-related statutes/regulations and Medicaid plans. Other data were publicly available. Principal Findings Medicaid acceptance was significantly higher for programs: (a) that were publicly funded and in states with Medicaid policy allowing SA treatment coverage; (b) with accreditation/licensure and nonprofit/government ownership, as well as mental- and general-health focused programs; and (c) in counties with lower household income. Conclusions SA treatment program Medicaid acceptance related to program-, county, and state-level factors. The data suggest the importance of state policy and licensure/accreditation requirements in increasing SA program Medicaid access. PMID:21105870

  9. [Study on high-risk behaviour and suicide associated risk factors related to HIV/AIDS among gay or bisexual men].

    Science.gov (United States)

    Chen, Hong-quan; Li, Yang; Zhang, Bei-chuan; Li, Xiu-fang

    2011-10-01

    Characteristics on AIDS high-risk behaviors in gay or bisexual men with suicide ideas were explored and analyzed. A cross-sectional survey was conducted with the snowball sampling method adopted. Subjects with suicide ideas were collected from responses to the valid questionnaires and subjects with no suicide ideas were collected from the age comparable men. The overall rate of gays or bisexuals with suicide ideas was 20.2% in this survey. The attitude for homogeneity and marital status among the unmarried was more than that among the comparable group (P sexual harassment, bleeding during sexual intercourse in the last year, coitus with unfamiliar same-sex partners in cities, suffering from adult same-sex sexual abuse before the age of 16, having had sexual abuse and abusive behavior, having had active or passive anal kiss, having had active or passive coitus with fingers, alcohol consumption weekly at least once or more, hurt by gays because of attitude and/or same-sex sexual activity and hurt by heterosexual men because of attitude and/or same-sex sexual activity were significantly higher in gays and bisexual men with suicide ideas than those without (P men (Waldχ(2) = 5.835, P = 0.016) due to attitude on homosexual activity appear to be the risk factors causing the suicide ideas. Reducing the social discrimination and harm towards gays and bisexual men could reduce the occurrence of the suicide ideas and have a positive effect on curbing the prevalence of AIDS.

  10. Drug addiction is not an independent risk factor for oncogenic human papillomavirus infections or high-grade cervical intraepithelial neoplasia: case-control study nested within the Latin American Screening study cohort.

    Science.gov (United States)

    Syrjänen, K; Naud, P; Derchain, S; Roteli-Martins, C; Longatto-Filho, A; Tatti, S; Branca, M; Erzen, M; Hammes, L S; Matos, J; Gontijo, R; Sarian, L; Bragança, J; Arlindo, F C; Maeda, M Y S; Lörincz, A; Dores, G B; Costa, S; Syrjänen, S

    2008-04-01

    Drug abuse (addiction) has been listed among the risk factors for human papillomavirus (HPV) infections, but no case-control studies exist to rule out sexual behaviour and other potential confounders. The aim of this study is to evaluate the role of drug addiction as an independent predictor of HR-HPV infections and (cervical intraepithelial neoplasia) CIN2+ in an age-matched case-control (1:4) study nested within the prospective Latin American Screening (LAMS) study cohort. All 109 women in the LAMS cohort (n=12,114) reporting drug abuse/addiction were matched with four controls (n = 436) of non-abusers strictly by age. Conditional logistic regression analysis was used to estimate the co-variates of drug abuse, and the whole series (n=545) was analysed for predictors of HR-HPV and CIN2+ using univariate and multivariate regression models. Oncogenic HPV infections were significantly (P=0.019) more prevalent among abusers (37.7%) than in controls (21.9%), but there was no difference in high-grade squamous intraepithelial lesions (P=0.180) or CIN2+ lesions (P=0.201). In multivariate conditional logistic regression, number of lifetime sexual partners (P=0.0001), ever smokers (P=0.0001), non-use of OCs (P=0.013), ever having sexually transmitted diseases (STD) (P=0.041) and no previous Pap smear (P=0.027) were independent co-variates of drug addiction. Drug abuse was not an independent risk factor of high-risk (HR)-HPV infection, which was significantly predicted by (1) age below 30 years (P=0.045), (2) more than five lifetime sexual partners (P=0.046) and (3) being current smoker (P=0.0001). In multivariate model, only HR-HPV infection was an independent risk factor of CIN2+ (P=0.031), with adjusted OR=11.33 (95% CI 1.25-102.50). These data indicate that drug addiction is not an independent risk factor of either HR-HPV infections or CIN2+, but the increased prevalence of HR-HPV infections is explained by the high-risk sexual behaviour and smoking habits of these women.

  11. Assessing Intimate Partner Abuse: Associated Factors and Health Consequences among Jordanian Women.

    Science.gov (United States)

    Safadi, Reema R; Daibes, Mayada A; Haidar, Waheda H; Al-Nawafleh, Ahmad H; Constantino, Rose E

    2018-04-01

    In this cross-sectional study, we assessed levels and types of psychological and physical intimate partner abuse (IPA), and the association of IPA with socio-demographic factors and health consequences. The Abusive Behavior Inventory was completed by 471 Jordanian women. IPA was higher among older women who were: of older age, of younger age at marriage, married to unemployed spouses, living in urban residence, and of lower educational level. IPA was associated with most of the health problems except dental injuries and burns. We recommend educational programs that raise women's awareness to their rights to education, free choices in marital age, and policies that mitigate IPA in Jordan and similar patriarchal societies.

  12. Individual psychological and social risk factors for violent criminal behavior in adolescents with organic mental disorder

    Directory of Open Access Journals (Sweden)

    Zubkova A.A.

    2016-10-01

    Full Text Available The article describes the risk factors for criminal aggression in adolescents with an organic mental disorder depending on the level of social deviations or severity of pathopsychological factor. The study involved 113 male adolescents aged 15 to 17 years. The main group consisted of juvenile offenders with organic mental disorder. We used the methods of investigation to determine the individual psychological characteristics, we also used structured risk assessment methods. It is shown that risk factors for criminal aggressive behavior in adolescents with organic mental disorder are a high level of proactive and reactive aggression, combined with underdeveloped mechanisms deter aggressive intentions. With the increase of organic disease, these features become more stable. An important role in shaping the aggressive criminal behavior plays an unsuccessful social environment. Interfamily problems, social deprivation, learning difficulties, communication in antisocial groups and substance abuse - all this increases the risk of aggressive illegal actions.

  13. Relationship power and sexual risk among women in community-based substance abuse treatment.

    Science.gov (United States)

    Campbell, Aimee N C; Tross, Susan; Dworkin, Shari L; Hu, Mei-Chen; Manuel, Jennifer; Pavlicova, Martina; Nunes, Edward V

    2009-11-01

    Relationship power has been highlighted as a major factor influencing women's safer sex practices. Little research, however, has specifically examined relationship power in drug-involved women, a population with increased risk for HIV transmission. Using baseline data from a National Institute on Drug Abuse Clinical Trials Network multisite trial of a women's HIV prevention intervention in community-based drug treatment programs, this paper examined the association between sexual relationship power and unprotected vaginal or anal sex. The Sexual Relationship Power Scale, a measure of relationship control and decision-making dominance, was used to assess the association between power and unprotected sex in relationships with primary male partners. It was hypothesized that increased relationship power would be associated with decreased unprotected sexual occasions, after controlling for relevant empirical and theoretical covariates. Findings show a more complex picture of the association between power and sexual risk in this population, with a main effect in the hypothesized direction for decision-making dominance but not for relationship control. Possible explanations for these findings are discussed, and future research directions for examining power constructs and developing interventions targeting relationship power among drug-involved women are suggested.

  14. Psychological and behavioural factors associated with sexual risk behaviour among Slovak students

    Directory of Open Access Journals (Sweden)

    van Dijk Jitse P

    2009-01-01

    Full Text Available Abstract Background Knowledge about the prevalence of sexual risk behaviour (SRB in adolescence is needed to prevent unwanted health consequences. Studies on SRB among adolescents in Central Europe are rare and mostly rely on a single indicator for SRB. This study aims to assess the association of behavioural and psychological factors with three types of SRB in adolescents in Central Europe. Methods We obtained data on behavioural factors (having been drunk during previous month, smoking during previous week, early sexual initiation, psychological factors (self-esteem, well-being, extroversion, neuroticism, religiousness, and SRB (intercourse under risky conditions, multiple sexual partners, and inconsistent condom use in 832 Slovak university students (response 94.3%. Results Among those with sexual experience (62%, inconsistent condom use was the most prevalent risk behaviour (81% in females, 72% in males. With the exception of having been drunk in males, no factor was associated with inconsistent condom use. Regarding the other types of SRB, early sexual initiation was most strongly associated. In addition, other, mostly behavioural, factors were associated, in particular having been drunk. Conclusion Results suggest that behavioural factors are more closely related to SRB than psychological factors. Associations differ by type of SRB and gender but offer few clues to target risk groups for inconsistent condom use. Results show a high need for health-promotion programmes in early adolescence that target SRB in conjunction with other health risk behaviours such as alcohol abuse.

  15. Risk Management Post-Marketing Surveillance for the Abuse of Medications Acting on the Central Nervous System: Expert Panel Report

    Science.gov (United States)

    Johanson, Chris-Ellyn; Balster, Robert L.; Henningfield, Jack E.; Schuster, Charles R.; Anthony, James C.; Barthwell, Andrea G.; Coleman, John J.; Dart, Richard C.; Gorodetzky, Charles W.; O’Keeffe, Charles; Sellers, Edward M.; Vocci, Frank; Walsh, Sharon L.

    2010-01-01

    The abuse and diversion of medications is a significant public health problem. This paper is part of a supplemental issue of Drug and Alcohol Dependence focused on the development of risk management plans and post-marketing surveillance related to minimizing this problem. The issue is based on a conference that was held in October, 2008. An Expert Panel was formed to provide a summary of the conclusions and recommendations that emerged from the meeting involving drug abuse experts, regulators and other government agencies, pharmaceutical companies and professional and other non-governmental organizations. This paper provides a written report of this Expert Panel. Eleven conclusions and eleven recommendations emerged concerning the state of the art of this field of research, the regulatory and public health implications and recommendations for future directions. It is concluded that special surveillance tools are needed to detect the emergence of medication abuse in a timely manner and that risk management tools can be implemented to increase the benefit to risk ratio. The scientific basis for both the surveillance and risk management tools is in its infancy, yet progress needs to be made. It is also important that the unintended consequences of increased regulation and the imposition of risk management plans be minimized. PMID:19783383

  16. Integrating Substance Abuse Treatment and Child Welfare Services: Findings from the Illinois Alcohol and Other Drug Abuse Waiver Demonstration

    Science.gov (United States)

    Ryan, Joseph P.; Marsh, Jeanne C.; Testa, Mark F.; Louderman, Richard

    2006-01-01

    Alcohol and other drug abuse is a major problem for children and families involved with public child welfare. Substance abuse compromises appropriate parenting practices and increases the risk of child maltreatment. A substantial proportion of substantiated child abuse and neglect reports involve parental substance abuse. Once in the system,…

  17. Traumatic brain injury and alcohol/substance abuse: A Bayesian meta-analysis comparing the outcomes of people with and without a history of abuse.

    Science.gov (United States)

    Unsworth, David J; Mathias, Jane L

    2017-08-01

    Alcohol and substance (drugs and/or alcohol) abuse are major risk factors for traumatic brain injury (TBI); however, it remains unclear whether outcomes differ for those with and without a history of preinjury abuse. A meta-analysis was performed to examine this issue. The PubMed, Embase, and PsycINFO databases were searched for research that compared the neuroradiological, cognitive, or psychological outcomes of adults with and without a documented history of alcohol and/or substance abuse who sustained nonpenetrating TBIs. Data from 22 studies were analyzed using a random-effects model: Hedges's g effect sizes measured the mean difference in outcomes of individuals with/without a history of preinjury abuse, and Bayes factors assessed the probability that the outcomes differed. Patients with a history of alcohol and/or substance abuse had poorer neuroradiological outcomes, including reduced hippocampal (g = -0.82) and gray matter volumes (g = -0.46 to -0.82), and enlarged cerebral ventricles (g = -0.73 to -0.80). There were limited differences in cognitive outcomes: Executive functioning (g = -0.51) and memory (g = -0.39 to -0.43) were moderately affected, but attention and reasoning were not. The findings for fine motor ability, construction, perception, general cognition, and language were inconclusive. Postinjury substance and alcohol use (g = -0.97 to -1.07) and emotional functioning (g = -0.29 to -0.44) were worse in those with a history of alcohol and/or substance abuse (psychological outcomes). This study highlighted the type and extent of post-TBI differences between persons with and without a history of alcohol or substance abuse, many of which may hamper recovery. However, variation in the criteria for premorbid abuse, limited information regarding the history of abuse, and an absence of preinjury baseline data prevented an assessment of whether the differences predated the TBI, occurred as a result of ongoing alcohol/substance abuse, or

  18. Application of satellite imagery to monitoring human rights abuse of vulnerable communities, with minimal risk to relief staff

    International Nuclear Information System (INIS)

    Lavers, C; Bishop, C; Hawkins, O; Grealey, E; Cox, C; Thomas, D; Trimel, S

    2009-01-01

    Space imagery offers remote surveillance of ethnic people groups at risk of human rights abuse. We highlight work in alleged violations in Burma and Sudan, using satellite imagery for verification with Amnesty International. We consider how imaging may effectively support small to medium-sized Non Governmental Organisations and charities, e.g. HART, working in dangerous zones on the ground. Satellite based sensing applications are now at a sufficiently mature stage for moderate Governmental funding levels to help prevent human rights abuse, rather than the greater cost of rebuilding communities and healing sectarian divisions after abuse has taken place.

  19. Application of satellite imagery to monitoring human rights abuse of vulnerable communities, with minimal risk to relief staff

    Energy Technology Data Exchange (ETDEWEB)

    Lavers, C; Bishop, C; Hawkins, O; Grealey, E; Cox, C; Thomas, D; Trimel, S, E-mail: brnc-radarcomms1@nrta.mod.u [Sensors Team, Plymouth University at Britannia Royal Naval College, Dartmouth (United Kingdom); DMC International Imaging, Tycho House, Surrey Research Park, Guildford (United Kingdom); Qinetiq, Cody Technology Park, Cody Building, Ively Road, Farnborough (United Kingdom); Humanitarian Aid Relief Trust (HART), 3 Arnellan House, Kingsbury, London (United Kingdom); Amnesty International USA, 5 Penn Plaza, New York (United States)

    2009-07-01

    Space imagery offers remote surveillance of ethnic people groups at risk of human rights abuse. We highlight work in alleged violations in Burma and Sudan, using satellite imagery for verification with Amnesty International. We consider how imaging may effectively support small to medium-sized Non Governmental Organisations and charities, e.g. HART, working in dangerous zones on the ground. Satellite based sensing applications are now at a sufficiently mature stage for moderate Governmental funding levels to help prevent human rights abuse, rather than the greater cost of rebuilding communities and healing sectarian divisions after abuse has taken place.

  20. Risk Factors

    Science.gov (United States)

    ... cells do not invade nearby tissues or spread. Risk Factors Key Points Factors That are Known to ... chemicals . Factors That are Known to Increase the Risk of Cancer Cigarette Smoking and Tobacco Use Tobacco ...

  1. Post Traumatic Stress Disorder/PTSD in adolescent victims of sexual abuse: resilience and social support as protection factors

    Directory of Open Access Journals (Sweden)

    Martine Hébert

    2014-03-01

    Full Text Available This analysis examined the contribution of personal, family (maternal and paternal support; sibling support and extra-familiar (peer support; other adults resilience to the prediction of clinical levels of PTSD symptoms in adolescents reporting sexual abuse. Controls were established for abuse-related variables (type of abuse, severity and multiple abuse in a representative sample of high schools students in the province of Quebec. A total of 15.2% of adolescent females and 4.4% adolescent males in high school reported a history of sexual abuse in childhood. Sexually abused adolescent females (27.8% were more likely than adolescent males (14.9% to achieve scores with high clinical levels of PTSD. Hierarchical logistic regression revealed that over and above the characteristics of the sexual abuse experienced, resilience factors (maternal and peer support contributed to the prediction of symptoms of PTSD attaining the clinical threshold. Alternative intervention and prevention practices geared to adolescent victims of sexual assault are discussed.

  2. Risk factors associated with injection initiation among drug users in Northern Thailand

    Directory of Open Access Journals (Sweden)

    Suriyanon Vinai

    2006-03-01

    Full Text Available Abstract Background Circumstances surrounding injection initiation have not been well addressed in many developing country contexts. This study aimed to identify demographic factors, sexual behaviors and drug use characteristics related to injection initiation among drug users in northern Thailand. Methods A cross-sectional survey was conducted among 2,231 drug users admitted to the Northern Drug Treatment Center in Mae Rim, Chiang Mai, Thailand, between February 1, 1999 and December 31, 2000. A multiple logistic regression was employed to identify the independent effects from potential risk factors of transition into injection. Results After controlling for other covariates, being 20 years of age or older, single, ever receiving education, urban residence, and having a history of smoking or incarceration were significantly associated with higher likelihood of injection initiation. Multiple sex partners and an experience of sex abuse were associated with an increased risk of injection initiation. Comparing to those whose first drug was opium, individuals using heroin as their initiation drug had greater risk of injection initiation; conversely, those taking amphetamine as their first drug had less risk of injection initiation. Age of drug initiation was negatively associated with the risk of injection initiation: the older the age of drug initiation, the less the risk of injection initiation. Conclusion Injection initiation was related to several demographic factors, sexual behaviors and drug use characteristics. Understanding these factors will benefit the design of approaches to successfully prevent or delay transition into injection.

  3. [Quality of life of older women with dependency and abuse experience].

    Science.gov (United States)

    Lang, G; Enzenhofer, E

    2013-01-01

    Quality of life is largely determined by changing biographical contexts of a person's behavioural action. In later age, health and social relationships are major determinants for a "good life". A decline in health status may lead to the need for support which may result in further dependency; thus, social relations play an even more important role for older people. Relationships characterised by strain and tension may increase the risk of exposure to force and violence. This article investigates the influence of dependency and abuse on the subjective quality of life of older people. The dataset was drawn from an Austrian survey of 593 home-dwelling older women aged 60 and over (71.0 ± 8.1 years). Quality of life was assessed by the EUROHIS-QOL Scale, dependency by the degree of need for support with respect to activities of daily living and by the levels of care allowance received by this cohort. Following the Conflict Tactics Scales (CTS), six different types of abuse have been operationalised by 34 indicators. The data were analysed by descriptive statistics, confirmatory factor analysis and structural equation modelling. With increasing dependency the subjective quality of life of older women decreases. At the same time it is reduced by the experience of abuse in the close social environment. Neglect, psychological abuse and the violation of personal liberties and rights can be identified as factors which have a negative impact on quality of life. It is also noted that neglect can be found particularly among women with a greater need for support and a higher level of care allowance, which is a particularly problematic situation. Dependency and abuse are major risk factors for low quality of life in old age. The results stress the importance of raising general awareness on violence and highlight the social taboos around the issue of abuse against older people, especially in the case of increasing dependency. In addition, the results point to an increasing

  4. Prevalence of stroke/cardiovascular risk factors in Hungary

    Science.gov (United States)

    Bodo, M.; Sipos, K.; Thuroczy, G.; Panczel, G.; Ilias, L.; Szonyi, P.; Bodo, M., Jr.; Nebella, T.; Banyasz, A.; Nagy, Z.

