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A challenge in safeguarding children from interpersonal violence (IV) in sport is the reliance on self-disclosures and a limited understanding of the frequency, barriers to and process of disclosures of IV. Through a mixed-methods design, combining survey and interviews, we explored the frequencies of childhood disclosures of experiences of IV in Australian community sport as well as who children disclosed to and how the interaction unfolded. Those who experienced peer violence disclosed at the highest frequency (35%), followed by coach (27%) or parent (13%) perpetrated IV. A parent/carer was most often the adult that the child disclosed to. Interviews highlighted how the normalisation of violence influenced all aspects of the disclosure and elements of stress buffering (normalising or rationalising) particularly underpinned the disclosure interaction. Policies and practices should explicitly identify all forms of IV in sport as prohibited conduct; education and intervention initiatives should target parents as first responders to disclosures.

Background: Interpersonal Violence (IV) against children in sports is a prevalent problem and has a major impact on their well-being. However, the causal relationship and the costs for society remain unclear. Objective: The aim of this study is to estimate the causal effect of severe IV in sports on Subjective Well-Being (SWB) and to monetize the collective loss for society. Participants and setting: The study used survey data from 4003 respondents in the Netherlands and Flanders (Belgium). The questionnaire included current SWB as well as 41 items to assess experiences with psychological, physical and sexual IV in sports before the age of 18. Severity was quantified by experts and reported frequency. Methods: By using the number of sports that someone participated in during their youth as an instrumental variable to control for confounding, the study estimates the causal effect of severe IV on SWB. The Three-Stage Well-Being Valuation Approach was used to monetize the loss in SWB in terms of income compensation. Results: The results show that experiencing severe IV in sports results in significant lower SWB levels (b = −0.45, p < .01). The lower SWB is comparable to an annual loss of income of 9672 euro per person. Conclusions: We have found evidence for a causal effect of severe IV in childhood on the SWB later in life. The results highlight the long-term, extensive impact of experiencing severe IV in sports that exceeds direct physical and psychological health outcomes.

The paper will discuss the connection between poverty and victimization of women. Instead of the usual focus on interpersonal violence, this text offers a different view of victimization. Namely, we have dealt with systemic violence which is, by definition, incorporated in social structures and which mostly passes undetected, despite leaving visible consequences. Our primary goal was to point to some of the illustrative examples of women victimization through structural violence and, besides the descriptive analysis, our intention was also to provide the reader with the explanatory analysis which led to two assumptions. The first one refers to etiology, while the second refers to systemic violence in the contemporary social context.

Across a correlational study and two experiments, this dissertation examined the link between media exposure to interpersonal violence and mental health, as well as the role of social (racial) identity in this link. In Chapter 2, observational data from a nationally representative U.S. sample were used to investigate correlates of watching videos of Black victims of violence, the association between frequent watching and mental health outcomes, and whether race (Black vs. non-Black) moderated this association. Results showed that (a) Black participants watched videos of Black victims of violence more frequently than non-Black participants, (b) more frequent watching was associated with greater video-specific distress, global distress, and functional impairment, and (c) more frequent watching was prospectively associated with greater stress about police violence against Black people 18 months later for Black, but not non-Black, participants. In Chapter 3, two experiments were conducted to assess the psychological impact of exposure to images of interpersonal violence and the roles of victim race, violence type (i.e., police vs. non-police [civilian] perpetrator), perpetrator race, and the viewer’s own race in these responses. Results in Experiment 1 indicated that both Black and White individuals’ negative affect and image-related distress were increased by exposure to images of Black victims (vs. White victims) of violence. Also, those who were more distressed by the images in the experiment reported more worry about and perceived risk of future violence one week later. Findings in Experiment 2 showed that Black individuals’ emotional responses to images of Black victims of violence depended on whether the perpetrator was a police officer (vs. civilian) and the perpetrator’s race (Black vs. White). Taken together, the results of this dissertation suggest that media exposure to Black victims of violence is associated with adverse mental health outcomes, both in the s

Although structural violence is known to interact with and reinforce direct violence in the form of interpersonal violence (e.g., intimate partner violence), little debate takes place in public health on how it can lead to revictimization, leading to even poorer health outcomes (including psychological ill health). This viewpoint aims to discuss this issue using examples from empirical studies to elucidate how structural violence (perpetrated through institutions) contributes to revictimization among people who are already suffering direct violence. Public health professionals (and researchers) need to make efforts to theorize and measure structural violence to aid efforts toward the study of how it intersects with interpersonal violence to influence health outcomes. This will ultimately contribute to better prevention and intervention efforts to curb interpersonal violence and improve population health and well-being. In addition, there is a need to include structural violence in the academic curriculum when training future generations of public health professionals. Increased education on structural violence will bring about an awareness of the grave consequences of the potential additional harm that institutions could inflict on the lives of people they should be protecting or care for., CC BY 4.0© 2023 The Author(s).

The aim of this study was to examine the association between the victim vulnerability factors included in the intimate partner violence (IPV) risk assessment tool used by the Swedish police (Brief Spousal Assault Form for the Evaluation of Risk [B-SAFER]) and rates of IPV revictimization among female victims living in rural towns, countryside, or remote areas. This study also aimed to examine the interaction between rurality and IPV revictimization in relation to victim vulnerability. The sample consisted of 695 cases of male-to-female perpetrated IPV, which had been reported to the Swedish police and subjected to a B-SAFER assessment. Rates of revictimization were examined in police registers. The results demonstrated that several vulnerability factors could discriminate between IPV revictimization across rurality. There was also an interaction effect between rurality and IPV revictimization in relation to the number of victim vulnerability factors present, where revictimization was more common for victims with many vulnerability factors living in more sparsely populated areas.

Este trabajo analiza la violencia interpersonal a finales del Antiguo Régimen a través del delito de injurias, tomando como estudio de caso el pleito de 1817 en Labastida (Álava). Se examinan los mecanismos en los que se apoyan los ofendidos para defenderse de los insultos sufridos, que atacan el honor de las personas para vivir en comunidad, y cómo esta vela por la paz vecinal. A través de la perspectiva de una historia de las emociones se pueden observar cuáles eran los miedos y las preocupaciones que esconden este tipo de agravios para los individuos, por atacar los valores morales de la sociedad porque debían regirse., This project analyses interpersonal violence at the end of the Ancien Régime through the crime of insult, taking as a case study the lawsuit of 1817 in Labastida (Álava). It examines the mechanisms used by the offended parties to defend themselves against the insults suffered, which attack people's honour in order to live in a community, and how the community ensures peace in the neighbourhood. Through the perspective of a history of emotions, it is possible to observe the fears and concerns that this type of offence concealed for individuals, attacking the moral values of the society they were supposed to govern., Departamento de Historia Moderna, Contemporánea y de América, Periodismo y Comunicación Audiovisual y Publicidad, Grado en Historia

Background and Objectives: Interpersonal violence is a social and public health problem globally, and though it is related to poor health outcomes across all genders, most research has been directed towards violence against women. As a result, the health consequences of men's victimization may be underreported and unaddressed. The purpose of this study was to assess the relationship between interpersonal violence and the psychological health outcomes of self-reported stress, anxiety, and depression among men. Materials and Methods: The study used data from the male sample (n = 2597) of the 2018 Health on Equal Terms Survey conducted in Gavleborg County in East-Central Sweden. Regression analysis was carried out to study the relationship between interpersonal violence and self-reported stress, anxiety, and depression. Results: The bivariate analysis showed that there was a statistically significant association between interpersonal violence and self-reported stress (OR 2.35; CI 1.45-3.81), anxiety (OR 1.54; CI 1.06-2.25), and depression (OR 2.30; CI 1.48-3.57). Controlling for other variables in the multivariate analysis removed the statistically significant relationship and reduced the odds ratios for stress (OR 1.46; CI 0.57-3.74), anxiety (OR 0.86; 0.40-1.84), and depression (OR 1.40; CI 0.67-3.32) respectively. Conclusions: The study found that interpersonal violence among men was associated with stress, anxiety and depression which was largely explained by demographic, socioeconomic, and health/behavior-related factors. The findings suggest the need for longitudinal studies to assess causal links between male victimization and psychological health outcomes at the county level.

