ABSTRACT
The COVID-19 pandemic and resultant public health measures, although helpful in reducing the spread of the disease, have disproportionately impacted women experiencing intimate partner violence (IPV). Despite these adverse circumstances, women continue to show resilience. Although difficult to define, resilience can be conceptualized as a dynamic process in which psychosocial and environmental factors interact to enable an individual to survive, grow, and thrive despite exposure to adversity. This research identifies facilitators and gaps in supports to promoting resilience among urban and rural women experiencing intimate partner violence (IPV) during the COVID-19 pandemic, via an online survey (n = 95) and interviews (n = 19). T-tests, Wilcoxon rank sum tests, and interpretive description were utilized for analyses. Almost 41% of participants experienced an increase in abuse during COVID-19, and resilience significantly decreased during COVID-19 (t(44) = 2.91, p = 0.006). Qualitatively, four parent themes (coercive control, social services, resilience, and future) and seven sub-themes emerged. Changes are needed in accessibility and delivery of support services for women experiencing IPV during COVID-19, and future pandemics.
ABSTRACT
BACKGROUND: Using traditional pharmacotherapy to treat Borderline Personality Disorder (BPD) such as mood stabilizers and second-generation antipsychotics has a lack of supporting evidence. Buprenorphine/Naloxone (BUP/N), a combination medication consisting of a partial opioid agonist, and a full opioid antagonist, is an effective treatment for opioid use disorder. It has also been found effective for treatment-resistant mood disorders. Previous studies suggest a relationship between BPD and endogenous opioids, therefore our case report investigates the effect of BUP/N on a patient diagnosed with BPD. CASE PRESENTATION: A 26-year-old female diagnosed with BPD, having recurrent visits to the emergency department (ED) for self-harm/suicidality was treated with BUP/N. Usage of crisis services, ED visits, and hospital admissions were tracked from 15 months prior to BUP/N to 15 months after using BUP/N. Since starting BUP/N, the length and frequency of mental health-related hospital admissions decreased drastically, as did the number of times that she reached out to community crisis services. Since the dosing adjustment to 6 mg in Oct 2020, there have been no calls to the community crisis lines. CONCLUSIONS: We suggest pharmacological treatment targeting BPD as a disorder of distress tolerance and self-soothing mediated by the opioid system is an effective individual healing attempt. An important note is that this patient did not use opioids prior to BUP/N and had never been diagnosed with an opioid use disorder. However, she exhausted multiple other pharmacologic therapies and was open to trying whatever was available to improve her quality of life.
ABSTRACT
Background: Strict public health measures central to slowing the spread of COVID-19 have, unintentionally, exacerbated risks for women experiencing intimate partner violence (IPV) while impeding their usual coping strategies. The goal of this study was to understand how coping was influenced by COVID-19 for women who have experienced IPV and identify changes in coping strategies and gaps that need to be addressed to support coping. Methods: A qualitatively driven, sequential, cross-sectional design, where quantitative data informed and was embedded within qualitative data collection, was used to explore the experiences of IPV (CAS-R-SF scale) and coping (Brief-COPE scale) specific to IPV of 95 Canadian women. A subset of 19 women was invited to complete an interview exploring coping strategies identified within the survey to contextualize and validate these findings. Results: Survey data subjected to quantitative content analysis identified ten themes, all of which were explored in semi-structured interviews. Thematic interview findings included (1) influence of COVID-19 on coping, (2) coping during COVID-19, and (3) needed coping strategies. Conclusion: COVID-19 had important impacts on the experiences and coping strategies of women who experience IPV. To better support this population in pandemic circumstances, in-person services should be prioritized with an emphasis on accessible and empathetic care. Public health measures in response to COVID-19, and the eventuality of future pandemics, should aim to be gender- and violence-informed.