    2010-04-01

    A cross-sectional survey was conducted in Hungary using the Cerberus system which includes: 1) a questionnaire addressing the risk factors for stroke/cardiovascular disease; 2) amplifiers to record the pulse waves of cerebral arteries (rheoencephalography) and peripheral arteries, electrocardiogram and electroencephalogram. Additionally, subjects were measured for carotid stenosis by Doppler ultrasound and 12-lead electrocardiogram; subjects were also screened for blood cholesterol, glucose, and triglyceride levels. Prevalence of the following stroke risk factors was identified: overweight, 63.25%; sclerotic brain arteries (by rheoencephalogram), 54.29%; heart disease, 37.92%; pathologic carotid flow, 34.24%; smoking, 30.55%; high blood cholesterol, 28.70%; hypertension, 27.83%; high triglyceride, 24.35%; abnormality in electrocardiogram, 20%; high glucose, 15.95%; symptoms of transient ischemic attack, 16.07%; alcohol abuse, 6.74%; and diabetes, 4.53%. The study demonstrates a possible model for primary cardiovascular disease/stroke prevention. This method offers a standardizable, cost effective, practical technique for mass screenings by identifying the population at high risk for cardiovascular disturbances, especially cerebrovascular disease (primary prevention). In this model, the rheoencephalogram can detect cerebrovascular arteriosclerosis in the susceptibility/presymptomatic phase, earlier than the Doppler ultrasound technique. The method also provides a model for storing analog physiological signals in a computer-based medical record and is a first step in applying an expert system to stroke prevention.

  5. Can an active aging index (AAI) provide insight into reducing elder abuse? A case study in Rajshahi District, Bangladesh.

    Science.gov (United States)

    Tareque, Md Ismail; Ahmed, Md Munsur; Tiedt, Andrew D; Hoque, Nazrul

    2014-01-01

    We use data from respondents aged 60 years and above, collected during April 2009 in the Rajshahi district of Bangladesh, to examine whether high activeness, as captured by an AAI or in sub-domains, can help reduce the risk of elder abuse. The findings suggest that more than half of rural elderly and 14 percent of urban elderly were at some point abused. High activeness in health and security dimensions lowers the risk of being abused while those who are low active in community participation have the lowest risk of being abused in both rural and urban areas. Being literate (elderly with primary/secondary education) is revealed to be a significant factor that lowers the risk of abuse in both rural and urban areas. These results imply a need for educational programs that bolster positive and proper community interaction, in turn promoting a secure later life for elders, and reducing burden for families and society. High activeness in health and security dimensions should also be promoted to keep the elderly healthy and protect from abusive behavior. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  6. Study of deaths related to drug abuse in France and Europe.

    Science.gov (United States)

    Ingold, F R

    1986-01-01

    A study of deaths related to drug abuse, based on information available in France and Europe, shows that data on such deaths are divergent and difficult to compare between countries because the definition of "death related to drug abuse" may vary from country to country. For this reason, the author attaches little importance to the use of such data as an indirect indicator for assessing the incidence and prevalence of drug abuse. The author carried out an in-depth study of 99 deaths of this type recorded by the police in the Paris area in 1983, which showed that 80 per cent of the cases involved heroin that had been injected intravenously. An analysis of the biographical background of persons who had died as a result of drug abuse revealed that, in addition to severe drug intoxication, the length of drug abuse and psychopathological disorders, a number of so-called "risk situations" were important factors contributing to their deaths. The risk situations included use of heroin for a long period of time, recent discontinuation of heroin use, regular and intensive use of psychotropic substances and alcohol, and injection of drugs in public places where there was no way of testing the drugs beforehand.

  7. A cross-sectional study of factors underlying the risk of female nurses' suffering abuse by their partners Estudio transversal sobre factores de riesgo de sufrir violencia por compañero íntimo en la mujer enfermera Estudo transversal sobre fatores de risco de violência por parceiro íntimo entre enfermeiras

    Directory of Open Access Journals (Sweden)

    María-Aurora Rodríguez-Borrego

    2012-02-01

    Full Text Available This study aimed to identify factors underlying the risk of suffering abuse by a partner. A cross-sectional study of 622 female nurses was accomplished, randomly chosen at their place of work, at a hospital and health centers. We used a self-administered validated questionnaire that covered psychological, physical and sexual abuse, complemented by a set of sociodemographic questions. The nurses at most risk of being abused by their partners were those who supported their family by their own salary (Odds Ratio: 2.41 [0.63-9.15], those who lived with dependents (Odds Ratio: 4.27 [1.43-2.78] and had a partner from social class IIIa (Odds Ratio: 2.62 [1.37-5.00]. The data appear to indicate financial independence as a risk factor for this type of abuse.Se tuvo por objetivo investigar los factores de riesgo relacionados al maltrato por compañero íntimo. Se trata de un estudio transversal realizado en 622 enfermeras, elegidas por aleatorización de sus lugares de trabajo, Hospitales y Centros de Salud. Se utilizó un cuestionario autoadministrado sobre maltratos psicológico, físico y sexual, complementado con preguntas de carácter sociodemográfico. Las mujeres enfermeras con mayor probabilidad de sufrir violencia del compañero íntimo fueron las que mantienen la familia con su salario (Odds Ratio: 2,41 [0,63-9,15], las que conviven con hijos (Odds Ratio: 4,27 [1,43-2,78] y las con pareja de clase social IIIa (Odds Ratio: 2.62 [1.37-5.00]. Se concluye que los datos parecen indicar que la independencia constituye un riesgo de maltrato.O objetivo deste estudo foi identificar os fatores de risco de abuso por parceiro íntimo entre enfermeiras. Trata-se de estudo transversal, realizado com 622 enfermeiras, selecionadas aleatoriamente nos seus locais de trabalho (hospitais e centros de saúde. Utilizou-se um questionário autoadministrado sobre maus-tratos psicológico, físico e sexual, complementado com perguntas de caráter sociodemográfico. As

  8. Measuring Economic Abuse in the Lives of Survivors: Revising the Scale of Economic Abuse.

    Science.gov (United States)

    Postmus, Judy L; Plummer, Sara-Beth; Stylianou, Amanda M

    2016-05-01

    Recent attention has been given by researchers to understanding how abusers use economic abuse strategies. Unfortunately, limited measures are available to accurately understand the prevalence of economic abuse in the lives of survivors. Recently, researchers created the 28-item Scale of Economic Abuse (SEA) but further validation is needed. This article describes the psychometric evaluation of the SEA through confirmatory and exploratory factor analyses using data collected with 120 survivors of abuse. The findings provide evidence for the reliability and validity of the SEA-12 as a shorter instrument to measure economic abuse as a distinct form of abuse. © The Author(s) 2015.

  9. Adverse childhood experiences among women prisoners: relationships to suicide attempts and drug abuse.

    Science.gov (United States)

    Friestad, Christine; Åse-Bente, Rustad; Kjelsberg, Ellen

    2014-02-01

    Women prisoners are known to suffer from an accumulation of factors known to increase the risk for several major health problems. This study examines the prevalence of adverse childhood experiences (ACE) and the relationship between such experiences and suicide attempts and drug use among incarcerated women in Norway. A total of 141 women inmates (75% of all eligible) were interviewed using a structured interview guide covering information on demographics and a range of ACE related to abuse and neglect, and household dysfunction. The main outcome variables were attempted suicide and adult drug abuse. Emotional, physical and sexual abuse during childhood was experienced by 39%, 36% and 19%, respectively, and emotional and physical neglect by 31% and 33%, respectively. Looking at the full range of ACE, 17% reported having experienced none, while 34% reported having experienced more than five ACEs. After controlling for age, immigrant background and marital status, the number of ACEs significantly increased the risk of attempted suicide and current drug abuse. The associations observed between early life trauma and later health risk behaviour indicate the need for early prevention. The findings also emphasize the important role of prison health services in secondary prevention among women inmates.

  10. Suicidal and self-injurious behavior among patients with alcohol and drug abuse

    Directory of Open Access Journals (Sweden)

    Al-Sharqi AM

    2012-07-01

    Full Text Available Abdullah Mohammed Al-Sharqi,1 Khaled Saad Sherra,2 Abdulhameed Abdullah Al-Habeeb,3 Naseem Akhtar Qureshi3,41Private Clinic, Riyadh, Saudi Arabia; 2Psychiatric Department, Faculty of Medicine, Mansoura University, Egypt; 3General Administration for Mental Health and Social Services, 4General Directorate of Research and Studies, Ministry of Health, Riyadh, Saudi ArabiaBackground: Self-injurious behavior, a major public health problem globally, is linked with alcohol and drug abuse. This cross-sectional study aimed to identify the prevalence and correlates of self-harming behavior in patients with alcohol or drug abuse problems.Methods: This was a one-year study that recruited a convenience sample of 736 outpatients and inpatients identified with alcohol or drug abuse, and was conducted at Al-Amal mental health hospitals in three major cities. All consecutively selected patients were interviewed on five working days for data collection on a semistructured sociodemographic form using the Columbia Suicide Severity Rating Scale Risk Assessment version.Results: In addition to the socioclinical profile revealed, 50.7% of respondents reported any suicidal ideation, while 6.9% reported self-injurious behavior without intent to die. Any suicidal and self-injurious behavior was reported by 13.1% of participants. A total of 71.3% of respondents reported any recent negative activating events. In addition to any treatment history, observed correlates were hopelessness (60.7%, perceived burden on family (29.5%, refusing a safety plan (26.1%, and sexual abuse (11%. Conversely, reasons for living (64.9%, fear of death or dying due to pain and suffering (64.3%, and spirituality (92% were largely endorsed as protective factors. There were multiple significant odds ratios (P ≤ 0.01 revealed when independent socioclinical variables were compared with dependent variables in terms of suspected risk and protective factors. In an adjusted logistic regression model

  11. Reliability, Validity and Factor Structure of Drug Abuse Screening Test

    OpenAIRE

    Sayed Hadi Sayed Alitabar; Mojtaba Habibi; Maryam Falahatpisheh; Musa Arvin

    2016-01-01

    Background and Objective: According to the increasing of substance use in the country, more researches about this phenomenon are necessary. This Study Investigates the Validity, Reliability and Confirmatory Factor Structure of the Drug Abuse Screening test (DAST). Materials and Methods: The Sample Consisted of 381 Patients (143 Women and 238 Men) with a Multi-Stage Cluster Sampling of Areas 2, 6 and 12 of Tehran Were Selected from Each Region, 6 Randomly Selected Drug Rehabilitation Center. T...

  12. Brain derived Neurotropic Factor (BDNF) is associated with childhood abuse but not cognitive domains in first episode psychosis.

    Science.gov (United States)

    Theleritis, Christos; Fisher, Helen L; Shäfer, Ingo; Winters, Laura; Stahl, Daniel; Morgan, Craig; Dazzan, Paola; Breedvelt, Josefien; Sambath, Irene; Vitoratou, Silia; Russo, Manuela; Reichenberg, Abraham; Falcone, M Aurora; Mondelli, Valeria; O'Connor, Jennifer; David, Anthony; McGuire, Philip; Pariante, Carmine; Di Forti, Marta; Murray, Robin M; Bonaccorso, Stefania

    2014-10-01

    The Brain-derived Neurotrophic Factor (BDNF) modulates cognitive processes and is associated with increased risk of schizophrenia. Childhood trauma (CT) is frequent in patients with psychosis and severely affects course and outcome. We investigated the hypothesis that BDNF is associated with both CT and cognitive deficits in a sample of first-episode psychosis (FEP) cases and unaffected controls. Participants with FEP and healthy controls were recruited between August 2008 and July 2011 from South London, UK. Childhood traumatic events were detected using the Childhood Experience of Care and Abuse Questionnaire (CECA-Q). Neuropsychological data were also collected. BDNF plasma levels were measured from fasting blood samples. Data were available on 87 FEP patients and 152 controls. Our results showed a significant effect of separation (F=5.5; df=1,115; p=.02), physical (F=4.7; df=1, 118; p=.03) and sexual abuse (F=5.4; df=1,117; p=.02) on BDNF levels with lower levels among those who experienced the traumatic event compared to those who did not. Physical abuse predicted lower plasma levels of BDNF (β=-.30; p=.03) whereas sexual and/or physical abuse showed a trend (β=-.26; p=.06) in FEP patients but not in unaffected controls. No association between BDNF plasma levels and cognitive functions was found among patients with FEP and controls. Our findings suggest the possible involvement of BDNF in the onset of first-episode psychosis in individuals exposed to early trauma and propose BDNF as a potential clinical biomarker to detect the detrimental effects of CT on human brain plasticity. Crown Copyright © 2014. Published by Elsevier B.V. All rights reserved.

  13. Risk factors of workplace violence at hospitals in Japan.

    Science.gov (United States)

    Fujita, Shigeru; Ito, Shinya; Seto, Kanako; Kitazawa, Takefumi; Matsumoto, Kunichika; Hasegawa, Tomonori

    2012-02-01

    Patients and their relatives exposed to mental stress caused by hospitalization or illness might use violence against healthcare staff and interfere with quality healthcare. The aim of this study was to investigate incidences of workplace violence and the attributes of healthcare staff who are at high risk. A questionnaire-based, anonymous, and self-administered cross-sectional survey. Healthcare staff (n = 11,095) of 19 hospitals in Japan. Incidence rates and adjusted odd ratios of workplace violence were calculated to examine the effect of attributes of healthcare staff to workplace violence by using logistic regression analysis. The response rate for survey completion was 79.1% (8711/11,095). Among the respondents, 36.4% experienced workplace violence by patients or their relatives in the past year; 15.9% experienced physical aggression, 29.8% experienced verbal abuse, and 9.9% experienced sexual harassment. Adjusted odds ratios of physical aggression were significantly high in psychiatric wards, critical care centers/intensive care units (ICU)/cardiac care units (CCU), long-term care wards, for nurses, nursing aides/care workers, and for longer working hours. Adjusted odds ratios of verbal abuse were significantly high in psychiatric wards, long-term care wards, outpatient departments, dialysis departments, and for longer years of work experience, and for longer working hours. Adjusted odds ratios of sexual harassment were significantly high in dialysis departments, for nurses, nursing aides/care workers, technicians, therapists and females. The general ward and direct interaction with patients were common risk factors for each type of workplace violence. The mechanisms and the countermeasures for each type of workplace violence at those high-risk areas should be investigated. Copyright © 2011 Society of Hospital Medicine.

  14. Maternal abuse history and self-regulation difficulties in preadolescence.

    Science.gov (United States)

    Delker, Brianna C; Noll, Laura K; Kim, Hyoun K; Fisher, Philip A

    2014-12-01

    Although poor parenting is known to be closely linked to self-regulation difficulties in early childhood, comparatively little is understood about the role of other risk factors in the early caregiving environment (such as a parent's own experiences of childhood abuse) in developmental pathways of self-regulation into adolescence. Using a longitudinal design, this study aimed to examine how a mother's history of abuse in childhood relates to her offspring's self-regulation difficulties in preadolescence. Maternal controlling parenting and exposure to intimate partner aggression in the child's first 24-36 months were examined as important early social and environmental influences that may explain the proposed connection between maternal abuse history and preadolescent self-regulation. An ethnically diverse sample of mothers (N=488) who were identified as at-risk for child maltreatment was recruited at the time of their children's birth. Mothers and their children were assessed annually from the child's birth through 36 months, and at age 9-11 years. Structural equation modeling and bootstrap tests of indirect effects were conducted to address the study aims. Findings indicated that maternal abuse history indirectly predicted their children's self-regulation difficulties in preadolescence mainly through maternal controlling parenting in early childhood, but not through maternal exposure to aggression by an intimate partner. Maternal history of childhood abuse and maternal controlling parenting in her child's early life may have long-term developmental implications for child self-regulation. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. Prevalence and risk factors of alcohol and substance abuse among motorcycle drivers in Fars province, Iran

    Institute of Scientific and Technical Information of China (English)

    Seyed Taghi Heydari; Mehrdad Vossoughi; Armin Akbarzadeh; Kamran B.Lankarani; Yaser Sarikhani; Kazem Javanmardi; Ali Akbary

    2016-01-01

    Purpose:The aim of this present study is to investigate the prevalence of alcohol and substance abuse (ASA) and its relationship with other risky driving behaviors among motorcycle drivers.Methods:This is a cross sectional study which is performed at Shiraz city of Iran.Data from motorcycle drivers were collected using a standard questionnaire in eight major streets at different times of the dayThe data includes consumption of alcohol and other substances two hours before driving and some of the risky behaviors during driving.Results:A total of 414 drivers with a mean ± SD age of(27.0 + 9.3) years participated in the study.Alcohol or substance consumptions two hours before driving was significantly associated with risky driving behaviors such as using mobile phone during driving,poor maneuvering,and driving over the speed limit (both p < 0.001).It was also associated with carelessness about safety such as driving with technical defects (p < 0.001) and not wearing a crash helmet (p =0.008).Conclusion:Screening for alcohol and substance consumption among motorcycle drivers is an efficient way to identifiy drivers that are at a greater risk for road traffic accidents.

  16. Risk Factors for Intimate Partner Violence: A Comparison of Antisocial and Family-Only Perpetrators.

    Science.gov (United States)

    Petersson, Joakim; Strand, Susanne; Selenius, Heidi

    2016-03-27

    Subtyping male perpetrators of intimate partner violence (IPV) based on their generality of violence could facilitate the difficult task of matching perpetrator subtype with efficient risk management strategies. As such, the aim of the present study was to compare antisocial and family-only male perpetrators of interpersonal violence in terms of (a) demographic and legal characteristics, (b) risk factors for violence, and (c) assessed risk and the importance of specific risk factors for violence. A quantitative design was used in this retrospective register study on data obtained from the Swedish police. Risk assessments performed with the Swedish version of the Brief Spousal Assault Form for the Evaluation of Risk (B-SAFER) and police registers were used. A sample of 657 male alleged IPV perpetrators were classified asantisocial(n= 341) orfamily-only(n= 316) based on their generality of violence. The results showed that the antisocial perpetrators were significantly younger, as well as more psychologically abusive. Antisocial perpetrators also had significantly more present risk factors for IPV, and were assessed with a significantly higher risk for acute and severe or deadly IPV, compared with the family-only perpetrators. The subtypes also evidenced unique risk factors with a significant impact on elevated risk for acute and severe or deadly such violence. Key findings in the present study concerned the subtypes evidencing unique risk factors increasing the risk for acute and severe or deadly IPV. Major implications of this study include the findings of such unique "red flag" risk factors for each subtype. To prevent future IPV, it is vital for the risk assessor to be aware of these red flags when making decisions about risk, as well as risk management strategies. © The Author(s) 2016.

  17. Sex differences in drug abuse.

    Science.gov (United States)

    Becker, Jill B; Hu, Ming

    2008-01-01

    Sex differences are present for all of the phases of drug abuse (initiation, escalation of use, addiction, and relapse following abstinence). While there are some differences among specific classes of abused drugs, the general pattern of sex differences is the same for all drugs of abuse. Females begin regularly self-administering licit and illicit drugs of abuse at lower doses than do males, use escalates more rapidly to addiction, and females are at greater risk for relapse following abstinence. In this review, sex differences in drug abuse are discussed for humans and in animal models. The possible neuroendocrine mechanisms mediating these sex differences are discussed.

