Mental health issues in recently returning women veterans: implications for practice.

Increasing numbers of women are found in the military, and they are now performing roles very similar to those of male service members. More returning servicewomen and veterans have been exposed to stressful and traumatic experiences, such as combat and difficult living circumstances, and military sexual trauma is common. These experiences have been found to be associated with adverse mental health outcomes, posttraumatic stress disorder, depression, and substance abuse in particular. Comorbidity rates are also high. In addition, more veterans are returning with injuries, including traumatic brain injuries. Although more women veterans of Operation Enduring Freedom and Operation Iraqi Freedom are seeking health services at Veterans Administration facilities, many are not. Thus, community-based social workers need to be familiar with the needs of this growing population to serve them effectively. Use of empirically supported assessment instruments and screening for military sexual trauma are recommended. Recommended interventions include the use of evidence-supported practices, such as cognitive-behavioral treatment, and offering assistance to enhance social support among women veterans.

A risk and resilience perspective on unaccompanied refugee minors.

In the United States, unaccompanied refugee minors (URMs) are a diverse and extremely vulnerable group served by social workers about whom there is little research. URMs enter the United States from many lands without parents or kin, often having experienced war and other traumatic events. Using a risk and resilience framework, we summarize the research on URMs, illustrating the challenges and issues with a case study of a resilient Lost Boy from Sudan who became a social worker. We discuss strengths, coping strategies, and resilience, exploring the ways in which many URMs are able to effectively meet the challenge of adapting to a new country and culture, thriving despite the extreme adversity they have experienced, as well as sources of resilience within URMs that have allowed them to adapt and even thrive in a vastly different cultural environment despite exposure to multiple risks. These sources of resilience include positive outlook, use of healthy coping mechanisms and religiosity, and connectedness to prosocial organizations. We conclude with recommendations for social work research to better understand the nature of risk and resilience among URMs.

Are We Misjudging How Well Informed Consent Forms are Read?

UNDERSTANDING THAT INFORMED CONSENT forms are provided to be read and comprehended, this study compares the research assistant's perception of comprehension with the actual time potential participants spend reading their consent form. After providing information verbally to two samples of women, research assistants observed as the women reviewed and signed the consent form recording the time spent reading and the assistant's impression of reading behavior. Over half of the women "read" their consent forms in thirty seconds or less before signing. Despite the brief time participants actually read, research assistants reported that 38%-74% (depending on the sample) appeared to have completely read the forms. Research to determine if timing aids will improve research assistants' assessment of participant reading behaviors should be considered.

Sibling incest: reports from forty-one survivors.

An exploratory study was conducted with a convenience sample of 41 adult survivors of sibling incest using a retrospective survey design. Participants were interviewed about their childhood sexual experiences with a sibling. Most participants reported vaginal or oral intercourse and coercive experiences. Half of the sample reported sexual experiences with family members, as well as other child abuse. Half of the participants showed evidence of distorted beliefs about child sexual abuse. Disclosure of the incest during childhood was rare. doi:10.1300/ J070v15n04_02.

Attitudes and beliefs about domestic violence: results of a public opinion survey: I. Definitions of domestic violence, criminal domestic violence, and prevalence.

This study reports analyses and findings from a public opinion survey designed to explore beliefs about domestic violence (DV)-what it is, when it is against the law, and how prevalent it is. The project interviewed 1,200 residents from six New York communities. The analyses reveal substantial firsthand and secondhand experience with DV and strong consensus that acts of physical aggression should be labeled as DV, but substantially less certainty about the illegality of the abusive behaviors. Overall, the respondents were less inclined to define women's aggressive behavior in pejorative or unlawful terms than men's. Respondents believed that DV was common in their communities, and that it affected a significant minority of couples. Multivariate analyses provide little support for conventional wisdom about the impact of socioeconomic background on tolerance for or knowledge about DV, although gender, generation, and secondhand familiarity with DV incidents play a role in opinions and beliefs.

Attitudes and beliefs about domestic violence: results of a public opinion survey: II. Beliefs about causes.

This report presents findings from a public opinion survey designed to measure beliefs about the causes of domestic violence (DV) based on telephone interviews with 1,200 residents across six New York State communities. Findings reveal substantial diversity and complexity among beliefs and interesting similarities and differences across open- and close-ended questions regarding explanations for partner abuse. Most respondents think about the causes of violence in the context of individual problems, relationships, and families, not as a problem with roots in our society or culture. Few believe that women are the cause of their own abuse, one fourth still believe that some women want to be abused, and most believe that women can end abusive relationships. Secondhand experiences with DV were associated with some beliefs about causes of abuse, and gender, age, education, and race were associated with certain beliefs in predictable ways.

