Violence Exposure and Disability in Colombian Female Survivors of Intimate Partner Violence: the Mediating Role of Depressive Symptoms.

BACKGROUND: Violence is an important public health problem and one of the main causes of deaths worldwide. The mental health consequences of surviving intimate partner violence (IPV) include depression, anxiety and post-traumatic stress disorder. Previous studies have identified that there is a relationship between depression and level of disability in female survivors of IPV. Estimating the direct, indirect or total effect of an exposure on an outcome makes it possible to identify mediating effects between a group of variables. Detecting mediation effects is useful for identifying casual pathways that generate a final outcome and provides a rationale for designing interventions to target the mediator, which in turn positively affects the outcome. The objective was to identify the mediating role of depressive symptoms on the relationship between IPV and disability. METHODS: This was a cross-sectional study of 94 women over the age of 18 who were survivors of IPV by men. They were recruited from two public hospitals in Cali and Tuluá in southwest Colombia. An analysis of casual relationships was performed using structural equation modelling that was made up of: four exogenous observed variables (age, current relationship status [in a relationship or single], level of schooling, and history of an impairment), intermediate endogenous variables (violence and depressive symptoms), and the main endogenous variable (disability). The analyses were carried out in Stata14.2. RESULTS: The direct effect of IPV severity on the level of disability was not statistically significant (ß=0.09; P=0.63). However, the indirect effect of IPV severity on disability mediated by depressive symptoms was (ß=0.39; P<0.01). The total effect of IPV severity on the level of disability was even greater (ß=0.48; P=0.01). CONCLUSIONS: This study found a complete mediating role of depressive symptoms on the relationship between the severity of IPV and the level of disability for the female participants in this study. The results of this research contribute to defining strategies to prevent and address intimate partner violence, depressive symptoms and disability in this population.

Effect of the non-application of the motorcycle male passenger restriction policy on the risk of homicides in Cali, Colombia.

BACKGROUND: Restrictions of male passengers of motorcycles to prevent homicides is a long-standing policy in Cali, Colombia. For some periods of time, the policy was suspended and then put into action again. All these changes were never evaluated and there has been controversy due to the perception of citizens, specifically motorcycle users, that the law was properly implemented in some periods and poorly applied in others. Our aim was to examine the effect of the non-application of the motorcycle male passenger restriction policy on the risk of homicides in Cali, Colombia. METHODS: Ecologic study conducted using an interrupted time series analysis. The main outcome was the aggregated daily counts of homicides. Secondary outcomes were the aggregated daily counts of homicides using a motorcycle and using motorcycle and firearm. Incidence rate ratios (IRR) were obtained by comparing periods of policy implementation with periods of lack of implementation in autoregressive negative binomial regression models. RESULTS: There was an increased risk of homicides when the policy was not implemented (IRR=1.12; 1.05-1.19). There was no effect on the risk of homicides committed in motorcycles (IRR=0.98; 0.88-1.10) and when a motorcycle and firearm were used (IRR=0.99; 0.89-1.10). CONCLUSIONS: The lack of implementation of the ban of motorcycle male passengers was associated with an increased risk of homicides. Our findings support the importance of this policy to prevent homicides in Cali, Colombia. Future work should examine how this policy influences other policies related to prevent homicide and violent risk-related behaviour.

[Suicide and medical practices: Assessing the way of life among Colombian coffee-growing rural men in mental health care]. / Suicidio y prácticas médicas: la valoración del modo de vida de hombres campesinos caficultores colombianos en la atención de la salud mental.

The aim was to understand the way of life and self-care practices in mental health among adult male farmers living in a municipality in the Risaralda department, located in the coffee axis of Colombia, marked by a high incidence of suicides. An ethnographic study was conducted between March and December 2021, employing a combination of methods including interviews, participant observation, document review, and field diaries. Economic and social aspects undergoing transformations were identified, impacting gender roles, family dynamics, and caregiving possibilities for these men. By observing how men discuss their suffering and the resources available to address it, it can be concluded that mental health practices function more as self-care resources, while health services often provide symptom-based care, neglecting attentive listening. These findings are valuable for shaping services and life care strategies that align with the conditions of rural men in Colombia.