Post-Traumatic Growth is a term that refers to an individual's experience of considerable positive transformation following the occurrence of a traumatic event. This growth may be rapid, gradual, or non-existent, depending on the circumstances (such as social support or societal stigma) to which the victims are subjected during the process. However, the high prevalence of trauma among traumatized victims and the benefits of post-traumatic growth (PTG) discovered in increasing empirical research demonstrate the need of fostering PTG in victims of interpersonal violence. As a result, the current study analysed risk variables for PTG development. The study enrolled 200 women and men recruited through an organization that provides services to trauma victims. The data were gathered via an online survey that included the PTG inventory and an information sheet on demographic, social support, and stigma-related characteristics. Social stigma and support were found to be significant predictors of PTG, with stigma being associated with lower PTG and family and religious support being associated with higher PTG. The limitations and policy implications were highlighted, and recommendations for additional research were presented., El crecimiento postraumático es un término que se refiere a la experiencia de un individuo de una considerable transformación positiva tras la ocurrencia de un suceso traumático. Este crecimiento puede ser rápido, gradual o inexistente, dependiendo de las circunstancias (como el apoyo social o el estigma social) a las que se vean sometidas las víctimas durante el proceso. Sin embargo, la alta prevalencia del trauma entre las víctimas traumatizadas y los beneficios del crecimiento postraumático (CPT) descubiertos en cada vez más investigaciones empíricas demuestran la necesidad de fomentar el CPT en las víctimas de violencia interpersonal. En consecuencia, el presente estudio analizó las variables de riesgo para el desarrollo del CPT. En el estudio participaron 200 mujeres y hombres reclutados a través de una organización que presta servicios a víctimas de trauma. Los datos se recopilaron mediante una encuesta en línea que incluía el inventario de CPT y una hoja de información sobre características demográficas, de apoyo social y relacionadas con el estigma. El estigma y el apoyo social resultaron ser predictores significativos de la CPT, asociándose el estigma con una menor CPT y el apoyo familiar y religioso con una mayor CPT. Se destacaron las limitaciones y las implicaciones políticas, y se presentaron recomendaciones para investigaciones adicionales.

En este artículo se realiza, en primer lugar, una breve reflexión sobre los argumentos de la preponderancia de la violencia en la Edad Media y sobre cómo abordar su estudio a partir de la Historia cultural y la microhistoria. Esta reflexión se centra en la violencia como característica estructural del sistema feudal; como característica de una cultura basada en el honor y en la venganza como mecanismo de resolución de conflictos; y como característica inherente a una sociedad emocional y carente de autocontrol. En segundo lugar, se analiza el caso del asesinato del clérigo Nicolás de Arrieta, acaecido en 1493 en la villa de Lekeitio (Señorío de Vizcaya), como ejemplo de violencia interpersonal y que permite adentrarse en el contexto social y cultural particular del conflicto y entender cómo se gestaba un crimen y se rompía la paz social. El estudio se estructura en los siguientes apartados: a) ¿cómo se produjo el asesinato?; b) ¿cómo llevó adelante la acusación y el proceso penal María Pérez de Arrieta, hermana del clérigo; c) las actuaciones judiciales y los conflictos jurisdiccionales; d) las condenas a los acusados; y e) ¿cuál fue la motivación del asesinato? El asesinato del clérigo Nicolás de Arrieta permite reconstruir y comprender, entre otras cuestiones, la capacidad de acción o agencia en el plano judicial de las mujeres; el funcionamiento de la justicia penal como mecanismo de control social disciplinario; la separación jurisdiccional entre villas y Tierra Llana en el Señorío de Vizcaya; el conflicto de la iglesia parroquial de Lekeitio con sus iglesias sufragáneas y su resolución a través de mecanismos arbitrales o, como es el caso, a través del ejercicio de la violencia., In this research article, first of all, a brief reflection is made on the arguments for the preponderance of violence in the Middle Ages and on how to approach its study from cultural history and microhistory. This reflection focuses on violence as a structural characteristic of the feudal system; as a characteristic of a culture based on honor and revenge as a conflict resolution mechanism; and as an inherent characteristic of an emotional society lacking in self-control. Secondly, the case of the murder of the clergyman Nicolás de Arrieta, which occurred in 1493 in the town of Lekeitio (Lordship of Biscay), is analyzed as an example of interpersonal violence and which allows one to delve into the particular social and cultural context of the conflict and understand how a crime was brewing and social peace was broken. The study is structured into the following sections: a) how did the murder take place?; b) how did María Pérez de Arrieta, sister of the cleric, carry out the accusation and criminal proceedings; c) judicial proceedings and jurisdictional conflicts; d) the sentences of the defendants; and e) what was the motivation for the murder? The murder of the cleric Nicolás de Arrieta allows us to reconstruct and understand, among other issues, the capacity for action or agency in the judicial sphere of women; the functioning of criminal justice as a disciplinary social control mechanism; the jurisdictional separation between towns and villages in the Lordship of Biscay; the conflict of the parish church of Lekeitio with its suffragan churches and its resolution through arbitration mechanisms or, as is the case, through the exercise of violence.

Interpersonal violence against women is a widely spread problem where one out of three women globally falls victim to violence during their lifetime. The Swedish government constructed 2016 six gender equality policies and one of these policies aims to violence against women to end. Despite this, there is no sign that the violence has decreased, neither in Sweden nor globally. Our empiricism consisted of six legal cases where the man was convicted of physical and/or physiological violence against the woman. The aim of this study was to through a content analysis get in-depth knowledge about the men’s use of their position of power and the power balance to use interpersonal violence. We found signs of domination techniques in all of the legal cases and therefore chose to focus on four of the most common methods; i.e. violence or threats of violence, transferring of blame and guilt, objectification, and double binding. While analyzing the legal cases using these techniques we found that men’s position of power and their exercising of power through violence not only is justified by Hirdman’s (1988, 2001) gender contract and gender system but also is romanticized in the relationship. The gender contract enabled the man to demand civil rights and create the definition of women since she’s nevertheless derived by her body. We also found that women often find themselves trapped in men’s illogical rules enabled by the man's power. The women were reduced to an object in the man’s world that he had the right to control.

