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Concept: Psychological abuse

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This article explores the repercussions of workplace bullying on nurses and the health-care profession as a whole. I discuss the nature of workplace bullying and draw upon prior studies to explore some of the barriers that prevent witnesses to bullying from intervening, as well as barriers faced by targets in taking action to stop the bullying. As overt forms of resistance are often not feasible in situations where nurses occupy subordinate positions to their bullies, I propose that cognitive reappraisal can be an effective coping strategy, and situate this perspective within the research on humour, hope and optimism.

Concepts: Positive psychology, Strategy, Abuse, Psychological abuse, Workplace bullying, Bullying, Sexual harassment, Mobbing

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Abstract Background: While intimate partner violence (IPV) affects 25% of women and impairs health, current societal conditions-including the normalization of abuse in popular culture such as novels, film, and music-create the context to support such violence. Fifty Shades of Grey, a best-selling novel, depicts a “romantic” and “erotic” relationship involving 28-year-old megamillionaire, Christian Grey, and a 22-year-old college student, Anastasia Steele. We argue that the relationship is characterized by IPV, which is harmful to Anastasia. Methods: All authors engaged in iterative readings of the text, and wrote narrative summaries to elucidate themes. Validity checks included double review of the first eight chapters of the novel to establish consistency in our analysis approach, iterative discussions in-person and electronically to arbitrate discrepancies, and review of our analysis with other abuse and sexual practice experts. To characterize IPV, we used the U.S. Centers for Disease Control and Prevention’s definitions of emotional abuse (intimidation/threats; isolation; stalking; and humiliation) and sexual violence (forced sex acts/contact against a person’s will, including using alcohol/drugs or intimidation/pressure). To characterize harm, we used Smith’s conceptualizations of perceived threat, managing, altered identity, yearning, entrapment, and disempowerment experienced by abused women. Results: Emotional abuse is present in nearly every interaction, including: stalking (Christian deliberately follows Anastasia and appears in unusual places, uses a phone and computer to track Anastasia’s whereabouts, and delivers expensive gifts); intimidation (Christian uses intimidating verbal and nonverbal behaviors, such as routinely commanding Anastasia to eat and threatening to punish her); and isolation (Christian limits Anastasia’s social contact). Sexual violence is pervasive-including using alcohol to compromise Anastasia’s consent, as well as intimidation (Christian initiates sexual encounters when genuinely angry, dismisses Anastasia’s requests for boundaries, and threatens her). Anastasia experiences reactions typical of abused women, including: constant perceived threat (“my stomach churns from his threats”); altered identity (describes herself as a “pale, haunted ghost”); and stressful managing (engages in behaviors to “keep the peace,” such as withholding information about her social whereabouts to avoid Christian’s anger). Anastasia becomes disempowered and entrapped in the relationship as her behaviors become mechanized in response to Christian’s abuse. Conclusions: Our analysis identified patterns in Fifty Shades that reflect pervasive intimate partner violence-one of the biggest problems of our time. Further, our analysis adds to a growing body of literature noting dangerous violence standards being perpetuated in popular culture.

Concepts: Sexual intercourse, Domestic violence, Child abuse, Abuse, Psychological abuse, Bullying, Psychological manipulation, Intimidation

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The role of empathy and perspective-taking in preventing aggressive behaviors has been highlighted in several theoretical models. In this study, we used immersive virtual reality to induce a full body ownership illusion that allows offenders to be in the body of a victim of domestic abuse. A group of male domestic violence offenders and a control group without a history of violence experienced a virtual scene of abuse in first-person perspective. During the virtual encounter, the participants' real bodies were replaced with a life-sized virtual female body that moved synchronously with their own real movements. Participants' emotion recognition skills were assessed before and after the virtual experience. Our results revealed that offenders have a significantly lower ability to recognize fear in female faces compared to controls, with a bias towards classifying fearful faces as happy. After being embodied in a female victim, offenders improved their ability to recognize fearful female faces and reduced their bias towards recognizing fearful faces as happy. For the first time, we demonstrate that changing the perspective of an aggressive population through immersive virtual reality can modify socio-perceptual processes such as emotion recognition, thought to underlie this specific form of aggressive behaviors.

