Social reactions to disclosure of interpersonal violence and psychopathology: A systematic review and meta-analysis.
ABSTRACT: Public attention has been increasingly paid to how friends, family members, and others can best support survivors of sexual assault and other forms of violence. The broader social support literature posits that perceiving social support positively is more important to mental health than the degree to which social support is actually received, and that negative interactions with social supporters are more harmful than positive interactions are helpful (potentially because negative reactions violate survivors' expectations of their social supporters). This may be especially true after a crisis, such as interpersonal violence. Thus, this systematic review and meta-analysis summarizes the literature on social reactions to interpersonal violence. Meta-regression analyses were performed on 1871 correlations from 51 studies reflecting the degree to which receiving specific reactions more frequently, or perceiving reactions more positively, was associated with psychopathology. Results indicated that negative social reactions to disclosure-especially reactions involving controlling, distracting, and treating survivors differently-were associated with worse psychopathology, whereas positive social reactions did not appear to be protective. Perceiving reactions more positively was associated with less severe psychopathology, but (although causation cannot be concluded) positive perceptions' potential benefit appeared to be smaller than the potential risk conveyed by negative reactions. These findings indicate that interventions which reduce the degree to which survivors receive negative social reactions are needed.
Project description:Children who are victims of interpersonal violence have a markedly elevated risk of engaging in aggressive behavior and perpetrating violence in adolescence and adulthood. Although alterations in social information processing have long been understood as a core mechanism underlying the link between violence exposure and externalizing behavior, scant research has examined more basic social cognition abilities that might underlie this association. To that end, this study examined the associations of interpersonal violence exposure with cognitive and affective theory of mind (ToM), core social-cognitive processes that underlie many aspects of social information processing. In addition, we evaluated whether difficulties with ToM were associated with externalizing psychopathology. Data were collected in a community-based sample of 246 children and adolescents aged 8-16 who had a high concentration of exposure to interpersonal violence. Violence exposure was associated with lower accuracy during cognitive and affective ToM, and the associations persisted after adjusting for co-occurring forms of adversity characterized by deprivation, including poverty and emotional neglect. Poor ToM performance, in turn, was associated with externalizing behaviors. These findings shed light on novel pathways that increase risk for aggression in children who have experienced violence.
Project description:OBJECTIVES:The 1995 Great Hanshin-Awaji Earthquake had an enormous negative impact on survivors' health. Many survivors experienced psychological distress and their long-term psychological recovery process remains unclear. Our objective was thus to explore this long-term psychological recovery process. DESIGN:Qualitative study. SETTING:From January to December 2015, face-to-face interviews were conducted in Kobe, Japan. PARTICIPANTS:20 affected survivors (55% female; ages ranged from 7 to 60 at the time of the disaster)-10 volunteer storytellers, six first responders (firefighters/public health nurses) and four post-traumatic stress disorder patients. OUTCOME MEASURES:We asked participants about their experiences and psychological distress relating to the earthquake and what facilitated or hindered their psychological recovery. We analysed interview data using constructivist grounded theory. RESULTS:Participants experienced diverse emotional reactions immediately after the disaster and often hyperfocused on what they should do now. This hyperfocused state led to both mental and physical health problems several months after the disaster. Months, and sometimes years, after the disaster, guilt and earthquake narratives (ie, expressing thoughts and feelings about the earthquake) played key roles in survivors' psychological recovery: guilt suppressed their earthquake narrative; conversely, the narrative alleviated feelings of distress about the earthquake. In time, participants reconsidered their earthquake experiences both alone and through social interaction. This alleviated their emotional reactions; however, participants still experienced attenuated emotional reactions, and some hid their feelings of distress even 20 years postdisaster. Interpersonal relationships modified this psychological process both positively and negatively. CONCLUSIONS:Future psychosocial support plans for disaster survivors may need to (1) include both mental and physical care in the transition from the acute phase to the recovery phase; (2) facilitate supportive interpersonal relationships for survivors during the mid-term recovery phase and (3) provide long-term psychological support to the most traumatised survivors, even if they appear to be functioning normally.
Project description:Low social support has been associated with several disorders. We test the relationship between perceived interpersonal social support (ISS) and aspects of mental and physical health.We used data from National Epidemiological Survey on Alcohol and Related Conditions in which 34,653 individuals aged 20-99 years were interviewed twice (2001-02 and 2004-05), with the second interview including the interpersonal support evaluation list. The association of perceived ISS with lifetime DSM-IV psychopathology and physical health from the past 12 months was investigated. We also tested whether this association changes as a function of number of traumatic events in accordance with the buffering hypothesis.Low perceived ISS correlated with increased prevalence of major depressive disorder, generalized anxiety, social phobia and several physical health problems. There was a strong association between excellent self-perceived physical health and high social support.There was evidence for both the main, beneficial effects of high perceived ISS and buffering, whereby increased perceived ISS ameliorated the pathogenic influence of exposure to traumatic life events on psychopathology. Current findings highlight the importance of perceived ISS in individuals' general mental and physical well-being, both in daily life and upon exposure to negative life events.