  18. Assessment of Substance Abuse Behaviors in Adolescents’: Integration of Self-Control into Extended Parallel Process Model

    Directory of Open Access Journals (Sweden)

    K Witte

    2005-04-01

    Full Text Available Introduction: An effective preventive health education program on drug abuse can be delivered by applying behavior change theories in a complementary fashion. Methods: The aim of this study was to assess the effectiveness of integrating self-control into Extended Parallel Process Model in drug substance abuse behaviors. A sample of 189 governmental high school students participated in this survey. Information was collected individually by completing researcher designed questionnaire and a urinary rapid immuno-chromatography test for opium and marijuana. Results: The results of the study show that 6.9% of students used drugs (especially opium and marijuana and also peer pressure was determinant factor for using drugs. Moreover the EPPM theoretical variables of perceived severity and perceived self-efficacy with self-control are predictive factors to behavior intention against substance abuse. In this manner, self-control had a significant effect on protective motivation and perceived efficacy. Low self- control was a predictive factor of drug abuse and low self-control students had drug abuse experience. Conclusion: The results of this study suggest that an integration of self-control into EPPM can be effective in expressing and designing primary preventive programs against drug abuse, and assessing abused behavior and deviance behaviors among adolescent population, especially risk seekers

  19. Diagnostic imaging of child abuse

    Energy Technology Data Exchange (ETDEWEB)

    Oguma, Eiji; Aihara, Toshinori [Saitama Children' s Medical Center, Iwatsuki (Japan)

    2002-04-01

    The major role of imaging in cases of suspected child abuse is to identify the physical injuries and to confirm the occurrence of abuse. In severely abused infants, the imaging findings may be the only evidence for a diagnosis of inflicted injury. Imaging may be the first clue to abuse in children seen with apparent other conditions and lead to appropriate measures to protect them from the risk of more serious injury. The radiologist must be familiar with imaging findings of inflicted injuries to fulfill these roles. (author)

  20. Diagnostic imaging of child abuse

    International Nuclear Information System (INIS)

    Oguma, Eiji; Aihara, Toshinori

    2002-01-01

    The major role of imaging in cases of suspected child abuse is to identify the physical injuries and to confirm the occurrence of abuse. In severely abused infants, the imaging findings may be the only evidence for a diagnosis of inflicted injury. Imaging may be the first clue to abuse in children seen with apparent other conditions and lead to appropriate measures to protect them from the risk of more serious injury. The radiologist must be familiar with imaging findings of inflicted injuries to fulfill these roles. (author)

  1. The development of focal segmental glomerulosclerosis secondary to anabolic steroid abuse

    Science.gov (United States)

    Harrington, Patrick; Ali, Galil; Chan, Anthony

    2011-01-01

    The authors present the case of a patient who presented to the nephrology department of a district general hospital with end-stage renal failure. He presented with malignant hypertension and symptoms and signs of uraemia. He also gave a history of prior abuse of anabolic steroids over a number of years. Renal biopsy was performed and the findings were in keeping with a diagnosis of advanced focal segmental glomerulosclerosis (FSGS). The patient went on to require renal replacement therapy within weeks of presentation. The authors suggest that anabolic steroid abuse is a direct cause of FSGS. People with raised body mass index are known to be at increased risk of developing this condition, due to increased haemodynamic stress on the glomeruli, with subsequent development of sclerosis. However, the authors believe that anabolic steroid abuse may be an independent risk factor, and that anabolic steroids have a direct nephrotoxic effect that leads to a more advanced initial presentation with rapid decline in renal function. PMID:22669525

  2. Assessment and Treatment of Abuse Risk in Opioid Prescribing for Chronic Pain

    Directory of Open Access Journals (Sweden)

    Robert N. Jamison

    2011-01-01

    Full Text Available Opioid analgesics provide effective treatment for noncancer pain, but many physicians have concerns about adverse effects, tolerance, and addiction. Misuse of opioids is prominent in patients with chronic back pain and early recognition of misuse risk could help physicians offer adequate patient care while implementing appropriate levels of monitoring to reduce aberrant drug-related behaviors. In this review, we discuss opioid abuse and misuse issues that often arise in the treatment of patients with chronic back pain and present an overview of assessment and treatment strategies that can be effective in improving compliance with the use of prescription opioids for pain. Many persons with chronic back pain have significant medical, psychiatric and substance use comorbidities that affect treatment decisions and a comprehensive evaluation that includes a detailed history, physical, and mental health evaluation is essential. Although there is no “gold standard” for opioid misuse risk assessment, several validated measures have been shown to be useful. Controlled substance agreements, regular urine drug screens, and interventions such as motivational counseling have been shown to help improve patient compliance with opioids and to minimize aberrant drug-related behavior. Finally, we discuss the future of abuse-deterrent opioids and other potential strategies for back pain management.

  3. Identifying perinatal risk factors for infant maltreatment: an ecological approach

    Directory of Open Access Journals (Sweden)

    Hallisey Elaine J

    2006-12-01

    Full Text Available Abstract Background Child maltreatment and its consequences are a persistent problem throughout the world. Public health workers, human services officials, and others are interested in new and efficient ways to determine which geographic areas to target for intervention programs and resources. To improve assessment efforts, selected perinatal factors were examined, both individually and in various combinations, to determine if they are associated with increased risk of infant maltreatment. State of Georgia birth records and abuse and neglect data were analyzed using an area-based, ecological approach with the census tract as a surrogate for the community. Cartographic visualization suggested some correlation exists between risk factors and child maltreatment, so bivariate and multivariate regression were performed. The presence of spatial autocorrelation precluded the use of traditional ordinary least squares regression, therefore a spatial regression model coupled with maximum likelihood estimation was employed. Results Results indicate that all individual factors or their combinations are significantly associated with increased risk of infant maltreatment. The set of perinatal risk factors that best predicts infant maltreatment rates are: mother smoked during pregnancy, families with three or more siblings, maternal age less than 20 years, births to unmarried mothers, Medicaid beneficiaries, and inadequate prenatal care. Conclusion This model enables public health to take a proactive stance, to reasonably predict areas where poor outcomes are likely to occur, and to therefore more efficiently allocate resources. U.S. states that routinely collect the variables the National Center for Health Statistics (NCHS defines for birth certificates can easily identify areas that are at high risk for infant maltreatment. The authors recommend that agencies charged with reducing child maltreatment target communities that demonstrate the perinatal risks

  4. Maternal History of Child Abuse and Obesity Risk in Offspring: Mediation by Weight in Pregnancy.

    Science.gov (United States)

    Leonard, Stephanie A; Petito, Lucia C; Rehkopf, David H; Ritchie, Lorrene D; Abrams, Barbara

    2017-08-01

    Women's experience of childhood adversity may contribute to their children's risk of obesity. Possible causal pathways include higher maternal weight and gestational weight gain, which have been associated with both maternal childhood adversity and obesity in offspring. This study included 6718 mother-child pairs from the National Longitudinal Survey of Youth 1979 in the United States (1979-2012). We applied multiple log-binomial regression models to estimate associations between three markers of childhood adversity (physical abuse, household alcoholism, and household mental illness) and offspring obesity in childhood. We estimated natural direct effects to evaluate mediation by prepregnancy BMI and gestational weight gain. Among every 100 mothers who reported physical abuse in childhood, there were 3.7 (95% confidence interval: -0.1 to 7.5) excess cases of obesity in 2- to 5-year olds compared with mothers who did not report physical abuse. Differences in prepregnancy BMI, but not gestational weight gain, accounted for 25.7% of these excess cases. There was no evidence of a similar relationship for household alcoholism or mental illness or for obesity in older children. In this national, prospective cohort study, prepregnancy BMI partially explained an association between maternal physical abuse in childhood and obesity in preschool-age children. These findings underscore the importance of life-course exposures in the etiology of child obesity and the potential multi-generational consequences of child abuse. Research is needed to determine whether screening for childhood abuse and treatment of its sequelae could strengthen efforts to prevent obesity in mothers and their children.

  5. Does age of onset of risk behaviors mediate the relationship between child abuse and neglect and outcomes in middle adulthood?

    Science.gov (United States)

    Horan, Jacqueline M; Widom, Cathy Spatz

    2015-03-01

    Child maltreatment has been linked with a number of risk behaviors that are associated with long-lasting maladaptive outcomes across multiple domains of functioning. This study examines whether the ages of onset of four risk behaviors-sexual intercourse, alcohol use, drug use, and criminal behavior-mediate the relationship between child maltreatment and outcomes in middle adulthood among a sample of court-documented victims of child abuse/neglect and matched controls (N = 1,196; 51.7% female; 66.2% White, 32.6% Black). Adult outcomes included employment status, welfare receipt, internalizing symptoms of anxiety and depressive symptoms, substance use problems, and criminal arrests. The results indicated gender differences in these relationships. For females, age of onset of sexual intercourse mediated the relationship between child abuse/neglect and both internalizing symptoms and substance use problems in middle adulthood. For males, age at first criminal arrest mediated the relationship between child abuse/neglect and extensive involvement in the justice system in middle adulthood. Age of onset of alcohol use and drug use did not mediate the relationship between child abuse/neglect and middle adult outcomes. This study expands current knowledge by identifying associations between early initiation of risk behavior in one domain and later, continuing problems in different domains. Thus, early initiation of specific risk behaviors may have more wide-ranging negative consequences than are typically considered during intervention or treatment and strategies may need to target multiple domains of functioning.

  6. Interpartner Conflict and Child Abuse Risk among African American and Latino Adolescent Parenting Couples

    Science.gov (United States)

    Moore, David R.; Florsheim, Paul

    2008-01-01

    Objective: The goal of this study was to identify links between observed conflict interactions and risk for child abuse and harsh parenting among a multiethnic sample of adolescent mothers (14-19 years) and young fathers (14-24 years). Methods: Prior to childbirth (T1), observation-based relationship data were collected from 154 expectant…

  7. Peer deviance, parental divorce, and genetic risk in the prediction of drug abuse in a nationwide Swedish sample: evidence of environment-environment and gene-environment interaction.

    Science.gov (United States)

    Kendler, Kenneth S; Ohlsson, Henrik; Sundquist, Kristina; Sundquist, Jan

    2014-04-01

    Peer deviance (PD) strongly predicts externalizing psychopathologic conditions but has not been previously assessable in population cohorts. We sought to develop such an index of PD and to clarify its effects on risk of drug abuse (DA). To examine how strongly PD increases the risk of DA and whether this community-level liability indicator interacts with key DA risk factors at the individual and family levels. Studies of future DA registration in 1,401,698 Swedish probands born from January 1, 1970, through December 31, 1985, and their adolescent peers in approximately 9200 small community areas. Peer deviance was defined as the proportion of individuals born within 5 years of the proband living in the same small community when the proband was 15 years old who eventually were registered for DA. Drug abuse recorded in medical, legal, or pharmacy registry records. Peer deviance was associated with future DA in the proband, with rates of DA in older and male peers more strongly predictive than in younger or female peers. The predictive power of PD was only slightly attenuated by adding measures of community deprivation, collective efficacy, or family socioeconomic status. Probands whose parents were divorced were more sensitive to the pathogenic effects of high PD environments. A robust positive interaction was also seen between genetic risk of DA (indexed by rates of DA in first-, second-, and third-degree relatives) and PD exposure. With sufficient data, PD can be measured in populations and strongly predicts DA. In a nationwide sample, risk factors at the level of the individual (genetic vulnerability), family (parental loss), and community (PD) contribute substantially to risk of DA. Individuals at elevated DA risk because of parental divorce or high genetic liability are more sensitive to the pathogenic effects of PD. Although the effect of our PD measure on DA liability cannot be explained by standard measures of community or family risk, we cannot, with

  8. Transtornos mentais como fatores de risco para o desenvolvimento de abuso/dependência de cocaína: estudo caso-controle Mental disorders as risk factors for the development of cocaine abuse/dependence: case-control study

    Directory of Open Access Journals (Sweden)

    Claudia S Lopes

    1999-10-01

    Full Text Available OBJETIVO: Avaliar o papel dos transtornos mentais e da dependência ao álcool como possíveis fatores de risco para o abuso/dependência de cocaína. MÉTODOS: Utilizou-se o desenho caso-controle e a técnica de bola-de-neve (snowball technique para selecionar uma amostra de usuários de cocaína não tratados na comunidade (casos e parear casos e controles por sexo, idade e amizade. A coleta de dados foi feita através da utilização do questionário CIDI (Composite International Diagnostic Interview que gera diagnósticos de acordo com os critérios do Diagnostic and Statistical Manual of Mental Disorders-III-R. A análise dos dados foi feita através de regressão logística condicional. RESULTADOS: O estudo incluiu 208 indivíduos. Os principais resultados mostraram que história passada de dependência ao álcool era o principal fator associado a um aumento no risco de desenvolvimento de abuso de cocaína (OR=15,1; IC 95% 3,8-60,2; nenhum outro transtorno mental isolado manteve-se significativamente associado ao aumento deste risco após a análise multivariada. Aumento no risco de abuso de cocaína também foi encontrado entre os indivíduos que relataram pensamentos suicidas (OR=3,1; IC 95% 0,91-10,8, sugerindo associação entre quadros mais graves de depressão e abuso de cocaína. CONCLUSÕES: Esses achados sugerem que os programas voltados para a prevenção e tratamento do abuso de cocaína devem estar preparados para o manejo de questões relacionadas à co-morbidade do abuso de drogas com o álcool e outros distúrbios psiquiátricos.OBJECTIVE: To evaluate the role of psychiatric disorders and alcohol dependence as possible risk factors for cocaine abuse/dependence. METHODS: The case-control study used the "snowball" technique in order to select untreated cocaine users (cases and to match sex, age and friendship. Information was gathered using the Composite International Diagnostic Interview (CIDI, and computer diagnosis were

  9. Underage drinking on saturday nights, sociodemographic and environmental risk factors: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Galasso Laura

    2011-07-01

    Full Text Available Abstract Background Excessive alcohol consumption in underage people is a rising phenomenon. A major proportion of the disease burden and deaths of young people in developed nations is attributable to alcohol abuse. The aim of this study was to investigate social, demographic and environmental factors that may raise the risk of Saturday night drinking and binge drinking among Italian school students. Methods The study was conducted on a sample of 845 Italian underage school students, by means of an anonymous, self-test questionnaire. Multivariate logistic regression was applied to identify independent risk factors for alcohol drinking and binge drinking. Ordered logistic regression was used to identify independent risk factors for harmful drinking patterns. Results The independent variables that confer a higher risk of drinking in underage students are older age classes, male sex, returning home after midnight, belonging to a group with little respect for the rules, or to a group where young people are not seen as leaders. The higher the perception of alcohol consumption by the group, the higher the risk. Spending time in bars or discos coincides with a two-fold or four-fold increase, respectively, in the risk of alcohol consumption. Conclusion Our findings show that certain environmental and social risk factors are associated with underage drinking. The most important role for preventing young people's exposure to these factors lies with the family, because only parents can exert the necessary control and provide a barrier against potentially harmful situations.

  10. Drama-based education to motivate participation in substance abuse prevention

    Directory of Open Access Journals (Sweden)

    Cameron Amura

    2007-04-01

    Full Text Available Abstract Background The substance abuse prevention goal of the theatre production "TUNNELS" was to provide community education on substance abuse to an audience in Durham, NC and surrounding communities. The education effort intended to increase awareness and understanding of the risk and protective factors associated with alcohol and other drug use, and to promote pro-active behaviors in substance abuse prevention within the adult community. It was hypothesized that community-based education via drama would change attitudes toward alcohol and substance abuse, and increase participation in family and community activities aimed at substance abuse prevention. Methods A focus group comprised of educators, substance abuse researchers and local substance abuse counselors developed "life stories" of users of alcohol and other drugs and a local playwright incorporated these and other experiences into a series of six vignettes. The production was publicized throughout the Durham area, and 700 adults attending the play signed a consent form and completed the pre-play survey. The participant pool was restricted to those adults who completed both the time-1 and time-2 surveys and resided within Durham and surrounding communities. Paired comparisons of mean responses were analyzed using a paired sample two-tailed t-test. A telephone survey three months after the play assessed attitudes toward substance abuse as a disease, and whether the respondents had increased their participation in prevention activities including discussions of the play with others. Results Viewing the play increased the knowledge base of participants regarding substance abuse as a disease, even though the audience demonstrated an appreciation of risk and protective factors prior to attending the performance. In the pre-play survey, participants indicated a strong opinion that parental involvement in teen life was important, and therefore this was not increased as a result of viewing

  11. Personality disorders in substance abusers: Validation of the DIP-Q through principal components factor analysis and canonical correlation analysis

    Directory of Open Access Journals (Sweden)

    Hesse Morten

    2005-05-01

    Full Text Available Abstract Background Personality disorders are common in substance abusers. Self-report questionnaires that can aid in the assessment of personality disorders are commonly used in assessment, but are rarely validated. Methods The Danish DIP-Q as a measure of co-morbid personality disorders in substance abusers was validated through principal components factor analysis and canonical correlation analysis. A 4 components structure was constructed based on 238 protocols, representing antagonism, neuroticism, introversion and conscientiousness. The structure was compared with (a a 4-factor solution from the DIP-Q in a sample of Swedish drug and alcohol abusers (N = 133, and (b a consensus 4-components solution based on a meta-analysis of published correlation matrices of dimensional personality disorder scales. Results It was found that the 4-factor model of personality was congruent across the Danish and Swedish samples, and showed good congruence with the consensus model. A canonical correlation analysis was conducted on a subset of the Danish sample with staff ratings of pathology. Three factors that correlated highly between the two variable sets were found. These variables were highly similar to the three first factors from the principal components analysis, antagonism, neuroticism and introversion. Conclusion The findings support the validity of the DIP-Q as a measure of DSM-IV personality disorders in substance abusers.

  12. Violence from young women involuntarily admitted for severe drug abuse.

    Science.gov (United States)

    Palmstierna, T; Olsson, D

    2007-01-01

    To simultaneously evaluate actuarial and dynamic predictors of severe in-patient violence among women involuntarily admitted for severe drug abuse. All patients admitted to special facilities for involuntary treatment of absconding-prone, previously violent, drug abusing women in Sweden were assessed with the Staff Observation Aggression Scale, revised. Actuarial data on risk factors for violence were collected and considered in an extended Cox proportional hazards model with multiple events and daily assessments of the Broset Violence Checklist as time-dependent covariates. Low-grade violence and being influenced by illicit drugs were the best predictors of severe violence within 24 h. Significant differences in risk for violence between different institutions were also found. In-patient violence risk is rapidly varying over time with being influenced by illicit drugs and exhibiting low-grade violence being significant dynamic predictors. Differences in violence between patients could not be explained by patient characteristics.

  13. Risk management and post-marketing surveillance for the abuse of medications acting on the central nervous system: expert panel report.

    Science.gov (United States)

    Johanson, Chris-Ellyn; Balster, Robert L; Henningfield, Jack E; Schuster, Charles R; Anthony, James C; Barthwell, Andrea G; Coleman, John J; Dart, Richard C; Gorodetzky, Charles W; O'Keeffe, Charles; Sellers, Edward M; Vocci, Frank; Walsh, Sharon L

    2009-12-01

    The abuse and diversion of medications is a significant public health problem. This paper is part of a supplemental issue of Drug and Alcohol Dependence focused on the development of risk management plans and post-marketing surveillance related to minimizing this problem. The issue is based on a conference that was held in October 2008. An Expert Panel was formed to provide a summary of the conclusions and recommendations that emerged from the meeting involving drug abuse experts, regulators and other government agencies, pharmaceutical companies and professional and other non-governmental organizations. This paper provides a written report of this Expert Panel. Eleven conclusions and 11 recommendations emerged concerning the state of the art of this field of research, the regulatory and public health implications and recommendations for future directions. It is concluded that special surveillance tools are needed to detect the emergence of medication abuse in a timely manner and that risk management tools can be implemented to increase the benefit to risk ratio. The scientific basis for both the surveillance and risk management tools is in its infancy, yet progress needs to be made. It is also important that the unintended consequences of increased regulation and the imposition of risk management plans be minimized.

  14. Codeine Shopping Behavior in a Retrospective Cohort of Chronic Noncancer Pain Patients: Incidence and Risk Factors.

    Science.gov (United States)

    Chenaf, Chouki; Kabore, Jean-Luc; Delorme, Jessica; Pereira, Bruno; Mulliez, Aurélien; Roche, Lucie; Eschalier, Alain; Delage, Noémie; Authier, Nicolas

    2016-12-01

    Codeine is a widely used opioid analgesic but studies on its misuse in chronic noncancer pain (CNCP) are still lacking. The aim of this study was to assess the incidence of codeine shopping behavior in CNCP patients and to identify the associated risk factors. This was a population-based retrospective cohort study from the French health insurance claims database from 2004 to 2014. The main outcome was the one-year incidence of codeine shopping behavior defined as ≥1 day of overlapping prescriptions written by ≥2 different prescribers and filled in ≥3 different pharmacies. A total of 1,958 CNCP patients treated with codeine were included, with a mean age of 62.7 ± 16.1 years, 36.8% men. The 1-year incidence rate of codeine shopping behavior was 4.03% (95% confidence interval [CI], 3.07-5.28). In multivariate analysis, risk factors associated with shopping behavior were younger age (≤40 years) (hazard ratio [HR] = 7.29; 95% CI, 4.28-12.42), mental health disorders (HR = 2.25; 95% CI, 1.08-4.67), concurrent use of anxiolytic benzodiazepines (HR = 3.12; 95% CI, 1.55-6.26), and previous use of strong opioids (HR = 2.94; 95% CI, 1.24-6.98). The incidence of codeine shopping behavior in CNCP patients was 4% and risk factors identified were shared with those of opioid abuse. Shopping behavior for codeine was not infrequent in CNCP patients. The risk factors identified in this study are similar to those identified for opioid abuse in other studies. Appropriate use of codeine from the perspectives of patients and healthcare providers should be encouraged. Copyright © 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.