Concepts: Domestic violence, Violence, Child abuse, Virtual reality, Abuse, Psychological abuse, Violence against women, Intimidation

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OBJECTIVEWe sought to estimate the association between intimate partner violence, a prevalent psychosocial stressor, and the incidence of type 2 diabetes in women.RESEARCH DESIGN AND METHODSIn 2001, 68,376 Nurses' Health Study II participants answered questions on physical, sexual, and psychological intimate partner violence in adulthood (age ‚Č•18 years) and reported the years in which any abuse occurred. We used Cox proportional hazards models to estimate the associations between intimate partner violence exposures and incidence of type 2 diabetes from 2001 to 2007. We also estimated effects of duration and time since intimate partner violence on type 2 diabetes incidence.RESULTSOf 68,376 respondents, 64,732 met inclusion criteria at the 2001 baseline; of these, 23% reported lifetime physical intimate partner violence, 11% reported lifetime sexual intimate partner violence, and 8% reported moderate and <2% reported severe psychological intimate partner violence. Hazard ratios (HRs) and 95% CIs for type 2 diabetes, adjusted for potential confounders, were 1.18 (1.00-1.39) and 1.08 (0.86-1.35) for more than one lifetime episode of physical and sexual intimate partner violence, respectively, and 1.78 (1.21-2.61) for severe psychological abuse. Addition of updated BMI and other diabetes risk factors reduced the physical intimate partner violence HR to 1.12 (0.94-1.33) and the psychological intimate partner violence HR to 1.61 (1.09-2.38).CONCLUSIONSPhysical intimate partner violence is modestly associated with incidence of type 2 diabetes in this population. Severe psychological violence may substantially increase type 2 diabetes risk.

Concepts: Domestic violence, Epidemiology, Diabetes mellitus type 2, Hazard ratio, Child abuse, David Cox, Abuse, Psychological abuse

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OBJECTIVE:The social vulnerability that is associated with food allergy (FA) might predispose children with FA to bullying and harassment. This study sought to quantify the extent, methods, and correlates of bullying in a cohort of food-allergic children.METHODS:Patient and parent (83.6% mothers) pairs were consecutively recruited during allergy clinic visits to independently answer questionnaires. Bullying due to FA or for any cause, quality of life (QoL), and distress in both the child and parent were evaluated via questionnaires.RESULTS:Of 251 families who completed the surveys, 45.4% of the children and 36.3% of their parents indicated that the child had been bullied or harassed for any reason, and 31.5% of the children and 24.7% of the parents reported bullying specifically due to FA, frequently including threats with foods, primarily by classmates. Bullying was significantly associated with decreased QoL and increased distress in parents and children, independent of the reported severity of the allergy. A greater frequency of bullying was related to poorer QoL. Parents knew about the child-reported bullying in only 52.1% of the cases. Parental knowledge of bullying was associated with better QoL and less distress in the bullied children.CONCLUSIONS:Bullying is common in food-allergic children. It is associated with lower QoL and distress in children and their parents. Half of the bullying cases remain unknown to parents. When parents are aware of the bullying, the child’s QoL is better. It is important to proactively identify and address cases in this population.

Concepts: Parent, Food, Mother, Father, Abuse, Psychological abuse, Bullying, Sexual harassment

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Childhood maltreatment increases the risk of subsequent depression, anxiety and alcohol abuse, but the rate of resilient victims is unknown. Here, we investigated the rate of victims that do not suffer from clinical levels of these problems after severe maltreatment in a population-based sample of 10980 adult participants. Compared to men, women reported more severe emotional and sexual abuse, as well as more severe emotional neglect. For both genders, severe emotional abuse (OR = 3.80 [2.22, 6.52]); severe physical abuse (OR = 3.97 [1.72, 9.16]); severe emotional neglect (OR = 3.36 [1.73, 6.54]); and severe physical neglect (OR = 11.90 [2.66, 53.22]) were associated with depression and anxiety while only severe physical abuse (OR = 3.40 [1.28, 9.03]) was associated with alcohol abuse. Looking at men and women separately, severe emotional abuse (OR = 6.05 [1.62, 22.60] in men; OR = 3.74 [2.06, 6.81] in women) and severe physical abuse (OR = 6.05 [1.62, 22.60] in men; OR = 3.03 [0.99, 9.33] in women) were associated with clinical levels of depression and anxiety. In addition, in women, severe sexual abuse (OR = 2.40 [1.10, 5.21]), emotional neglect (OR = 4.78 [2.40, 9.56]), and severe physical neglect (OR = 9.86 [1.99, 48.93]) were associated with clinical levels of depression and anxiety. Severe emotional abuse in men (OR = 3.86 [0.96, 15.48]) and severe physical abuse in women (OR = 5.18 [1.48, 18.12]) were associated with alcohol abuse. Concerning resilience, the majority of severely maltreated participants did not report clinically significant levels of depression or anxiety (72%), or alcohol abuse (93%) in adulthood. Although the majority of severely abused or neglected individuals did not show clinical levels of depression, anxiety or alcohol use, severe childhood maltreatment increased the risk for showing clinical levels of psychopathology in adulthood.