Project description:Disasters affect the school and community microsystems in which children and youth recover. This study explored characteristics of the school (school violence, teachers' attitudes) and community microsystem (neighborhood climate, neighborhood monitoring, community violence) that may affect the disaster exposure and internalizing psychopathology relationship in children and youth 12-27 months after Hurricane Georges hit Puerto Rico. A representative sample (N=1,637) of caregivers and children/youth completed structured interviews in Spanish. Controlling for gender and perception of poverty, for children (age 6-10 years), hurricane exposure increased risk for internalizing psychopathology, but the school and community variables did not have an influence. For all youth (age 11-17 years), witnessing community violence and poor teacher attitudes increased the risk of psychopathology. In addition, neighborhood climate and school violence were moderators. For non-exposed youth, poor neighborhood climate and perceiving greater school violence increased the risk of internalizing psychopathology, whereas for exposed youth it did not.
Project description:Intimate partner violence (IPV) during pregnancy increases adverse pregnancy outcomes. Knowledge of societal, community, family and individual related factors associated with IPV in pregnancy is limited in Ethiopia. Our study examined these factors in an Ethiopian context.A cross sectional study was conducted among pregnant women attending antenatal care at governmental health institutions, using a consecutive probability sampling strategy. A total of 720 pregnant women were interviewed by five trained nurses or midwives, using a standardized and /pretested survey questionnaire. Bivariate and multivariate logistic regression analyses were applied to assess factors contributing to IPV. We used Akaike's information criteria, to identify the model that best describes the factors influencing IPV in pregnancy.Among the women interviewed, physical IPV was reported by 35.6%, and lifetime emotional or physical abuse by 81.0%. Perceiving violence as a means to settle interpersonal conflicts, presence of supportive attitudes of wife beating in the society, regarding violence as an expression of masculinity, and presence of strict gender role differences in the society, were all positively associated to IPV in pregnancy. The presence of groups legitimizing men's violence in the community, feeling isolated, having no social support for victims, and presence of high unemployment, were the perceived community related factors positively associated with IPV in pregnancy.IPV in pregnancy is very prevalent in Ethiopia and is associated with multiple social ecologic factors. Reduction of IPV in pregnancy calls for cross sectorial efforts from stakeholders at different levels.
Project description:There are pronounced developmental changes in perceived social support during adolescence. The present study used the newly developed Adolescent Social Support Questionnaire (ASSQ) to examine both the consultation frequency of, and the satisfaction with perceived social support across adolescence in a longitudinal study focusing on nine different familial and non-familial supporters. The sample of N = 857 adolescents was derived from the Zurich Adolescent Psychology and Psychopathology Study (ZAPPS) and included three measurement time points. Overall, there was a decrease in the perceived frequency and satisfaction from adolescents with social support from both parents and grandparents from preadolescence to late adolescence. Best friends and romantic partners were consulted more frequently, and their support was perceived as more satisfying with increasing age. Teachers were contacted more frequently with increasing age, while satisfaction with their support remained stable. In contrast, though contacted less frequently, brothers and other relatives showed no changes in perceived satisfaction with support during adolescence. Parents and best friends were perceived as the most satisfying supporters during adolescence followed by romantic partners in later adolescence. Grandparents were perceived as an important support source but only in preadolescence. There were developmental differences during the various stages of adolescence with regard to the importance placed on each social support source. Both parents remained a very a satisfying support source, although they were consulted less often. Romantic partners and best friends gained importance as supporters in older adolescents, whereas grandparents represented a more important support source for preadolescents. Although teachers were not frequently consulted, they remained a stable and satisfying source of support.
Project description:BackgroundAlthough childhood adversity is a strong determinant of psychopathology, it remains unclear whether there are 'sensitive periods' when a first episode of adversity is most harmful.AimsTo examine whether variation in the developmental timing of a first episode of interpersonal violence (up to age 18) associates with risk for psychopathology.MethodUsing cross-sectional data, we examined the association between age at first exposure to four types of interpersonal violence (physical abuse by parents, physical abuse by others, rape, and sexual assault/molestation) and onset of four classes of DSM-IV disorders (distress, fear, behaviour, substance use) (n = 9984). Age at exposure was defined as: early childhood (ages 0-5), middle childhood (ages 6-10) and adolescence (ages 11-18).ResultsExposure to interpersonal violence at any age period about doubled the risk of a psychiatric disorder (odds ratios (ORs) = 1.51-2.52). However, few differences in risk were observed based on the timing of first exposure. After conducting 20 tests of association, only three significant differences in risk were observed based on the timing of exposure; these results suggested an elevated risk of behaviour disorder among youth first exposed to any type of interpersonal violence during adolescence (OR = 2.37, 95% CI 1.69-3.34), especially being beaten by another person (OR = 2.44; 95% CI 1.57-3.79), and an elevated risk of substance use disorder among youth beaten by someone during adolescence (OR = 2.77, 95% CI 1.94-3.96).ConclusionsChildren exposed to interpersonal violence had an elevated risk of psychiatric disorder. However, age at first episode of exposure was largely unassociated with psychopathology risk.