  15. Diabetes mellitus and drug abuse during pregnancy and the risk for orofacial clefts and related abnormalities

    Directory of Open Access Journals (Sweden)

    Ivy Kiemle Trindade-Suedam

    Full Text Available Abstract Objective: to assessed the prevalence of diabetes mellitus (DM and drug abuse in mothers of children with orofacial clefts (OFC. Methods: 325 women who had children (0-3y with clefts were interviewed. Data regarding type of diabetes, use of legal/illegal drugs during pregnancy, waist girth and fasting blood sugar at the first prenatal consult were collected. Results: twenty seven percent of the women had DM, out of these, 89% had gestational DM, 5,5% type 1 DM and 5,5% type 2 DM. The prevalence of DM in mothers of children with OFC was 27%, it is significantly higher than the average Brazilian population which is 7.6% (p<0.01 (OR=4.5, 95%CI=3.5-5.8. Regarding drug abuse during pregnancy, 32% of the mothers used drugs and a significant positive correlation was observed between drug abuse and the occurrence of clefts and other craniofacial anomalies (p=0.028 (OR=2.87; 95%CI=1.1-7.4. Conclusions: DM and drug abuse during pregnancy increases the risk for OFC and related anomalies and early diagnosis of DM and prevention of drug abuse, especially in pregnant women, should be emphasized.

  16. Intergenerational continuity of child abuse among adolescent mothers: authoritarian parenting, community violence, and race.

    Science.gov (United States)

    Valentino, Kristin; Nuttall, Amy K; Comas, Michelle; Borkowski, John G; Akai, Carol E

    2012-05-01

    Among the negative sequelae of child maltreatment is increased risk for continuity of maltreatment into subsequent generations. Despite acknowledgment in the literature that the pathways toward breaking the cycle of maltreatment are likely the result of dynamic interactions of risk and protective factors across multiple ecological levels, few studies have followed high-risk samples of maltreated and nonmaltreated parents over time to evaluate such processes. In the current investigation, exposure to community violence and authoritarian parenting attitudes were evaluated as predictors of the intergenerational continuity of abuse, and the moderating effect of African American race was examined. The sample included 70 mothers and their 18-year-old children, who have been followed longitudinally since the third trimester of the adolescent mothers' pregnancy. Results revealed that among mothers with a child abuse history, higher exposure to community violence and lower authoritarian parenting attitudes were associated with increased risk for intergenerational continuity of abuse. The relation of authoritarian parenting attitudes to intergenerational continuity was moderated by race; the protective effects of authoritarian parenting were limited to the African American families only. The salience of multiple ecological levels in interrupting the intergenerational continuity of child abuse is discussed, and implications for preventive programs are highlighted.

  17. Abuse Characteristics and Individual Differences Related to Disclosing Childhood Sexual, Physical, and Emotional Abuse and Witnessed Domestic Violence.

    Science.gov (United States)

    Bottoms, Bette L; Peter-Hagene, Liana C; Epstein, Michelle A; Wiley, Tisha R A; Reynolds, Carrie E; Rudnicki, Aaron G

    2016-04-01

    Many adult survivors of childhood abuse hide their victimization, avoiding disclosure that could identify perpetrators, end the abuse, and bring help to the victim. We surveyed 1,679 women undergraduates to understand disclosure of childhood sexual, physical, and emotional abuse, and, for the first time, witnessed domestic violence, which many consider to be emotionally abusive. A substantial minority of victims failed to ever disclose their sexual abuse (23%), physical abuse (34%), emotional abuse (20%), and witnessed domestic violence (29%). Overall, abuse-specific factors were better predictors of disclosure than individual-level characteristics. Disclosure of sexual abuse was related to experiencing more frequent abuse (by the same and by multiple perpetrators), being more worried about injury and more upset at the time of the abuse, and self-labeling as a victim of abuse. Disclosure of physical abuse was related to experiencing more frequent abuse (by the same and multiple perpetrators), being less emotionally close to the perpetrator, being older when the abuse ended, being more worried and upset, and self-labeling as a victim. Disclosure of emotional abuse was associated with being older when the abuse ended, and being more worried and upset. Disclosure was unrelated to victim demographic characteristics or defensive reactions (dissociative proneness, fantasy proneness, repressive coping style, and temporary forgetting), except that among physical and emotional abuse victims, repressors were less likely to disclose than non-repressors. Disclosure of witnessing domestic violence was not significantly related to any factors measured. © The Author(s) 2014.

  18. Risk factors for development of schizophrenia

    OpenAIRE

    Dunglová, Eva

    2013-01-01

    Schizophrenia is a severe disease. There is a complicity of genetic and environmental factors in schizophrenia onset. Factors with probable influence on development of schizophrenia are rate of urbanization, geographic location, migration, month of birth, maternal nutrition during pregnancy and birth complications, stress during pregnancy, length of lactation period, prenatal and postnatal infection exposure, exposure to a cat during childhood or cannabis abuse. Until now the information on t...

  19. Childhood Sexual Abuse and Sociodemographic Factors Prospectively Associated with Intimate Partner Violence Perpetration Among South African Heterosexual Men.

    Science.gov (United States)

    Teitelman, Anne M; Bellamy, Scarlett L; Jemmott, John B; Icard, Larry; O'Leary, Ann; Ali, Samira; Ngwane, Zolani; Makiwane, Monde

    2017-04-01

    Intimate partner violence directed at women by men continues to be a global concern. However, little is known about the factors associated with perpetrating intimate partner violence among heterosexual men. History of childhood sexual abuse and other sociodemographic variables were examined as potential factors associated with severe intimate partner violence perpetration toward women in a sample of heterosexual men in South Africa. Longitudinal logistic generalized estimating equations examined associations of childhood sexual abuse and sociodemographic variables at baseline with intimate partner violence perpetration at subsequent time points. Among participants with a steady female partner, 21.81 % (190/ 871) reported perpetrating intimate partner violence in the past year at baseline. Having a history of childhood sexual abuse (p sexual impulses in order to use a condom (p = .006) at baseline were associated with self-reported intimate partner violence perpetration in the past year at subsequent time points. With high levels of recent severe physical and/or sexual intimate partner violence perpetration in South Africa, comprehensive interventions are urgently needed. To more fully address gender-based violence, it is important to address associated factors, including exposure to childhood sexual abuse that could impact behavior later in life and that have long-lasting and deleterious effects on men and their female partners.

  20. Occupational injury among hospital patient-care workers: what is the association with workplace verbal abuse?

    Science.gov (United States)

    Sabbath, Erika L; Hurtado, David A; Okechukwu, Cassandra A; Tamers, Sara L; Nelson, Candace; Kim, Seung-Sup; Wagner, Gregory; Sorenson, Glorian

    2014-02-01

    To test the association between workplace abuse exposure and injury risk among hospital workers. We hypothesized that exposed workers would have higher injury rates than unexposed workers. Survey of direct-care workers (n = 1,497) in two hospitals. Exposure to workplace abuse was assessed through self-report; occupational injury reports were extracted from employee records. We tested associations between non-physical workplace violence and injury using log-binomial regression and multilevel modeling. Adjusted prevalence ratio (PR) for injury associated with being yelled at was 1.52 (95% CI 1.19, 1.95); for experiencing hostile/offensive gestures 1.43 (1.11, 1.82); and for being sworn at 1.41 (1.09, 1.81). In analyses by injury subtypes, musculoskeletal injuries were more strongly associated with abuse than were acute traumatic injuries. Associations operated on group and individual levels and were most consistently associated with abuse perpetrated by patients. Exposure to workplace abuse may be a risk factor for injuries among hospital workers. © 2013 Wiley Periodicals, Inc.

  1. Risk and protective factors for suicidal ideation and suicide attempts among deployed Danish soldiers from 1990 to 2009.

    Science.gov (United States)

    Ejdesgaard, Bo Andersen; Zøllner, Lilian; Jensen, Børge Frank; Jørgensen, Hans-Ole; Kähler, Henrik

    2015-01-01

    The study was undertaken to identify risk and protective factors for suicidal ideation and suicide attempts among deployed Danish soldiers. Research on suicide among Danish veterans has only been conducted to a limited degree. The method applied was a questionnaire survey administered to a population of 1,264 Danish soldiers deployed from 1990 to 2009. The data were analyzed using backward logistic regression modeling in SAS 9.2. In the logistic regression analysis, the following were significant risk factors for suicidal ideation: drug abuse, a poor financial situation before deployment, a heavy workload and/or repatriation during deployment, and attending a poor athletic and recreation program after deployment. Significant protective factors against suicidal ideation were support from friends at home during deployment and appreciation by the general population after deployment. Significant risk factors for suicide attempts were an unhappy childhood and pointless tasks during deployment. No significant protective factors against suicide attempts were identified. On the basis of the results presented in this study, intervention against suicidal behavior would benefit from screening for certain childhood issues, drug abuse, and poor financial situation before deployment. During deployment, measures should be taken to minimize the amount of meaningless tasks and heavy workloads. At the same time, efficient ways of communicating with home should be ensured. After deployment, good athletic and recreation programs should be warranted for all military personnel-including repatriated soldiers. Finally, priority should be given to ensure public appreciation of what deployed soldiers accomplish. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

  2. Risk and protective factors associated with adolescent girls' substance use: Data from a nationwide Facebook sample.

    Science.gov (United States)

    Schwinn, Traci M; Schinke, Steven P; Hopkins, Jessica; Thom, Bridgette

    2016-01-01

    Despite overall reductions in teenage substance use, adolescent girls' rates of substance use remain unacceptably high. This article examines whether girls' substance use is associated with general risk and protective factors (goal setting, problem solving, refusal skills, peer use, and self-efficacy) and gender-specific risk and protective factors (communication style, coping skills, self-esteem, body image, perceived stress, anxiety, and depression). Cross-sectional data were collected in 2013 via online surveys from a nationwide sample of adolescent girls (N = 788), aged 13 and 14 years, who were recruited through Facebook. In multivariate analyses, controlling for correlates of adolescent substance use, 11 of the 13 general and gender-specific risk and protective factors were consistently associated with past-month alcohol, cigarette, and other drug use in the expected direction; past-month marijuana use was associated with 8 of the 13 factors. Refusal skills, peer use, coping, and depressive mood were most consistently and strongly associated with substance use. Substance abuse prevention programs targeting adolescent girls should focus on such general risk and protective factors as problem solving, refusal skills, peer influences, and self-efficacy, as well as such gender-specific risk and protective factors as communication style, coping, self-esteem, body image, perceived stress, and mood management.

  3. Heart disease - risk factors

    Science.gov (United States)

    Heart disease - prevention; CVD - risk factors; Cardiovascular disease - risk factors; Coronary artery disease - risk factors; CAD - risk ... a certain health condition. Some risk factors for heart disease you cannot change, but some you can. ...

  4. Schizophrenia, substance abuse, and violent crime.

    Science.gov (United States)

    Fazel, Seena; Långström, Niklas; Hjern, Anders; Grann, Martin; Lichtenstein, Paul

    2009-05-20

    Persons with schizophrenia are thought to be at increased risk of committing violent crime 4 to 6 times the level of general population individuals without this disorder. However, risk estimates vary substantially across studies, and considerable uncertainty exists as to what mediates this elevated risk. Despite this uncertainty, current guidelines recommend that violence risk assessment should be conducted for all patients with schizophrenia. To determine the risk of violent crime among patients diagnosed as having schizophrenia and the role of substance abuse in mediating this risk. Longitudinal designs were used to link data from nationwide Swedish registers of hospital admissions and criminal convictions in 1973-2006. Risk of violent crime in patients after diagnosis of schizophrenia (n = 8003) was compared with that among general population controls (n = 80 025). Potential confounders (age, sex, income, and marital and immigrant status) and mediators (substance abuse comorbidity) were measured at baseline. To study familial confounding, we also investigated risk of violence among unaffected siblings (n = 8123) of patients with schizophrenia. Information on treatment was not available. Violent crime (any criminal conviction for homicide, assault, robbery, arson, any sexual offense, illegal threats, or intimidation). In patients with schizophrenia, 1054 (13.2%) had at least 1 violent offense compared with 4276 (5.3%) of general population controls (adjusted odds ratio [OR], 2.0; 95% confidence interval [CI], 1.8-2.2). The risk was mostly confined to patients with substance abuse comorbidity (of whom 27.6% committed an offense), yielding an increased risk of violent crime among such patients (adjusted OR, 4.4; 95% CI, 3.9-5.0), whereas the risk increase was small in schizophrenia patients without substance abuse comorbidity (8.5% of whom had at least 1 violent offense; adjusted OR, 1.2; 95% CI, 1.1-1.4; Pgenetic or early environmental) confounding of the

  5. Reasons for dropout from drug abuse treatment: symptoms, personality, and motivation.

    Science.gov (United States)

    Ball, Samuel A; Carroll, Kathleen M; Canning-Ball, Monica; Rounsaville, Bruce J

    2006-02-01

    Previous research has identified risk factors for early attrition from substance abuse treatment, but has not assessed reasons for dropout from the client's perspective. Interview and self-report assessment data were collected from 24 clients who prematurely terminated outpatient treatment to evaluate their subjective reasons for dropping out and the association of these reasons with demographic and clinical variables. Items from scales indicating problems with client motivation or conflicts with program staff were the most commonly endorsed. The severity of participant's symptoms and logistical problems interfering with appointments were less commonly reported as reasons for dropping out. Demographic, substance abuse, and motivational stage indicators were infrequently associated with subjective reasons for dropout. In contrast, indicators of maladaptive personality functioning were strongly associated with many reasons for dropping out, especially concerns about privacy and boundary issues within the program. Results from this preliminary evaluation will guide the development of an instrument and intervention focused on dropout risk factors and treatment reengagement.

  6. Re-experiencing Violence across the Life Course: Histories of Childhood Maltreatment and Elder Abuse Victimization.

    Science.gov (United States)

    Kong, Jooyoung; Easton, Scott D

    2018-03-26

    This study primarily examines the associations between histories of childhood maltreatment (i.e., neglect, emotional, physical, and sexual abuse) and elder abuse victimization and explores whether gender moderates the associations. We conducted a secondary data analysis of 5,968 older adults (mean age = 71 years) based on data from the Wisconsin Longitudinal Study (2010-2011). Using retrospective self-reports of childhood and current (past 12 months) victimization experiences, logistic regression analyses were conducted to estimate the effects of early-life adversities on the likelihood of elder abuse victimization. Results indicate that childhood emotional abuse and childhood sexual abuse were associated with greater risk of being abused as older adults, after controlling for childhood and adult background factors. We also found that the effect of childhood sexual abuse on elder abuse victimization was weaker for women than men. Findings suggest that the phenomenon of revictimization may occur not only in early and middle adulthood, but also in late life. To advance our understanding of victimization across the life course, future research on root causes of elder abuse should include histories of child abuse.

  7. The problem of Elder Abuse: review of foreign investigations

    Directory of Open Access Journals (Sweden)

    Gorfan Ya.Yu.

    2013-03-01

    Full Text Available The article analyzes the empirical findings obtained by foreign scholars and centered on the problem of Elder Abuse. It also contains the description of some elaborated strategies to resist the criminal victimization of the elderly. The article cites data about the crimes against the elderly persons in different countries. It also describes theoretical approaches to understanding the reasons for Elder Abuse. It then compares and analyzes the risk factors for some crimes committed against the elders which are disclosed by foreign scholars. With reference to conclusions drawn by the foreign investigators the author of the article indicates the possible ways of victimological prophylaxes of crimes against elders.

  8. The dark side of family communication: a communication model of elder abuse and neglect.

    Science.gov (United States)

    Lin, Mei-Chen; Giles, Howard

    2013-08-01

    To further address the potential factors that lead up to elder abuse in domestic settings, this paper proposes a model from a communication approach to explain dyadic influences between the family caregiver and the elderly care receiver that give rise to the abuse. That is, dysfunctional communication between the caregivers and care receivers may, therefore, increase the likelihood of elder abuse. Grounded in Bugental and her colleagues' work (1993, 1999, 2002) on child abuse, we propose a power-oriented communication model based, in part, on research in the fields of family violence and intergenerational communication to explain the likelihood of occurrence of elder abuse in family caregiving situations. We argue that certain risk factors pertaining to caregivers' characteristics--those who perceive high stress in caregiving, have mental health issues, have a history of substance abuse, and/or display verbal aggressiveness--may be more likely to attribute considerable power to those elderly under their custodianship. At the same time, such caregivers tend to feel powerless and experience loss of control when interacting with their elderly counterparts. When an elderly care receiver displays noncompliant behaviors, caregivers may be prone to employ abusive behaviors (in our model, it refers to physical abuse, verbal abuse, or communication neglect) to seek such compliance. Consequences of such abuse may result in lower self-esteem or lower confidence in one's ability to manage his/her life. It is suggested that researchers and practitioners investigate both parties' interactions closely and the role of elderly care receivers in order to detect, intervene, and prevent elder abuse.

  9. Identifying Risk Factors for Drug Use in an Iranian Treatment Sample: A Prediction Approach Using Decision Trees.

    Science.gov (United States)

    Amirabadizadeh, Alireza; Nezami, Hossein; Vaughn, Michael G; Nakhaee, Samaneh; Mehrpour, Omid

    2018-05-12

    Substance abuse exacts considerable social and health care burdens throughout the world. The aim of this study was to create a prediction model to better identify risk factors for drug use. A prospective cross-sectional study was conducted in South Khorasan Province, Iran. Of the total of 678 eligible subjects, 70% (n: 474) were randomly selected to provide a training set for constructing decision tree and multiple logistic regression (MLR) models. The remaining 30% (n: 204) were employed in a holdout sample to test the performance of the decision tree and MLR models. Predictive performance of different models was analyzed by the receiver operating characteristic (ROC) curve using the testing set. Independent variables were selected from demographic characteristics and history of drug use. For the decision tree model, the sensitivity and specificity for identifying people at risk for drug abuse were 66% and 75%, respectively, while the MLR model was somewhat less effective at 60% and 73%. Key independent variables in the analyses included first substance experience, age at first drug use, age, place of residence, history of cigarette use, and occupational and marital status. While study findings are exploratory and lack generalizability they do suggest that the decision tree model holds promise as an effective classification approach for identifying risk factors for drug use. Convergent with prior research in Western contexts is that age of drug use initiation was a critical factor predicting a substance use disorder.

  10. Views of child sexual abuse in two cultural communities: an exploratory study among African Americans and Latinos.

    Science.gov (United States)

    Fontes, L A; Cruz, M; Tabachnick, J

    2001-05-01

    This exploratory study investigates knowledge and ideas about child sexual abuse among African Americans and Latinos through focus group discussions. Participants defined and described child sexual abuse, acknowledged that it occurred in their communities, and expressed their sense that family risk factors, risky institutions, and offender propensities were its root causes. Latino participants identified cultural transitions as another contributor. Responses and conversational style differed somewhat by gender and cultural identity. The authors discuss implications for child sexual abuse prevention, intervention, and research.

  11. Workplace abuse: finding solutions.

    Science.gov (United States)

    Christmas, Kate

    2007-01-01

    The atmosphere within the work setting speaks volumes about your culture, and is often a primary factor in recruitment and retention (or turnover) of staff. Workplace tension and abuse are significant contributing factors as to why nurses are exiting workplaces--and even leaving the profession. Abuse can take many forms from inappropriate interpersonal communication to sexual harassment and even violence. Administrators should adopt a zero tolerance policy towards abusive communication. Addressing peer behavior is essential, but positive behavior must also be authentically modeled from the CNO and other nursing leaders. Raising awareness and holding individuals accountable for their behavior can lead to a safer and more harmonious work environment.

