This study surveyed 200 back pain patients and 64 health care providers/staff on their physical, emotional, and sexual abuse histories as victims or perpetrators. Depending on the type of abuse, 27%-36% of female patients, 6%-23% of male patients, and 33%-55% of female providers/staff were abuse victims. From 1%-12% of female patients, 3%-10% of male patients, and 3%-15% of providers/staff were abuse perpetrators, depending on the type of abuse. A startling 94% of abuse perpetrators were also abuse victims. Among those who were both victim and perpetrator, 81% of physical-abuse perpetrators, 60% of sexual-abuse perpetrators, and 41 % of emotional-abuse perpetrators were previously or concurrently some type of abuse victim. The study discusses the implications for health care diagnoses and treatment decisions, caregiving by providers/staff, and the psychologist's role on multidisciplinary treatment teams.Physical, emotional, and sexual abuse are powerful life events. Yet health care providers rarely inquire about abuse in their standard history and physical examinations. The lack of attention to this subject by health care providers is particularly ROBERT L. KAROL received his PhD from the University of Missouri-Columbia in 1981. He is the director of Psychological Services at the Institute for Low Back Care and program director for the Backs at Work Reactivation Program. He also sees brain-injury survivors through Karol Neuropsychological Services & Consulting. His clinical and research interests focus on the application of medical psychology to back pain and neuropsychological assessment and intervention after brain injury. REBECCA GORMAN MICKA received her physician assistant B.A. from the University of Nebraska in 1985. She works clinically with neurological patients, and her research interests concern the interaction of psychological variables and medical treatment. She is also studying at the Gestalt Institute of the Twin Cities. MICHAEL KUSKOWSKI received his PhD from the Institute of Child Development at the University of Minnesota in 1983. He is currently employed at the Geriatric Research, Education and Clinical Center (GRECC) at the Minneapolis Veterans Administration Medical Center. His research interests include the psychophysiology of the aging nervous system, particularly as it relates to Alzheimer's disease.
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