El objetivo fue conocer el modo de vida y las prácticas de autocuidado en salud mental de los hombres adultos campesinos, que viven en un municipio del departamento de Risaralda en el eje cafetero de Colombia con alta incidencia de suicidios. Entre marzo y diciembre de 2021, se realizó un estudio etnográfico, haciendo uso de una combinación de métodos: entrevistas, observación participante, revisión documental y diario de campo. Se identificaron aspectos económicos y sociales cuyas transformaciones han afectado los roles de género, las dinámicas familiares y las posibilidades de cuidado para los hombres. Al observar cómo los hombres hablan de su sufrimiento y de los recursos con que cuentan para atenderlo, puede concluirse que las prácticas de salud mental se encuentran más bien como recursos de autoatención y los servicios de salud ofrecen atención basada en síntomas del cuerpo, de modo que abandonan la escucha. Estos hallazgos son útiles para pensar servicios y estrategias de cuidado de la vida que se adapten a las condiciones de hombres campesinos en Colombia.

One-year outcomes of two community-based mental health interventions for Afro-Colombian survivors of the armed conflict and displacement.

The objective of the study is to assess the middle-term effects (1 year after intervention) of two community-based mental health interventions, Common Elements Treatment Approach intervention, CETA, and Narrative Community Group Therapy intervention, NCGT, in two cities of the Colombian Pacific region (Buenaventura and Quibdó). A follow-up study was conducted on a cohort of trial participants. In this trial, the positive effects of two mental health interventions were evaluated; assessment was carried out in separate groups (CETA arm, NCGT arm and a control group) of the reduction of symptoms of anxiety, depression, post-traumatic stress and function impaired mentality. The participants were Afro-Colombian survivors of the armed conflict and displacement living in Buenaventura and Quibdó. They were surveyed using the same instrument used in the original trial. Intent-to-treat analyses were performed, and longitudinal mixed-effects regression models with random effects were used to analyse the middle-term effects of the interventions. At 1-year post-intervention, participants in Buenaventura who received the CETA intervention experienced a decrease in depression (-0.23; p = 0.02), post-traumatic stress symptoms (-0.23; p = 0.02) and total mental health symptoms (-0.14; p = 0.048). In Quibdó, the NCGT intervention significantly improved function impairment (-0.30; p = 0.005). CETA and NCGT interventions have the potential to maintain a reduction of mental health symptoms in participants from the Colombian Pacific region.

Mental health Narrative Community-Based Group Therapy in violence-displaced Afro-Colombians: a randomized controlled trial.

This study aims to evaluate the effect of a mental health Narrative Community-Based Group Therapy (NCGT) in Afro-Colombian violence survivors. A randomized controlled trial was conducted in Buenaventura and Quibdó, Colombia. Afro-Colombian adults (n=521) were randomly allocated to a NCGT (n1=175), a wait-control group (n2=171) or a Common Elements Treatment Approach (CETA, n3=175). The CETA was described separately given conceptual/methodological differences. Lay psychosocial community workers delivered the NCGT. Symptoms were assessed before and after intervention/wait with culturally adapted mental health symptoms and gender-specific functionality scales. Intent to treat analysis and mean difference of differences were used for comparisons. In Buenaventura, a significant reduction in functional impairment (mean difference: -0.30, 95% Confidence Interval [95% CI]: -0.55, -0.05) and depression (mean difference: -0.24, 95% CI: -0.42, -0.07) were found, with small and moderate effect size, respectively. In Quibdó, functionality improved significantly (mean difference: -0.29, 95% CI: -0.54, -0.04, small effect size). Even though differences in depression and anxiety were not significant, there were reductions in symptoms. The NCGT is effective in improving daily functioning among violence victims in the Colombian Pacific and has the potential to reduce symptoms of depression. Further exploration is required to understand the effects of a narrative group therapy for mental health in Afro-Colombian populations.Trial Registration: ClinicalTrials.gov number: NCT01856673 (https://clinicaltrials.gov/ct2/show/NCT01856673).

Seasonal and Temporal Patterns of Homicides and Suicides in Cali and Manizales, Colombia: A Times-Series Analysis 2008-2015.

