Somatización, ansiedad y depresión en mujeres víctimas de violencia de pareja íntima / Somatization, anxiety and depression in women victims of intimate partner violence

Resumen A pesar de que la violencia de pareja íntima (VPI) presenta en la mujer una variedad de síntomas evidenciables, varios de los actores involucrados en el sistema de salud no cuentan con mecanismos de evaluación temprana, ni de reconocimiento de los tipos de secuelas psicológicas, entre los que se incluye una diversa sintomatología psicofisiológica. Con el objetivo de conocer las características de somatización, ansiedad y depresión en mujeres víctimas de VPI, como parte de una investigación macro de corte transversal no experimental de campo, se realizó el presente estudio cuantitativo correlacional a través de las variables del Inventario de Evaluación de la Personalidad (PAI). Los datos obtenidos se sometieron a análisis estadístico con métodos descriptivos e inferenciales. La muestra consta de 50 mujeres de la población de víctimas de VPI de la sierra ecuatoriana. Los resultados obtenidos son bastante contradictorios en cuanto al bajo porcentaje de mujeres con afectación típica relacionada con este tipo de violencia, en comparación con los datos presentados por otros autores sobre los niveles de somatización, ansiedad y depresión en ellas. A pesar de esto, se obtuvieron tres factores independientes presentes en esta muestra: trastorno ansioso-depresivo, con elementos de estrés postraumático; trastorno obsesivo compulsivo, con elementos de ansiedad, y quejas somáticas. Al momento de finalizar este estudio, se puede concluir que el PAI, sin su validación previa en esta población, no muestra una idoneidad suficiente para evaluar mujeres víctimas de VPI en el Ecuador. Se recomiendan nuevas investigaciones en otras muestras, en las que se utilicen diversos esquemas empíricos que incluyan varios instrumentos y medios cualitativos.

Abstract Various studies have noticed that women victims of intimate partner violence (IPV) also report having various types of health-related problems. However, health systems do not appear to have established procedures to recognize these problems (i. e., psychophysiological) in women. This study assessed somatic symptoms, anxiety, and depressive characteristics in women who have been victims of IPV. These symptoms were assessed using the scales of the Personality Assessment Inventory (PAI). The sample consisted of 50 women victims of IPV from the Ecuadorian sierra. Group participants came from two different cities: the first group included 28 women victims of IPV from Riobamba. Their ages ranged from 15 to 58. These women were receiving psychological services from a not-for-profit organization in the city. The second group included 22 women with similar characteristics between the ages of 27-63. This group of women came from the southern regions of Quito, the capital city of Ecuador. Women in this group were receiving services from two different places offering help to women experiencing IPV. Sixteen percent of women reported having a medium level of "anxiety" (some level of stress), and 14 % reported having a high level of tension and stress. Thirty-four percent of women reported medium levels of "anxiety-related disorders". These women reported having specific fears, little confidence in themselves and negative perspectives of their future. Sixteen percent of the women reported high levels of anxiety. They reported imitations in daily life (i. e., specific fears and feelings of insecurity in social situations). Thirty percent of women reported having medium levels of "depression" (sensitivity, pessimism, and feeling unhappy part of the time). Eighteen percent of women reported having high levels of "depression" (notable unhappiness and dysphoria). Forty-four percent of women in this study reported having some type of physical problem. These findings suggest that women who are victims of IPV could benefit from receiving mental health services aimed at managing their tension, stress, specific fears, and symptoms of depression. They also suggest that women victims of IPV could benefit from receiving training to increase their social competency and medical assistance to address their somatic complaints. Findings in this study are somewhat divergent from the results observed in previous investigations. Previous studies identified that most women who experienced IPV report symptoms of depression and anxiety. However, in this study, only a relatively low percentage of women reported having these symptoms. The sole utilization of the PAI as a method of evaluation may not have been sufficient to identify these symptoms. These results suggest the importance of using qualitative methods (i. e., clinical interview) or more holistic methodologies (i. e., clinical interview and tests) to better assess mental health symptoms in this group of women. It is also possible that the PAI might not be the most adequate tool to assess these symptoms in this population. The results of this investigation do reveal the importance of evaluating other mental health symptoms in women victims of IPV: post-traumatic stress, and obsessive-compulsive disorder. Future studies should focus on assessing these symptoms using other assessment methodologies (e. g. instruments designed to assess post-traumatic stress and obsessive-compulsive disorder). The efficiency of health systems evaluations and interventions depends on the methodologies used to assess problems. The sole use of one instrument such as the PAI may not provide sufficient information about symptoms experienced by women experiencing IPV. Health systems should use batteries of instruments in conjunction with the clinical interviewing processes to readily assess symptoms. However, such an alternative may not be entirely feasible taking into account that such methodology requires more time and likely financial support to acquire tests.

