Jeffrey B. Kingree

Gender differences in long-term health consequences of physical abuse of children: data from a nationally representative survey

OBJECTIVESnThis study investigated the effects of physical abuse in childhood on health problems in adulthood and assessed gender differences in these associations.nnnMETHODSnWe used data from 8000 men and 8000 women who were interviewed in the National Violence Against Women Survey. We used multivariate logistic regression to test for main and interactive effects and conducted post hoc probing of significant moderational effects.nnnRESULTSnMen were more likely than women to have experienced physical abuse during childhood. Whereas abuse had negative consequences for both boys and girls, it was generally more detrimental for girls.nnnCONCLUSIONSnFindings suggest the need to consider gender differences and long-term adverse health consequences in the development of intervention strategies to address physical abuse in childhood.

Partner violence, social support, and distress among inner-city African American women

This study examined the role of social support in the partner violence–psychological distress relation in a sample of African American women seeking medical care at a large, urban hospital (n = 138). Results from bivariate correlational analyses revealed that partner violence was related to lower perceived social support and greater psychological distress, and lower social support was related to more distress. Furthermore, findings based on path analysis indicated that low levels of social support helped account for battered womens increased distress. Findings point to the need for service providers to screen for partner violence in nontraditional sites, such as hospital emergency rooms, and to address the role of social support resources in preventive interventions with African American battered women.

Risk Factors for Suicide Attempts Among African American Women Experiencing Recent Intimate Partner Violence

The purposes of this study were to identify risk factors for suicide attempts among 200 African American abused women (100 attempters, 100 nonattempters) and to test a cumulative risk model to determine if a woman’s likelihood of making a suicide attempt increased as the number of risk factors increased. Results revealed that attempters were significantly more likely than nonattempters to report high levels of depressive symptoms, hopelessness, drug abuse, and childhood abuse and neglect. Results from the cumulative risk model revealed a linear association between the number of risk factors and the odds of making a suicide attempt. Compared to women with no risk factors, women with two risk factors, women with three risk factors, and women with four to five risk factors were 10, 25, and 107 times, respectively, more likely to attempt suicide. The identification of risk variables highlights the importance of designing interventions to address these factors in order to reduce the risk of suicidal behavior in abused, African American women.

Partner abuse and posttraumatic stress disorder as risk factors for suicide attempts in a sample of low-income, inner-city women.

This study examined partner abuse and posttraumatic stress disorder (PTSD) as risk factors for suicidal behavior among women, and whether or not PTSD mediated the partner abuse-suicidal behavior association. Attempters (n = 119) were approximately three times more likely to be above clinical cut-points for physical partner abuse, nonphysical abuse, and PTSD than nonattempters (n = 85). Physical partner abuse, but not nonphysical partner abuse, was associated with an increased risk for PTSD. Further, PTSD mediated the link between physical partner abuse and suicidality, such that when PTSD was statistically controlled, the association between physical partner abuse and suicide attempt status was reduced to nonsignificance. Implications of findings for interventions for female victims of partner abuse, and women who make nonfatal suicide attempts are discussed.

Childhood Maltreatment, PTSD, and Suicidal Behavior Among African American Females

The independent and combined roles of childhood maltreatment (physical abuse, sexual abuse, emotional abuse, emotional neglect, and physical neglect) and current post-traumatic stress disorder (PTSD) were examined in predicting nonfatal suicide attempts among 335 African American women. It was hypothesized that suicide attempters (n = 157) would evidence higher rates of all forms of childhood maltreatment and higher rates of current PTSD than controls (n = 178). The authors predicted that women with both current PTSD and a lifetime history of child maltreatment would be at greatest risk for making a nonfatal suicide attempt. Results revealed that current PTSD and all five forms of childhood maltreatment were independently related to risk for suicide attempts. PTSD in combination with any of the five forms of childhood maltreatment increased a womans risk for making a nonfatal suicide attempt. This suggests interventions designed to reduce suicidal behavior should focus on women with PTSD and a history of child maltreatment.