Concepts: Domestic violence, Child abuse, Suffering, Abuse, Psychological abuse, Physical abuse, Neglect, Bullying

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The risk of harm/injury in homes where intimate partner violence (IPV) occurs is not limited to humans; animals reside in as many as 80% of these homes and may be at substantial risk of suffering severe or fatal injury. Gaining a better understanding of IPV-pet abuse overlap is imperative in more accurately identifying the risks of harm for all individuals and animals residing in these homes. The objectives of this study were to utilize law enforcement officers' observations and IPV victim reports from the scene of the incident to (a) determine the prevalence of pet abuse perpetration among suspects involved in IPV incidents, (b) compare characteristics of IPV incidents and the home environments in which they occur when the suspect has a history of pet abuse with incidents involving suspects with no reported history of pet abuse, and © compare IPV incident outcomes involving suspects with a history of pet abuse with those involving suspects with no reported history of pet abuse. IPV victims residing in homes with a suspect who has a history of pet abuse often describe “extremely high-risk” environments. With nearly 80% reporting concern that they will eventually be killed by the suspect, victims in these environments should be considered at significant risk of suffering serious injury or death. In addition, IPV victims involved in incidents with a suspect that has a history of pet abuse were significantly more likely to have had at least one prior unreported IPV incident with the suspect (80%) and to have ever been strangled (76%) or forced to have sex with the suspect (26%). Effective prevention/detection/intervention strategies are likely to require multidisciplinary collaboration and safety plans that address the susbstantial risk of harm/injury for all adults, children, and animals residing in the home.

Concepts: Domestic violence, Report, Criminal law, Violence, Child abuse, Suffering, Abuse, Psychological abuse

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Digital dating abuse (DDA) behaviors include the use of digital media to monitor, control, threaten, harass, pressure, or coerce a dating partner. In this study, 703 high school students reported on the frequency of DDA victimization, whether they were upset by these incidents, and how they responded. Results suggest that although both girls and boys experienced DDA at similar rates of frequency (with the exception of sexual coercion), girls reported that they were more upset by these behaviors. Girls also expressed more negative emotional responses to DDA victimization than boys. Although DDA is potentially harmful for all youth, gender matters. These findings suggest that the experience and consequences of DDA may be particularly detrimental for girls.

Concepts: Childhood, Experience, Control theory, High school, Abuse, Psychological abuse, Bullying, Intimidation

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Child maltreatment is a public health concern with well-established sequelae. However, compared to research on physical and sexual abuse, far less is known about the long-term impact of emotional maltreatment on mental health. The overall purpose of this study was to examine the association of emotional abuse, emotional neglect, and both emotional abuse and neglect with other types of child maltreatment, a family history of dysfunction, and lifetime diagnoses of several Axis I and Axis II mental disorders. Data were from the National Epidemiological Survey on Alcohol and Related Conditions collected in 2004 and 2005 (n=34,653). The most prevalent form of emotional maltreatment was emotional neglect only (6.2%), followed by emotional abuse only (4.8%), and then both emotional abuse and neglect (3.1%). All categories of emotional maltreatment were strongly related to other forms of child maltreatment (odds ratios [ORs] ranged from 2.1 to 68.0) and a history of family dysfunction (ORs ranged from 2.2 to 8.3). In models adjusting for sociodemographic characteristics, all categories of emotional maltreatment were associated with increased odds of almost every mental disorder assessed in this study (adjusted ORs ranged from 1.2 to 7.4). Many relationships remained significant independent of experiencing other forms of child maltreatment and a family history of dysfunction (adjusted ORs ranged from 1.2 to 3.0). The effects appeared to be greater for active (i.e., emotional abuse) relative to passive (i.e., emotional neglect) forms of emotional maltreatment. Childhood emotional maltreatment, particularly emotionally abusive acts, is associated with increased odds of lifetime diagnoses of several Axis I and Axis II mental disorders.

Concepts: Mental disorder, Child abuse, Abuse, Psychological abuse, Neglect, Family therapy, Bullying, Psychological manipulation

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Guns figure prominently in the homicide of women by an intimate partner. Less is known, however, about their nonfatal use against an intimate partner. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched eight electronic databases and identified 10 original research articles that reported the prevalence of the nonfatal use of firearms against an intimate partner. Results indicate that (1) there is relatively little research on the subject of intimate partners' nonfatal gun use against women. (2) The number of U.S. women alive today who have had an intimate partner use a gun against them is substantial: About 4.5 million have had an intimate partner threaten them with a gun and nearly 1 million have been shot or shot at by an intimate partner. Whether nonfatal gun use is limited to the extreme form of abuse (battering) or whether it occurs in the context of situational violence remains to be seen. Regardless, when it comes to the likely psychological impact, it may be a distinction without a difference; because guns can be lethal quickly and with relatively little effort, displaying or threatening with a gun can create a context known as coercive control, which facilitates chronic and escalating abuse. Implications for policy, practice, and research are discussed, all of which include expanding an implicit focus on homicide to include an intimate partner’s nonfatal use of a gun.

Concepts: Domestic violence, Violence, Meta-analysis, Child abuse, Psychological abuse, Firearm, Gun, Intimidation