OBJECTIVE: To identify seasonal and temporal variations in daily incidence of homicides and suicides in Cali and Manizales, Colombia during 2008-2015. MATERIALS AND METHODS: An ecological time series study was performed using negative binomial regression models for daily incidence of homicides and suicides; analyses were controlled for yearly trends and temporal autocorrelations. RESULTS: Saturdays, Sundays, December holidays as well as New Year and New Year's Eve were associated with an increased risk of homicides in both cities. Suicide risk increased during December holidays and New Year in both cities. In addition, the suicide risk increased on paydays, Saturdays, Sundays, and Mondays in Cali, and it decreased during the Holy Week holidays in Manizales. December patterns of suicides and homicides are the opposite in each city, and between cities. CONCLUSIONS: The incidences of homicides and suicides are not homogeneous over time. These patterns can be explained partially by alcohol consumption and changes in people's routine activities which may modify exposure to violent circumstances.

Do caregiver interventions improve outcomes in relatives with dementia and mild cognitive impairment? A comprehensive systematic review and meta-analysis.

Some reviews suggest benefits of nonpharmacological interventions for informal caregivers of people with dementia and mild cognitive impairment. These benefits may transfer to the care-recipients (CRs) through increased caregiving capability, reduced burden and depression among caregivers, and decreased negative mood contagion. However, large-scale review on these effects on the CRs is lacking. We searched PsycINFO, CINAHL with Full Text, MEDLINE, and PubMed from inception to end of 2020 and found 142 articles that reported randomized controlled trials (RCTs) of caregiver interventions using CR outcomes. Interventions were found to reduce neuropsychiatric symptoms (NPS) in general and behavioral and mood disturbance specifically, enhance cognition and quality of life, and delay institutionalization and mortality, with care coordination/case management, educational intervention with psychotherapeutic components (psychoeducation-b), and direct training of the CR (with caregiver involvement) being the more potent interventions. The kinds of benefit depend on the types of intervention. NPS was reduced by psychoeducation-b, care coordination/case management, and CR training. Cognition and quality of life were enhanced by CR training and care coordination/case management, respectively. Institutionalization was delayed by multicomponent interventions and respite (based on one study). However, the effects were generally small to very small. Together with existing findings on caregiver outcomes, a tripartite scaffolding model of caregiver support is proposed. The model is composed of three components: (a) care coordination/case management (i.e., enhanced usual care), (b) psychoeducation-b, and (c) CR training. Future directions in terms of developing consensual guidelines, a registry of intervention manuals, and family-centered programs with flexibility in delivery are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Performance of a Likert adaptation of the SRQ-20 scale among women victims of intimate partner violence in Colombia: an exploratory study.

Women who are victims of intimate partner violence often suffer of depression and anxiety disorders. We evaluated the performance of the SRQ-20 scale (screening test for common mental health disorders), in women victims of intimate partner violence by male partners. A total of 100 women were surveyed from the out-patient mental health services in four health institutions in Valle del Cauca (Colombia). SRQ-20 scales (Binary version versus Likert version) were compared with mental health diagnoses based on the HSCL-25 scale, as the gold standard. Optimal SRQ-20 cut-off score is > = 6 points; lower than the initially suggested, sensitivity of 96.6% and specificity of 90.9%. The new SRQ-20-Likert scale, establishing a cut-off of > = 8 points, shows better sensitivity (98.9%) and equal specificity than the original scale. Studied SRQ-20 scales are promising instruments for screening mental health disorders among women victims of intimate partner violence in primary health care settings.

Exposición a violencia de género en una población de mujeres consultantes a un servicio de psiquiatría comunitaria en Cali, Colombia / Exposure to gender violence in a population of women consulting a Community Psychiatry service in Cali, Colombia

