Rosemary B. Hughes

Vulnerabilities for abuse among women with disabilities

Research findings reveal that women with disabilities experience rates of emotional, physical, and sexual abuse that are comparable to, if not greater than, women without disabilities. Disability specialists propose that women with disabilities experience specific vulnerabilities to abuse. The question in the present study was, “What types of abuse experienced by women with physical disabilities are directly related to their disability?” Of the 504 women with disabilities who responded to a questionnaire assessing sexuality and relationships, 181 of the women completed open-ended questions about abuse. Using qualitative techniques, we analyzed their responses and identified disability-specific types of emotional, physical, and sexual abuse. Certain disability-related settings increased vulnerability for abuse. The need for personal assistance with daily living created additional vulnerability. We conclude that disability is not a protective factor against abuse; indeed, it often serves to reduce a womans emotional and physical defenses. These findings indicate a need for the development of disability-sensitive abuse screening instruments, and development and testing of interventions to assist women with disabilities in recognizing abuse, protecting themselves in abusive situations, and removing themselves from potentially abusive relationships and situations.

SELF-ESTEEM AND WOMEN WITH DISABILITIES

This study examines the sense of self of women with physical disabilities in terms of self-esteem, self-cognition (perceptions of how others see them), and social isolation. It was hypothesized that these variables mediate the relation of precursor variables (age, education, severity of disability, and childhood experiences, including overprotection, familial affection, and school environment) and outcomes (intimacy, employment, and health promoting behaviors). Data were gathered from a sample of 881 community-dwelling women in the USA, 475 with a variety of mild to severe physical disabilities, and 406 without disabilities. Correlation analyses indicated that the women with disabilities had significantly lower self-cognition and self-esteem, and greater social isolation than the women without disabilities, as well as significantly less education, more overprotection during childhood, poorer quality of intimate relationships, and lower rates of salaried employment. Path analysis indicated that each of the sense of self mediators was significantly related to the outcome of intimacy, that both social isolation and self-esteem were significantly related to health promoting behaviors, and that only self-esteem was significantly related to employment. Respondents who were older, less disabled, less educated, less over-protected, and had more affection shown in the home tended to feel that others saw them more positively. Women with positive school environments, less over-protection, and more affection in the home experienced less social isolation; age, education, and disability severity were not significantly related to social isolation. Older respondents with less disability, a more positive school environment, less over-protection, and more affection in the home tended to have greater self-esteem; education was not significantly related to self-esteem. Older respondents tended to report less intimacy. Younger, more educated, and less disabled respondents were significantly more likely to be employed. More highly educated respondents reported engaging in more health promoting behaviors.

Abuse Assessment Screen-Disability (AAS-D): Measuring Frequency, Type, and Perpetrator of Abuse toward Women with Physical Disabilities

An interview questionnaire was presented to a multiethnic sample of 511 women, age 18-64 years, at public and private specialty clinics to determine the frequency, type, and perpetrator of abuse toward women with physical disabilities. The four-question Abuse Assessment Screen-Disability (AAS-D) instrument detected a 9.8% prevalence (50 of 511) of abuse during the previous 12 months. Using two standard physical and sexual assault questions, 7.8% of the women (40 of 511) reported abuse. The two disability-related questions detected an additional 2.0% of the women (10 of 511) as abused. Women defining themselves as other than black, white, or Hispanic (i.e., Asian, mixed ethnic background) were more likely to report physical or sexual abuse or both, whereas disability-related abuse was reported almost exclusively by white women. The perpetrator of physical or sexual abuse was most likely to be an intimate partner. Disability-related abuse was attributed equally to an intimate partner, a care provider, or a health professional. This study concludes that both traditional abuse-focused questions and disability-specific questions are required to detect abuse toward women with physical disabilities.

Psychosocial Issues of Women with Physical Disabilities The Continuing Gender Debate

Rehabilitation and disability related research has only recently begun to examine the complex interaction of gender and disability. Women with disabilities experience the double impact of being female and disabled. As women, they have greater risks of psychosocial health problems than do men. As persons with disabilities, they may be even more vulnerable to these gender disparities; for example, compared to women in general, women with disabilities report higher rates of depression and stress. This article describes a new and promising body of research. We offer evidence that corrects any misunderstandings held by rehabilitation specialists that the psychosocial experiences of women with disabilities can be explained by research conducted on men with disabilities or women in general. Clinically and empirically based gender-driven recommendations are offered for research and practice.