Malgrat que el maltractament animal pot ser un acte d'exploració en la infància, resulta pertinent que la criminologia investigui i incideixi en les possibles vinculacions ocultes entre el maltractament animal i la violència interpersonal, en la hipòtesi de que la crueltat cap als animals pugui dur a d'altres tipus de conductes violentes, així com ser un indicador de la pròpia victimització que les persones poden experimentar. S'explora la necessitat d'un enfocament multidisciplinari en aquest àmbit, que encara no ha obtingut molta rellevància en el pla real degut a la baixa consideració que una part important de la societat continua tenint envers els animals i, a la dissociació existent, atès què encara resulta complex concentrar-se en víctimes humanes i no humanes alhora. Basant-nos en la literatura científica existent en aquest tòpic i la opinió d'experts en la matèria, s'evidencia que el maltractament animal duu a una insensibilització i normalització de la conducta violenta, i que les victimitzacions que més es relacionen amb aquesta conducta són: la violència de gènere, la violència domèstica, l'abús sexual, la radicalització violenta, el bullying i l'abús de persones grans. El factor estructural pren una importància primordial a l'hora d'entendre la violència interpersonal vinculada al maltractament animal, essent precís eliminar tota aquella cultura social favorable a la violència. Alhora, es busca respondre a aquells aspectes que presenten més incògnites, tals com la possible graduació de la violència cap als animals a la violència cap a les persones., Although animal abuse may be an act of exploration in childhood, it is relevant that criminology investigates and focuses on the possible hidden links between animal abuse and interpersonal violence, in the hypothesis that cruelty to animals may lead to other types of violent behavior, as well as being an indicator of one's own victimization that people may experience. It explores the need for a multidisciplinary approach in this area, which has not yet gained much relevance in the real world due to the low regard that an important part of society continues to have for animals and, in the existing dissociation, given which is still complex to focus on human and non-human victims at the same time. Based on the existing scientific literature on this topic and the opinions of experts in the field, it is evident that animal abuse leads to a desensitization and normalization of violent behavior, and that the victimizations that are most related to this behavior they are: gender-based violence, domestic violence, sexual abuse, violent radicalization, bullying and elder abuse. The structural factor is of paramount importance in understanding interpersonal violence linked to animal abuse, and it is necessary to eliminate all those social cultures that are conducive to violence. At the same time, it seeks to respond to those aspects that present more unknowns, such as the possible graduation of violence against animals to violence against people.

A substantial minority of women who experience interpersonal violence will develop posttraumatic stress disorder (PTSD). One critical challenge for preventing PTSD is predicting whose acute posttraumatic stress symptoms will worsen to a clinically significant degree. This 6-month longitudinal study adopted multilevel modeling and exploratory machine learning (ML) methods to predict PTSD onset in 58 young women, ages 18 to 30, who experienced an incident of physical and/or sexual assault in the three months prior to baseline assessment. Women completed baseline assessments of theory-driven cognitive and neurobiological predictors and interview-based measures of PTSD diagnostic status and symptom severity at 1-, 3-, and 6-month follow-ups. Higher levels of self-blame, generalized anxiety disorder severity, childhood trauma exposure, and impairment across multiple domains were associated with a pattern of high and stable posttraumatic stress symptom severity over time. Predictive performance for PTSD onset was similarly strong for a gradient boosting machine learning model including all predictors and a logistic regression model including only baseline posttraumatic stress symptom severity. The present findings provide directions for future work on PTSD prediction among interpersonal violence survivors that could enhance early risk detection and potentially inform targeted prevention programs.

BackgroundThe prevalence of elder abuse has only rarely been investigated in Sweden and never in a hospital setting. Therefore, the aims of this study were to: 1) Estimate the prevalence of elder abuse and life-course victimization among hospitalized older adults in Sweden, 2) Explore factors associated with elder abuse in the same sample, and 3) Explore the associations between life-course victimization and mental ill-health. MethodsThe study was conducted at a university hospital in Sweden. Adults over the age of 65 years admitted to a medical or geriatric acute care ward during spring 2018 were consecutively recruited. The participant rate was 44% (n = 135/306). Participants were assessed via a face-to-face interview about their experiences of elder abuse and abuse earlier in life. Mental ill-health was measured using a self-administered depression assessment (Patient Health Questionnaire-9), along with information about medications and diagnoses retrieved from medical records. ResultsAltogether, 40.7% (n = 55) of the participants reported some form of abusive experience during their life course. The prevalence of elder abuse was 17.8% (n = 24), and 58% (n = 14) of elder abuse victims also reported victimization earlier in life. Being abused before the age of 65 was the only background factor associated with elder abuse (OR = 5.4; 95% CI 1.9–15.7). Reporting abusive experiences both before and after the age of 65 was associated with current anti-depressant medication (OR = 6.6; 95% CI 1.1–39.2), a PHQ-9 result of 10 or more (OR = 10.4; 95% CI 2.1–51.0), and nine or more symptom diagnoses (OR = 4.0, 95% CI 1.0–16.1). Being abused only before or after the age of 65 was not significantly associated with any mental ill-health outcome measure. ConclusionsElder abuse and victimization earlier in life are highly prevalent among hospitalized older patients, and our findings underline the importance of a life-course perspective both in research on elder abuse and in clini, Funding: Linkoping University; Swedish Crime Victim Fund [3322/2017, 2944/2018, 3384/2019]; Region OEstergoetland [ROE-964271]

Background: Intentional interpersonal youth violence is a significant public health issue, causing acute and chronic health problems affecting individuals, families, and communities. Social emotional learning (SEL) programs, such as Roots of Empathy (ROE), delivered in schools decrease physical aggression and increase prosocial behaviours. These are risk and protective factors for later involvement in interpersonal violence. The purpose of this research is to study whether individuals who participated in ROE in childhood/early adolescence have a reduced risk of serious intentional interpersonal violent injury as youths between the ages of 16-24, and whether this relationship differs based on sex at birth (male/female) or grade level of exposure (K-3, 4-6, and 7-10). Methods: This retrospective population-based cohort study uses data from Manitoba, Canada, relying on the linkable health and social databases through the Manitoba Center for Health Policy (MCHP). The participants in this study were born from 1986 to 2002; cases were identified as those who participated in the 2002-2007 Phase I and II ROE studies (n = 4,437). ROE youth were matched up to10:1 to youth who did not participate in ROE (n = 44,254). Severe interpersonal violent injuries in youths ages 16-24 was defined as a serious injury requiring admission to hospital or death due to interpersonal violence inflicted by others. Hazard ratios (HR) were obtained using survival analysis. Results: Youth in this study were followed for an average of 7.3 years (SD 1.8). The rates of intentional violent injury were 13.2 and 10.5 per 10,000 for the ROE and the control group, respectively (HR =1.26; 95% CI 0.91-1.73). This was non-significant. The relationship did not vary for males (HR = 1.34; 95% CI 0.95-1.89) or females (HR = 0.90; 95% CI 0.39-2.10). Additionally, the relationship between exposure to ROE and interpersonal intentional violent injury was non-significant for those who participated in grades k-3 (HR =