Project description:Disclosing pre-assault drinking may influence reactions sexual assault survivors receive from their support networks. Such reactions likely affect survivor's post-assault adjustment. Thus, it is important to identify assault and disclosure characteristics related to disclosing one's drinking and receiving social reactions that specifically comment on pre-assault alcohol use. This exploratory study examined demographic, assault, and disclosure factors as predictors of both survivors' decisions to disclose their pre-assault alcohol use and social reactions survivors received related to their pre-assault alcohol use. Out of survivors who were drinking at the time of the assault, those with more education and who reported greater alcohol impairment or resistance during the assault were more likely to disclose pre-assault alcohol use. As expected, this study found that of women disclosing pre-assault drinking, those with more education and more violent assaults received more negative social reactions specifically commenting on their use of alcohol prior to the assault. Such negative reactions were more common for those telling parents, police, or medical professionals. Women with less education received more positive and negative social reactions that commented specifically on their use of alcohol prior to the assault. Interestingly, results showed that disclosing pre-assault alcohol use in greater detail was related to positive social reactions specific to preassault drinking and experiencing greater alcohol impairment at the time of the assault was associated with both positive and negative social reactions specific to pre-assault alcohol use. Implications for research and intervention are provided for survivors disclosing alcohol-related sexual assaults.
Project description:OBJECTIVE:Exposure to interpersonal violence is a known risk factor for psychopathology. However, it is unclear whether there are sensitive periods when exposure is most deleterious. We aimed to determine whether there were time periods when physical or sexual violence exposure was associated with greater child psychopathology. METHOD:This study (N = 4,580) was embedded in Generation R, a population-based prospective birth cohort. Timing of violence exposure, reported through maternal reports (child age, 10 years) was categorized by age at first exposure, defined as: very early (0-3 years), early (4-5 years), middle (6-7 years), and late (8+ years) childhood. Using Poisson regression, we assessed the association between timing of first exposure and levels of internalizing and externalizing symptoms, using the Child Behavior Checklist at age 10 years. RESULTS:Violence exposure at any age was associated with higher internalizing (physical violence: risk ratio [RR] = 1.46, p < 0.0001; sexual violence: RR = 1.30, p < .0001) and externalizing symptoms (physical violence: RR = 1.52, p < 0.0001; sexual violence: RR = 1.31, p = 0.0005). However, the effects of violence were time dependent: compared to children exposed at older ages, children first exposed during very early childhood had greater externalizing symptoms. Sensitivity analyses suggested that these time-based differences emerged slowly across ages 1.5, 3, 6, and 10 years, showing a latency between onset of violence exposure and emergence of symptoms, and were unlikely to be explained by co-occurring adversities. CONCLUSION:Interpersonal violence is harmful to childhood mental health regardless of when it occurs. However, very early childhood may be a particularly sensitive period when exposure results in worse psychopathology outcomes. Results should be replicated in fully prospective designs.
Project description:Exposure to violence and other forms of potentially traumatic events (PTEs) are common among youths with externalizing psychopathology. These associations likely reflect both heightened risk for the onset of externalizing problems in youth exposed to PTEs and elevated risk for experiencing PTEs among youth with externalizing disorders. In this study, we disaggregate the associations between exposure to PTEs and externalizing disorder onset in a population-representative sample of adolescents.We analyzed data from 13- to 18-year-old participants in the National Comorbidity Survey Replication-Adolescent Supplement (NCS-A) (N = 6,379). Weighted survival models estimated hazard ratios (HRs) for onset of oppositional defiant disorder (ODD), conduct disorder (CD), and substance use disorders (SUDs) associated with PTEs, and for exposure to PTEs associated with prior-onset externalizing disorders. Multiplicative interaction terms tested for effect modification by sex, race/ethnicity, and household income.All types of PTEs were associated with higher risk for SUD (HRs = 1.29-2.21), whereas only interpersonal violence (HR = 2.49) was associated with onset of CD and only among females. No associations were observed for ODD. Conversely, ODD and CD were associated with elevated risk for later exposure to interpersonal violence and other/nondisclosed events (HRs = 1.45-1.75).Externalizing disorders that typically begin in adolescence, including SUDs and CD, are more likely to emerge in adolescents with prior trauma. ODD onset, in contrast, is unrelated to trauma exposure but is associated with elevated risk of experiencing trauma later in development. CD and interpersonal violence exposure exhibit reciprocal associations. These findings have implications for interventions targeting externalizing and trauma-related psychopathology.