  12. Bad experience, good birthing: Dutch low-risk pregnant women with a history of sexual abuse

    NARCIS (Netherlands)

    van der Hulst, Leonie A. M.; Bonsel, Gouke J.; Eskes, Martine; Birnie, Erwin; van Teijlingen, Edwin; Bleker, Otto P.

    2006-01-01

    OBJECTIVE: The long-term effects on women in childbirth with a history of sexual abuse have only been studied to a limited degree. We estimated the prevalence of lifetime experience among low-risk pregnant women (non-clinical) in The Netherlands as well as the association with (1) psycho-social

  13. RISK FACTORS FOR VERY PRETERM DELIVERY

    Directory of Open Access Journals (Sweden)

    Наталья Витальевна Батырева

    2018-01-01

    Full Text Available The aim of the research – assess risk factors for very preterm delivery in the Omsk region. Materials and methods. The main group comprised women with very preterm delivery (n = 64; сomparison group – pregnant women with a threat of interruption in terms of 22-27 weeks and successful preserving therapy (n = 63; control group – pregnant women in whom this pregnancy was taking place without the threat of interruption (n = 62. Results. Risk factors for very preterm delivery were bacterial vaginosis, specific vaginitis, kidney disease and the threat of interruption. There was a significant lead in streptococci (32.3 ± 5.8 %, especially group B (19.0 ± 4.9 % in the main group. The risk factor for very preterm delivery was infectious viral diseases transferred during pregnancy, observed in 12.7 ± 4.2 % of women in the main group, in 7.8 ± 3.3 % in the comparison group (p < 0.01 and in 4.8 ± 2,7 % – control (p < 0,001. In the main group, placental insufficiency was 2 times more common than in the comparison group and 13 times than in the control group. Every sixth pregnant of the main group had manifestations of gestosis. Such complications of gestation as the premature detachment of the normally inserted placenta (7.8 ± 3.3 % and inborn malformations of a fruit (1.6 ± 1.6 % were observed only in the main group. Conclusion. The results of the research and literature data showed that the significant influence on the level of very early premature births is due to: the age of the parents, the abuse of nicotine, alcohol, drugs, abortion, preterm birth, urinary tract and genital tract infections, severe somatic diseases, multiple pregnancies. In the structure of complications of gestation during miscarriages, placental insufficiency predominates, the threat of abortion, fetal growth retardation, and polyhydramnios.

  14. Risk Factors in Adolescent Problem Behaviors Among Native and Nonnative Americans

    OpenAIRE

    Christensen, Roger B.

    1998-01-01

    The high incidence of adolescent problem behaviors in the United States raises major concerns. These problem behaviors include: sexually transmitted diseases, unintended pregnancies, suicide, depression, substance abuse, crime against persons and property, and delinquency. Consequently, there continues to be a high level of concern and interest in different ethnic populations of adolescents and their level of risk. This study evaluated the following problem behaviors: substance abuse, suic...

  15. Predisposing risk factors for delirium in living donor liver transplantation patients in intensive care units.

    Directory of Open Access Journals (Sweden)

    Szu-Han Wang

    Full Text Available BACKGROUND: Delirium is one of the main causes of increased length of intensive care unit (ICU stay among patients who have undergone living donor liver transplantation (LDLT. We aimed to evaluate risk factors for delirium after LDLT as well as to investigate whether delirium impacts the length of ICU and hospital stay. METHODS: Seventy-eight patients who underwent LDLT during the period January 2010 to December 2012 at a single medical center were enrolled. The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU scale was used to diagnose delirium. Preoperative, postoperative, and hematologic factors were included as potential risk factors for developing delirium. RESULTS: During the study period, delirium was diagnosed in 37 (47.4% patients after LDLT. The mean onset of symptoms occurred 7.0±5.5 days after surgery and the mean duration of symptoms was 5.0±2.6 days. The length of stay in the ICU for patients with delirium (39.8±28.1 days was significantly longer than that for patients without delirium (29.3±19.0 days (p<0.05. Risk factors associated with delirium included history of alcohol abuse [odds ratio (OR = 6.40, 95% confidence interval (CI: 1.85-22.06], preoperative hepatic encephalopathy (OR = 4.45, 95% CI: 1.36-14.51, APACHE II score ≥16 (OR = 1.73, 95% CI: 1.71-2.56, and duration of endotracheal intubation ≥5 days (OR = 1.81, 95% CI: 1.52-2.23. CONCLUSIONS: History of alcohol abuse, preoperative hepatic encephalopathy, APACHE II scores ≥16 and endotracheal intubation ≥5 days were predictive of developing delirium in the ICU following liver transplantation surgery and were associated with increased length of ICU and hospital stay.

  16. Neurologic Complications of Psychomotor Stimulant Abuse.

    Science.gov (United States)

    Sanchez-Ramos, Juan

    2015-01-01

    Psychomotor stimulants are drugs that act on the central nervous system (CNS) to increase alertness, elevate mood, and produce a sense of well-being. These drugs also decrease appetite and the need for sleep. Stimulants can enhance stamina and improve performance in tasks that have been impaired by fatigue or boredom. Approved therapeutic applications of stimulants include attention deficit hyperactivity disorder (ADHD), narcolepsy, and obesity. These agents also possess potent reinforcing properties that can result in excessive self-administration and abuse. Chronic use is associated with adverse effects including psychosis, seizures, and cerebrovascular accidents, though these complications usually occur in individuals with preexisting risk factors. This chapter reviews the adverse neurologic consequences of chronic psychomotor stimulant use and abuse, with a focus on two prototypical stimulants methamphetamine and cocaine. © 2015 Elsevier Inc. All rights reserved.

  17. School staff perpetration of physical violence against students in Uganda: a multilevel analysis of risk factors.

    Science.gov (United States)

    Merrill, Katherine G; Knight, Louise; Glynn, Judith R; Allen, Elizabeth; Naker, Dipak; Devries, Karen M

    2017-08-18

    To conduct a multilevel analysis of risk factors for physical violence perpetration by school staff against Ugandan students. Multilevel logistic regression analysis of cross-sectional survey data from 499 staff and 828 caregivers of students at 38 primary schools, collected in 2012 and 2014 during the Good Schools Study. Luwero District, Uganda. Past-week use of physical violence by school staff against students was measured using the International Society for the Prevention of Child Abuse and Neglect 'Child Abuse Screening Tool- Child International' and the WHO Multi-Country Study on Women's Health and Domestic Violence against Women. Of 499 staff, 215 (43%) reported perpetration of physical violence against students in the past week. Individual risk factors associated with physical violence perpetration included being a teacher versus another type of staff member (pviolence against non-students (pviolence (IPV) (pviolence perpetration compared with male staff who had not been a victim of IPV. No evidence was observed for school- or community-level risk factors. Physical violence perpetration from school staff is widespread, and interventions are needed to address this issue. Staff who have been victims of violence and who use violence against people other than students may benefit from additional interventions. Researchers should further investigate how school and community contexts influence staff's physical violence usage, given a lack of associations observed in this study. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  18. Mental disorder prevalence and associated risk factors in three prisons of Spain.

    Science.gov (United States)

    Zabala-Baños, M C; Segura, A; Maestre-Miquel, C; Martínez-Lorca, M; Rodríguez-Martín, B; Romero, D; Rodríguez, M

    2016-01-01

    To determine the lifetime and monthly prevalence of people with mental disorders and its association with sociodemographic factors and criminal risk in three Spanish prisons (Ocaña, Madrid I, II and VI). Cross-sectional epidemiological study of a sample of 184 inmates. Socio-demographic and criminal data were collected by an ad hoc interview. Mental disorders were assessed with the clinical version of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders Axis I Disorders (SCID-I). Life prevalence of mental disorders was 90.2%. The most common mental disorders and substance abuse or dependence was 72.3%, followed by mood disorder (38.5%) and psychotic disorders (34.2%). Moreover, the prevalence of any mental disorder in the last month was 52.2%. The main psychotic disorder (20.7%) was followed by substance abuse or dependence (18.5%), and mood disorder state (13%). A socio-demographic profile as a risk for each disorder was found. The prevalence of people with mental disorders is very high in Spanish prisons, and is associated with a distinct demographic profile. It is essential to continue researching this reality, translating the results into therapeutic and preventive action adapted to the status of inmates to reduce social inequalities in this high priority public health situation.

  19. Impact of Traumatic Events on Posttraumatic Stress Disorder among Danish Survivors of Sexual Abuse in Childhood

    DEFF Research Database (Denmark)

    Elklit, Ask; Christiansen, Dorte Mølgaard; Palic, Sabina

    2014-01-01

    Childhood sexual abuse can be extremely traumatic and lead to lifelong symptomatology. The present study examined the impact of several demographic, abuse, and psychosocial variables on posttraumatic stress disorder severity among a consecutive sample of treatment-seeking, adult child sexual abuse...... survivors (N = 480). The child sexual abuse sample was characterized by severe trauma exposure, insecure attachment, and significant traumatization, with an estimated 77% suffering from posttraumatic stress disorder, more than twice the level of the comparison group. Regression analyses revealed risk...... factors associated with the development of posttraumatic stress disorder in which the strongest predictors being additional traumas, negative affectivity, and somatization. The findings add to existing research confirming the stressful nature of child sexual abuse and the variables that contribute...

  20. Psychometric properties of the Vulnerability to Abuse Screening Scale for screening abuse of older adults

    Directory of Open Access Journals (Sweden)

    Raquel Batista Dantas

    Full Text Available ABSTRACT OBJECTIVE Adapt and evaluate the psychometric properties of the Vulnerability to Abuse Screening Scale to identify risk of domestic violence against older adults in Brazil. METHODS The instrument was adapted and validated in a sample of 151 older adults from a geriatric reference center in the municipality of Belo Horizonte, State of Minas Gerais, in 2014. We collected sociodemographic, clinical, and abuse-related information, and verified reliability by reproducibility in a sample of 55 older people, who underwent re-testing of the instrument seven days after the first application. Descriptive and comparative analyses were performed for all variables, with a significance level of 5%. The construct validity was analyzed by the principal components method with a tetrachoric correlation matrix, the reliability of the scale by the weighted Kappa (Kp statistic, and the internal consistency by the Kuder-Richardson estimator formula 20 (KR-20. RESULTS The average age of the participants was 72.1 years (DP = 6.96; 95%CI 70.94–73.17, with a maximum of 92 years, and they were predominantly female (76.2%; 95%CI 69.82–83.03. When analyzing the relationship between the scores of the Vulnerability to Abuse Screening Scale, categorized by presence (score > 3 or absence (score < 3 of vulnerability to abuse, with clinical and health conditions, we found statistically significant differences for self-perception of health (p = 0.002, depressive symptoms (p = 0.000, and presence of rheumatism (p = 0.003. There were no statistically significant differences between sexes. The Vulnerability to Abuse Screening Scale acceptably evaluated validity in the transcultural adaptation process, demonstrating dimensionality coherent with the original proposal (four factors. In the internal consistency analysis, the instrument presented good results (KR-20 = 0.69 and the reliability via reproducibility was considered excellent for the global scale (Kp = 0

  1. Understanding the etiology of prescription opioid abuse: implications for prevention and treatment.

    Science.gov (United States)

    Rigg, Khary K; Murphy, John W

    2013-07-01

    Although studies on the initiation of substance abuse abound, the body of literature on prescription opioid abuse (POA) etiology is small. Little is known about why and how the onset of POA occurs, especially among high-risk populations. In this study we aimed to fill this important knowledge gap by exploring the POA initiation experiences of 90 prescription opioid abusers currently in treatment and their narrative accounts of the circumstances surrounding their POA onset. This research was conducted within a storyline framework, which operates on the premise that the path to drug abuse represents a biography or a process rather than a static condition. Audiotapes of in-depth interviews were transcribed, coded, and thematically analyzed. Analyses revealed the presence of four trajectories leading to POA. This study adds to the limited research on POA etiology by not only illuminating the psychosocial factors that contribute to POA onset, but also by situating initiation experiences within broader life processes. The study findings provide crucial insights to policymakers and interventionists in identifying who is at risk for POA, and more important, when and how to intervene most efficaciously.

  2. Child abuse potential in mothers with early life maltreatment, borderline personality disorder and depression.

    Science.gov (United States)

    Dittrich, Katja; Boedeker, Katja; Kluczniok, Dorothea; Jaite, Charlotte; Hindi Attar, Catherine; Fuehrer, Daniel; Herpertz, Sabine C; Brunner, Romuald; Winter, Sibylle Maria; Heinz, Andreas; Roepke, Stefan; Heim, Christine; Bermpohl, Felix

    2018-05-24

    Early life maltreatment (ELM), borderline personality disorder (BPD) and major depressive disorder (MDD) have been shown to increase the potential of abuse. Emotion regulation is an identified mediator for the association of ELM and BPD with abuse potential. Until now, there has been no study to account for the co-occurrence of these risk factors in one analysis, although BPD and MDD are known as common sequelae of ELM. This is paired with a lack of studies investigating the effects of abuse potential on child well-being.AimsOur study aims at (a) disentangling the effects of maternal ELM, MDD and BPD on abuse potential; (b) exploring the role of emotion regulation as a mediator; and (c) testing for intergenerational effects of abuse potential on child psychopathology. The research design included 114 mothers with/without ELM, BPD and MDD in remission and their children, all of which were between 5 and 12 years of age. A path analysis was conducted to investigate the multiple associations between our variables. ELM, MDD and BPD were all associated with abuse potential, with emotion regulation acting as a mediator for BPD and MDD. Furthermore, an elevated abuse potential was related to higher psychopathology in the child. History of ELM as well as the common sequelae, BPD and MDD, pose risks for child abuse. Our findings suggest improvement of emotion regulation as a potential target for intervention programs. These programs should also aim at non-substantiated cases because even an elevated abuse potential affected child mental health.Declaration of interestNone.

  3. Environmental risk factors and their impact on the age of onset of schizophrenia: Comparing familial to non-familial schizophrenia.

    Science.gov (United States)

    Scherr, Martin; Hamann, Melanie; Schwerthöffer, Dirk; Froböse, Teresa; Vukovich, Ruth; Pitschel-Walz, Gabriele; Bäuml, Josef

    2012-04-01

    Several risk factors for schizophrenia have yet been identified. The aim of our study was to investigate how certain childhood and adolescent risk factors predict the age of onset of psychosis in patients with and without a familial component (i.e. a relative with schizophrenia or schizoaffective disorder). Aside from the age of onset of psychosis, we examined the risk factors for schizophrenia including obstetric complications, birth during winter or spring, behavioral deviances or delayed motor and speech development, exposure to adverse life events and exposure to substance use within a group of 100 patients (45 female, 55 male) with a mean age (± standard deviation) of 35.15 ± 13.21. Birth complications and cannabis abuse are predictors for an earlier onset of schizophrenia in patients with non-familial schizophrenia. No environmental risk factors for an earlier age of onset in familial schizophrenia have been identified. Certain environmental risk factors for schizophrenia seem to have an impact on the age of onset of psychosis in non-familial schizophrenia, they do not seem to have an impact on familial schizophrenia.

  4. Association Between Depressive Symptoms, Multiple Dimensions of Depression, and Elder Abuse: A Cross-Sectional, Population-Based Analysis of Older Adults in Urban Chicago.

    Science.gov (United States)

    Roepke-Buehler, Susan K; Simon, Melissa; Dong, XinQi

    2015-09-01

    Depression is conceptualized as both a risk factor for and a consequence of elder abuse; however, current research is equivocal. This study examined associations between elder abuse and dimensions of depressive symptoms in older adults. Participants were 10,419 older adults enrolled in theChicago Health and Aging Project (CHAP), a population-based study of older adults. Regression was used to determine the relationships between depressive symptoms, depression dimensions, and abuse variables. Depressive symptoms were consistently associated with elder abuse. Participants in the highest tertile of depressive symptoms were twice as likely to have confirmed abuse with a perpetrator (odds ratio = 2.07, 95% confidence interval = [1.21, 3.52], p = .008). Elder abuse subtypes and depression dimensions were differentially associated. These findings highlight the importance of routine depression screening in older adults as a component of abuse prevention and intervention. They also provide profiles of depressive symptoms that may more accurately characterize risk for specific types of abuse. © The Author(s) 2015.

  5. The effects of early prevention programs for families with young children at risk for physical child abuse and neglect : A meta-analysis

    NARCIS (Netherlands)

    Geeraert, L; Van den Noortgate, W; Grietens, H; Onghena, P

    In this article, a meta-analysis is presented on 40 evaluation studies of early prevention programs for families with young children at risk for physical child abuse and neglect with mostly nonrandomized designs. The main aim of all programs was to prevent physical child abuse and neglect by

  6. The Association Between Childhood Abuse and Elder Abuse Among Chinese Adult Children in the United States.

    Science.gov (United States)

    Dong, XinQi; Li, Ge; Simon, Melissa A

    2017-07-01

    The previous researchers have postulated that an abused child may abuse his or her abuser parent when the parent is getting old, also known as the intergenerational transmission of violence. However, few studies use data to support this model, and it has yet to be examined in the U.S. Chinese community. This study aims to examine the association between childhood abuse and elder abuse reported by Chinese adult children in the United States. Guided by a community-based participatory research approach, 548 Chinese adult children aged 21 years and older participated in this study. Childhood abuse was assessed by four-item Hurt-Insult-Threaten-Scream (HITS) scale. Elder abuse was assessed by a 10-item instrument derived from the Caregiver Abuse Screen (CASE). Logistic regression analysis was performed. Childhood abuse was associated with caregiver abuse screen results (odds ratio = 1.92, 95% confidence interval = 1.24-2.95). Being physically hurt (r = .13, p abuse screen results. This study suggests that childhood abuse is associated with increased risk of elder abuse among Chinese adult children in the United States. Longitudinal research should be conducted to explore the mechanisms through which childhood abuse and its subtypes links with elder abuse. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. CHILD-PARENT VIOLENCE: MAIN CHARACTERISTICS, RISK FACTORS AND KEYS TO INTERVENTION

    Directory of Open Access Journals (Sweden)

    M. Luisa Martínez

    2015-09-01

    Full Text Available Child-parent Violence (hereinafter CPV is an increasingly evident problem in the social, health, and judicial protection systems which, however, continue to show a number of major deficiencies with respect to the main characteristics of CPV, the people involved, the underlying factors, and efficacious interventions. Nevertheless, there is a consensus regarding its devastating consequences. The present bibliographical review is focused on analysing the problem of CPV with the aim of offering useful data for future research and intervention proposals. Specifically, this paper provides a definition of CPV and its types, some data on prevalence, the main characteristics of aggressive children and abused parents, and the most important individual, family, school and community risk factors highlighted in the current scientific literature. The keys areas of intervention with this group are also presented.

  8. Association of childhood abuse with homeless women's social networks.

    Science.gov (United States)

    Green, Harold D; Tucker, Joan S; Wenzel, Suzanne L; Golinelli, Daniela; Kennedy, David P; Ryan, Gery W; Zhou, Annie J

    2012-01-01

    Childhood abuse has been linked to negative sequelae for women later in life including drug and alcohol use and violence as victim or perpetrator and may also affect the development of women's social networks. Childhood abuse is prevalent among at-risk populations of women (such as the homeless) and thus may have a stronger impact on their social networks. We conducted a study to: (a) develop a typology of sheltered homeless women's social networks; (b) determine whether childhood abuse was associated with the social networks of sheltered homeless women; and (c) determine whether those associations remained after accounting for past-year substance abuse and recent intimate partner abuse. A probability sample of 428 homeless women from temporary shelter settings in Los Angeles County completed a personal network survey that provided respondent information as well as information about their network members' demographics and level of interaction with each other. Cluster analyses identified groups of women who shared specific social network characteristics. Multinomial logistic regressions revealed variables associated with group membership. We identified three groups of women with differing social network characteristics: low-risk networks, densely connected risky networks (dense, risky), and sparsely connected risky networks (sparse, risky). Multinomial logistic regressions indicated that membership in the sparse, risky network group, when compared to the low-risk group, was associated with history of childhood physical abuse (but not sexual or emotional abuse). Recent drug abuse was associated with membership in both risky network groups; however, the association of childhood physical abuse with sparse, risky network group membership remained. Although these findings support theories proposing that the experience of childhood abuse can shape women's social networks, they suggest that it may be childhood physical abuse that has the most impact among homeless women

  9. Children Seeking Refuge: A Review of the Escalating Humanitarian Crisis of Child Sexual Abuse and HIV/AIDS in Latin America.