BackgroundWomen are more likely to present with genitourinary complaints immediately after exposure to interpersonal violence, but little is known about the long-term effects of violence on women's urologic health, including their susceptibility to bladder pain and infections.ObjectiveTo determine whether lifetime interpersonal violence exposure and current posttraumatic stress disorder (PTSD) symptoms are associated with the prevalence or severity of painful bladder symptoms and a greater lifetime history of antibiotic-treated urinary tract infections in community-dwelling midlife and older women.Study designWe examined the cross-sectional data from a multiethnic cohort of community-dwelling women aged 40 to 80 years enrolled in a northern California integrated healthcare system. Women completed structured self-report questionnaires about their past exposure to physical and verbal/emotional intimate partner violence and sexual assault. The symptoms of PTSD were assessed using the PTSD checklist for the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition, Civilian version. Additional structured self-report measures assessed the current bladder pain, other lower urinary tract symptoms, and the history of antibiotic-treated urinary tract infections. Multivariable logistic regression models examined self-reported interpersonal violence exposure history and current PTSD symptoms in relation to current bladder pain and antibiotic-treated urinary tract infection history.ResultsAmong 1974 women (39% non-Latina White, 21% Black, 20% Latina, and 19% Asian), 22% reported lifetime interpersonal violence exposure, 22% reported bladder pain, and 60% reported a history of ever having an antibiotic-treated urinary tract infection. Lifetime experiences of sexual assault (odds ratio, 1.39; [95% confidence interval, 1.02-1.88]) and current PTSD symptoms (odds ratio, 1.96; [95% confidence interval, 1.45-2.65]) were associated with current bladder pain. A lifetime expe

The effects of violence exposure on the risk of self-harming behaviors of youth in low- and middle-income countries is not well-understood. Using household survey data from one nationally representative sample and one sample from conflict-affected areas, we examined violence exposure and self-harm among Colombian youth aged 13-24. Survey-weighted prevalence ratios comparing self-harming behaviors by exposure to violence were estimated with Poisson log-linear models, controlling for age, sex, education and food insecurity. Compared to unexposed youth, those exposed to violence in both home and community settings were 7.97 (95% confidence interval [CI]:2.72-23.36) times more likely in the conflict-affected sample, and 21.05 (95% CI: 8.80-50.34) times more likely in the national sample to report having attempted suicide. Among Colombian youth, exposure to violence as either witness or victim was associated with greater prevalence of self-harming behaviors. Youth suicide prevention programs can address exposures to violence as a risk factor for self-harm.

Using a case study, this paper focuses on the possibilities for a male adolescent to reflect, question and make ruptures on his own exercises of violence and on the interpellations he has experienced with women and feminism. Despite the negative consequences it entails, the repetition of rigid male gender roles and male mandates associated with violence, is often maintained as part of a male identity marked by dominance. However, gender socialization, as a process in continuous construction, opens the possibility for male adolescents to question the rigid learning acquired in childhood. It is concluded that adolescents who exercise violence can question themselves and break with previously acquired mandates associated with violence., A partir de un estudio de caso, este trabajo se centra en las posibilidades que tiene un adolescente varón de reflexionar, cuestionar y hacer rupturas sobre sus propios ejercicios de violencia y sobre las interpelaciones que ha vivido con las mujeres y el feminismo. A pesar de las consecuencias negativas que conlleva, la repetición de los rígidos roles de género y de los mandatos masculinos asociados a la violencia suelen mantenerse como parte de una identidad masculina marcada por la dominación. Sin embargo, la socialización de género, como proceso en continua construcción, abre la posibilidad de que los adolescentes varones cuestionen el rígido aprendizaje adquirido en la infancia. Se concluye que los adolescentes que ejercen la violencia pueden cuestionarse a sí mismos y romper con los mandatos previamente adquiridos asociados con la violencia.

Blunt force trauma is a common homicide method, inflicted in three different ways: bodily force, assault with blunt objects of various types and falls from height. The objective of this study is to provide thorough information on blunt force homicides with data on the victims, the offenders, the surrounding circumstances, the injury methods, the extent of injuries, and survival time, which will help inform the inexperienced as well as the seasoned forensic pathologist in their daily work with death investigation and as expert witnesses in court. We have analyzed autopsy reports and available case files of 311 blunt force homicides, making up 21.9% of all homicides in Denmark during 1992–2016. Most victims and offenders were male. Altercation in the setting of nightlife and intoxication was common in male victims, while most female victims were killed in a domestic setting. Bodily force was the most common primary homicide method, followed by assault with a blunt object and fall from height. The head was the region that most often had external injuries, with no noteworthy difference between cases with bodily force and blunt objects. Two out of three victims had one or more lacerations, most often located on the head and more often on the front. Brain injury was the primary cause of death in at least 72.0% victims. Compared to bodily force victims of blunt object assault were especially prone to skull and brain injuries, had a higher trauma score, and more died at the crime scene and had a shorter survival time.

In this retrospective study, we present the findings in 250 homicides by asphyxia in Denmark in a 25-year period, with a particular focus on the autopsy findings in strangulation. Our intention is for the results to be used in future death investigations, where difficulties in interpretation of findings in potential asphyxial deaths arise. Asphyxia homicides showed a strong bias with respect to sex, age, and homicide type. The frequent female victim was typically an adult, whereas the rarer male victim was most often a child. Female offenders most often killed their children, and male offenders most often killed their female partner. Generally, most asphyxia homicides took place in a domestic setting. Manual strangulation and ligature strangulation were the most common mechanisms of asphyxia homicides (81.6%). A lack of petechial hemorrhages, especially in the conjunctiva, was rare in homicidal strangulation, but there were exceptions, especially when there was postmortem decomposition, making it impossible to verify them. Most victims of strangulation had skin lesions in the face (including the jawline) or on the neck, with accompanying hemorrhages in muscle and connective tissue, but the findings could be subtle or compounded by decomposition. Fractures of the laryngo-hyoid complex were common in strangulation, particularly in manual strangulation (chi-sq =4.0993, df = 1, P < 0.05) and were clearly related to the age of the victim (chi-sq =82.193, df = 4, P < 0.001). In children and young adults dying from homicidal strangulation, a lack of fractures is to be expected, while a lack of fractures is unusual, but not entirely unexpected, for adults and aged people.

This article addresses an under analysed aspect in the history of the civil-military relations during the early modern period: civilian violence against soldiers. While the causes and factors behind the widespread aggressions and extortions civilians suffered at the hands of military men have attracted a great deal of scholarly attention, we know very little about the former’s violence on the latter. Analysing court trials against a wide array of civilians (from local authorities to peasants and manufacturing workers) on their attacks against the soldiers deployed in a new frontier city: Pamplona, I argue that civilian violence against soldiers, far from being a simple reaction to military aggressions, was the result of first, their incorporation into urban society; and second, the civilians’ active engagement in the shaping of informal rules and practices regulating civil-military relations from below., La historia de las relaciones entre civiles y militares ha privilegiado la violencia de los segundos sobre los primeros por lo que sabemos poco sobre la violencia ejercida por civiles contra soldados. Este artículo se centra en ella examinando un corpus de pleitos sobre las agresiones sufridas por soldados a manos de agentes de la autoridad local, campesinos o trabajadores, en una nueva ciudad de frontera: la Pamplona del s. XVI. Este análisis muestra que la violencia civil sobre los soldados, más que una mera respuesta a sus abusos era el resultado de la incorporación de los militares al tejido social local, así como de la activa participación de los civiles en la configuración de las prácticas y normas que regulaban la interacción a ras de suelo entre civiles y militares.

