A longitudinal investigation of interpersonal violence in relation to mental health and substance use.

Abstract

The authors examined longitudinally the mental health status of women as a function of different types and combinations of exposure to interpersonal violence. A structured telephone interview was administered to a household probability sample of 4,008 women (18-89 years of age), who were then recontacted for 1- and 2-year follow-up interviews. Interviews assessed lifetime violence history (i.e., sexual assault, physical assault, witnessed serious injury or violent death), past-year mental health functioning (i.e., posttraumatic stress disorder [PTSD], depression, and substance use problems), and new instances of violence occurring after the baseline interview. Results indicate that (a) lifetime violence exposure was associated with increased risk of PTSD, depression, and substance use problems; (b) odds of PTSD, depression, and substance use problems increased incrementally with the number of different types of violence experienced; (c) relations were fairly stable over a 2-year period; and (d) new incidents of violence between the baseline and follow-up interviews were associated with heightened risk of PTSD and substance use problems. Greater understanding of the cumulative impact of violence exposure will inform service provision for individuals at high risk.

The Impact of Sexual Assault History on Perceived Consequences of Risky Dating Scenarios

“…For instance, the speed at which women with and without a SAH respond (i.e., how long they stay in the scene) is a primary difference reported in the literature. However, no studies to-date have controlled for depressive symptoms, which are common in sexual assault survivors [22,23] and are related to psychomotor slowing [24] and slower processing speed [25]. Similarly, a recent study utilized a written vignette and replicated the finding that women with a SAH left later in the scene [26].…”

Traumatic Event Re-exposure in Injecting Drug Users

“…In addition, the well-known relationship between even a single traumatic event and the development of PTSD or other psychiatric problems 39 is strengthened following multiple occurrences of trauma, particularly physical assaults. 8,40 For drug users who are not in treatment, the occurrence of new traumatic events is likely to destabilize progress toward healthy behavior change by intensifying psychiatric and drug use severity, 8,17,41 which, in turn, increases risk of further traumatic event exposure. Future studies should assess the mental health outcomes related to these very high re-exposure rates, with particular attention to the greater risk for women injecting drug users.…”

“…6,7 The clinical relevance of these data is clear from studies that show that traumatic event reexposure alone or followed by PTSD increases the risk of further psychiatric impairment, including both PTSD and drug use. [6][7][8] There is good reason to believe that urban drug users experience a considerable amount of traumatic event re-exposure. Drug use, urban living, and low income are each associated with elevated risk of traumatic event exposure and re-exposure.…”

Toward an integrated approach in research on interpersonal violence : Conceptual and methodological challenges

“…For victims developing PTSD after a trauma the risk of developing PTSD also after a subsequent trauma is heightened (Briere and Jordan, 2004;Breslau, Peterson and Schultz, 2008). Some researchers have also suggested that prior merely stressful life events may have a sensitizing effect, making victims of a trauma more prone to develop PTSD (Lloyd and Turner, 2003;Hedtke, Ruggiero, Fitzgerald et al, 2008). Experiencing high level of community violence has been associated with increased severity of symptoms of PTSD above and beyond the trauma that was used as the reference for reporting PTSD symptoms.…”