Humiliation,Manipulation, and Control: Evidence of Centrality in Domestic Violence Against an Adult Partner

This paper describes two related studies. Study 1 is a literature review of existing adult partner domestic violence assessment scales. Results of the review revealed that the scales varied on the available amount of empirical evidence for validity and reliability. More importantly, results showed that the content of the scales focused most heavily on the physical abuse aspects of domestic violence. Study 2 is a factor analysis performed on the results of 64 items taken from the Artemis Intake Questionnaire, a clinically relevant tool constructed by treatment providers used in working with the victims of domestic violence. Results indicate that reported humiliation and blame of the victim accounted for the largest amount of variance, followed by controlling the victim, and then physical violence. Results of this factor analysis suggest that greater emphasis must be put on factors other than physical violence in the construction of future domestic violence scales.     

A positive domestic violence screen predicts future domestic violence

The objective of this study was to determine if a brief screen for domestic violence (DV) predicts future violence. We conducted a cohort study of adult women who presented to an inner-city emergency department during an 8-week study period. Participants were screened for DV using the Partner Violence Screen (PVS). At 4 months, follow-up telephone interviews were conducted: rates of verbal and physical violence were measured using the modified Conflict Tactics Scale. Relative risks of violent events (physical and verbal) were calculated. Of the 215 women who enrolled, 36 (16%) had an initial screen positive for DV. Ninety-six women participated in the follow-up phase; of these women, 9% had screened positive for DV. At 4 months, women with DV were 11.3 times more likely to experience physical violence and 7.3 times more likely to experience verbal aggression. The study's screen identified women at high risk for subsequent physical violence and verbal aggression.     

Use of prostate specific antigen in the identification of semen in postmortem cases

Over the past 20 years, the use of prostate specific antigen (PSA) as evidence of the presence of semen in forensic cases has been well established. In this study, we compared a commercially available immunoradiometric assay (IRMA) for the identification of PSA with the identification of spermatozoa in swabs obtained from the vagina of deceased females. There was agreement between the 2 methods in 67 of the 80 cases (84%), including 18 cases where both the PSA was positive and sperm were observed microscopically. The remaining cases had 1 positive result and 1 negative result. We concluded that although there was substantial agreement between the presence of sperm and a positive PSA, there were enough discrepancies between the 2 methods (16%) to justify the use of both methodologies, if possible, to make the determination of sexual activity prior to death.     

Drug abuse's smallest victims: in utero drug exposure

The social and economic impact of drug use on our global population continues to increase leaving no geographical, social or cultural group untouched. The National Institute on Drug Abuse (NIDA), in one of the few large surveys of maternal abuse, found that 5.5% of mothers reported taking an illicit substance during gestation. These figures certainly are underestimates due to the stigma of drug use during pregnancy and the accompanying legal, ethical and economic issues. Although drugs of choice and routes of administration vary by country, exposure of our most valuable resource, our children, to the developmental effects of drugs is an enormous problem. In utero drug exposure can have a severe impact not only on the development of the fetus, but also on the child during later stages of life. More than 75% of infants exposed to drugs have major medical problems as compared to 27% of unexposed infants. The cost of treating drug-affected infants was twice the cost of non-affected infants. Obstetrical complications including placental insufficiency, miscarriage, intrauterine death, and increased incidence of infectious and sexually-transmitted diseases are higher in the drug-abusing mother. Treatment for pregnant addicts should be a high priority for our governments. Increased awareness and improvement in our understanding of drug abuse in the medical, legal and social realms will enable us to reduce the barriers to treatment for this important population.Accurate identification of in utero drug exposure has important implications for the care of the mother and child, but can raise difficult legal issues. Society discourages prenatal care with the infliction of harsh criminal penalties. Maternal drug use during pregnancy can be monitored with urine, sweat, oral fluid and/or hair testing. Detection of in utero drug exposure has traditionally been accomplished through urine testing; however, the window of detection is short, reflecting drug use for only a few days before delivery. Monitoring exposure through testing of alternative matrices, such as neonatal meconium and hair, offers advantages including non-invasive collection and detection earlier in gestation. There are many unresolved issues in monitoring in utero drug exposure that urgently require research. These can be divided into research to definitively differentiate drug exposed and non-drug-exposed fetuses, determine the most efficient methods to routinely monitor women's drug use, and determine how these drug test results relate to neonatal and maternal outcomes. Research in this area is difficult and expensive to perform, but necessary to assess accurately drug effects on the fetus. By increasing our understanding of the physiological, biochemical and behavioral effects of gestational drug exposure, we may ultimately provide solutions for better drug prevention, treatment and a reduction in the number of drug-exposed children.