Cruelty to animals is a symptom of conduct disorder and associated with psychopathic traits in childhood. One of the factors thought to contribute to animal cruelty is reduced empathy and concern for the well-being of animals. A first aim of this study was to examine empathy towards animals in distress in male adolescents with disruptive behavior disorders (DBD) and high or low psychopathic traits, and normal controls (NC). Psychopathic traits were assessed by the Antisocial Process Screening Device (APSD). Respondents were exposed to a short film clip depicting a baby bear in distress. Heart rate (HR) responses were monitored during film exposure. Afterwards, respondents were asked to report the emotions they had observed and experienced. Contrary to expectations based on research on human empathy, no group differences were found in empathy-related responses to witnessing animal distress. Both DBD groups and normal controls observed equal levels of distress in the baby bear, experienced as much empathy and sympathy, and showed similar levels of HR reduction during the most dramatic scene. Results suggest that empathy for humans does not generalize to animals, and vice versa. A second aim was to examine the associations between empathy-related responses and the broad concept of psychopathy as well as its dimensions. The relationships were different and for the most part reversed in the NC and DBD groups. Group proved to be an important moderating factor, indicating that results obtained within a sample of healthy adolescents do not generalize to adolescents with DBD, and vice versa.

Domestic violence is a public health issue that affects women of all races and ethnicities. However, women of Latin American origin or descent in the United States are more likely to experience severe negative consequences of domestic violence, such as increased risk of HIV and other sexually transmitted infections, depression and PTSD (Da Silva) and face unique obstacles when dealing with domestic violence like language barriers, immigration status, cultural factors and knowledge and access of resources.The population of those that are of Latin American origin or descent is not only increasing in the United States, but there is also an increase in migration of those that are of Latin American origin or descent to areas outside traditional settlement areas. Latinx is a gender-neutral term for those of Latin American origin and descent, referring to any person of Mexican, Cuban, Puerto Rican, Central or South American or other Spanish origin or culture regardless of race (US Census Bureau, n.d) and will be used to refer to this population. People of Latin American origin or descent most commonly identify by their country of origin, however, since this research looks at those from several countries, including Mexico, Central America, the Caribbean and South America the term Latinx will be used (Kaur, 2020). When referring to women of Latin American origin or descent, the term Latina will be used. Since the 1990s, there has been an increase of Latinx migration to the Southeast. The purpose of this research is to compare and contrast what types of resources are available for Latinas in new settlement areas (Southeast) and traditional settlement areas (Southwest) who face domestic violence. Surveys and interviews were conducted with domestic violence organizations in the Southwest and Southeast and asked about resources and their capacity to help Latina victims. The Southeast needs more resources to meet the needs of Latina victims, including more bilingual staff. Negati

Background: Compulsive Sexual Behavior Disorder (CSBD) is characterized by sexual preoccupation and loss of control of sexual behaviors causing distress, negative consequences, and impairment. Despite its high prevalence, the condition is understudied in terms of background factors and treatment. Aims: The overall aim of this thesis is to investigate clinical characteristics with a specific focus on self-reported experience of interpersonal violence and various dimensions of impulsivity, and to evaluate treatment with naltrexone in help-seeking men with CSBD. Methods: In Study I, 67 men with CSBD were compared with 40 healthy, age-matched controls concerning interpersonal violence measured with the Karolinska Interpersonal Violence Scale (KIVS). In Study II, clinical, neurocognitive, and self-reported measures of impulsivity were compared between men with CSBD (n=20), a clinical control cohort with pedophilic disorder (n=55), and a healthy male control cohort (n=57). In Study III, 20 men with CSBD received four weeks of treatment with the opioid antagonist naltrexone, followed by a four-week follow-up phase. Adverse effects, adherence to treatment, and changes in compulsive sexual behavior were assessed. Study IV is an ongoing randomized controlled trial in which 80 individuals with CSBD receive either naltrexone or the selective serotonin reuptake inhibitor (SSRI) fluoxetine for eight weeks, followed by a six-week follow-up phase. The primary outcome measure is Hypersexual Disorder: Current Assessment Scale (HD:CAS), also used in Study III. Results: In Study I, men with CSBD had higher scores on self-reports of exposure to violence in childhood and use of violence as adults, as well as higher KIVS total scores compared with healthy controls. Those who had made a suicide attempt (n=8, 12%) reported higher scores of sexual abuse in childhood as well as the highest value of total experience of interpersonal violence. In Study II, neurodevelopmental disorders were co

© 2020 Elsevier Inc. Objective: To reconstruct the etiology of a perimortem injury observed on a Neolithic – Chalcolithic cranium (5060 – 4400 yrs cal. BP). Materials: A cranium of an old adult male individual belonging to a collective burial from Cova Foradada site (Calafell, Tarragona, Spain). Methods: The cranium was analyzed macroscopically and microscopically using micro-CT scan. Results: The fracture on the right parietal bone presents characteristics of perimortem trauma. The morphology of the point of impact allows for the interpretation of this fracture as a result of impact by an object with a straight and sharp edge. In addition, the same cranium presents two healed antemortem injuries. Conclusions: The object that most likely caused the cranial fracture was a stone adze. The blow occurred from behind the individual, possibly by a right-handed attacker. Significance: The potential to link cranial fractures with specific tools increases our understanding of interpersonal violence during the Neolithic. Limitations: It is not possible to infer if this cranial injury was related to a large-scale intergroup confrontation or an intragroup violent event. Suggestions for further research: To investigate additional similar sites in the northeastern Iberian Peninsula to better characterize the fracture pattern caused by stone axes and adzes as well as other objects used as weapons during the Neolithic – Chalcolithic ages.

(1) Background: Sexual violence (SV) has become common in universities for reasons related to unwanted social/peer pressures regarding alcohol/drug use and sexual activities. Objectives: To identify perceptions of SV and alcohol use and estimate prevalence among nursing students in Catalonia, Spain. (2) Methods: Observational descriptive cross-sectional study of a convenience sample of nursing students attending public universities. (3) Results: We recruited 686 students (86.11% women), who reported as follows: 68.7% had consumed alcohol, 65.6% had been drunk at least once in the previous year, 62.65% had experienced blackouts and 25.55% had felt pressured to consume alcohol. Drunkenness and blackouts were related (p < 0.000). Of the 15.6% of respondents who had experienced SV, 47.7% experienced SV while under the influence of alcohol and were insufficiently alert to stop what was happening, while 3.06% reported rape. SV was more likely to be experienced by women (OR: 2.770; CI 95%: 1.229–6.242; p = 0.014), individuals reporting a drunk episode in the previous year (OR: 2.839; 95% CI: 1.551–5.197; p = 0.001) and individuals pressured to consume alcohol (OR: 2.091; 95% CI: 1.332–3.281; p = 0.001). (4) Conclusions: Nursing instructors need to raise student awareness of both the effects of alcohol use and SV, so as to equip these future health professionals with the knowledge and skills necessary to deal with SV among young people.