La violencia. Cómo la asumen y enfrentan un grupo de jóvenes universitarios mexicanos. Estudio cualitativo / Violence: how a group of young mexican university students face and assume it. A qualitative study

Resumen A raíz de la problemática derivada de la violencia social vivida en México, surge una línea de investigación en la Facultad de Psicología Xalapa (Universidad Veracruzana, México) con la finalidad de examinar los requerimientos de atención psicosocial que demanda la población afectada por este fenómeno social; para ser contemplados en el currículo de los futuros psicólogos. En este artículo, se presentan resultados parciales de la investigación, usando una metodología cualitativa. Donde se privilegió el uso de grupos focales con estudiantes de pregrado de psicología, se coleccionaron sus vivencias respecto de la violencia social que padecieron en su región. La muestra fue intencional, conformada por 16 jóvenes de entre los 19 y 24 años de edad, ocho mujeres y ocho hombres. Se realizó análisis del discurso, creando categorías derivadas de la información colectada. Dentro de los resultados destaca que: el 100 % de los estudiantes tuvo al menos una experiencia de violencia social, la tercera parte de los participantes, vivió dos o tres situaciones que involucran entre otras: intento de secuestro, robo a mano armada, ser testigo de asesinato y/o balaceras e intimidación por parte de cuerpos policiacos. Adicionalmente se identificaron dos formas básicas de reaccionar ante estas circunstancias: la evasión y la organización social. Discusión: Frente a estos hallazgos, se discute la pertinencia de utilizar el concepto de sobreviviente sobre el de víctima, comúnmente utilizado por la literatura; dado que este último, está asociado a la vivencia pasiva de una situación de violencia.

Abstract Due to the multiple problems generated by social violence in Mexico, a new research topic was originated in the Faculty of Psychology in Xalapa (Universidad Veracruzana, Mexico) with the main goal of examining the requirements of psychosocial care wanted and needed by the persons who are affected by this social phenomenon; in order to include these requirements in the curricula of future psychologists. Partial results of the research are presented in this paper, using a qualitative approach. Focus groups with undergraduate psychology students where the applied research method to collect the students experience regarding social violence in Mexico. The sample was intentional, consisting of 16 young people between 19 and 24 years old, eight women and eight men. The discourse analysis of the Focus Groups allowed to classify the collected information. It stands out that 100% of the students had experienced social violence at least once; one third had experienced 2 or 3 events that involved kidnap attempt, armed robbery, witnessing a homicide and/or a shooting and being intimidated by police force. Additionally have been identified two basic ways of response to these violent events: evasion and social organization. Discussion: based on the findings, the pertinence of using the term survivor instead of victim (commonly used in literature) is discussed; since the last one is associated more with a passive response to a violent event.

Atendimento pré-hospitalar ao idoso vítima de violência em cinco capitais brasileiras / Pre-hospital attendance to elders victims of violence in five Brazilian capitals

This article reviews the characteristics and operation in the daily routine of a pre-hospital care to the elderly victims of violence and accidents in five capitals (Manaus, Recife, Brasília, Rio de Janeiro and Curitiba). Besides that, it analyses their abilities, and potential obstacles. It was based on the triangulation of quantitative and qualitative methods analyzing data from 80 departments of mobile and fixed pre-hospitals: 32 in Manaus, 18 in Recife, 10 in Brasilia, 12 in Rio de Janeiro and eight in Curitiba. Among the findings are the differences in size and diversity of occupational categories and difficulties of the teams to identify, serve and report cases for lack of training, limited preventive action, almost no involvement and guidance to the family, practically no attention to the perpetrator; incipient articulation and partnership network, especially regarding on pre-hospital services and the hospital.

Este artigo analisa as características e a operacionalização no cotidiano da atenção pré-hospitalar aos idosos vítimas de violências e acidentes de cinco capitais (Manaus, Recife, Brasília, Rio de Janeiro e Curitiba), abordando ainda suas capacidades, seus obstáculos e potencialidades. Pautou-se na triangulação de métodos quantitativos e qualitativos. Analisaram-se dados de oitenta serviços da atenção pré-hospitalar móvel e fixa: 32 em Manaus; 18 em Recife; dez em Brasília; 12 no Rio de Janeiro e oito em Curitiba. Entre os achados estão as diferenças (de tamanho e diversidade de categorias profissionais) e dificuldades das equipes para identificar, atender e notificar os casos por falta de capacitação; pouca atuação preventiva; quase nenhum envolvimento com a família e orientação a ela; praticamente nenhum atendimento ao autor da agressão; incipiente articulação e parcerias da rede, sobretudo dos serviços pré-hospitalares com os hospitalares.

Development of clinical forensic medicine in India A need of time.

Forensic medicine is the medical specialty that is practiced at the interface with the law. It involves the assessment and interpretation in an individual who has become involved either as a suspect or victim in some form of alleged criminal action. In practice however, the role of practitioners of forensic medicine has widened to include civil jurisdictions and matters of medical ethics. Clinical Forensic Medicine is the application of forensic medical techniques to living. To address the un-met forensic needs of victims who are survivors of violent crimes and trauma there is urgent need of examination of victims of violence by a specially trained person in medicolegal matters i.e. clinical forensic physicians. In this program, the clinical forensic physicians will evaluate adult and pediatric victims of blunt and penetrating trauma, sexual and physical abuse and collect evidentiary material when indicated. In this paper the importance of Clinical Forensic Medicine Program and recommendations made by the “Survey Committee Report on Medico-Legal Practices in India, 1964” regarding its implementation are presented.