Browsing by Subject "abuse"

Now showing 1 - 6 of 6
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    Abuse-Related Post-Traumatic Stress, Coping, and Tobacco Use in Pregnancy
    (2011-07-01) Lopez, William D.; Konrath, Sara H.; Seng, Julia S.
    Objective: To examine the relationship between trauma history, posttraumatic stress disorder (PTSD), coping, and smoking in a diverse sample of pregnant women, some of whom are active smokers. Design: Secondary analysis from a prospective study on PTSD and pregnancy outcomes. Setting: Maternity clinics at three health systems in the midwestern United States. Participants: Women age 18 or older (1,547) interviewed at gestational age fewer than 28 weeks. Methods: Participants were classified at nonsmokers, quitters (stopped smoking during pregnancy), and pregnancy smokers. Demographic, trauma, and pregnancy factors, substance use, and use of tobacco to cope were compared across groups. Logistic regression assessed the influence of these factors on being a smoker versus a nonsmoker and a quitter versus a pregnancy smoker. Results: Smokers differed from nonsmokers on all demographic risk factors (being African American, being pregnant as a teen, having lower income and less education, and living in high-crime areas), had higher rates of current and lifetime PTSD, and were more likely to report abuse as their worst trauma. Pregnancy smokers had lower levels of education, were more likely to classify their worst trauma as “extremely troubling,” and were more likely to exhibit PTSD hyperarousal symptoms. In regression models, smoking “to cope with emotions and problems” doubled the odds of continuing to smoke while pregnant even after accounting for several relevant risk factors. Conclusion: Smoking behavior in pregnancy may be influenced by the need to cope with abuse-related PTSD symptoms. Clinicians should consider using trauma-informed interventions when working with tobacco-using pregnant women.
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    The adverse childhood experiences questionnaire: Two decades of research on childhood trauma as a primary cause of adult mental illness, addiction, and medical diseases
    (Taylor & Francis, 2019-01-01) Zarse, Emily M.; Neff, Mallory R.; Yoder, Rachel; Hulvershorn, Leslie; Chambers, Joanna E.; Chambers, R. Andrew; Psychiatry, School of Medicine
    Objective. In 1998, Felitti and colleagues published the first study of the Adverse Childhood Experiences-Questionnaire (ACE-Q), a 10-item scale used to correlate childhood maltreatment and adverse rearing contexts with adult health outcomes. This paper qualitatively reviews nearly two decades of research utilizing the ACE-Q, highlighting its contribution to our understanding of the causal roots of common, interlinked comorbidities of the brain and body.Methods. An OVID/PubMed search was conducted for English language articles published before 2016, containing the phrase “Adverse Childhood Experiences” in which the ACE-Q was utilized. Source review included a manual search of bibliographies, resulting in 134 articles, including 44 based on the original ACE-Q study population.Results. ACE-Q research has demonstrated that exposures to adverse childhood experiences converge dose-dependently to potently increase the risk for a wide array of causally interlinked mental illnesses, addictions, and multi-organ medical diseases. The intergenerational transmission of this disease burden via disrupted parenting and insecure rearing contexts is apparent throughout this literature. However, the ACE-Q does not tease out genetic or fetal drug exposure components of this transmission.Conclusions. Adverse childhood experiences and rearing may generate a public health burden that could rival or exceed all other root causes. Translating this information to health-care reform will require strengthening brain-behavioral health as core public and preventative health-care missions. Greater integration of mental health and addiction services for parents should be accompanied by more research into brain mechanisms impacted by different forms and interactions between adverse childhood experiences.
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    Domestic Violence Advocacy
    (2014) Wood, Leila Grace; Hostetter, Carol; Sullenberger, Sabrina Williamson; Barton, William H., 1949-; Adamek, Margaret E.; Sloan, Rebecca S.
    Advocacy, in the form of direct service, is a critical type of intervention to help intimate partner or domestic violence survivors. Little is known the best practices for social workers and other helping professionals to assist survivors of domestic violence who present for services at shelters, non-residential outreach, and legal settings. This dissertation reviews relevant research related to domestic violence direct services, which is also called advocacy. The study also outlines a brief overview of the history, theory, and paradigms of thought related to the movement to end intimate partner violence. The research project used the grounded theory method to conduct and analyze semi-structured, in-depth interviews with advocates at domestic violence agency to answer the research question: What constructs and practices inform the delivery of direct services to survivors of domestic violence from shelter and non-residential service advocates? A total of 22 women working primarily with domestic violence survivors in shelters and non-residential agencies participated in the dissertation study. Participants came from one Midwestern and one Southwestern state. The interviewees had a range 1-20 years of experience in the field of domestic violence advocacy. Eighteen of 22 participants had experienced some sort of intimate violence in their lifetime. Several important findings emerged. Advocates typically enter the field because of personal motivations. The empowerment and strengths-based perspective are important to the delivery of advocacy services, as is belief in hope. Advocates typically endorse a survivor centered approach to their work. Data analysis revealed a concurrent process of advocacy that occurs within advocates and between advocates and survivors. This parallel process is marked in the earlier state of assessing and grounding; in the middle stage of establishing and affirming; and the ending stages of hoping and reflecting. These findings suggest the importance of personal experiences, hope, and reflection in the delivery of advocacy services. Community collaboration and support are essential to maintaining services that are aimed at the individual needs of survivors. More research is needed about the perceptions of services among survivors of domestic violence.