    Science.gov (United States)

    Thornton, Clifton P; Veenema, Tener Goodwin

    2015-01-01

    Early identification and intervention for victims of child sexual abuse (CSA) is essential to halting the spread of HIV in Latino populations because children who are sexually abused are at an increased risk of contracting HIV. The recent influx of unaccompanied children into the United States exposed histories of victimization, vulnerability to CSA, and suggested an epidemic of CSA in Latin America. CSA has been identified as a contributory event to HIV infection. The aim of our research was to identify factors associated with CSA and Latin Americans. A systematic review and a document search were conducted on factors associated with CSA in Latin America. Victimization was associated with lifelong risk factors for HIV. Males were consistently underrepresented in the published CSA literature and machismo attitudes may contribute to abuses of sexual power by males and contribute to males not reporting or under-reporting victimization. Copyright © 2015 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

  10. Witnessing Domestic Abuse in Childhood as an Independent Risk Factor for Depressive Symptoms in Young Adulthood

    Science.gov (United States)

    Russell, David; Springer, Kristen W.; Greenfield, Emily A.

    2010-01-01

    Objective: This study addresses the relationship between retrospective reports of witnessing domestic abuse in childhood and levels of depressive symptoms in young adulthood. We examine whether the association between having witnessed violence in childhood and depression is independent of having been the direct target of sexual and/or physical…

  11. Benzodiazepine abuse among the elderly

    Directory of Open Access Journals (Sweden)

    Shalini Singh

    2016-01-01

    Full Text Available Benzodiazepines belong to the hypnotic-sedative class of drugs which have anxiolytic, sedative, and hypnotic properties. These drugs have been in clinical use for at least half a century. The propensity for development of dependence, especially on prescription benzodiazepines, coupled with the risk of falls and cognitive impairment due to benzodiazepines makes the elderly population susceptible to adverse outcomes with the use of benzodiazepines, and hence, cautious use is desired in this population. This review discusses the various aspects pertaining to benzodiazepine abuse in the elderly including pharmacology, prevalence of abuse, adverse consequences of benzodiazepine abuse, and subsequently assessment and management of elderly patients with benzodiazepine abuse.

  12. Substance abuse prevalence and its relation to scholastic achievement and sport factors: an analysis among adolescents of the Herzegovina-Neretva Canton in Bosnia and Herzegovina.

    Science.gov (United States)

    Sekulic, Damir; Ostojic, Marko; Ostojic, Zdenko; Hajdarevic, Braco; Ostojic, Ljerka

    2012-04-05

    Substance abuse among adolescents is a major public health and social problem. However, studies rarely investigate the relationships between substance abuse, educational achievement and sport factors. Substance abuse is an even more significant problem in societies that have experienced trauma, such as Bosnia and Herzegovina, which have had recent wars. The aims of this study were to investigate substance abuse among adolescents in Bosnia and Herzegovina and to study the potential gender-specific relationships between a) sport factors (physical activity/exercise/athletic participation) and substance abuse and b) scholastic achievement and substance abuse. Our sample consisted of 1,032 adolescents who were 17 to 18 years old (435 boys and 597 girls) and who were in the final grade of high school. These subjects were randomly selected from the territory of Herzegovina-Neretva Canton of Bosnia and Herzegovina. Retrospective testing was performed using an extensive self-administered questionnaire. The questionnaire included questions involving topics such as sociodemographic variables, scholastic variables, sport factors, and substance abuse data (smoking habits, drugs consumption and alcohol consumption using the AUDIT questionnaire). Descriptive statistics, frequencies, analyses of the differences and correlational analyses were performed. Our results found that greater than one-third of the boys and one-fourth of the girls were daily smokers, and almost half of the boys and one-fifth of the girls practiced harmful drinking; other drugs (i.e. heroin, cocaine, amphetamines, etc.) were rarely consumed. Boys dominated in sport factors, whereas girls were more successful in scholastic achievement. Approximately 23% of the boys and 6% of the girls reported that they practiced harmful drinking and smoked simultaneously. Educational failure, which was defined as having one or more negative grades at the end of the last two school years, was identified in 20% of the boys

  13. Substance abuse prevalence and its relation to scholastic achievement and sport factors: an analysis among adolescents of the Herzegovina–Neretva Canton in Bosnia and Herzegovina

    Science.gov (United States)

    2012-01-01

    Background Substance abuse among adolescents is a major public health and social problem. However, studies rarely investigate the relationships between substance abuse, educational achievement and sport factors. Substance abuse is an even more significant problem in societies that have experienced trauma, such as Bosnia and Herzegovina, which have had recent wars. The aims of this study were to investigate substance abuse among adolescents in Bosnia and Herzegovina and to study the potential gender-specific relationships between a) sport factors (physical activity/exercise/athletic participation) and substance abuse and b) scholastic achievement and substance abuse. Methods Our sample consisted of 1,032 adolescents who were 17 to 18 years old (435 boys and 597 girls) and who were in the final grade of high school. These subjects were randomly selected from the territory of Herzegovina-Neretva Canton of Bosnia and Herzegovina. Retrospective testing was performed using an extensive self-administered questionnaire. The questionnaire included questions involving topics such as sociodemographic variables, scholastic variables, sport factors, and substance abuse data (smoking habits, drugs consumption and alcohol consumption using the AUDIT questionnaire). Descriptive statistics, frequencies, analyses of the differences and correlational analyses were performed. Results Our results found that greater than one-third of the boys and one-fourth of the girls were daily smokers, and almost half of the boys and one-fifth of the girls practiced harmful drinking; other drugs (i.e. heroin, cocaine, amphetamines, etc.) were rarely consumed. Boys dominated in sport factors, whereas girls were more successful in scholastic achievement. Approximately 23% of the boys and 6% of the girls reported that they practiced harmful drinking and smoked simultaneously. Educational failure, which was defined as having one or more negative grades at the end of the last two school years, was

  14. Fatal child abuse: a study of 13 cases of continuous abuse

    Directory of Open Access Journals (Sweden)

    Juhani Merikanto

    2012-01-01

    Full Text Available A parent who continuously physically abuses her/his child doesn’t aim to kill the child but commits an accidental filicide in a more violent outburst of anger. Fatal abuse deaths are prevented by recognition of signs of battering in time. Out of 200 examined intra-familial filicides, 23 (12% were caused by child battering and 13 (7% by continuous battering. The medical and court records of the victim and the perpetrator were examined. The perpetrator was the biological mother and the victim was male in 69 per cent of the cases. The abused children were either younger than one year or from two-and-a-half to four years old. Risk factors of the victim (being unwanted, premature birth, separation from the parent caused by hospitalization or custodial care, being ill and crying a lot and the perpetrator (personality disorder, low socioeconomic status, chaotic family conditions, domestic violence, isolation, alcohol abuse were common. The injuries caused by previous battering were mostly soft tissue injuries in head and limbs and head traumas and the battering lasted for days or even an year. The final assault was more violent and occurred when the parent was more anxious, frustrated or left alone with the child. The perpetrating parent was diagnosed as having a personality disorder (borderline, narcissistic or dependent and often substance dependence (31%. None of them were psychotic. Authorities and community members should pay attention to the change in child’s behavior and inexplicable injuries or absence from daycare. Furthermore if the parent is immature, alcohol dependent, have a personality disorder and is unable to cope with the demands the small child entails in the parent’s life, the child may be in danger.

  15. CHILD SEXUAL ABUSE, BULLYING, CYBERBULLYING, AND MENTAL HEALTH PROBLEMS AMONG HIGH SCHOOLS STUDENTS: A MODERATED MEDIATED MODEL.

    Science.gov (United States)

    Hébert, Martine; Cénat, Jude Mary; Blais, Martin; Lavoie, Francine; Guerrier, Mireille

    2016-07-01

    Child sexual abuse is associated with adverse outcomes, including heightened vulnerability that may translate into risk of revictimization. The aims of the study were: (1) to explore the direct and indirect links between child sexual abuse and cyberbullying, bullying, and mental health problems and (2) to study maternal support as a potential protective factor. Teenagers involved in the two first waves of the Quebec Youths' Romantic Relationships Survey (N = 8,194 and 6,780 at Wave I and II, respectively) completed measures assessing child sexual abuse and maternal support at Wave I. Cyberbullying, bullying, and mental health problems (self-esteem, psychological distress, and suicidal ideations) were evaluated 6 months later. Rates of cyberbullying in the past 6 months were twice as high in sexually abused teens compared to nonvictims both for girls (33.47 vs. 17.75%) and boys (29.62 vs. 13.29%). A moderated mediated model revealed a partial mediation effect of cyberbullying and bullying in the link between child sexual abuse and mental health. Maternal support acted as a protective factor as the conditional indirect effects of child sexual abuse on mental health via cyberbullying and bullying were reduced in cases of high maternal support. Results have significant relevance for prevention and intervention in highlighting the heightened vulnerability of victims of child sexual abuse to experience both bullying and cyberbullying. Maternal support may buffer the risk of developing mental health distress, suggesting that intervention programs for victimized youth may profit by fostering parent involvement. © 2016 Wiley Periodicals, Inc.

  16. Risk factors associated with default among new pulmonary TB patients and social support in six Russian regions.

    Science.gov (United States)

    Jakubowiak, W M; Bogorodskaya, E M; Borisov, S E; Borisov, E S; Danilova, I D; Danilova, D I; Kourbatova, E V; Kourbatova, E K

    2007-01-01

    Tuberculosis (TB) services in six Russian regions in which social support programmes for TB patients were implemented. To identify risk factors for default and to evaluate possible impact of social support. Retrospective study of new pulmonary smear-positive and smear-negative TB patients registered during the second and third quarters of the 2003. Data were analysed in a case-control study including default patients as cases and successfully treated patients as controls, using multivariate logistic regression modelling. A total of 1805 cases of pulmonary TB were enrolled. Default rates in the regions were 2.3-6.3%. On multivariate analysis, risk factors independently associated with default outcome included: unemployment (OR 4.44; 95%CI 2.23-8.86), alcohol abuse (OR 1.99; 95%CI 1.04-3.81), and homelessness (OR 3.49; 95%CI 1.25-9.77). Social support reduced the default outcome (OR 0.13; 95%CI 0.06-0.28), controlling for age, sex, region, residence and acid-fast bacilli (AFB) smear of sputum. Unemployment, alcohol abuse and homelessness were associated with increased default outcome among new TB patients, while social support for TB patients reduced default. Further prospective randomised studies are necessary to evaluate the impact and to determine the most cost-effective social support for improving treatment outcomes of TB in patients in Russia, especially among populations at risk of default.

  17. Trajectories of Childhood Sexual Abuse and Early Adolescent HIV/AIDS Risk Behaviors: The Role of Other Maltreatment, Witnessed Violence, and Child Gender

    Science.gov (United States)

    Jones, Deborah J.; Runyan, Desmond K.; Lewis, Terri; Litrownik, Alan J.; Black, Maureen M.; Wiley, Tisha; English, Diana E.; Proctor, Laura J.; Jones, Bobby L.; Nagin, Daniel S.

    2013-01-01

    Childhood sexual abuse (CSA) has been associated with HIV/AIDS risk behavior; however, much of this work is retrospective and focuses on women. The current study used semiparametric mixture modeling with youth (n = 844; 48.8% boys) from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) to examine the link between trajectories of CSA (2 to 12 y.o.) and HIV/AIDS risk behavior at age 14 (i.e., sexual intercourse & alcohol use). Trajectory analyses revealed a link between a history of CSA and the development of risky behavior. In addition, trajectories for physical and emotional abuse, but not neglect or witnessed violence, contributed to risky behavior over and above the role of CSA. Child gender did not moderate the findings. Findings highlight the signficance of CSA histories, as well as the broader context of maltreatment, for better understanding the development of risk behaviors in both girls and boys. PMID:20706919

  18. Contextual Predictive Factors of Child Sexual Abuse: The Role of Parent-Child Interaction

    Science.gov (United States)

    Ramirez, Clemencia; Pinzon-Rondon, Angela Maria; Botero, Juan Carlos

    2011-01-01

    Objectives: To determine the prevalence of child sexual abuse in the Colombian coasts, as well as to assess the role of parent-child interactions on its occurrence and to identify factors from different environmental levels that predict it. Methods: This cross-sectional study explores the results of 1,089 household interviews responded by mothers.…

  19. Psychological Abuse, Mental Health, and Acceptance of Dating Violence Among Adolescents.

    Science.gov (United States)

    Temple, Jeff R; Choi, Hye Jeong; Elmquist, JoAnna; Hecht, Michael; Miller-Day, Michelle; Stuart, Gregory L; Brem, Meagan; Wolford-Clevenger, Caitlin

    2016-08-01

    Existing literature indicates that acceptance of dating violence is a significant and robust risk factor for psychological dating abuse perpetration. Past work also indicates a significant relationship between psychological dating abuse perpetration and poor mental health. However, no known research has examined the relationship between acceptance of dating violence, perpetration of dating abuse, and mental health. In addition to exploring this complex relationship, the present study examines whether psychological abuse perpetration mediates the relationship between acceptance of dating violence and mental health (i.e., internalizing symptoms of depression, anxiety, and hostility). Three waves of longitudinal data were obtained from 1,042 ethnically diverse high school students in Texas. Participants completed assessments of psychological dating abuse perpetration, acceptance of dating violence, and internalizing symptoms (hostility and symptoms of anxiety and depression). As predicted, results indicated that perpetration of psychological abuse was significantly associated with acceptance of dating violence and all internalizing symptoms. Furthermore, psychological abuse mediated the relationship between acceptance of dating violence and internalizing symptoms. Findings from the present study suggest that acceptance of dating violence is an important target for the prevention of dating violence and related emotional distress. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  20. The intellectual profile of abused and neglected children in the Philippines: An analysis of SB5 IQ scores of sexually abused, physically abused and neglected children.

    Science.gov (United States)

    Bengwasan, Peejay D

    2018-05-24

    Child abuse and neglect have been associated with cognitive deficits, among other effects on child development. This study explores the prediction that child abuse and neglect has an impact on Stanford-Binet Intelligence Scales 5th Edition (SB5) IQ scores, in relation to gender, age and type of abuse experienced. 300 children with experiences of abuse and neglect were included in the study, comprising 100 sexually abused, 100 physically abused and 100 neglected children. Overall, all scores on the SB5 were found to be significantly lower than the minimum average scores on the test. Verbal IQ (VIQ) scores were likewise found to be significantly lower than Nonverbal IQ (NVIQ) scores. Full Scale IQ (FSIQ) scores did not reveal heterogeneity when gender was factored in. Age and type of abuse (with a moderate effect size) on the other hand, showed significant differences among groups. Statistical analyses of SB5 Factor Index Scores revealed that abused children, in general, have significantly higher Visual-Spatial Processing (VS) and Quantitative Reasoning (QR) scores and lower scores in Knowledge (KN). There was a large effect size found in such an analysis. Age (with a large effect size), gender and type of abuse (with moderate effect sizes) give significant variations to this obtained profile. Copyright © 2018 Elsevier Ltd. All rights reserved.

  1. The Educational Needs of Abused and Neglected Children: A Review of the Literature.

    Science.gov (United States)

    Trocme, Nico; Caunce, Carrie

    1995-01-01

    Examines the literature on the relationship between educational deficit and various risk and protective factors: history of abuse or neglect, foster placement, child age, and environmental conditions. Findings suggest interventions with preschoolers that focus on strengthening children's socioemotional competencies and differentiate between needs…

  2. Epigenetic Risk Factors in PTSD and Depression

    Directory of Open Access Journals (Sweden)

    Florian Joachim Raabe

    2013-08-01

    Full Text Available Epidemiological and clinical studies have shown that children exposed to adverse experiences are at increased risk for the development of depression, anxiety disorders and PTSD. A history of child abuse and maltreatment increases the likelihood of being subsequently exposed to traumatic events or of developing PTSD as an adult. The brain is highly plastic during early life and encodes acquired information into lasting memories that normally subserve adaptation. Translational studies in rodents showed that enduring sensitization of neuronal and neuroendocrine circuits in response to early life adversity are likely risk factors of life time vulnerability to stress. Hereby, the hypothalamic-pituitary-adrenal (HPA axis integrates cognitive, behavioural and emotional responses to early-life stress and can be epigenetically programmed during sensitive windows of development. Epigenetic mechanisms, comprising reciprocal regulation of chromatin structure and DNA methylation, are important to establish and maintain sustained, yet potentially reversible, changes in gene transcription. The relevance of these findings for the development of PTSD requires further studies in humans where experience-dependent epigenetic programming can additionally depend on genetic variation in the underlying substrates which may protect from or advance disease development. Overall, identification of early-life stress associated epigenetic risk markers informing on previous stress history can help to advance early diagnosis, personalized prevention and timely therapeutic interventions, thus reducing long-term social and health costs.

  3. Recipient clinical risk factors predominate in possible transfusion-related acute lung injury.

    Science.gov (United States)

    Toy, Pearl; Bacchetti, Peter; Grimes, Barbara; Gajic, Ognjen; Murphy, Edward L; Winters, Jeffrey L; Gropper, Michael A; Hubmayr, Rolf D; Matthay, Michael A; Wilson, Gregory; Koenigsberg, Monique; Lee, Deanna C; Hirschler, Nora V; Lowell, Clifford A; Schuller, Randy M; Gandhi, Manish J; Norris, Philip J; Mair, David C; Sanchez Rosen, Rosa; Looney, Mark R

    2015-05-01

    Possible transfusion-related acute lung injury (pTRALI) cases by definition have a clear temporal relationship to an alternative recipient risk factor for acute respiratory distress syndrome (ARDS). We questioned whether transfusion factors are important for the development of pTRALI. In this nested case-control study, we prospectively identified 145 consecutive patients with pTRALI and randomly selected 163 transfused controls over a 4-year period at the University of California at San Francisco and the Mayo Clinic (Rochester, Minnesota). For pTRALI, we found evidence against transfusion being important: receipt of plasma from female donors (odds ratio [OR], 0.82; 95% confidence interval [CI], 0.29-2.3; p = 0.70), total number of units transfused (OR, 0.99; 95% CI, 0.89-1.10; p = 0.86), and number of red blood cell and whole blood units transfused (OR, 0.78; 95% CI, 0.59-1.03; p = 0.079). In contrast, we found that risk for pTRALI was associated with additional recipient factors: chronic alcohol abuse (OR, 12.5; 95% CI, 2.8-55; p transfusion (OR, 4.6; 95% CI, 2.0-10.7; p transfusion (OR, 1.32/L; 95% CI, 1.20-1.44; p transfusion risk factors predominate in pTRALI. © 2014 AABB.