RESUMEN Objetivo Conocer las características sociales, sintomatología mental y exposiciones a hechos de violencia de mujeres consultantes a un servicio de salud mental comunitaria en una Institución de Atención Primaria. Metodología Se realizó un estudio de corte trasversal descriptivo en el programa de Psiquiatría Comunitaria de dos centros asistenciales de la Red de Salud de Ladera E. S. E. en Cali, Colombia. Se analizó el contenido de 157 registros del año 2018, usando estadística descriptiva para las variables sociodemográficas, clínicas y relacionadas con su historial psiquiátrico. Resultados El 43,59% del total de las mujeres consultó por trastornos afectivos, ninguna enunció situaciones relacionadas con violencia en el motivo de consulta. Sin embargo, cerca del 16% enunció situaciones de violencia en el apartado de "enfermedad actual", mientras que el 39,49% lo señaló como parte de los "antecedentes personales", y el 15,29% lo relacionó con los "antecedentes familiares". tras comparar este grupo de mujeres expuestas a violencia con las no expuestas, se encontró que los trastornos depresivos eran más frecuentes en el grupo expuesto (58,53%; p=0,035). El manejo farmacológico fue más frecuente en mujeres no expuestas y de tipo psicosocial en mujeres expuestas (p<0,05). Conclusiones Aunque se hubiese enunciado alguna forma de violencia dentro del contenido de las historias clínicas, menos del 2% de los reportes incluyó diagnósticos relacionados con violencia de género.

ABSTRACT Objective This study aims to know the social characteristics, mental health symptoms, and exposure of violence of women who are patients of the community psychiatry service in a Primary Care Institution. Methodology An observational and descriptive study was conducted. Patients were women who have been treated in the Community Mental Health Program in two healthcare centers of the Ladera Health Network: E.S.E in Cali, Colombia. 157 records from 2018 was analyzed using descriptive statistics for sociodemographic and clinical variables and those related to their psychiatric history. Results 43.59% of all women consulted for affective disorders. None reported any situation related to violence as the reason for consultation. However, violent situations were enunciated by 15.92% of the women in the "current illness" box, while 39.49% pointed it out as part of "personal history," and 15.29% related it to the "family history". Comparing this group of women exposed to violence with those not exposed, it was found that depressive disorders were more frequent in the exposed group (58.53%; p=0.035). Pharmacological management was more frequent in unexposed women and psychosocial in exposed women (p<0.05). Conclusions Although some form of violence had been stated within the medical record content, less than 2% of the reports included diagnoses related to gender violence.

Guilt Focused Intervention for Family Caregivers. Preliminary Results of a Randomized Clinical Trial.

OBJECTIVES: A pilot randomized controlled trial study was conducted for testing the efficacy of a novel Guilt Focused Intervention (GFI), that was compared with a Cognitive Behavioral Intervention (CBI) for caregivers of people with dementia with high levels of guilt and distress. METHODS: Participants were 42 caregivers who were randomized assigned to the intervention conditions. RESULTS: Participants in the GFI showed significant reductions in depression, anxiety, and guilt at posttreatment and follow-up. Participants in the CBI presented reductions in anxiety and guilt at posttreatment and follow-up. Clinically significant change for guilt was found in 62.5% in the GFI and 9.09% in the CBI group at posttreatment. At follow-up, 58.33% in GFI and 12.5% in the CBI group were recovered. CONCLUSIONS: The preliminary results of this pilot study suggest that caregivers with significant levels of guilt and distress might benefit from an intervention specifically designed to target guilt feelings. CLINICAL IMPLICATIONS: A novel and initial intervention approach specifically designed for targeting caregivers' feelings of guilt might have the potential to reduce caregiver's emotional distress.

"I Feel Guilty". Exploring Guilt-Related Dynamics in Family Caregivers of People with Dementia.

Objectives: Family caregivers of people with dementia often report feelings of guilt. However, the number of studies analyzing guilt and the factors associated with its appearance are scarce. The aim of this study is to explore the subjective experience of guilt in the family care of people with dementia.Methods: A qualitative analysis of the narratives of 13 family caregivers of people with dementia about their feelings of guilt was done.Results: Seven categories for understanding guilt in caregiving were obtained: guilt derived from actions themselves; guilt derived from one's limitations; guilt for feeling negative emotions; guilt associated with the change in the relationship with the person cared for; guilt for neglecting other areas; guilt induced by the person cared for, and guilt induced by others. The results showed the existence of cases in which guilt is absent by distress-avoiding processes.Conclusions: Guilt is a relevant variable in understanding caregiver distress, and its analysis is necessary for therapeutic work in the field of care.Clinical implications: Psychological interventions aimed at family caregivers should include specific techniques in order to address guilt feelings.

An Exploration of the Psychometric Properties of the PASS-20 in Older Adults with Chronic Pain: Preliminary Development and Validity.

