Psychotherapy with Sexual Assault Survivors

Author(s):  
Amie R. Newins ◽  
Laura C. Wilson

Sexual assault is associated with an increased risk of a wide range of mental health problems; therefore, treatment should be targeted to address the client’s primary presenting concerns. In this chapter, specific recommendations are provided for using psychotherapy to treat survivors of sexual assault. In particular, suggestions are given for using exposure-based treatments and cognitive-based treatments with these clients. These recommendations focus on how to increase disclosure of details of the assault and to address negative reactions that clients may have received from other disclosure recipients. Furthermore, suggestions are offered related to the terminology and language used during these discussions in treatment.

2020 ◽  
Author(s):  
Nick A Francis ◽  
Beth Stuart ◽  
Matthew Knight ◽  
Rama Vancheeswaran ◽  
Charles Oliver ◽  
...  

ABSTRACTObjectiveIdentify predictors of adverse outcome in a Virtual Hospital (VH) setting for COVID 19.DesignReal-world prospective observational study.SettingVirtual hospital remote assessment service in West Hertfordshire NHS Trust, UK.ParticipantsPatients with suspected COVID-19 illness enrolled directly from the community (post-accident and emergency (A&E) or medical intake assessment) or post-inpatient admission.Main outcome measureDeath or (re-)admission to inpatient hospital care over 28 days.Results900 patients with a clinical diagnosis of COVID-19 (455 referred from A&E or medical intake and 445 post-inpatient) were included in the analysis. 76 (8.4%) of these experienced an adverse outcome (15 deaths in admitted patients, 3 deaths in patients not admitted, and 58 additional inpatient admissions). Predictors of adverse outcome were increase in age (OR 1.04 [95%CI: 1.02, 1.06] per year of age), history of cancer (OR 2.87 [95%CI: 1.41, 5.82]), history of mental health problems (OR 1.76 [95%CI: 1.02, 3.04]), severely impaired renal function (OR for eGFR <30 = 9.09 [95%CI: 2.01, 41.09]) and having a positive SARS-CoV-2 PCR result (OR 2.0 [95% CI: 1.11, 3.60]).ConclusionsThese predictors may help direct intensity of monitoring for patients with suspected or confirmed COVID-19 who are being remotely monitored by primary or secondary care services. Further research is needed to identify the reasons for increased risk of adverse outcome associated with cancer and mental health problems.ARTICLE SUMMARYStrengths and limitations of this studyThe study uses anonymised data from all patients registered for the virtual hospital between 17/03/20 and 17/05/20, and therefore selection bias is not an issue.At the time of this study, this was the only service providing remote follow-up for patients with suspected COVID-19 in the area, and therefore our findings are likely to be relevant to primary care patients receiving remote follow-up.We were able to collect reliable data on a wide range of clinical and demographic features, and reliably follow all patients for the primary outcome for at least two weeks following their discharge from the VH.We were not able to extract detailed symptom or clinical examination data, and there were significant amounts of missing data for some variables.Our study is likely underpowered to detect all predictors, especially in the analysis of our two sub-groups


2009 ◽  
Vol 13 (2) ◽  
pp. 74-81 ◽  
Author(s):  
Karin Monshouwer ◽  
Margreet ten Have ◽  
Mireille Van Poppel ◽  
Han Kemper ◽  
Wilma Vollebergh

Author(s):  
Kennedy Amone-P'Olak ◽  
Boniface Kealeboga Ramotuana

In Africa, the structure of the family is changing rapidly. The effects of this change on mental health remain unknown. This study investigated the extent to which different family types (intact, single-mother, and multiple) predict mental health problems in young adults in Botswana (N = 264, mean age = 21.31, SD = 2.40). In a cross-sectional design, the study sampled students registered at various faculties at the University of Botswana. The revised symptoms checklist (SCL-90-R) was used to assess symptoms of mental health problems (depression, anxiety and hostility). Binary logistic regression analyses were performed to obtain odds ratios (ORs) and 95 per cent confidence intervals (CIs) of mental health problems for mother-only and multiple family types relative to the intact family type. Compared to the intact family type, single-mother (OR = 2.34; 95% CI: 1.21, 4.51) and multiple family types (OR = 1.56; CI: 0.88, 2.78) were associated with an increased risk of depression. For anxiety, the ORs were 2.27 (CI: 1.18, 4.38) and 1.10 (CI: 0.56, 1.82) for single-mother and multiple family types respectively. For hostility, the ORs were 2.60 (CI: 1.34, 5.04), and 0.79 (CI: 0.44, 1.42) for single-mother and multiple family types, respectively. Family types predict mental health problems in young adults and therefore the interventions to mitigate the effects should consider family backgrounds and the ramifications of family types for treatment and care.


BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e045356
Author(s):  
Nick A Francis ◽  
Beth Stuart ◽  
Matthew Knight ◽  
Rama Vancheeswaran ◽  
Charles Oliver ◽  
...  

