Screening for intimate partner violence in orthopedic patients: a comparison of three screening tools

Accurately identifying victims of intimate partner violence (IPV) can be a challenge for clinicians and clinical researchers. Multiple instruments have been developed and validated to identify IPV in patients presenting to health care practitioners, including the Woman Abuse Screening Tool (WAST) and the Partner Violence Screen (PVS). The purpose of the current study is to determine if female patients attending an outpatient orthopaedic fracture clinic who screen positive for IPV using three direct questions (direct questioning) also screen positive on the WAST and PVS. We conducted a prevalence study at two Level I trauma centres to determine the prevalence of IPV in female patients presenting to orthopaedic fracture clinics for treatment of injuries. We used three methods to determine the prevalence of IPV; 1) direct questioning, 2) WAST, and 3) PVS. We compared the prevalence rates across the three screening tools. Ninety-four women screened positive for IPV using any method. The prevalence of IPV was 30.5% when a direct questioning approach was utilized, 12.4% using the WAST, and 9.2% using the PVS. The WAST identified 37.2% (35/94) of the IPV victims detected and the PVS identified 27.7% (53/94) of the IPV victims detected, whereas direct questioning identified 89.4% of the IPV victims. Identification of IPV may be under-estimated by the WAST and PVS screening tools. Our findings suggest direct questioning may increase the frequency of disclosure of IPV among women attending outpatient orthopaedic clinics.     

Traumatized Youth in Residential Treatment Settings: Prevalence, Clinical Presentation, Treatment, and Policy Implications

Children and adolescents with histories of traumatic exposure comprise a substantial portion of youth in residential treatment programs. However, until recently, little has been known about this specific population. Given the well-documented unique treatment considerations for traumatized youth, it is important to understand how the distinct needs of this population factor into the particular residential treatment setting approach. This paper presents a comprehensive overview of the current understanding of this vulnerable youth population, the impact trauma exposure can have on their clinical presentation and response to treatment, and the available empirical research regarding effective intervention strategies. In addition, policy implications specific to traumatized youth receiving treatment in residential settings are discussed.     

Childhood Maltreatment Experiences and Child Abuse Potential: Temperamental Sensitivity as Moderator?

This study aimed to examine the relationship between negative experiences in childhood (physical-, sexual-, and emotional abuse and emotional neglect) and the risk for an individual to become a perpetrator of child maltreatment in adulthood. Participants were 337 female college students who completed self-report measures of childhood trauma and temperament. Risk for child abuse was assessed with the Child Abuse Potential Inventory. Results showed experiences of emotional neglect significantly predicted higher child abuse potential. Additionally it was shown that experiences of physical abuse significantly predicted higher child abuse potential but only in those individuals with high temperamental orienting sensitivity. These results underline the potentially damaging long-term effects of emotional neglect in childhood and indicate temperamental sensitivity may moderate the relationship between being abused as a child and being at risk for maltreating one’s own offspring.     

Attachment as a Mediator between Childhood Maltreatment and Adult Symptomatology

This study examined the mediating role of attachment in the relationship between childhood maltreatment perpetrated by parents and adult symptomatology. Young adults (N = 803), with and without a history of abuse, were recruited from a local university to complete a series of questionnaires inquiring about past maltreatment experiences, adult attachment in current close relationships, and psychological symptomatology. While attachment was found to be a mediator for all three types of abuse when they were looked at individually, a more robust mediated effect was found in the case of psychological abuse. When all three types of parental maltreatment (psychological, physical, and exposure to family violence) were considered simultaneously, attachment mediated the relationship between only psychological abuse and symptomatology. Parallel meditated effects were observed across two measures of symptomatology: trauma-related symptomatology and externalizing and internalizing symptomatology. The results of this study further our understanding of psychological maltreatment and its intra-individual correlates.     

Pretrial Detention in India: an Examination of the Causes and Possible Solutions

The average rate of pretrial detention in India is 20 per 100,000 of the general population, which is less than half the global average. However, as of 2013, the number of pretrial detainees as a proportion of all prisoners is 67.6 %—over twice the global average. This article seeks to understand the causes of such a high proportion of pretrial detention. Answering this question will help evaluate the present governmental response to the problem of pretrial detention. The article begins by examining the laws and practice of pretrial detention in India and then tries to explain the disjuncture between the two by analysing, first, the role of various functionaries, namely the police, prosecutors, judiciary and prison officials; second, the profile of the pretrial detainees and their (in)ability to post bail and, finally, the (in)effectiveness of the existing legal aid system. It posits that while partly a result of relatively low overall convict populations, the high incidence of corruption; shortage of human, physical and monetary resources and governance and lack of coordination contribute to the high number of pretrial detainees in the prison population in India. It then concludes by describing existing solutions and referencing the practice in Pakistan and Bangladesh, which face similar problems and have similar laws and institutional structures.