OBJECTIVES: The Pain Anxiety Symptoms Scale (PASS-20) is well validated in adults and younger populations, but not in older adults. This study aimed to analyze the psychometric properties of the PASS-20 in Spanish older adults who experience chronic pain. METHODS: Participants were 111 older adults with chronic pain living in nursing homes (mean age = 83.36; SD = 6.53; 78.6% female). Face-to-face interviews were conducted which included assessment of pain anxiety (PASS-20), chronic pain acceptance (CPAQ), depression symptoms (GDS), catastrophizing beliefs (PCS), pain severity, and sociodemographic information. An Exploratory Structural Equation Modeling (ESEM) approach was used to refine the scale. RESULTS: The final scale was composed of seven items, measuring two factors that could be labeled "Internal experiences" and "Escape/Avoidance behaviors". The two factors explained 60.98% of the total variance. PASS-7 version fit properly: χ2/df = 14.57/13, CMIN/df = 1.121, CFI = 0.99, RMSEA = 0.033, TLI = 0.98, GFI = 0.96, AGFI = 0.92. Good validity indices were found and acceptable reliability results in the scale and its subscales (Chronbach´s α; Internal Experiences = 0.70; Escape/Avoidance Behaviors= 0.73; Total Scale = 0.77). CONCLUSIONS: The short version of the PASS-7 has good psychometric properties. CLINICAL IMPLICATIONS: The brevity of the PASS-7 increases the feasibility of this instrument which could potentially be utilized in a variety of clinical settings and research studies with older people with chronic pain samples, specially institutionalized older adults.

Internet-delivered guided self-help acceptance and commitment therapy for family carers of people with dementia (iACT4CARERS): a feasibility study.

OBJECTIVES: The feasibility of research into internet-delivered guided self-help Acceptance and Commitment Therapy (ACT) for family carers of people with dementia is not known. This study assessed this in an uncontrolled feasibility study. METHOD: Family carers of people with dementia with mild to moderate anxiety or depression were recruited from primary and secondary healthcare services in the UK. Participants were offered eight, guided, self-help online ACT sessions adapted for the needs of family carers of people with dementia with optional online peer support groups. Pre-defined primary indicators of success included recruitment of 30 eligible carers over 6 months and ≥70% completing at least two online sessions. RESULTS: Thirty-three participants (110% of the target sample) were recruited over 6 months and 30 participants (91%) completed two or more sessions, and thus both indicators of success were met. Further, 70% of participants completed seven or all eight sessions, and 27% of participants were lost to follow-up, but none of the reasons for early withdrawal were related to the intervention. CONCLUSION: This study supports the feasibility, including recruitment and treatment completion. A full-scale trial to assess the clinical- and cost-effectiveness of the intervention including its long-term effects is warranted.

Caring for Relatives with Dementia in Times of COVID-19: Impact on Caregivers and Care-recipients.

OBJECTIVES: To analyze caregivers' perceived impact of the pandemic in their mental health and the well-being of the care-recipients. METHODS: Caregivers (N = 88) were asked if they had COVID-19 and about their perceptions of change of care-recipients' health conditions as well as whether their own mental health, conflicts with care-recipients and other relatives, thoughts of giving up caregiving, and feelings of coping well with the situation. RESULTS: A large percentage of caregivers perceived a worsening of care-recipients' symptoms and of their own negative emotions, an increase in the number of conflicts and thoughts of needing to give up caregiving. Having had COVID-19 and reporting higher levels of distress as well as giving up caregiving were related to perceived worsening in care-recipients well-being. Perceived increases were mainly reported by younger caregivers, those who perceived to have not coped well, and those reporting an increase in conflicts. Some caregivers perceived an increase in positive emotions. CONCLUSIONS: The pandemic has a negative impact on caregivers' perceptions about the course of their own emotions and care-recipients' well-being. CLINICAL IMPLICATIONS: Interventions are needed to train caregivers in strategies to cope with the sources of stress caused by the pandemic and to promote social support.

To pay attention or not: The associations between attentional bias towards negative emotional information and anxiety, guilt feelings, and experiential avoidance in dementia family caregivers.