ObjectiveIdentify predictors of clinical deterioration in a virtual hospital (VH) setting for COVID-19.DesignReal-world prospective observational study.SettingVH remote assessment service in West Hertfordshire NHS Trust, UK.ParticipantsPatients with suspected COVID-19 illness enrolled directly from the community (postaccident and emergency (A&E) or medical intake assessment) or postinpatient admission.Main outcome measureDeath or (re-)admission to inpatient hospital care during VH follow-up and for 2 weeks post-VH discharge.Results900 patients with a clinical diagnosis of COVID-19 (455 referred from A&E or medical intake and 445 postinpatient) were included in the analysis. 76 (8.4%) of these experienced clinical deterioration (15 deaths in admitted patients, 3 deaths in patients not admitted and 58 additional inpatient admissions). Predictors of clinical deterioration were increase in age (OR 1.04 (95% CI 1.02 to 1.06) per year of age), history of cancer (OR 2.87 (95% CI 1.41 to 5.82)), history of mental health problems (OR 1.76 (95% CI 1.02 to 3.04)), severely impaired renal function (OR for eGFR <30=9.09 (95% CI 2.01 to 41.09)) and having a positive SARS-CoV-2 PCR result (OR 2.0 (95% CI 1.11 to 3.60)).ConclusionsThese predictors may help direct intensity of monitoring for patients with suspected or confirmed COVID-19 who are being remotely monitored by primary or secondary care services. Further research is needed to confirm our findings and identify the reasons for increased risk of clinical deterioration associated with cancer and mental health problems.


2020 ◽  
pp. 1-4 ◽  
Author(s):  
Agata Debowska ◽  
Beata Horeczy ◽  
Daniel Boduszek ◽  
Dariusz Dolinski

Abstract Background The time of widespread outbreaks of infectious diseases can lead to elevated stress and mental health problems among all persons affected, and in particular those sub-groups of the population that are at an increased risk of mental health problems. One such vulnerable group constitutes university students. The aim of this study is to assess stress, depression, anxiety, and suicidality among different groups of university students (medical, psychology, and other). Methods Using a repeated cross-sectional study design, we collected survey data among a large sample of 7228 university students from Poland (mean age = 22.78, s.d. = 4.40; 81% female). Data were collected in five waves, during the first 2 months of the COVID-19 pandemic in Europe (March and April 2020). Results The results demonstrate a significant increase in depression levels as the pandemic was progressing. We also found that female students scored significantly higher than male students on depression, anxiety, and stress. Psychology students recorded the lowest scores on depression and anxiety. Young adult students (aged 18–24 years) had more symptoms of depression, anxiety, and suicidality than adult students (⩾25 years). Conclusions These results provide insights into stress and mental health among university students during the early stages of the COVID-19 pandemic. Findings can be used for a more effective identification of students who may struggle during next stages of the pandemic and future crises.


2018 ◽  
Vol 25 (9) ◽  
pp. 1270-1284 ◽  
Author(s):  
Tilmann von Soest ◽  
Leila Torgersen ◽  
Ingela Lundin Kvalem

Cosmetic breast surgery experience and a wide range of mental health, psychosocial, and sociodemographic variables were assessed in the population-based Norwegian Mother and Child Cohort Study ( N = 78,252). Breast augmentation patients reported elevated mental health problems. Factors in the domains of physical appearance, drug use, relationships, and exposure to abuse were all related to breast augmentation. Adjusting for such factors reduced the relationships between breast augmentation surgery and all mental health problems to non-significance. Results indicate that the increased prevalence of mental health problems among breast augmentation patients has to be understood from multiple perspectives involving several psychosocial domains.


2019 ◽  
Vol 30 (4) ◽  
pp. 761-766 ◽  
Author(s):  
Unnur Jónsdóttir ◽  
Edda Björk þórðardóttir ◽  
Thor Aspelund ◽  
þórarinn Jónmundsson ◽  
Kristjana Einarsdóttir

Abstract Background The world was hit hard by the 2008 recession which led to increased unemployment and financial strain. However, how the recession affected people with pre-existing mental health problems has been understudied. This study investigates the effect of the 2008 recession in Iceland on stress, well-being and employment status of people with regard to whether they are suffering from mental health problems. Methods The study cohort included participants (18–69 years old) of the ‘Health and Wellbeing of Icelanders’, a 3-wave survey conducted before (in 2007) and after (in 2009 and 2012) the recession in 2008. Self-assessed well-being was measured with the Short Warwick-Edinburgh Mental Well-being Scale and the 4-item Perceived Stress Scale. Logistic regression was used to assess the effect of the 2008 recession on self-assessed well-being and employment status in 2009 and 2012, using 2007 as a reference year. Results Participants with no pre-recession mental health problems were at increased risk of both poor well-being, (with adjusted odds ratio at 1.66, in 2009 and 1.64 in 2012) and higher perceived stress, (with adjusted odds ratio at 1.48 in 2009 and 1.53 in 2012), after the recession. Interestingly, no significant change in well-being and perceived stress was observed among participants suffering from pre-recession mental health problems. Both groups had increased risk of unemployment after the recession. Conclusion Results indicate that after recessions, the risk of stress and poor well-being increases only among those who do not suffer from pre-recession mental health problems.