Previous studies have demonstrated the relationship between the accumulation of situations involving interpersonal violence (IV) and psychotic-like experiences. This study explored whether IV is related to aberrant salience (AS), using a sequential mediation model that included memories of relationship with parents (submission, devaluation, and threat; Early Life Experiences Scale (ELES)), ideas of reference (IR), and dissociative symptoms (absorption and depersonalization), and whether the patient/nonpatient condition moderated this effect. The sample was made of 401 participants (including 43 patients with psychotic disorders) aged 18 to 71 years (Mage = 30.43; SD = 11.19). Analysis of a serial multiple mediator model revealed that IR, ELES, absorption, and depersonalization fully mediated the effect of IV on AS, explaining 39% of the variance, regardless of the patient/nonpatient condition. The indirect paths, which place IR and dissociation (especially absorption, the variable to which the IR and ELES lead) in a primordial position for being related to AS, are discussed. This continuum model could be useful for understanding processes related to the onset of psychosis unmoderated by the patient/nonpatient condition.

A substantial minority of women who experience interpersonal violence will develop posttraumatic stress disorder (PTSD). One critical challenge for preventing PTSD is predicting whose acute posttraumatic stress symptoms will worsen to a clinically significant degree. This 6-month longitudinal study adopted multilevel modeling and exploratory machine learning (ML) methods to predict PTSD onset in 58 young women, ages 18 to 30, who experienced an incident of physical and/or sexual assault in the three months prior to baseline assessment. Women completed baseline assessments of theory-driven cognitive and neurobiological predictors and interview-based measures of PTSD diagnostic status and symptom severity at 1-, 3-, and 6-month follow-ups. Higher levels of self-blame, generalized anxiety disorder severity, childhood trauma exposure, and impairment across multiple domains were associated with a pattern of high and stable posttraumatic stress symptom severity over time. Predictive performance for PTSD onset was similarly strong for a gradient boosting machine learning model including all predictors and a logistic regression model including only baseline posttraumatic stress symptom severity. The present findings provide directions for future work on PTSD prediction among interpersonal violence survivors that could enhance early risk detection and potentially inform targeted prevention programs.

The emergency department (ED) serves as the main source of care for patients who are victimsof interpersonal violence. As a result, emergency physicians across the nation are at the forefrontof delivering care and determining dispositions for many at-risk patients in a dynamic healthcareenvironment. In the majority of cases, survivors of interpersonal violence are treated and dischargedbased on the physical implications of the injury without consideration for risk of reinjury and thestructural drivers that may be at play. Some exceptions may exist at institutions with hospital-basedviolence intervention programs (HVIPs). At these institutions, disposition decisions often includeconsideration of a patient’s risk for repeat exposure to violence. Ideally, HVIP services would beavailable to all survivors of interpersonal violence, but a variety of current constraints limit availability.Here we offer a scoping review of HVIPs and our perspective on how risk-stratification could helpemergency physicians determine which patients will benefit most from HVIP services and potentiallyreduce re-injury secondary to interpersonal violence.

Although the negative consequences of traumatic exposure across various domains of functioning have been well-documented, gaps and discrepancies continue to exist in the understanding of the impact of complex trauma, such as interpersonal violence (IPV), and how outcomes may vary across diverse populations and identities. In this cross-sectional study investigating the impact of traumatic exposure on physiological domains of functioning, a sample of female-identifying college students completed a number of self-reported measures (assessing past and present trauma exposure, complex posttraumatic stress disorder [CPTSD] symptoms, racial-ethnic minority status, and age of onset of first traumatic exposure) and provided resting high-frequency heart rate variability (hfHRV) data, which served as a biomarker for the potential impact of trauma exposure on physiological domains. Correlational and multiple regression analyses were conducted to determine the strength of relationships between variables and the predictive value of the models. Results indicated endorsement of IPV trauma was significantly associated with earlier age of onset, more severe levels of CPTSD symptoms, and higher hfHRV, but not racial-ethnic minority status. Racial-ethnic minority status was significantly related to more severe CPTSD symptoms. Type of trauma exposure was the only variable that emerged as having predictive value for changes in hfHRV. These findings suggest that experiencing IPV may have unique implications for trauma symptomatology and functioning above and beyond other forms of traumatic exposure, but that continued research must be conducted in order to draw more robust conclusions about the effects of exposure on physiological regulation across various racial-ethnic identities.

Previous studies have demonstrated the relationship between the accumulation of situations involving interpersonal violence (IV) and psychotic-like experiences. This study explored whether IV is related to aberrant salience (AS), using a sequential mediation model that included memories of relationship with parents (submission, devaluation, and threat; Early Life Experiences Scale (ELES)), ideas of reference (IR), and dissociative symptoms (absorption and depersonalization), and whether the patient/nonpatient condition moderated this effect. The sample was made of 401 participants (including 43 patients with psychotic disorders) aged 18 to 71 years (Mage = 30.43; SD = 11.19). Analysis of a serial multiple mediator model revealed that IR, ELES, absorption, and depersonalization fully mediated the effect of IV on AS, explaining 39% of the variance, regardless of the patient/nonpatient condition. The indirect paths, which place IR and dissociation (especially absorption, the variable to which the IR and ELES lead) in a primordial position for being related to AS, are discussed. This continuum model could be useful for understanding processes related to the onset of psychosis unmoderated by the patient/nonpatient condition.

Background: The consumption of alcohol increases the risk of drinkers harming others. The extent of alcohol's morbidity and mortality harms to others in Germany in 2014 was estimated for (1) fetal alcohol syndrome (FAS) or fetal alcohol spectrum disorders (FASD) among newborns, (2) road traffic fatalities, and (3) interpersonal violence-related deaths. Methods: The incidences of FAS and FASD were estimated by means of a meta-analytical approach, combining data on alcohol use during pregnancy and the risk relationship between alcohol consumption during pregnancy and FAS/FASD. In order to estimate alcohol-attributable road traffic fatalities and interpersonal violence due to the drinking of others, an attributable fraction methodology was applied to cause-of-death statistics for road traffic and interpersonal violence-related deaths. Results: For 2014, the incidences of FAS and FASD were estimated at 41 children per 10,000 live births (95% CI 24; 63) and 177 children per 10,000 live births (95% CI 135; 320), or 2930 (95% CI 1720; 4500) and 12,650 (95% CI 9650; 23,310) children, respectively. Furthermore, alcohol was estimated to be responsible for 1214 (95% CI 1141; 1287) third-party road traffic fatalities and 55 (95% CI 46; 64) deaths from interpersonal violence, representing 45.1% of all third-party road traffic fatalities and 14.9% of all interpersonal violence deaths. Conclusion: These study's estimates indicate there is a substantial degree of health harm to third parties caused by alcohol in Germany. While more research on harms to others caused by alcohol is needed to provide comprehensive estimates, the results indicate a need for effective prevention.