Disability, Psychosocial, and Demographic Characteristics of Abused Women With Physical Disabilities

In a sample of 415 predominantly minority women with physical disabilities recruited from private and public specialty outpatient clinics, we examined experiences of physical, sexual, and disability-related abuse within the past year and its associations with demographic, disability, and psychosocial characteristics. Logistic regression analyses identified 27% of the variance and indicated that women with disabilities who were younger, more educated, less mobile, more socially isolated, and who had higher levels of depression may have a higher likelihood of having experienced abuse in the past year. This model correctly identified 84% of the abused women with disabilities. Questions of directionality, the role of disability, and validity testing are discussed.

The Investigation of Abuse and Women With Disabilities

This article delineates issues that should be considered by investigators endeavoring to conduct empirically sound research on abuse and women with disabilities. These issues include (a) incorporating in the research design variables that assess increased vulnerability; (b) using literature-based definitions that distinguish emotional, physical, sexual, and disability-related abuse; (c) using population-based sampling methodologies; (d) securing informed consent; (e) maintaining confidentiality; (f) installing safety measures to protect study participants and project staff from retaliation; (g) making special efforts to include women with disabilities from minority backgrounds; (h) using appropriate, validated, disability-sensitive screening instruments; (i) understanding the legal requirements for reporting abusive incidents; (j) implementing abuse studies in clinical settings; and (k) including formative and summative evaluations in outcome studies of abuse interventions. To increase the capacity of battered womens programs to serve women with disabilities, considerably more needs to be known about interventions that are most effective for this population.

Depression and Women with Spinal Cord Injury

This study examines the phenomenon of depression among 64 women living with SCI for at least two years who were interviewed in a clinic setting. The high prevalence (59.4%) of clinically significant depressive symptomatology as measured by the Center for Epidemiologic Studies Depression Scale (CES-D) was associated primarily with perceived stress. Other correlates included social support, vitality, social isolation, mobility, pain, unemployment, and current abuse. Findings suggest that women with SCI may be at elevated risk for depression, especially those women who perceive their lives as highly stressful and who lack social support.

Prevalence of interpersonal violence against community-living adults with disabilities: A literature review

OBJECTIVE To review the empirical literature on the prevalence of interpersonal violence (IPV) against people with disabilities. METHOD The authors searched for, obtained, and reviewed 6,000 abstracts published between January, 2000 and August, 2010 via searches in PsycINFO and PubMed. Subsequently, 177 potentially applicable full-text articles were independently assessed for inclusion; 22 articles describing 21 individual studies were included in this review. RESULTS The prevalence of IPV varied depending on the time frame, the definition and type of violence, perpetrator, and disability. Prevalence of any type of IPV among women with disabilities ranged from 26.0%-90.0% for lifetime; 4.9%-29.1% for the past 5 years; and 2.0%-70.0% for the past year. In some studies, when compared to women without disabilities, women with disabilities experienced more lifetime, 5 year, and past year physical and sexual IPV. Prevalence of any IPV in men with disabilities ranged from 28.7%-86.7% for lifetime; 24.9% for the past 5 years; and 36.7% for the past year. CONCLUSIONS/IMPLICATIONS IPV occurs at elevated and disproportionate rates among women and men with disabilities, especially when assessed over the course of their lives. Future research that relies on standard definitions of disability and violence, uses accessible measurement, and examines IPV in diverse populations of people with disabilities will strengthen future reviews and better inform research and policy priorities on disability and violence.

Interpersonal Violence and Women With Disabilities: Analysis of Safety Promoting Behaviors

Very little information exists related to the interpersonal violence safety promoting behaviors of women with disabilities. Information about women’s use of safety promoting behaviors was gathered from 305 disabled and deaf women who completed an anonymous Audio Computer-Assisted Self-Interview. Exploratory factor analyses revealed factors related to seeking abuse-related safety information, building abuse-related safety promoting skills, using relationship support, planning for emergencies, taking legal action, and managing safety in personal assistance relationships. Four of these factors demonstrated significant relationships to women’s experience of different forms of abuse and their perpetrator’s characteristics.

Development of an Accessible Audio Computer-Assisted Self-Interview (A-CASI) to Screen for Abuse and Provide Safety Strategies for Women With Disabilities

To increase safety and minimize the risk of interpersonal violence, it is critical that women with disabilities and Deaf women have an opportunity to identify whether or not abuse is happening in their lives. Awareness and knowledge of what constitutes abusive behaviors is an essential first step in addressing interpersonal violence. This article includes a description of the development and evaluation of the Safer and Stronger Program (SSP), an audio computer-assisted self-interview program, which was created for women with disabilities and Deaf women for the purposes of increasing awareness of abuse, encouraging safety-planning behaviors, and providing information about community resources.