Search

IntroductionAs many as 74% of veterans with alcohol use disorders (AUDS) report symptoms of insomnia. Insomnia represents a barrier to alcohol treatment because insomnia symptoms (1) may lead to relapse among those who use alcohol to help them sleep and may negatively impact (2) executive functions and (3) emotion regulation skills. Cognitive-behavioural therapy for insomnia (CBT-I) is an efficacious first-line treatment for insomnia; however, no research has examined the impact of CBT-I on individuals' response to alcohol treatment. In the Sleep and Alcohol for Veterans (Project SAVE) randomised controlled trial, we hypothesise that CBT-I will enhance the efficacy of alcohol treatment among Veterans with insomnia by enhancing their abilities to attend to treatment, regulate emotions and initiate sleep without alcohol.Methods and analysisEighty Veterans enrolled in alcohol treatment at the Veterans Administration (VA) hospital will be randomly assigned to receive either CBT-I or single-session sleep hygiene (SH) education. Individuals will be eligible to participate if they meet Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for moderate to severe AUD and Insomnia Disorder of at least 1-month duration. Participants will complete assessments at baseline, post-treatment and 6-week follow-up. Preliminary process outcomes include retention/recruitment rates and treatment satisfaction (feasibility and acceptability, respectively). Primary outcomes are insomnia severity, percentage of heavy-drinking days and alcohol-related problems. We will assess a variety of secondary clinical and mechanistic outcomes (eg, post-traumatic stress disorder (PTSD) symptoms, attention and working memory).Ethics and disseminationEthics approval was obtained in October 2018. Data collection began in July 2019 and is planned for completion by July 2021. Trial results will be disseminated at local and national conferences, in peer-reviewed publications and through media outlets, as available. Results will also be shared with interested participants and clinical collaborators at the end of the trial.Trial registration numberclinicaltrials.gov identifier NCT03806491 (pre-results).

Intimate partner violence (IPV) is a common public health problem that has serious consequences for women in terms of health and functioning. Post-traumatic stress disorder (PTSD) is one of the major health issues that women face after experiencing intimate partner violence. There is evidence that sufficient and sustainable employment might decrease risk for PTSD in women who have experienced violence. The purpose of this study is to investigate if variables related to employment (i.e., income, hours worked per week, job benefits) affect risk for PTSD over 5 years after women left abusive relationships. Data collection took place between 2010 and 2016. To test the hypothesis that present employment variables predict the woman's PTSD in the future, a series of conditional latent growth curve (LGC) models were conducted. The overall models indicated that there appears to be a consistent impact of economic factors on PTSD symptoms; however, the variable with the greatest impact was the number of hours worked. Women who had full-time or near full-time employment were at less risk to have PTSD in the future. These findings support efforts to increase access to full time work for women who have experienced intimate violence., Author(s): Heidi Gilroy [sup.1] , John Maddoux [sup.2] , Judith McFarlane [sup.3] Author Affiliations: (1) grid.430695.d, 0000 0004 0444 5322, Memorial Hermann Hospital-Texas Medical Center, , 6411 Fannin St, 77030, [...]

Poverty is a risk factor for intimate partner violence (IPV); however, little is known about the economic state at which women are no longer at risk for IPV due to their economic status, which is economic solvency. A Model of Economic Solvency in women has been developed from the literature that includes four factors: human capital, social capital, sustainable employment, and independence. The purpose of this research is to validate the model in a sample of women reporting IPV. A confirmatory factor analysis was performed to test the model using data from 280 abused women. Examination of the model yielded adequate fit with the data, indicating that the model is valid for use with women reporting IPV. The validation of the model offers strength of association between constructs and can be used to plan interventions to improve economic solvency in abused women to potentially reduce violence and facilitate recovery. Keywords: intimate partner violence, U.S. violence, poverty, economic solvency, women's health, Introduction Economic issues are often major factors contributing to the beginning and continuation of intimate partner violence. Although intimate partner violence against women can occur in any relationship, women with [...]