This study was conducted to examine the relationships among acceptance of couple violence, attraction to abuse, and beliefs about relationship red flags among college students. We conducted an online survey of 159 students at Chapman University to investigate the relationship among attraction to abuse, acceptance of couple violence, and perceived relationship. The results indicated that there is a positive correlation between students feeling attracted to abuse and acceptance of violence in their relationship. However, there was not a clear correlation between the acceptance of violence and the ability to perceive relationship red flags, but we did find that students who feel that jealousy is okay in a relationship are also more accepting of violence in their relationship.

We present the findings for homicides in Denmark for 1992–2016. There were 1417 homicide victims (62.2% males, 37.8% females) that were killed in 1321 homicide events. The most common methods were sharp force trauma (33.2%), gunshot (22.2%), blunt force trauma (21.9%) and asphyxia (17.6%), and all methods exhibited a reduction during the study period. The homicide rate was 1.05 per 100,000, 1.32 per 100,000 for males, and 0.78 per 100,000 for females. Domestic homicides were the largest main group of homicides (76.5% of all female victims vs. 23.6% of male victims). Of the non-domestic homicides, 84.2% of victims were male, the largest group being in the setting of nightlife and/or intoxication. Most female victims (76.9%) were killed by someone in their family, while the largest share of male victims (34.5%) were killed by a friend or acquaintance. The offenders were males in 87.9% of all homicides.

This paper proposes an interdisciplinary approach on interpersonal violence understood as a complex and multidimensional phenomenon. As will be discussed initially, there is a broad socially shared view of the notion that interactional conflicts can only be resolved through rational conversational practices based on argumentation. However, there are some argumentative styles that work rather as motors of a symbolic epistemological violence. Such argumentative styles (so-called "vertiginous") are intimately related to the claim of neutrality that participants take in disputes, by bringing to the field of communication the prerogatives of the principle of objectivity reigning in the domain of science (and derived from an indiscriminate application of the third excluded law to the areas of the understanding of human behavior). The main objective of the reflections presented here is to show that the argumentative exercise has implications not only in cognitive terms but also in values. In the sense, both the defense and the attack of the reasons that validate the knowledge, imply modes of social relation that can be deeply disqualifying and devaluing the reasons alleged by the Others. Thus, it requires a philosophical approach that takes up the problem of relational violence from a deep dialogue between epistemology, ethics and social sciences., Este trabalho propõe uma abordagem interdisciplinar sobre a violência interpessoal entendida como um fenômeno complexo e multidimensional. Como inicialmente expostos, há uma ampla visão socialmente compartilhado na ideia de que conflitos de interação só pode ser resolvido por meio de práticas de conversação racionais, com base no argumento. No entanto, existem alguns estilos argumentativos que funcionam mais como uns motores de violência epistemológica. Tais estilos de plotagem (chamado de "vertiginosa") estão intimamente relacionados com a pretensão de neutralidade que os participantes adoptem em disputas, trazendo o campo da comunicação as prerrogativas do princípio de objetividade da ciência (e derivado de uma aplicação indiscriminada da lei do terceiro excluído para as áreas de compreensão do comportamento humano). O principal objetivo das reflexões aqui apresentadas é mostrar que o exercício argumento tem implicações avaliativas e cognitivas, no sentido de que tanto a defesa eo ataque das razões que validam o conhecimento, representam formas de relação social pode seja profundamente desqualificante e desvalorizando os motivos alegados pelos Outros. Se assim for, ele requer uma abordagem filosófica para retomar o problema da violência relacional a partir de um diálogo profundo entre a epistemologia, a ética e ciências sociais., Este trabajo propone un abordaje interdisciplinario acerca de la violencia interpersonal entendida como un fenómeno complejo y multidimensional. Tal como se expondrá inicialmente, existe una amplia visión socialmente compartida sobre la idea de que los conflictos interaccionales sólo pueden resolverse mediante prácticas conversacionales racionales, basadas en la argumentación. Sin embargo, hay algunos estilos argumentativos que funcionan más bien como motores de una violencia simbólica de corte epistemológico. Tales estilos argumentales (denominados “vertiginosos”) están íntimamente emparentados con la pretensión de neutralidad que los participantes adoptan en las disputas, al traer al campo comunicacional las prerrogativas del principio de objetividad reinante en el dominio de las ciencias (y derivado de una indiscriminada aplicación de la ley del tercero excluido a los ámbitos de la comprensión de la conducta humana). El objetivo principal de las reflexiones aquí presentadas es mostrar que el ejercicio argumental tiene implicaciones no sólo cognoscitivas sino también valorativas, en el sentido de que, tanto la defensa como el ataque de las razones que validan el conocimiento, suponen modos de relación social que pueden ser profundamente descalificantes y devaluadoras de las razones alegadas por los Otros. Siendo así, se requiere de un enfoque filosófico que retome el problema de la violencia relacional a partir de un diálogo profundo entre la epistemología, la ética y las ciencias sociales.

The Late Iron Age to early historic period site of Non Ban Jak (ca. fourth to eighth centuries A.D.), in the Upper Mun River Valley, northeast Thailand, provides one of the largest and best preserved skeletal samples from an important period of change in social and technological complexity in prehistoric Southeast Asia. This study assessed the patterning of individual-level trauma prevalence and long bone fracture rates in this community to determine the level of risk of injury and the possible relationship with cultural change. One quarter (25.5%) of adults experienced antemortem or perimortem trauma. This level of trauma is high when compared to other Iron Age sites in the Southeast Asian region. Injury patterning suggests the majority of antemortem trauma is the result of accidental injury through occupational hazards and lifestyle activities. However, cranial injuries such as a depressed fracture, facial fractures, and perimortem sharp force trauma, as well as a possible parry injury and multiple trauma observed in some individuals, are indicative that at least a portion of the population had been engaged in interpersonal violence. This study emphasizes local variation. Non Ban Jak is one of only a few excavated sites that contributes to an understanding of the transition from the late Iron Age to the early protohistoric period in Thailand as well as the wider region in Southeast Asia. KEYWORDS: trauma, interpersonal violence, bioarchaeology, Iron Age, protohistoric period, Southeast Asia, northeast Thailand.

Initial research on moral injury has shown the construct to be associated with many negative mental health outcomes such as depression, suicidal ideation, reduced sense of belonging, anxiety, anger, and spiritual distress. In addition, moral injury among service members has also been shown to be related to experiences of interpersonal violence occurring pre-deployment. Given that social support has consistently been found to play a key role in moderating the relationship between experiences of interpersonal violence and stress and trauma related symptoms and disorders, this study will be the first to explore the relationship between experiences of interpersonal violence and moral injury, and the moderating role of social support. This study will use stepwise regression analysis to examine secondary data collected from 935 U.S. military personnel primarily from the Army National Guard.

Spy Cave is one of the most iconic Pleistocene sites yielding two adult Neanderthal skeletons recovered in the 19th century. The cave is located in Belgium and is one of the most important sites for human evolution in European context. The remains of Spy definitively influenced the concept of Neanderthals as archaic fossil humans in relation to modern human populations. This paper shows the results of the taphonomic study of these human remains to investigate the cause of death of the two individuals, and why they occurred at this site, specifically whether they were buried. Excavation in the 19th century lacked some of the present-day methodology of excavation, and there is little information about context, but we have examined the taphonomic modifications of the bones of the two skeletons in comparison with the putative faunal remains found in the cave. Several hypotheses have been proposed for the Spy human remains, from human cannibalism to intentional funerary burials. We will try to clarify the possible cause of death and propose the most congruent hypothesis in the taphonomic context of these human remains, from accidental death due to falling limestone blocks to interpersonal violence.