Author(s):  
Maria Teresa Gutmann ◽  
Metin Aysel ◽  
Zeliha Özlü-Erkilic ◽  
Christian Popow ◽  
Türkan Akkaya-Kalayci

Abstract Background Compared to their indigenous peers, migrant children and adolescents are at increased risk for mental health problems. The aim of our study was to compare psychological disorders of children and adolescents with Turkish migration background and their native Austrian peers. Methods We analysed 302 children and adolescents aged between 7 and 18 years. The sample consisted of 100 Austrian and 100 Turkish outpatients with mental health problems, and 102 healthy controls, 52 with Austrian and 50 with Turkish background, recruited from various Viennese local child and youth centres. Results Native patients had more frequently externalizing problems (42.1%) compared to the Turkish-speaking sample (28%). However, in the control group, Turkish-speaking children and adolescents had higher levels of internalizing, depressive and anxiety symptoms compared to their native peers. Conclusions We found noticeable differences in psychological problems among children and adolescents with and without migration background. We assume that migration-related stress factors are responsible for these differences. Also, children and adolescents with migration background seek for psychological help less frequently than their indigenous peers.


Autism ◽  
2020 ◽  
pp. 136236132094751
Author(s):  
Geovanna Rodriguez ◽  
Kim Drastal ◽  
Sigan L Hartley

Youth with autism spectrum conditions have been shown to be at an increased risk for bullying victimization. The overall aim of this study was to identify factors associated with increased risk for bullying victimization in youth with autism during middle childhood to early adolescence (aged 5–12 years) and to explore the potential time-ordered associations between bullying victimization and mental health problems 12 months later. The average age of the youth with autism was 7.90 years ( SD = 2.33), 86% were male, 34.6% had an intellectual disability, and 84% were White, non-Hispanic. Youth with autism who experienced bullying victimization (vs no victimization) were older in age, had more severe autism symptoms, and higher levels of internalizing and externalizing mental health problems at study onset. Using two cross-lagged structural equation models, the associations between maternal report of youth bullying victimization and teacher report of youth mental health problems using two waves of data were tested. Internalizing and externalizing mental health problems at Time 1 did not relate to change in likelihood of being bullied 1 year later. In contrast, bullying victimization at Time 1 was associated with an increase in internalizing mental health problems ( β = 0.24, p < 0.05). Lay Abstract Youth with autism spectrum disorders are disproportionately at risk for bullying victimization compared to typically developing children and adolescents. While internalizing and externalizing mental health problems have been linked to victimization experiences, few studies have examined the longitudinal effects bullying victimization experiences may have on youth mental health outcomes. The present study investigated longitudinal associations between bullying victimization and mental health problems in a sample of children with autism in middle childhood to early adolescence (aged 5 to 12 years). Findings from our study suggest that youth with autism who experienced bullying victimization (versus no victimization) were older in age, had more severe autism symptoms, and higher levels of internalizing and externalizing mental health problems at study onset. Though externalizing mental health problems at study onset (Time 1) did not relate to change in the likelihood of being bullied one year later (Time 2), experiences of bullying victimization did relate to an increase in parent reports of internalizing mental health problems. This study expanded on previous cross-sectional studies by including two waves of data in a relatively large sample of youth with autism and highlights important information that may be helpful in adapting approaches to intervention at the individual level. Moreover, our findings support the need for bullying programs that may need to focus particular attention to subgroups of youth with autism who may be most at-risk for bullying victimization such as those with more autism symptoms and those with past experiences of victimization (given the chronic nature of bullying).


2016 ◽  
Vol 22 (4) ◽  
pp. 354 ◽  
Author(s):  
Thi Nguyen ◽  
Sarah Dennis ◽  
Huy An ◽  
Sanjyot Vagholkar ◽  
Siaw Teng Liaw

Objective The aim of the present study was to determine the prevalence of psychological distress among Vietnamese adults attending Vietnamese-speaking general practices and explore possible risk factors in this population. Methods A cross-sectional survey of Vietnamese adult patients was conducted at 25 general practices with Vietnamese-speaking general practitioners (GPs) in south-western Sydney between October 2012 and February 2013. Patients completed the Kessler (K10) scale and a demographic questionnaire, available in Vietnamese or English. Data were analysed using SPSS version 21. Results Of the 350 patients invited to participate, 247 completed surveys (response rate 71%). One-quarter (25%) of participants had a very high K10 score for psychological distress, nearly twice that reported in the NSW Health Survey. Participants with high exposure to trauma were at increased risk of psychological distress (odds ratio 5.9, 95% confidence interval 2.4–14.4; P < 0.0001) compared with those with mild or no trauma exposure. Similarly, risk was increased if there was a past history of mental health problems and a lack of personal and social support. Conclusion The high prevalence of mental health problems in adult Vietnamese people attending Vietnamese-speaking general practices is associated with exposure to trauma. This highlights the importance of personal, social and professional support in effective management. Vietnamese-speaking GPs who see Vietnamese or similar refugee groups should actively seek out a history of exposure to trauma, a past history of mental illness and the existence of support systems.


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