Caring for a relative with dementia has been linked to negative consequences for caregivers' psychological health, such as anxiety or guilt. Cognitive theories of psychopathology propose that attentional bias towards negative stimuli contribute to the development and maintenance of emotional disorders and clinical symptomatology. However, attentional bias has scarcely been explored in dementia family caregivers. The aim of this study was to examine the relationship between attentional bias and anxiety symptomatology, guilt feelings, and experiential avoidance in a sample of dementia family caregivers. Participants were 226 dementia family caregivers. Attentional bias was measured using a novel priming adaptation of the dot-probe task. The sample was divided into high and low anxiety symptomatology, guilt feelings, and experiential avoidance groups. The results revealed two opposite patterns of emotional information processing in dementia family caregivers. While anxiety was found to be associated with an attentional preference for negative information, experiential avoidance was related to attentional avoidance of this information. Although guilt was also related to an attentional preference for negative information, this relationship was no longer significant when controlling for anxiety levels. These inflexible attentional patterns may have negative clinical consequences, given that in both cases relevant information necessary for adaptive coping with the stressful situation of caregiving may be unattended to or omitted.

Compassion in dementia caregiving: Psychometric properties of the Caregiving Compassion Scale in Spanish caregivers.

Compassion has been suggested as a relevant variable for understanding dementia caregivers' psychological distress. The objectives were to analyse the psychometric properties of the Caregiving Compassion Scale (CCS) and to explore the association between caregivers' compassion and their emotional health. Two hundred and thirty-six dementia caregivers were evaluated for compassion, depressive symptoms, guilt, ambivalence, care-recipient's functional and cognitive status, frequency of behavioural problems and desire to institutionalise the care-recipient. Exploratory factor analyses, correlations and regression analyses were done. Two factors were obtained. The factor labelled "Distress from witnessing the care recipient suffering" was associated with higher stress linked to witness depressive problems in the care-recipient and with caregivers' ambivalence and guilt levels. The factor labelled "Motivation/disposition for helping" was associated with less desire for institutionalisation, and it showed a negative association with ambivalence and guilt feelings. The CCS seems to be a valid and reliable scale for assessing compassion in dementia caregivers.

Performance of the Paediatric Trauma Score on survival prediction of injured children at a major trauma centre: A retrospective Colombian cohort, 2011-2019.

Background: Despite improvements in children's health due to a reduction in infections, trauma continues to cause many deaths among adolescents. Strategies to mitigate morbidity and mortality from trauma include severity scores to classify and refer patients to the appropriate hospitals to provide better management; however, these strategies have not been assessed in Colombian children. This study aimed to describe the characteristics and outcomes of injured children and evaluate the performance of the Pediatric Trauma Score (PTS) in predicting survival at a major trauma centre in a Colombian city. Methods: This was a retrospective cohort study of children aged <18 years who were treated for injuries at a hospital in Colombia. The primary outcome was 30-day mortality. A simple logistic regression model was used with PTS as the predictor variable and vital status at discharge as the outcome variable. PTS performance was assessed by discrimination using the area under the receiver-operating characteristic (AUROC) curve and by calibration using the Hosmer-Lemeshow (HL) goodness-of-fit test. Findings: A total of 1047 children were admitted. The median age was 12 years (interquartile range [IQR]=5-15); 73·7% were male, and 66·1% had blunt trauma. The most frequent cause of injury was traffic accident (31·5%) followed by assaults (29%). Mortality was 5·9%; 61·3% of these deaths occurred in adolescents between 15 and 17 years of age and 71% of deaths in this age group were due to injuries from a firearm. The PTS had a median of 7 (IQR=5-9), an AUROC of 0·93, and good calibration (HL=7·97, p = 0·33). Interpretation: The highest proportion of trauma and death occurred among adolescents. Interpersonal violence was the most frequent cause of death in this age group. The PTS showed good predictive power for survival, with excellent discrimination and good calibration. Funding: None.

A qualitative study on factors associated with intimate partner violence in Colombia.