Sexual violence (SV) is common; however, the prevalence of SV and its long term sequela vary geographically and among subpopulations within the USA. As such, the aims of this study are the following: (1) to determine the prevalence of SV, (2) to identify correlates of SV, and (3) to determine if SV is associated with depression among male and female risky drug users in urban Federally Qualified Health Centers (FQHCs) in Los Angeles. This study includes adult patients of five urban FQHCs who self-reported risky drug use. We identified survivors of SV and those experiencing depression through survey questions that queried, before or after age 18, "Were you ever sexually assaulted, molested or raped?" and with the RAND Mental Health Index (MHI-5). We utilized Pearson's chi-square tests to assess predictors of SV and logistic regression to assess for an association between SV and depression. Data collection took place from February 2011 to November 2012. Of the 334 study patients, 49% of females and 25% of males reported surviving SV. Exposure to SV, (both before 18 years of age and after 18 years of age) was the strongest predictor of depression among men and women in this study (OR 4.7, p < 0.05). These data demonstrate that sexual violence is prevalent in this urban FQHC population and is strongly associated with depression. Providers should consider screening both men and women with risky drug use for SV while health systems should continue to align mental health and primary care services to appropriately care for these extremely vulnerable patients. Trial Registration Clinical Trials. gov ID NCT01942876, Protocol ID DESPR DA022445, http://www.clinicaltrials.gov.

Background: Approximately 25% of the world's population consists of young people. The experience of violence peaks during adolescence and the early adult years. A link between personal experience of violence and mental health among young people has been demonstrated but rural-urban differences in these associations are less well known in low to middle income countries. The aim of this study was to investigate the associations between interpersonal violence and psychological distress among rural and urban young women. Methods: Data on experiences of violence and psychological distress were collected from a total of 926 nonpregnant young women aged between 18 and 22 years of age in rural and urban sites in South Africa. The General Health Questionnaire-28 was used to assess psychological distress as an indicator of mental health. Generalised structural equation models were employed to assess potential pathways of association between interpersonal violence and psychological distress. Results: Thirty-four percent of the urban young women (n = 161) reported psychological distress compared to 18% of rural young women (n = 81). In unadjusted analysis, exposure to interpersonal violence doubled the odds of psychological distress in the urban adolescents and increased the odds 1.6 times in the rural adolescents. In adjusted models, the relationship remained significant in the urban area only (OR 1.84, 95% CI 1.13-3.00). Rural residence seemed protective against psychological distress (OR 0.41, 95% CI 0.24-0.69). Structural equation modelling did not reveal any direct association between exposure to interpersonal violence and psychological distress among rural young women. Stressful household events were indirectly associated with psychological distress, mediated by violence among young women in the urban area. Conclusion: The relationship between violence and psychological distress differs between urban and rural-residing young women in South Africa, and is influenced by ind

Aim: To explore forensic care in EDs for victims of violence and their family members from the perspectives of ED department heads, ED nurses, and a family member of a victim of violence. Methods: Study I consisted of a questionnaire to all heads of EDs in Sweden, data were analyzed with descriptive statistics. Study II consisted of a similar questionnaire which also included the instrument Families’ Importance in Nursing Care-Nurses’ Attitudes. It was sent to all nurses at 28 EDs and data were analyzed using descriptive statistics, multiple linear and ordinal regression analysis. Study III comprised of individual interviews with twelve nurses from seven EDs and data were analyzed with content analysis. Study IV was a single case study with two interviews with a family member of a victim of violence. Data were analyzed with a Gadamer-inspired hermeneutic approach. Results: ED preparedness for forensic care varied and was often limited to women and children. Nurses played a key role, but most of them had no training for this task and felt uncertain (I, II, III). Creating a caring encounter was the main challenge for providing forensic care and nurses perceived hindering factors to overcome this challenge (III). Family members were rarely included in forensic care and nurses perceived that family members were offered little help (I-III). Having ED documents that included family members, was associated with a more positive attitude to family members, which in turn was associated with involving them in care (II). For the family member, perfunctory encounters and caring alliances had a major impact and the experience reframed life (IV). Conclusion: Lack of preparedness in EDs to care for all types of victims of violence and differences between individual nurses may prohibit the provision of equal care. Hindering factors for a caring encounter can result in forensic care being unaddressed, which may limit possibilities for alleviated suffering and legal justice. Family me

Purpose: To develop a trauma-informed substance use and sexual risk reduction intervention for young South African women at risk of HIV. Patients and methods: Guided by the ADAPT-ITT framework for intervention development, we selected four focus groups (n=26) to assess the service needs and preferences of trauma-exposed young women (aged 18–25 years) who use substances. We used findings to develop a needs-based and contextually appropriate intervention. In addition four focus groups (n=30) were selected to explore potential service users’ views of this intervention and recommendations for improving acceptability and appeal. Expert stakeholders were also consulted. Results: Young women described therapeutic, self-care, and social support needs for coping with traumatic experiences and reducing substance-and sexual-related risks for HIV and further trauma. To address these needs, we expanded the Women’s Health Co-Operative (WHC; an evidence-based HIV prevention program) to include trauma-related psychoeducation; cognitive-behavioral strategies for coping with the emotional impact of trauma, stress, and substance use craving; social support strategies; and self-care components to help young women create a life with purpose. This novel and expanded six-session group-based intervention is called the trauma-informed WHC. Focus group participants and expert stakeholders viewed the trauma-informed WHC as highly relevant and acceptable. They provided recommendations for modifications to the intervention structure and reformatting of intervention materials to enhance the intervention’s appeal and the feasibility of reaching and retaining young women in the program. Conclusion: Engaging women as potential service users in the process of developing a trauma-informed substance use and sexual risk reduction intervention helped identify service needs not commonly addressed in trauma-informed substance use interventions but critical for recovery and local relevance. It also enhance

Background: The contribution of interpersonal violence (IPV) to trauma burden varies greatly by region. The high rates of IPV in sub-Saharan Africa are thought to relate in part to the high rates of collective violence. Malawi, a country with no history of internal collective violence, provides an excellent setting to evaluate whether collective violence drives the high rates of IPV in this region. Methods: This is a retrospective review of a prospective trauma registry from 2009 through 2016 at Kamuzu Central Hospital in Lilongwe, Malawi. Adult (>16 years) victims of IPV were compared with non-intentional trauma victims. Log binomial regression determined factors associated with increased risk of mortality for victims of IPV. Results: Of 72 488 trauma patients, 25 008 (34.5%) suffered IPV. Victims of IPV were more often male (80.2% vs. 74.8%; p Discussion: Even in a sub-Saharan country that never experienced internal collective violence, IPV injury rates are high. Public health efforts to measure and address alcohol use, and studies to determine the role of "mob justice," poverty, and intimate partner violence in IPV, in Malawi are needed. Level of evidence: Level III.