Risk factors for suicide attempts among low-income women with a history of alcohol problems

This study used bivariate and multivariate analyses to examine nine risk factors for suicide attempts among 80 women (51 attempters, 29 controls) with a history of alcohol problems who were recruited from a large, inner-city hospital. Prior studies established that each of the examined factors increased the risk for suicidal behavioral, but these studies have varied according to whether or not they consisted exclusively of persons with alcohol problems. Whereas eight of the nine factors were bivariately associated with suicide attempt status in this study, only three factors (hopelessness, recent interpersonal loss, childhood trauma) remained significant in the multivariate analysis. These findings illuminate the importance of using multivariate analyses when aiming to identify factors that uniquely increase the risk for suicidal behavior among persons with alcohol problems.

Role of Secondary Stressors in the Parental Death–Child Distress Relation

This study examined the psychological consequences and secondary stressors associated with death of a parent. The sample (N = 116) consisted of 26 youths who had lost a parent to homicide, 45 youths who had lost a parent to natural death, and 45 nonbereaved youths. Youngsters completed face-to-face interviews, while their guardians completed measures assessing the childrens functioning. Results based on both child and guardian reports indicated that parental death was associated with an increase in secondary stressors, regardless of the mode of death. Findings based on guardian reports also revealed that parental death was related to increased internalizing distress, and that parental death due to homicide was related to increased externalizing distress. Furthermore, secondary stressors mediated the parental death–child distress relation such that parental death led to an increase in stressors, which in turn led to increased child distress. Implications for secondary and tertiary preventive interventions are discussed.

The frequency and impact of violent trauma among pregnant substance abusers

This research was conducted with 96 low-income pregnant women who enrolled in a residential substance abuse treatment program. The study had three goals: (a) to document the prevalence of exposure to violent trauma, (b) to examine the prevalence of posttraumatic stress symptomatology, and (c) to assess if trauma exposure and posttraumatic stress were related to program completion. Results indicated that the sample had high rates of exposure to violent trauma, as 72% had experienced sexual assault, 67% had experienced physical assault, and 68% had experienced indirect violent trauma. High rates of traumatic stress were found in that 62% displayed symptoms consistent with posttraumatic stress disorder. Finally, logistic regression analyses revealed that traumatic stress, but not trauma exposure, was related to program completion. Findings suggest that treatment providers need to assess trauma histories and traumatic stress symptoms.

Mutual Help Groups, Perceived Status Benefits, and Well-Being: A Test with Adult Children of Alcoholics with Personal Substance Abuse Problems

A field experiment was conducted to examine the potential effects of mutual help group participation on perceived status benefits, depression, and substance use among adult children of alcoholics (ACOAs) with personal substance abuse problems. Participants were randomly assigned to attend either ACOA-specific mutual help group meetings or substance abuse education classes during the initial month that they were enrolled in a residential treatment program for low-income substance abusers. Analyses were based on assessments made at baseline, a 1-month posttest, and a 6-month follow-up. Results indicated that participation in the mutual help group promoted perceived status benefits, which in turn led to reductions in depression and substance use. These findings have clear implications for consumers of ACOA groups and can inform research on the social psychological underpinnings of different types of mutual help groups.

The role of alcohol use in intimate partner violence and non-intimate partner violence.

Alcohol use is a risk factor for violent victimization in general, and intimate partner violence in particular. However, there has been limited empirical attention on whether alcohol use is more often associated with IPV or non-IPV offenses. Further, few studies on the association between alcohol use and victimization have assessed for incident-specific alcohol use, or examined both victim and perpetrator alcohol use. We used data from the National Violence Against Women Survey to determine if incident-specific alcohol use is more prevalent in IPV or non-IPV physical assaults, and to determine if the association varied by gender. Results indicated that among women, perpetrator alcohol use was twice as likely in IPV incidents than in non-IPV incidents, but among men, perpetrator alcohol use was four times less likely in IPV incidents than in non-IPV incidents. Our results highlight the important role of gender in understanding the association between alcohol use and victimization risk.