Intimate partner violence (IPV) is a human rights violation and a serious global public health problem. This study investigated factors associated with IPV in female survivors in Colombia. Four focus group discussions with female survivors of IPV and 15 key informant interviews with professionals from psychological, social and legal services and community leaders were conducted in Cali and Tuluá. Participant recruitment was via purposive sampling. Transcripts were analysed manually taking a social constructivist standpoint and a content analysis approach. Factors associated with IPV were divided into four themes: cultural beliefs, jealousy, alcohol abuse, and personal history of IPV. The first theme was divided into: patriarchy, gender roles, normalisation of violence, and unawareness of rights, economic dependence, and 'men own women'. The sub-themes were all inter-related and underpinned by patriarchal values. IPV was described as a sociocultural construction formed by patriarchal values ingrained in community and societal norms and individual processes. Therefore, academia, governmental and non-governmental bodies and society are urged to together, create preventative, context specific strategies for individuals, communities and societies.

A qualitative study on factors associated with intimate partner violence in Colombia

Abstract Intimate partner violence (IPV) is a human rights violation and a serious global public health problem. This study investigated factors associated with IPV in female survivors in Colombia. Four focus group discussions with female survivors of IPV and 15 key informant interviews with professionals from psychological, social and legal services and community leaders were conducted in Cali and Tuluá. Participant recruitment was via purposive sampling. Transcripts were analysed manually taking a social constructivist standpoint and a content analysis approach. Factors associated with IPV were divided into four themes: cultural beliefs, jealousy, alcohol abuse, and personal history of IPV. The first theme was divided into: patriarchy, gender roles, normalisation of violence, and unawareness of rights, economic dependence, and 'men own women'. The sub-themes were all inter-related and underpinned by patriarchal values. IPV was described as a sociocultural construction formed by patriarchal values ingrained in community and societal norms and individual processes. Therefore, academia, governmental and non-governmental bodies and society are urged to together, create preventative, context specific strategies for individuals, communities and societies.

Resumo A violência por parceiro íntimo (VPI) é uma violação dos direitos humanos e um grave problema de saúde pública global. Este estudo investigou fatores associados à VPI em mulheres sobreviventes na Colômbia. Quatro discussões de grupos focais com mulheres sobreviventes de VPI e 15 entrevistas com informantes-chave com profissionais de serviços sócio-médico-legais foram realizadas usando amostragem intencional nas cidades de Cali e Tuluá. As transcrições foram analisadas manualmente, sob um ponto de vista construtivista social e uma abordagem de análise de conteúdo. Os fatores associados à VPI foram divididos em 4 temas: crenças culturais, ciúmes, abuso de álcool e história pessoal da VPI. O primeiro tema foi dividido em: patriarcado, papéis de gênero, normalização da violência, desconhecimento de direitos, dependência econômica e 'homens possuem mulheres'. VPI foi descrita como uma construção sociocultural formada por valores patriarcais e processos individuais. A VPI é causada por uma complexa interação de diferentes fatores nos níveis do indivíduo, relacionamentos, comunidade e social. Os órgãos governamentais e não governamentais e a sociedade são instados a criar juntos estratégias preventivas e específicas no contexto.

Impacts of violence on the mental health of Afro-descendant survivors in Colombia.

The Colombian armed conflict has disproportionately affected minorities, especially afro-Colombian communities. However, there is a lack of evidence about mental health of victims. This study aims to describe the prevalence of mental illness and its associated factors in Afro-descendant violence survivors in Buenaventura and Quibdó, Colombia. A cross-sectional study was carried out using data from a previous trial which aimed to reduce mental health symptoms (ClinicalTrials.gov: NCT01856673). Data of 710 adults identified through a snowball sampling technique was analysed. Diagnoses of depression, anxiety, post-traumatic stress disorder (PTSD), and dysfunction were established using adapted versions of the Hopkins Symptoms Checklist and the Harvard Trauma Questionnaire, plus variables identified in a qualitative study. Multivariate regressions were used to identify associated factors with these diagnoses. The prevalence of depression, anxiety and PTSD in both cities was 26.62% (95% confidence interval [95%CI]: 20.30;23.89), 36.53% (95%CI: 30.63;42.36), and 39.15% (95%CI: 33.36;44.83), respectively. Being married and having registered with the government as victim of the conflict were found to be protective factors for depression and PTSD, respectively. Psychological trauma, unemployment, and traumatic experiences, amongst others, were found as risk factors. The Colombian armed conflict, plus disparities and social exclusion, may be associated with mental health morbidity.