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March 2006 Research · Teen Depression and Domestic Violence
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Women Exposed to Intimate Partner Violence: A
Meta-Analysis of Qualitative Studies Announcements
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· American Psychological
Foundation Research Grant Research
Teen
Depression and Domestic Violence
Reuters Health - Tuesday, March 7, 2006 Reuters Health reports that teens with a history of depression are more likely to become victims of intimate partner violence than their peers. It is well established that depression is a consequence of domestic violence. However, depression as a precursor to violence is uncharted territory. A recent study, detailed in the Archives
of Pediatrics & Adolescent Medicine, attempted to chronicle the
correlation between teen depression and domestic violence. Led by Jocelyn
Lehrer of the The study sampled 1, 659 female students in steady relationships. These young women were assessed for depression symptoms at age 16, and classified in the “high” symptom category, equivalent to having clinical depression. Reexamined at age 21, 20% of those women with “high” depression symptoms went on to being victims of violence, as compared to the 8.5% of those without depression symptoms. There are many reasons why early depression may drive a young woman towards a “high risk” partner, Lehrer explains. Often depressed teens tend to gravitate towards others with similar symptoms when seeking a boyfriend or husband. Among men, depression is linked to greater abusive tendencies. Women with a history of depression also may be less likely to leave an abusive relationship. Lehrer claims that "the study findings suggest that depression or elevated depressive symptoms during adolescence may, at the very least, be a red flag or marker for girls' increased risk of experiencing violence by a relationship partner during young adulthood." It has yet to be definitively established whether depression directly contributes to future abuse. But if proven, intimate partner violence could be added to the likes of substance abuse, self-injury, and suicide as possible consequences of teen depression. Women
Exposed to Intimate Partner Violence
Expectations and Experiences When They Encounter Health Care
Professionals
In the realm of domestic violence research, systematic reviews and quantitative studies dictate clinical guidelines and international policy. Qualitative study, however, has been largely excluded from scrutiny and clinical thought. Albeit intangible and hard to synthesize, qualitative research’s merits lie in the ability to truly ask the patient about their individual violent relationship. Instead of asking women to pigeon-hole their traumatic experience into a list of predestinated adjectives, victims are given their voice back - to tell their story in their own words. In the 2006 edition of the Archives of Internal Medicine, a meta-analysis of qualitative studies was done to answer two questions: “(1) How do women with histories of intimate partner violence perceive the responses of health care professionals? and (2) How do women with histories of intimate partner violence want their health care providers to respond to disclosures of abuse?” In looking at multiple databases, Dr. Gene Feder and colleges analyzed the responses of 847 women in an attempt to make qualitative findings a useful tool in training health professionals’ approach and response to partner violence It was discovered that a physician’s approach to discussing domestic violence was equivalently as important as the discussion itself. “Raising the issue in a sensitive and confident manner was important, as was not rushing or hurrying the discussion. Women valued confirmation that the violence they had experienced was unacceptable and undeserved, and they wanted the health care professional to challenge false assumptions made by some abused women (eg, that the abuse was somehow their fault). They hoped the health care professional would bolster their confidence. Women wanted to be able to progress at their own pace and not to be pressured to disclose, leave the relationship, or press charges against their partner or ex-partner. Women wanted the health care professional to respect their decisions and to share decision making with them.” Conflicting evidence arose as to whether victims preferred a male or female physician when broaching the topic of violence in the home. In general, the meta-analysis found that women wanted “health care professionals to be nonjudgmental, compassionate, sensitive, and able to maintain confidentiality. Women wanted health care professionals to avoid medicalizing the issue” The meta-analysis was done in hopes that qualitative domestic violence research will someday find a niche in the world of policy and health provider guidelines, now largely based in quantitative studies. The hope is that providers will practice according to guidelines that take into account that which is most important – the individual voice of the victim. Gene S. Feder, MD; Madeleine Hutson, MBBS; Jean Ramsay, PhD; Ann R. Taket, MSc Arch Intern Med. 2006;166: 22-37. Announcements
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