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    First Do No Harm - The Indiana Providers Guide to the Safe, Effective Management of Chronic Non-Terminal Pain
    (State of Indiana, 2013) Bell-Sharp, Kim; Gregory, Eigner; Brooks, Tracy L.; Elliott, Alicia; Cragen, Debbie; Ersin, Ozlem H.; Croasdell, Lori; Fernandes, Taya; Duwve, Joan; Fielding, Stephen M.; Gentry, Mark E.; Greene, Marion S.; King, Timothy E.; Kelley, Kristen; Konchalski, Jan; Kuzma, Abigail; LaHood, Amy; MacKie, Palmer J.; McMahan, Deborah; Mowry, James B.; Park, Esther J.; Pontones, Pam; Ring, Barry S.; Robinson, Natalie; Roth, Daniel C.; Rumsey, Todd C.; Schreier, Eric M.; Stone, Cynthia L.; Straub, Tom; Welch, Peggy; Sybesma, J. Michelle; Symmes, Shelly; Whitworth, Michael; Vaught, Cynthia; Weitlauf, Sharon L.; Weaver, Tamara; Zachodni, Carla
    "First Do No Harm: The Indiana Healthcare Providers Guide to the Safe, Effective Management of Chronic Non-Terminal Pain" was developed by the Indiana Prescription Drug Abuse Prevention Task Force’s Education Committee under the leadership of Dr. Deborah McMahan. This provider toolkit, based on expert opinion and recognized standards of care, was developed over many months with the input of healthcare providers representing multiple specialties and all corners of the state. First Do No Harm provides options for the safe and responsible treatment of chronic pain, including prescriptions for opioids when indicated, with the ultimate goals of patient safety and functional improvement. It was developed as an interactive compendium to the new Medical Licensing Board rule addressing Opioid Prescribing for Chronic, Non-terminal Pain to give healthcare providers tools they can use to comply with the rule.
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    Physical and sexual abuse in orphaned compared to non-orphaned children in sub-Saharan Africa: A systematic review and meta-analysis
    (Elsevier B.V., 2014-02) Nichols, J.; Embleton, L.; Mwangi, A.; Morantz, G.; Vreeman, R.; Ayaya, S.; Ayuku, D.; Braitstein, P.; Department of Medicine, IU School of Medicine
    This systematic review assessed the quantitative literature to determine whether orphans are more likely to experience physical and/or sexual abuse compared to non-orphans in sub-Saharan Africa (SSA). It also evaluated the quality of evidence and identified research gaps. Our search identified 10 studies, all published after 2005, from Zimbabwe, South Africa, Kenya and Uganda. The studies consisted of a total 17,336 participants (51% female and 58% non-orphans). Of those classified as orphans (n = 7,315), 73% were single orphans, and 27% were double orphans. The majority of single orphans were paternal orphans (74%). Quality assessment revealed significant variability in the quality of the studies, although most scored higher for general design than dimensions specific to the domain of orphans and abuse. Combined estimates of data suggested that, compared to non-orphans, orphans are not more likely to experience physical abuse (combined OR = 0.96, 95% CI [0.79, 1.16]) or sexual abuse (combined OR = 1.25, 95% CI [0.88, 1.78]). These data suggest that orphans are not systematically at higher risk of experiencing physical or sexual abuse compared to non-orphans in sub-Saharan Africa. However, because of inconsistent quality of data and reporting, these findings should be interpreted with caution. Several recommendations are made for improving data quality and reporting consistency on this important issue.
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    Training Indiana's Family Medicine Residents to Address the Problem of Prescription Drug Abuse
    (2013-08-05) Fielding, Stephen M.; Duwve, Joan; Wilson, Gregory; Steele, Gregory
    Prescription drug abuse has been a growing problem in Indiana and around the nation for almost two decades. In recent years, prescription drug overdoses have pushed drug poisonings ahead of motor vehicle crashes as the leading cause of injury death. However, deaths due to overdoses of prescription drugs are only the tip of the iceberg when it comes to the much larger problem of abuse. This study has characterized prescription drug abuse in Indiana and taken an in-depth look at how it is and can be addressed both through organizational policies and state legislation. Opioid painkillers such as hydrocodone, oxycodone, and methadone are the most commonly abused prescription drugs, and most of these prescriptions are written by primary care physicians. Because more than 70% of Indiana’s family medicine residents will remain in the state to practice medicine following the conclusion of their residencies, it is worthwhile to take a look at how these residents are being educated during their training. St. Vincent’s Family Medicine Residency program in Indianapolis is one of several residency programs in Indiana training their residents on best practices of prescribing controlled substances. A review of residents’ prescribing patterns before and after training on the subject went into effect showed significant reductions in the number of opioid painkillers being prescribed, and showed the same reductions for alprazolam, a benzodiazepine anxiolytic.