The most important things learned about violence and trauma in the past 20 years.

In the past 2 decades, important insights have been gained regarding violence and trauma. Complications occur in how violence and trauma, their causes, and their effects on victims should be defined. Violence and abuse to women--physical, sexual, and emotional--are not rare events and are most often perpetrated by partners or acquaintances rather than strangers and occur in nonmarital as well as marital relationships, including same-sex relationships. A promising methodological innovation in the study of violence and trauma is the use of longitudinal designs. Innovations in treatments for victims such as evidence-based interventions have been slow to emerge; they include eye movement desensitization and reprocessing (EMDR) and the Seeking Safety group intervention for drug-abusing women with trauma histories. Future research should address increased understanding of variation in individual responses to violence and trauma, matching of treatment to different types of male offenders, better understanding of how culture affects violence perpetration and victimization, and evaluation of domestic violence interventions.

Childhood and adult abuse among women in primary health care: effects on mental health.

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

Cumulative abuse experiences, physical health and health behaviors.

PURPOSE: Our purpose was to investigate the complex relationship between a range of lifetime abuse experiences with current physical health and health behaviors. METHODS: Between October 1998 and May 1999, interviews were conducted with 557 ethnically diverse women seen at two urban primary care centers. Seven forms of abuse were measured: childhood physical and sexual abuse, past physical and sexual intimate partner violence (IPV), and recent emotional, physical, and sexual IPV. Severity was measured for six of these forms. Multiple non-specific physical symptoms were measured with a modified PRIME-MD, and four health behaviors were ascertained. RESULTS: Approximately 10% of women never experiencing abuse reported multiple non-specific physical symptoms, compared with 25.8% to 78.4% of women reporting a range of abuse experiences. Increases in recent IPV, past IPV, child abuse, and economic hardship were associated with increases in reported symptoms. Women who experienced IPV were more likely to report smoking cigarettes, binge drinking, and having poor nutritional habits. CONCLUSIONS: Recent IPV is associated with physical symptoms and risky health behaviors beyond the effects of child abuse, past IPV, and economic disadvantage. Understanding a person's IPV experiences may inform interventions for health behaviors, such as smoking cessation programs.

Partner violence intervention in the busy primary care environment.

BACKGROUND: Few studies of intimate partner violence (IPV) interventions have been conducted in primary care settings. Based on recommendations, we implemented a multifaceted IPV intervention that included a sticker placed in medical charts listing screening questions, routine IPV screening by nursing staff, clinician follow-up for women screening positive, and referral to on-site services. METHODS: A prospective cohort study compared multiple measures collected at the intervention site and a center providing usual care. Measures included self-reported IPV, documented IPV screening and IPV experiences, and quantity of IPV materials taken from the centers. RESULTS: Of 746 charts reviewed in a random chart review conducted at the intervention site, 36.6% were tagged for IPV screening, and of those tagged, 86.1% had documentation of screening. Approximately 5% (11 of 235) of women screened positive for IPV; about half had documented clinician follow-up and referral to on-site services. Comparison of survey responses and medical record reviews (intervention site) indicated that the screening protocol primarily identified severely abused women (sensitivity 80%, specificity 98%), but rarely identified women experiencing low to moderate levels of abuse. IPV brochures were taken from the intervention site at a rate of 51 per 1000 visits versus 29 per 1000 visits taken from the control site. CONCLUSIONS: Utilizing screening as the only gateway to on-site services limited access for many IPV victims. The removal of IPV brochures from examination rooms suggests that providing contact information for self-referral to on-site services may improve access.

Children's beliefs about punishment.

It has been asserted that family violence is linked to the physical punishment of children. To explore children's views on different types of punishment, brief vignettes depicting a child misbehaving were presented to 201 9-12-year-olds who were asked to provide a "parental" response. Although few recommended physical punishment, the findings suggest that for some children physical punishment and aggression are associated.

The father's contribution to child care: effects on children's perceptions of parental roles.

Adult role behavior and its effects on children were explored in a study of dual-career and traditional families. Fathers who were active in child care were found to be more nurturant and to partake in more housework. Fewer stereotypes about the maternal role were held by girls than by boys; and boys whose parents shared responsibility for child care held fewer stereotypes about the paternal role than did boys from traditional families.