  4. Research design considerations for clinical studies of abuse-deterrent opioid analgesics: IMMPACT recommendations

    Science.gov (United States)

    Turk, Dennis C.; O’Connor, Alec B.; Dworkin, Robert H.; Chaudhry, Amina; Katz, Nathaniel P.; Adams, Edgar H.; Brownstein, John S.; Comer, Sandra D.; Dart, Richard; Dasgupta, Nabarun; Denisco, Richard A.; Klein, Michael; Leiderman, Deborah B.; Lubran, Robert; Rappaport, Bob A.; Zacny, James P.; Ahdieh, Harry; Burke, Laurie B.; Cowan, Penney; Jacobs, Petra; Malamut, Richard; Markman, John; Michna, Edward; Palmer, Pamela; Peirce-Sandner, Sarah; Potter, Jennifer S.; Raja, Srinivasa N.; Rauschkolb, Christine; Roland, Carl L.; Webster, Lynn R.; Weiss, Roger D.; Wolf, Kerry

    2013-01-01

    Opioids are essential to the management of pain in many patients, but they also are associated with potential risks for abuse, overdose, and diversion. A number of efforts have been devoted to the development of abuse-deterrent formulations of opioids to reduce these risks. This article summarizes a consensus meeting that was organized to propose recommendations for the types of clinical studies that can be used to assess the abuse deterrence of different opioid formulations. Due to the many types of individuals who may be exposed to opioids, an opioid formulation will need to be studied in several populations using various study designs in order to determine its abuse-deterrent capabilities. It is recommended that the research conducted to evaluate abuse deterrence should include studies assessing: (1) abuse liability; (2) the likelihood that opioid abusers will find methods to circumvent the deterrent properties of the formulation; (3) measures of misuse and abuse in randomized clinical trials involving pain patients with both low risk and high risk of abuse; and (4) post-marketing epidemiological studies. PMID:22770841

  5. Childhood Sexual Abuse

    Directory of Open Access Journals (Sweden)

    Evrim Aktepe

    2009-08-01

    behavioral and psychological results by itself, early trauma may also lead to biological effects. Especially traumas during neuron plasticity phase may lead hypersensitivity of neuroendocrine stress response. Early life stresses are shown to lead changes in corticotrophin releasing factor system in preclinical and clinical phase studies. In the treatment of sexual abuse, emotional process related with trauma should be focused on. This process may be conducted with play therapy. Development of higher level defense mechanism, increasing ego capacity, orientation to social activity and personal activity according to skills is aimed. For the elimination of guiltiness related with stigmatization, the child should be told that it is not herhis fault to incorporate into sexual interaction and the culprit is abuser. It is fairly important for medical staff, school and family to have sufficient information about sexual abuse for prevention and early recognition.

  6. The mediating role of parent-child bonding to prevent adolescent alcohol abuse among Asian American families.

    Science.gov (United States)

    Wang, Meme; Kviz, Frederick J; Miller, Arlene M

    2012-10-01

    The purpose of this paper is to describe unique culturally-based factors that may increase the vulnerability of Asian American adolescents to engage in alcohol use and abuse and the role of parent-child bonding as a protective factor. In particular, this paper addresses the interactions among acculturation, alcohol use, and parent-child bonding and the challenges Asian American families face in strengthening parent-child bonds. We begin by examining likely causes for alienation that occur as a result of immigration to the United States. We then present the cultural context of Asian American families that can also serve to create distance between parent and child, including the contrasting cultural orientations of individualism and collectivism, Asian traditional values, differences in Eastern and Western parenting styles, and intergenerational cultural dissonance. Next, we present a review of the research that has examined acculturation as a risk factor for alcohol use and abuse among Asian American adolescents, with special attention to the mediating role of parent-child bonding. Finally, we conclude with recommendations for future research on the risk and protective factors for adolescent substance abuse, as well as other risky health behaviors among the growing population of Asian Americans in the United States.

  7. Gender differences in depression risk and coping factors in a clinical sample.

    Science.gov (United States)

    Wilhelm, K; Roy, K; Mitchell, P; Brownhill, S; Parker, G

    2002-07-01

    To examine gender differences in depression risk and coping factors in a clinical sample of patients with a diagnosis of DSM-IV major depression. Patients were assessed for substance use and abuse, family history of psychiatric disorder, interpersonal depressogenic factors and lifetime history of anxiety disorders. Trait anxiety, coping styles when depressed, parental bonding, marital features and personality style were also measured. Patients were reassessed at 12-month follow-up. There were few gender differences in experience of depression (either in duration, type or severity prior to treatment) in a group with established episodes of major depression but women reported more emotional arousability when depressed. Women reported higher rates of dysfunctional parenting and childhood sexual abuse, and rated their partners as less caring and as more likely to be a depressogenic stressor. Men were more likely to have a generalized anxiety disorder at assessment, to use recreational drugs prior to presentation. Men were rated as having a more rigid personality style and 'Cluster A' personality traits both at assessment and follow-up. There were few gender differences in severity or course of established episodes of major depression. Gender differences were related to levels of arousal, anxiety disorders, and repertoires for dealing with depression, rather than depressive symptoms per se.

  8. Depression, Abuse, Relationship Power and Condom Use by Pregnant and Postpartum Women with Substance Abuse History.

    Science.gov (United States)

    Dévieux, Jessy G; Jean-Gilles, Michèle; Rosenberg, Rhonda; Beck-Sagué, Consuelo; Attonito, Jennifer M; Saxena, Anshul; Stein, Judith A

    2016-02-01

    Substance-abusing pregnant and postpartum women are less likely to maintain consistent condom use and drug and alcohol abstinence, which is particularly concerning in high HIV-prevalence areas. Data from 224 pregnant and postpartum women in substance abuse treatment were analyzed to examine effects of history of substance use, child abuse, and mental health problems on current substance use and condom-use barriers. Mediators were depression, relationship power and social support. Most participants (72.9 %) evidenced current depression. Less social support (-0.17, p power (-0.48, p power (0.15, p power limit highest-risk women's ability to negotiate condom use and abstain from substance use, increasing their risk of acute HIV infection and vertical transmission.

  9. [Intra and extra-familiar sexual abuse].

    Science.gov (United States)

    Taveira, Francisco; Frazão, Sofia; Dias, Ricardo; Matos, Eduarda; Magalhães, Teresa

    2009-01-01

    The sexual abuse of a child or young person constitutes a major social and public health problem and there is recent evidence that intra-familial (IF) sexual abuses are more serious in their consequences than extra-familial (EF). However, there are no studies on this phenomenon in Portugal. Thus, the aim of the present study is to contribute to a better characterization of these types of abuses and to identify possible differences between IF and EF cases. A retrospective study was preformed based on medico-legal reports related to victims below the age of 18, suspected of being sexually abused (n = 764), corresponding to 67% of the total of observed sexual crimes. Results revealed that 34.9% of the abuses are IF and they show statistically significant differences when compared to EF cases. These are due to the following factors found in IF situations: a) lower victim age; b) closeness between victim and abuser; c) abusers with a higher rate of previous sexual abuse; d) sexual practices of reduced physical intrusion; e) decreased physical violence but increased emotional violence; f) greater delay between last abuse and the forensic exam; g) reduced number of injuries or biological evidence (none in the great majority of the cases). Results point out the existence of several characteristics in IF abuse that have been identified as factors that influence the severity of the abuse consequences. Among them are: a) lower victim age; b) greater proximity to the abuser; c) increased amount of emotional violence. These factors account for the reduced visibility of this kind of cases and therefore explain their delayed disclosure and diagnosis. The association of this fact with the reduced intrusiveness of this sort of practice and the consequent decrease in number of injuries and other evidence leads to a marked reduction of the number of cases where evidence of the abuse can be found by physical examination alone. The above aspects underlie the need of using different

  10. Child Abuse and Aggression among Seriously Emotionally Disturbed Children

    Science.gov (United States)

    Ford, Julian D.; Fraleigh, Lisa A.; Connor, Daniel F.

    2010-01-01

    Abused children may be at risk for problems with aggression. In a sample of 397 seriously emotionally disturbed children, reactive aggression was associated with documented history of physical abuse but not sexual abuse. Girls were equally likely to be classified as reactively aggressive regardless of physical abuse history, but boys with physical…

  11. Theories and measures of elder abuse.

    Science.gov (United States)

    Abolfathi Momtaz, Yadollah; Hamid, Tengku Aizan; Ibrahim, Rahimah

    2013-09-01

    Elder abuse is a pervasive phenomenon around the world with devastating effects on the victims. Although it is not a new phenomenon, interest in examining elder abuse is relatively new. This paper aims to provide an overview of the aetiological theories and measures of elder abuse. The paper briefly reviews theories to explain causes of elder abuse and then discusses the most commonly used measures of elder abuse. Based on the reviewed theories, it can be concluded that elder abuse is a multifactorial problem that may affect elderly people from different backgrounds and involve a wide variety of potential perpetrators, including caregivers, adult children, and partners. The review of existing measurement instruments notes that many different screening and assessment instruments have been developed to identify elders who are at risk for or are victims of abuse. However, there is a real need for more measurements of elder abuse, as the current instruments are limited in scope. © 2013 The Authors. Psychogeriatrics © 2013 Japanese Psychogeriatric Society.

  12. Human immunodeficiency virus infection and child sexual abuse

    African Journals Online (AJOL)

    Child sexual abuse (CSA) has not previously been regarded as important in the overall ... episode of abuse is unknown," but because of greater risk of mucosal trauma, the risk is .... Children and adolescents started on HIV PEP should receive sufficient ... A clear message should be proclaimed by all political and community ...

  13. Local macroeconomic trends and hospital admissions for child abuse, 2000-2009.

    Science.gov (United States)

    Wood, Joanne N; Medina, Sheyla P; Feudtner, Chris; Luan, Xianqun; Localio, Russell; Fieldston, Evan S; Rubin, David M

    2012-08-01

    To examine the relationship between local macroeconomic indicators and physical abuse admission rates to pediatric hospitals over time. Retrospective study of children admitted to 38 hospitals in the Pediatric Hospital Information System database. Hospital data were linked to unemployment, mortgage delinquency, and foreclosure data for the associated metropolitan statistical areas. Primary outcomes were admission rates for (1) physical abuse in children <6 years old, (2) non-birth, non-motor vehicle crash-related traumatic brain injury (TBI) in infants <1 year old (which carry high risk for abuse), and (3) all-cause injuries. Poisson fixed-effects regression estimated trends in admission rates and associations between those rates and trends in unemployment, mortgage delinquency, and foreclosure. Between 2000 and 2009, rates of physical abuse and high-risk TBI admissions increased by 0.79% and 3.1% per year, respectively (P ≤ .02), whereas all-cause injury rates declined by 0.80% per year (P < .001). Abuse and high-risk TBI admission rates were associated with the current mortgage delinquency rate and with the change in delinquency and foreclosure rates from the previous year (P ≤ .03). Neither abuse nor high-risk TBI rates were associated with the current unemployment rate. The all-cause injury rate was negatively associated with unemployment, delinquency, and foreclosure rates (P ≤ .007). Multicenter hospital data show an increase in pediatric admissions for physical abuse and high-risk TBI during a time of declining all-cause injury rate. Abuse and high-risk TBI admission rates increased in relationship to local mortgage delinquency and foreclosure trends.

  14. Risk factors

    International Nuclear Information System (INIS)

    Dennery, M.; Dupont, M.A.

    2007-01-01

    This article deals with the development of risk management in the gas sector business: why a risk factor legal mention must precede any published financial information? Do gas companies have to face new risks? Is there specific risks bound to gas activities? Why companies want to master their risks? Is it mandatory or just a new habit? Do they expect a real benefit in return? These are the risk management questions that are analyzed in this article which is based on the public communication of 15 gas companies randomly selected over the world. The information comes from their annual reports or from documents available on their web sites. The intention of this document is not to be exhaustive or to make statistics but only to shade light on the risk factors of the gas sector. (J.S.)

  15. Personal contextual characteristics and cognitions: predicting child abuse potential and disciplinary style.

    Science.gov (United States)

    Rodriguez, Christina M

    2010-02-01

    According to Social Information Processing theory, parents' cognitive processes influence their decisions to engage in physical maltreatment, although cognitions occur in the context of other aspects of the parents' life. The present study investigated whether cognitive processes (external locus of control, inappropriate developmental expectations) predicted child abuse potential and overreactive disciplinary style beyond personal contextual factors characteristic of the parent (hostility, stress, and coping). 363 parents were recruited online. Results highlight the relative importance of the contextual characteristics (particularly stress, avoidant coping, and irritability) relative to cognitive processes in predicting abuse potential and overreactive discipline strategies, although an external locus of control also significantly contributed. Findings do not support that parents' developmental expectations uniquely predict elevated abuse risk. Results indicate stressed parents who utilize avoidance coping strategies are more likely to use overreactive discipline and report increased abuse potential. Findings are discussed with regard to implications for prevention/intervention efforts.

  16. Dextromethorphan: a case study on addressing abuse of a safe and effective drug.

    Science.gov (United States)

    Spangler, David C; Loyd, Catherine M; Skor, Emily E

    2016-06-23

    Dextromethorphan is a safe, effective cough suppressant, available without a prescription in the United States since 1958. Due to a perceived prevalence of abuse of dextromethorphan by teens, in 2007 the Drug Enforcement Administration requested the Food and Drug Administration evaluate whether dextromethorphan should be recommended for scheduling under the Controlled Substances Act. The Food and Drug Administration held an Advisory Committee meeting in 2010 to provide a scientific and medical evaluation of dextromethorphan and its abuse potential. To address reports of abuse, particularly by teens in the United States, the Consumer Healthcare Products Association initiated an abuse mitigation plan in 2010 with specific goals related to awareness of the behavior, perception of risk, social disapproval, and access to the products. In identifying abuse interventions, experts acknowledge that substance abuse among teens is a highly complex behavior and indicate that the best course of action is to address prevention by focusing on the factors that impact teen behavior. It is noteworthy that the annual prevalence of over-the-counter cough medicine abuse has sharply decreased since 2010. While a true cause-and-effect relationship cannot be assured, the Consumer Healthcare Products Association and its member companies believe that the increased awareness of the issue since the 2010 Food and Drug Administration Advisory Committee meeting, and the subsequent implementation of a well-delivered and targeted abuse mitigation plan that addressed the levers influencing teen decisions is contributing to the observed reduction in abuse. During the period of 2010-2015, reported abuse of dextromethorphan by 8(th), 10(th), and 12(th) graders decreased 35 %. The authors believe this reduction supports the view of the Consumer Healthcare Products Association at the outset of the abuse mitigation plan effort and today: Controlled substance scheduling or prescription requirements would

  17. Impact of traumatic events on posttraumatic stress disorder among Danish survivors of sexual abuse in childhood.

    Science.gov (United States)

    Elklit, Ask; Christiansen, Dorte M; Palic, Sabina; Karsberg, Sidsel; Eriksen, Sara Bek

    2014-01-01

    Childhood sexual abuse can be extremely traumatic and lead to lifelong symptomatology. The present study examined the impact of several demographic, abuse, and psychosocial variables on posttraumatic stress disorder severity among a consecutive sample of treatment-seeking, adult child sexual abuse survivors (N = 480). The child sexual abuse sample was characterized by severe trauma exposure, insecure attachment, and significant traumatization, with an estimated 77% suffering from posttraumatic stress disorder, more than twice the level of the comparison group. Regression analyses revealed risk factors associated with the development of posttraumatic stress disorder in which the strongest predictors being additional traumas, negative affectivity, and somatization. The findings add to existing research confirming the stressful nature of child sexual abuse and the variables that contribute to the development and severity of posttraumatic stress disorder.

  18. Update on child abuse prevention.

    Science.gov (United States)

    Krugman, Scott D; Lane, Wendy G; Walsh, Christina M

    2007-12-01

    Child abuse remains a significant problem in the United States with 2.9 million reports and 825 000 indicated cases in 2005. This report will highlight recent efforts toward child abuse prevention, focusing on home visiting programs, abusive head trauma primary prevention, parent training programs, sexual abuse prevention, and the effectiveness of laws banning corporal punishment. Most home visitation programs have demonstrated a lack of effectiveness in recent randomized trials. One exception is the Nurse Family Partnership, which remains the most effective and longest enduring intervention for high-risk families. Child sexual abuse prevention programs and parent training programs need further evaluation with more rigorous methodology and outcome measures. Providing universal parent education about coping with crying infants appears to be effective in lowering the incidence of abusive head trauma. Although advocated for, further study will determine the effectiveness of laws banning corporal punishment or mandating abusive head trauma education to parents of newborns. Pediatricians play an important role in the prevention of child maltreatment. Their knowledge of the effectiveness of different programs can help guide parents toward appropriate services.

  19. Child and Family Factors Associated With Child Maltreatment in Vietnam

    OpenAIRE

    Tran, N.K. (Nhu K.); van Berkel, S.R. (Sheila R.); IJzendoorn, Rien; Alink, Lenneke R.A.

    2018-01-01

    textabstractThis study aims to explore possible risk factors for child maltreatment in Vietnam by investigating the association of child and family factors with different types of child maltreatment (i.e., sexual abuse, physical abuse, emotional abuse, witnessing parental conflict, and neglect) and the occurrence of multiple types of child maltreatment. Cross-sectional data of 1,851 secondary and high school students aged 12 to 17 years (47.3% boys) in four provinces of Northern Vietnam were ...

  20. Factors Related to Korean Nurses' Willingness to Report Suspected Elder Abuse

    Directory of Open Access Journals (Sweden)

    Chungmee Ko, PhD

    2012-09-01

    Conclusion: As the Welfare of the Aged Act included a clause on mandated reporters, nurses' role in intervening in elder abuse cases has become more critical. In order to increase nurses' reporting, education on elder abuse should be provided to all nurses, and support programs should be designed for nurses to effectively involve them in reporting elder abuse.

  1. Is impulsivity a link between childhood abuse and suicide?

    Science.gov (United States)

    Braquehais, M Dolores; Oquendo, Maria A; Baca-García, Enrique; Sher, Leo

    2010-01-01

    Childhood abuse and neglect are known to affect psychological states through behavioral, emotional, and cognitive pathways. They increase the risk of having psychiatric diseases in adulthood and have been considered risk factors for suicidal behavior in all diagnostic categories. Early, prolonged, and severe trauma is also known to increase impulsivity, diminishing the capacity of the brain to inhibit negative actions and to control and modulate emotions. Many neurobiological studies hold that childhood maltreatment may lead to a persistent failure of the inhibitory processes ruled mainly by the frontal cortex over a fear-motivated hyperresponsive limbic system. Multiple neurotransmitters and hormones are involved in the stress response, but, to our knowledge, the two major biological consequences of the chronic exposure to trauma are the hypofunction of the serotonergic system and changes in the hypothalamic-pituitary-adrenal axis function. Some of these findings overlap with the neurobiological features of impulsivity and of suicidal behavior. Impulsivity has also been said to be both a consequence of trauma and a risk factor for the development of a pathological response to trauma. Thus, we suggest that impulsivity could be one of the links between childhood trauma and suicidal behavior. Prevention of childhood abuse could significantly reduce suicidal behavior in adolescents and adults, in part, through a decrease in the frequency of impulsive behaviors in the future. Copyright 2010 Elsevier Inc. All rights reserved.

  2. Epidemiology of drug abuse treatment in South Africa

    Directory of Open Access Journals (Sweden)

    Shandir Ramlagan

    2010-04-01

    Full Text Available Background. The aim of the study was to explore the epidemiology of drug abuse treatment in South Africa. Methods. Treatment demand statistics were analysed from South African National Council on Alcoholism and Drug Dependence and the South African Community Epidemiology Network on Drug Use records, and a rapid situation assessment was conducted. Twenty-one key informant interviews were conducted in all 9 provinces among provincial substance abuse co-ordinators, and one manager per treatment centre from a sample of treatment centres. Three focus groups were conducted and 46 self-administered questionnaires were distributed among inpatients at 2 selected treatment centres in Free State and North West provinces. Qualitative data were analysed using grounded theory, and quantitative data analysed using SPSS. Results. Treatment records show that the most frequent substance of abuse was alcohol (51%, followed by cannabis (21%, crack/cocaine (9.6%, heroin/opiates (7.9%, methamphetamine (Tik (4.5%, prescription/over-the-counter drugs (2.0%, and cannabis/mandrax (1.7%. More substance abusers were male, of lower education, white or black, than were female, more highly educated, coloured and Indian/Asian. Key informant interviews showed that females are the ‘hidden’ substance abusers and tend not to be identified in research statistics and at treatment centres. Poverty, unemployment, lack of recreational facilities, being surrounded by substance abusers, and long work shifts were also mentioned as factors contributing to substance abuse. The age of initiation of substance abuse using non-drugs such as glue was 9 years old, alcohol 10 - 12 years old, dagga 11 - 12 years old, poly-drug use (alcohol, tobacco and dagga 14 years old, and harder drugs such as cocaine and heroin at 16 - 17 years old, as reported by key informants. Family care and support, improved socio-economic conditions and increased law enforcement would help to discourage substance

  3. A cross-national exploration of societal-level factors associated with child physical abuse and neglect.

    Science.gov (United States)

    Klevens, Joanne; Ports, Katie A; Austin, Chelsea; Ludlow, Ivan J; Hurd, Jacqueline

    2017-11-28

    Children around the world experience violence at the hands of their caregivers at alarming rates. A recent review estimates that a minimum of 50% of children in Asia, Africa, and North America experienced severe physical violence by caregivers in the past year, with large variations between countries. Identifying modifiable country-level factors driving these geographic variations has great potential for achieving population-level reductions in rates of child maltreatment. This study builds on previous research by focusing on caregiver-reported physical abuse and neglect victimisation, examining 22 societal factors representing 11 different constructs among 42 countries from 5 continents at different stages of development. Our findings suggest that gender inequity may be important for both child physical abuse and neglect. Indicators of literacy and development may also be important for child neglect. Given the limitations of the correlational findings and measurement issues, it is critical to continue to investigate societal-level factors of child maltreatment so that interventions and prevention efforts can incorporate strategies that have the greatest potential for population-level impact.