Violence against women is a global epidemic with potential consequences of injury, illness, and death. Children exposed to the violence may also be impacted with functional impairments. Little is known of the intergenerational impact of violence experienced by the mother from an intimate partner on functioning of her children. No dyad analysis was found in the literature. To examine the inter-generational impact of violence against women on the behavioral functioning of children, 300 mothers reporting intimate partner abuse and one randomly chosen child, age 18 months to 16 years of age; were evaluated for borderline and clinical diagnostic levels of problem behaviors. Linear, Logistic, and Ordinal regression models were applied. Mothers' problem behavior scores were significantly related to children's problem behavior scores (internalizing r = 0.611, externalizing r = 0.494, total problems r = 0.662, all ps < 0.001). Mothers who reported clinical and borderline clinical internalized problems (i.e., depression, anxiety) were 7 times more likely to have children with the same problems and mothers with borderline clinical and clinical external problems (i.e., aggression, hostility) were 4.5 times more likely to have children with the same external problems. These dyadic analyses provide evidence of a direct relationship of maternal functioning on child behavioral functioning. Intervention strategies to decrease internalizing maternal behavioral problems, such as depression, anxiety, and post traumatic stress disorder, and/or externalizing problems, such as hostility and aggression, can be expected to have a pass through, secondary impact on the behavioral functioning of children. Awareness of the relationship between intimate partner violence against mothers and child behavioral function can support interventions that decrease the distress experienced by mothers and their children, interrupt intergenerational transmission of abusive behaviors, and promote better maternal child functioning. Keywords Intimate partner violence * Mother-child dyads * Intergenerational, Introduction In the United States (US) and worldwide, it is estimated that 30%, or more, of women have experienced intimate partner violence [8, 33]. Children of abused women often witness [...]

There is a particular need for valid scales to screen for posttraumatic stress disorder (PTSD) among women who seek safe shelter from intimate partner violence. Screening to identify women who are at risk for PTSD can lead to early intervention that reduces the risk for PTSD-related outcomes such as poor decision making, inconsistent parenting, and behavior dysfunction among their children. The gold standard for diagnosing PTSD is the Clinician-Administered PTSD Scale for Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) (CAPS-5). A seven-item PTSD screen has been used for in this population and has a well-established cutoff score but has not been validated against the DSM-5 diagnostic criteria for PTSD. The study purpose was to establish concurrent validity for a seven-item screen for PTSD with the CAPS-5. Participants were 75 women, 18 years or older, who were residents of a 120-bed shelter in the southern United States. They spoke English or Spanish. They reported intimate partner physical or sexual violence within 4 months of their entry into the study. Following informed consent, data were collected in individual interviews, conducted in either English or Spanish. In addition to demographic data, the seven-item PTSD screen and the CAPS-5 were administered. A receiver operating characteristic (ROC) curve analysis was conducted to assess the concurrent validity of the seven-item PTSD screen with the CAPS-5. The seven-item PTSD screen results were significantly correlated with the CAPS-5 results in this sample (area under the curve [AUC] =.640, z = 2.670, p =.008). Sensitivity was 96.2, and observed specificity was 31.8. The seven-item PTSD screen demonstrates excellent sensitivity (e.g., 96% of true PTSD cases) and acceptable specificity (32% of non-PTSD cases) and can be used to quickly and accurately identify individuals for diagnostic assessment and intervention. [ABSTRACT FROM AUTHOR]

An intergenerational model to explain the long-term effect of partner violence against mothers on child behavior was evaluated 48 months after 278 mothers first sought safe shelter or justice services. Twelve percent reported recent abuse, and six mothers reported severe or extreme danger. Self-efficacy (−.58, p <.05), social support (−28, p <.05), and financial support (−.25) were inversely associated with mental health concerns. Higher maternal mental health concerns (.55, p <.05) and child witnessing abuse (.70, p <.05) were associated with child behavioral problems. Child behavioral problems were inversely associated with child academic functioning (−.22, p <.05). To improve child outcomes, interventions that establish safety for mothers and children and promote maternal mental health are needed. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to explore the association of the characteristics of abused immigrant women and approval of legal immigrant status. The research is based on 44 month follow-up data of a subsample of 94 abused immigrant women in the U.S. The findings show that there is a significant relationship between acculturation, anxiety, and emotional support and legal immigrant status. The paper concludes that abused immigrant women who apply for legal status are more acculturated, more anxious, and have less emotional support. Implications for front line providers are discussed. [ABSTRACT FROM AUTHOR]