Dependent Adult Abuse A Guide for Mandatory Reporters, July 2009

“Dependent adult” abuse allegations involve people who are aged 18 or over and are incapable of adequate self care due to physical or mental conditions and require assistance from other people. Dependent adults may be elderly or may have diminished physical or mental capacities that prevent them from meeting their own needs adequately. Researchers estimate that only 1 in 14 incidents of elder abuse actually come to the attention of law enforcement or human service agencies. Elder abuse is one of the most under-recognized and under-reported social problems in the United States. It is far less likely to be reported than child abuse because of the lack of public awareness. Nationally, it is estimated that over 55% of elder abuse is due to self-neglect. Such abuse can happen anywhere … in private homes, at health care facilities and in the community at large. Iowa has an increasing proportion of people who are aged 60 or over. The number of persons 80 or over is increasing more rapidly than any other age group. Iowa’s proportion of older adults in the population exceeds that of the United States as a whole.

Modeling the impact of social discrimination on the physical and mental health of portuguese gay, lesbian and bisexual people

Background: Despite growing acceptance of same-sex sexuality in Portugal, identity development of lesbian, gay and bisexual (LGB) individuals is still restricted by negative societal attitudes, which maintain the experience of stigmatization and discrimination. The purpose of this study is to document the frequency of discriminatory events experienced by sexual minorities and their association with indicators of physical and mental health in Portugal. Methods: A total of 610 LGB participants completed an online survey (mean age = 34.48, SD = 11.54). Most participants were single and self-identified as gay (73.8%). The survey included five categories of survey items: demographic information, social support, physical health, mental health, and discrimination experiences. Results: Physical and mental health results revealed that bisexual people were more likely to report higher levels of psychological distress than gay men. Overall, between one-fifth and one-fourth of the participants in this sample frequently felt the need to hide their sexual orientation to prevent discrimination experiences across the different settings. Regarding actual discrimination experiences, close to 20% reported having suffered from verbal abuse, followed by close to 10% who suffered from written threats, harassment, and physical threats. A hierarchical multiple regression analysis was performed to assess the effects of anticipated and actual discrimination on mental health. Possible confounding variables were added in the first block – age, sexual orientation, being in a relationship, body mass index, and HIV status. Anticipated and actual discrimination experiences were added in the second block. The first block of the analysis explained 6% of the overall variance, while the second block – discrimination experiences – explained an additional 17%. Conclusion: Portuguese culture and stigma/discrimination create discriminatory experiences which impact LGB people’s health. Unless policies are changed to allow for the acceptance of LGB people, they will continue to experience violence and discrimination as a result of homophobia.

Blame Attributions Among Child Sexual Abuse Survivors and Disclosure of the Abuse

Child sexual abuse (CSA) disclosure is critical for survivor´s psychosocial adjustment later in life. The aim of the present study was to analyze the relationship between attributions of blame for child sexual abuse by the victim and the disclosure of the abuse to parents or caregivers while controlling for characteristics of the abuse. Female college students between 17 and 24 years of age (M = 19.44, SD = 1.64) from a southern Spanish University were surveyed. Of 1547 respondents, 153 (9.90%) reported having suffered some form of CSA before the age of 15. Information about the characteristics of abuse (age of onset, type of abuse suffered, continuity of abuse, and relationship with and age of the perpetrator) and the existence of abuse disclosure by the survivor was obtained from a self-reported questionnaire developed for the present study. The Attributions of Responsibility and Blame Scale (McMillen & Zuravin, 1997) was used to assess attributions made about CSA (self-blame, perpetrator blame and family blame). The results of a logistic regression model was statistically significant, χ² (9) = 43.856, p < .001. The model explained 41% (Nagelkerke R²) of the variance of abuse disclosure and correctly classified 85.6% of cases. Survivor disclosure was 5.50 times more likely to occur when the perpetrator was not a family member (Wald = 8.14, p < .01) and 3.95 times more likely to occur when there was not physical contact with the perpetrator (Wald = 4.30, p < .05). The occurrence of disclosure was also related to increased perpetrator age (Wald = 4.83, p < .05). With regard to the attributions of blame, the occurrence of disclosure was related to lower scores on self-blame (Wald = 6.78, p < .01) and higher scores on family blame (Wald = 9.67, p < .001). However, no relationship was found between perpetrator blame and disclosure of abuse. The results confirm the idea that not only self-blame attributions, but also family blame attributions are critical to the decision of a CSA victim to disclose abuse. The possibility that children who do not disclose abuse have a greater need to deny the occurrence of abuse, or have more confusion about being abused is discussed. Attributions of blame should be taken into serious consideration when evaluating children for possible sexual abuse.

Child Abuse and Mental Disorders in Iranian Adolescents

Background: Child abuse is a serious social health problem all over the world with important adverse effects. Objectives: The aim of this study was to extend our understanding of the relation between mental disorders and child abuse. Materials and Methods: The study was designed as a cross-sectional survey on 700 students in secondary schools using multiple cluster sampling in Yazd, Iran in 2013. We applied 2 self reported questionnaires: DASS (depression anxiety stress scales)-42 for assessing mental disorders (anxiety, stress and depression) and a standard self-reported valid and reliable questionnaire for recording child abuse information in neglect, psychological, physical and sexual domains. The collected data was analyzed using SPSS software. P-values < 0.05 were considered as significant. Results: There was a statically significant correlation between mental disorder and child abuse score (Spearman rho: 0.2; P-value < 0.001). The highest correlations between mental disorders and child abuse were found in psychological domain, Spearman’s rho coefficients were 0.46, 0.41 and 0.36 for depression, anxiety and stress respectively (P-value < 0.001). Based on the results of logistic regression for mental disorder, females, last born adolescents and subjects with drug or alcohol abuser parents had mental disorder odds of 3, 0.4 and 1.9 times compared to others; and severe psychological abuse, being severely neglected and having sexual abuse had odds 90, 1.6 and 1.5 respectively in another model. Conclusions: Programming for mandatory reporting of child abuse by physicians and all health care givers e.g. those attending schools or health centers, in order to prevent or reduce its detrimental effects is useful and success in preventing child abuse could lead to reductions in the prevalence of mental disorders.