  4. Childhood maltreatment as a risk factor for COPD: findings from a population-based survey of Canadian adults

    Directory of Open Access Journals (Sweden)

    Shields ME

    2016-10-01

    Full Text Available Margot E Shields, Wendy E Hovdestad, Charles P Gilbert, Lil E Tonmyr Public Health Agency of Canada, Ottawa, ON, Canada Objective: The aim of this study was to examine the associations between childhood maltreatment (CM and COPD in adulthood.Methods: Data were from 15,902 respondents to the 2012 Canadian Community Health Survey – Mental Health. Multiple logistic regression models were used to examine associations between CM and COPD and the role of smoking and mental and substance use variables as mediators in associations.Results: COPD in adulthood was related to CM, with associations differing by sex. Among females, COPD was related to childhood physical abuse (CPA, childhood sexual abuse, and childhood exposure to intimate partner violence, but in the fully adjusted models, the association with CPA did not persist. Among males, COPD was related to childhood exposure to intimate partner violence and severe and frequent CPA, but these associations did not persist in the fully adjusted models.Conclusion: Results from this study establish CM as a risk factor for COPD in adulthood. A large part of the association is attributable to cigarette smoking, particularly for males. These findings underscore the importance of interventions to prevent CM as well as programs to assist victims of CM in dealing with tobacco addiction. Keywords: child abuse, cigarette, smoking, physical abuse, sexual abuse, intimate partner violence, domestic violence, family violence

  5. Hostility Ratings by Parents at Risk for Child Abuse: Impact of Chronic and Temporary Schema Activation

    Science.gov (United States)

    Farc, Maria-Magdalena; Crouch, Julie L.; Skowronski, John J.; Milner, Joel S.

    2008-01-01

    Objective: Two studies examined whether accessibility of hostility-related schema influenced ratings of ambiguous child pictures. Based on the social information processing model of child physical abuse (CPA), it was expected that CPA risk status would serve as a proxy for chronic accessibility of hostile schema, while priming procedures were used…

  6. Gender Differences in Risk/Protection Profiles for Low Academic Performance

    Science.gov (United States)

    Whitney, Stephen D.; Renner, Lynette M.; Herrenkohl, Todd I.

    2010-01-01

    Using holistic-interactionistic theory, the simultaneous nature of risk and protection factors for both males and females (age 6-11 in Wave 1) is examined using latent profile analysis (LPA). Risk/protection classes are estimated using multiple risk factor variables (e.g., physical child abuse) and multiple protective factors (e.g.,…

  7. Organizational factors and collaboration and integration activities in criminal justice and drug abuse treatment agencies.

    Science.gov (United States)

    Lehman, Wayne E K; Fletcher, Bennett W; Wexler, Harry K; Melnick, Gerald

    2009-08-01

    Despite strong interest in improving collaborations between correctional and substance abuse treatment organizations, there is a lack of empirical data describing the existing practices. The current study used a national survey of correctional administrators to examine organizational factors related to cross-agency collaboration and integration activities between corrections and substance abuse treatment organizations. Using a measure of collaboration that scaled cross-agency activities from less structured, informal networking and coordination to more structured and formalized levels of cooperation and collaboration, we found that different correctional settings (e.g., community corrections, jails, prisons) differed significantly in terms of their collaborative activities with substance abuse treatment agencies. We also found that the organizational characteristics that were associated with different levels of collaboration and integration differed across the correctional settings. Further research is needed to better understand how and why correctional agencies decide to formalize collaborative arrangements with treatment agencies and whether these efforts lead to more favorable outcomes.

  8. Elder abuse telephone screen reliability and validity.

    Science.gov (United States)

    Buri, Hilary M; Daly, Jeanette M; Jogerst, Gerald J

    2009-01-01

    (a) To identify reliable and valid questions that identify elder abuse, (b) to assess the reliability and validity of extant self-reported elder abuse screens in a high-risk elderly population, and (c) to describe difficulties of completing and interpreting screens in a high-need elderly population. All elders referred to research-trained social workers in a community service agency were asked to participate. Of the 70 elders asked, 49 participated, 44 completed the first questionnaire, and 32 completed the duplicate second questionnaire. A research assistant administered the telephone questionnaires. Twenty-nine (42%) persons were judged abused, 12 (17%) had abuse reported, and 4 (6%) had abuse substantiated. The elder abuse screen instruments were not found to be predictive of assessed abuse or as predictors of reported abuse; the measures tended toward being inversely predictive. Two questions regarding harm and taking of belongings were significantly different for the assessed abused group. In this small group of high-need community-dwelling elders, the screens were not effective in discriminating between abused and nonabused groups. Better instruments are needed to assess for elder abuse.

  9. A COMPREHENSIVE ANALYSIS DIABETES OF RISK FACTORS IN PATIENTS WITH CHRONIC PANCREATITIS

    Directory of Open Access Journals (Sweden)

    M. A. Kunitsyna

    2012-01-01

    Full Text Available Aim – to perform comprehensive analysis of the risk factors of diabetes mellitus (DM in patients with chronic pancreatitis (CP. Materials and methods. All examined patients with chronic pancreatitis (CP were divided into 2 groups. The first group – 38 patients with the progression of the diabetes in the first 3 years of the CP, the second – 44 people with no diabetes after 10 years of disease. Formation of CP etiologic groups based on the mandatory presence of one of two factors: alcohol abuse, the presence of disease of biliary system. The combination of two etiological factors wasl exclusion criteria. Results and conclusion. Among the examined patients biliary form of CP occurred in 52 patients, alcohol – in 30 patients. It was found that in the first three years of CP risk of diabetes is not associated with family history, obesity, number of exacerbations, but in the form of alcoholic CP DM formed almost two times more often than in the biliary. When combined with CP in patients with diabetes were significantly more common strain of the main flow and structural changes in the tail of the pancreas.

  10. Mental disorder prevalence and associated risk factors in three prisons of Spain

    Directory of Open Access Journals (Sweden)

    M.C. Zabala-Baños

    2016-06-01

    Full Text Available Aims: To determine the lifetime and monthly prevalence of people with mental disorders and its association with sociodemographic factors and criminal risk in three Spanish prisons (Ocaña, Madrid I, II and VI. Method: Cross-sectional epidemiological study of a sample of 184 inmates. Socio-demographic and criminal data were collected by an ad hoc interview. Mental disorders were assessed with the clinical version of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders Axis I Disorders (SCID-I. Results: Life prevalence of mental disorders was 90.2%. The most common mental disorders and substance abuse or dependence was 72.3%, followed by mood disorder (38.5% and psychotic disorders (34.2%. Moreover, the prevalence of any mental disorder in the last month was 52.2%. The main psychotic disorder (20.7% was followed by substance abuse or dependence (18.5%, and mood disorder state (13%. A socio-demographic profile as a risk for each disorder was found. Discussion: The prevalence of people with mental disorders is very high in Spanish prisons, and is associated with a distinct demographic profile. It is essential to continue researching this reality, translating the results into therapeutic and preventive action adapted to the status of inmates to reduce social inequalities in this high priority public health situation.

  11. Forensic and family psychiatry in abuse dwarfism: Munchausen's syndrome by proxy, atonement, and addiction to abuse.

    Science.gov (United States)

    Money, J; Annecillo, C; Hutchison, J W

    1985-01-01

    The syndrome of abuse dwarfism is characterized by gross impairment of statural and intellectual growth and social maturation while the abused child remains in the domicile of abuse. The parents collude as child abusers, and are medical impostors regarding the symptoms of abuse. The syndrome as a whole is appropriately named Munchausen's syndrome by proxy. Though the mother typically initiates abuse, she cannot give a rational explanation for doing so. In her own history there is a sin that is expiated or atoned for symbolically by the sacrifice of the child--explainable in terms of the theory of opponent-process learning. In the two cases presented, the sin was the mother's own birth out of wedlock, in one case as a sequel to incest. The child's addiction to abuse is a challenge to the program of rehabilitation. With respect to parents at risk, the data of this paper are relevant to the prevention of a predisposition toward, or the actual implementation of child abuse, though a program of prevention needs still to be formulated. The sexological relevance of this paper is that the data demonstrate that the effects of sexual abuse may be transmitted to the next generation and manifested as child abuse which is not necessarily sexual in content.

  12. Preventing child abuse: psychosocial description of clients of brief intervention programs in Chile

    Directory of Open Access Journals (Sweden)

    Esteban Gómez

    2010-02-01

    Full Text Available The study describe characteristics and risk factors for child abuse and neglect,in 591 children and adolescents, their parents and families served by eight brief intervention programs (PIB “Viviendo en Familia”, funded by the Chilean National Service of Children (SENAME and implemented by Protectora de la Infancia (a non-profit organization in Chile. The results revealed the existence of problems of moderate complexity, on the environment,parental competencies, family interactions, family safety and child well-being. About three of each four caregivers show signs of high risk for the abuse or neglect of children, especially in their mental health, a topic that must be considered by the staff to develop a plan of coordinated work with the local network of health services.

  13. Risk Factors for Scleroderma

    Science.gov (United States)

    ... You are here: Home For Patients Risk Factors Risk Factors for Scleroderma The cause of scleroderma is ... what biological factors contribute to scleroderma pathogenesis. Genetic Risk Scleroderma does not tend to run in families ...

  14. Risk Factors and Prevention

    Science.gov (United States)

    ... Resources Risk Factors & Prevention Back to Patient Resources Risk Factors & Prevention Even people who look healthy and ... Blood Pressure , high cholesterol, diabetes, and thyroid disease. Risk Factors For Arrhythmias and Heart Disease The following ...

  15. Risk factors for deep surgical site infection following operative treatment of ankle fractures.

    Science.gov (United States)

    Ovaska, Mikko T; Mäkinen, Tatu J; Madanat, Rami; Huotari, Kaisa; Vahlberg, Tero; Hirvensalo, Eero; Lindahl, Jan

    2013-02-20

    Surgical site infection is one of the most common complications following ankle fracture surgery. These infections are associated with substantial morbidity and lead to increased resource utilization. Identification of risk factors is crucial for developing strategies to prevent these complications. We performed an age and sex-matched case-control study to identify patient and surgery-related risk factors for deep surgical site infection following operative ankle fracture treatment. We identified 1923 ankle fracture operations performed in 1915 patients from 2006 through 2009. A total of 131 patients with deep infection were identified and compared with an equal number of uninfected control patients. Risk factors for infection were determined with use of conditional logistic regression analysis. The incidence of deep infection was 6.8%. Univariate analysis showed diabetes (odds ratio [OR] = 2.2, 95% confidence interval [CI] = 1.0, 4.9), alcohol abuse (OR = 3.8, 95% CI = 1.6, 9.4), fracture-dislocation (OR = 2.0, 95% CI = 1.2, 3.5), and soft-tissue injury (a Tscherne grade of ≥1) (OR = 2.6, 95% CI = 1.3, 5.3) to be significant patient-related risk factors for infection. Surgery-related risk factors were suboptimal timing of prophylactic antibiotics (OR = 1.9, 95% CI = 1.0, 3.4), difficulties encountered during surgery, (OR = 2.1, 95% CI = 1.1, 4.0), wound complications (OR = 4.8, 95% CI = 1.6, 14.0), and fracture malreduction (OR = 3.4, 95% CI = 1.3, 9.2). Independent risk factors for infection identified by multivariable analyses were tobacco use (OR = 3.7, 95% CI = 1.6, 8.5) and a duration of surgery of more than ninety minutes (OR = 2.5, 95% CI = 1.1, 5.7). Cast application in the operating room was independently associated with a decreased infection rate (OR = 0.4, 95% CI = 0.2, 0.8). We identified several modifiable risk factors for deep surgical site infection following operative treatment of ankle fractures.

  16. Personal, social and environmental risk factors of problematic gambling among high school adolescents in Addis Ababa, Ethiopia.

    Science.gov (United States)

    Abdi, Tariku A; Ruiter, Robert A C; Adal, Tamirie A

    2015-03-01

    Understanding risk factors of problematic gambling is prerequisite to effective intervention design to alleviate the negative consequences of gambling. This study explored the personal, social and environmental risk factors of problematic gambling in four high schools in Addis Ababa, Ethiopia, among students (N = 422) ranging from 12 to 21 years of age. Results from the cross-sectional survey showed that personal feelings (e.g., self-esteem, false perceptions about winning, drug abuse), social factors (e.g., peer influence, parental gambling), and environmental factors (e.g., accessibility of gambling venues, advertisements) were significant correlates of problematic gambling. The study also revealed that men were more at risk for severe problematic gambling than females. Among the identified types of gambling activities, the most prevalent ones were playing cards followed by flipping coin and pool gambling while internet gambling was among the least reported gambling activities. By identifying personal, social and environmental correlates of risky gambling activities this study provides evidence-based information for the systematic design and evaluation of educational interventions to prevent problematic gambling in young people.

  17. The neglected sociobehavioral risk factors of low birth weight

    Directory of Open Access Journals (Sweden)

    Mohsen Momeni

    2016-08-01

    Full Text Available Background: Low Birth Weight (LBW is one of the most important health indicators in the world. It has certain known and unknown causes. The present study was designed to evaluate the role of socio-behavioral factors on neonatal birth weight.Methods: The current case-control study was conducted on 300 eligible neonates (150 LBW infants as cases and 150 normal body weight infants as controls in 2015. The national pregnancy care forms of the neonates kept in heath care centers in Kerman were used. The data was analyzed running Independent samples t-test, Chi square test, and Fisher’s Exact test in SPSS. The significance level was set as 0.05.Results: Preterm birth (P<0.001, number of primary care during pregnancy (P=0.001, mother’s age (P=0.049, consumption of supplements during pregnancy (P=0.03, and history of substance abuse in mothers (P=0.03 were found to have significant roles in having LBW neonate.Conclusion: Identifying the sociobehavioral risk factors of Preterm labor and modifying them to prevent preterm birth are essential approaches to prevent LBW. Governments should pay special attention to nutritional status of teenage and young girls to have healthy mothers and babies in the future. Women of childbearing age should be screened and educated about risky behaviors. Pregnancy care and support should be delivered to all pregnant women according to the standard methods.Keywords: Low Birth Weight; Risk Factors; Behavior; Preterm Labor

  18. Current information on the scope and nature of child sexual abuse.

    Science.gov (United States)

    Finkelhor, D

    1994-01-01

    Approximately 150,000 confirmed cases of child sexual abuse were reported to child welfare authorities in the United States during 1993. This number represents about 15% of the more than one million confirmed cases of all child abuse and neglect. But the true scope of this problem is better reflected in retrospective surveys of adults, and this article summarizes data from 19 of these surveys. Considerable evidence exists to show that at least 20% of American women and 5% to 10% of American men experienced some form of sexual abuse as children. The rates are somewhat lower among people born before World War II, but there is little evidence of a dramatic increase for recent generations. The studies provide little evidence that race or socioeconomic circumstances are major risk factors. They do show elevated risk for children who experienced parental inadequacy, unavailability, conflict, harsh punishment, and emotional deprivation. Adult retrospective studies are also good sources of information about the characteristics of abuse. Most sexual abuse is committed by men (90%) and by persons known to the child (70% to 90%), with family members constituting one-third to one-half of the perpetrators against girls and 10% to 20% of the perpetrators against boys. Family members constitute a higher percentage of the perpetrators in child protective agency cases because the mandate of these agencies generally precludes their involvement in extrafamily abuse. Around 20% to 25% of child sexual abuse cases involve penetration or oral-genital contact. The peak age of vulnerability is between 7 and 13. Studies of the criminal justice processing of sexual abusers suggest that, compared with other violent criminals, slightly fewer are prosecuted, but of those prosecuted, slightly more are convicted. Studies conducted in the 1980s also showed that, once convicted, relatively few sexual abusers receive sentences longer than one year, while 32% to 46% serve no jail time. Overall, there

  19. What factors determine Belgian general practitioners' approaches to detecting and managing substance abuse? A qualitative study based on the I-Change Model.

    Science.gov (United States)

    Ketterer, Frederic; Symons, Linda; Lambrechts, Marie-Claire; Mairiaux, Philippe; Godderis, Lode; Peremans, Lieve; Remmen, Roy; Vanmeerbeek, Marc

    2014-06-14

    General practitioners (GPs) are considered to play a major role in detecting and managing substance abuse. However, little is known about how or why they decide to manage it. This study investigated the factors that influence GP behaviours with regard to the abuse of alcohol, illegal drugs, hypnotics, and tranquilisers among working Belgians. Twenty Belgian GPs were interviewed. De Vries' Integrated Change Model was used to guide the interviews and qualitative data analyses. GPs perceived higher levels of substance abuse in urban locations and among lower socioeconomic groups. Guidelines, if they existed, were primarily used in Flanders. Specific training was unevenly applied but considered useful. GPs who accepted abuse management cited strong interpersonal skills and available multidisciplinary networks as facilitators.GPs relied on their clinical common sense to detect abuse or initiate management. Specific patients' situations and their social, psychological, or professional dysfunctions were cited as cues to action.GPs were strongly influenced by their personal representations of abuse, which included the balance between their professional responsibilities toward their patients and the patients' responsibilities in managing their own health as well the GPs' abilities to cope with unsatisfying patient outcomes without reaching professional exhaustion. GPs perceived substance abuse along a continuum ranging from a chronic disease (whose management was part of their responsibility) to a moral failing of untrustworthy people. Alcohol and cannabis were more socially acceptable than other drugs. Personal experiences of emotional burdens (including those regarding substance abuse) increased feelings of empathy or rejection toward patients.Multidisciplinary practices and professional experiences were cited as important factors with regard to engaging GPs in substance abuse management. Time constraints and personal investments were cited as important barriers

  20. Bilateral testicular self-castration due to cannabis abuse: a case report

    Directory of Open Access Journals (Sweden)

    Stuurman-Wieringa Roos E

    2011-08-01

    Full Text Available Abstract Introduction The self-mutilating patient is an unusual psychiatric presentation in the emergency room. Nonetheless, serious underlying psychiatric pathology and drug abuse are important background risk factors. A careful stepwise approach in the emergency room is essential, although the prognosis, follow-up, and eventual rehabilitation can be problematic. We present a unique and original case of bilateral self-castration caused by cannabis abuse. Case Presentation We report a case of a 40-year-old Berber man, who was presented to our emergency room with externalization of both testes using his long fingernails, associated with hemodynamic shock. After stabilization of his state, our patient was admitted to the operating room where hemostasis was achieved. Conclusion The clinical characteristics of self-mutilation are manifold and there is a lack of agreement about its etiology. The complex behavior associated with drug abuse may be one cause of self-mutilation. Dysfunction of the inhibitory brain circuitry caused by substance abuse could explain why this cannabis-addicted patient lost control and self-mutilated. To the best of our knowledge, this is the first case report which presents an association between self-castration and cannabis abuse.